MEDICAL VALVE IMPLANT FOR IMPLANTATION IN AN ANIMAL BODY AND/OR HUMAN BODY

Abstract

A medical valve implant having a medical heart valve fastened to a base body, the base body having a circumferential arrangement of cells with a proximal end and a distal end to provide inflow and outflow sections when implanted, where some of the cells at the distal end are connected to holding devices that cant inward. Within the cells can be smaller cells having two halves configured for outward movement relative to the larger surrounding cell.

Claims

1. A medical valve implant comprising a medical heart valve fastened to a base body, the base body comprising a circumferential arrangement of cells with a proximal end and a distal end to provide inflow and outflow sections when implanted, wherein some of the cells at the distal end are connected to holding devices that cant inward.

2. The medical valve implant according to claim 1, wherein the medical valve is an aortic valve.

3. The medical valve implant according to claim 1, wherein the medical valve is selected from the group consisting of a pulmonary valve, a mitral valve, and a tricuspid valve.

4. The medical valve implant according to claim 1, wherein the base body is a self-expanding stent.

5. The medical valve implant according to claim 1, wherein three holding devices are situated in the circumferential direction.

6. The medical valve implant according to claim 5, wherein the three holding devices are distributed at 120-degree intervals around the circumference.

7. The medical valve implant according to claim 1, wherein the holding devices also cant outward.

8. A medical valve implant comprising: an implant structure configured as a medical valve; and a collar comprising a plurality of cells joined to form an open mesh extending in a circumferential direction around the implant structure, and a smaller cell situated within an inner contour of a larger surrounding cell, wherein the smaller cell has two halves configured for outward movement relative to the larger surrounding cell.

9. The medical valve implant according to claim 8, wherein three smaller cells situated within inner contours of three larger cells are situated circumferentially around the implant.

10. The medical valve implant according to claim 8, wherein the medical valve is a heart valve.

11. The medical valve implant according to claim 8, wherein the medical valve is an aortic valve.

12. The medical valve according to claim 8, wherein the medical valve is selected from the group consisting of a pulmonary valve, a mitrial valve, and a tricuspid valve.

13. The medical valve according to claim 8, wherein a lower and/or upper row of cells comprises at least one smaller cell situated within an inner contour of a larger surrounding cell.

Description

DESCRIPTION OF THE DRAWINGS

[0036] The invention is explained in the following in greater detail, as an example, with reference to an embodiment depicted in drawings. They show:

[0037] FIG. 1 a medical valve implant according to the invention, in a perspective view,

[0038] FIG. 2 the valve implant according to FIG. 1, in the implanted state,

[0039] FIG. 3A a section through the aortic wall including the implanted valve implant according to FIG. 2,

[0040] FIG. 3B a detailed depiction of the outer contour depicted in FIG. 3A,

[0041] FIG. 4 a schematic depiction of the insertion of an aortic valve implant at an implantation site, and

[0042] FIG. 5 an alternative embodiment of a valve implant in a perspective view.

DETAILED DESCRIPTION

[0043] Elements that are functionally identical or similar-acting are labeled using the same reference numerals in the figures. The figures are schematic depictions of the invention. They do not depict specific parameters of the invention. Furthermore, the figures merely show typical embodiments of the invention and should not limit the invention to the embodiments shown.

[0044] Regarding elements in a figure that are not described further, reference is made to the respective description of the elements in preceding figures to avoid unnecessary repetition.

[0045] FIG. 1 shows, in a perspective view, a medical valve implant 10a for implantation in an animal body and/or human body, having a base body 12a which comprises a self-expanding stent 64a and contains an elastic and/or superelastic and/or self-expanding material, in particular Nitinol. Valve implant 10a is furthermore an aortic implant in which an implant structure 22a is fastened to base body 12a or stent 64a, implant structure 22a being designed as an artificial percutaneous aortic valve 66a.

[0046] Base body 12a comprises a wire mesh as the base body structure, the wire mesh being formed by a collar 16a that extends in circumferential direction 14a of valve implant 10a. Collar 16a has a first cell structure 18a composed of a large number of cells 58a. Cells 58a are substantially diamond-shaped and are situated next to each other in circumferential direction 14a, and in three rows 70a, 72a, 74a in axial direction. Rows 70a, 72a, 74a are offset in circumferential direction 14a such thatreferring to rows 70a and 72a as examplesan upper half 76a, in each case, of a cell 58a of a row 72a is fitted into an intermediate space 78a between two lower halves 80a of cells 58a in row 70a. Cells 58a in rows 70a and 74a are situated axially one above the other. First cell structure 18a is provided to form, in the intended end state i.e. the implanted state of valve implant 10a, an intended inner cross section 24a of base body 12a that is matched to an intended outer cross section 20a of implant structure 22a (see FIG. 3A).

[0047] In addition, a further row 82a of end cells 84a adjoin first cell structure 18a of collar 16a, in the same manner as described for rows 70a and 72a; the diamond shape of row 82a includes an extended end section 86a that extends against a flow direction 42a of a flow medium 44a such as blood. Furthermore, end section 86a bulges in a curved shape outwardly in radial direction 68a, toward a wall 88a of a blood vessel 90a such as aorta 92a in the implanted state, and therefore valve implant 10a has a larger diameter in end region 94a than in the region of collar 16a.

[0048] Furthermore, collar 16a or base body 12a of valve implant 10a or stent 64a includes further or three second cell structures 26a, 28a, 30a. Second cell structures 26a, 28a, 30a are distributed in circumferential direction 14a along collar 16a, or they are distributed evenly at 120? intervals. Each second cell structure 26a, 28a, 30a includes a cell group 50a, 52a, 54a, each of which includes two cells 50a, 50a, 52a, 52a, 54a, 54a. Cells 50a, 52a, 54a are located in row 70a and cells 50a, 52a, 54a are located in row 74a. Each of the two cells 50a, 50a, 52a, 52a, 54a, 54a belonging to one cell group 50a, 52a, 54a are situated, in the implanted state of valve implant 10a, axially one behind the other in flow direction 42a of flow medium 44a, that is, from left ventricle 96a to aorta 92a, and with mirror symmetry relative to each other.

[0049] Each of the cells 50a, 50a, 52a, 52a, 54a, 54a of cell group 50a, 52a, 54a is substantially diamond-shaped and is situated on an inner contour 56a of a cell 58a of first cell structure 18a. Therefore, cells 50a, 50a, 52a, 52a, 54a, 54a are smaller than cells 58a. In addition, each of the cells 50a, 50a, 52a, 52a, 54a, 54a has a portion 98a that is composed of two sides 100a of the diamond and is connected via three fastening points 102a to cell 58a. When stent 64a expands, portion 98a moves in dependence of stent 64a.

[0050] A fastening point is not provided on the tip of the V on a further portion 40a of cells 50a, 50a, 52a, 52a, 54a, 54a which are composed of two further sides 104a of the diamond that form the V, and is therefore movable independently of the first cell structure 18a, thereby enabling second cell structure 26a, 28a, 30a to move relative to first cell structure 18a or enabling it to move in radial direction 68a. Portion 40a of second cell structure 26a, 28a, 30a can therefore be situated obliquely relative to flow direction 42a of flow medium 44a. In the absence of resistance to portion 40a, portions 40a, 98a of cells 50a, 50a, 52a, 52a, 54a, 54a can therefore assume an angled orientation relative to each other.

[0051] Base body 12a furthermore includes three fastening devices 60a, each having the shape of a segment 108a having fastening holes 110a, to which implant structure 22a or aortic valve 66a is fastened. Segment 108a is an axial extension, which extends in flow direction 42a, on a cell 58a of row 72a of collar 16a. In addition, cell 58a is equipped with a reinforcement 112a on its inner contour 56a. End cell 84a, which is located at the same height, likewise includes a reinforcement 112a and an attachment 114a that extends against flow direction 42a. By way of reinforcements 112a, fastening devices 60a contribute to the stability of base body 12a. Attachment 114a is used to connect base body 12a to a catheter in the implantation procedure in case of a transapical implantation, where the catheter is inserted from below or from the tip of the heart, respectively (not shown).

[0052] Each fastening device 60a is situated in circumferential direction 14a in the center between two second cell structures 26a, 28a, 30a, and therefore one cusp tip 116a of a cusp 118a of aortic valve 66a is situated in circumferential direction 14a at a level of second cell structure 26a, 28a, 30a. The three cusp suspensions are located at the level of segment 108a, the lower edge of cusp 118a being located approximately at cusp tip 106a. Cusps 118a are therefore not planar, but rather form a three-dimensional, pyramid-shaped structure. Holding devices 120a of base body 12a or stent 64a for a catheter 122a for inserting valve implant 10a are situated in circumferential direction 14a, and extend in flow direction 42a, at the level of second cell structure 26a, 28a, 30a on cell 58a that has contour 56a.

[0053] Cusps 118a of valve implant 10a can be provided with a coating to prevent a deposition of calcium salts and, therefore, to prevent calcification of new cusps 118a.

[0054] FIG. 2 shows a schematic view of medical valve implant 10a in the implanted state, e.g. in an annulus 62a of a natural aortic valve, that is disposed in blood vessel 90a, which is aorta 92a in this case, in front of left ventricle 96a of the heart. End region 94a, including end section 86a of end cells 84a, which extends further radially outwardly, is situated in front of annulus 62a in flow direction 42a, thereby fixing the broader diameter of end region 94a of stent 64a in position. Furthermore, in the intended end state, second cell structures 26a, 28a, 30a are situated axially behind an annulus 62a, e.g. at the level of an aortic bulb 124a, in flow direction 42a of flow medium 44a, which is indicated only schematically and in regions in FIG. 2.

[0055] When the stent 64a is implanted, base body 12a presses the natural aortic valve (see FIG. 4) against a luminal wall 88a of blood vessel 90a, thereby creating open space for implantation structure 22a or artificial aortic valve 66a including cusps 118a in the inner region of base body 12. Natural cusps 118a are pressed upwardly against the vessel wall 88a. Cusps 118a function as non-return valves and permit blood to flow from ventricle 96a to blood vessel 90a, but block the flow of blood in the opposite direction.

[0056] When valve implant 10a expands, first cell structure 18a expands, thereby causing end cells 84a of end region 94a to come in contact with wall 88a and fix valve implant 10a in position. A further fixation takes place at two uncalcified regions 126a of the aortic wall in aortic bulb 124a by second cell structure 26a, 28a or portion 40a of cells 50a, 52a which can move independently of first cell structure 18a further radially outwardly than first cell structure 18a (structures 26a and 50a are shown only in FIG. 3A, in which cells 50a, 52a and 54a were left out to ensure clarity). On a calcified region 128a in aortic bulb 124a, second cell structure 30a expands (indicated schematically in FIG. 3A) only as far as first cell structure 18a since a further expansion of second cell structure 30a or portion 40a is prevented by a calcification 130a in aortic bulb 124a.

[0057] As shown in FIG. 3A, which shows a section through wall 88a of aorta 92a with implanted valve implant 10a according to FIG. 2, second cell structures 26a, 28a each have one contact point 32a. Contact points 32a form outer contour 34a of base body 12a together with a surface 132a, which faces the direction of wall 88a, of first cell structure 18a, and of first and second cell structure 18a, 30a, which adjoin calcification 130a. Outer contour 34a is shown alone in FIG. 3B for clarity. As shown in FIG. 3B, contact points 32a form extreme points 36a of outer contour 34a relative to a geometric center of gravity 38a of base body 12a. Second cell structures 26a, 28a are therefore provided to compensate for a difference in a shape or, in this case, the circular shape of inner cross section 24a of base body 12a and a cross-sectional area 46a of an implantation site 48a.

[0058] The insertion of medical valve implant 10a is illustrated schematically in a partial sectional view, in FIG. 4. Valve implant 10a is moved, in a compressed state, on a tip 134a of catheter 122a through the aorta 92a in a manner known per se to implantation site 48a e.g. annulus 62a of the natural aortic valve having cusps 118a. In this case, an implantation direction 136a is opposite flow direction 42a. Attachment 114 has no function in the event of this implantation direction 136a.

[0059] In FIG. 5 an alternative embodiment of the medical valve implant 10a is shown. Components, features and functions that remain identical are in principle substantially denoted by the same reference characters. To distinguish between the two embodiments, however, the letters a and b have been added to the reference characters of the embodiments. The following description is confined substantially to the differences from the embodiment in FIGS. 1 to 4, wherein with regard to components, features and functions that remain identical reference may be made to the description of the embodiment in FIGS. 1 to 4.

[0060] FIG. 5 shows, in a perspective view, a medical valve implant 10b for implantation in an animal body and/or human body, having a base body 12b which comprises a self-expanding stent 64b and contains an elastic and/or superelastic and/or self-expanding material, in particular Nitinol. Valve implant 10b is furthermore an aortic implant in which an implant structure 22b is fastened to base body 12b or stent 64b, implant structure 22b being designed as an artificial percutaneous aortic valve 66b.

[0061] Base body 12b comprises a wire mesh as the base body structure, the wire mesh being formed by a collar 16b that extends in circumferential direction 14b of valve implant 10b. Collar 16 has a first cell structure 18b composed of a large number of cells 58b. Cells 58b are substantially diamond-shaped and are situated next to each other in circumferential direction 14b, and in three rows 70b, 72b, 74b in axial direction, wherein an upper half 76b, in each case, of a cell 58b of a row 72b is fitted into an intermediate space 78b between two lower halves 80b of cells 58b in row 70b. Cells 58b in rows 70b and 74b are situated axially one above the other. First cell structure 18b is provided to form, in the intended end state i.e. the implanted state of valve implant 10b, an intended inner cross section of base body 12b that is matched to an intended outer cross section of implant structure 22b (not shown, analogous to FIG. 3A).

[0062] In addition, a further row 82b of diamond shaped end cells 84b adjoin first cell structure 18b of collar 16b as described above and includes an extended end section 86b that extends against a flow direction 42b of a here not shown flow medium such as blood and bulges in a curved shape outwardly in radial direction 68b, toward a wall of a blood vessel in the implanted state (not shown), and therefore valve implant 10b has a larger diameter in end region 94b than in the region of collar 16b.

[0063] Furthermore, collar 16b or base body 12b of valve implant 10b includes further or three second cell structures 26b, 28b, 30b. Second cell structures 26b, 28b, 30b are distributed in circumferential direction 14b along collar 16b, or they are distributed evenly at 120? intervals. Each second cell structure 26b, 28b, 30b includes a cell 50b, 52b, 54b, wherein these cells 50b, 52b, 54b are located in row 72b. Each of the cells 50b, 52b, 54b includes two cell halves 50b, 50b, 52b, 52b, 54b, 54b, wherein each of these two cell halves 50b, 50b, 52b, 52b, 54b, 54b are situated, in the implanted state of valve implant 10b in circumferential direction 14b one behind the other and with mirror symmetry relative to each other (cell 52b and cell halves 52b, 52b are not shown, but embodied identical to cells 50b, 54b or cell halves 50b, 50b, 54b, 54b, respectively).

[0064] Each of the cells 50b, 52b, 54b is substantially diamond-shaped and is situated on an inner contour 56b of a cell 58b of first cell structure 18b. Thus, cells 50b, 52b, 54b are smaller than cells 58b. Additionally, each of the cell halves 50b, 50b, 52b, 52b, 54b, 54b has a portion 40b that is composed of two sides 104b of the diamond and that form a V. Ends of the sides 104b are each connected via a fastening point 102b to cell 58b. A fastening point is not provided on the tip of the V and therefore the portion 40b is movable independently of the first cell structure 18b, thereby enabling second cell structure 26b, 28b, 30b to move relative to first cell structure 18b or enabling it to move in radial direction 68b. Portion 40b of second cell structure 26b, 28b, 30b can therefore be situated obliquely relative to flow direction 42b of the flow medium. In the absence of resistance to portion 40b, portions 40b, of cells 50b, 52b, 54b can therefore assume an angled orientation relative cells 58b.

[0065] Base body 12b furthermore includes three fastening devices 60b, wherein each fastening device 60b is situated in circumferential direction 14b between two second cell structures 26b, 28b, 30b. The fastening devices have a segment 108b extending from a cell 58b of row 72b and fastening holes 110b, to which the aortic valve 66b is fastened. Cell 58b and end cell 84b, which is located at the same height as cell 58b are equipped with a reinforcement 112 on their inner contour 56b. End cell 84b has an attachment 114b to connect base body 12b to a catheter in the implantation procedure. Holding devices 120b of base body 12b for a catheter for inserting valve implant 10b are situated in circumferential direction 14b, and extend in flow direction 42b.

[0066] In the case of the here not shown implantation of the stent 64b and thus its expansion the cells 50b, 52b, 54b or the portion 40b of each cell 50b, 52b, 54b, respectively, has/have the ability to adapt to an unknown format or a cross sectional area of an implantation site in respect to an amount of a calcification at the annulus or the natural valve. This process could vary from its pre shaped form till staying inside the cells 58b of the first cell structure 18b following the shape of the main stent 64b or collar 16b, respectively.

[0067] It will be apparent to those skilled in the art that numerous modifications and variations of the described examples and embodiments are possible in light of the above teaching. The disclosed examples and embodiments are presented for purposes of illustration only. Therefore, it is the intent to cover all such modifications and alternate embodiments as may come within the true scope of this invention.