[go: up one dir, main page]

WO1998032401A1 - Anneau pour annuloplastie - Google Patents

Anneau pour annuloplastie Download PDF

Info

Publication number
WO1998032401A1
WO1998032401A1 PCT/US1998/000922 US9800922W WO9832401A1 WO 1998032401 A1 WO1998032401 A1 WO 1998032401A1 US 9800922 W US9800922 W US 9800922W WO 9832401 A1 WO9832401 A1 WO 9832401A1
Authority
WO
WIPO (PCT)
Prior art keywords
prosthesis
annulus
mpa
annuloplasty ring
annuloplasty
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.)
Ceased
Application number
PCT/US1998/000922
Other languages
English (en)
Inventor
George N. Foutrakis
Pete L. Villalpando
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.)
WL Gore and Associates Inc
Original Assignee
WL Gore and Associates Inc
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 WL Gore and Associates Inc filed Critical WL Gore and Associates Inc
Priority to AU59614/98A priority Critical patent/AU5961498A/en
Publication of WO1998032401A1 publication Critical patent/WO1998032401A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2445—Annuloplasty rings in direct contact with the valve annulus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2466—Delivery devices therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2496—Devices for determining the dimensions of the prosthetic valve to be implanted, e.g. templates, sizers

Definitions

  • the present invention relates to heart valve repair devices, their manufacture and use to restore a dilated heart valve annulus More specifically the present invention relates to a thin, flexible, high strength, biocompatible prosthesis used to repair and maintain the corrected heart valve annulus size and shape, and a holding and delivery device for the prosthesis
  • the annulus of a living heart valve is the semi-rigid circumference or ring of tissue surrounding and supporting the valve leaflets In some instances, the annulus becomes abnormally expanded or dilated with the result that the valve leaflets can no longer contact each other and close properly (valve incompetence)
  • the blood flow through the valve regurgitates back flows), raising the normal chamber pressures in the heart
  • mitral valve regurgitation allows blood to flow back into the left atrium during systole
  • the left at ⁇ al pressure may then rise, causing raised pulmonary pressures and pulmonary edema (excess interstitial fluid build up)
  • the higher systemic pressures require a higher workload on the heart Chronic or continued mitral valve regurgitation may result in congestive heart failure
  • annuloplasty To correct a dilated valve annulus, surgical procedures referred to as annuloplasty are performed, which return the expanded circumference of the annulus back to a smaller circumference
  • annuloplasty By reducing the annular circumference, the valve leaflets are able to fully contact each other, thereby allowing the valve to function properly and eliminating valvular regurgitation
  • a common surgical repair procedure involves forcing the dilated annulus into a smaller circumference, and while in this reduced diameter state, suturing a support ring onto the natural annulus The support ring thereby constrains the annulus to the reduced circumference state, and also helps prevent long term re-dilatation of the natural annulus
  • These support structures, or prostheses normally remain in the heart as a long term, permanent implant
  • Two such support devices include those taught by U S Patent No 5,061 ,277 to Carpentier and U S Patent No 5,104,407 to Lam Carpentier describes a planar, flexible valvular support ring, its use and method of assembly.
  • the support ring is comprised of a flexible support section combined with a semi- rigid section.
  • the flexible ring section allows the natural valve annulus to contract with the normal contraction of the heart, while the semi-rigid or stiffer section provides long term rigidity to reduce future dilation of the natural annulus.
  • the flexible and semi-rigid portions of the prosthesis are aligned to the stiff and flexible sections of the natural annulus.
  • the Carpentier support ring is of a substantially circular cross section and is comprised of an assembly of metallic and biocompatible polymer elements. The flexible and semi-rigid features of the support ring result from the varying cross sections and stiffness of the metallic elements.
  • the Lam patent also describes a semi-flexible valvular support ring, comprised of flexible and rigid metallic sections, covered with a biocompatible polymer sheath. To more accurately conform to the natural anatomy, the Lam device is curved or non-planar.
  • Another drawback pertaining to these prior art devices is the large, usually circular cross section.
  • the large cross section further inhibits the conformity of the prosthesis to the natural annulus.
  • the large high profile of the device can also interfere with the natural flow of blood and increase the level of turbulence around the valve. Increased turbulence can cause additional thrombus formation, increasing the danger of stroke or damage to organs.
  • a further drawback to both of these prior art devices is their inability to be axially compressed.
  • the annulus circumference is decreased as the heart contracts.
  • the support ring used to repair the dilated annulus should therefore have the ability to be compressed axially along with the natural annulus. Due to their metallic elements and large cross sectional areas, the devices taught by Carpentier and Lam must bend out of their natural plane during compression, which further increases the stress on the natural annulus and device and restricts the natural motion of the annulus.
  • the annulus with the plurality of metallic support segments must be covered with a biocompatible sheath such as pericardium, which requires additional time to harvest, cut to size and suture into place.
  • a biocompatible sheath such as pericardium
  • the risk of blood contact exposure to the metallic elements is present if the protective sheath is damaged or improperly placed.
  • the suture spacing in the support device is limited to the predetermined hole spacing, limiting the surgeon's flexibility in determining the suture spacing.
  • the valve annulus is not axially compressible under the structure, which increases the stress on the annulus and sutures during natural contraction of the heart.
  • Chang, et al. (Long-Term Results of Polytetrafluoroethylene Mitral Annuloplasty, Ann Thorac Su , 1994; 57:644-647), describe a procedure using an ePTFE vascular graft for the repair of dilated valve annulus.
  • an ePTFE graft is tailored to length and sutured to the dilated annulus, using a plurality of suture pairs. Upon drawing up or tightening of the suture the annulus is pinched or compressed, thus reducing the circumference of the dilated annulus affecting repair of the valve.
  • the disadvantages of this procedure include the irregular surface resulting from the kinking of the graft during the tightening of the suture, the relatively large profile of the flattened graft, the resistance to axial compression and the unfilled lumen or inner diameter of the graft.
  • U.S. Patent 5,450,860 to O'Connor teaches the use of an ePTFE ligament for the plication of tissue, or for the repair of an dilated annulus.
  • This device is essentially a thick suture which can be threaded through an annulus in a purse string configuration. Once threaded through the annulus, one end of the ligament is secured to the annulus with an additional suture. The second end of the ligament is then drawn tight, reducing the circumference of the annulus. This second end is then secured to the annulus with an additional suture, completing the annulus repair.
  • the ligament can also be threaded completely subcutaneously or completely within the annulus, leaving only the two ends exposed.
  • Drawbacks to this device include the relatively low tensile strength of the device, the inability to perform the "parachute" repair procedure and the damage to the annulus caused by passing a large ligament through the tissue.
  • a heart valve annulus repair prosthesis that eliminates the metallic elements, is flexible and conformable to the natural annulus, is axially compressible, has good axial tensile strength, is resistant to creep, has a minimal transverse cross section allowing a low profile, and is highly biocompatible and easy to manufacture.
  • the present invention can meet these needs.
  • other major components of the present invention include a prosthesis holder, a family of valve sizers and a detachable handle capable of engaging both the prosthesis holder and the sizers.
  • a common annulus repair procedure involves the "parachute" technique. This procedure involves passing both ends of a single suture through the natural annulus, taking a relatively large bite or large gap between the needle penetration points. The two ends of this same suture are then passed through the prosthesis, taking a smaller bite than that of the natural annulus. The prosthesis is normally held away from the natural valve annulus during this procedure to allow easy access to the natural annulus and the prosthesis. The prosthesis must be properly aligned to the natural annulus during this procedure. This suturing pattern is repeated using additional sutures, resulting in several suture "pairs" spaced around the enlarged natural annulus.
  • the prosthesis is then lowered or parachuted down against the natural annulus.
  • the annulus is forced to compress or pinch up between the suture points.
  • the annulus compression is caused by the large suture bites in the natural tissue and the smaller bites in the prosthesis. After all the suture pairs are secured, the result is a reduced annular circumference with an attached prosthesis.
  • Another common surgical repair procedure involves placing the prosthesis directly against the enlarged annulus and passing a single continuous suture through both the annulus and the prosthesis, in a "purse string" fashion.
  • the suture is drawn tight, the annulus is forced into a reduced circumference state.
  • the suture is secured, the result is a repaired or smaller annulus with an attached prosthesis.
  • Both of these repair procedures require the use of a "sizer" to approximate and select the proper size of the prosthesis to be used. Progressively larger or smaller sizers are positioned over the natural annulus until the optimum size of the prosthesis is determined.
  • the holding device should allow remote positioning, that is, be held by a surgical assistant so as not to interfere with the suturing procedure.
  • the holding device should be easily detachable from the prosthesis.
  • the Cosgrove patent describes a holding device for use with a fixed circumference annuloplasty ring.
  • the Myers patent describes a device for use with the DURANTM Flexible Annuloplasty Ring (Medtronic, Inc., Minneapolis MN).
  • the Wright patent describes a device for use with an adjustable drawstring annuloplasty ring. All of these prior art devices have numerous drawbacks particularly in that they rely on sutures to secure the prosthesis to the holder. To allow separation of the prosthesis and removal of the holder, this holding suture must be cut and fully retrieved from the heart during the surgical procedure. All of these devices of the prior art obscure, to some extent, the vision of the surgeon in that it is not possible to readily see through the holder. In addition, the devices of the prior art do not incorporate any suture spacing reference marks.
  • the present invention provides a heart valve annulus repair prosthesis that overcomes the above-described drawbacks and disadvantages of the prior art.
  • the annuloplasty ring of the present invention generally has a C-shape and a low profile. In its preferred embodiment it has a high tensile strength and a high degree of flexibility.
  • the ⁇ devices of the present invention preferably rely on porous expanded polytetrafluoroethylene (hereinafter ePTFE) films, laminated together to form a thin, conformable, high strength sheet. A prosthesis of the desired size and shape is then cut out of this sheet, resulting in a highly biocompatible device made predominantly from a single material.
  • ePTFE porous expanded polytetrafluoroethylene
  • the prosthesis of the present invention is highly conformable to the natural anatomy, is flexible, axially compressible and easy to suture.
  • the sutures can be located anywhere along or across the prosthesis.
  • the laminating of the ePTFE films results in a thin, high strength, creep resistant prosthesis, comprised of a single biocompatible material.
  • the holding device for this prosthesis clamps the prosthesis on the inner surface, does not rely on sutures for retention and is thus easily detachable from the prosthesis.
  • the holding device is transparent and does not obscure the vision of the surgeon and incorporates suture spacing guides.
  • the holding device also allows either the parachute or purse string procedures to be performed.
  • the holding device is capable of engaging and holding the annulus sizers.
  • Figure 1 A shows the individual plies of the laminating material angularly oriented and stacked together to form a laminated sheet. Embedded within the sheet are radiopaque markers.
  • Figure 1 B shows the laminated sheet with the cut patterns defining the prosthesis shape.
  • Figure 1 C shows a side view of the cut prosthesis.
  • Figure 2A shows a valve sizer with the trigone alignment marks.
  • Figure 2B shows the prosthesis supported by the holder with the trigone alignment marks and the suture spacing marks.
  • Figure 2C shows the handle assembly attached to the sizer, the sizer trigone alignment marks, the natural valve and natural trigones.
  • Figure 2D shows the handle to sizer (or holder) release feature.
  • Figure 3A shows the handle assembly attached to the holder which supports the prosthesis. Also shown is the holder to prosthesis release feature.
  • Figure 3B shows a side cross sectional view of the holder supporting the prosthesis, with the handle assembly detached from the holder.
  • Figure 3C shows a side cross sectional view of the holder to prosthesis release feature.
  • Figure 4 shows the handle, holder and prosthesis positioned above the valve to be repaired in a typical parachute procedure.
  • Figure 5 shows the handle, holder and prosthesis being forced down against the valve to be repaired, in a typical parachute procedure.
  • Figure 6 shows the handle being removed from the holder during the repair procedure.
  • Figure 7 shows the holder being removed from the prosthesis at the completion of the repair procedure.
  • Figure 8A shows a cross section of the prosthesis conforming to the natural non- planar anatomy of a valve annulus.
  • Figure 8B shows a cross section of the prosthesis in the normal non-compressed state.
  • Figure 8C shows the prosthesis axially compressing as the valve annulus contracts
  • the membrane that is used for the annuloplasty prosthesis can be manufactured from various biocompatible polymeric materials such as polyethylenes (including polyethylene terephthalate (PET)), polypropylenes, polyesters, fluoropolymers, polyurethanes, silicones (polydimethyl siloxanes), etc Preferred membrane materials are fluoropolymers, including fluorinated ethylene propylene (FEP), perfluoroalkoxy resin (PFA), polytetrafluoroethylene (PTFE), and in particular, porous expanded PTFE.
  • the preferred membrane used in the present invention is made from layers of film stacked and bonded together to create a laminate. A preferred method of making this laminate is taught by U.S.
  • Patent 5,645,915 (published PCT application WO 96/03457), incorporated by reference herein.
  • the holder assembly can be manufactured from any variety of materials, preferably a highly transparent material such as an acrylic.
  • the preferred material can be sterilized by steam, ETO or radiation processes and does not particulate when stressed or fractured.
  • the C-shaped annuloplasty ring made according to the materials and methods taught by the present invention may be made to have a low profile wherein the thickness of the C-shaped ring is less than 1.0 mm It may be made to have a transverse width to thickness ratio of greater than about 5.0 As described in US Patent 5,645,915, the preferred material has great strength in all directions, which allows the annuloplasty ring made from this material to have high tensile strength such as at least about 30 0 MPa, 40 0 MPa, or 60.0 MPa.
  • the individual prostheses 26 are cut from the sheet 24, using the radiopaque markers 22 as an alignment guide.
  • the prosthesis can be cut by a laser, following pattern 28, by steel rule dies, or any other suitable means
  • the resulting prosthesis 26 is of a substantially rectangular cross section and is thin 34 relative to the prosthesis width.
  • FIG. 2A describes a sizer 36 which is used to determine proper prosthesis size
  • Sizer 36 has trigone alignment marks 38. These marks are positioned over the natural valve trigones during the sizing operation Also shown is the handle attachment feature 40, which is used to engage the handle
  • the holder 42 which constrains the prosthesis 26 also has a handle attachment feature 44 which is identical to the handle attachment feature on sizer 36
  • the handle is interchangeable with both the sizers and the prosthesis holder
  • the trigone alignment marks 46 and the suture spacing marks 48 As shown in Figure 2C, the handle 50 is engaged into the sizer 36
  • the trigone marks 38 on the sizer 36 are aligned with the natural trigones 52 of the valve 54 to be repaired
  • Various sizers are positioned in such a manner until the optimum size is determined
  • the corresponding size prosthesis is then used for the valve repair
  • a bendable section 56 on the handle so that the sizer or prosthesis holder can be optimally positioned.
  • the sizer 36 can be removed from the handle 50 by compressing release means 58 on the handle.
  • FIG. 3A the handle 50 is engaged onto the holder 42 which constrains the prosthesis 26.
  • Figure 3B shows a cross section of the holder 42, with the prosthesis 26 clamped between the top section 60 and the bottom section 62 of the holder 42 Also shown is the prosthesis release feature 64.
  • FIG 3C shows the prosthesis 26 being released from the holder 42 By applying a squeezing force 66 onto the release feature 64 (Figure 3B), the clamping force on the prosthesis is removed and the prosthesis 26 can be readily removed from the holder 42
  • Figure 4 depicts the initial step of a typical parachute procedure
  • the handle 50 is engaged onto the holder 42 which constrains the prosthesis 26
  • the prosthesis 26 is aligned over the valve 54 and valve trigones 52 by reference of the trigone marks 46 located on the holder 42
  • Sutures 68 are passed through the natural annulus 70 taking a relatively large bite 72
  • This same suture 68 is then passed through the prosthesis 26, taking a smaller bite 74 than that of the large bite 72 in the natural annulus 70
  • This suturing process is repeated, resulting in several sutures, relatively evenly spaced around the prosthesis 26 and the natural annulus 70
  • the suture spacing marks 48 on the holder 42 assist in achieving uniform suture spacing
  • FIG. 5 shows the holder 42 and constrained prosthesis 26 being forced down against the valve annulus 70
  • the sutures 68 are pulled through the prosthesis 26 as the prosthesis is forced against the valve annulus
  • the prosthesis 26 is aligned to the valve trigones 52 by reference to the trigone marks 46 on the holder
  • Figure 6 shows the sutures 68 tied into knots 76, during which the valve annulus 70 is pinched up due to the smaller bites in the valve annulus This pinching up reduces the circumference of the valve annulus, bringing the valve leaflets closer together and effecting the valve repair
  • the handle can be removed by simply depressing the handle release feature 58 located on the handle 50
  • the holder 42 is separated from the prosthesis 26 by squeezing the prosthesis release feature 64 with forceps 78 or by any other suitable means As shown in Figure 8A, the attached prosthesis 26 conforms naturally to the annulus
  • the prosthesis 26 is attached to the natural annulus 70 by the sutures 68
  • the sutures are secured by knots 76
  • the prosthesis 26 is shown in the normal or non-compressed state
  • the prosthesis 26 is axially compressible if necessary during systole or contraction 80 of the natural annulus 70
  • the prosthesis 26 can deform or fold 82 between the sutures 68 and suture knots 76 during compression
  • the prosthesis will still provide tensile support or protection against re-dilatation of the annulus which would again require surgical intervention
  • This folding action does not impart any undue stress to the sutures or the natural valve annulus
  • Various annuloplasty devices were tested to determine tensile strengths and degrees of flexibility Tensile tests were performed in accordance with the test methods described in published PCT application WO 96/03457 while flexibility was quantified by calculating the moment of inertia (I) about the central axis and multiplying this value by the modules of elasticity
  • the device with the lowest El, or most flexible device tested was the device taught by the O'Connor patent
  • the O'Connor device had a force to break of only 1 kg, a tensile strength of 15 MPa and a low El of 8 0 MPa
  • the low force to break and low stiffness is primarily due to the small 1 0 mm diameter of this device
  • the device of the present invention has a comparable force to break as that of the DURAN Flexible Annuloplasty Ring, has a higher tensile strength of 60 MPa along with equivalent or less stiffness than that of the O'Connor device
  • the device of the present invention can have a stiffness as low as 2 0 MPa(mm 4 ) while still maintaining adequate force to break and tensile strength It can thus have a tensile strength of at least about 30 0 MPa, or 40 0 MPa, or 60 0 MPa, in combination with a stiffness or flexibility of 8 0 MPa(mm 4 ) or less While particular embodiments of the present invention have been illustrated and described herein, the present invention should not be limited to such illustrations and descriptions It should be apparent that changes and modifications may be incorporated and embodied as part of the present invention within the scope of the following claims

Landscapes

  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

Anneau pour annuloplastie en forme de C, à base de matériau polymérique, ayant un profil étroit, une haute résistance à la traction et un degré élevé de flexibilité. L'anneau en question peut être utilisé pour réparer l'anneau d'une valvule cardiaque, soit en mode 'cordon de bourse', soit en mode 'parachute'.
PCT/US1998/000922 1997-01-29 1998-01-22 Anneau pour annuloplastie Ceased WO1998032401A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU59614/98A AU5961498A (en) 1997-01-29 1998-01-22 An annuloplasty ring

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US78986497A 1997-01-29 1997-01-29
US08/789,864 1997-01-29

Publications (1)

Publication Number Publication Date
WO1998032401A1 true WO1998032401A1 (fr) 1998-07-30

Family

ID=25148892

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1998/000922 Ceased WO1998032401A1 (fr) 1997-01-29 1998-01-22 Anneau pour annuloplastie

Country Status (2)

Country Link
AU (1) AU5961498A (fr)
WO (1) WO1998032401A1 (fr)

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6183512B1 (en) 1999-04-16 2001-02-06 Edwards Lifesciences Corporation Flexible annuloplasty system
WO2001026587A1 (fr) * 1999-10-14 2001-04-19 The International Heart Institute Of Montana Foundation Moule de formage de valvules cardiaques de remplacement sans tuteur a partir de membranes biologiques
US6626899B2 (en) 1999-06-25 2003-09-30 Nidus Medical, Llc Apparatus and methods for treating tissue
US6991643B2 (en) 2000-12-20 2006-01-31 Usgi Medical Inc. Multi-barbed device for retaining tissue in apposition and methods of use
US7070618B2 (en) * 2000-10-25 2006-07-04 Viacor, Inc. Mitral shield
WO2007072399A1 (fr) * 2005-12-19 2007-06-28 Robert William Mayo Frater Prothese pour annuloplastie
US7632308B2 (en) 2005-11-23 2009-12-15 Didier Loulmet Methods, devices, and kits for treating mitral valve prolapse
US8926603B2 (en) 2004-03-05 2015-01-06 Hansen Medical, Inc. System and method for denaturing and fixing collagenous tissue

Citations (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4042979A (en) * 1976-07-12 1977-08-23 Angell William W Valvuloplasty ring and prosthetic method
US4055861A (en) * 1975-04-11 1977-11-01 Rhone-Poulenc Industries Support for a natural human heart valve
EP0338994A1 (fr) * 1988-01-12 1989-10-25 Mario Morea Dispositif prothétique pour la correction chirurgicale de l'insuffisance tricuspidienne
US5011481A (en) 1989-07-17 1991-04-30 Medtronic, Inc. Holder for annuloplasty ring
US5041130A (en) 1989-07-31 1991-08-20 Baxter International Inc. Flexible annuloplasty ring and holder
US5061277A (en) 1986-08-06 1991-10-29 Baxter International Inc. Flexible cardiac valvular support prosthesis
US5104407A (en) 1989-02-13 1992-04-14 Baxter International Inc. Selectively flexible annuloplasty ring
US5450860A (en) 1993-08-31 1995-09-19 W. L. Gore & Associates, Inc. Device for tissue repair and method for employing same
WO1996003938A1 (fr) * 1994-07-29 1996-02-15 Baxter International Inc. Anneau dilatable pour annuloplastie
WO1996004852A1 (fr) 1994-08-10 1996-02-22 Northrup William F Iii Appareil pour la reduction de la circonference d'une structure vasculaire
US5522884A (en) 1993-02-19 1996-06-04 Medtronic, Inc. Holder for adjustable mitral & tricuspid annuloplasty rings
US5645915A (en) 1994-07-27 1997-07-08 W. L. Gore & Associates, Inc. High strength porous PTFE sheet material

Patent Citations (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4055861A (en) * 1975-04-11 1977-11-01 Rhone-Poulenc Industries Support for a natural human heart valve
US4042979A (en) * 1976-07-12 1977-08-23 Angell William W Valvuloplasty ring and prosthetic method
US5061277B1 (en) 1986-08-06 2000-02-29 Baxter Travenol Lab Flexible cardiac valvular support prosthesis
US5061277A (en) 1986-08-06 1991-10-29 Baxter International Inc. Flexible cardiac valvular support prosthesis
EP0338994A1 (fr) * 1988-01-12 1989-10-25 Mario Morea Dispositif prothétique pour la correction chirurgicale de l'insuffisance tricuspidienne
US5104407B1 (en) 1989-02-13 1999-09-21 Baxter Int Selectively flexible annuloplasty ring
US5104407A (en) 1989-02-13 1992-04-14 Baxter International Inc. Selectively flexible annuloplasty ring
US5011481A (en) 1989-07-17 1991-04-30 Medtronic, Inc. Holder for annuloplasty ring
US5041130A (en) 1989-07-31 1991-08-20 Baxter International Inc. Flexible annuloplasty ring and holder
US5522884A (en) 1993-02-19 1996-06-04 Medtronic, Inc. Holder for adjustable mitral & tricuspid annuloplasty rings
US5450860A (en) 1993-08-31 1995-09-19 W. L. Gore & Associates, Inc. Device for tissue repair and method for employing same
US5645915A (en) 1994-07-27 1997-07-08 W. L. Gore & Associates, Inc. High strength porous PTFE sheet material
WO1996003938A1 (fr) * 1994-07-29 1996-02-15 Baxter International Inc. Anneau dilatable pour annuloplastie
WO1996004852A1 (fr) 1994-08-10 1996-02-22 Northrup William F Iii Appareil pour la reduction de la circonference d'une structure vasculaire

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6183512B1 (en) 1999-04-16 2001-02-06 Edwards Lifesciences Corporation Flexible annuloplasty system
US6503274B1 (en) 1999-04-16 2003-01-07 Edwards Lifesciences Corporation Method of implanting a flexible annuloplasty system
US6626899B2 (en) 1999-06-25 2003-09-30 Nidus Medical, Llc Apparatus and methods for treating tissue
US7186262B2 (en) 1999-06-25 2007-03-06 Vahid Saadat Apparatus and methods for treating tissue
US7217284B2 (en) 1999-06-25 2007-05-15 Houser Russell A Apparatus and methods for treating tissue
WO2001026587A1 (fr) * 1999-10-14 2001-04-19 The International Heart Institute Of Montana Foundation Moule de formage de valvules cardiaques de remplacement sans tuteur a partir de membranes biologiques
US6491511B1 (en) 1999-10-14 2002-12-10 The International Heart Institute Of Montana Foundation Mold to form stent-less replacement heart valves from biological membranes
US7070618B2 (en) * 2000-10-25 2006-07-04 Viacor, Inc. Mitral shield
US6991643B2 (en) 2000-12-20 2006-01-31 Usgi Medical Inc. Multi-barbed device for retaining tissue in apposition and methods of use
US8926603B2 (en) 2004-03-05 2015-01-06 Hansen Medical, Inc. System and method for denaturing and fixing collagenous tissue
US7632308B2 (en) 2005-11-23 2009-12-15 Didier Loulmet Methods, devices, and kits for treating mitral valve prolapse
WO2007072399A1 (fr) * 2005-12-19 2007-06-28 Robert William Mayo Frater Prothese pour annuloplastie

Also Published As

Publication number Publication date
AU5961498A (en) 1998-08-18

Similar Documents

Publication Publication Date Title
US20240197472A1 (en) Leaflet support devices and methods of making and using the same
US20230277318A1 (en) Percutaneous papillary muscle relocation
EP1418865B1 (fr) Anneau automodelant pour annuloplastie
EP2293739B1 (fr) Dispositif de réparation de valvule cardiaque
CN105188610B (zh) 多股热定形瓣膜成形环
US5843178A (en) Suture guard for annuloplasty ring
US12186182B2 (en) Valved conduit
US20130030522A1 (en) Devices and methods for heart treatments
US10531956B2 (en) Apparatus for repairing heart valves and method of use thereof
CA2227142A1 (fr) Piece d'appui pour la refection des valvules cardiaques
US20230240840A1 (en) Protective covers for prosthetic valves
US7776082B2 (en) Method and extravenous corrector for simultaneous repair of multiple incompetent valves
WO1998032401A1 (fr) Anneau pour annuloplastie
JP7634557B2 (ja) 弁付き導管人工器官
CN117915865A (zh) 二尖瓣瓣叶夹
CN116472009A (zh) 假体瓣膜的保护罩

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AL AM AT AU AZ BA BB BG BR BY CA CH CN CU CZ DE DK EE ES FI GB GE GH HU IL IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MD MG MK MN MW MX NO NZ PL PT RO RU SD SE SG SI SK SL TJ TM TR TT UA UG UZ VN YU ZW

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): AT BE CH DE DK ES FI FR GB GR IE IT LU MC NL PT SE

DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
121 Ep: the epo has been informed by wipo that ep was designated in this application
REG Reference to national code

Ref country code: DE

Ref legal event code: 8642

NENP Non-entry into the national phase

Ref country code: JP

Ref document number: 1998532064

Format of ref document f/p: F

122 Ep: pct application non-entry in european phase
NENP Non-entry into the national phase

Ref country code: CA