CN1806775A - 组织瓣环成形术带 - Google Patents
组织瓣环成形术带 Download PDFInfo
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- 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
- A61F2/2448—D-shaped rings
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- 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
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- 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
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- 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
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- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
- A61F2250/001—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting a diameter
Abstract
采用装置(10)来切割组织,采用装置(70)将组织成形(即滚卷、折叠和聚束)为瓣膜成形术带(100),从而形成瓣膜成形术带。具有安装环(140)的尺寸调整器(120)用于在组织瓣膜成形术带连接到心脏瓣膜环上时确定和保持组织瓣膜成形术带的合适尺寸和形状。
Description
本申请为申请日2001年1月12日和申请号01806300.4并名称为“组织瓣膜成形术带及用于所述带的成形、大小调整和植入的装置与方法”的分案申请。
未决先有专利申请的引用
本专利申请要求享有由John R.Liddicoat等人于2000年1月14日提交的题为“用于成形、大小调整和植入组织瓣环成形术装置的器械和方法”(代理人档案号为No.VIA-14 PROV)的美国临时专利申请No.60/176046的权益,此专利申请通过引用结合于本文中。
技术领域
本发明涉及心脏瓣膜疾病的矫正。特别是,本发明涉及组织的成形、大小调整和植入,使其成为用于心脏瓣膜疾病矫正的瓣环成形术带或环。
背景技术
人体心脏包括四个心瓣膜。这些瓣膜中的两个位于左右心房和心室之间,分别称为二尖瓣和三尖瓣。这些瓣膜用于保持血液单向地流入心室中,并防止血液回流到心房中。虽然本发明可以应用于包括二尖瓣和三尖瓣修复在内的许多不同的用途,但是出于示例的目的,在下文中本发明将结合二尖瓣的修复来进行介绍。
二尖瓣修复是用于矫正所有病原学范畴内的二尖瓣回流的外科手术选择。通过采用当前的外科技术,可以修复所有回流二尖瓣中的约70到95%。二尖瓣修复较二尖瓣替换的优点在许多文献中已有记录。这些优点包括可以更好地保持心脏功能,减小与抗凝血剂有关的出血、血栓栓塞和心内膜炎的危险。
几乎所有的二尖瓣修复均包括瓣环成形术。瓣环成形术包括植入修复性的带或环,使其围绕着瓣膜环的所有周边或一部分周边。瓣环成形术可起若干作用:其重新塑造瓣膜环,减小缝合线的张力,提高心瓣膜尖的接合,并防止再发性环状扩张。另外,瓣环成形术提高了修复的耐久性。
将修复性瓣环成形术带或环放置到心脏中会带来血栓栓塞和感染的危险,这些危险是不可避免的,并在病人的一生中均一直存在。心脏中的修复性材料上所形成的血块通常会引起中风,修复性瓣环成形术带或环的感染可引起威胁生命的败血病,并需要进行紧急的再次手术。
理想的瓣环成形术可采用通用的柔性自体材料来进行。这种材料实际上是以病人自身的心包形式而存在。心包是心脏所处的囊。心脏外科医生通常采用心包来修复先天性的心脏缺陷。其治愈效果好,几乎不会发生感染。然而,心包非常难以进行处理。
为了能实际采用自体心包来进行二尖瓣瓣环成形术,外科医生需要用装置来促进具有合适长度和厚度的组织瓣环成形术带或环的形成,并保证组织瓣环成形术带或环在应用到心脏上时保持其所选的尺寸。
构造和使用心包瓣环成形术带或环的系统的研制对病人具有重要意义。由于在心脏内不放置任何修复性材料,这就极大地减小了血栓栓塞和感染的危险。不需要任何抗凝血剂。另外,在医治时心包保持柔性,这就能保持二尖瓣的生理功能。
发明内容
因此,本发明的一个目的是提供一种心包瓣环成形术带,包括:一移植组织环;相连于所述移植组织的支撑结构,所述支撑结构轴向地位于所述移植组织内;所述移植组织绕所述轴向支撑结构卷动并且在本身缠绕后提供移植组织的叠层;其中所述支撑结构包括一终止于一对端部的柔性中间部分,从而使所述一对端部彼此相对和彼此连接。
本发明的另一目的是提供装置和方法,便于构建精确尺寸的来自病人自身的心包上的瓣环成形术带。
本发明的另一目的是提供一种成形的组织瓣环成形术带可以安装在其上的模板,便于进行组织瓣环成形术带的大小调整和将其放置在心脏中,并保证组织瓣环成形术带在其应用过程中保持其形状。
包括了组织瓣环成形术带和用于成形、大小调整和植入所述带的装置和方法在内的本发明致力于实现这些和其它目的。在本发明的一个优选形式中,首先将移植组织切成适当的尺寸。然后,将所切的组织成形为适当的形状,即具有细长的长度。如果需要的话,可以设置内部或外部支撑结构,以帮助支撑和/或操作细长长度的组织。接着,将细长长度的组织安装在可调节的安装环上,使得形成组织瓣环成形术带。然后,确定组织瓣环成形术带的合适大小和形状。这是通过直接地测量二尖瓣,或者通过将组织瓣环成形术带(其安装在可调节的安装环上)放置左心房中并将其与病人的二尖瓣进行目测比较来完成的。然后通过调节可调节的安装环的大小来调节组织瓣环成形术带的大小,直到组织瓣环成形术带具有合适的尺寸为止。对任何多余的组织做标记,以便随后切除。接着,将缝合线穿过病人的瓣膜环和仍位于可调节的安装环内的组织瓣环成形术带。然后在可调节的安装环的辅助下将组织瓣环成形术带引导到位。然后,将组织瓣环成形术带系住,同时组织瓣环成形术带仍安装在可调节的安装环上,使得在最后就位的过程中带能够保持其形状和长度。一旦将组织瓣环成形术带系住,就将组织瓣环成形术带从可调节的安装环上卸下。然后取出可调节的安装环,切除先前被标记的任何多余组织。
在本发明的另一优选形式中,可以用一组预定尺寸的安装环来代替可调节的安装环。在这种情况下,通过直接测量二尖瓣,或者通过将不同的预定尺寸的安装环放置在左心房中并将其与病人的二尖瓣进行目测比较,选择出一个合适的预定尺寸的安装环。一旦选择了一个合适的预定尺寸的安装环,就将细长长度的移植组织安装在预定尺寸的安装环上,然后以上述方式进行瓣环成形术的其余操作。
具体地,本发明提出用于调整组织瓣膜成形术带的大小的尺寸调整器,所述尺寸调整器包括:可调节的安装环;其中所述可调节的安装环包括多个部件,各部件均具有弧形的周边表面,所述多个部件设置成可为所述可调节的安装环整体地形成一个弧形周边表面,所述多个部件可相互间相对移动,从而改变所述整体的弧形周边表面的尺寸。
也提出一种移植组织切割组件,包括:具有一定周边的表面的阳部件;和具有一定周边的开口的阴部件,所述开口的周边与所述表面的周边相一致;这样,当将一块移植组织放在所述表面上且所述表面进入到所述开口中时,可切除任何在所述表面的所述周边上延伸的组织;其中,所述表面的周边设置成可产生尺寸适用于形成组织瓣膜成形术带的所述移植组织。
所述表面包括形成在其中有凹槽。
还提出一种瓣环成形术带,其特征在于,该带包括有一片移植组织,其自身卷动并紧紧包装以形成一个圆柱形。
进一步提出一种瓣环成形术带,其特征在于,该带包括有为移植组织的覆盖层构成的细长基本实心主体,该主体具有选定长度并且适于到一挠曲到一个基本弯曲结构,该带适于缝合到心脏瓣膜环。
附图说明
在本发明的优选实施例的下述详细介绍中将进一步公开本发明的这些和其它目的及特征,这些介绍将结合附图一起进行,在附图中相同的部件以相同标号表示,在图中:
图1是在本发明一个优选形式中使用的阳/阴冲模的示意图;
图2是位于阳冲模上的被卷成组织瓣环成形术带的移植组织的示意图;
图3是根据本发明所形成的第一尺寸调整器,其带有正交于尺寸调整器的可调节的安装环所在平面而延伸的第一尺寸调整器的把手;
图4是与图3相似的视图,不同之处在于其显示了图3所示的第一尺寸调整器的后部;
图5是第一尺寸调整器的远端的示意图,并显示了可调节的安装环的最大直径结构;
图6是第一尺寸调整器的远端的示意图,并显示了可调节的安装环的最小直径结构;
图7是第一尺寸调整器的远端的示意性端视图,并显示了可调节的安装环的最小直径结构;
图8是根据本发明所形成的第二尺寸调整器的示意图,其带有平行于尺寸调整器的可调节的安装环所在平面而延伸的第二尺寸调整器的把手;
图9是第二尺寸调整器的远端的示意图,并显示了可调节的安装环的最大直径结构;
图10是第二尺寸调整器的远端的示意性侧视图,并显示了可调节的安装环的最大直径结构;
图11是第二尺寸调整器的远端的示意图,并显示了可调节的安装环的最小直径结构;
图12是显示了安装在第二尺寸调整器的可调节的安装环上的组织瓣环成形术环的示意图;
图13是显示了一组第三尺寸调整器的示意图,其中各个第三尺寸调整器包括预定尺寸的安装环;
图14是显示了用于组织瓣环成形术带的移植组织的人工大小调整的示意图;
图15是用于辅助引导移植组织通过外部网的导管的示意图;
图16是显示了外部网、导管和组织钩的示意图;
图17是显示了在被拉入导管之前的移植组织的示意图;
图18是显示了在被拉入导管之后的移植组织的示意图;
图19是显示了被取下的导管和被切成符合外部网的组织的示意图;
图20是显示了固定在外部网内的组织的示意图,在同时拉紧端部的系紧缝合线并使其闭合后形成了组织瓣环成形术带;
图21是显示了正与预定尺寸(即固定直径)的安装环相连的组织瓣环成形术带的示意图;和
图22是显示了已与预定尺寸、固定直径的安装环相连的组织瓣环成形术带的示意图。
具体实施方式
本发明涉及一般用于心瓣膜修复的组织瓣环成形术带的快速成形、大小调整和植入。虽然这里的介绍是描述用于二尖瓣修复的系统的使用,但此装置和方法也可用于其它的应用。因此,下述介绍只是作为如何使用本发明的装置和方法的示例,并不是限制性的。
根据本发明,首先将移植组织(即心包、静脉或其它自体或非自体组织)切成适当的尺寸。这可以通过任何合适的切割工具来完成。然而,最好采用阳/阴冲模来将组织切割成适于形成组织瓣环成形术带的常规尺寸和形状。
具体地说,参见图1,图中显示了阳/阴冲模10。冲模10包括形成有凹槽30的阳模20,以及形成有开口50的阴模40。当将一块供体组织(如心包)放置在阳模20和阴模40之间且两件模具之后闭合在一起时,可以从供体组织中切下一块移植组织(其尺寸与阴模40中的开口50相一致)。
一旦移植组织被切成适当的尺寸,就将其成形为适当的形状,即,使其具有细长的长度。这可通过滚卷、折叠、聚束等来完成。
在本发明的一个优选形式中,采用阳模作为基体使组织绕一个轴进行滚动。具体地说,参见图2,在切出一块移植组织60后,当移植组织60平放在阳模20上时,将轴70压入到凹槽30中。然后,将组织的一个端部80折叠到组织的另一端部90上,并且滚动轴70,从而形成组织瓣环成形术带100。如果需要的话,可以在组织上涂敷粘合剂、密封剂、药物或类似物。例如,可以在最终的滚边上涂敷粘合剂,以防止组织瓣环成形术带展开。轴70是由相对柔性的材料如顺应性塑料或金属制成。轴体是柔性的,其可以沿其线性轴线伸展,或者不能沿其线性轴线伸展。轴70的两个端部110A,110B最好具有弹性,使得轴的这些部分可以沿其线性轴线伸展。
一旦移植组织被卷成组织瓣环成形术带100,就将其安装在安装环上以进行大小调整和植入。这可以采用多种装置通过多种方式来进行。
在本发明的一个优选形式中,参见图3-7,采用了第一尺寸调整器120。第一尺寸调整器120包括把手130和可调节的安装环140。把手130最好包括可相互间移动的两段圆柱体150,160。圆柱体150可通过驱动电缆170(以虚线示出)与安装环140相连。驱动电缆170又与可调节的安装环140内的中央锥齿轮180(图7)相连。中央锥齿轮180的旋转又使得另外的锥齿轮190旋转。这些锥齿轮190与螺纹杆200相连。可调节的安装环部件210是带内螺纹的,并靠在螺纹杆200上。螺纹杆200的旋转使得安装环部件210能径向地移动,因此使得可调节的安装环140能扩大和缩小(即,径向尺寸可变化)。因此,可以看到,圆柱体150相对于圆柱体160的旋转导致了可调节的安装环140的几何形状(即尺寸)的变化。圆柱体160(即不是通过驱动电缆170与可调节的安装环140相连的那个)用作把手的支撑部分,并相对于可调节的安装环140保持在相对固定的方位。圆柱体160可具有恒定的外径,或者,可以具有如图3和4所示的台阶式外径。把手130还具有位于圆柱体160外侧上的大小指示器220,其显示了经过适当的大小调整后的组织瓣环成形术带的尺寸。
如上所述,可调节的安装环140(i)通过驱动电缆170与圆柱体150相连,并且(ii)固定在圆柱体160上。可调节的安装环140包括中心件230,其含有上述锥齿轮180和190。这些齿轮180和190又与安装环部件210相连,组织瓣环成形术带100连接在部件210上。这些安装环部件210通过螺纹杆200与中心件230相连。因此,上述锥齿轮180通过电缆170的运动使得安装环部件210可相对于中心件230扩大和缩小。因此,此组织瓣环成形术带100可以为不同的病人解剖模型而调节到合适的尺寸。安装环部件210可具有另外的支撑,例如相互作用的侧柱240。各环部件210的外边缘250最好具有凹槽260,组织瓣环成形术带100就安装在其中。
在上述第一尺寸调整器120中,尺寸调整器的把手130沿正交于尺寸调整器的可调节的安装环140的平面而延伸。或者,参见图8-11,图中显示了第二尺寸调整器120A,其中尺寸调整器的把手130沿平行于尺寸调整器的可调节的安装环140的平面而延伸。
组织瓣环成形术带100(图2)置于可调节的安装环140(图12)的凹槽260中。然后,将轴70的弹性端部110A,110B连接在一起。这就在组织上形成了张力,使得将组织瓣环成形术带100保持在安装环的凹槽260中。为提高稳定性,如有必要的话还可以使用夹子、系带或缝合线。
接下来确定组织瓣环成形术带100的合适大小和形状。为此,将现在已安装在可调节的安装环140上的组织瓣环成形术带100置于病人的左心房中,并将其与病人的二尖瓣进行目测比较。或者,直接地测量二尖瓣。然后外科医生通过转动把手130的圆柱体150来调节组织瓣环成形术带100的大小,直到组织瓣环成形术带100具有合适的尺寸为止。对任何多余的组织进行标记以便以后切除。
接着,将缝合线穿过病人的环带,然后穿过组织瓣环成形术带100。然后在尺寸调整器120(或120A)的帮助下将组织瓣环成形术带100引导到位。将组织瓣环成形术带100系住,同时它仍安装在可调节的安装环140上,使得在最后就位时仍能保持其形状。一旦将组织瓣环成形术带100系住,就将轴70的弹性端部110A,110B相互松开。拆下任何其它的固定部件,如辅助用于将组织瓣环成形术带100安装在可调节的安装环140上的夹子、系带或缝合线。然后取下可调节的安装环140,取出轴70。切除任何被标记的多余的组织。
如果需要的话,尺寸调整器120(或120A)可构造成能将把手130从可调节的安装环140上拆下来。通过这种结构,可以在将组织瓣环成形术带100引导到手术部位之后且在将带从可调节的安装环140上拆下之前将把手130拆下。
也可以采用预定尺寸、固定直径的安装环来进行本发明。具体地说,参见图13,图中显示了一组第三尺寸调整器120B,其中各第三尺寸调整器120B包括预定尺寸、固定直径的安装环140B(最好具有周向槽260B)和相关的把手130B。各安装环140B可包括一个完整的圆(如图13所示),或者包括一部分圆(如图22所示)。在本发明的这种形式中,通过直接地测量二尖瓣,或者将不同的预定尺寸的安装环置于左心房中并将它们与病人的二尖瓣进行目测比较,从而从预定尺寸的安装环140B中选择一个合适的环。一旦选择出合适的预定尺寸的安装环140B,就将组织瓣环成形术带100(图2)安装在预定尺寸的安装环140B上,即通过将组织瓣环成形术带100滑入到周边槽260B中并将轴70的弹性端部110A,110B连接到一起来完成。然后以上述方式将组织瓣环成形术带100传送到病人的二尖瓣环带中。
在本发明的另一优选形式中,参见图14-22,可以采用外部结构网300(图16)来形成组织瓣环成形术带100A(图20)。具体地说,采用标准化的可买到的组织抓紧器330和组织切割器340来将移植组织310(图14)切割成具有所需的较长长度320。为了帮助将组织长度320插入到外部网300中,可以采用临时性的导管340(图15)来使外部网300保持打开,并引导组织长度320通过网。
参见图16,外部网300最好由柔性但不可伸展的材料如单丝或编织缝合线来制成,以便永久地植入体内。编织物最好构造成使网300不会通过笔直部件350而在纵向轴线上伸展。编织物还可以提供较大的网360,从而允许大量的组织暴露在植入表面上,从而促进植入体内的组织内生长。网300的端部处的系紧缝合线370提供了可将移植组织320固定在外部网内且将所得的组织瓣环成形术带100A固定在安装环140(或140B)上的装置。如果需要各种长度的带,那么可以提供单独的带或者将较长的带切成所需的长度。如果将较长的带切成一定长度,另外的系紧缝合线370A提供了可将带切短并能将组织320固定在外部网内的装置。任何未使用的系紧缝合线370,370A可在将带固定到安装环上之前切除。
参见图16,导管340插入并穿过外部网300,为组织320提供了顺畅的路径。组织钩382和杆384插入并穿过导管340,然后组织320被折成两半并通过钩382而插入(图17)。对于此实施例来说,组织320的长度必须是预定尺寸的带长的至少两倍。钩382的一个变型是抓紧器(未示出),其可以将一段单一无折叠长度的组织拉到导管340中。对于这种实施例来说,单一无折叠长度的组织可比折叠长度的组织更宽,使得在各实施例中位于外部网300内的组织的体积相似。
再参见图18-20,通过拉动组织回缩把手386来将组织320拉动而穿过导管340。然后将导管340从组织320和外部网300之间拉出。切除任何多余的组织320,使其符合外部网300的长度,在387处束紧系紧缝合线370,将组织320固定在外部网300内,形成了大小合适的组织瓣环成形术带100A。
参看图21和22,用系紧缝合线370的剩余长度打个结388(图22),从而将组织瓣环成形术带100A暂时地固定在安装环(如预定尺寸、固定直径的安装环140B)上。一旦外科医生采用标准的手术技术将组织瓣环成形术带100A缝合到二尖瓣上,通过切除和收回靠近组织瓣环成形术带100A的端部的系紧缝合线370,可以将安装环140B取下。
应该理解,本发明决不限于这里介绍和/或附图所示的特定结构和方法步骤,而是还包括在权利要求范围内的任何修改和等效物。
Claims (5)
1.用于调整组织瓣膜成形术带的大小的尺寸调整器,所述尺寸调整器包括:
可调节的安装环;
其中所述可调节的安装环包括多个部件,各部件均具有弧形的周边表面,所述多个部件设置成可为所述可调节的安装环整体地形成一个弧形周边表面,所述多个部件可相互间相对移动,从而改变所述整体的弧形周边表面的尺寸。
2.一种移植组织切割组件,包括:
具有一定周边的表面的阳部件;和
具有一定周边的开口的阴部件,所述开口的周边与所述表面的周边相一致;
这样,当将一块移植组织放在所述表面上且所述表面进入到所述开口中时,可切除任何在所述表面的所述周边上延伸的组织;
其中,所述表面的周边设置成可产生尺寸适用于形成组织瓣膜成形术带的所述移植组织。
3.根据权利要求2所述的移植组织切割组件,其特征在于,所述表面包括形成在其中有凹槽。
4.一种瓣环成形术带,其特征在于,该带包括有一片移植组织,其自身卷动并紧紧包装以形成一个圆柱形。
5.一种瓣环成形术带,其特征在于,该带包括有为移植组织的覆盖层构成的细长基本实心主体,该主体具有选定长度并且适于到一挠曲到一个基本弯曲结构,该带适于缝合到心脏瓣膜环。
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- 2001-01-12 AU AU2001229476A patent/AU2001229476A1/en not_active Abandoned
- 2001-01-12 CA CA002399905A patent/CA2399905C/en not_active Expired - Fee Related
- 2001-01-12 CN CNB018063004A patent/CN1243520C/zh not_active Expired - Fee Related
- 2001-01-12 US US09/760,222 patent/US6942694B2/en not_active Expired - Lifetime
- 2001-01-12 CN CNA2005101381957A patent/CN1806775A/zh active Pending
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2005
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CN105326582A (zh) * | 2008-12-22 | 2016-02-17 | 瓦尔泰克卡迪欧有限公司 | 可调瓣环成形装置及其调节机构 |
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CN103547236A (zh) * | 2010-12-22 | 2014-01-29 | 佛多斯大学医学研究中心 | 瓣环成形术环系统 |
CN103547236B (zh) * | 2010-12-22 | 2016-04-20 | 佛多斯大学医学研究中心 | 瓣环成形术环系统 |
CN103491902A (zh) * | 2011-04-01 | 2014-01-01 | 爱德华兹生命科学公司 | 可压缩心脏瓣环定型模板 |
CN103491902B (zh) * | 2011-04-01 | 2016-05-25 | 爱德华兹生命科学公司 | 可压缩心脏瓣环定型模板 |
CN106510901A (zh) * | 2016-11-21 | 2017-03-22 | 上海交通大学医学院附属上海儿童医学中心 | 一种新型的折叠补片一体化成环形设计 |
CN106510901B (zh) * | 2016-11-21 | 2018-06-05 | 上海交通大学医学院附属上海儿童医学中心 | 一种新型的折叠补片一体化成环形设计 |
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CN1418074A (zh) | 2003-05-14 |
CN1243520C (zh) | 2006-03-01 |
CA2399905A1 (en) | 2001-07-19 |
US7427291B2 (en) | 2008-09-23 |
WO2001050985A1 (en) | 2001-07-19 |
CA2399905C (en) | 2008-11-18 |
US6942694B2 (en) | 2005-09-13 |
US20060074486A1 (en) | 2006-04-06 |
AU2001229476A1 (en) | 2001-07-24 |
US20010049558A1 (en) | 2001-12-06 |
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