Abstract
The present application relates to a separately releasable aortic valve stent, which includes a valve sewing segment, a positioning member, and a prosthetic valve. The prosthetic valve is connected to the valve sewing segment. The valve sewing segment and the positioning member are two independent components and connected to each other via a guiding device. The positioning member is able to be released prior to the valve sewing segment. A slide connection structure is disposed on the valve sewing segment. One end of the guiding device is connected to the positioning member, and another end of the guiding device passed through the slide connection structure is connected to the positioning member. The valve sewing segment is slidable along the guiding device.
Claims
1. A separately releasable aortic valve stent, comprising a valve sewing segment, a positioning member, and a prosthetic valve, wherein the prosthetic valve is connected to the valve sewing segment, the valve sewing segment and the positioning member are two independent components and connected to each other via a guiding device, the positioning member is able to be released prior to the valve sewing segment, a slide connection structure is disposed on the valve sewing segment, one end of the guiding device is connected to the positioning member, another end of the guiding device passed through the slide connection structure is connected to the positioning member, and the valve sewing segment is slidable along the guiding device.
2. The separately releasable aortic valve stent of claim 1, wherein the positioning member comprises an anchoring segment and a clamping segment connected to the anchoring segment, one end of the guiding device is connected to the clamping segment, another end of the guiding device passed through the slide connection structure is connected to the anchoring segment, and the valve sewing segment is slidable along the guiding device via the slide connection structure.
3. The separately releasable aortic valve stent of claim 2, wherein the clamping segment has claws, ends of the claws are inwardly congregated toward an axis of the clamping segment, and a recess is defined on an outer periphery of the valve sewing segment; when the valve sewing segment is completely released, the recess is engaged with the inwardly congregated claws.
4. The separately releasable aortic valve stent of claim 1, wherein the guiding device has a flexible string structure or a strip structure.
5. The separately releasable aortic valve stent of claim 1, wherein the guiding device is located between the positioning member and the valve sewing segment.
6. The separately releasable aortic valve stent of claim 1, wherein when the valve sewing segment is completely released, the guiding device straddles over free edges of the autologous valve leaflets.
7. The separately releasable aortic valve stent of claim 6, wherein the autologous valve leaflets are straddled and lowered by the guiding device.
8. The separately releasable aortic valve stent of claim 1, wherein a relative position between the valve sewing segment and the positioning member is limited by a length of the guiding device.
9. The separately releasable aortic valve stent of claim 1, wherein the valve sewing segment and the positioning member are restricted and positioned at different positions in a delivery sheath.
10. The separately releasable aortic valve stent of claim 1, wherein the slide connection structure is located at a proximal end portion of the valve sewing segment, and connection sites between the guiding device and the anchoring segment are located on a distal end portion of the anchoring segment.
11. The separately releasable aortic valve stent of claim 1, further comprising an auxiliary guiding device, one end of the auxiliary guiding device is connected to the anchoring segment, and another end of the auxiliary guiding device is connected to the valve sewing segment.
12. The separately releasable aortic valve stent of claim 1, wherein a sealing member is disposed at a proximal end of the valve sewing segment.
13. The separately releasable aortic valve stent of claim 12, wherein the sealing member has a discontinuous strip structure.
14. The separately releasable aortic valve stent of claim 1, wherein a coordination structure is disposed on a distal end of the anchoring segment, a connection structure is disposed on a proximal end of the valve sewing segment, and the coordination structure and the connection structure are restrained to each other when being restricted and loaded in a delivery sheath.
15. The separately releasable aortic valve stent of claim 14, wherein the connection structure is a rod, the coordination structure is a hole, and when the separately releasable aortic valve stent is restricted and loaded in the delivery sheath, the connection structure is passed through the coordination structure.
16. The separately releasable aortic valve stent of claim 15, wherein a position-limiting hole is defined in the connection structure, and when the separately releasable aortic valve stent is restricted and loaded in the delivery sheath, the connection structure is passed through the coordination structure, and a position-limiting wire is passed through the position-limiting hole.
17. The separately releasable aortic valve stent of claim 14, wherein the connection structure is a loop, the coordination structure is a hole, and when the separately releasable aortic valve stent is restricted and loaded in the delivery sheath, the connection structure is passed through the coordination structure, and a position-limiting wire is passed through the loop.
18. The separately releasable aortic valve stent of claim 2, wherein the clamping segment has three claws which are circumferentially disposed and uniformly spaced and are configured to engage with physiological structures of the three aortic sinuses.
19. The separately releasable aortic valve stent of claim 2, wherein the clamping segment is located at a proximal end of the anchoring segment, and integrated with the anchoring segment.
20. The separately releasable aortic valve stent of claim 1, wherein the guiding device comprises a plurality of flexible strings.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0042] To describe the technical solutions in the embodiments of the present application or in the traditional technology more clearly, the following briefly describes the accompanying drawings referred in the description of the embodiments. The accompanying drawings in the following description show merely some embodiments of the present application, and a person of ordinary skill in the art may derive other drawings from the provided accompanying drawings without creative efforts.
[0043] FIG. 1A and FIG. 1B are schematic views of an embodiment of the present application.
[0044] FIG. 1C is a schematic structural view of a positioning member in the present application.
[0045] FIG. 1D and FIG. 1E are partial views of aortic valve stents in the present application.
[0046] FIG. 2A to FIG. 2C are schematic views showing the movement trajectories of a valve sewing segment, a positioning member, and a guiding device in the present application.
[0047] FIG. 2D is a schematic view of an embodiment of the positioning member in the present application.
[0048] FIG. 3A to FIG. 3D are schematic views of a coordination structure and a connection structure in the present application.
[0049] FIG. 3E is a schematic view of an embodiment of the coordination structure and the connection structure in the present application.
[0050] FIG. 4A to FIG. 4L are schematic views of operation steps in the present application.
[0051] FIG. 5A and FIG. 5B are schematic views of another embodiment in the present application.
[0052] FIG. 6A is a schematic view of another embodiment in the present application.
[0053] FIG. 6B is a schematic view of an embodiment of a sealing member.
[0054] FIG. 6C is a schematic view of another embodiment of the valve sewing segment and the positioning member in the present application.
[0055] FIG. 6D is a schematic view of yet another embodiment in the present application.
DETAILED DESCRIPTION
[0056] The technical solutions in the embodiments of the present application will be described clearly and completely in the following with reference to the accompanying drawings in the embodiments of the present application. Apparently, the described embodiments are merely some rather than all of the embodiments of the present application. All other embodiments obtained by one of ordinary skill in the art based on the embodiments of the present application without creative efforts shall fall within the protection scope of the present application.
[0057] Unless otherwise defined, all the technical and scientific terms used in this specification have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs. Additionally, the terms used in the specification of the present application are merely for describing the specific embodiments, and are not intended to limit the present application. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items.
[0058] The distal end described in the present application refers to the end farther from the apex of the heart, and the proximal end described in the present application refers to the end nearer to the apex of the heart.
Example 1
[0059] Referring to FIG. 1A to FIG. 1E, in an embodiment, a separately releasable aortic valve stent 100 includes a valve sewing segment 110, a positioning member 120, and a prosthetic valve 130. The prosthetic valve 130 is connected to the valve sewing segment 110. The valve sewing segment 110 and the positioning member 120 are two independent components and connected to each other via a guiding device 140, such that the valve sewing segment 110 and the positioning member 120 are positioned at different positions when restricted in a delivery sheath, thereby reducing the diameter of the delivery sheath. The positioning member 120 is released prior to the valve sewing segment 110. A slide connection structure 111 is disposed on the valve sewing segment 110. One end of the guiding device 140 is connected to the positioning member 120, and the other end of the guiding device 140 is passed through the slide connection structure 111 and then connected to the positioning member 120. The valve sewing segment 110 is slidable along the guiding device 140. In an embodiment, the positioning member 120 includes an anchoring segment 121 and a clamping segment 122. The clamping segment 122 is located at a proximal end of the anchoring segment 121. A distal end of the clamping segment 122 is connected to the proximal end of the anchoring segment 121. In this embodiment, the clamping segment 122 is integrated with the anchoring segment 121. One end 1401 of the guiding device 140 is connected to the clamping segment 122, and the other end 1402 of the guiding device 140 is passed through the slide connection structure 111 and then connected to the anchoring segment 121. The valve sewing segment 110 is slidable along the guiding device 140. The clamping segment 122 has three claws 1221 (1221a, 1221b, 1221c) which are circumferentially disposed and uniformly spaced. The claws have U-shaped or V-shaped structures and are configured to engage with physiological structures of the three aortic sinuses. After the release, the claws reach the backs of the autologous valve leaflets and the bottoms of the aortic sinuses to accomplish the positioning. The guiding device 140 has a flexible string structure. In an embodiment, the guiding device 140 includes three flexible strings. In another embodiment, more flexible strings can be used to connect the valve sewing segment 110 and the positioning member 120, so as to achieve a more stable positioning. It should be noted that more flexible strings may increase the delivery resistance. FIG. 1D shows a portion of the positioning member 120. FIG. 1E shows a portion of the valve sewing segment 110.
[0060] As shown in FIG. 2A to 2C, in an embodiment, the guiding device 140 is located between the positioning member 120 and the valve sewing segment 110. As such, the damage in the slide caused by the guiding device 140 to the prosthetic valve 130 sewed onto the valve sewing segment 110 can be maximally prevented. Moreover, it is possible to lower the free edges of the autologous valve leaflets in the subsequent process. Specifically, the proximal end portion of the valve sewing segment 110 is provided with three slide connection structures 111 which are holes. In an embodiment, the slide connection structures 111 are integrated with the valve sewing segment 110. When the valve sewing segment 110 is completely released, the guiding device 140 straddles over the free edges of the autologous valve leaflets 180. The axial relative position between the valve sewing segment 110 and the positioning member 120 is limited by the length of the guiding device 140. In fact, by adjusting the length of the guiding device 140, when the position of the valve sewing segment 110 is limited at the position of the valve annulus of the patient, the autologous valve leaflets 180 are straddled and are lowered by the guiding device 140, thus ensuring that the coronary artery ostia will not be blocked. Moreover, as shown in FIG. 2D, the anchoring segment 121 has a mesh structure, and the surface of the anchoring segment 121 is coated by a film or a fabric 160 to avoid the blood vessel dissection. In another embodiment, the anchoring segment 121 has a wavy structure (not shown). The connecting site between the guiding device 140 and the anchoring segment 121 is located at a distal end portion of the anchoring segment 121. The valve sewing segment 110 and the positioning member 120 are compressed and positioned at different positions in the delivery sheath. The guiding device 140 can assist the released positioning member 120 to be reloaded into the sheath, especially when the vast majority of the positioning member 120 has been released. The doctor can draw back the positioning member 120 and release the positioning member 120 again depending on the positioning effect, thus significantly increasing the success rate of operation. In view of the above, different from the traditional technology, the guiding device in the present application has at least the following four main functions: 1. The valve sewing segment can slide to the specified position along the guiding device, and such movement manner can significantly increase the concentricity between the valve sewing segment and the positing member, avoiding the mutual interference and malposition therebetween in the process of the relative movement. 2. In the process of aligning and releasing the main valve stent part and the positioning member, the guiding device straddles over the free edges of the protogenetic autologous valve leaflets to effectively limit the movements of the free edges of the autologous valve leaflets. When the release is completed, the height of the free edges of the autologous valve leaflets can be automatically lowered, so that the blockage of the coronary artery ostia can be prevented, and the anchoring effect can be increased. 3. The controllable release of the positioning member can be achieved with the assist of the guiding device. 4. The guiding device can also limit the relative position between the main valve stent part and the positioning member, thus facilitating the operation of the doctor.
[0061] As shown in FIG. 3A, the distal end of the anchoring segment 121 is provided with a coordination structure 1210. The proximal end of the valve sewing segment 110 is provided with a connection structure 1101. When being restricted and loaded in the delivery sheath, the connection structure 1101 and the coordination structure 1210 are restrained to each other. As shown in FIG. 3B, in an embodiment, the connection structure 1101 is a rod, and the coordination structure 1210 is a hole. When the valve stent 100 is restricted and loaded in the delivery sheath, the connection structure 1101 is passed through the coordination structure 1210. As shown in FIG. 3C and FIG. 3D, a position-limiting hole 1102 is defined in the connection structure 1101. When the valve stent 100 is restricted and loaded in the delivery sheath, the connection structure 1101 is passed through the coordination structure 1210, and then a position-limiting wire 1103 is passed through the position-limiting hole 1102. The connection structure 1101 can be removed from the coordination structure 1210 only when the position-limiting wire 1103 is pulled out. Due to the mutual restraint between the valve sewing segment 110 and the positioning member 120, the controllable release of the positioning member 120 can be achieved, thus preventing the influence on the implantation effect caused by the bounce of the positioning member 120 from the delivery sheath in the release process, facilitating the control and the regulation of the angle and the position of the clamping segment 122, allowing the positioning member 120 that has been completely released to be reloaded into the sheath, and decreasing the operation risk. As compared to the traditional technology which separately controls the main valve stent part and the positioning member, such mutual restraint can maximally reduce the size of the sheath. In another embodiment, as shown in FIG. 3E, the connection structure 1101 is a loop, and the coordination structure 1210 is a hole. When the valve stent 100 is restricted and loaded in the delivery sheath, the connection structure 1101 is passed through the coordination structure 1210, and then the position-limiting wire 1103 is passed through the connection structure 1101.
[0062] To better illustrate the present embodiment, the operation steps of delivering and releasing the valve stent 100 is described as follows.
[0063] (1) As shown in FIG. 4A and FIG. 4B, the valve stent 100 is compressed and loaded into the delivery sheath 170. The valve sewing segment 110 is located at the distal end of the positioning member 120. With the assistance of an imaging instrument, the implant is delivered to the lesion site of the patient via a transfermoral route or the like route.
[0064] (2) As shown in FIG. 4C and FIG. 4D, the clamping segment 122 is gradually released until all of the claws 1221 are opened at an angle. The released clamping segment 122 is located at the autologous valve sinuses. At this time, the anchoring segment 121 is still compressed in the delivery sheath.
[0065] (3) As shown in FIG. 4E and FIG. 4F, the angles and the positions of the claws 1221 are adjusted. After the claws 1221 reach the backs of the autologous valve leaflets and the bottoms of the aortic valve sinuses, the anchoring segment 121 is gradually released. At least a portion of the released anchoring segment 121 is located in the blood vessel to provide the anchoring force. Due to the mutual restraint between the valve sewing segment 110 and the positioning member 120, the anchoring segment 121 will not bounce. Moreover, due to the fixation manner utilizing the ascending aorta, the completely released positioning member 120 will not be displaced or removed under the blood current flush. Thus, sufficient time can be provided for the subsequent release of the main valve stent part. More importantly, if the position of the positioning member 120 is unsatisfactory, with the assist of the guiding device 140, the positioning member 120 can be reloaded into the sheath, and released again or removed from the body, thereby significantly decreasing the operation risk.
[0066] (4) As shown in FIG. 4G and FIG. 4H, after the position is assured, the position-limiting wire 1103 is pulled out, the connection structure 1101 is removed from the coordination structure 1210, and the anchoring segment 121 is completely released and anchored into the ascending aorta.
[0067] (5) As shown in FIG. 4I and FIG. 4J, the guiding tip is re-located onto the sheath, so that the delivery sheath 170 with the valve sewing segment 110 compressed therein can better pass through the autologous valve leaflets. The sheath is pushed along the guiding device 140 until the position of the sheath is limited by the length of the guiding device 140. At this time, the autologous valve leaflets 180 are straddled and lowered by the guiding device 140.
[0068] (6) As shown in FIG. 4K and FIG. 4L, the valve sewing segment 110 is gradually released until it is completely released. When the valve sewing segment 110 is completely released, the autologous valve leaflets 180 are maintained in the lowered state and located between the claws 1221 and the valve sewing segment 110.
[0069] (7) The delivery sheath is removed.
[0070] The valve stent 100 can also be delivered and released via the heat apex route, the atrial septostomy, or other routes. The operation steps are similar to those described above and will not be repeated again.
Example 2
[0071] Referring to FIG. 5A, in another embodiment, a separately releasable aortic valve stent 200 includes a valve sewing segment 210, a positioning member 220, and a prosthetic valve (not shown). The prosthetic valve is connected to the valve sewing segment 210. The valve sewing segment 210 and the positioning member 220 are two independent components and connected to each other via a guiding device 240. The guiding device 240 has a strip structure. Example 2 is distinguished with Example 1 in that the valve stent 200 further includes an auxiliary guiding device 250. Specifically, the auxiliary guiding device 250 is strings. One end 2501 of the auxiliary guiding device 250 is connected to the anchoring segment 221, and the other end 2502 of the auxiliary guiding device 250 is connected to the valve sewing segment 210. The auxiliary guiding device 250 in combination with the guiding device 240 makes the valve sewing segment 210 and the positioning member 220 be more stably positioned. Since the two ends of the auxiliary guiding device 250 are not connected to the same positions as those of the guiding device 240, the length of the auxiliary guiding device 250 should be well-designed according to the length of the guiding device 240.
[0072] The distal end of the anchoring segment 221 is provided with a coordination structure 2210. The proximal end of the valve sewing segment 210 is provided with a connection structure 2101. When being restricted and loaded in the delivery sheath, the connection structure 2101 and the coordination structure 2210 are restrained to each other. In an embodiment, as shown in FIG. 5B, a recess 2104 is defined on the connection structure 2101, a protrusion 2211 is defined on the coordination structure 2210, and the recess 2104 and the protrusion 2211 are complementary to each other.
Example 3
[0073] As shown in FIG. 6A, in another embodiment, a separately releasable aortic valve stent 300 includes a valve sewing segment 310, a positioning member 320, and a prosthetic valve 330. The prosthetic valve 330 is connected to the valve sewing segment 310. The valve sewing segment 310 and the positioning member 320 are two independent components and connected to each other via a guiding device 340. The positioning member 320 is released prior to the valve sewing segment 310. The positioning member 320 includes an anchoring segment 321 and a clamping segment 322. The clamping segment 322 has three claws 3221. A slide connection structure 311 is disposed on the valve sewing segment 310. One end 3401 of the guiding device 340 is connected to the holes on the bottom ends of the claws 3221, and the other end 3402 of the guiding device 140 is passed through the slide connection structure 311 and then connected to the anchoring segment 321. The valve sewing segment 310 is slidable along the guiding device 340. Example 3 is distinguished with the aforementioned examples in that a sealing member 370 is disposed at the proximal end of the valve sewing segment 310. When the valve stent 300 is implanted, the sealing member 370 prevents the blood from passing through the gap between the valve sewing segment and the autologous tissue. Since the autologous valve leaflets have the auxiliary leakage-proof effect, the regurgitation tends to occur at the junctions between the autologous valve leaflets. In an embodiment, as shown in FIG. 6B, the sealing member 370 has a discontinuous strip structure. When the valve stent 300 is implanted, the lower portions of the claws 3221 (3221a, 3221b, 3221c) are corresponding to the discontinuous regions of the sealing member 370; that is, the continuous portions of the sealing member 370 are corresponding to the junctions between the autologous valve leaflets. Such a well-designed partial blocking technique effectively decreases the diameter of the sheath while ensuring the effect of reducing the perivalvular leakage.
[0074] As show in FIG. 6C, the ends of the claws 3221 have a structure congregated inwardly toward an axis of the clamping segment 322. In an embodiment, a recess 3105 is defined on the outer periphery of the valve sewing segment 310. When the valve sewing segment 310 is completely released, the recess 3105 is engaged with the inwardly congregated structure of the claws 3221. Such design allows the convenient alignment and fixation of the positioning member and the main valve stent part, facilitates the anchoring, and reduces the perivalvular leakage.
[0075] As shown in FIG. 6D, in another embodiment, a slide connection structure 311 is disposed on the valve sewing segment 310. The connection sites between the guiding device 340 and the positioning member 320 are staggered with the claws 3221 in the axial direction. The valve sewing segment 310 is slidable along with the guiding device 340.
[0076] The technical features of the above-described embodiments may be arbitrarily combined. In order to make the description simple, not all possible combinations of the technical features in the above embodiments are described. However, as long as there is no contradiction in the combination of these technical features, the combinations should be in the scope of the present application.
[0077] What described above are only several embodiments of the present application, and these embodiments are specific and detailed, but not intended to limit the scope of the present application. It should be understood by one ordinary skill in the art that various modifications and improvements can be made without departing from the conception of the present application, and all fall within the protection scope of the present application. Therefore, the patent protection scope of the present application is defined by the appended claims.
