Artificial heart valve
10932904 ยท 2021-03-02
Assignee
Inventors
Cpc classification
A61F2220/0008
HUMAN NECESSITIES
A61F2/915
HUMAN NECESSITIES
A61F2220/0075
HUMAN NECESSITIES
A61F2002/9155
HUMAN NECESSITIES
A61F2250/0048
HUMAN NECESSITIES
A61F2/91
HUMAN NECESSITIES
A61F2/2412
HUMAN NECESSITIES
A61F2250/0082
HUMAN NECESSITIES
B33Y80/00
PERFORMING OPERATIONS; TRANSPORTING
International classification
A61F2/24
HUMAN NECESSITIES
Abstract
A device for treating regurgitation of a tricuspid valve (4). The device comprises a tricuspid valve plug (21) capable of compressing and expanding and a tricuspid valve plug fixing device used for anchoring the tricuspid valve plug (21) to an orifice of the tricuspid valve (4). The tricuspid valve plug (21) is provided with an inflow end (42, 52) and an opposite outflow end (47, 57), and a prosthetic valve (50, 70) capable of being opened and closed is disposed in the tricuspid valve plug (21). When the tricuspid valve (4) is closed, the prosthetic valve (50, 70) is automatically closed, and when the tricuspid valve (4) is opened, the prosthetic valve (50, 70) is automatically opened. The device for treating regurgitation of a tricuspid valve (4) and the implantation method therefor help to treat regurgitation of a tricuspid valve and do not block the flow of blood in a heart, and the device can be recycled, has the characteristics of high operationality and high safety in minimally-invasive repair, and has high clinical value.
Claims
1. A prosthetic valve, comprising a tubular frame, being of a lattice structure that can be radially expanded and distorted, wherein a plurality of U-shaped protrusions are evenly arranged on the frame configured to be placed at a downstream end relative to a blood flow direction; a plurality of U-shaped recession is provided between every two adjacent protrusions, one or more foldable joints are provided on edge(s) of each of the plurality of U-shaped recessions; wherein the protrusions and the recessions are unfolded when the prosthetic valve is expanded during implant for a first time, and the foldable joints are unfolded when the prosthetic valve is expanded for a second time after implant; an arch portion of each protrusion is converged to a lower fixing strut, and the lower fixing struts are connected to a lower annular base; several upper fixing struts on the frame are connected to the upstream end relative to the blood flow direction, and the upper fixing struts are connected to an upper annular base; and width of either the upper fixing struts or the lower fixing strut is greater than width of net wires of the frame.
2. The prosthetic valve according to claim 1, wherein three protrusions and three recessions are provided, three valve leaflets are attached in reference to the protrusions and the recessions, such that the valve leaflets are able to open and close in the blood flow; a covering membrane is provided on the lattice structure of the frame, and the valve leaflets are sutured on the covering membrane such that sutured portions are hermetically engaged to the covering membrane, and suturing thread is sutured through the frame or not.
3. The prosthetic valve according to claim 2, wherein the valve leaflets are sutured in reference to edges of the protrusions and the recessions, wrinkles of the valve leaflets corresponding to the foldable joints are preserved and can be expanded and stretched when the prosthetic valve is expanded after implant; and wrinkles on the covering membrane corresponding to the foldable joints are preserved and can be expanded and stretched when the prosthetic valve is expanded after implant.
4. The prosthetic valve according to claim 2, wherein the covering membrane is provided on the inner surface, or on the outer surface, or on both of the inner surface and the outer surface, of the lattice structure of the frame.
5. The prosthetic valve according to claim 4, wherein the covering membrane on the outer surface comprises an upper part and a lower part, the lower part wraps the protrusions and part of a frame body, the upper part wraps the remaining part of the frame, the upper covering and the lower covering are made of different materials or the same material, and are sutured together along a periphery of the frame.
6. The prosthetic valve according to claim 1, wherein the protrusions and the recessions are connected through a smooth curve.
7. The prosthetic valve according to claim 6, wherein 1-3 foldable joints in the shape of pointed tips are provided, and the tips of the foldable joints point up or down axially.
8. The prosthetic valve according to claim 6, wherein a U-shaped or V-shaped reinforcement is connected to two edges of a corresponding recession, the protruding direction of the reinforcements is the same as the protrusions, and the two bottom ends of each reinforcement are respectively connected to the two edges of the corresponding recession.
9. The prosthetic valve according to claim 8, wherein an annular guide is provided on the protruding portion of each reinforcement, and the annular guide is formed by bending an edge at the protruding portion of the reinforcement.
10. The prosthetic valve according to claim 1, wherein the recession comprises a combination of two smooth arcuate edges, and the arcuate edges connect smoothly to the protrusions adjacent to the recessions, and bottom ends of the arcuate edges are connected to the lattice structure of the frame.
11. The prosthetic valve according to claim 10, wherein 1-3 foldable joints are provided at each recession wherein at least 1 of the foldable joints is provided between the bottom joint of the two smooth arcuate edges, 1 foldable joint is provided on each smooth arcuate edge or not.
12. The prosthetic valve according to claim 1, wherein rhombic meshes are provided in the lattice structure of the frame, U-shaped process slots are provided at intersections of net wires, to facilitate deformation of the net wires when the tubular frame is radially expanded, and the intersections of the net wires are of a distorted H shape or an X shape.
13. The prosthetic valve according to claim 12, wherein two or more layers of the rhombic meshes are provided, and are axially distributed along the frame, and the meshes extend downwardly to interior of the protrusions in the blood flow direction.
14. The prosthetic valve according to claim 1, wherein the frame and the protrusions are manufactured by laser cutting, wire weaving or 3D printing.
15. The prosthetic valve according to claim 1, wherein the frame and the protrusions are compressed into a slim tubular shape before the prosthetic valve is radially expanded and deformed, and are expanded and deformed by a force being applied from the interior of the slim tube, or the frame and the protrusions are manufactured by using a shape memory functional material to realize self-expansion.
16. The prosthetic valve according to claim 1, wherein an annular guide is provided on an arch portion of each protrusion, and the annular guide is formed by bending an edge at the arch portion of the protrusions; or several U-shaped or V-shaped guides on the frame are provided at an upstream end relative to the blood flow direction, the guides extend out of the frame.
17. The prosthetic valve according to claim 1, wherein the upper annular base and the lower annular base form guiding elements, to connect a delivery device to position the prosthetic valve.
18. The prosthetic valve according to claim 1, wherein, a U-shaped or V-shaped reinforcement is connected to two edges of a corresponding recession, the protruding direction of the reinforcements is the same as the protrusions, and two bottom ends of each reinforcement are respectively connected to the two edges of the corresponding recession, and a protruding portion of the reinforcements is connected to the lower annular base.
19. The prosthetic valve according to claim 1, wherein the prosthetic valve is expandable during initial implant at the first time, and the prosthetic valve is expandable for further intervention after the implant at the second time after an extended use period.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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(14)
(15) In the drawings: 1. protrusions; 2. frame; 3. recessions; 4. inner covering membrane; 4-1. suturing reference; 5. outer covering layer; 5-1. suturing line; 5-2. suturing line; 5-3. lower covering membrane; 5-4. upper covering membrane; 6. valve leaflets; 7. guides; 8. reinforcements; 9. blood vessel; 10. suturing thread.
(16) A. foldable joint; B. foldable joint; C. X-shaped connection; D. H-shaped connection. 11. protrusion; 12. frame; 13. recession; 14. lower fixing strut; 15. upper fixing strut; 16. lower fixing base; 17. upper fixing base; 18. reinforcement.
DETAILED DESCRIPTION
(17) The embodiments of the present invention will be further described in detail below with reference to the accompanying drawings.
Embodiment 1
(18)
(19) The blood stream direction is indicated by the arrow in
(20) The purpose of the foldable joints A is to provide room for future expansion after the initial expansion of the prosthetic valve during implant. When the prosthetic valve is expanded during implant, the foldable joints A are still in the folded state, or are unfolded at a smaller scale. After the patient is implanted with the prosthetic valve, as the patient grows, the prosthetic valve may be further expanded, so as to adapt for the growth of the patient. Further expansion may be once or several times, but generally does not exceed twice.
(21) Because the structures of the protrusions 1 and the recessions 3 on the frame 2 are all U-shaped, which has a wide bottom edge, the protrusions 1 and the recessions 3 can be stretched more easily than the foldable joints A that are of smaller size; this structure is substantially different from the V-shaped protrusions and recessions that are commonly used in the prior art. If the protrusions 1 and the recessions 3 are V-shaped, the side edges of the protrusions and the recessions will, during initial expansion, make the small foldable joints unfold together, so future expansion may be limited.
(22) As shown by
(23) The valve leaflets 6 may be designed with various shapes, such as half-moon shape, elliptical shape, U shape or approximately egg shape. The material of the valve leaflets 6 may employ animal (preferably pig) valves, pig or cattle pericardium materials, biological tissue materials, polymer materials or tissue engineering materials.
(24) As shown by
(25) In the present embodiment, 1-3 foldable joints A in a shape of pointed tips are provided, and the tips of the foldable joints A point axially to downstream or upstream of blood stream direction. When the prosthetic valve is expanded after implant, the foldable joints A may be unfolded.
(26) Rhombic meshes are provided in the lattice structure of the frame 2. U-shaped process joints are formed at intersections of net wires to facilitate deformation of the meshes when the tubular frame is radially expanded, and the intersections of the net wires are of an H shape or an X shape, such as the X-shaped connection C shown in
(27) As shown by
(28) The valve leaflets 6 are sutured in reference to edges of the protrusions 1 and the recessions 3, wrinkles corresponding to the foldable joints A on the valve leaflets are preserved, and can be stretched and deformed when the prosthetic valve is expanded after implant. The design of the wrinkles is required to form the seal, and to prevent perivavular leak.
(29) The covering membrane also has wrinkles corresponding to the foldable joints A, and can be stretched and distorted when the prosthetic valve is expanded after implant. The design of the wrinkles is required to form a seal, and to prevent perivavular leak.
(30) As shown by
(31) The inner covering membrane 4 on the inner surface is required to be sutured in the axial direction of the frame 2 (the suturing edge 4-1).
(32) The outer covering membrane 5 on the outer surface comprises an upper part and a lower part, the upper part 5-3 wraps the three U-shaped protrusions 1 and part of the frame body of the frame 2; the lower part 5-4 wraps the remaining part of the frame body of the frame 2. The upper and the lower coverings can be made of different materials or of the same material. They are firstly individually sutured in the axial direction of the frame 2 (the suturing edge 5-2), and then sutured together along the periphery of the frame 2 (the suturing edge 5-1). The upper part 5-3 is made of pericardium materials, such as porcine or bovine pericardium material, which have the characteristics of a smooth surface and is resistant to thrombus formation. The material of the lower covering 5-4 is not specially limited, and it may employ the material the same as that of 5-3. The material of the covering membrane may also be selected from any of polyethylene materials, artificial tissue materials and polyurethane materials.
(33) The artificial tissue materials include tissues that are manufactured by tissue engineering in a laboratory, such as the combination of extracellular matrixes, cells and biologically active molecules as designed. They can prevent the calcification problems of natural tissue materials, which results in undesirable structural deterioration of artificial heart valves. The artificial tissue materials may employ tissue originated from kangaroo, ostrich, whale or any other suitable heterograft or homograft of any reasonable size. The artificial tissue materials also include connective tissue proteins that are employed as the supporting frames of tissue materials (that is, collagen and elastin). In order to strengthen the tissue protein compound, a chemical fixation process can be employed to link proteins.
(34) The frame 2 and the three U-shaped protrusions 1 are manufactured in one process, and are manufactured by laser cutting, wire braiding/weaving or 3D printing. The frame 2 and the three U-shaped protrusions 1 are optionally manufactured by using elastic metal materials, such as stainless steel, and may also be manufactured by using shape memory alloy materials, such as nickel titanium alloy.
(35) The frame 2 and the three U-shaped protrusions 1 were compressed into a slim tube shape before the prosthetic valve is radially expanded and deformed, and a force is applied from the interior of the tube shape to make the frame 2 and the three U-shaped protrusions 1 expand and deform. The implanting method and the implanting instruments may refer to the implant procedures in the prior art.
(36) If the prosthetic valve is implanted by surgery, the prosthetic valve is required to be expanded to a suitable size before the suturing to the implant position. If the prosthetic valve is implanted by transcatheter delivering, the prosthetic valve is expanded to a suitable size after it has been delivered to the pulmonary valve or the tricuspid position.
(37) As shown in
(38) The suturing thread 10 is sutured around the periphery of the frame 2, and the suturing forms a complete circle of sutured area (by using a continuous suture), or the suturing forms several sections of interrupted sutured areas.
(39) Each section of the suturing thread 10 that is sutured on the vessel wall of the implantation site penetrates through the vessel wall at least twice, and the sutures are distributed in the axial direction of the frame 2, or are distributed in the circumferential direction of the frame 2.
(40) The prior art does not provide precedents wherein a prosthetic valve is designed to be sutured on the vessel wall, so the perpendicular suturing area of the present embodiment is substantially different from the prior art.
(41) In order to facilitate implantation of the prosthetic valve by transcatheter delivery, an annular guide may be provided on the arch portion of each protrusion 1. The annular guide may be connected to the retrieving element that is used in the implantation procedure, and the annular guide is formed by the bending edge at the arch portion of the protrusion 1. A sample structure is shown in
(42) The prosthetic valve is expanded for the first time during the implantation into a human body (which may also applies to other animal bodies), and the prosthetic valve is expanded after implant. The particular sizes after expanding at the implant and subsequent expansions may be adjusted according to the structures of the pulmonary artery.
Embodiment 2
(43)
(44) In the present embodiment, 1-3 foldable joints B are provided wherein at least 1 foldable joint 8 is provided between the bottom ends of the two smooth arcuate edges. When the prosthetic valve is expanded during implant, the foldable joints B are still in the folded state, and the foldable joints B are unfolded when the prosthetic valve is expanded after implant.
(45) When the prosthetic valve is expanded after implant, the foldable joints B cannot be unfolded to be a smooth curve, but the foldable joints B have more integrated structure for it is part of rhombic mesh.
(46) Optionally, the smooth arcuate edges may be individually provided with 1 foldable joint, and the foldable joints on those positions may refer to joint A in
(47) In the present embodiment, rhombic meshes are provided in the lattice structure of the frame 2. U-shaped process joints are present at intersections of the net wires, to facilitate deformation of the tubular frame when it is radially expanded, and the intersections of the net wires are of an H shape or an X shape, the H-shaped connection D is shown in
(48) The other parts of the prosthetic valve of the present embodiment are the same as those of Embodiment 1.
Embodiment 3
(49)
(50) Annular guide 7 is provided on the protruding portion of each reinforcement 8, and the annular guide 7 is formed by the bending edge at the protruding portion of the reinforcement.
(51) The annular guide 7 may be connected to the retrieving element that is used in the implantation procedure in order to adjust the implantation position of the prosthetic valve.
(52) The frame 2, the three U-shaped protrusions 1 and the reinforcements 8 are manufactured in one process. The reinforcements 8 may also be V-shaped.
(53) The other parts of the prosthetic valve of the present embodiment are the same as those of Embodiment 1.
Embodiment 4
(54)
(55) The width of the guides 7 and the width of the net wires of the frame 2 may be the same.
(56) The guides 7 may also be set to be U-shaped.
(57) The guides 7 may be connected to the retrieving element that is used in the implantation procedure to adjust the implantation position of the prosthetic valve.
(58) The other parts of the prosthetic valve of the present embodiment are the same as those of Embodiment 1.
Embodiment 5
(59)
(60) The blood flow direction is indicated by the arrow in
(61) When the tricuspid occluder is expanded during implant, the foldable joints B are still in the folded state, or are unfolded to a small angle. In the late stage after the patient is implanted with the prosthetic valve, as the patient progresses, the tricuspid valve occluder may be balloon expanded, so as to adapt to the changing heart size of the patient.
(62) Certainly, the recessions 13 may be provided with the structure of the foldable joints a of the first embodiment at the edges.
(63) The frame 12 may be of a circular cylinder cage structure, or a cone cage structure, or a truncated cone cage structure.
(64) The total length of the frame 12 may be 20-80 mm, with the internal diameter of 0.5-50 mm.
(65) Rhombic meshes are provided within the lattice structure of the frame 12. U-shaped process slots are provided at intersections of net wires to facilitate deformation of the net wires when the tubular frame is radially expanded. The intersections of the net wires are of an H shape or an X shape, such as the H-shaped connection D shown in
(66) Several upper fixing struts 15 are connected to the upstream end in reference to the blood flow direction on the frame 12, and the upper fixing struts 15 are extended to an upper annular base 17. The width of the upper fixing struts 15 or the lower fixing strut 14 is greater than the width of the net wires of the frame 12.
(67) The lower annular base 16 and the upper annular base 17 serve as the guiding elements, and can be connected to the positioning device of the prosthetic valve that is used in the implantation procedure.
(68) The positioning device of the prosthetic valve is used for reliable positioning of the tricuspid valve occluder; which comprises a hollow sleeve that connects to an annular base and a guide wire that has an anchoring hook penetrating through the hollow sleeve and the center of the tricuspid valve occluder. The anchoring hook is located at a distal end of the guide wire and is anchored on the myocardium; the preferable anchoring position is at or near the apex of the right ventricle.
(69) The prosthetic valve of the present embodiment may be applied in the patent for invention PCT/CN 2017/073069 DEVICE FOR TREATING TRICUSPID REGURGITATION AND IMPLANTATION METHOD THEREOF. The patent describes a device for treating tricuspid regurgitation, and the device comprises a plug with a prosthetic valve in the tricuspid valve (abbreviated as the valve plug thereof), the valve plug can be compressed and expanded, and a fixing device for anchoring the valve plug to the tricuspid orifice. The valve plug has an inflow end and an opposite outflow end, and prosthetic valve leaflets that can open and close within the valve plug.
(70) The covering membrane and the prosthetic valve leaflets on the frame 12 are not shown, and the configurations of those components can refer to the structure and the suturing method of the prosthetic valve of Embodiment 1 and will not be described in detail here.
(71) The covering membrane on the frame 12 is not shown, and it can refer to the structure of the prosthetic valve of Embodiment 1, or refer to the structure of the sleeve in accordance with the patent PCT/CN2017/073069, and will not be described in detail here.
Embodiment 6
(72)
(73) The reinforcements 18 can enhance the structural strength of the frame and facilitate withdrawal. The reinforcements 18 may also be set to be U-shaped.
(74) The other structures of the tricuspid valve occluder of the present embodiment are the same as those of Embodiment 5 and will not be described in detail here.
(75) The above are only the preferred embodiments of the present invention, and are not intended to limit the scope of the present invention. Any modifications, equivalents and improvements made within the spirit and scope of the present invention are included in the scope of the present invention.