Biologically implantable prosthesis
Abstract
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Term
Term ended
Expired 20 December 2023, 2.8 years ago.
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18 claims: 5 independent, 13 dependent
- 1生物学的に植え込み可能な第1のプロテーゼであって、外周が伸張可能な壁を含み、当該壁が長手方向の軸を有し、当該壁が長手方向の軸に垂直な横方向の断面を有し、かつ当該壁が長手方向の軸と平行である縦方向の断面を有し、かつ当該壁が伸張した状態で実質的に円形である外周形状を規定する、第1のプロテーゼ;複数のローブを有する外周形状を有する心臓弁冠を含む第2のプロテーゼ;および 第1のプロテーゼが生物学的な弁環状部内に埋め込まれた後で、第2のプロテーゼが挿入されて第1のプロテーゼと係合するときに、互いに自己係合させる、第1および第2のプロテーゼの周囲に配置された1または複数の係合要素を含み、 第1のプロテーゼが、生物学的な弁環状部に導入される間は、伸張していない状態に圧縮可能であり、弁環状部内に導入されて弁環状部に係合させるときに伸張した状態に伸張可能であ り 、 第2のプロテーゼが挿入されて第1のプロテーゼと係合するときに、第2のプロテーゼを第1のプロテーゼと角度に関して整列させる、協働要素を、第1および第2のプロテーゼ上にさらに含み、 協働要素が、第1および第2のプロテーゼの外周に沿って配置された、複数の磁石を含む、 心臓弁アセンブリ。
- 2生物学的に植え込み可能な心臓弁用の第1のプロテーゼであって、第1の縁および第2の縁を含む壁を含み、当該壁が第1のプロテーゼの中心にて、長手方向の軸を有する、第1のプロテーゼ、および 弁葉を有する心臓弁冠を含み、当該心臓弁冠が複数のローブを有する外周形状を有する、第2のプロテーゼを含む心臓弁アセンブリであって、 当該壁の少なくとも一部が、長手方向の軸から遠ざかるように、または長手方向の軸に向かって、傾斜しており、 第1のプロテーゼが生物学的な弁環状部内に埋め込まれた後で、第2のプロテーゼを第1のプロテーゼに固定する、複数の係合要素を第1のプロテーゼが含んでおり、 第1のプロテーゼが、生物学的な弁環状部に導入される間は、伸張していない状態に圧縮可能であり、弁環状部内に導入されて弁環状部に係合させるときに伸張した状態に伸張可能であり、かつ第1のプロテーゼが、伸張した状態で実質的に円形である外周形状を有 し 、 第2のプロテーゼが挿入されて第1のプロテーゼと係合するときに、第2のプロテーゼを第1のプロテーゼと角度に関して整列させる、協働要素を、第1および第2のプロテーゼ上にさらに含み、 協働要素が、第1および第2のプロテーゼの外周に沿って配置された、複数の磁石を含む、 心臓弁アセンブリ。
- 3心臓の生物学的な弁環状部内に埋め込み可能な心臓弁アセンブリであって、 外周を規定する壁を含み、当該壁が生物学的な弁環状部に導入される間は伸張していない状態に圧縮可能であり、弁環状部内に導入されて弁環状部に係合させるときに外周を増加させるために半径方向に伸張した状態に伸張可能であり、かつ当該壁は伸張した状態で実質的に円形である外周形状を有し、当該壁の少なくとも一部の上に布のカバリングを含む、第1の環状プロテーゼ;第1のプロテーゼを弁環状部に固定するために、第1のプロテーゼの一部を通過して受け入れ可能な複数の固定デバイス;複数のローブを有する外周形状を有する心臓弁冠を含む第2の弁プロテーゼ;および 第1のプロテーゼが弁環状部内に埋め込まれた後で、第2のプロテーゼを第1のプロテーゼに接続するための、1または複数の係合要素を含 み 、 第2のプロテーゼが挿入されて第1のプロテーゼと係合するときに、第2のプロテーゼを第1のプロテーゼと角度に関して整列させる、協働要素を、第1および第2のプロテーゼ上にさらに含み、 協働要素が、第1および第2のプロテーゼの外周に沿って配置された、複数の磁石を含む、 心臓弁アセンブリ。
- 4心臓弁冠が、隣接するローブの間で波形を含む、3つのローブを含む周形状を有する、請求項1~3のいずれか1項に記載の心臓弁アセンブリ。
- 5複数の固定デバイスをさらに含み、第2のプロテーゼが環状部に挿入される前に、第1のプロテーゼを環状部に固定するために、当該固定デバイスが、第1のプロテーゼの一部を経由して挿入されるようになっている、請求項1または2に記載の心臓弁アセンブリ。
- 6固定デバイスがクリップを含む、請求項3または5に記載の心臓弁アセンブリ。
- 7第1のプロテーゼが、第1のプロテーゼを環状部に固定するために、そこを通過させて固定デバイスを受け入れる固定デバイスコネクタを複数含む、請求項3、5、または6に記載の心臓弁アセンブリ。
- 8係合要素が、第2のプロテーゼを第1のプロテーゼにスナップ嵌めするコネクタを含む、請求項1~3のいずれか1項に記載の心臓弁アセンブリ。
- 9係合要素が、第2のプロテーゼが第1のプロテーゼに収容されたときに、自己係合する、複数の係合要素を含む、請求項2または3に記載の心臓弁アセンブリ。
- 10第1のプロテーゼが、環状部に係合するために、外周が弾性的に伸張状態に伸張可能な壁を含む、請求項1~9のいずれか1項に記載の心臓弁アセンブリ。
- 11固定デバイスコネクタが、複数のポートを壁に含む、請求項7に記載の心臓弁アセンブリ。
- 12第1のプロテーゼが、周に実質的に垂直に延びる長手方向の軸を含み、当該壁の少なくとも一部が長手方向の軸に対して傾斜している、請求項1または5に記載の心臓弁アセンブリ。
- 13前記壁の第1の部分が、長手方向の軸に対して第1の角度で傾斜しており、当該壁の第2の部分が長手方向の軸に対して第2の角度で傾斜している、請求項1または3に記載の心臓弁アセンブリ。
- 14第1のプロテーゼが、環状トップ・セグメントおよび環状ボトム・セグメントを含み、トップおよびボトム・セグメントのうち少なくとも一方が、トップ・セグメントがボトム・セグメントよりも大きい外周を有するように、長手方向の軸に対して角度を規定する、請求項2または13に記載の心臓弁アセンブリ。
- 15第1のプロテーゼが長手方向の軸と平行に第2のプロテーゼに対して移動させられたときに、係合要素が自己係合するようになっている、請求項9に記載の心臓弁アセンブリ。
- 16前記壁が、互いに隣り合うように配置された第1および第2の端部を含み、第1および第2の端部が互いに対して、壁の外周を伸張させるために、移動可能である、請求項1~15のいずれか1項に記載の心臓弁アセンブリ。
- 17複数の係合要素が、第1のプロテーゼを1または複数の平行な面にて係合するようになっている、請求項1~16のいずれか1項に記載の心臓弁アセンブリ。
- 18協働要素が、リブおよびグルー ブ を第1および第2のプロテーゼ上に含み、第2のプロテーゼが挿入されて第1のプロテーゼと係合するときに、リブがグルーブ内にフィットする、請求項 1~16のいずれか1項 に記載の心臓弁アセンブリ。
Independent claims18
87 paragraphs, as filed
Detailed description of the invention
Technical field The present invention generally relates to a biologically implantable prosthesis (or prosthesis or prosthesis), a heart valve assembly that uses the prosthesis, and a method of using it within an annulus (or annulus or annulus) of the body. Regarding.
Background technology Artificial heart valves can replace the patient's defective human valve. The prosthetic valve generally includes a suture ring or suture cuff that is attached to the outer circumference of the prosthetic valve orifice and extends along it.
In a typical prosthetic valve implantation procedure, an incision is made in the heart to remove the defective valve, leaving the area around the locally tougher tissue. Known heart valve replacement techniques include passing multiple sutures individually through tough tissue to form an array (or line) of sutures. The free ends of the suture extend outside the thoracic cavity and are spaced apart on the patient's body. The free end of the suture is then individually threaded through the edge around the suture ring. Once all sutures have passed through the ring, all sutures are pulled up and the prosthetic valve is slid into place adjacent to the tough tissue or "lowered". The prosthetic valve is then secured in place by a conventional thread knot with sutures.
Suture rings are often made of biocompatible cloth through which needles and threads can pass. The prosthetic valve is typically sewn onto the body mass (or body or biological aggregate) or ring that remains when the surgeon removes the existing valve from the patient's heart. The suture is tightly tied, thereby anchoring the suture ring to the annulus and thus the prosthetic valve to the heart.
Attaching the suture ring to the orifice of the valve can be monotonous and tedious. Moreover, attaching the suture ring to the ring is time consuming and cumbersome. The complexity of the suture increases the chances of making mistakes and requires the patient to be in cardiopulmonary bypass for extended periods of time. It is also desirable to have as large a lumen (or cavity) as possible through the prosthetic valve to improve hemodynamics. However, according to the technique of attaching the suture ring to the orifice, it is generally required to reduce the area of the valve cavity to accommodate the attachment mechanism. For example, the suture ring is generally held on top of the annulus, so that the lumen is at most the size of the original cavity.
Patients may also have a disadvantageously small innate (or original) valve lumen. In these cases, the innate valve can be gusseted before the prosthetic valve is implanted. A lengthwise incision can be made along the wall of the lumen to gusset the innate valve. The lumen can then be stretched around (or the outer edge), and the incision that is now stretched can be covered with a graft or other membrane and can be sutured closed.
Magladry's US Pat. No. 4,743,253 discloses a suture ring with a continuous compression ring. Magladry's rings are supple, compressive, but not stretchable. In fact, the ring taught by Magladry is placed over the heart valve and exerts compressive force on the heart valve.
U.S. Pat. No. 6,217,610 of Carpentier et al. Discloses an extendable valve forming ring. Carpentier et al. Teach to increase the size of the ring by stretching the balloon on the actual patient. The ring is intended to reshape the annulus and does not serve as the basis for attaching a second prosthesis to form the heart valve.
U.S. Pat. No. 5,984,959 of Robertson et al. Discloses an extendable heart valve ring for attaching a prosthetic valve to it and an instrument for attaching the ring to the prosthetic valve. Robertson et al. Teach a ring with tabs that is used to attach to a second prosthesis by using a second device for engaging the tabs.
There is a demand for bioprostheses with inflatable perimeters (or perimeter or outer dimensions). There is a need for prostheses and methods that can stretch the annulus and maintain the perimeter of the enlarged annulus. Furthermore, there is a demand for minimally invasive heart valve replacement procedures. There is also a need for a prosthesis that can provide engagement with the second prosthesis described above (eg, the crown of a heart valve). Furthermore, the implantation time break to good, there is a need for a second prosthesis and the above-described prosthesis can engage self locking.
Disclosure of invention One form of the disclosed prosthesis is a first form for a biologically implantable heart valve that has an extensible (or outwardly inflatable, or extensible or circumferential) wall on the outer circumference. The prosthesis. The wall has a horizontal cross section perpendicular to the length axis and a vertical cross section parallel to the length axis. The prosthesis also has an engaging element configured to self-engage with the second prosthesis.
The first prosthesis has a stop (or hit or stop), which prevents the outer circumference of the wall from diminishing. The first prosthesis may also have a fixed device connector. The wall may also have a corrugation. The wall may also have a bent lip (or edge) at its anterior edge (or tip). The first prosthesis may also be in an assembly in which the first prosthesis can accept (or contain) a second prosthesis (eg, crown).
Another form of prosthesis is a bioimplantable prosthesis for heart valves that has a wall with a first rim and a second rim. The wall has a longitudinal axis in the center of the first prosthesis, and the first edge has an engaging element for engaging with the second prosthesis. The engaging element is also bent (or folded) towards the second edge.
The engaging element may be bent towards the second edge. The first edge may be the leading edge. The first prosthesis may also have a fixed device connector that can be a port (or mouth or hole) on the wall. The wall may also have a corrugation. The first prosthesis can also be present in an assembly with a second prosthesis connected to the engaging element. The second prosthesis may be a crown (or crown).
One form of implanting a heart valve in the annulus is to attach a first prosthesis to the annulus and a second prosthesis to the first prosthesis. The first prosthesis has an stretchable wall on the outer circumference. The wall has a longitudinal axis and the wall has a lateral cross section perpendicular to the longitudinal axis.
The first prosthesis may be a ring. The second prosthesis may be a crown (or crown or crown). The wall of the first prosthesis may have a first end and a second end. Attaching the first prosthesis may include immobilizing the first prosthesis on the body mass using a fixation device. Attaching the first prosthesis may also include snapping the second prosthesis into the first prosthesis.
Another form of implantation of a heart valve in the annulus involves attaching a first prosthesis to the annulus and attaching a second prosthesis to the first prosthesis. The first prosthesis has a wall with a first edge and a second edge. The wall can also have a longitudinal axis. The first edge contains the engaging element, which is bent towards the second edge.
The engaging element may be bent away from the longitudinal axis. The first prosthesis may be a ring. The second prosthesis may be a crown. Attaching the crown may include snapping the crown into the first prosthesis.
One form of a method of increasing and maintaining the size of a biological annulus comprises placing a first prosthesis with an extendable perimeter in the annulus. The method also includes stretching the outer circumference of the first prosthesis and fixing the outer circumference of the first prosthesis.
Stretching the outer circumference of the first prosthesis may include increasing the radius of the annular portion from about 0.1 mm (0.004 inches) to about 2.0 mm (0.08 inches) or more. The first prosthesis may also include engaging elements configured to accept the second prosthesis.
Detailed description and industrial applicability Figures 1 and 2 show a form of the first bioimplantable prosthesis 2. The first prosthesis 2 may have a wall 4. The wall 4 may have material strength and dimensions (or dimensions) known to those of skill in the art to allow the first prosthesis to be elastically stretchable. Wall 4 is open or spiral, as shown in FIG.<u style="single">side</u>Can have a directional cross section.<u style="single">side</u>The directional cross section can be perpendicular to the central longitudinal axis 6.
The wall 4 may have a first end 8 and a second end 10. Each end 8 and 10 may be defined at each end 8 and 10 from the midpoint 12 of the wall 4 to the first end 14 or the second end 16 of the wall 4. The wall 4 may have an end difference length of 18. The end difference length 18 is the shortest angular length (or angle-forming length) from the first end 14 to the second end 16. The wall 4 may also have a front edge 20 and a hem edge 22. The front edge 20 and the hem edge 22 are substantially perpendicular to the longitudinal axis 6. The first prosthesis may have an outer circumference equal to the wall length 24 minus the end difference length 18. The wall 4 may have a wall height of 25. Wall heights can range from about 3.18 mm (0.125 inches) to about 12.7 mm, 8.26 mm (0.50 inches), for example about 0.325 inches. Wall 4 also has one end 8 or 10 of wall 4 on the other end of wall 4.<u style="single">10</u>Or<u style="single">8</u>It may be a gap (or a hole) for any mounting device to be mounted on the device. Wall 4 is a stainless steel alloy, nickel-titanium alloy (eg Nitinol), cobalt-chromium alloy (eg Elgin Specialty Metals (Elgin, Illinois)) El GILOY (registered trademark: ELGILOY); Carpenter Metals Corp. (Wyomissing, Pennsylvania) CONICHROME®), polyester (eg, EI Du Pont de Nemours and Company (Wilmington, Delaware)), Dacron®, polypropylene, polytetrafluoroethylene (PTFE), extended PTFE (eg) It can be formed from polymers such as ePTFE), polyether ether ketone (PEEK), nylon, extruded collagen, silicone, radiation opaque materials, or combinations thereof. Examples of radiation opaque materials are barium, Sulfate (or sulfate ester), titanium, stainless steel, nickel-titanium alloy and gold.
Figures 3 and 4 show one form of the first prosthesis 2 that is mechanically stretchable. The first protrusion 26 and the second protrusion 28 at the first end 8 may extend from the wall 4. The protrusions 26 and 28 can extend perpendicular to the wall 4 or perpendicular to the longitudinal axis 6. Protrusions 26 and 28 can be tabs, headless nails (or brads), extensions, balls, rods, or a combination thereof. The protrusions may have a protrusion depth of 30 sufficient to hold the wall 4.
The wall 4 also has a first receiving element 32 and a second receiving element 34 at the second end 10 that accommodate or engage the first protrusion 26 and the second protrusion 28, respectively. Can be done. The wall 4 may also have more or less (eg, 1 or zero) accepting elements 32 or 34. Receiving elements 32 and 34 may be holes provided in the wall 4. Receiving elements 32 and 34 can also be divets, depressions (or dimples), hooks, slots, or a combination thereof. Protrusions 26 and 28 and receiving elements 32 and 34 can act together as a clasp or clasp to prevent the perimeter of the first prosthesis 2 from stretching or diminishing beyond the desired limits. To do.
Figures 5 and 6 show one form of a first prosthesis 2 that may have a receiving element 32 and a protrusion 26 that may be recessed. The protrusion 26 and the receiving element 32 may reside in a first row 36, a second row 38 and an additional row 40. The protrusions 26 may also be present in the first column 42, the second column 44, and the additional column 46. The receiving element 32 may have a receiving element depth 46 that is within the same dimensions as the protrusion depth 36 described above.
FIGS. 7 and 8 show a form of the first prosthesis 2 which may have protrusions 26 and 28 extending substantially tangent to the wall 4 from the first end 14. The protrusions 26 and 28 may be rods 48 and may have balls 50 at the ends of rods 48. Receiving elements 32 and 34 may extend substantially tangent to wall 4 from the second end 16. Receiving elements 32 and 34 for accommodating the ball 50<u style="single">Color</u>(Or joint ring or brim) 52. Wall 4<u style="single">As shown in Figure 7.</u>Of the shape of a circular open curve<u style="single">side</u>Has a directional cross section. A circumferential gap 54 may exist between the first end 14 and the second end 16.
Figures 9 and 10 show the morphology of the first prosthesis 2 which may have various forms of protrusions 26 and 28 as well as receiving elements 32 and 34. The first prosthesis 2 of FIGS. 9 and 10 is also longitudinally controlled by the dimensions of the protrusions 26 and 28 and the receiving elements 32 and 34, and the position of the protrusions 26 and 28 and the receiving elements 32 and 34 on the wall 4. It can have a wall angle of 56 with respect to the axis. The wall angle 56 may be from about 10 ° to about 60 °, more narrowly from about 20 ° to about 45 °, for example about 25 °. The protrusions 26 and 28 and the receiving elements 32 and 34 may be located along or between the hem 22 and the front edge 20.
Figures 11 and 12 show one form of a first prosthesis 2 with a wall 4 having a bottom segment 58 and a top segment 60. The first prosthesis 2 is deformable and its outer circumference can be extended. The bottom segment 58 may have a wall angle 56 with respect to the longitudinal axis 6. The angle between the bottom segment 58 and the top segment 60 can be the connection angle (or joint angle) 62. The connection angle 62 can be from about 90 ° to about 180 ° and, more narrowly, from about 90 ° to about 160 °, for example about 120 °. The wall 4 may also have a first steering groove 64 that may extend over the length of the bottom segment 58. The wall 4 may also have a second steering groove 66 that may extend over a portion of the length of the bottom segment 58. Grooves 64 and 66 help to align (or align) the second prosthesis 68, which can be attached to the first prosthesis 2, with respect to the axial axis in the longitudinal direction. Grooves 64 and 66 can also prevent the first prosthesis 2 from rotating relative to the second prosthesis 68. The second groove 66 also helps to occupy (or align) the second prosthesis 68 in the correct position in the longitudinal direction.
The first prosthesis 2 may also have engaging elements such as an upper magnet 70 in the top segment 60 and a lower magnet 72 in the bottom segment 58. Magnets 70 and 72 may have a magnet height of 74, a magnet width of 76, and a magnet length of 78. Magnets 70 and 72 can be rare earth high-strength magnets. The magnet may consist of neodymium-iron-boron and is also inert like PTFE (eg, EI Du Pont de Nemours and Company (Delaware) Teflon®), PEEK. It may be encapsulated in a coating made of a polymer having stable biocompatibility or a combination thereof. Radiation-impermeable substances can also be added to the coating. Top and / or bottom magnets 70 and / or 72, one or an irregular number of magnets 70 and / or 72 (eg, N poles) polarities, other magnets 70 and / or 72 polarities (eg, eg N poles) , S pole) may be designed to allow only one angular orientation of the second prosthesis 68.
In one example 24, the magnets 70 may be evenly distributed around the first prosthesis 2. The magnet height 74 can be about 3.175 mm (0.125 inches). The magnet width 76 can be about 3.175 mm (0.125 inches). The magnet length 78 can be about 1.59 mm (0.0625 inches).
13 and 14 show a form of the first prosthesis 2 similar to the morphology shown in FIGS. 11 and 12. This form of the first prosthesis 2 may have a suture surface 80 of the fabric. The magnet 70 can have a square or rectangular cross section (as shown in FIGS. 11 and 12) or an elliptical or circular cross section (as shown in FIGS. 13 and 14). The wall 4 can also have multiple segments 58 and 60, as shown in FIGS. 11 and 12, or can have a single segment, as shown in FIGS. 13 and 14.
FIG. 15 shows a form of the first prosthesis 2 similar to the morphology shown in FIGS. 11 and 12. The first prosthesis in this form can also be mechanically and / or elastically stretchable on the outer circumference.
16-18 show the deformable morphology of the first prosthesis 2. In the unstretched state, the first prosthesis 2 may have an unstretched diameter of 82. The form of the first prosthesis 2 in FIG. 16 can have a smooth wall 4, thereby stretching depending on the hoop strain. The form of FIG. 17 may have a bellows wall 4 with a plurality of folds or folds 84. The fold 84 can be opened or unfolded during use to maximize the stretch of the outer circumference of the wall 4. The first prosthesis 2 form of FIG. 18 may have a single large fold 84 for the same purpose as the fold 84 shown in FIG. FIG. 19 shows the deformable morphology of the first prosthesis 2 in the stretched state. A radial force, as indicated by the arrow, away from the longitudinal axis 6 can extend the first prosthesis 2 to an enlarged diameter of 86. Those skilled in the art will appreciate the material and dimensions of the first prosthesis 2, with the ratio of unstretched diameter 82 to stretched diameter 86 being about 0% to about 50%, narrower about 5% to about 20%, and even more. It can be selected to allow a narrow range of about 9% to about 12%, for example about 9.5%.
FIG. 20 shows a wall 4 of a certain length that may have a first fixed device connector 88 and a second fixed device connector 90. Fixed device connectors 88 and 90 can be ports (or mouths) or holes in wall 4. The fixed device connectors 88 and 90 can be oval and can have a fixed device connector height 92 and a fixed device connector length 94. The fixed device connector height 92 can range from about 0.51 mm (0.020 inches) to about 3.18 mm (about 0.125 inches), and narrower is about 1.0 mm (0.040 inches) to about 1.5 mm (0.060 inches), for example about. It may be 1.3 mm (0.050 inch).
FIG. 21 shows a wall 4 of a certain length, which may have first, second and additional fixed device connectors 88, 90 and 96. The fixed device connectors 88, 90 and 96 may be circular in shape. FIG. 22 shows a wall 4 of a certain length, which may have fixed device connectors 88, 90 and 96 attached to the front and hem edges 20 and 22. Fixed device connectors 88, 90 and 96 are made of cloth or metal, eg polyester (EI). Du Pont de Nemours and Company (Wilmington, Delaware) Dacron®, polypropylene, PTFE, ePTFE, nylon, extruded collagen, polymers such as silicone, stainless steel alloys, nickel-titanium alloys (eg, nickel-titanium alloys) , Nitinol), cobalt-chromium alloy (eg, Elgin Specialty Metals (Elgin, Illinois), ELGILOY (registered trademark: ELGILOY); Carpenter Metals Corp. (Wyomissing, Pennsylvania), CONICHROME®) or a combination thereof. Can consist of. Fixed device connectors 88, 90 and 96 of different shapes and configurations may be present on the same wall 4.
FIG. 23 shows a wall 4 of a certain length that may have receiving elements 32 and 34. Receiving elements 32 and 34 can be ports or holes in wall 4. Accepting elements 32 and 34 and fixed device connectors 88, 90 and 96 may be the same element. Accepting elements 32 and 34 may have a first neck 100 at one end of a first set position (or setting position) 98 and a first set position 98. The first set position 98 may have a set position length 102 of about 4 mm (0.2 inches) to about 10 mm (0.4 inches), for example about 6.3 mm (0.25 inches). The first neck 100 can have a neck width 104. The first neck may be at the first end of the second set position 106. Accepting elements 32 and 34 may have more or less (eg, one or zero) set positions 98 and 106 than two. At the second end of the second set position 106, the second set position 106 may have a second neck 108. The second neck 108 may be at the first end of the final stop (or stop) position 110. The final stop position 110 may have a final stop length 112.
1st and 2nd set positions 98 and<u style="single">10</u>The 6 has a ramp angle of 114 and can lead to the first and second necks 100 and 108, respectively. The stop position 110 and the second set position 106 can reach the second neck 108 and the first neck 100, respectively, with the stop angle 116.
FIG. 24 shows the narrowing oval or teardrop-shaped receiving elements 32 and 34. FIG. 25 shows rectangular accepting elements 32 and 34.
FIG. 26 shows a receiving element 32 that can be in collar or sleeve shape. The receiving element 32 can be attached by a connecting zone 118 to a rod (not shown) that extends from or towards the wall 4 itself. The receiving element 32 may have a first wedge (or wedge) 120 and a second wedge 122. The length between the closest points of the first wedge 120 or the second wedge 122 can be a neck width of 104. Wedges 120 and 122 can rotate around the entire receiving element 32, thereby (when viewed three-dimensionally) a single circular first wedge 120, and a single circular Form a second wedge 122.
The receiving element shaft passage 124 can be opened at one end of the receiving element 32. The receiving element 32 may have a first narrowed portion 126 near the connection zone 118 and a second narrowed portion 128 near the shaft passage 124 of the receiving element. FIG. 27 shows the receiving element 32, which may have wedges 120 and 122 formed like scales or stop tabs.
A wall 4 of a certain length, which may have protrusions 26 and 28, is shown in FIG. The protrusions 26 and 28 are shown alone in various forms in FIGS. 29 and 25 and can be formed from the extension 130 and the cuff 132. The extension 130 can be formed in a cylindrical shape or, as shown in FIG. 30, like a shaft having a triangular cross section. The extension 130 may have an extension height 134 and an extension width 136. The extension height 134 may be from about 0.51 mm (0.020 inch) to about 2.54 mm (about 0.100 inch), for example about 1.3 mm (0.050 inch). The final stop length 112 may be approximately between an extension width of 136 and about 10 mm (0.4 inches), for example about 6.3 mm (0.25 inches).
The cuff 132 can be formed in a circular or square shape and can have a substantially constant depth. The cuff 132 may have a cuff height of 138 and a cuff width of 140. Cuff height 138 is approximately between fixed device connector height 92 and approximately 5.08 mm (0.200 inches).<u style="single">Well, for example, 2.0 mm (0.080 inch)</u>I. The cuff width 140 may be within the range with respect to the cuff height 138 described above.
FIG. 31 shows a wall 4 of a length with protrusions 26 and 28 consisting of tabs cut out from the wall 4. The cut-out hole 142 could be present in wall 4, where the components of protrusions 26 and 28 were present in wall 4 prior to the cut-out.
FIG. 32 shows the length of a wall 4 that may have a first set of protrusions 26 extending from wall 4 and a second set of protrusions 28 extending from wall 4. The wall 4 may have a radius of curvature of 144 on the wall. The protrusions 26 and 28 may have a radius of curvature of the protrusion 146. The radius of curvature 146 of the protrusion may be approximately between the radius of curvature 144 of the wall and infinity.
FIG. 33 shows a wall 4 of a certain length that may have an engaging element 148. The engaging element 148 can be formed in a lip shape and can be wrapped around the protrusion 26. Engagement element 148 allows the first prosthesis to self-engage with the second prosthesis 68. For example, the engaging element 148 can be snap-fitted into the second prosthesis 68.
FIG. 34 shows the first end 8 and the second end 10. The second end 10 may have a first guide 150 and a second guide 152 that can wrap around the front edge 20 and the hem edge 22 of the first end 8, respectively. The first end 8 can slide within the guides 150 and 152 in an angle (or angular displacement) with respect to the longitudinal axis. Guides 150 and 152 can also minimize the risk of the first end 8 moving too far or inconsistent with the second end 10.
Figures 35 to 43 show<u style="single">Vertical</u>A cross-sectional view in the direction shows one form of the first prosthesis 2.<u style="single">Vertical</u>The directional cross section can be a cross section parallel to the longitudinal axis 6. Figure 35 shows the waveform.<u style="single">Vertical</u>A form including a wall 4 having a cross section in a direction is shown. FIG. 36 is parallel to longitudinal axis 6,<u style="single">Vertical</u>A form with a wall 4 having a straight cross section in the direction is shown.
FIG. 37 shows an embodiment having a hem 22 that is inclined at a wall angle of 56 toward axis 6 in the longitudinal direction. FIG. 38 shows a form having a hem 22 that is inclined away from the longitudinal axis 6 at a wall angle of 56.
FIG. 39 shows an embodiment having a wall 4 that is convex with respect to the longitudinal axis 6. Wall 4 may be straight or<u style="single">Vertical</u>It may have a convex radius of curvature 154 in the direction. FIG. 40 shows an embodiment having a wall 4 that is concave with respect to the longitudinal axis. Wall 4<u style="single">Vertical</u>Within the same range as the convex radius of curvature 154 in the direction,<u style="single">Vertical</u>It may have a recessed radius of curvature 156 in the direction.
FIG. 41 shows an embodiment having a wall 4 with a top segment 60, a middle segment 158 and a bottom segment 58. The top segment 60 and the leading edge 20 may be tilted away from the longitudinal axis 6. The bottom segment 58 and the hem 22 may be inclined away from the longitudinal axis 6. The middle segment 158 may remain parallel to the longitudinal axis.
FIG. 42 shows an embodiment having a top segment 60 and a leading edge 20 that may slope towards axis 6 in the longitudinal direction. The bottom segment 58 and hem 20 may also be inclined towards longitudinal axis 6. The middle segment 158 may remain parallel to longitudinal axis 6.
Figures 43 and 44 extend from wall 4 at a retainer angle of 160, which is about 0 ° to about 90 °, more narrowly about 10 ° to about 50 °, for example about 30 °, with respect to longitudinal axis 6. Shown is an embodiment of a wall 4 that may have a bottom segment 58 capable of. The bottom segment 58 may also have a notch (or cut or cut) 162 as shown in FIG. The cut 162 may minimize stress as the bottom segment 58 widens away from the middle segment 158. The bottom segment 58 can also act as a retaining element, extending beyond the general hem 22 and stabilizing the first prosthesis 2 after the first prosthesis 2 has been implanted.
FIG. 45 shows a cross section of a wall 4 that may have cloth covering 164. Cloth covering is, for example, polyester (EI Du Pont de Nemours and Company (Wilmington, Delaware) Dacron®), polypropylene, PTFE, ePTFE, nylon, extruded collagen, silicone, or a combination thereof. Is. The cloth can be attached to the wall 4 at the first attachment point 166 and the second attachment point 168. The exposed area of the wall between mounting points 166 and 168 can be the engaging surface 170. The second prosthesis 68 can engage the first prosthesis 2 at the engaging surface 170.
FIG. 46 shows a cross section of a wall 4 entirely covered with covering 164. The second prosthesis 68 can also engage the first prosthesis 2 at the engagement surface 170 covered by the covering 164.
FIG. 47 shows a wall 4 of a length having an engaging element 148 formed like an open lip on the front edge 20. The engaging element 148 may be bent towards the longitudinal axis 6 and the hem 22. FIG. 48 shows an engaging element 148 that is bent away from the longitudinal axis 6 and toward the hem 22.
Figures 49 and 50 show one form of the first prosthesis 2 which may have a first length 172, a second length 174 and a third length 176. Lengths 172, 174 and 176 are separated by a notch 162 in the wall 4. The engaging element 148 at the first length 172 and the third length 176 may be bent toward the longitudinal axis 6. The top segment 60 and middle segment 158 of the first length 172 and the third length 176 may also be bent away from the bottom segment 58 indicated by the arrow in FIG. The top segment 60 and middle segment 158 of the second length 174 are similar to, but opposite to, the top segment 60 and middle segment 158 of the first length 172 and the third length 176. Can be bent in the direction of. The engaging element 148 at the second length 174 can be bent away from the longitudinal axis 6. The lip length 178 is the second lip of the engaging element 148 at the first lip edge 180 and the second length 174 of the engaging element 148 at the first length 172 or the third length 176. It may be the distance between the edge 182 and the edge 182. The lip length 178 can be small enough to form a seam, crease, or seat (or seat) 184 for installing, accommodating and engaging a second prosthesis.
FIG. 51 shows a wall 4 of a certain length, which may have lengths 172, 174, and 176. The engaging element 148 at the first length 172 and the third length 176 may be bent away from the longitudinal axis 6. The engaging element 148 at the second length 174 can be bent toward axis 6 in the longitudinal direction. The engaging element 148 can engage the second prosthesis on both sides of the wall 4.
Figure 52. It shows one form which can have a spring 186. One segment of each spring 186 may be a latch 188. The spring 186 may have a winding (or winding) 190 around a rail 192 fixed under the engaging element 148. The spring 186 can also have holding legs 194 pressed against the wall 4. The latch 188 can be biased and contracted (or retracted) against the wall 4 as indicated by arrow 196. The latch 188 can be held in a non-contracted position by the interference beam 198 as shown in FIG. The interference beams 198 are firmly attached to each other directly or indirectly at the proximal end (in the direction of arrow 200) to minimize the warpage of the interference beam 198 from latch 188 under the action of force. .. When the second prosthesis is placed within reach of the latch 188, the interfering beam 198 can be removed as indicated by arrow 200 and, for example, applied to the second prosthesis and latched as indicated by arrow 196. Shrink 188.
Production method The wall 4 can be made by a method known to those skilled in the art. For example, the wall 4 can be molded or mechanically machined. Engagement elements 148, corrugations, and any other bends in the wall 4 are formed (eg, pressure molded), molded, or machined within the wall 4 by methods known to those of skill in the art. Or it can be folded into metal.
Protrusions 26 and 28 and receiving elements 32 and 33 (eg, in connection zone 118) are pleated (or wrinkled), punched, glued, melted, screwed.<u style="single">, Da</u>It can be fixed to wall 4 or formed from wall 4 by ecutting, welding, laser cutting, electrical discharge machining (EDM), or a combination thereof. The cuts 162 and openings in the wall 4 can be formed by die cutting, laser or EDM.
The first prosthesis 2 or the first prosthesis 2 as a whole after assembly can be coated by a dip coating method or a spray coating method known to those skilled in the art. An example of a method used to coat a medical device for a tube (or blood vessel) is provided in US Pat. No. 6,358,556 of Ding et al., All of which is incorporated herein by reference. Sustained-release coating methods known to those of skill in the art can also be used to delay the release of the drug in the coating. The coating may be thrombogenic or antithrombotic. For example, the inner coating of the first prosthesis 2 and the side coating facing the longitudinal axis 6 may be antithrombotic and away from the outer coating of the first prosthesis and the longitudinal axis. The coating on the facing side may be thrombogenic.
The first prosthesis 2 is a fabric, such as polyester (EI Du Pont de Nemours and Company (Deraware) Dacron®), polypropylene, PTFE, ePTFE, nylon, extruded collagen, silicone, Or a combination of them. Methods of covering the implantable device with a cloth are known to those of skill in the art.
how to use The first prosthesis 2 can be introduced into the chamber 202 adjacent to the target annulus 204 in a non-extended state by a method known to those of skill in the art. FIG. 53 shows that the first prosthesis 2 is placed on the annulus 204 and lowered, as indicated by the arrow. Due to the foldable and extensible nature of the first prosthesis 2, the procedure for implanting the first prosthesis 2 is using a thoracoscope, endoscope and / or endolumina. , Can be carried out. The first prosthesis 2 is provided so that it does not block the opening of the duct in the chamber adjacent to the annulus 204 (eg, the opening of the coronary vessel) and from the annulus 204 (eg, the chamber of the heart, eg). It can be placed sufficiently accurately within the annulus 204 so that it does not fall (into the ventricle). The annulus 204 may have an initial ring diameter of 206. FIG. 54 shows the placement and installation of the first prosthesis 2.
When the first prosthesis 2 is not fully extended, the protrusions 26 and the receiving element 32 can be aligned as shown in FIGS. 55 and 56. As shown in FIG. 55, the extension portion 130 can be arranged at the first set position 98. As shown in FIG. 56, the sphere 50 can be placed at the first set position 98.
The outer circumference of the first prosthesis 2 can be extended as shown by an arrow in FIG. 57. The prosthesis may have an extended ring diameter of 208. The elongated ring diameter 208 may range from about 5 mm (0.2 inches) to about 40 mm (1.6 inches), depending on the size of the initial ring diameter 206, other anatomical structures, variants (eg, stenosis, etc.). Stenosis) and age (eg, pediatric sizing). An extension device 210 can be used to extend the first prosthesis 2. Examples of stretchers 210 include balloons, the back of clamp jaws, or flexible plug assemblies as shown in FIGS. 58-61. An example of another stretcher 210 is disclosed in US Pat. No. 5,984,959 by Robertson et al., Which patent is incorporated herein by reference in its entirety.
FIG. 58 shows a flexible plug 212 that is cylindrical and has a stationary plate on the first side 216. The plug 212 can be made of a polymer, for example polyurethane or silicone. The plug 212 may have an opening 218 in the center of the plug 212. The rigid inner tube 220 can pass through the opening 218 and is firmly secured to the washer 222 at the first side 216 or resists the washer 222 at the first side 216. Can be pulled (or washer 222 in the opposite direction). The squeeze plate 224 can be firmly attached to the end of the rigid outer tube 226. The outer tube 226 may be larger than the inner tube 220, and the inner tube 220 can slide through the outer tube 226. A force in the direction of the plug 212 can be applied to the outer tube 226 as indicated by arrow 228. A force away from the plug 212 can be applied to the inner tube 220 as indicated by the arrow 230. The plug may have a stationary (or dormant) radius of 232 when no force is applied.
When the force indicated by arrows 228 and 230 is applied to the plug 212, the plug 212 can deform and deform away from the tubes 220 and 226, as shown by arrow 234. When deformed, the plug 212 may have an extended diameter of 236. The quiescent radius 232 and the extended diameter 236 are properly fitted to the dimensions of the first prosthesis 2. Deformation of the plug 212 can also generate a force in the same direction as arrow 234. When the forces indicated by arrows 228 and 230 are removed, the plug 212 can be returned to the shape shown in FIG.
FIG. 60 shows another form of the plug 212. The plug 212 may have a recessed upper surface 238 and a recessed lower surface 240. The upper outer circumference 242 and the lower outer circumference 244 can be inclined from the recessed surfaces 238 and 240 to intersect the wall 246 of the plug 212. Both the squeeze plate 224 and the stationary plate 214 can be formed in a conical shape or in part in a conical shape to fit the outer circumferences 242 and 244 of the plug 212. As shown in FIG. 61, when the forces indicated by arrows 228 and 230 are applied, the plug wall 246 can extend radially to maintain a flat surface.
When the first prosthesis 2 is fully extended, the protrusions 26 and the receiving element 32 can be aligned as shown in FIGS. 62 and 63. As shown in FIG. 62, the extension 130 can be arranged at the final stop position 110. As shown in FIG. 63, the ball 50 can be placed at the final stop position 110. The tight fit provided by the stop angle 116 and the neck width 104 of the second neck 108 can prevent the protrusion 26 from re-entering the second set position 106. In addition, when stretched, the first prosthesis frictionally engages the annular portion, stretching the ring diameter. Upon extension, the first prosthesis 2 can also capture plaque in the duct (or blood vessel) between the wall 4 and the outer circumference of the annulus 204. The first prosthesis can also be partially stretched to push the protrusion 26 into the second set position 106.
As shown in FIG. 64, the fixation device 248 can be used to secure the first prosthesis 2 to the biological mass of the annular portion 204 via the fixation device connector 88. Fixed device<u style="single">Of</u>Examples are sutures, clips, staples, pins and combinations thereof.
FIGS. 65-68 show one form of a method of fixing the first prosthesis 2 to the annular portion 204. FIG. 65 shows the fixed device assembly 250. The fixed device assembly 250 may have a needle 252. The needle 252 may be bent or may have a bent tip. Needle 252 can also be attached to the distal end of the line at the proximal end. The proximal end of the needle 252 can also be attached directly to the container (can) 256 without the use of line 254, or can be formed as a container 256. The proximal end of line 254 can be attached to container 256. Container 256 can be a flexible cylindrical storage device, such as a coil. Container 256 can hold the fixed device 148 so that it can be removed. The fixing device 148 may have a fixing element 258, which is, for example, a wire or fiber. The fixing element 258 can have the ball 260 at the first end and a radially extendable portion 262 at the second end. The fixing device 248 can also have a cotton thread 264 between the ball 260 and the stretchable portion 262 on the fixing element 258.
The fixed device assembly 250 can be positioned so that the needle 252 is close to the fixed device connector 88, as indicated by arrow 266. The needle 252 is then pushed through the fixed device connector 88 and the annular portion 204, as indicated by arrow 268 in FIG. The needle 252 is then pulled away from the annular portion 204, as indicated by arrow 270 in FIG. The container 256 can follow the path of the needle 252 via the annular portion 204, as indicated by the arrow 272. The cotton thread 264 may be larger than the fixed device connector 88, and the cotton thread 264 may also provide a tight fit to the fixed device connector 88. The needle 252 can continue to be pulled away from the annular portion 204, pulling the container 256 out of the annular portion 204, as indicated by arrow 274 in FIG. The tight fit of the cotton thread 264 to the fixed device connector 88 holds the fixed device 248 and also provides resistance to slide the fixed element 258 out of the container 256 as the needle 252 is pulled away from the annular portion 254. be able to. The radially extendable portion 262 can then be radially stretched so that the first prosthesis 2 and the annular portion 204 can be stretched between the cotton strip 264 and the radially extendable portion 262. Fix it.
The inner surface of the container 256 can be configured, for example, by rolling, corrugating, or other roughening treatment to adjust the friction between the inner surface of the container 256 and the fixation device 148. This friction can affect the amount of resistance required to remove the fixation device 148 from the container 256. The resistance can be greater than the approximate force required to drop the fixed device 148 from the container 256 before the fixed device 148 has passed through the ring 104. The resistance can also be less than the force required to deform the cotton removal thread 265 enough to pull the cotton removal thread 256 through the fixed device connector 88. The resistance can be, for example, about 1.1 N (0.25 lbs).
The second prosthesis 68 can then be placed on the engaging element 148 as indicated by the arrows in FIG. Once the engaging element 148 is installed, the second prosthesis 68 is then engaged by the first prosthesis 2, as shown in FIG. 70. Examples of a second prosthesis 68 include a connection adapter and a heart valve crown with a leaflet 276, such as Lane's US Pat. No. 6,371,983. The US patent is incorporated herein by reference in its entirety.
FIG. 71 shows another form of heart valve assembly 278 with a second prosthesis 68. The first prosthesis 2 provides a longitudinal stop and, as indicated by arrow 282, a wall 280 with a taper to guide the insertion of the second prosthesis 68 into the first prosthesis 2. May have. The tapered wall 280 can also push back the annular portion 204 to maintain an extended ring diameter 208 as the second prosthesis 68 engages the first prosthesis 2. The second prosthesis 68 may have a spring-locking tab 284 to secure it to the engaging element 148. The spring-locked tab 284 may be inclined outward from axis 6 in the longitudinal direction. The first and second prostheses 2 and 68 can have first and second prosthesis diameters 288 and 290, respectively. The diameter 288 of the first prosthesis may be larger than the diameter 290 of the second prosthesis. FIG. 72 shows one form of the heart valve assembly 278 of FIG. 71, where the diameter 290 of the second prosthesis may be larger than the diameter 288 of the first prosthesis, and the spring-locking tab 284 has a longitudinal axis. It may be inclined inward toward 6. The first prosthesis 2 and the second prosthesis 68 can act to retain the lumen diameter 208 of the extended annular portion.
FIG. 73 is another form of a heart valve assembly 278 having a second prosthesis 68 that may have a fixation point 286 aligned with a fixation point 286 on the first prosthesis 2, the first prosthesis. Demonstrates a form that allows a suture, grommet (or eyelet), clip 292 or pin 294 to be inserted through an aligned fixation point 286 to secure the 2 to the second prosthesis 68.
FIG. 74 has multiple lobes (or notches, or earlobe-like protrusions) that can be placed near the edge of the second prosthesis 68, as indicated by arrow 298.<u style="single">Equipped with reinforcing ring 296</u>, Another form of heart valve assembly 278 is shown. The second prosthesis 68 may have a plurality of flaps 300. The flap 300 may wrap around (or wrap around) the stiffening ring 296, as indicated by arrow 302. The wrapped reinforcing ring 296 can increase the rigidity of the second prosthesis 68 and can engage with the engaging element 148.
FIG. 75 shows yet another form of heart valve assembly 278 having a first prosthesis 2 in a form equivalent to that of FIG. 52. The second prosthesis 68 can have a latch opening 304 for receiving the latch 188. When the second prosthesis 68 is lowered into the first prosthesis 2, the interfering beam 198 can be removed, as indicated by arrow 200. The latch 188 then contracts at the latch opening 304.
FIG. 76 shows another form of heart valve assembly 278 with a first prosthesis 2 in a form equivalent to that of FIGS. 11 and 12. The second prosthesis may have ribs 306 that fit within the groove 64. The second prosthesis 68 may also have an upper arm 308 that may have an upper magnet 70 and a lower arm 310 that may have a lower magnet 72. The magnets 70 and 72 in the second prosthesis can have polarities opposite to the polarities of the corresponding magnets 70 and 72 in the first prosthesis 2. FIG. 77 shows a form of heart valve assembly 278 having a first prosthesis in a form equivalent to that of FIGS. 13 and 14.
FIG. 78 shows a form of heart valve assembly 278 with an adapter 312 connecting the second prosthesis 68 to the first prosthesis 2. The adapter 312 may have a spring-locking tab 284 for fastening to the engaging element 148, and the adapter 312 may have a stop ridge (or stop) for placing the adapter 312 against the wall 4. -Ridge) 314 can be held.
The adapter 312 also has a fixing point 286 that aligns with the other fixing points 286 on the second prosthesis 68, and to secure the adapter 312 to the second prosthesis 68, sutures, grommets, clips, pins or The fixed device 248 may be inserted past the aligned fixed point 286. The second prosthesis 68 can also be lowered into the top of the adapter 312 as indicated by arrow 316. The adapter 312 can be mounted inside or outside the first prosthesis 2 or the second prosthesis 68, depending on the size and orientation of the mounting device (eg, one-way clips).
The adapter 312 can also have multiple cross-sections, as shown in FIGS. 79 and 80. As shown in FIG. 79, the cross section CC can have three lobes 318 and three corrugated parts (or scallop or scalloped parts) 320. One corrugated portion 320 may be between each lobe 318. As shown in FIG. 79, the cross section CC can be the same as the cross section of the second prosthesis 68, where the second prosthesis 68 engages the adapter 312. As shown in FIG. 80, the cross section DD may be circular. The cross section DD may have the same shape as the first prosthesis 2, where the first prosthesis 2 engages the adapter 312.
FIG. 81 shows a second prosthesis 68 housed in the first prosthesis 2. The second prosthesis 68 can have three robes 318. The second prosthesis may have a corrugated portion 312 between each of the two lobes 318. The scallop gap 322 between each scallop 320 and wall 4 may be covered with a cloth during the use of prostheses 2 and 68.
FIG. 82 shows that the lever device 324 (eg, clamp or scissors) can be pushed into the scalloped gap 322 as indicated by the arrows. As shown in FIG. 83, when the leg 326 of the lever device 324 is placed close to the two corrugated parts 320, the lever device 324 is squeezed as indicated by the arrow, thereby the second. Prosthesis 68 can be broken and separated from the first prosthesis 2. As shown in FIG. 84, when the second prosthesis 68 is separated from the first prosthesis 2, the second prosthesis 68 can be removed from the first prosthesis 2 as indicated by the arrows. Once the second prosthesis 68 has been removed, a new second prosthesis 68 can be added as described above. Leaflet failure can be repaired easily and inexpensively by implanting a new second prosthesis 68. Stretching the perimeter of the first prosthesis 2 and replacing the second prosthesis 68 to result in pediatric valve stretch can also be performed easily and inexpensively.
It will be apparent to those skilled in the art that various modifications and modifications can be made to this disclosure and the equivalents adopted without departing from the spirit and scope of the invention. The elements shown for any form are exemplary for a particular form and can be used in other forms within this disclosure.
<figref num="1">FIG. 1 is a bottom view of a form of prosthesis.</figref><figref num="2">FIG. 2 is a top perspective view of the prosthesis of the form of FIG.</figref><figref num="3">FIG. 3 is a bottom view of another form of the prosthesis.</figref><figref num="4">FIG. 4 is a top perspective view of the prosthesis in the form of FIG.</figref><figref num="5">FIG. 5 is a bottom view of another form of the prosthesis.</figref><figref num="6">FIG. 6 is a top perspective view of the prosthesis in the form of FIG.</figref><figref num="7">FIG. 7 is a bottom view of another form of the prosthesis, with the collar shown in a notched view.</figref><figref num="8">FIG. 8 is a top perspective view of the prosthesis of the form of FIG. 7, with the collars shown in cutouts.</figref><figref num="9">FIG. 9 is a bottom view of another form of the prosthesis, showing the collar in a cut view.</figref><figref num="10">FIG. 10 is a top perspective view of the prosthesis of the form of FIG. 8 with the collars shown in cutouts.</figref><figref num="11">FIG. 11 is a top perspective view of another form of prosthesis with magnets.</figref><figref num="12">FIG. 12 shows a cross-sectional view of AA in FIG.</figref><figref num="13">FIG. 13 is a top perspective view of another form of prosthesis with magnets.</figref><figref num="14">FIG. 14 shows a cross-sectional view of the BB of FIG.</figref><figref num="15">FIG. 15 is a top perspective view of another form of prosthesis with magnets.</figref><figref num="16">FIG. 16 is a top view of a form of deformable prosthesis in the unstretched state.</figref><figref num="17">FIG. 17 is a top view of a form of deformable prosthesis in the unstretched state.</figref><figref num="18">FIG. 18 is a top view of a form of deformable prosthesis in the unstretched state.</figref><figref num="19">FIG. 19 is a top view of the prosthesis in the form of FIG. 12 in the stretched state.</figref><figref num="20">FIG. 20 shows a form of a fixed device connector.</figref><figref num="21">FIG. 21 shows a form of a fixed device connector.</figref><figref num="22">FIG. 22 shows a form of a fixed device connector.</figref><figref num="23">FIG. 23 shows one form of the accepting element.</figref><figref num="24">FIG. 24 shows one form of the accepting element.</figref><figref num="25">FIG. 25 shows one form of the accepting element.</figref><figref num="26">FIG. 26 is a cut-out view of the receiving element.</figref><figref num="27">FIG. 27 is a cut-out view of the receiving element.</figref><figref num="28">FIG. 28 shows one form of protrusion.</figref><figref num="29">FIG. 29 shows one form of protrusion.</figref><figref num="30">FIG. 30 shows one form of protrusion.</figref><figref num="31">FIG. 31 shows a form of protrusion.</figref><figref num="32">FIG. 32 shows a form of protrusion.</figref><figref num="33">FIG. 33 shows one form of protrusion.</figref><figref num="34">FIG. 34 shows the steering element.</figref><figref num="35">FIG. 35 is a cross-sectional view of a form of the wall of the prosthesis.</figref><figref num="36">FIG. 36 is a cross-sectional view of a form of the wall of the prosthesis.</figref><figref num="37">FIG. 37 is a cross-sectional view of a form of the wall of the prosthesis.</figref><figref num="38">FIG. 38 is a cross-sectional view of a form of the wall of the prosthesis.</figref><figref num="39">FIG. 39 is a cross-sectional view of a form of the wall of the prosthesis.</figref><figref num="40">FIG. 40 is a cross-sectional view of a form of the wall of the prosthesis.</figref><figref num="41">FIG. 41 is a cross-sectional view of a form of the wall of the prosthesis.</figref><figref num="42">FIG. 42 is a cross-sectional view of a form of the wall of the prosthesis.</figref><figref num="43">FIG. 43 is a cross-sectional view of a form of the wall of the prosthesis.</figref><figref num="44">FIG. 44 shows one form of the prosthesis of FIG. 38.</figref><figref num="45">FIG. 45 shows a cross-sectional view of the wall of a prosthesis with covering.</figref><figref num="46">FIG. 46 shows a cross-sectional view of the wall of a prosthesis with covering.</figref><figref num="47">FIG. 47 shows one form of engaging element.</figref><figref num="48">FIG. 48 shows one form of engaging element.</figref><figref num="49">FIG. 49 shows one form of engaging element.</figref><figref num="50">FIG. 50 shows one form of engaging element.</figref><figref num="51">FIG. 51 shows a form of engaging element.</figref><figref num="52">FIG. 52 shows one form of engaging element.</figref><figref num="53">FIG. 53 is a notch view of a form in which the prosthesis is arranged in the annular portion, and the prosthesis is shown in a three-dimensional view.</figref><figref num="54">FIG. 54 is a notched view of a form in which the prosthesis is arranged in the annular portion.</figref><figref num="55">FIG. 55 shows a form of protrusions and accepting elements when the prosthesis is not stretched.</figref><figref num="56">FIG. 56 shows a form of protrusions and accepting elements when the prosthesis is not stretched.</figref><figref num="57">FIG. 57 is a notched view of a form of stretching the prosthesis.</figref><figref num="58">FIG. 58 shows a form of stretching tool.</figref><figref num="59">FIG. 59 shows a form of the stretching tool.</figref><figref num="60">FIG. 60 shows another form of the stretching tool.</figref><figref num="61">FIG. 61 shows another form of the stretching tool.</figref><figref num="62">FIG. 62 shows a form of protrusions and accepting elements when the prosthesis is stretched.</figref><figref num="63">FIG. 63 shows a form of protrusions and accepting elements when the prosthesis is stretched.</figref><figref num="64">FIG. 64 is a notched view of fixing the prosthesis to the biological mass.</figref><figref num="65">FIG. 65 shows a method of immobilizing a prosthesis to a biological mass and a form of assembly.</figref><figref num="66">FIG. 66 shows a method of immobilizing a prosthesis to a biological mass and a form of assembly.</figref><figref num="67">FIG. 67 shows a method of immobilizing a prosthesis to a biological mass and a form of assembly.</figref><figref num="68">FIG. 68 shows a method of immobilizing a prosthesis to a biological mass and a form of assembly.</figref><figref num="69">FIG. 69 is a notched view in which the second prosthesis is placed in the first prosthesis, and the second prosthesis is shown in three dimensions.</figref><figref num="70">FIG. 70 is a notched view of attaching the second prosthesis to the first prosthesis.</figref><figref num="71">FIG. 71 is an exploded view of a form in which the second prosthesis is attached to the first prosthesis.</figref><figref num="72">FIG. 72 is an exploded view of a form in which the second prosthesis is attached to the first prosthesis.</figref><figref num="73">FIG. 73 is an exploded view of a form in which the second prosthesis is attached to the first prosthesis.</figref><figref num="74">FIG. 74 is an exploded view of a form in which the second prosthesis is attached to the first prosthesis.</figref><figref num="75">FIG. 75 is an exploded view of a form in which the second prosthesis is attached to the first prosthesis.</figref><figref num="76">FIG. 76 is an exploded view of a form in which the second prosthesis is attached to the first prosthesis.</figref><figref num="77">FIG. 77 is an exploded view of a form in which the second prosthesis is attached to the first prosthesis.</figref><figref num="78">FIG. 78 is an exploded view of a form in which the second prosthesis is attached to the adapter and the adapter is attached to the first prosthesis.</figref><figref num="79">FIG. 79 shows a cross-sectional view of the CC of FIG. 78.</figref><figref num="80">FIG. 80 shows a cross-sectional view of the DD of FIG. 78.</figref><figref num="81">FIG. 81 is a top view of one form of the first prosthesis with the second prosthesis attached.</figref><figref num="82">FIG. 82 shows one form of a method of removing the second prosthesis from the first prosthesis.</figref><figref num="83">FIG. 83 shows one form of a method of removing the second prosthesis from the first prosthesis.</figref><figref num="84">FIG. 84 shows one form of a method of removing the second prosthesis from the first prosthesis.</figref>
Every citation, both ways
| Document | Relation | Office |
|---|---|---|
| US05984959A | Cites | United States of America |
| US06371983B1 | Cites | United States of America |
| EP00443994A1 | Cites | European Patent Office (EPO) |
| US03997923A | Cites | United States of America |
| JP57040783B2 | Cites | Japan |
| US03579642A | Cites | United States of America |
| US04743253A | Cites | United States of America |
| US06042607A | Cites | United States of America |
30 members in 6 offices
Priority claims9
| Document | Office | Kind | Date |
|---|---|---|---|
| 10327821 | United States of America | – | |
| 32782102 | United States of America | A | |
| 32782102 | United States of America | A | |
| 0341222 | United States of America | W | |
| 0341222 | United States of America | W | |
| 2002327821 | – | – | – |
| 2003041222 | – | – | – |
| US20020327821 | – | – | – |
| WO2003US41222 | – | – | – |
Members30
| Document | Office | Kind | |
|---|---|---|---|
| US2004122514A1 | United States of America | A1 | |
| US2004122516A1 | United States of America | A1 | |
| CA2509211A1 | Canada | A1 | |
| WO2004058106A2 | World Intellectual Property Organization (WIPO) | A2 | |
| AU2003299886A1 | Australia | A1 | |
| WO2004058106A3 | World Intellectual Property Organization (WIPO) | A3 | |
| US6939365B1 | United States of America | B1 | |
| EP1585463A2 | European Patent Office (EPO) | A2 | |
| US2005240263A1 | United States of America | A1 | |
| JP2006511279A | Japan | A | |
| EP1585463A4 | European Patent Office (EPO) | A4 | |
| JP2010246957A | Japan | A | |
| JP4635122B2This record | Japan | B2 | |
| US7981153B2 | United States of America | B2 | |
| US8025695B2 | United States of America | B2 | |
| US2011257737A1 | United States of America | A1 | |
| US2012053688A1 | United States of America | A1 | |
| EP2476394A1 | European Patent Office (EPO) | A1 | |
| US8460373B2 | United States of America | B2 | |
| US8551162B2 | United States of America | B2 | |
| EP2476394B1 | European Patent Office (EPO) | B1 | |
| US8623080B2 | United States of America | B2 | |
| JP5386664B2 | Japan | B2 | |
| US2014088697A1 | United States of America | A1 | |
| CA2509211C | Canada | C | |
| EP1585463B1 | European Patent Office (EPO) | B1 | |
| US9333078B2 | United States of America | B2 | |
| US2016250021A1 | United States of America | A1 | |
| US2019336277A1 | United States of America | A1 | |
| US10595991B2 | United States of America | B2 |
33 legal events, as the office reported them to INPADOC
Over the term
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| Receipt of annual feesJAPANESE INTERMEDIATE CODE: R250R250 | R250 | |
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| First payment of annual fees (during grant procedure)JAPANESE INTERMEDIATE CODE: A61A61 | A61 | |
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| Request for written amendment filedJAPANESE INTERMEDIATE CODE: A523A521 | A521 | |
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Numbers
- Publication
- 4635122
- Publication, DOCDB
- 4635122
- Publication, EPODOC
- JP4635122B
- Application
- 2004564040
- Application, DOCDB
- 2004564040
- Application, EPODOC
- JP20040564040
Titles2
- Japanese
- 生物学的に植え込み可能なプロテーゼおよびその使用方法
- English
- Biologically implantable prosthesis and how to use it
Classification
- CPC, 17
- A61F2/2409
- A61B17/0401
- A61B2017/00243
- A61B2017/0406
- A61B2017/0417
- A61B2017/0496
- A61B2017/0608
- A61F2/2412
- A61F2/2415
- A61F2002/30545
- A61F2250/001
- Y10S623/91
- A61F2220/0016
- A61F2220/0041
- A61F2220/0066
- A61F2220/0075
- A61F2/2445
- IPC, 5
- A61F2 24
- A61B17 00
- A61B17 04
- A61B17 06
- A61F2 02