DE4114826A1 - Opening flap of heart valve - involves wire which is guided by ultrasonic probe - Google Patents

Opening flap of heart valve - involves wire which is guided by ultrasonic probe

Info

Publication number
DE4114826A1
DE4114826A1 DE4114826A DE4114826A DE4114826A1 DE 4114826 A1 DE4114826 A1 DE 4114826A1 DE 4114826 A DE4114826 A DE 4114826A DE 4114826 A DE4114826 A DE 4114826A DE 4114826 A1 DE4114826 A1 DE 4114826A1
Authority
DE
Germany
Prior art keywords
heart valve
ultrasonic probe
guided
wire
opening flap
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
DE4114826A
Other languages
German (de)
Inventor
Eckart Dr Miche
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to DE4114826A priority Critical patent/DE4114826A1/en
Publication of DE4114826A1 publication Critical patent/DE4114826A1/en
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/32056—Surgical snare instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22001—Angioplasty, e.g. PCTA
    • A61B2017/22002—Angioplasty, e.g. PCTA preventing restenosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22097—Valve removal in veins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
    • A61B2090/3782—Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument

Abstract

The method is for opening the flap of a heart valve, which avoids the risk of tearing the flap. The method involves the use of a cathether which is inserted into a blood vessel through the patient's skin. The catheter inserts a balloon (1) which is filled with a contrast medium. An ultrasonic probe (2) is then inserted and is used to guide a wire to the heart valve. The wire is manipulated to open the heart valve and then withdrawn. USE - Heart surgery.

Description

1. Ziel des Systems1. Aim of the system

Durch gezielte Plazierung eines Schneidesystems mit Hilfe einer Ultraschallsonde werden bei Patienten mit Mitralstenose die Kommissuren der Mitralklappe getrennt, um eine Vergrößerung der Klappenöffnungsfläche zu erreichen.By placing a cutting system with the help of an ultrasound probe Patients with mitral stenosis separated the commissures of the mitral valve to enlarge the To reach the flap opening area.

2. Vorteile gegenüber bisheriger Systeme in Doppelballon- oder Einzelballontechnik2. Advantages over previous systems in double balloon or single balloon technology

Unkontrolliertes Einreißen der Kommissuren und der Mitralsegel mit daraus resultierender Mitralinsuffizienz werden vermieden. Restenosierungen infolge alleiniger Dehnung des Klappenringes treten nicht auf.Uncontrolled tearing of the commissures and the mitral sail with the resultant Mitral regurgitation is avoided. Residual doses due to the sole stretching of the Flap ring do not occur.

3. Vorgehen3. Procedure

  • a) Übliches transvenöses, transseptales Vorgehen bis zur Mitralklappe.a) Usual transvenous, transseptal procedure up to the mitral valve.
  • b) Mit Hilfe des Führungsdrahtes wird der Katheter mit seinem Ballonanteil bis in den linken Ventrikel vorgeschoben.
    Nach Füllen des Ballons mit Kontrastmittels Fixierung im Mitralklappenring.    b) With the help of the guide wire, the catheter with its balloon portion is advanced into the left ventricle.
    After filling the balloon with contrast medium, fixation in the mitral valve ring.
  • c) Nach Einführen der Ultraschallsonde werden die Kommissuren der Mitralklappe dargestellt.c) After insertion of the ultrasound probe, the commissures of the mitral valve are shown.
  • d) Durch eine Markierung an der Ultraschallsonde ist das gezielte Positionieren des Schneidesystems hinter der Mitralklappe an der Kommissur möglich.d) A marking on the ultrasound probe enables the targeted positioning of the Cutting system behind the mitral valve on the commissure possible.
  • e) Durch Herausfahren des Haltedrahtes wird die spätere Schnittgröße bestimmt. Der Schnitt wird durch Zug am Schneidedraht durchgeführt.e) The later cutting size is determined by pulling out the holding wire. The cut will performed by pulling on the cutting wire.
  • f) Alternativ ist der Schnitt durch ein Messer- oder Thermosystem denkbar.f) Alternatively, a cut through a knife or thermal system is conceivable.
  • g) Kontrolle des Ergebnisses durch Ultraschall, evtl. auch mit Dopplermessung.g) Control of the result by ultrasound, possibly also with Doppler measurement.
4. Kathetersystem4. Catheter system

9 French Kathetersystem mit 4 Kanälen9 French catheter system with 4 channels

  • a) Instrumentierkanala) Instrument channel
  • b) Kanal für Ultraschallsondeb) Channel for ultrasound probe
  • c) Kanal für den Führungsdraht und Kontrastmittelc) Channel for the guidewire and contrast medium
  • d) Kanal zum Ballonsystem
    12,5 Mhz Ultraschallsonde    d) Channel to the balloon system
    12.5 Mhz ultrasonic probe

Claims (1)

Oberbegriff: 1. Perkutanes System zur Mitralklappensprengung
Kennzeichnender Teil: dadurch gekennzeichnet, daß ein ultraschallgesteuertes Schneidesystem die Mitralklappe an den Kommissuren eröffnet.General term: 1. Percutaneous system for detonating the mitral valve
Characteristic part: characterized in that an ultrasound-controlled cutting system opens the mitral valve on the commissures.
DE4114826A 1991-05-07 1991-05-07 Opening flap of heart valve - involves wire which is guided by ultrasonic probe Withdrawn DE4114826A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
DE4114826A DE4114826A1 (en) 1991-05-07 1991-05-07 Opening flap of heart valve - involves wire which is guided by ultrasonic probe

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DE4114826A DE4114826A1 (en) 1991-05-07 1991-05-07 Opening flap of heart valve - involves wire which is guided by ultrasonic probe

Publications (1)

Publication Number Publication Date
DE4114826A1 true DE4114826A1 (en) 1991-12-05

Family

ID=6431125

Family Applications (1)

Application Number Title Priority Date Filing Date
DE4114826A Withdrawn DE4114826A1 (en) 1991-05-07 1991-05-07 Opening flap of heart valve - involves wire which is guided by ultrasonic probe

Country Status (1)

Country Link
DE (1) DE4114826A1 (en)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994001047A1 (en) * 1992-07-10 1994-01-20 Baxter International Inc. Ultrasonic angioplasty and ablative devices for treating vasospasm
US5380274A (en) * 1991-01-11 1995-01-10 Baxter International Inc. Ultrasound transmission member having improved longitudinal transmission properties
US5382228A (en) * 1992-07-09 1995-01-17 Baxter International Inc. Method and device for connecting ultrasound transmission member (S) to an ultrasound generating device
US5390678A (en) * 1993-10-12 1995-02-21 Baxter International Inc. Method and device for measuring ultrasonic activity in an ultrasound delivery system
US5405318A (en) * 1992-05-05 1995-04-11 Baxter International Inc. Ultra-sound catheter for removing obstructions from tubular anatomical structures such as blood vessels
EP0835075A1 (en) * 1995-06-30 1998-04-15 Boston Scientific Corporation Ultrasound imaging catheter with a cutting element
US6929632B2 (en) 1991-01-11 2005-08-16 Advanced Cardiovascular Systems, Inc. Ultrasonic devices and methods for ablating and removing obstructive matter from anatomical passageways and blood vessels

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0291170A1 (en) * 1987-04-17 1988-11-17 EASTMAN KODAK COMPANY (a New Jersey corporation) Rearwardly acting surgical catheter
SU1438745A1 (en) * 1986-12-24 1988-11-23 Всесоюзный научно-исследовательский и испытательный институт медицинской техники Ultrasonic surgical instrument
EP0321132A2 (en) * 1987-12-14 1989-06-21 BAXTER INTERNATIONAL INC. (a Delaware corporation) Optical valvulotome
DE3803697A1 (en) * 1988-02-08 1989-08-17 Wolfgang Arno Karl Dr Radtke LASER - VALVOTOMY - CATHETER (HEART CATHETER FOR PERCUTANICALLY TARGETED VALVOTOMY OF NARROWED HEART VALVES)
WO1990007909A1 (en) * 1989-01-18 1990-07-26 Applied Urology, Inc. Dilatation catheter assembly with cutting element
WO1990011722A1 (en) * 1989-04-04 1990-10-18 Intra-Sonix, Inc. Apparatus for positioning and stabilizing a catheter
WO1991001687A1 (en) * 1989-07-31 1991-02-21 Israel Barken Ultrasound-laser surgery apparatus and method

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU1438745A1 (en) * 1986-12-24 1988-11-23 Всесоюзный научно-исследовательский и испытательный институт медицинской техники Ultrasonic surgical instrument
EP0291170A1 (en) * 1987-04-17 1988-11-17 EASTMAN KODAK COMPANY (a New Jersey corporation) Rearwardly acting surgical catheter
EP0321132A2 (en) * 1987-12-14 1989-06-21 BAXTER INTERNATIONAL INC. (a Delaware corporation) Optical valvulotome
DE3803697A1 (en) * 1988-02-08 1989-08-17 Wolfgang Arno Karl Dr Radtke LASER - VALVOTOMY - CATHETER (HEART CATHETER FOR PERCUTANICALLY TARGETED VALVOTOMY OF NARROWED HEART VALVES)
WO1990007909A1 (en) * 1989-01-18 1990-07-26 Applied Urology, Inc. Dilatation catheter assembly with cutting element
WO1990011722A1 (en) * 1989-04-04 1990-10-18 Intra-Sonix, Inc. Apparatus for positioning and stabilizing a catheter
WO1991001687A1 (en) * 1989-07-31 1991-02-21 Israel Barken Ultrasound-laser surgery apparatus and method

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
De-Z: WERNER, G.S. *
u.a.: Intravaskuläre Ultra- schalldiagnostik. In: Deutsche medizinische Wochenschrift, 115, 1990, S.1259-1265 *

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5380274A (en) * 1991-01-11 1995-01-10 Baxter International Inc. Ultrasound transmission member having improved longitudinal transmission properties
US6929632B2 (en) 1991-01-11 2005-08-16 Advanced Cardiovascular Systems, Inc. Ultrasonic devices and methods for ablating and removing obstructive matter from anatomical passageways and blood vessels
US5405318A (en) * 1992-05-05 1995-04-11 Baxter International Inc. Ultra-sound catheter for removing obstructions from tubular anatomical structures such as blood vessels
US5382228A (en) * 1992-07-09 1995-01-17 Baxter International Inc. Method and device for connecting ultrasound transmission member (S) to an ultrasound generating device
WO1994001047A1 (en) * 1992-07-10 1994-01-20 Baxter International Inc. Ultrasonic angioplasty and ablative devices for treating vasospasm
US5390678A (en) * 1993-10-12 1995-02-21 Baxter International Inc. Method and device for measuring ultrasonic activity in an ultrasound delivery system
EP0835075A1 (en) * 1995-06-30 1998-04-15 Boston Scientific Corporation Ultrasound imaging catheter with a cutting element
EP0835075A4 (en) * 1995-06-30 1999-06-23 Boston Scient Corp Ultrasound imaging catheter with a cutting element

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Legal Events

Date Code Title Description
OAV Applicant agreed to the publication of the unexamined application as to paragraph 31 lit. 2 z1
8122 Nonbinding interest in granting licences declared
8101 Request for examination as to novelty
8105 Search report available
8141 Disposal/no request for examination