CN100553590C - 修整心瓣体环的装置 - Google Patents
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Abstract
一种采用植入物的装置、系统和方法,该植入物的尺寸和外形做成连接于功能失调的心瓣体环。在使用中,该植入物(10)在瓣体环之上和/或沿瓣体环延伸过该体环的主轴。该植入物修整该主轴的尺度和/或其他周围解剖学结构。该植入物使心瓣体环和叶状体恢复到更有功能的解剖学形状和张紧。更有功能的解剖学形状和张紧有利于叶状体的接合,这反过来又减少逆流或反流。该植入物改善瓣的功能,而不需要对大部分扩张的体环进行外科捆紧、切除和/或固定,或者不需要环状结构的外科固定。
Description
相关申请
本申请要求2000年9月20日提交的名称为“心瓣体环装置及其使用方法”的待审查美国专利申请序列号09/666,617号的优先权,该申请通过参考结合于此。该申请还要求2002年10月1日提交的名称为“用于心瓣治疗的系统和装置”的国际专利申请序列号PCT/US02/31376的优先权,该申请要求2001年10月1日提交的美国专利临时专利申请号60/326,590号的优先权,其通过参考结合于此。本申请还要求2002年11月26日提交的名称为“心瓣改造装置”的临时申请序列号60/429,444号、2002年11月26日提交的名称为“新叶状体医疗装置”临时申请序列号60/429,709号以及2002年11月26日提交的名称为“心瓣叶状体保持装置”的临时申请序列号60/429,709号的优先权,它们每个都通过参考结合于此。
技术领域
本发明涉及用于改善心瓣功能,例如用于二尖瓣反流的治疗的装置、系统和方法。
背景技术
I.健康心脏的解剖学
心脏(见图1)稍大于握紧的拳头。它是双向(左侧和右侧)自调节肌肉泵,其各部分调和地工作以将血液送到身体各部分。心脏的右侧接收来自身体上腔静脉和下腔静脉的贫氧的(“静脉的”)血液并通过肺动脉将其抽送到肺脏以进行充氧。左侧通过肺静脉接收来自肺脏的富氧的(“动脉的”)血液并将其抽送到主动脉以分配到全身。
心脏有四个腔室,每侧两个——左右心房和左右心室。心房是血液接收腔室,它将血液抽送到心室。由膜质部分和肌肉部分构成的壁称之为心房间隔膜,它将左右心房分开。心室是血液排放腔室。由膜质部分和肌肉部分构成的壁称之为心室间隔膜,它将左右心室分开。
心脏左右侧的同时抽送动作构成心搏动周期。该周期开始于称之为心室舒张期的心室松弛期,结束于称之为心室收缩期的心室挛缩期。
心脏有四瓣(见图2和图3),它们确保在心搏动周期期间血液不会沿着错误的方向流动。也就是说,确保血液不从心室回流到相应的动脉,或从主动脉回流到相应的心室。左心房和左心室之间的瓣是二尖瓣。右心房和右心室之间的瓣是三尖瓣。肺动脉瓣是在肺动脉的开口处。主动脉瓣在主动脉的开口处。
在心室舒张期的开始(即心室充血)(见图2),主动脉瓣和肺动脉瓣闭合以防止从主动脉回流到心室。在此短时间之后,三尖瓣和二尖瓣打开(如图2所示),以允许从动脉流到相应的心室。在心室舒张期开始短时间之后(即心室排空),三尖瓣和二尖瓣关闭(见图3),以防止血液从心室排放到相应的主动脉,并且主动脉瓣和肺动脉瓣打开,以允许血液从相应的心室排放到主动脉。
心瓣的打开和关闭主要是由于压差的结果引起的。例如,二尖瓣的打开和关闭是由于左心房和左心室之间的压差引起的。在心室舒张期期间,当心室松弛时,从肺静脉的静脉血液返回到左心房引起该心房中的压力超过心该室的压力。结果,二尖瓣打开,允许血液进入该心室。在心室收缩期期间当心室挛(收)缩时,该心室内的压力上升超过心房的压力,并且将二尖瓣关闭。
二尖瓣和三尖瓣由每个称之为体环的骨胶原的纤维环形成,这种骨胶原纤维环形成心脏的纤维基干部分。体环提供二尖瓣的两个瓣尖或叶状体(称之为前后瓣尖)和三尖瓣的三个瓣尖或叶状体的连接。该叶状体接纳来自一个以上的乳头肌的腱索。在健康的心脏中,这些肌肉和它们的腱索组织支撑二尖瓣和三尖瓣,允许叶状体承受左右心室在收缩(抽送)期间产生的高压。
在健康的心脏中,腱索是张紧的,防止叶状体被迫进入左右主动脉和翻转。脱垂(prolapse)是用来描述这种状态的术语。脱垂通常通过心室中的乳头肌的收缩来防止,其通过腱索连接于二尖瓣叶状体。乳头肌的与心室同时收缩并且在由心室产生的峰值收缩压力下用来保持健康的瓣叶状体的紧密关闭。
II.二尖瓣机能失调的特点和原因
在健康心脏中(见图4)二尖瓣体环的尺度——当从中隔(S)到横向(L),以及从后结合处CP到前结合处CA测量时——形成解剖学的形状并且在峰值收缩压力下张紧,使得叶状体接合,形成牢固的连接。该叶状体在体环的相对的中间和横向侧接合之处称之为叶状体的接合处,并且在图4和其他图中用CP(表示后接合处)和AP(表示前接合处)表示。
瓣的常功失灵能能够导致腱索(腱)拉伸,并且在某些情况下撕裂。当腱撕裂时,结果是叶状体发生障碍。还有,正常构造的瓣由于瓣体环变大或变形可能失去正常的功能。这种状况称之为体环扩张并且通常是由于心肌障碍引起的。此外,瓣可能由先天的缺陷或由于疾病造成的缺陷。
不管什么原因(见图5),当叶状体在峰收缩值压力下不接合时能够发生二尖瓣机能失调。如图5所示,在心室舒张期二尖瓣的接合线不紧密。结果,可能发生血液从左心室向左心房的不希望的回流。这种状况称之为反流。
在一些情况下(见图6),由于二尖瓣的尺寸,从接合处到接合处——CP到CA和/或从中隔到横向——S到L测量发生变化,叶状体不形成紧密的接合连接。这种改变的尺寸不再形成在峰值收缩压力下使叶状体接合的解剖学的形状和张紧。
将图4的健康的体环与图6的不健康的体环相比,不健康的体环是扩张的,特别是,中隔到横向的距离增大。结果,由体环形成的形状和张紧变成不太像卵形(见图4)而是比较圆(见图6)。这种状况称之为扩张。当体环被扩张时,有助于在峰值收缩压力下接合的形状和张紧逐渐变差。而是,在峰值压力下叶状体不完全接合,并且在叶状体之间形成间隙。在心室舒张期期间通过这种间隙发生反流。据信,接合处距离和中隔到横向的距离之间的比例承担着叶状体接合的有效性的关系。如果中隔到横向的距离增加,比例改变,当比例达到一定值时,表示反流或反流的可能性。
由于反流的结果,“额外的”血液回流到左心房。在随后的心室舒张期期间(当心脏松弛时),这些“额外的”血液返回到左心室,造成容积超负荷。在随后的心室收缩期期间(当心室挛缩时),在该心室中的血液比希望的多。这意味着:(1)心脏必须更努力地抽送以排出该额外的血液;(2)从心脏送到身体其余部分的血液太少;(3)时间一长,左心室可能开始拉伸并变大以容纳大量的血液,并且左心室可能变得更弱。
虽然,二尖瓣反流的和缓的情况不会导致什么问题,但是较严重的和慢性的情况最终是心脏变弱并且能够导致心脏故障。二尖瓣反流可以是急性的或慢性的。有时叫做机能不全。
III.现有的治疗方法
在二尖瓣反流的治疗中,可以用利尿剂和血管扩张剂以帮助减少流回到左心房的血液量。如果用药物疗法情况不能稳定,可以用主动脉内气球式反向搏动装置。对于慢性或急性二尖瓣反流,经常需要修复或替换二尖瓣的外科手术。
到现在为止,侵害的开放性的外科手术用来修复二尖瓣功能失调。在这些外科修复手术期间,努力系住或切除部分和/或固定在位扩张的体环的大部分。在这些外科修复手术期间,该体环能够用环形的或近乎环形的环或类似的装置来修整。该修复装置通常用基于缝合的固定方法固定子体环和周围的组织。该修复装置在体环的周边和叶状体表面之上延伸过大部分或全部。
内科医生决定更换不健康的二尖瓣而不是修复它。侵害性的打开心脏手术用来以机械瓣或取自猪、牛或马的生物组织(生物修复术)更换天然瓣。
需要一种简单、成本效率高和很少侵害性的装置、系统和方法,用来治疗功能失常的心瓣,例如治疗二尖瓣的反流。
发明内容
本发明提供一种修整瓣体环的装置、系统和方法。该装置、系统和方法包括植入物,其尺寸和结构做成放置在心脏瓣体环的叶状体接合处附近或其内。在使用中,该植入物接触并向外移动组织以修整心脏瓣体环。在使用中该植入物可以使心脏瓣体环和叶状体恢复到比较有效的解剖学形状和张紧。比较正常的解剖学形状和张紧有利于叶状体的接合,这反过来又减少逆流或反流。该植入物恢复瓣的功能,而不需要对大部分扩张的体环进行外科捆紧、切除和/或固定,或者不需要环状结构的外科固定。
本发明的其他特征和优点从下面的说明、附图和权利要求将更加明白。
附图说明
图1是健康心脏内部的前透视解剖图。
图2是健康心脏内部的俯视透视解剖图,其心房被去掉,示出在心室舒张期期间的心瓣状况。
图3是健康心脏内部的俯视透视解剖图,其心房被去掉,示出在心室收缩期期间的心瓣状况。
图4是心室收缩期期间的健康二尖瓣的俯视解剖图,示出叶状体适当的接合。
图5是心脏内部的俯视解剖图,其心房被去掉,示出在心室收缩期期间的心瓣状况,并且还示出功能失调的二尖瓣,其中叶状体没有适当地接合,引起反流。
图6是在心室收缩期期间功能失调的二尖瓣俯视解剖图,示出叶状体没有适当地接合,引起反流。
图7A是弹性植入物的侧透视图,其尺寸和结构做成放置在功能失调的心瓣体环的叶状体结合处内或其附近,以重新修复体环并改善叶状体的接合。
图7B到体7E是侧视图,示出图7A所示的植入物的可选结构。
图8是二尖瓣体环的侧视外部解剖图,其中,图7A所示的弹性体植入物已经被植入。
图9是二尖瓣俯视解剖图,其中图7A所示的弹性体植入物已经被植入,示出该植入物拉伸接合处以恢复叶状体的接合。
图10是弹性植入物另一个实施例的侧透视图,其尺寸和结构做成放置在功能失调的心瓣体环的叶状体接合处内或其附近,以重新修复体环并恢复叶状体的接合,该植入物形成封闭的环状结构。
图11是从二尖瓣的前部并稍稍俯视点所取的透视解剖图,其中图10所示类型的弹性植入物已经被植入,示出该植入物伸展该结合处,以恢复叶状体的接合,并且还示出该植入物紧靠该体环。
图12是从二尖瓣的前部并稍稍俯视点所取的透视解剖图,其中图10所示类型的弹性植入物已经被植入,示出该植入物伸展该结合处,以恢复叶状体的接合,并且还示出该植入物升高在该体环之上。
图13A至13C是弹性植入物说明性实施例的侧透视图,其尺寸和结构做成放置在功能失调的心瓣体环的叶状体接合处内或其附近,以恢复叶状体的接合,该植入物形成开口的环状结构。
图13D和13E是弹性植入物说明性实施例的侧透视图,其尺寸和结构做成放置在功能失调的心瓣体环的叶状体接合处内或其附近,以重新修复该体环并恢复叶状体的接合,该植入物形成可以选择地闭合的开口的环状结构。
图14是图13D和13E所示的开口环型的弹性植入物的侧透视图,示出了该植入物的机械特性如何能够沿其结构、表面区域和组织的接合面改变。
图15A是开口环状结构的弹性植入物另一个实施例的侧透视图,其尺寸和结构做成放置在功能失调的心瓣体环的叶状体接合处内或其附近,以重新修复体环并恢复叶状体的接合,该植入物形成可对称地折叠在其自身上的封闭的环状结构。
图15B是图15A所示的植入物折叠在其自身上时的侧视图
图15C是从二尖瓣的前部并稍稍俯视点所取的透视解剖图,其中图15A所示类型的弹性植入物已经被植入,示出该植入物伸展该结合处,以恢复叶状体的接合,并且还示出该植入物紧靠该体环。
图15D是弹性植入物另一个实施例的侧透视图,其尺寸和结构做成放置在功能失调的心瓣体环的叶状体接合处内或其附近,以重新修复该体环并恢复叶状体的接合,该植入物形成能够对称地折叠在其自身上的封闭的环状结构。
图15E是从二尖瓣的前部并稍稍俯视点所取的透视解剖图,其中图15D所示类型的弹性植入物已经被植入,示出该植入物拉伸该结合处,以恢复该叶状体的接合,并且还示出该植入物紧靠该体环。
图16A是图10所示类型的弹性植入物的侧透视图,示出用于将该植入物固定并稳定在体环中的接片(tab)结构的说明性实施例。
图16B是二尖瓣体环的侧前视解剖图,其中,图16A所示的弹性植入物已经被植入。
图17A是图10所示类型的弹性植入物的侧透视图,示出用于将该植入物固定并稳定在体环中的多个接触结构的说明性实施例。
图17B是二尖瓣体环的侧前视解剖图,其中,图17A所示的弹性植入物已经被植入。
图18A和18B是图10所示类型的弹性植入物的侧透视图,示出用于将该植入物固定并稳定在体环中的摩擦支撑件的说明性实施例。
图19是图10所示类型的弹性植入物的侧透视图,示出用于将该植入物固定并稳定在体环中的组织生长表面的说明性实施例。
图20A和20B分别是弹性植入物的侧透视图和解剖图(植入时),其尺寸和结构做成放置在功能失调的心瓣体环的叶状体接合处内或其附近,以重新修复该体环并恢复叶状体的接合,并且还示出该植入物明显地升高在该体环之上。
图20C和20D分别是弹性植入物的侧透视图和解剖图(植入时),其尺寸和结构做成放置在功能失调的心瓣体环的叶状体接合处内或其附近,以重新修复该体环并恢复叶状体的接合,并且示出一个横条紧靠该体环,而用于将该植入物固定并稳定在体环中的另一个横条在该植入物之上。
图21是在为了修整瓣体环并恢复叶状体的工作而打开心脏的外科手术中用于将弹性植入物植入瓣体环中的工具。
图22A至22F示意地示出使用图21所示的工具将弹性植入物安放在瓣体环中以修整瓣体环并恢复叶状体的工作的方法。
图23A至23C示意地示出从血管进入左心房的方法,为了布置引导导管,以将植入物安放在瓣体环中以修整瓣体环并恢复叶状体的工作。
图24是图23C所示的植入物引导导管远端的侧视图,示出图10所示类型的弹性植入物折叠成套状,用于以图23A至23C所示的方式布置在左心房中。
图25A至25E是操作图24所示的植入物引导导管的远端的方法的示意透视图,以将图10所示的弹性植入物在瓣体环中展开,以修整瓣体环并恢复叶状体的工作。
图26是图23C所示的植入物引导导管远端的侧视图,示出图10所示类型的弹性植入物折叠成套状,用于以图23A至23C所示的方式布置在左心房中,还示出帮助展开的引导线环。
图27A至27I是用引导线环的帮助将图10所示类型的弹性植入物布置在瓣体环内,以修整瓣体环并恢复叶状体的工作的方法的示意透视图。
图28A和28B是图13A至图13E所示类型的弹性植入物的透视图,示出将这种植入物系于一个或多个线环上以帮助它们在瓣体环中展开,以修整瓣体环并恢复叶状体的工作。
图29是图23C所示类型的植入物引导导管远端的侧视图,示出图15A所示类型的对称折叠的弹性植入物折叠成套状,用于以图23A至23C所示的方式布置在左心房中。
图30A至30D是操作图29所示植入物引导导管的远端的方法的示意图,以将图15A所示类型的对称折叠的弹性植入物布置在瓣体环中,以修整瓣体环并恢复叶状体的工作。
图31A至31E是操作图29所示的植入物引导导管的远端的方法的示意图,以将图15D所示类型的对称折叠的弹性植入物布置在瓣体环中,以修整瓣体环并恢复叶状体的工作。
图32是是图23C所示类型的植入物引导导管远端的侧视图,示出图15A所示类型的对称折叠的弹性植入物,系于线环上以帮助它们在瓣体环中展开,以修整瓣体环并恢复叶状体的工作。
图33A至33D是操作图32所示的植入物引导导管的远端的方法的示意图,以将图15A所示类型的对称折叠的弹性植入物用引导线环的帮助布置在瓣体环中,以修整瓣体环并恢复叶状体的工作。
图34是图23C所示类型的植入物引导导管远端的侧视图,示出图15A所示类型的对称折叠的弹性植入物,系于两个引导线环上以帮助将它们植入瓣体环中,以修整瓣体环并恢复叶状体的工作。
图35和36A至36D是操作植入物引导导管的远端的方法的示意图,以将图15A所示类型的对称折叠的弹性植入物用分开的引导线环的帮助布置在瓣体环中,以修整瓣体环并恢复叶状体的工作。
图37A至37C是用覆盖物或护套的帮助将图15A所示类型对称折叠的弹性植入物布置在瓣体环内,以修整瓣体环并恢复叶状体的工作的方法的示意透视图。
图38是塑性变形的植入物的侧透视图,其尺寸和结构做成现场扩展。以放置在功能失调的心瓣体环的叶状体接合处内或其附近,以修整瓣体环并恢复叶状体的工作。
图39A至39C是用机械扩展装置的帮助将图38所示类型的对称折叠的可变形弹性植入物布置在瓣体环内的示意图。
图40A至40C是用气球扩展装置的帮助将图38所示类型的可塑性变形的植入物布置在瓣体环内的示意图。
图41是布置在瓣体环内非顺从气球的示意图,用于评估用于该体环的植入物的尺寸和机械性质。
图42是多功能弹性植入物的侧视图,其尺寸和结构做成放置在功能失调的心瓣体环的叶状体接合处内或其附近,以修整瓣体环并恢复叶状体的工作,并用作新叶状体以替换或补充损坏的心瓣叶状体。
图43和44是多功能弹性植入物的侧视图,其尺寸和结构做成放置在功能失调的心瓣体环的叶状体接合处内或其附近,以修整瓣体环并恢复叶状体的工作,并防止原来的瓣叶状体在心室收缩时被推入心房中。
图45至47图43和44是多功能弹性植入物的侧视图,其尺寸和结构做成放置在功能失调的心瓣体环的叶状体接合处内或其附近,以修整瓣体环并恢复叶状体的工作,并用作叶状体的保持器,并防止原来的瓣叶状体在心室收缩时被推入心房中,该植入物还包括用来帮助将该植入物定位及固定在原位的支架。
虽然这里公开的内容是详细准确的,本领域的业内人士能够实施本发明,但是这里所公开的实际实施例仅仅是举例说明本发明,本发明还可以用其他具体结构实施。虽然已经描述了优选实施例,但是在不脱离由权利要求限定的本发明范围的情况下可以进行变化。
具体实施方式
I.用于修整心瓣体环的植入物
A.概述
图7A和图8示出植入物10,其尺寸和结构做成放置心瓣体环叶状体内或其附近。该植入物示于二尖瓣中,并且在这种结构中沿主(即最长)轴在该瓣体环之上和/或沿该瓣体环延伸。该植入物10的尺寸和形状做成使得在使用中它沿主轴施加一机械力。该机械力用来向外移动组织(即,将组织从体环的中心向外位移),以修整该体环。在所示的实施例中(在二尖瓣上),该机械力用来拉长该体环的长轴,并且,在这样做时,能够反应性地缩短短(即最短)轴,以及相应地修整其他周围的解剖学结构。应当明白,为了治疗,当设置在其他的瓣结构中时,由于周围的解剖学,起作用的可能不是“主”和“短”轴。还应当明白,在心脏循环部分该植入物仅仅需要修整该体环,诸如在心室收缩期的挛缩期间。例如,该植入物的尺寸可以做成当该组织放松时在心室收缩期期间使组织产生很小的或可以忽略的向外位移,但是在心室收缩期的挛缩期间,限制该组织向内移动。
由植入物10施加的机械力使心瓣体环和叶状体恢复到比较正常的解剖学形状和张紧(见图9)。该比较正常的解剖学形状和张紧有利于在心室收缩期叶状体的接合,这反过来又减少反流。该植入物10恢复瓣正常的功能,在扩大的体环或叶状体的大部分位置中不需要外科綁紧、切除和/或固定,或者不需要环状结构的外科固定。
正如将要在下面详细描述的,植入物10适合于通过基于导管的血管内的技术,在图像引导下提供给目标心瓣部分,图像引导包括但不限于X射线荧光检测、超声波、磁共振、计算机层析X射线摄影法、或它们的结合。可选地,植入物10可用常规的打开心脏外科技术或胸部观察外科技术提供。
在其最基本的形式中,植入物10例如通过弯曲、成形、结合、机械加工、模制或挤压用生物适应的金属或聚合物材料制造,或用赋予生物适应性的材料或这种材料的组合适当地涂覆、浸渍或其他处理的金属或聚合物制造。还希望材料是不透过射线的,以便于荧光检查器的目视观测。
如图7A所示,该植入物包括一对由中间横条14连接的支杆12。如图8所示,该支杆12的尺寸和结构做成放置在该叶状体接合处或其附近。应当理解,该叶状体接合处可能不,或通常不位于在该体环的几何相对侧(虽然为了说明,它们被示为图中的形式)。正如在后面结合图13A和13B所描述的,支杆12的位置可以选择成适应该体环的不对称结构。
横条14横跨所述支杆12之间。横条14(像支杆12一样)可以采用各种形状并且具有各种截面几何形状。该横条14(和/或该支杆12)可以具有例如,大致曲线形(即圆形或卵形)截面,或大致直线的截面(例如正方形或长方形),或其组合。
在图7A和图8中,该植入物是“弹性的”。横条14的尺寸和结构做成具有正常的去载的形状或状况(图7A所示),其中,该横条14不处于压缩状态,并且支杆12间隔开的距离大于该目标心瓣体环的后部接合处尺寸。该植入物的材料选择成具有所希望的弹簧常数。该弹簧常数响应施加于支杆的外部压力,赋予该横条14弹性地压缩超出其正常的去载状况。横条14的尺寸和结构做成负载压缩状况下承受弹性载荷,负载压缩时,支杆12间隔开足够短的距离,以与组织的接合形式放置在该叶状体接合处或在其附近(见图8)。
当处于弹性载荷压缩状态下时(见图9),该横条14通过支杆12对接合处的或其附近的组织施加相反方向的力,力图向外位移组织并沿主轴拉伸该体环,通常也拉伸该叶状体结合处,缩短短轴,和/或修整周围的解剖学结构。因此该植入物将该瓣体环修整到比较有利于叶状体的接合的形状。
弹性植入物可以用例如,高级弹性合金制造,使得该植入物在布置期间能够弹性地应变和/或折叠以安放在导管或套内,并且当布置时能够重新获得其形状(这种特性将在下面详细地描述)。
希望,该植入物10自身的弹性与该瓣组织的弹性一起,确保该植入物10能够在净压缩状态下定位在该瓣内,并且因此保持固定而不使用缝合、粘接或其他固定材料,也就是这叫做压缩固定。该植入物10自身能够弹性变形,虽然这不是必须的,但是植入物10弹性变形的这种特性能够有助于维持压缩固定。如果植入物不弹性变形或仅仅稍微弹性变形,那么该植入物10依靠组织的弹性保持该植入物固定。
如图7A至图7E和图8所示,并且正如将在下面更详细地描述地,支杆12可以具有其他结构或机构16以进一步增强植入物在心瓣体环中的固定和稳定性。该机构16可以位于该体环的平面之下,以接合沿垂直方向毗连该体环的在体环下面的心心脏组织,和/或位于在该体环平面或在其之上,以接合该体环上的组织或接合在二尖瓣中。
植入物的弹簧常数可以选择成大于毗连组织的弹簧常数。可选地,植入物的弹簧常数可以选择成近似于毗连组织的弹簧常数,因而提供顺从性,在使用期间允许该植入物10适合于组织结构。植入物的弹簧常数可以沿横条14的长度变化,以便横条14的某些部分比横条14的其他部分更硬或更顺从。
在另一个种结构中,植入物10可以用塑性变形材料制造。在这种实施例中,植入物10可在正常收缩状态下制造。该植入物10通过充气体(例如气球)或合适的机械装置在体环中原地膨胀成使用状态。在描述弹性植入物的构造、布置和使用之后,可塑性变形的植入物的使用和布置将在下面详细地描述。
B.说明性的弹性植入物结构
具有刚才描述的特性的弹性植入物可以采用各种形式和结构,下面描述各种说明性的布局。
1.可收缩的环形植入物
图7A至图7C的植入物10包括横跨支杆12之间的距离的横条14。如图7D和图10所示,植入物10可以包括对于多于一个的横条14,给予该植入物一个封闭的环形的形状。正如在下面更详细地描述的,这种类型的植入物10能够被输送1在植入地,例如,以收缩的、直线的状态(横条14并排收缩)在导管或护套内。当从导管或护套中部署时,该植入物10弹开以呈现图7D和图10所示的正常封闭的环形形状。
在图10示出的这种布局中,植入物10包括横跨支杆12的两个横条14。根据所希望的横条14相对于该体环本身的取向,横条14的形状和结构可以改变。例如,在图11中,两个横条14的形状和结构做成当植入时使得该横条14跟随该体环的周边路径,并放置在与该体环基本同一平面内。该植入物可以称为“拥抱”该体环。在图12所示的例子中,两个横条14的形状和结构做成使得当植入时,该横条14跟随该体环的周边路径,并且升高在该体环的平面之上。该植入物10可以称为“跨在该体环之上”。“跨在该体环之上”的植入物10能够延伸靠近该体环(如图12所示)或朝向心房的穹顶明显地高于该体环之上,如图20A和20B所示。如图20C和20D所示,植入物10可以包括拥抱体环的横条14A和高于该体环之上并且与心壁接触的横条14B,用作定向并稳定该植入物的机构16。
当给予该植入物的一个或多个横条14是在该体环的平面处或在该体环的平面之上跟随该体环的外形时,该横条14放置在离开血流过该瓣的通路,并且可以减少熔血作用和血栓形成。
如图13A至13E所示,给定的环形植入物10的横条14可以被中断,以给予该植入物10正常的开口(半)环形形状。正如将要在下面详细描述的,这种类型的植入物10叶能够被输送到植入地点,例如在导管或护套内,以收缩的、伸展的状况,并且然后展开以呈现如图13A至13E所示的该开口的环形形状。
在图13A中,该开口的环形形状构造成使得,当植入时,该植入物拥抱该体环。在图13B中,该开口的环形形状构造成使得,当植入时,该植入物跨在该体环之上。图13C和13D示出另一种类型的开口环形植入物,一个拥抱该体环(图13C),一个跨在该体环之上(13D)。在这种布局中,该中断的横条14包括能够连接的互锁钩18,如果希望的话,以使该植入物的环闭合(见图13E)在图13E中,该互锁的植入物10构造成跨在该体环之上。
如图13A和13B所示,支杆12不必放置在横条14的直径上相对的两侧。给定的瓣体环的结合处可以不是该体环几何相对的两侧。因此,支杆12的位置可以选择成适应于该体环的非对称的结构。可以利用该支杆12只是将该植入物定位在体环中,在其上只有很小的力或没有力。在这种布局中,该体环的修整力从该接合处之上的一个或多个横条14上产生。
该植入物的她弹簧常数近似于组织的弹簧常数,使该植入物更加适应于该组织的移动。如图14所示,给定的横条14在给定区域可以包括波浪形等,以使沿着该横条14的长度具有不同的常数和/或机械性质。可选地,或以组合的方式,截面的宽度和/或厚度和/或给定横条的几何形状不必是均匀的,但是可以沿着该横条14的长度变化,以使不同的区域具有不同的弹簧常数和/或机械性质。例如,在图13A中,在不对称地放置的支杆12之间的连续的区域可以变厚或变薄,以给予不同的机械性质,以实现所希望的形状改变目的。
2.可折叠的弹性环形植入物
图15A至图15E所示的植入物10包括多于一个的横条14,使该植入物具有正常的闭合的环形形状。不同于图10所示的正常的闭合的环形植入物10,图15A至图15E所示的植入物10的横条14包括尖突20。该尖突20允许该植入物沿其短轴(横轴)弹性地折叠——用该尖突进行折叠——该植入物没有永久变形(见图15B)。正如将要在下面详细地描述的,这种类型的植入物10可以例如,在导管或护套内,以像收缩状态一样的折叠形式,输送到植入地点,并且然后展开以呈现在图15A所示的正常的闭合的环形形状,如图15C所示。正如前面所说明的,该横条14的形状和结构可以变化,以便当展开时该植入物拥抱该体环或跨在该体环之上。
在图15中,该尖突20时对称的,形成在对于支杆12等距离处的横条14上。在图15A中,支杆12也示作关于该横条14之上的高度对称的,图15D示出该尖突20无论在那一方面不需要时对称的。正如将要在下面详细描述的,这种不对称允许该植入物分段的交错展开,其中,该植入物的零件连续地一次展开一个——例如,一个支杆,然后一个尖突,然后另一个支杆,并且然后另一个尖突——直到该植入物呈现图15D所示的闭合的环形形状,如图15E所示。
3.植入物的固定
如前所述,该支杆12可以包括其他结构或机构16,以进一步增强该植入物在心瓣体环中的固定和稳定。这些结构和机构16可以包括,例如,环、凸缘、倒钩、垂直支臂、圆周支臂或在该体环下面、在该瓣平面下、瓣平面处和/或瓣平面之上的其他固定结构。希望该结构或机构16增加该支杆12和毗连体环的组织之间的接触表面积。希望该结构或机构16仅仅依赖或部分地依赖于该瓣和相邻的解剖学结构,以将该植入物锚定或固定在该体环中并防止它移出该体环外。植入物固定也能够帮助实现所希望的叶状体的接合,并且防止在心搏动周期期间该叶状体向上移动或外翻。
例如,在图7A和图8所示的实施例中,横条14具有四个支杆12、两个上环形(在瓣的心房一侧接触组织)和两个下环形(在瓣的心室一侧接触组织)。该支杆12被从支杆12弯曲开的小隆起分开,以避免与结合处接触,以便不干扰瓣的打开和关闭。
如图7A所示,,该支杆12可以装上垫子以增加牵引力,减少腐蚀,并且改善与瓣体环的相互作用。此外,支杆12可以用组织生长促进材料涂覆、覆盖或浸渍。横跨该支杆12的横条14起对体环施加压力的作用。支杆12被该横条14与瓣体环的相互作用产生的压力固定。支杆12确保该植入物原地正确定位,因为它们仅仅当定位在瓣接合处或其附近时才固定。
支杆12的尺寸和形状可以做成各种方式。图7B、7C、7D示出具有支杆的可选结构的各种实施例。如另一个例子,在图7E中,上环形支杆12稍稍大于下环形支杆12,以改善该装置在现场的解剖学安装。
在图16A和16B所示的实施例中,支杆12可以具有位于该瓣体环平面下面的扁平的下环形组织接触凸缘26。该凸缘26放置在该结合处下面的向外弯曲成弓形的伸出部分上,对心壁施加保持力。该凸缘26可以采取扁平表面的形式,如图16A和16B所示。穿过组织的倒钩28(示于图16B)可以增强压力的作用,以固定该植入物的位置。
如图17A和17B所示,支杆12可以在该瓣体环下面以波动形式延伸,以在该体环下面并毗邻该体环在该植入物和心壁之间形成一系列环形接触表面30。该一系列接触表面30增加该植入物和该体环下面的组织之间的接触点。这些多个接触点30对于在该结合处本身或在其附近的该植入物和该组织之间的接触是辅助的。在图17A和17B中,额外的支杆和/或倒钩或类似的固定表面(诸如图16A和16B所示的)没有与相关的接触表面一起示出,但是如果希望的话,它们可以包括这些额外的支杆和/或倒钩或类似的固定表面。
如图18A和18B所示,该植入物可以包括位于该体环平面之下的下环形摩擦支杆32。该下环形摩擦支杆32接合在该体环下面并毗邻该体环的心壁组织。该下环形摩擦支杆32防止该植入物向该体环的外面移动。如图18A所示,该摩擦支杆32可以放置在紧靠该体环下面的一个平面中,或(如图18B所示),该支杆32可以设置在该体环下面的多个平面中。
如图19所示,支杆12和/或横条14可以包括组织生长表面34。该表面34提供一种在该植入物上促进邻近组织生长的环境。一旦发生生长,该植入物10能抵抗来自该体环迁移或移动。常规上,能够利用诸如聚酯纤维的生长材料。
如果希望,任何固定机构或结构可以接合有粘接剂等以进一步固定植入物。
II.展开弹性植入物用于修整心瓣体环
正如刚刚描述的各种植入物使它们自己适合于植入心瓣体环中。它们能够,例如,在开放性心外科手术中植入。可选地,它们可以用基于导管的方法,经由诸如股骨静脉或颈静脉的周围静脉进入部分或股骨动脉,或可选地,通过胸腔由胸部观察或通过由心房借助其他外科进入。
A.开放性心外科手术。
图21示出在开放性外科手术中用于将大致描述的这种类型的弹性植入物布置在心瓣体环中的器具40。图22A至22F示意地示出利用图21所示的器具40将植入物10布置在二尖瓣体环中的开放性外科手术的步骤。
该器具40包括剪刀动作机构42,其包括工作端46和把手端48。该工作端46包括尖头44,其通过操作把手端48能够移动分开和移动到一起(见图22A和22B)。该尖头44的尺寸和结构做成与形成在该植入物10的支杆12上的布置孔50(示于图21)相配合。该布置孔50在前面的图10至19也示于该植入物上,该植入物同样能够用该器具40展开。
在使用器具40时,操作剪刀动作机构42以展开尖头44(见图22A和22B),以便它能够配合在布置孔50中。操作该剪刀动作机构42将该尖头44合在一起,以便对支杆12施加力,以在压力状态下放置该植入物10(见图22C)。
在这种状态下用器具40保持植入物10,该器具40和植入物10通过开放性外科手术被引进左心房。该器具40将植入物放置在二尖瓣体环内(见图22D)。如图22D所示,所示的体环的尺寸为D1。这个尺寸D1不利于叶状体接合,并且发生反流。外科手术的目的是通过用植入物10修整该体环以修复这种功能失调。
操作该剪刀动作机构42,以展开该尖头44,直到植入物10的支杆12放置在该二尖瓣的结合处内或其附近(见图22E)。在手术中的这时,该体环的尺寸D1保持不变。器具40后撤,尖头44从孔50自由离开。该植入物10的弹性去载位移并展开瓣组织,达到体环新的尺寸D2,D2大于D1。新尺寸D2有利于叶状体的接合。植入物10已经修整了该体环以恢复瓣功能。
B.说明性的基于导管的脉管内手术
1.弹性植入物的线性展开
图23至25示出图7至图14所示类型的去载的弹性植入物10的基于导管的经皮的线性展开的代表性实施例。
经皮的脉管进入通过常规的方法进入股骨静脉或颈静脉实现。如图23A所示,在图像引导下,导管52通过静脉进入右心房。携带在该导管远端上的针管54被展开以穿刺左右心房之间的隔膜。如图23B所示,引导线56通过针导管52贯穿隔膜进入左心房。第一导管52被撤出,并且(如图23C所示)在图像引导下,植入物传输导管58在引导线56上前进进入左心房,进入到接近二尖瓣。可选地,该植入物传输导管58可以通过右心房借助于外科进入能够贯穿隔膜地布置。
该植入物传输导管58在其远端具有护套60(见图24)。该护套60包围图7至图14所示类型的弹性植入物10。该植入物10在护套内被约束在收缩的平直状态,如图24所示。该护套60的尺寸和结构可以做成能够被撤出(例如通过滑动),以脱离该植入物10。护套60的脱离,该植入物10将伸展。可选地,导管58中的柔性推杆62能够用来从护套60中推进该植入物10,具有同样的结果。希望,在该植入物10尾端的支杆12被折叠在护套60内,以减少收缩的外形并且一旦脱离该护套60之后便于该植入物10的膨胀。
如图25所示,在图像的引导下,植入物10前端的支杆12脱离该护套60并向后安放在该瓣体环的后接合处。与该支杆12相关的固定结构或机构也放置成与该体环的拼命之下或之上的毗邻的组织接触。如图25B所示,由于护套60沿接合线沿从后到前的方向沿与接合线的直线后撤,提供导管58在后结合处的前支杆12保持力。如图25B所示,该提供导管58可能需要向后下降到该叶状体平面之下,以在该植入物的前端上保持足够的力,同时尾端与护套60脱离。但是,如图25C所示,该提供导管58的尺寸合结构可以做成具有足够强度的圆柱形,以在该前支杆上保持力而不通过该叶状体平面之下。
逐渐从护套60脱离,该弹性植入物10形成形状并安放(如图25B/C合25D所示)直到该尾部支杆12去载并安放在前接合处(见图25F)。该植入物在图像引导下用导管展开控制装置也能够被定位或重新定位在左心房内。
2.打开的弹性植入物的引导环展开
图26和图27A至27I示出植入物提供导管的58的另一个实施例,其能够用于将图7至图14所示类型的折叠的弹性植入物10布置在左心房中。
在这个实施例中,如前面的实施例一样,该植入物传输导管58包括护套60,其将植入物10约束成收缩的平直的方式,以通过进入左心房(见图26)。该护套60的尺寸和结构做成能够后撤(例如,通过滑动),以脱离在左心房内扩展的该植入物,或推杆62能够用于将该植入物从护套60中顶出。为了形成所希望的外形,一个或两个支杆可以折叠成靠在该护套60内的植入物体上。
不像前面的实施例,金属纤维或聚合物引导线64结成环形在将植入物10插入护套60内之前通过该植入物10的支杆12上的布置孔50。正如将要描述的,结果得到的引导线环66的支臂穿出该护套60的近端,用于操作。
在使用中,该植入物传输导管58以前面所述的方式穿过隔膜引进左心房中。由于导管58的远端定位在该瓣体环之上(见图27A),并且在护套60后撤之前,该引导线环66的两支臂以级联方式远端地向前通过该护套60,使环66超过布置孔50并且在该护套60的远端外面。希望该引导环66具有不透射线的标记68,以帮助荧光检查器的目视观测。该标记68识别它们与护套60远端之间距离,标记出该植入物10能够自由地伸展而不接触心房内的组织和解剖学结构的空间。通过标记68的引导,环66能够下降超过护套60的远端进入到该体环内所希望的距离,如图27A所示。
环66以所希望的方式定位在体环内,该护套60能够后撤以使该植入物10脱离,以便伸展(见图27B)。当系于引导线环66时,当护套60后撤时,植入物10在左心房内的打开——首先一个支杆,然后另一个,如图27C和27D所示。
一旦植入物10完全脱离护套60并伸展之后,引导线环66的两个支臂能够以级联方式向近端地前进通过护套60(见图27E)。该线环66对支杆12施加力并将它们带到一起(见图27F)。这将植入物10放置成受压的弹性加载状态。线环66的支臂向近端前进也将植入物10拉到紧靠该导管58远端的状态,以便更好地控制,如图27F所示。
由于植入物10在这种状态系于导管58(见图27G),导管58能够在图像引导下向前,以将植入物10放置在体环内。对导管58的操作将使植入物的支杆成为所希望的对齐。随后该线环支臂向远侧的前进(见图27H)使植入物的支杆能够弹性去载并使它与周围的组织接触。与支杆12相关的固定结构或机构也可以放置成与该体环平面之下和/或之上的毗邻的组织所希望的接触。可以操作线环66的支臂以将支杆12拉到一起和/或使它们能够分开,直到实现在该体环中或体环之上所希望的定向和与组织接触。
一旦所希望的植入物10定向和与组织接触实现之后,能够拉动该线环66的一个支臂,以从引导线64释放该植入物(见图27I)。该植入物10能够充分地打开并安放在体环内。
除闭合环形植入物之外,引导环66也能够用于布置开口环形植入物。如图28A所示,单个引导环66能够穿过图13B所示类型的开口环形植入物10,或,如图28B所示,两个引导线环66A和66B能够穿过图13D和13E所示类型的互锁的植入物。在这种设置中,可以操作第一引导线环66A以将植入物的支杆12定位在体环内,正如刚刚描述的。能够分开地操作第二引导线环,一旦支杆以所希望的方式放置在接合处之后,以将横条14拉到一起,以便互锁,
3.折叠的弹性植入物的布置
图15A至15E示出能够绕尖突20折叠的弹性植入物10。如图29所示,该折叠使植入物10能够在植入物供给导管58的护套60内输送到左心房,传输外形不仅构成并排的收缩状态——使传输外形直径最小,而且也构成纵向折叠状态——使传输外形长度最小。
图30A至30D示出图15A至15E所示类型的对称折叠的弹性植入物10的布置。该植入物10以对称折叠和收缩的状态约束在护套60内,如图30A所示。在这种状态中,支杆12形成该植入物的前端。在导管58中的推杆62包括夹持机构70,它用尖突20夹持该折叠的植入物10。推杆62前进以从护套60内推进该植入物10,首先推进两个支杆12。
如图30B所示,在图像引导下,该植入物10与和接合处大致等距离的接合线对齐,支杆12定向成面向该接合处(正如已经描述的,供给导管58已经穿过隔膜在先引进到左心房中)。操作推杆62使植入物10前进,首先使两支杆12从护套60前进。推杆62与植入物10的连接使该植入物10在布置期间能够转移并且能够旋转和缩回。从护套脱离(见图30B),该植入物10开始沿尖突20打开,并且支杆12向接合处拉开。推杆62进一步的向前使植入物10进一步从护套60脱离,直到支杆12充分拉开以接触接合处(见图30C)。在尖突20从夹持机构70释放之前,可以操作该植入物10以确保与支杆相关的固定结构或机构被放置成与该体环平面之下和/或之上的毗邻的组织希望的接触。该夹持机构70然后可以动作(见图30D),释放该植入物10。
图31A至31E示出示出图15A至15E所示类型的非对称折叠的弹性植入物10的布置。该植入物10以非对称折叠和收缩的状态约束在护套60内,如图31A所示,夹持机构70夹持一个,而不是两个尖突。这是由于在横条14上方的尖突的高度也是不对称的。夹持机构70将连接于较高的尖突20。推杆62能够向前以从护套60推进该植入物10。由于尖突20的不对称,支杆12之一在另一个之前被定位以便展开。还是由于尖突20的不对称,较短的尖突20被定位以便在较高的尖突被夹持机构70释放之前前进到该护套60的外面。
如图31B所示,在图像引导下,该折叠的并收缩的植入物10与和接合处之一附近的接合线对齐(正如已经描述的,传输导管58已经穿过隔膜在先引进到左心房中)。操作推杆62使植入物10从护套60前进,前支杆12首先脱离(见图30B),并放置在紧靠邻近的接合处。可以操作该植入物10以确保与前支杆相关的固定结构或机构被放置成与该体环平面之下和/或之上的毗邻的组织希望的接触。推杆62的进一步前进引起该植入物10向相对的接合处打开。推杆62继续前进使打开的植入物10进一步从护套60脱离,直到后支杆12接触相对的接合处(如图31C所示)。可以操作该植入物10以确保与后支杆12相关的固定结构或机构被放置成与该体环平面之下和/或之上的毗邻的组织希望的接触。推杆62进一步前进使较短的尖突20从护套60脱离,并且植入物10沿其侧面弹性打开(见图31D)。然后夹持装置70可以动作(见图31E),释放较高的尖突20。植入物10沿这个方向打开。可以看到,植入物10的不对称使该植入物10能够一次一个元件地分步骤布置在体环中。
4.折叠的弹性植入物用引导线辅助展开
前面已经描述过利用一个或多个引导环66或系绳帮助未折叠的弹性植入物展开。一个或多个引导环66或系绳同样能够用来帮助对称或非对称型的折叠弹性植入物展开。
例如,如图32所示,金属、纤维、或聚合物引导线64可以结成环在将植入物10折叠并插入护套60中之前通过对称或非对称型的折叠弹性植入物10的支杆上的布置孔。结果得到的引导线环66的支臂穿出该护套60的近端,用于操作。
在使用中(见图33A)——该植入物传输导管58以前面所述的方式穿过隔膜引进左心房中之后,并且在推杆62动作之前——该引导线环66的两支臂以级联方式向远端地向前通过该护套60,使环66前进超过布置孔50并且在该护套60的远端外面。该环66放置在该体环内。
操作推杆62使折叠的植入物10脱离以便伸展(见图33B)。该植入物10打开同时系于该引导线环66。由于支杆12伸展开该环66沿直径方向增大。环66的圆周将其自身定向成沿该体环最大的尺度——这是接合处之间的距离。因而该环66在植入物10伸展时以接合线定向(调整)该植入物10。环66的支臂引导支杆12到接合处(如图33C所示)。
系于导管58,该植入物10布置在体环内。该引导线环66在植入物伸展期间控制支杆在接合处内的间隔。
实现在植入物10的希望的定向和与组织的接触之后,夹持机构70可以释放植入物10。可以推动线环66的一个支臂以使该植入物10与该引导线脱离(见图33D)。该植入物10能够完全打开并放置在体环内。
如图34所示,第二引导线环72也能够通过尖突20上的孔。这个引导线环72可以独立于第一引导线环66单独操作,以中隔横向的尺度的方式控制伸展的植入物10的布置。虽然是独立的,但是同时,控制伸展的植入物10可以由操作第一引导线环66实现。
如35和图36A至36D所示,在将植入物10折叠并插入护套60中之前,分开的金属、纤维,或聚合物引导线92能够单个地穿(没有结环)过对称或非对称折叠的植入物10的支杆上的小孔(见图35)。分开的引导线92穿过该护套60的近端,用于操作。
在使用中(见图36A)——该植入物传输导管58以前面所述的方式穿过隔膜引进左心房中之后,并且在推杆62动作之前——该分开的引导线92以级联方式向远端地向前通过该护套60,并且在该护套60的远端外面。该线92的端部放置在该体环内。
操作推杆62使折叠的植入物10脱离以便伸展(见图36B)。该植入物10打开同时系于该分开的引导线92。该分开的引导线92将其自身沿该体环的主轴定向——这是接合处之间的距离,以在植入物10伸展时以接合线定向(调整)该植入物10。引导线92分开地引导相应地支杆12到接合处(如图36C所示)。
系于导管58,该植入物10布置在体环内。该引导线92在植入物伸展期间控制支杆在接合处内的间隔。
实现在植入物10的希望的定向和与组织的接触之后,夹持机构70可以释放植入物10。可以推动引导线92以使该植入物10与该引导线脱离(见图33D)。该植入物10能够完全打开并放置在体环内。
5.折叠的弹性植入物用其他方式辅助展开
前面的实施例表明未折叠的弹性植入物10在布置期间能够控制成沿主轴方向的尺度或沿短轴(中隔到横向)方向的尺度,或通过引导线沿两个方向的尺度。可以用其他方式的约束机构控制植入物10的打开。
例如,如图37A所示,当植入物10从传输护套中前进时,折叠的植入物10可以约束在袋子或封套76中。该袋子或封套76限制植入物10的伸展超过选定点(例如,完全展开的80%),使内科医生在该植入物10完全打开横过该体环之前能够参与将支杆安放在接合处的重要任务。一旦在该植入物10已经被放置在该接合处并且与传输护套60分离之后(见图37B),可以拉动连接于袋子或封套76的拉索78,以使袋子或封套76与植入物10分离(见图37C)。与袋子或封套76脱离,该植入物10进行其伸展,以实现其最终的形状并放置在体环内。可以接合结合一个或多个与袋子或封套76使用引导线。可选地,该袋子或封套76的尺寸和外形做成当植入物10伸展超过给定点时能够撕开,而不使用拉索78或类似的诱发撕开机构。在另外的实施例中,该植入物10可以封闭在具有刻痕线的热缩塑料包中。在这种设置中,该结构的大小和结构做成约束植入物10的伸展,直到该植入物10前进到供给护套外面超过指定点,这时,超过刻痕线部分或材料的强度,以打开或完全释放该植入物10。
III.用于修整心瓣体环的塑性变形的植入物及其布置
如前所述,该植入物10可以用塑性变形材料制造(紧图38)。该植入物10如前所述包括多个支杆以及一个或多个横条。该植入物10以正常的折叠状态通过植入物传输导管58布置进左心房中。在这种设置中,植入物传输导管58可以具有机械伸展装置80,例如剪刀装置等(见图39A至39C),以在该体环内现场扩展该植入物10的塑性变形材料。可选地,植入物传输导管58可以具有可充气物体82(例如,气球)(见图40A至40C),以在体环内伸展植入物10。在伸展期间,塑性变形的植入物10伸长该体环以达到所希望的主轴尺寸。一旦扩展之后,该塑性变形的植入物10保持所希望的距离,从而防止该体环收缩。植入供给导管58可以包括其他结构或机构以进一步将该植入物10固定并稳定在该体环中。
IV.确定植入物的尺寸和阻力(resistance)
利用人体解剖学教科书和他们临床知识以及关于其疾病和损害,医学专业人员通常懂得诸如二尖瓣的心瓣以及相邻的解剖学结构的形状和结构。对于给定的植入物的形状和尺度的范围由将要治疗的部分确定。对于给定的病人的精确尺度可以在植入植入物之前通过对将要进行治疗的该部分进行X射线、MRI或CT扫描确定。
内科医生也可以通过在目标体环中布置一个非顺从的气球检测仪84确定给定植入物的尺寸和阻力,如图41所示。该气球检测仪84能够有不透射线的标记86,以便能够用成像装置和/或其他形式的现场目测确定体环的尺度。体环的顺从和张紧力也可以通过检测并量化该气球检测仪在该体环中伸展期间所遇到的阻力来物理地测量。根据这些数据,并考虑到内科医生的临床知识和其疾病或损害,内科医生能够选择植入物的希望的尺寸和机械性质。
V.多功能植入物
植入物10的各种实施例已经描述了修整心瓣体环的来龙去脉。具有适合这种功能的技术特征的给定植入物10也可以包含适合于其他功能的其他技术特征。
图42以说明的方式示出体环修整植入物10,其中,横条14的尺寸和外形做成以形成假体环。包括覆盖织物的桥结构的新叶状体元件88连接于该横条。该新叶状体元件的尺寸和外形做成占据至少原心瓣叶状体部分的空间,以提供单向瓣的功能。根据心室的舒张压,该单向瓣功能在该假体环内呈现打开状态。根据心室的收缩压,该单向瓣的功能在该假体环内呈现关闭状态。该新叶状体元件88用作修复、更换或补充损坏的心瓣。
图43和43示出体环修整植入物10,其中,横条14的尺寸和外形做成用作假体环。该植入物10包括在该假体环附近或在其内的夹持结构90,其尺寸和外形做成至少覆盖一个或多个原瓣叶状体的一部分。该夹持结构90夹持原瓣叶状体,保持该瓣叶状体不反向流动,例如,由于被推进心房中,即外翻和/或脱垂。
作为多功能植入物的其他例子,图45至47示出体环修整植入物10,其中,横条还包括支架38(如前所述)以帮助现场定位并固定该装置。在图45至47中,该支架38还包括刚刚所述的叶状体夹持结构。
虽然新装置和方法已经具体描述了治疗二尖瓣心瓣的来龙去脉,但是应当明白,以同样的或等同物的方式也能够治疗其他类型的心瓣。通过举例方式,但不限于此,本系统和方法能够用于防止或减少在任何心瓣体环中的反向流动,包括三尖瓣、肺动脉瓣或主动脉瓣。此外,对于本领域的技术人员来说,从这里所公开的本发明的说明书的内容和实践,本发明的其他实施例和用途将变得显而易见。该说明书和例子应当看作是示例性的和关键技术的描述,而不是限制。本发明的实际范围和精神实质由权利要求限定。正如本领域的普通技术人员容易明白的,在由权利要求限定的本发明的范围内很容易对每个公开的实施例进行该变和修改。
Claims (26)
1.一种修整具有心瓣体环和位于该心瓣体环相反侧的叶状体接合处的心瓣的植入物,所述植入物在叶状体接合处之间限定了心瓣体环的主轴,该植入物包括:
弹性线形式主体,其尺寸和外形做成在心瓣体环处或其上的叶状体接合处之间延伸,所述弹性线形式主体具有能弹性地压缩超出正常去载状况而成为受压的弹性加载状况的弹簧常数,和
间隔开的支杆,当所述弹性线形式主体在其受压的弹性状况下于心瓣体环之间延伸时,该支杆附接到该主体,以接触在该叶状体接合处或其附近的组织,该支杆的尺寸和外形做成由于在心瓣体环处或其上延伸的弹性线形式主体的压缩的结果而使该组织沿主轴移动和拉伸,以修整该心瓣体环。
2.根据权利要求1的植入物,其中所述弹性线形式主体包括环形形状。
3.根据权利要求1的植入物,其中所述弹性线形式主体包括闭合的环形形状。
4.根据权利要求1的植入物,其中所述弹性线形式主体包括开口的环形形状。
5.根据权利要求1的植入物,其中所述弹性线形式主体包括至少一个横条。
6.根据权利要求1的植入物,其中所述弹性线形式主体是可收缩的,用于放置在导管内。
7.根据权利要求1的植入物,其中所述弹性线形式主体包括至少一个尖突,其尺寸和外形做成能够折叠该主体而没有永久变形。
8.根据权利要求1的植入物,其中所述弹性线形式主体带有组织生长材料。
9.根据权利要求1的植入物,
还包括至少一个附接到所述弹性线形式主体的结构,并且其尺寸和外形做成接触该心瓣体环处、在该心瓣体环之上或在该心瓣体环之下的组织,以稳定所述弹性线形式主体。
10.根据权利要求1的植入物,其中所述弹性线形式主体的尺寸和外形做成延伸到靠近该体环。
11.根据权利要求1的植入物,其中所述弹性线形式主体的尺寸和外形做成延伸到该体环之上。
12.根据权利要求1的植入物,其中所述弹性线形式主体的尺寸和外形做成接触该体环之上的组织。
13.根据权利要求1的植入物,其中所述弹性线形式主体的尺寸和外形做成包括延伸到靠近该体环的一部分和延伸到该体环之上的另一部分。
14.根据权利要求1的植入物,其中所述弹性线形式主体的尺寸和外形做成包括延伸到靠近该体环的一部分和接触该体环之上的组织的另一部分。
15.根据权利要求1的植入物,其中所述弹性线形式主体包括塑性变形材料。
16.根据权利要求1的植入物,其中该弹性线形式主体包括超弹性材料。
17.根据权利要求1的植入物,
还包括附接到该弹性线形式主体并且至少在原心瓣叶状体的一部分上延伸的夹持元件,该夹持元件的形状做成限制该心瓣叶状体的反向移动。
18.根据权利要求1的植入物,
还包括附接到所述弹性线形式主体并且占有至少一个原心瓣叶状体的空间的新叶状体元件,该新叶状体元件的形状做成提供单向瓣功能。
19.根据权利要求1的植入物,
还包括附接到所述弹性线形式主体的第二心瓣治疗元件,以影响心瓣功能。
20.根据权利要求19的植入物,
其中所述第二心瓣治疗元件包括用于补充、修复或更换原心瓣叶状体的装置。
21.根据权利要求19的植入物,
其中所述第二心瓣治疗元件包括用于夹持原心瓣叶状体的装置。
22.根据权利要求1的植入物,
其中所述支杆中至少一个包括线形式结构。
23.根据权利要求1的植入物,
其中所述支杆每个包括线形式结构。
24.根据权利要求1的植入物,
其中所述支杆中至少一个收缩到所述弹性线形主体上。
25.根据权利要求1的植入物,
其中所述支杆中至少一个带有组织生长材料。
26.根据权利要求1的植入物,
其中所述支杆中至少一个具有这样的结构结构:其尺寸和外形做成增加与该体环处、该体环之上或该体环之下的组织接触的表面积。
Applications Claiming Priority (10)
Application Number | Priority Date | Filing Date | Title |
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USPCT/US02/31376 | 2002-10-01 | ||
USPCTUS02/31376 | 2002-10-01 | ||
PCT/US2002/031376 WO2003028558A2 (en) | 2001-10-01 | 2002-10-01 | Methods and devices for heart valve treatments |
US42946202P | 2002-11-26 | 2002-11-26 | |
US42944402P | 2002-11-26 | 2002-11-26 | |
US42970902P | 2002-11-26 | 2002-11-26 | |
US60/429,444 | 2002-11-26 | ||
US60/429,462 | 2002-11-26 | ||
US60/429,709 | 2002-11-26 | ||
PCT/US2003/030831 WO2004030569A2 (en) | 2002-10-01 | 2003-10-01 | Devices, systems, and methods for reshaping a heart valve annulus |
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CN1703176A CN1703176A (zh) | 2005-11-30 |
CN100553590C true CN100553590C (zh) | 2009-10-28 |
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CNB2003801008335A Expired - Fee Related CN100553590C (zh) | 2002-10-01 | 2003-10-01 | 修整心瓣体环的装置 |
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US (2) | US20060106456A9 (zh) |
EP (1) | EP1562522B1 (zh) |
JP (1) | JP2006501033A (zh) |
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AT (1) | ATE418938T1 (zh) |
AU (2) | AU2003277116A1 (zh) |
CA (1) | CA2498030A1 (zh) |
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Families Citing this family (402)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6050936A (en) | 1997-01-02 | 2000-04-18 | Myocor, Inc. | Heart wall tension reduction apparatus |
US7883539B2 (en) | 1997-01-02 | 2011-02-08 | Edwards Lifesciences Llc | Heart wall tension reduction apparatus and method |
WO1999000059A1 (en) * | 1997-06-27 | 1999-01-07 | The Trustees Of Columbia University In The City Of New York | Method and apparatus for circulatory valve repair |
FR2768324B1 (fr) | 1997-09-12 | 1999-12-10 | Jacques Seguin | Instrument chirurgical permettant, par voie percutanee, de fixer l'une a l'autre deux zones de tissu mou, normalement mutuellement distantes |
US6332893B1 (en) | 1997-12-17 | 2001-12-25 | Myocor, Inc. | Valve to myocardium tension members device and method |
US6260552B1 (en) | 1998-07-29 | 2001-07-17 | Myocor, Inc. | Transventricular implant tools and devices |
US10327743B2 (en) * | 1999-04-09 | 2019-06-25 | Evalve, Inc. | Device and methods for endoscopic annuloplasty |
US7811296B2 (en) | 1999-04-09 | 2010-10-12 | Evalve, Inc. | Fixation devices for variation in engagement of tissue |
ATE484241T1 (de) | 1999-04-09 | 2010-10-15 | Evalve Inc | Verfahren und vorrichtung zur herzklappenreperation |
US8216256B2 (en) | 1999-04-09 | 2012-07-10 | Evalve, Inc. | Detachment mechanism for implantable fixation devices |
US20040044350A1 (en) | 1999-04-09 | 2004-03-04 | Evalve, Inc. | Steerable access sheath and methods of use |
US7563267B2 (en) | 1999-04-09 | 2009-07-21 | Evalve, Inc. | Fixation device and methods for engaging tissue |
US6752813B2 (en) | 1999-04-09 | 2004-06-22 | Evalve, Inc. | Methods and devices for capturing and fixing leaflets in valve repair |
EP1113497A3 (en) * | 1999-12-29 | 2006-01-25 | Texas Instruments Incorporated | Semiconductor package with conductor impedance selected during assembly |
US7527646B2 (en) * | 2000-09-20 | 2009-05-05 | Ample Medical, Inc. | Devices, systems, and methods for retaining a native heart valve leaflet |
US7691144B2 (en) | 2003-10-01 | 2010-04-06 | Mvrx, Inc. | Devices, systems, and methods for reshaping a heart valve annulus |
US20080091264A1 (en) | 2002-11-26 | 2008-04-17 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus, including the use of magnetic tools |
US8784482B2 (en) * | 2000-09-20 | 2014-07-22 | Mvrx, Inc. | Method of reshaping a heart valve annulus using an intravascular device |
US6602288B1 (en) * | 2000-10-05 | 2003-08-05 | Edwards Lifesciences Corporation | Minimally-invasive annuloplasty repair segment delivery template, system and method of use |
US6723038B1 (en) | 2000-10-06 | 2004-04-20 | Myocor, Inc. | Methods and devices for improving mitral valve function |
US6602286B1 (en) | 2000-10-26 | 2003-08-05 | Ernst Peter Strecker | Implantable valve system |
US6974476B2 (en) * | 2003-05-05 | 2005-12-13 | Rex Medical, L.P. | Percutaneous aortic valve |
US6800090B2 (en) | 2001-05-14 | 2004-10-05 | Cardiac Dimensions, Inc. | Mitral valve therapy device, system and method |
US7635387B2 (en) | 2001-11-01 | 2009-12-22 | Cardiac Dimensions, Inc. | Adjustable height focal tissue deflector |
US6824562B2 (en) * | 2002-05-08 | 2004-11-30 | Cardiac Dimensions, Inc. | Body lumen device anchor, device and assembly |
US7311729B2 (en) * | 2002-01-30 | 2007-12-25 | Cardiac Dimensions, Inc. | Device and method for modifying the shape of a body organ |
US6575971B2 (en) | 2001-11-15 | 2003-06-10 | Quantum Cor, Inc. | Cardiac valve leaflet stapler device and methods thereof |
US6976995B2 (en) | 2002-01-30 | 2005-12-20 | Cardiac Dimensions, Inc. | Fixed length anchor and pull mitral valve device and method |
US6793673B2 (en) * | 2002-12-26 | 2004-09-21 | Cardiac Dimensions, Inc. | System and method to effect mitral valve annulus of a heart |
US7179282B2 (en) | 2001-12-05 | 2007-02-20 | Cardiac Dimensions, Inc. | Device and method for modifying the shape of a body organ |
US6764510B2 (en) | 2002-01-09 | 2004-07-20 | Myocor, Inc. | Devices and methods for heart valve treatment |
US20050209690A1 (en) * | 2002-01-30 | 2005-09-22 | Mathis Mark L | Body lumen shaping device with cardiac leads |
US7004958B2 (en) * | 2002-03-06 | 2006-02-28 | Cardiac Dimensions, Inc. | Transvenous staples, assembly and method for mitral valve repair |
US6752828B2 (en) | 2002-04-03 | 2004-06-22 | Scimed Life Systems, Inc. | Artificial valve |
CA2950492C (en) | 2002-05-08 | 2018-12-04 | Cardiac Dimensions Pty. Ltd. | Device and method for modifying the shape of a body organ |
AU2003247526A1 (en) * | 2002-06-12 | 2003-12-31 | Mitral Interventions, Inc. | Method and apparatus for tissue connection |
EP1562522B1 (en) * | 2002-10-01 | 2008-12-31 | Ample Medical, Inc. | Devices and systems for reshaping a heart valve annulus |
US7112219B2 (en) | 2002-11-12 | 2006-09-26 | Myocor, Inc. | Devices and methods for heart valve treatment |
US7837729B2 (en) | 2002-12-05 | 2010-11-23 | Cardiac Dimensions, Inc. | Percutaneous mitral valve annuloplasty delivery system |
US7316708B2 (en) | 2002-12-05 | 2008-01-08 | Cardiac Dimensions, Inc. | Medical device delivery system |
US6945957B2 (en) | 2002-12-30 | 2005-09-20 | Scimed Life Systems, Inc. | Valve treatment catheter and methods |
US7314485B2 (en) | 2003-02-03 | 2008-01-01 | Cardiac Dimensions, Inc. | Mitral valve device using conditioned shape memory alloy |
US20040158321A1 (en) * | 2003-02-12 | 2004-08-12 | Cardiac Dimensions, Inc. | Method of implanting a mitral valve therapy device |
US20040220654A1 (en) | 2003-05-02 | 2004-11-04 | Cardiac Dimensions, Inc. | Device and method for modifying the shape of a body organ |
US10646229B2 (en) | 2003-05-19 | 2020-05-12 | Evalve, Inc. | Fixation devices, systems and methods for engaging tissue |
US7351259B2 (en) * | 2003-06-05 | 2008-04-01 | Cardiac Dimensions, Inc. | Device, system and method to affect the mitral valve annulus of a heart |
US7887582B2 (en) | 2003-06-05 | 2011-02-15 | Cardiac Dimensions, Inc. | Device and method for modifying the shape of a body organ |
US8052751B2 (en) * | 2003-07-02 | 2011-11-08 | Flexcor, Inc. | Annuloplasty rings for repairing cardiac valves |
CA2533353A1 (en) * | 2003-07-21 | 2005-02-03 | The Trustees Of The University Of Pennsylvania | Percutaneous heart valve |
US7837728B2 (en) * | 2003-12-19 | 2010-11-23 | Cardiac Dimensions, Inc. | Reduced length tissue shaping device |
US9526616B2 (en) | 2003-12-19 | 2016-12-27 | Cardiac Dimensions Pty. Ltd. | Mitral valve annuloplasty device with twisted anchor |
US7794496B2 (en) | 2003-12-19 | 2010-09-14 | Cardiac Dimensions, Inc. | Tissue shaping device with integral connector and crimp |
US20050137449A1 (en) * | 2003-12-19 | 2005-06-23 | Cardiac Dimensions, Inc. | Tissue shaping device with self-expanding anchors |
US8128681B2 (en) | 2003-12-19 | 2012-03-06 | Boston Scientific Scimed, Inc. | Venous valve apparatus, system, and method |
US7854761B2 (en) | 2003-12-19 | 2010-12-21 | Boston Scientific Scimed, Inc. | Methods for venous valve replacement with a catheter |
US8287584B2 (en) * | 2005-11-14 | 2012-10-16 | Sadra Medical, Inc. | Medical implant deployment tool |
CA2566666C (en) | 2004-05-14 | 2014-05-13 | Evalve, Inc. | Locking mechanisms for fixation devices and methods of engaging tissue |
US7566343B2 (en) | 2004-09-02 | 2009-07-28 | Boston Scientific Scimed, Inc. | Cardiac valve, system, and method |
US7635329B2 (en) | 2004-09-27 | 2009-12-22 | Evalve, Inc. | Methods and devices for tissue grasping and assessment |
US8052592B2 (en) | 2005-09-27 | 2011-11-08 | Evalve, Inc. | Methods and devices for tissue grasping and assessment |
CA2583591C (en) | 2004-10-02 | 2018-10-30 | Christoph Hans Huber | Methods and devices for repair or replacement of heart valves or adjacent tissue without the need for full cardiopulmonary support |
WO2006041877A2 (en) * | 2004-10-05 | 2006-04-20 | Ample Medical, Inc. | Atrioventricular valve annulus repair systems and methods including retro-chordal anchors |
SE0403046D0 (sv) * | 2004-12-15 | 2004-12-15 | Medtentia Ab | A device and method for improving the function of a heart valve |
DE102005003632A1 (de) | 2005-01-20 | 2006-08-17 | Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. | Katheter für die transvaskuläre Implantation von Herzklappenprothesen |
CA2595580A1 (en) | 2005-01-20 | 2006-07-27 | Cardiac Dimensions, Inc. | Tissue shaping device |
US7854755B2 (en) | 2005-02-01 | 2010-12-21 | Boston Scientific Scimed, Inc. | Vascular catheter, system, and method |
US20060173490A1 (en) | 2005-02-01 | 2006-08-03 | Boston Scientific Scimed, Inc. | Filter system and method |
US7878966B2 (en) | 2005-02-04 | 2011-02-01 | Boston Scientific Scimed, Inc. | Ventricular assist and support device |
US8470028B2 (en) | 2005-02-07 | 2013-06-25 | Evalve, Inc. | Methods, systems and devices for cardiac valve repair |
US7780722B2 (en) | 2005-02-07 | 2010-08-24 | Boston Scientific Scimed, Inc. | Venous valve apparatus, system, and method |
CA2597066C (en) | 2005-02-07 | 2014-04-15 | Evalve, Inc. | Methods, systems and devices for cardiac valve repair |
US7670368B2 (en) | 2005-02-07 | 2010-03-02 | Boston Scientific Scimed, Inc. | Venous valve apparatus, system, and method |
US7867274B2 (en) | 2005-02-23 | 2011-01-11 | Boston Scientific Scimed, Inc. | Valve apparatus, system and method |
WO2006097931A2 (en) | 2005-03-17 | 2006-09-21 | Valtech Cardio, Ltd. | Mitral valve treatment techniques |
US7722666B2 (en) | 2005-04-15 | 2010-05-25 | Boston Scientific Scimed, Inc. | Valve apparatus, system and method |
US8333777B2 (en) | 2005-04-22 | 2012-12-18 | Benvenue Medical, Inc. | Catheter-based tissue remodeling devices and methods |
EP1874217A4 (en) * | 2005-04-25 | 2014-11-19 | Evalve Inc | DEVICE AND METHOD FOR ENDOSCOPIC ANNULOPLASTY |
US20060247672A1 (en) * | 2005-04-27 | 2006-11-02 | Vidlund Robert M | Devices and methods for pericardial access |
US10195014B2 (en) | 2005-05-20 | 2019-02-05 | Neotract, Inc. | Devices, systems and methods for treating benign prostatic hyperplasia and other conditions |
US8945152B2 (en) | 2005-05-20 | 2015-02-03 | Neotract, Inc. | Multi-actuating trigger anchor delivery system |
US8668705B2 (en) | 2005-05-20 | 2014-03-11 | Neotract, Inc. | Latching anchor device |
US8394113B2 (en) | 2005-05-20 | 2013-03-12 | Neotract, Inc. | Coiled anchor device |
US10925587B2 (en) | 2005-05-20 | 2021-02-23 | Neotract, Inc. | Anchor delivery system |
US7896891B2 (en) | 2005-05-20 | 2011-03-01 | Neotract, Inc. | Apparatus and method for manipulating or retracting tissue and anatomical structure |
US8628542B2 (en) | 2005-05-20 | 2014-01-14 | Neotract, Inc. | Median lobe destruction apparatus and method |
US9549739B2 (en) | 2005-05-20 | 2017-01-24 | Neotract, Inc. | Devices, systems and methods for treating benign prostatic hyperplasia and other conditions |
US9504461B2 (en) | 2005-05-20 | 2016-11-29 | Neotract, Inc. | Anchor delivery system |
US7645286B2 (en) | 2005-05-20 | 2010-01-12 | Neotract, Inc. | Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures |
US8834492B2 (en) | 2005-05-20 | 2014-09-16 | Neotract, Inc. | Continuous indentation lateral lobe apparatus and method |
US9364212B2 (en) | 2005-05-20 | 2016-06-14 | Neotract, Inc. | Suture anchoring devices and methods for use |
US8333776B2 (en) | 2005-05-20 | 2012-12-18 | Neotract, Inc. | Anchor delivery system |
US7758594B2 (en) | 2005-05-20 | 2010-07-20 | Neotract, Inc. | Devices, systems and methods for treating benign prostatic hyperplasia and other conditions |
US8603106B2 (en) | 2005-05-20 | 2013-12-10 | Neotract, Inc. | Integrated handle assembly for anchor delivery system |
US9149266B2 (en) | 2005-05-20 | 2015-10-06 | Neotract, Inc. | Deforming anchor device |
US8425535B2 (en) | 2005-05-20 | 2013-04-23 | Neotract, Inc. | Multi-actuating trigger anchor delivery system |
US8529584B2 (en) | 2005-05-20 | 2013-09-10 | Neotract, Inc. | Median lobe band implant apparatus and method |
US8012198B2 (en) | 2005-06-10 | 2011-09-06 | Boston Scientific Scimed, Inc. | Venous valve, system, and method |
US7616122B2 (en) | 2005-06-20 | 2009-11-10 | Biovigil, Llc | Hand cleanliness |
US8502681B2 (en) | 2005-06-20 | 2013-08-06 | Biovigil, Llc | Hand cleanliness |
US8951285B2 (en) | 2005-07-05 | 2015-02-10 | Mitralign, Inc. | Tissue anchor, anchoring system and methods of using the same |
BRPI0617066A2 (pt) * | 2005-09-07 | 2011-07-12 | Medtentia Ab | dispositivos e método de aprimoramento da função de válvula cardìaca |
US7530253B2 (en) * | 2005-09-09 | 2009-05-12 | Edwards Lifesciences Corporation | Prosthetic valve crimping device |
US7569071B2 (en) | 2005-09-21 | 2009-08-04 | Boston Scientific Scimed, Inc. | Venous valve, system, and method with sinus pocket |
WO2007058857A2 (en) | 2005-11-10 | 2007-05-24 | Arshad Quadri | Balloon-expandable, self-expanding, vascular prosthesis connecting stent |
US7799038B2 (en) | 2006-01-20 | 2010-09-21 | Boston Scientific Scimed, Inc. | Translumenal apparatus, system, and method |
US7648527B2 (en) * | 2006-03-01 | 2010-01-19 | Cook Incorporated | Methods of reducing retrograde flow |
US8585594B2 (en) * | 2006-05-24 | 2013-11-19 | Phoenix Biomedical, Inc. | Methods of assessing inner surfaces of body lumens or organs |
US20110276127A1 (en) * | 2006-05-24 | 2011-11-10 | Forster David C | Multiple inflation of an expandable member as a precursor to an implant procedure |
WO2007140470A2 (en) * | 2006-06-01 | 2007-12-06 | Edwards Lifesciences Corporation | Prosthetic insert for improving heart valve function |
US20080126131A1 (en) * | 2006-07-17 | 2008-05-29 | Walgreen Co. | Predictive Modeling And Risk Stratification Of A Medication Therapy Regimen |
US11285005B2 (en) | 2006-07-17 | 2022-03-29 | Cardiac Dimensions Pty. Ltd. | Mitral valve annuloplasty device with twisted anchor |
WO2008013915A2 (en) | 2006-07-28 | 2008-01-31 | Arshad Quadri | Percutaneous valve prosthesis and system and method for implanting same |
US7854849B2 (en) * | 2006-10-10 | 2010-12-21 | Multiphase Systems Integration | Compact multiphase inline bulk water separation method and system for hydrocarbon production |
SE530568C2 (sv) | 2006-11-13 | 2008-07-08 | Medtentia Ab | Anordning och metod för förbättring av funktionen hos en hjärtklaff |
US9883943B2 (en) | 2006-12-05 | 2018-02-06 | Valtech Cardio, Ltd. | Implantation of repair devices in the heart |
WO2010004546A1 (en) | 2008-06-16 | 2010-01-14 | Valtech Cardio, Ltd. | Annuloplasty devices and methods of delivery therefor |
US11259924B2 (en) | 2006-12-05 | 2022-03-01 | Valtech Cardio Ltd. | Implantation of repair devices in the heart |
AU2007330338A1 (en) * | 2006-12-05 | 2008-06-12 | Valtech Cardio, Ltd. | Segmented ring placement |
US20100249920A1 (en) * | 2007-01-08 | 2010-09-30 | Millipede Llc | Reconfiguring heart features |
US20100121433A1 (en) * | 2007-01-08 | 2010-05-13 | Millipede Llc, A Corporation Of Michigan | Reconfiguring heart features |
WO2008091493A1 (en) | 2007-01-08 | 2008-07-31 | California Institute Of Technology | In-situ formation of a valve |
US9192471B2 (en) * | 2007-01-08 | 2015-11-24 | Millipede, Inc. | Device for translumenal reshaping of a mitral valve annulus |
JP5313928B2 (ja) | 2007-02-05 | 2013-10-09 | ボストン サイエンティフィック リミテッド | 経皮的な弁およびシステム |
US7753949B2 (en) | 2007-02-23 | 2010-07-13 | The Trustees Of The University Of Pennsylvania | Valve prosthesis systems and methods |
US8070802B2 (en) | 2007-02-23 | 2011-12-06 | The Trustees Of The University Of Pennsylvania | Mitral valve system |
US11660190B2 (en) | 2007-03-13 | 2023-05-30 | Edwards Lifesciences Corporation | Tissue anchors, systems and methods, and devices |
US7896915B2 (en) | 2007-04-13 | 2011-03-01 | Jenavalve Technology, Inc. | Medical device for treating a heart valve insufficiency |
US8529620B2 (en) * | 2007-05-01 | 2013-09-10 | Ottavio Alfieri | Inwardly-bowed tricuspid annuloplasty ring |
US8828079B2 (en) | 2007-07-26 | 2014-09-09 | Boston Scientific Scimed, Inc. | Circulatory valve, system and method |
US7892276B2 (en) | 2007-12-21 | 2011-02-22 | Boston Scientific Scimed, Inc. | Valve with delayed leaflet deployment |
WO2009094585A2 (en) * | 2008-01-24 | 2009-07-30 | Coherex Medical, Inc. | Methods and apparatus for reducing valve prolaspe |
ES2903231T3 (es) | 2008-02-26 | 2022-03-31 | Jenavalve Tech Inc | Stent para el posicionamiento y anclaje de una prótesis valvular en un sitio de implantación en el corazón de un paciente |
US9044318B2 (en) | 2008-02-26 | 2015-06-02 | Jenavalve Technology Gmbh | Stent for the positioning and anchoring of a valvular prosthesis |
US8382829B1 (en) | 2008-03-10 | 2013-02-26 | Mitralign, Inc. | Method to reduce mitral regurgitation by cinching the commissure of the mitral valve |
US10456259B2 (en) | 2008-04-16 | 2019-10-29 | Heart Repair Technologies, Inc. | Transvalvular intraannular band for mitral valve repair |
US11013599B2 (en) | 2008-04-16 | 2021-05-25 | Heart Repair Technologies, Inc. | Percutaneous transvalvular intraannular band for mitral valve repair |
US8262725B2 (en) * | 2008-04-16 | 2012-09-11 | Cardiovascular Technologies, Llc | Transvalvular intraannular band for valve repair |
US20100131057A1 (en) | 2008-04-16 | 2010-05-27 | Cardiovascular Technologies, Llc | Transvalvular intraannular band for aortic valve repair |
US20100121435A1 (en) | 2008-04-16 | 2010-05-13 | Cardiovascular Technologies, Llc | Percutaneous transvalvular intrannular band for mitral valve repair |
US11083579B2 (en) | 2008-04-16 | 2021-08-10 | Heart Repair Technologies, Inc. | Transvalvular intraanular band and chordae cutting for ischemic and dilated cardiomyopathy |
US20100121437A1 (en) * | 2008-04-16 | 2010-05-13 | Cardiovascular Technologies, Llc | Transvalvular intraannular band and chordae cutting for ischemic and dilated cardiomyopathy |
US8163010B1 (en) | 2008-06-03 | 2012-04-24 | Cardica, Inc. | Staple-based heart valve treatment |
US7976578B2 (en) * | 2008-06-04 | 2011-07-12 | James Marvel | Buffer for a human joint and method of arthroscopically inserting |
US8323335B2 (en) * | 2008-06-20 | 2012-12-04 | Edwards Lifesciences Corporation | Retaining mechanisms for prosthetic valves and methods for using |
WO2010014825A1 (en) | 2008-07-30 | 2010-02-04 | Neotract, Inc. | Slotted anchor device |
US8006594B2 (en) * | 2008-08-11 | 2011-08-30 | Cardiac Dimensions, Inc. | Catheter cutting tool |
US8652202B2 (en) | 2008-08-22 | 2014-02-18 | Edwards Lifesciences Corporation | Prosthetic heart valve and delivery apparatus |
US20100100174A1 (en) * | 2008-09-15 | 2010-04-22 | Gurskis Donnell W | Tools, systems, and methods for remodeling tissue |
CN102292053A (zh) | 2008-09-29 | 2011-12-21 | 卡迪尔克阀门技术公司 | 心脏瓣膜 |
CA2739326A1 (en) * | 2008-10-10 | 2010-04-15 | Intervalve, Inc. | Valvuloplasty catheter and methods |
US8147542B2 (en) | 2008-12-22 | 2012-04-03 | Valtech Cardio, Ltd. | Adjustable repair chords and spool mechanism therefor |
US8940044B2 (en) | 2011-06-23 | 2015-01-27 | Valtech Cardio, Ltd. | Closure element for use with an annuloplasty structure |
US10517719B2 (en) | 2008-12-22 | 2019-12-31 | Valtech Cardio, Ltd. | Implantation of repair devices in the heart |
US8545553B2 (en) | 2009-05-04 | 2013-10-01 | Valtech Cardio, Ltd. | Over-wire rotation tool |
US9011530B2 (en) | 2008-12-22 | 2015-04-21 | Valtech Cardio, Ltd. | Partially-adjustable annuloplasty structure |
US8241351B2 (en) | 2008-12-22 | 2012-08-14 | Valtech Cardio, Ltd. | Adjustable partial annuloplasty ring and mechanism therefor |
US8715342B2 (en) | 2009-05-07 | 2014-05-06 | Valtech Cardio, Ltd. | Annuloplasty ring with intra-ring anchoring |
US8926696B2 (en) | 2008-12-22 | 2015-01-06 | Valtech Cardio, Ltd. | Adjustable annuloplasty devices and adjustment mechanisms therefor |
US20100174363A1 (en) * | 2009-01-07 | 2010-07-08 | Endovalve, Inc. | One Piece Prosthetic Valve Support Structure and Related Assemblies |
US20100179565A1 (en) * | 2009-01-13 | 2010-07-15 | Medtronic Vascular, Inc. | Rail for Delivering an Endovascular Stapler |
US8353956B2 (en) | 2009-02-17 | 2013-01-15 | Valtech Cardio, Ltd. | Actively-engageable movement-restriction mechanism for use with an annuloplasty structure |
WO2010106438A2 (en) | 2009-03-17 | 2010-09-23 | Biomedxl | Heart valve prosthesis with collapsible valve and method of delivery thereof |
US8366767B2 (en) | 2009-03-30 | 2013-02-05 | Causper Medical Inc. | Methods and devices for transapical delivery of a sutureless valve prosthesis |
CA2961053C (en) | 2009-04-15 | 2019-04-30 | Edwards Lifesciences Cardiaq Llc | Vascular implant and delivery system |
US9968452B2 (en) | 2009-05-04 | 2018-05-15 | Valtech Cardio, Ltd. | Annuloplasty ring delivery cathethers |
EP2477555B1 (en) | 2009-09-15 | 2013-12-25 | Evalve, Inc. | Device for cardiac valve repair |
WO2011047168A1 (en) | 2009-10-14 | 2011-04-21 | Cardiovascular Technologies, Llc | Percutaneous transvalvular intraannular band for mitral valve repair |
US10098737B2 (en) | 2009-10-29 | 2018-10-16 | Valtech Cardio, Ltd. | Tissue anchor for annuloplasty device |
US9180007B2 (en) | 2009-10-29 | 2015-11-10 | Valtech Cardio, Ltd. | Apparatus and method for guide-wire based advancement of an adjustable implant |
US9011520B2 (en) | 2009-10-29 | 2015-04-21 | Valtech Cardio, Ltd. | Tissue anchor for annuloplasty device |
EP2506777B1 (en) | 2009-12-02 | 2020-11-25 | Valtech Cardio, Ltd. | Combination of spool assembly coupled to a helical anchor and delivery tool for implantation thereof |
US8449599B2 (en) | 2009-12-04 | 2013-05-28 | Edwards Lifesciences Corporation | Prosthetic valve for replacing mitral valve |
KR101231140B1 (ko) * | 2011-08-12 | 2013-02-07 | 부산대학교 산학협력단 | 승모판막 서클라지 시술용 장치 |
US8870950B2 (en) | 2009-12-08 | 2014-10-28 | Mitral Tech Ltd. | Rotation-based anchoring of an implant |
US10058323B2 (en) | 2010-01-22 | 2018-08-28 | 4 Tech Inc. | Tricuspid valve repair using tension |
US8475525B2 (en) | 2010-01-22 | 2013-07-02 | 4Tech Inc. | Tricuspid valve repair using tension |
US9307980B2 (en) | 2010-01-22 | 2016-04-12 | 4Tech Inc. | Tricuspid valve repair using tension |
US8579964B2 (en) | 2010-05-05 | 2013-11-12 | Neovasc Inc. | Transcatheter mitral valve prosthesis |
BR112012029896A2 (pt) | 2010-05-25 | 2017-06-20 | Jenavalve Tech Inc | válcula cardíaca protética para endoprótese e endoprótese |
US8496671B1 (en) | 2010-06-16 | 2013-07-30 | Cardica, Inc. | Mitral valve treatment |
AU2011271007A1 (en) | 2010-06-21 | 2013-01-31 | Cardiaq Valve Technologies, Inc. | Replacement heart valve |
EP4241701A3 (en) | 2010-07-09 | 2023-12-13 | Highlife SAS | Transcatheter atrio-ventricular valve prosthesis |
US11653910B2 (en) | 2010-07-21 | 2023-05-23 | Cardiovalve Ltd. | Helical anchor implantation |
EP2595569A4 (en) | 2010-07-23 | 2016-02-24 | Edwards Lifesciences Corp | RETENTION MECHANISMS FOR VALVULAR PROSTHESES |
US20120053680A1 (en) | 2010-08-24 | 2012-03-01 | Bolling Steven F | Reconfiguring Heart Features |
EP3459500B1 (en) | 2010-09-23 | 2020-09-16 | Edwards Lifesciences CardiAQ LLC | Replacement heart valves and delivery devices |
US9198756B2 (en) | 2010-11-18 | 2015-12-01 | Pavilion Medical Innovations, Llc | Tissue restraining devices and methods of use |
US9289295B2 (en) | 2010-11-18 | 2016-03-22 | Pavilion Medical Innovations, Llc | Tissue restraining devices and methods of use |
CA3035048C (en) | 2010-12-23 | 2021-05-04 | Mark Deem | System for mitral valve repair and replacement |
AU2012204392B2 (en) * | 2011-01-04 | 2015-06-11 | The Cleveland Clinic Foundation | Apparatus and method for treating a regurgitant heart valve |
CN103987341B (zh) * | 2011-01-04 | 2017-02-22 | 克利夫兰临床基金会 | 治疗心脏瓣膜返流的装置和方法 |
EP2478868A1 (en) | 2011-01-25 | 2012-07-25 | The Provost, Fellows, Foundation Scholars, and the other Members of Board, of the College of the Holy and Undivided Trinity of Queen Elizabeth | Implant device |
EP2667824A4 (en) * | 2011-01-25 | 2017-11-01 | Emory University | Devices and methods for surgical and percutaneous repair of heart valve lesions |
US9161749B2 (en) | 2011-04-14 | 2015-10-20 | Neotract, Inc. | Method and apparatus for treating sexual dysfunction |
US9308087B2 (en) | 2011-04-28 | 2016-04-12 | Neovasc Tiara Inc. | Sequentially deployed transcatheter mitral valve prosthesis |
US9554897B2 (en) | 2011-04-28 | 2017-01-31 | Neovasc Tiara Inc. | Methods and apparatus for engaging a valve prosthesis with tissue |
AU2012272855C1 (en) | 2011-06-21 | 2018-04-05 | Twelve, Inc. | Prosthetic heart valve devices and associated systems and methods |
US9918840B2 (en) | 2011-06-23 | 2018-03-20 | Valtech Cardio, Ltd. | Closed band for percutaneous annuloplasty |
US10792152B2 (en) | 2011-06-23 | 2020-10-06 | Valtech Cardio, Ltd. | Closed band for percutaneous annuloplasty |
US9668859B2 (en) | 2011-08-05 | 2017-06-06 | California Institute Of Technology | Percutaneous heart valve delivery systems |
US8945177B2 (en) | 2011-09-13 | 2015-02-03 | Abbott Cardiovascular Systems Inc. | Gripper pusher mechanism for tissue apposition systems |
US9655722B2 (en) | 2011-10-19 | 2017-05-23 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
US9039757B2 (en) | 2011-10-19 | 2015-05-26 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
EP2750630B1 (en) | 2011-10-19 | 2021-06-30 | Twelve, Inc. | Device for heart valve replacement |
US10016271B2 (en) | 2011-10-19 | 2018-07-10 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
US9763780B2 (en) | 2011-10-19 | 2017-09-19 | Twelve, Inc. | Devices, systems and methods for heart valve replacement |
US11202704B2 (en) | 2011-10-19 | 2021-12-21 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
US8858623B2 (en) | 2011-11-04 | 2014-10-14 | Valtech Cardio, Ltd. | Implant having multiple rotational assemblies |
US9724192B2 (en) | 2011-11-08 | 2017-08-08 | Valtech Cardio, Ltd. | Controlled steering functionality for implant-delivery tool |
US9078747B2 (en) | 2011-12-21 | 2015-07-14 | Edwards Lifesciences Corporation | Anchoring device for replacing or repairing a heart valve |
EP2620125B1 (en) | 2012-01-24 | 2017-10-11 | Medtentia International Ltd Oy | An arrangement, a loop-shaped support, a prosthetic heart valve and a method of repairing or replacing a native heart valve |
JP6049761B2 (ja) * | 2012-01-31 | 2016-12-21 | マイトラル・ヴァルヴ・テクノロジーズ・エス・アー・エール・エル | 僧帽弁ドッキングデバイス、システム、および方法 |
EP2811939B8 (en) | 2012-02-10 | 2017-11-15 | CVDevices, LLC | Products made of biological tissues for stents and methods of manufacturing |
US9579198B2 (en) | 2012-03-01 | 2017-02-28 | Twelve, Inc. | Hydraulic delivery systems for prosthetic heart valve devices and associated methods |
US9770332B2 (en) | 2012-03-06 | 2017-09-26 | Highlife Sas | Treatment catheter member with encircling function |
EP2886083B1 (en) | 2012-03-23 | 2018-05-16 | Sorin Group Italia S.r.l. | A collapsible valve prosthesis |
US10292801B2 (en) | 2012-03-29 | 2019-05-21 | Neotract, Inc. | System for delivering anchors for treating incontinence |
US9011515B2 (en) | 2012-04-19 | 2015-04-21 | Caisson Interventional, LLC | Heart valve assembly systems and methods |
US9427315B2 (en) * | 2012-04-19 | 2016-08-30 | Caisson Interventional, LLC | Valve replacement systems and methods |
US9345573B2 (en) | 2012-05-30 | 2016-05-24 | Neovasc Tiara Inc. | Methods and apparatus for loading a prosthesis onto a delivery system |
DE102012010798A1 (de) * | 2012-06-01 | 2013-12-05 | Universität Duisburg-Essen | Implantierbare Vorrichtung zur Verbesserung oder Behebung einer Herzklappeninsuffizienz |
US10130353B2 (en) | 2012-06-29 | 2018-11-20 | Neotract, Inc. | Flexible system for delivering an anchor |
ES2735536T3 (es) | 2012-08-10 | 2019-12-19 | Sorin Group Italia Srl | Una prótesis de válvula y un kit |
US10849755B2 (en) | 2012-09-14 | 2020-12-01 | Boston Scientific Scimed, Inc. | Mitral valve inversion prostheses |
US10543088B2 (en) | 2012-09-14 | 2020-01-28 | Boston Scientific Scimed, Inc. | Mitral valve inversion prostheses |
EP2900150B1 (en) | 2012-09-29 | 2018-04-18 | Mitralign, Inc. | Plication lock delivery system |
US9949828B2 (en) | 2012-10-23 | 2018-04-24 | Valtech Cardio, Ltd. | Controlled steering functionality for implant-delivery tool |
US10376266B2 (en) | 2012-10-23 | 2019-08-13 | Valtech Cardio, Ltd. | Percutaneous tissue anchor techniques |
EP2730252A1 (en) * | 2012-11-07 | 2014-05-14 | Medtentia International Ltd Oy | Medical device for a cardiac valve implant, and a metod of manufacturing the medical device |
WO2014081796A1 (en) | 2012-11-21 | 2014-05-30 | Edwards Lifesciences Corporation | Retaining mechanisms for prosthetic heart valves |
WO2014087402A1 (en) | 2012-12-06 | 2014-06-12 | Valtech Cardio, Ltd. | Techniques for guide-wire based advancement of a tool |
EP2943132B1 (en) | 2013-01-09 | 2018-03-28 | 4Tech Inc. | Soft tissue anchors |
ITRM20130016A1 (it) * | 2013-01-10 | 2014-07-11 | Jacob Zeitani | Dispositivo per plastica della valvola mitrale. |
EP2948103B1 (en) | 2013-01-24 | 2022-12-07 | Cardiovalve Ltd | Ventricularly-anchored prosthetic valves |
US20140228937A1 (en) | 2013-02-11 | 2014-08-14 | Joshua Krieger | Expandable Support Frame and Medical Device |
WO2014134183A1 (en) | 2013-02-26 | 2014-09-04 | Mitralign, Inc. | Devices and methods for percutaneous tricuspid valve repair |
WO2014136056A1 (en) * | 2013-03-04 | 2014-09-12 | Medical Research, Infrastructure And Health Services Fund Of The Tel-Aviv Medical Center | Cardiac valve commissure brace |
US11259923B2 (en) | 2013-03-14 | 2022-03-01 | Jc Medical, Inc. | Methods and devices for delivery of a prosthetic valve |
EP2967931B8 (en) | 2013-03-14 | 2017-04-12 | 4Tech Inc. | Stent with tether interface |
EP2967810B1 (en) | 2013-03-14 | 2020-04-22 | Suzhou Jiecheng Medical Technology Co., Ltd. | Embolic protection devices |
US10449333B2 (en) | 2013-03-14 | 2019-10-22 | Valtech Cardio, Ltd. | Guidewire feeder |
US11406497B2 (en) | 2013-03-14 | 2022-08-09 | Jc Medical, Inc. | Heart valve prosthesis |
US9730791B2 (en) | 2013-03-14 | 2017-08-15 | Edwards Lifesciences Cardiaq Llc | Prosthesis for atraumatically grasping intralumenal tissue and methods of delivery |
US20140277427A1 (en) | 2013-03-14 | 2014-09-18 | Cardiaq Valve Technologies, Inc. | Prosthesis for atraumatically grasping intralumenal tissue and methods of delivery |
AU2014229628B2 (en) * | 2013-03-15 | 2019-02-28 | Fabian Hermann Urban Fuglister | Tongue deformation implant |
US9744037B2 (en) | 2013-03-15 | 2017-08-29 | California Institute Of Technology | Handle mechanism and functionality for repositioning and retrieval of transcatheter heart valves |
CN105283214B (zh) | 2013-03-15 | 2018-10-16 | 北京泰德制药股份有限公司 | 平移导管、系统及其使用方法 |
US9572665B2 (en) | 2013-04-04 | 2017-02-21 | Neovasc Tiara Inc. | Methods and apparatus for delivering a prosthetic valve to a beating heart |
CN108294846A (zh) | 2013-05-20 | 2018-07-20 | 托尔福公司 | 可植入心脏瓣膜装置、二尖瓣修复装置以及相关系统和方法 |
US10524904B2 (en) * | 2013-07-11 | 2020-01-07 | Medtronic, Inc. | Valve positioning device |
US9895219B2 (en) * | 2013-07-31 | 2018-02-20 | Medtronic Vascular Galway | Mitral valve prosthesis for transcatheter valve implantation |
EP2835112B1 (en) | 2013-08-08 | 2021-01-27 | Sorin Group Italia S.r.l. | Heart valve prosthesis |
WO2015028209A1 (en) | 2013-08-30 | 2015-03-05 | Jenavalve Technology Gmbh | Radially collapsible frame for a prosthetic valve and method for manufacturing such a frame |
US10070857B2 (en) | 2013-08-31 | 2018-09-11 | Mitralign, Inc. | Devices and methods for locating and implanting tissue anchors at mitral valve commissure |
US20150094803A1 (en) * | 2013-09-30 | 2015-04-02 | The Cleveland Clinic Foundation | Apparatus and method for treating a regurgitant heart valve |
US10299793B2 (en) | 2013-10-23 | 2019-05-28 | Valtech Cardio, Ltd. | Anchor magazine |
US9050188B2 (en) | 2013-10-23 | 2015-06-09 | Caisson Interventional, LLC | Methods and systems for heart valve therapy |
US10052095B2 (en) | 2013-10-30 | 2018-08-21 | 4Tech Inc. | Multiple anchoring-point tension system |
US10022114B2 (en) | 2013-10-30 | 2018-07-17 | 4Tech Inc. | Percutaneous tether locking |
US9610162B2 (en) | 2013-12-26 | 2017-04-04 | Valtech Cardio, Ltd. | Implantation of flexible implant |
EP3107497B1 (en) | 2014-02-21 | 2020-07-22 | Edwards Lifesciences CardiAQ LLC | Delivery device for controlled deployment of a replacement valve |
US9572666B2 (en) | 2014-03-17 | 2017-02-21 | Evalve, Inc. | Mitral valve fixation device removal devices and methods |
US10390943B2 (en) | 2014-03-17 | 2019-08-27 | Evalve, Inc. | Double orifice device for transcatheter mitral valve replacement |
EP2921140A1 (en) * | 2014-03-18 | 2015-09-23 | St. Jude Medical, Cardiology Division, Inc. | Percutaneous valve anchoring for a prosthetic aortic valve |
CN106456321B (zh) | 2014-05-14 | 2019-08-27 | 索林集团意大利有限责任公司 | 植入设备与植入套件 |
EP3128952A1 (en) | 2014-05-19 | 2017-02-15 | Edwards Lifesciences CardiAQ LLC | Replacement mitral valve with annular flap |
US9974647B2 (en) | 2014-06-12 | 2018-05-22 | Caisson Interventional, LLC | Two stage anchor and mitral valve assembly |
WO2015193728A2 (en) | 2014-06-19 | 2015-12-23 | 4Tech Inc. | Cardiac tissue cinching |
JP2017520375A (ja) * | 2014-07-03 | 2017-07-27 | メドテンティア インターナショナル アェルテーデー オーイューMedtentia International Ltd Oy | 弁輪形成システム |
US9180005B1 (en) | 2014-07-17 | 2015-11-10 | Millipede, Inc. | Adjustable endolumenal mitral valve ring |
EP4331503A2 (en) | 2014-10-14 | 2024-03-06 | Edwards Lifesciences Innovation (Israel) Ltd. | Leaflet-restraining techniques |
FR3027212A1 (fr) * | 2014-10-16 | 2016-04-22 | Seguin Jacques | Implant intervalvulaire pour valve mitrale |
US9750605B2 (en) | 2014-10-23 | 2017-09-05 | Caisson Interventional, LLC | Systems and methods for heart valve therapy |
US9750607B2 (en) | 2014-10-23 | 2017-09-05 | Caisson Interventional, LLC | Systems and methods for heart valve therapy |
EP3284412A1 (en) | 2014-12-02 | 2018-02-21 | 4Tech Inc. | Off-center tissue anchors |
EP3226810A4 (en) | 2014-12-04 | 2018-08-15 | Edwards Lifesciences Corporation | Percutaneous clip for repairing a heart valve |
US10188392B2 (en) | 2014-12-19 | 2019-01-29 | Abbott Cardiovascular Systems, Inc. | Grasping for tissue repair |
CN110141399B (zh) | 2015-02-05 | 2021-07-27 | 卡迪尔维尔福股份有限公司 | 带有轴向滑动框架的人工瓣膜 |
EP3256077B1 (en) | 2015-02-13 | 2024-03-27 | Boston Scientific Scimed, Inc. | Valve replacement using rotational anchors |
US20160256269A1 (en) | 2015-03-05 | 2016-09-08 | Mitralign, Inc. | Devices for treating paravalvular leakage and methods use thereof |
US10524912B2 (en) | 2015-04-02 | 2020-01-07 | Abbott Cardiovascular Systems, Inc. | Tissue fixation devices and methods |
CR20170480A (es) | 2015-04-30 | 2018-02-21 | Valtech Cardio Ltd | Tecnologías de anuloplastía |
US10376363B2 (en) | 2015-04-30 | 2019-08-13 | Edwards Lifesciences Cardiaq Llc | Replacement mitral valve, delivery system for replacement mitral valve and methods of use |
US10709555B2 (en) | 2015-05-01 | 2020-07-14 | Jenavalve Technology, Inc. | Device and method with reduced pacemaker rate in heart valve replacement |
US10517726B2 (en) | 2015-05-14 | 2019-12-31 | Edwards Lifesciences Corporation | Heart valve sealing devices and delivery devices therefor |
WO2016196270A1 (en) | 2015-06-01 | 2016-12-08 | Edwards Lifesciences Corporation | Cardiac valve repair devices configured for percutaneous delivery |
US10376673B2 (en) | 2015-06-19 | 2019-08-13 | Evalve, Inc. | Catheter guiding system and methods |
CA2990872C (en) | 2015-06-22 | 2022-03-22 | Edwards Lifescience Cardiaq Llc | Actively controllable heart valve implant and methods of controlling same |
US10092400B2 (en) | 2015-06-23 | 2018-10-09 | Edwards Lifesciences Cardiaq Llc | Systems and methods for anchoring and sealing a prosthetic heart valve |
US10238494B2 (en) | 2015-06-29 | 2019-03-26 | Evalve, Inc. | Self-aligning radiopaque ring |
US10667815B2 (en) | 2015-07-21 | 2020-06-02 | Evalve, Inc. | Tissue grasping devices and related methods |
US10413408B2 (en) | 2015-08-06 | 2019-09-17 | Evalve, Inc. | Delivery catheter systems, methods, and devices |
CN107920895B (zh) | 2015-08-21 | 2020-06-26 | 托尔福公司 | 可植入心脏瓣膜装置、二尖瓣修复装置以及相关系统和方法 |
US10575951B2 (en) | 2015-08-26 | 2020-03-03 | Edwards Lifesciences Cardiaq Llc | Delivery device and methods of use for transapical delivery of replacement mitral valve |
US10117744B2 (en) | 2015-08-26 | 2018-11-06 | Edwards Lifesciences Cardiaq Llc | Replacement heart valves and methods of delivery |
US10350066B2 (en) | 2015-08-28 | 2019-07-16 | Edwards Lifesciences Cardiaq Llc | Steerable delivery system for replacement mitral valve and methods of use |
US10335275B2 (en) | 2015-09-29 | 2019-07-02 | Millipede, Inc. | Methods for delivery of heart valve devices using intravascular ultrasound imaging |
US10765517B2 (en) | 2015-10-01 | 2020-09-08 | Neochord, Inc. | Ringless web for repair of heart valves |
US10238495B2 (en) | 2015-10-09 | 2019-03-26 | Evalve, Inc. | Delivery catheter handle and methods of use |
CN108289737B (zh) | 2015-11-17 | 2020-03-31 | 魅尔皮德股份有限公司 | 用于使心脏瓣环重新定形的可植入装置和输送系统 |
CN113143539A (zh) | 2015-12-10 | 2021-07-23 | 姆维亚克斯股份有限公司 | 用于使心脏瓣膜环再成形的系统 |
WO2017117370A2 (en) | 2015-12-30 | 2017-07-06 | Mitralign, Inc. | System and method for reducing tricuspid regurgitation |
US10751182B2 (en) | 2015-12-30 | 2020-08-25 | Edwards Lifesciences Corporation | System and method for reshaping right heart |
WO2017117388A1 (en) | 2015-12-30 | 2017-07-06 | Caisson Interventional, LLC | Systems and methods for heart valve therapy |
CN108882981B (zh) | 2016-01-29 | 2021-08-10 | 内奥瓦斯克迪亚拉公司 | 用于防止流出阻塞的假体瓣膜 |
US10531866B2 (en) | 2016-02-16 | 2020-01-14 | Cardiovalve Ltd. | Techniques for providing a replacement valve and transseptal communication |
US10357365B2 (en) * | 2016-03-07 | 2019-07-23 | Serca Biomedical, LLC | Annuloplasty repair devices, systems and methods |
US10799675B2 (en) | 2016-03-21 | 2020-10-13 | Edwards Lifesciences Corporation | Cam controlled multi-direction steerable handles |
US10799676B2 (en) | 2016-03-21 | 2020-10-13 | Edwards Lifesciences Corporation | Multi-direction steerable handles for steering catheters |
US10799677B2 (en) | 2016-03-21 | 2020-10-13 | Edwards Lifesciences Corporation | Multi-direction steerable handles for steering catheters |
US11219746B2 (en) | 2016-03-21 | 2022-01-11 | Edwards Lifesciences Corporation | Multi-direction steerable handles for steering catheters |
US10835714B2 (en) | 2016-03-21 | 2020-11-17 | Edwards Lifesciences Corporation | Multi-direction steerable handles for steering catheters |
CN105726072B (zh) * | 2016-04-14 | 2018-02-27 | 江苏大学 | 一种经心尖植入的二尖瓣气囊闭合板阻塞体及植入方法 |
CN109069272A (zh) | 2016-04-29 | 2018-12-21 | 美敦力瓦斯科尔勒公司 | 具有带系绳的锚定件的假体心脏瓣膜设备以及相关联的系统和方法 |
CN109475419B (zh) | 2016-05-13 | 2021-11-09 | 耶拿阀门科技股份有限公司 | 用于通过引导鞘和装载系统来递送心脏瓣膜假体的心脏瓣膜假体递送系统和方法 |
US20200146854A1 (en) | 2016-05-16 | 2020-05-14 | Elixir Medical Corporation | Methods and devices for heart valve repair |
WO2017198789A1 (en) | 2016-05-20 | 2017-11-23 | Vivasure Medical Limited | Vascular closure device |
US10702274B2 (en) | 2016-05-26 | 2020-07-07 | Edwards Lifesciences Corporation | Method and system for closing left atrial appendage |
US20170354500A1 (en) * | 2016-06-08 | 2017-12-14 | Cook Medical Technologies Llc | Mitral prolapse valve restrictor |
US10736632B2 (en) | 2016-07-06 | 2020-08-11 | Evalve, Inc. | Methods and devices for valve clip excision |
US10973638B2 (en) | 2016-07-07 | 2021-04-13 | Edwards Lifesciences Corporation | Device and method for treating vascular insufficiency |
GB201611910D0 (en) | 2016-07-08 | 2016-08-24 | Valtech Cardio Ltd | Adjustable annuloplasty device with alternating peaks and troughs |
EP3496664B1 (en) | 2016-08-10 | 2021-09-29 | Cardiovalve Ltd | Prosthetic valve with concentric frames |
BR112019005927A2 (pt) * | 2016-09-26 | 2019-06-18 | Innercore Medical Ltd | dispositivo de anuloplastia para reparo de válvula mitral e método de tratamento de insuficiência da válvula mitral |
US11071564B2 (en) | 2016-10-05 | 2021-07-27 | Evalve, Inc. | Cardiac valve cutting device |
CN106618798B (zh) * | 2016-10-24 | 2019-10-11 | 宁波健世生物科技有限公司 | 一种通过室间隔固定的心脏瓣膜假体及其输送和释放方法 |
WO2018077371A1 (en) * | 2016-10-28 | 2018-05-03 | Coramaze Technologies Gmbh | Heart implant |
US10653862B2 (en) | 2016-11-07 | 2020-05-19 | Edwards Lifesciences Corporation | Apparatus for the introduction and manipulation of multiple telescoping catheters |
US10363138B2 (en) | 2016-11-09 | 2019-07-30 | Evalve, Inc. | Devices for adjusting the curvature of cardiac valve structures |
US10398553B2 (en) | 2016-11-11 | 2019-09-03 | Evalve, Inc. | Opposing disk device for grasping cardiac valve tissue |
US10426616B2 (en) | 2016-11-17 | 2019-10-01 | Evalve, Inc. | Cardiac implant delivery system |
EP3541462A4 (en) | 2016-11-21 | 2020-06-17 | Neovasc Tiara Inc. | METHODS AND SYSTEMS FOR RAPID RETRACTION OF A TRANSCATHETER HEART VALVE DELIVERY SYSTEM |
US10779837B2 (en) | 2016-12-08 | 2020-09-22 | Evalve, Inc. | Adjustable arm device for grasping tissues |
US10314586B2 (en) | 2016-12-13 | 2019-06-11 | Evalve, Inc. | Rotatable device and method for fixing tricuspid valve tissue |
EP3558166A4 (en) | 2016-12-22 | 2021-03-31 | Heart Repair Technologies, Inc. | PERCUTICAL ADMINISTRATION SYSTEMS FOR ANCHORING AN IMPLANT IN A VALVE RING |
US10905554B2 (en) | 2017-01-05 | 2021-02-02 | Edwards Lifesciences Corporation | Heart valve coaptation device |
CN110392557A (zh) | 2017-01-27 | 2019-10-29 | 耶拿阀门科技股份有限公司 | 心脏瓣膜模拟 |
US10675017B2 (en) | 2017-02-07 | 2020-06-09 | Edwards Lifesciences Corporation | Transcatheter heart valve leaflet plication |
JP6788746B2 (ja) | 2017-02-10 | 2020-11-25 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | 心臓弁輪を再形成するための埋め込み可能な機器および送達システム |
US10390953B2 (en) | 2017-03-08 | 2019-08-27 | Cardiac Dimensions Pty. Ltd. | Methods and devices for reducing paravalvular leakage |
US11160653B2 (en) * | 2017-03-27 | 2021-11-02 | Truleaf Medicai Ltd. | Docking elements |
US10433961B2 (en) | 2017-04-18 | 2019-10-08 | Twelve, Inc. | Delivery systems with tethers for prosthetic heart valve devices and associated methods |
ES2906137T3 (es) | 2017-04-18 | 2022-04-13 | Edwards Lifesciences Corp | Dispositivos de sellado de válvula cardíaca y dispositivos de suministro para los mismos |
US11224511B2 (en) | 2017-04-18 | 2022-01-18 | Edwards Lifesciences Corporation | Heart valve sealing devices and delivery devices therefor |
US11045627B2 (en) | 2017-04-18 | 2021-06-29 | Edwards Lifesciences Corporation | Catheter system with linear actuation control mechanism |
US10702378B2 (en) | 2017-04-18 | 2020-07-07 | Twelve, Inc. | Prosthetic heart valve device and associated systems and methods |
US10575950B2 (en) | 2017-04-18 | 2020-03-03 | Twelve, Inc. | Hydraulic systems for delivering prosthetic heart valve devices and associated methods |
US10799312B2 (en) | 2017-04-28 | 2020-10-13 | Edwards Lifesciences Corporation | Medical device stabilizing apparatus and method of use |
US10959846B2 (en) | 2017-05-10 | 2021-03-30 | Edwards Lifesciences Corporation | Mitral valve spacer device |
US10792151B2 (en) | 2017-05-11 | 2020-10-06 | Twelve, Inc. | Delivery systems for delivering prosthetic heart valve devices and associated methods |
US10842619B2 (en) | 2017-05-12 | 2020-11-24 | Edwards Lifesciences Corporation | Prosthetic heart valve docking assembly |
US11065119B2 (en) | 2017-05-12 | 2021-07-20 | Evalve, Inc. | Long arm valve repair clip |
US10646338B2 (en) | 2017-06-02 | 2020-05-12 | Twelve, Inc. | Delivery systems with telescoping capsules for deploying prosthetic heart valve devices and associated methods |
US10709591B2 (en) | 2017-06-06 | 2020-07-14 | Twelve, Inc. | Crimping device and method for loading stents and prosthetic heart valves |
US10517598B2 (en) * | 2017-06-07 | 2019-12-31 | Evalve, Inc. | Tissue tensioning device for cardiac valve repair |
US10729541B2 (en) | 2017-07-06 | 2020-08-04 | Twelve, Inc. | Prosthetic heart valve devices and associated systems and methods |
ES2923913T3 (es) | 2017-07-06 | 2022-10-03 | Edwards Lifesciences Corp | Sistema de suministro de carril orientable |
US10786352B2 (en) | 2017-07-06 | 2020-09-29 | Twelve, Inc. | Prosthetic heart valve devices and associated systems and methods |
US11069220B2 (en) | 2017-07-10 | 2021-07-20 | Biovigil Hygiene Technologies, Llc | Hand cleanliness monitoring |
EP3672530A4 (en) | 2017-08-25 | 2021-04-14 | Neovasc Tiara Inc. | SEQUENTIALLY INSERTED TRANSCATHETER MITRAL VALVE PROSTHESIS |
US11051940B2 (en) | 2017-09-07 | 2021-07-06 | Edwards Lifesciences Corporation | Prosthetic spacer device for heart valve |
US11065117B2 (en) | 2017-09-08 | 2021-07-20 | Edwards Lifesciences Corporation | Axisymmetric adjustable device for treating mitral regurgitation |
US11040174B2 (en) | 2017-09-19 | 2021-06-22 | Edwards Lifesciences Corporation | Multi-direction steerable handles for steering catheters |
US10835221B2 (en) | 2017-11-02 | 2020-11-17 | Valtech Cardio, Ltd. | Implant-cinching devices and systems |
US11135062B2 (en) | 2017-11-20 | 2021-10-05 | Valtech Cardio Ltd. | Cinching of dilated heart muscle |
EP3727171B1 (en) | 2017-12-23 | 2023-06-07 | Teleflex Life Sciences Limited | Expandable tissue engagement apparatus |
CN210301304U (zh) | 2018-01-07 | 2020-04-14 | 苏州杰成医疗科技有限公司 | 假体心脏瓣膜输送系统 |
CN210301305U (zh) | 2018-01-07 | 2020-04-14 | 苏州杰成医疗科技有限公司 | 心脏瓣膜假体递送系统 |
EP3964175A1 (en) | 2018-01-09 | 2022-03-09 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10123873B1 (en) | 2018-01-09 | 2018-11-13 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10111751B1 (en) | 2018-01-09 | 2018-10-30 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10136993B1 (en) | 2018-01-09 | 2018-11-27 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10231837B1 (en) | 2018-01-09 | 2019-03-19 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10507109B2 (en) | 2018-01-09 | 2019-12-17 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10076415B1 (en) | 2018-01-09 | 2018-09-18 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10159570B1 (en) | 2018-01-09 | 2018-12-25 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10973639B2 (en) | 2018-01-09 | 2021-04-13 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10105222B1 (en) | 2018-01-09 | 2018-10-23 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10245144B1 (en) | 2018-01-09 | 2019-04-02 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10238493B1 (en) | 2018-01-09 | 2019-03-26 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
EP3743015A1 (en) | 2018-01-24 | 2020-12-02 | Valtech Cardio, Ltd. | Contraction of an annuloplasty structure |
WO2019145941A1 (en) | 2018-01-26 | 2019-08-01 | Valtech Cardio, Ltd. | Techniques for facilitating heart valve tethering and chord replacement |
US11051934B2 (en) | 2018-02-28 | 2021-07-06 | Edwards Lifesciences Corporation | Prosthetic mitral valve with improved anchors and seal |
US11026791B2 (en) | 2018-03-20 | 2021-06-08 | Medtronic Vascular, Inc. | Flexible canopy valve repair systems and methods of use |
US11285003B2 (en) | 2018-03-20 | 2022-03-29 | Medtronic Vascular, Inc. | Prolapse prevention device and methods of use thereof |
US11389297B2 (en) | 2018-04-12 | 2022-07-19 | Edwards Lifesciences Corporation | Mitral valve spacer device |
US11207181B2 (en) | 2018-04-18 | 2021-12-28 | Edwards Lifesciences Corporation | Heart valve sealing devices and delivery devices therefor |
CN112423709A (zh) * | 2018-05-18 | 2021-02-26 | 万能医药公司 | 心脏瓣膜修复的方法和装置 |
CN112437649A (zh) | 2018-05-23 | 2021-03-02 | 索林集团意大利有限责任公司 | 心脏瓣膜假体 |
CR20210020A (es) | 2018-07-12 | 2021-07-21 | Valtech Cardio Ltd | Sistema de anuloplastía y herramientas de bloqueo para ello |
US10945844B2 (en) | 2018-10-10 | 2021-03-16 | Edwards Lifesciences Corporation | Heart valve sealing devices and delivery devices therefor |
JP7260930B2 (ja) | 2018-11-08 | 2023-04-19 | ニオバスク ティアラ インコーポレイテッド | 経カテーテル僧帽弁人工補綴物の心室展開 |
CN113301868A (zh) * | 2018-11-14 | 2021-08-24 | 半月医疗有限公司 | 心脏瓣膜小叶的小叶延伸部 |
JP2022519694A (ja) | 2019-02-06 | 2022-03-24 | インキュベート メディカル テクノロジーズ、 エルエルシー | 心臓内の左心房およびデュアル補助システム |
CN114206264A (zh) | 2019-02-14 | 2022-03-18 | 爱德华兹生命科学公司 | 心脏瓣膜密封装置及其递送装置 |
EP3946163A4 (en) | 2019-04-01 | 2022-12-21 | Neovasc Tiara Inc. | ADJUSTABLE VALVE PROSTHESIS |
CN113924065A (zh) | 2019-04-10 | 2022-01-11 | 内奥瓦斯克迪亚拉公司 | 具有自然血流的假体瓣膜 |
EP3972673A4 (en) | 2019-05-20 | 2023-06-07 | Neovasc Tiara Inc. | INTRODUCER DEVICE WITH HEMOSTASIS MECHANISM |
WO2020257643A1 (en) | 2019-06-20 | 2020-12-24 | Neovasc Tiara Inc. | Low profile prosthetic mitral valve |
KR20220122966A (ko) | 2019-10-29 | 2022-09-05 | 에드워즈 라이프사이언시스 이노베이션 (이스라엘) 리미티드 | 고리 성형술 및 조직 앵커 기술 |
AU2021320088B2 (en) | 2020-08-03 | 2022-06-23 | Teleflex Life Sciences Llc | Handle and cartridge system for medical interventions |
JP2023554000A (ja) | 2020-12-14 | 2023-12-26 | カーディアック・ディメンションズ・プロプライエタリー・リミテッド | モジュール式事前装填型医療用インプラント及び送達システム |
Family Cites Families (72)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US191528A (en) * | 1877-06-05 | Improvement in check-row attachments to seed-planters | ||
US4491986A (en) * | 1976-05-12 | 1985-01-08 | Shlomo Gabbay | Heart valve |
US4056854A (en) * | 1976-09-28 | 1977-11-08 | The United States Of America As Represented By The Department Of Health, Education And Welfare | Aortic heart valve catheter |
US4275469A (en) * | 1979-12-13 | 1981-06-30 | Shelhigh Inc. | Prosthetic heart valve |
US4994069A (en) * | 1988-11-02 | 1991-02-19 | Target Therapeutics | Vaso-occlusion coil and method |
JPH05184611A (ja) * | 1991-03-19 | 1993-07-27 | Kenji Kusuhara | 弁輪支持器具及びその取り付け方法 |
US5792155A (en) * | 1991-07-16 | 1998-08-11 | Van Cleef; Jean-Francois | Process for partially or totally flattening a vein |
US5370685A (en) * | 1991-07-16 | 1994-12-06 | Stanford Surgical Technologies, Inc. | Endovascular aortic valve replacement |
US5545241B1 (en) * | 1995-01-17 | 1999-09-28 | Donaldson Co Inc | Air cleaner |
US5830224A (en) * | 1996-03-15 | 1998-11-03 | Beth Israel Deaconess Medical Center | Catheter apparatus and methodology for generating a fistula on-demand between closely associated blood vessels at a pre-chosen anatomic site in-vivo |
US5855601A (en) * | 1996-06-21 | 1999-01-05 | The Trustees Of Columbia University In The City Of New York | Artificial heart valve and method and device for implanting the same |
US5716397A (en) * | 1996-12-06 | 1998-02-10 | Medtronic, Inc. | Annuloplasty device with removable stiffening element |
EP0850607A1 (en) * | 1996-12-31 | 1998-07-01 | Cordis Corporation | Valve prosthesis for implantation in body channels |
US5961440A (en) * | 1997-01-02 | 1999-10-05 | Myocor, Inc. | Heart wall tension reduction apparatus and method |
US6045497A (en) * | 1997-01-02 | 2000-04-04 | Myocor, Inc. | Heart wall tension reduction apparatus and method |
US6077214A (en) * | 1998-07-29 | 2000-06-20 | Myocor, Inc. | Stress reduction apparatus and method |
US6183411B1 (en) * | 1998-09-21 | 2001-02-06 | Myocor, Inc. | External stress reduction device and method |
US6050936A (en) * | 1997-01-02 | 2000-04-18 | Myocor, Inc. | Heart wall tension reduction apparatus |
US5776189A (en) * | 1997-03-05 | 1998-07-07 | Khalid; Naqeeb | Cardiac valvular support prosthesis |
US6332893B1 (en) * | 1997-12-17 | 2001-12-25 | Myocor, Inc. | Valve to myocardium tension members device and method |
EP0941791B1 (en) * | 1998-03-09 | 2004-06-16 | De Beers Industrial Diamonds (Proprietary) Limited | Abrasive body |
US7452371B2 (en) * | 1999-06-02 | 2008-11-18 | Cook Incorporated | Implantable vascular device |
US6260552B1 (en) * | 1998-07-29 | 2001-07-17 | Myocor, Inc. | Transventricular implant tools and devices |
US6102932A (en) * | 1998-12-15 | 2000-08-15 | Micrus Corporation | Intravascular device push wire delivery system |
DE60037309T2 (de) * | 1999-01-26 | 2008-11-27 | Edwards Lifesciences Corp., Irvine | Flexible herzklappe |
ATE484241T1 (de) * | 1999-04-09 | 2010-10-15 | Evalve Inc | Verfahren und vorrichtung zur herzklappenreperation |
US6312464B1 (en) * | 1999-04-28 | 2001-11-06 | NAVIA JOSé L. | Method of implanting a stentless cardiac valve prosthesis |
US6287339B1 (en) * | 1999-05-27 | 2001-09-11 | Sulzer Carbomedics Inc. | Sutureless heart valve prosthesis |
US6626899B2 (en) * | 1999-06-25 | 2003-09-30 | Nidus Medical, Llc | Apparatus and methods for treating tissue |
SE514718C2 (sv) * | 1999-06-29 | 2001-04-09 | Jan Otto Solem | Anordning för behandling av bristande tillslutningsförmåga hos mitralisklaffapparaten |
US6312465B1 (en) * | 1999-07-23 | 2001-11-06 | Sulzer Carbomedics Inc. | Heart valve prosthesis with a resiliently deformable retaining member |
US6299637B1 (en) * | 1999-08-20 | 2001-10-09 | Samuel M. Shaolian | Transluminally implantable venous valve |
US6440164B1 (en) * | 1999-10-21 | 2002-08-27 | Scimed Life Systems, Inc. | Implantable prosthetic valve |
US6458153B1 (en) * | 1999-12-31 | 2002-10-01 | Abps Venture One, Ltd. | Endoluminal cardiac and venous valve prostheses and methods of manufacture and delivery thereof |
US6402781B1 (en) * | 2000-01-31 | 2002-06-11 | Mitralife | Percutaneous mitral annuloplasty and cardiac reinforcement |
US6797002B2 (en) * | 2000-02-02 | 2004-09-28 | Paul A. Spence | Heart valve repair apparatus and methods |
US6821297B2 (en) * | 2000-02-02 | 2004-11-23 | Robert V. Snyders | Artificial heart valve, implantation instrument and method therefor |
US6537198B1 (en) * | 2000-03-21 | 2003-03-25 | Myocor, Inc. | Splint assembly for improving cardiac function in hearts, and method for implanting the splint assembly |
US6454799B1 (en) * | 2000-04-06 | 2002-09-24 | Edwards Lifesciences Corporation | Minimally-invasive heart valves and methods of use |
US6652583B2 (en) * | 2000-04-07 | 2003-11-25 | Rhode Island Hospital | Cardiac valve replacement |
US6419695B1 (en) * | 2000-05-22 | 2002-07-16 | Shlomo Gabbay | Cardiac prosthesis for helping improve operation of a heart valve |
US6805711B2 (en) * | 2000-06-02 | 2004-10-19 | 3F Therapeutics, Inc. | Expandable medical implant and percutaneous delivery |
EP1330189B1 (en) * | 2000-06-23 | 2007-12-19 | Viacor Incorporated | Automated annular plication for mitral valve repair |
US6419696B1 (en) * | 2000-07-06 | 2002-07-16 | Paul A. Spence | Annuloplasty devices and related heart valve repair methods |
US7510572B2 (en) * | 2000-09-12 | 2009-03-31 | Shlomo Gabbay | Implantation system for delivery of a heart valve prosthesis |
US6893459B1 (en) * | 2000-09-20 | 2005-05-17 | Ample Medical, Inc. | Heart valve annulus device and method of using same |
WO2004030568A2 (en) * | 2002-10-01 | 2004-04-15 | Ample Medical, Inc. | Device and method for repairing a native heart valve leaflet |
US7527646B2 (en) * | 2000-09-20 | 2009-05-05 | Ample Medical, Inc. | Devices, systems, and methods for retaining a native heart valve leaflet |
US6602288B1 (en) * | 2000-10-05 | 2003-08-05 | Edwards Lifesciences Corporation | Minimally-invasive annuloplasty repair segment delivery template, system and method of use |
US6616684B1 (en) * | 2000-10-06 | 2003-09-09 | Myocor, Inc. | Endovascular splinting devices and methods |
US6723038B1 (en) * | 2000-10-06 | 2004-04-20 | Myocor, Inc. | Methods and devices for improving mitral valve function |
US6913608B2 (en) * | 2000-10-23 | 2005-07-05 | Viacor, Inc. | Automated annular plication for mitral valve repair |
US7070618B2 (en) * | 2000-10-25 | 2006-07-04 | Viacor, Inc. | Mitral shield |
US6696074B2 (en) * | 2000-12-04 | 2004-02-24 | Tei Biosciences, Inc. | Processing fetal or neo-natal tissue to produce a scaffold for tissue engineering |
US6338470B1 (en) * | 2000-12-05 | 2002-01-15 | Kevin L. Steely | Powered lift for raising a two-wheeled vehicle |
WO2002062408A2 (en) * | 2001-02-05 | 2002-08-15 | Viacor, Inc. | Method and apparatus for improving mitral valve function |
US6955689B2 (en) * | 2001-03-15 | 2005-10-18 | Medtronic, Inc. | Annuloplasty band and method |
US6503272B2 (en) * | 2001-03-21 | 2003-01-07 | Cordis Corporation | Stent-based venous valves |
US6733525B2 (en) * | 2001-03-23 | 2004-05-11 | Edwards Lifesciences Corporation | Rolled minimally-invasive heart valves and methods of use |
EP1434542A2 (en) * | 2001-10-01 | 2004-07-07 | Ample Medical, Inc. | Methods and devices for heart valve treatments |
US20030120340A1 (en) * | 2001-12-26 | 2003-06-26 | Jan Liska | Mitral and tricuspid valve repair |
US6764510B2 (en) * | 2002-01-09 | 2004-07-20 | Myocor, Inc. | Devices and methods for heart valve treatment |
US6676699B2 (en) * | 2002-04-26 | 2004-01-13 | Medtronic Ave, Inc | Stent graft with integrated valve device and method |
US20030233022A1 (en) * | 2002-06-12 | 2003-12-18 | Vidlund Robert M. | Devices and methods for heart valve treatment |
EP1562522B1 (en) * | 2002-10-01 | 2008-12-31 | Ample Medical, Inc. | Devices and systems for reshaping a heart valve annulus |
US7112219B2 (en) * | 2002-11-12 | 2006-09-26 | Myocor, Inc. | Devices and methods for heart valve treatment |
US6945978B1 (en) * | 2002-11-15 | 2005-09-20 | Advanced Cardiovascular Systems, Inc. | Heart valve catheter |
US8052751B2 (en) * | 2003-07-02 | 2011-11-08 | Flexcor, Inc. | Annuloplasty rings for repairing cardiac valves |
US7004176B2 (en) * | 2003-10-17 | 2006-02-28 | Edwards Lifesciences Ag | Heart valve leaflet locator |
CA2597066C (en) * | 2005-02-07 | 2014-04-15 | Evalve, Inc. | Methods, systems and devices for cardiac valve repair |
SE531468C2 (sv) * | 2005-04-21 | 2009-04-14 | Edwards Lifesciences Ag | En anordning för styrning av blodflöde |
EP2583640B1 (en) * | 2006-02-16 | 2022-06-22 | Venus MedTech (HangZhou), Inc. | Minimally invasive replacement heart valve |
-
2003
- 2003-10-01 EP EP03799343A patent/EP1562522B1/en not_active Expired - Lifetime
- 2003-10-01 CA CA002498030A patent/CA2498030A1/en not_active Abandoned
- 2003-10-01 AT AT03799343T patent/ATE418938T1/de not_active IP Right Cessation
- 2003-10-01 JP JP2004541902A patent/JP2006501033A/ja active Pending
- 2003-10-01 CN CNB2003801008335A patent/CN100553590C/zh not_active Expired - Fee Related
- 2003-10-01 US US10/677,104 patent/US20060106456A9/en not_active Abandoned
- 2003-10-01 WO PCT/US2003/030831 patent/WO2004030569A2/en active Application Filing
- 2003-10-01 AU AU2003277116A patent/AU2003277116A1/en not_active Abandoned
- 2003-10-01 DE DE60325634T patent/DE60325634D1/de not_active Expired - Lifetime
-
2006
- 2006-02-17 HK HK06102076.7A patent/HK1082175A1/xx not_active IP Right Cessation
-
2009
- 2009-08-07 AU AU2009208049A patent/AU2009208049A1/en not_active Abandoned
- 2009-08-12 US US12/462,956 patent/US9861475B2/en active Active
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CA2498030A1 (en) | 2004-04-15 |
EP1562522A2 (en) | 2005-08-17 |
JP2006501033A (ja) | 2006-01-12 |
AU2003277116A1 (en) | 2004-04-23 |
US20040127982A1 (en) | 2004-07-01 |
US9861475B2 (en) | 2018-01-09 |
US20060106456A9 (en) | 2006-05-18 |
WO2004030569A3 (en) | 2004-12-29 |
EP1562522A4 (en) | 2007-02-28 |
EP1562522B1 (en) | 2008-12-31 |
AU2009208049A1 (en) | 2009-08-27 |
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