HEART VALVE PROSTHESES WIITH SENSOR FOR HEMODYNAMIC MONITORING
20240415639 ยท 2024-12-19
Assignee
Inventors
Cpc classification
A61F2220/0075
HUMAN NECESSITIES
A61F2250/0058
HUMAN NECESSITIES
A61F2210/00
HUMAN NECESSITIES
International classification
Abstract
Prosthetic valve devices for implantation within a body or lumen that are configured for hemodynamic monitoring. The prosthetic valve device includes one or more sensors in electrical communication with an inductor formed by a portion of the frame or coupled to the frame of the prosthetic valve device. The sensor is configured to measure a flow parameter within the prosthesis. The inductor is configured to relay a signal to an external detector, the signal being associated with the flow parameter measured by the sensor.
Claims
1. A prosthesis for implantation within a body or lumen, comprising: a frame including a plurality of rows of struts and crowns formed between adjacent pairs of said struts, each row having a first set of crowns and a second set of crowns with the first set of crowns being disposed closer to an inflow end of the prosthesis than the second set of crowns, the frame having a first longitudinal portion and a second longitudinal portion disposed axially adjacent to the first longitudinal portion, wherein the second longitudinal portion forms at least two rows of the plurality of rows and the first longitudinal portion forms at least two rows of the plurality of rows, and wherein the second longitudinal portion is formed from a single composite wire having a first end and a second end opposing the first end, the composite wire having a core of a first material, an intermediate layer of a second material, and an outer layer of a third material, the third material being an electrically insulative material; a prosthetic valve component disposed within the frame; at least one sensor configured to measure a flow parameter within the prosthesis, wherein a first end of the sensor is attached to the first end of the single component wire and a second end of the sensor is attached to the second end of the single composite wire; and wherein the second longitudinal portion forms an inductor configured to relay a signal to an external detector, the signal being associated with the at least one sensor.
2. The prosthesis of claim 1, wherein the first longitudinal portion forms three rows of the plurality of rows and the second longitudinal portion forms three rows of the plurality of rows.
3. The prosthesis of claim 1, wherein the second set of crowns of each row is disposed against and attached to the first set of crowns of an adjacent row by at least two axial suture loops extending over adjacent crowns.
4. The prothesis of claim 1, wherein the first longitudinal portion includes an inflow end of the prosthesis and the second longitudinal portion includes an outflow end of the prosthesis.
5. The prosthesis of claim 1, wherein the prosthetic valve component is disposed adjacent to a junction between the first longitudinal portion and the second longitudinal portion.
6. The prosthesis of claim 1, wherein the first longitudinal portion of the frame is formed from one or more solid wires of the second material.
7. The prosthesis of claim 1, wherein the first material is platinum and the second material is nitinol.
8. The prosthesis of claim 1, wherein the at least one sensor is a passive capacitive pressure sensor.
9. The prosthesis of claim 8, wherein the flow parameter is blood pressure.
10. The prosthesis of claim 1, wherein the at least one sensor includes a first sensor and the prosthesis further includes a second sensor, and wherein the flow parameter is a gradient between the first sensor and the second sensor.
11. The prosthesis of claim 10, wherein the second sensor is disposed closer to an inflow end of the prosthesis and the first sensor is disposed closer to an outflow end of the prosthesis.
12. The prosthesis of claim 1, wherein the at least one sensor is a compliant sensor or a rigid sensor.
13. The prosthesis of claim 1, wherein the at least one sensor includes a plurality of sensors, and wherein each sensor of the plurality of sensors is electrically coupled to the second longitudinal portion of the frame.
14. The prosthesis of claim 1, wherein the at least one sensor is wireless and batteryless.
15. The prosthesis of claim 1, wherein the external detector is configured to power the at least one sensor and communicate with the inductor.
16. The prosthesis of claim 1, wherein the signal relayed by the inductor to the external detector is achieved through inductive coupling.
17. The prosthesis of claim 1, wherein the inductor is a first inductor and the at least one sensor is a first sensor, and wherein the first longitudinal portion is formed from a second single composite wire having a first end and a second end opposing the first end, the composite wire having a core of the first material, an intermediate layer of the second material, and an outer layer of the third material, and wherein the prosthesis further includes a second sensor electrically coupled to the first longitudinal portion of the frame, the second sensor being configured to measure the flow parameter within the prosthesis, wherein a first end of the second sensor is attached to the first end of the second single component wire and a second end of the second sensor is attached to the second end of the second single composite wire, and wherein the first longitudinal portion forms a second inductor configured to relay a signal to the external detector, the signal being associated with the second sensor.
18. The prosthesis of claim 1, wherein the inductor is a first inductor and the at least one sensor is a first sensor, and wherein the prosthesis further includes a second sensor electrically coupled to the first longitudinal portion of the frame, the second sensor being configured to measure the flow parameter within the prosthesis, and wherein the prosthesis further includes a coil having a plurality of windings coupled to the first longitudinal portion of the frame and electrically coupled to the second sensor, the coil forming a second inductor configured to relay a signal to the external detector, the signal being associated with the second sensor.
19. The prosthesis of claim 18, wherein the coil is formed from stainless steel coated with a polymer.
20. The prosthesis of claim 19, wherein the coil has a sinusoidal configuration along its length.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] The accompanying figures, which are incorporated herein, form part of the specification and illustrate embodiments of a delivery system. Together with the description, the figures further explain the principles of and enable a person skilled in the relevant arts to make, use, and implant the prosthesis described herein. In the drawings, like reference numbers indicate identical or functionally similar elements.
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DETAILED DESCRIPTION OF THE INVENTION
[0042] Specific embodiments of the present invention are now described with reference to the figures, wherein like reference numbers indicate identical or functionally similar elements. Unless otherwise indicated, the terms distal and proximal, when used in the following description to refer to a shaft, a sheath, or a delivery device, are with respect to a position or direction relative to the treating clinician. Thus, distal and distally refer to positions distant from, or in a direction away from the treating clinician, and the terms proximal and proximally refer to positions near, or in a direction toward the treating clinician. The terms distal and proximal, when used in the following description to refer to a device to be implanted into a vessel, such as a heart prosthetic valve device, are used with reference to the direction of blood flow. Thus, distal and distally refer to positions in a downstream direction with respect to the direction of blood flow, and the terms proximal and proximally refer to positions in an upstream direction with respect to the direction of blood flow.
[0043] In addition, the term self-expanding is used in the following description with reference to one or more stent structures of the prostheses hereof and is intended to convey that the structures are shaped or formed from a material that can be provided with a mechanical memory to return the structure from a radially compressed or constricted radially compressed configuration to a radially expanded deployed configuration. Non-exhaustive illustrative self-expanding materials include stainless steel, a pseudo-elastic metal such as a nickel titanium alloy or nitinol, various polymers, or a so-called super alloy, which may have a base metal of nickel, cobalt, chromium, or other metal. Mechanical memory may be imparted to a wire or stent structure by thermal treatment to achieve a spring temper in stainless steel, for example, or to set a shape memory in a susceptible metal alloy, such as nitinol. Various polymers that can be made to have shape memory characteristics may also be suitable for use in embodiments hereof to include polymers such as polynorborene, trans-polyisoprene, styrene-butadiene, and polyurethane. As well poly L-D lactic copolymer, oligo caprylactone copolymer and poly cyclo-octine can be used separately or in conjunction with other shape memory polymers.
[0044] Embodiments hereof relate to prosthetic valve devices for implantation within a body or lumen that is configured for hemodynamic monitoring. The prosthetic valve device includes one or more sensors in electrical communication with an inductor formed by a portion of the frame or coupled to the frame of the prosthetic valve device. The sensor is configured to measure a flow parameter within the prosthesis. The inductor is configured to relay a signal to an external detector, the signal being associated with the flow parameter measured by the sensor. As such, the inductor functions or operates as an antenna to relay the signal associated with the flow parameter to the external detector.
[0045] With reference to the embodiment of
DETAILED DESCRIPTION
[0046] A side view and an end view of the prosthetic valve device 100 are shown in
[0047] In an embodiment, the prosthetic valve device 100 is an infundibular reducer device configured to be implanted in the pulmonary valve or the infundibulum.
[0048] The tubular graft 110 of the prosthetic valve device 100 has a first or inflow end 112, a second or outflow end 114, and a body 116 therebetween which defines a central lumen 118 that extends from the inflow end 112 to the outflow end 114. The central lumen 118 may also be considered a central lumen through the prosthetic valve device 100. A longitudinal axis LA of the prosthetic valve device 100 is defined by or extends parallel to the central lumen 118 of the tubular graft 110. In an embodiment, the inflow end 112 of tubular graft 110 may be referred to as a proximal end of tubular graft 110 and a proximal end of prosthetic valve device 100, which may be the end that is coupled to the delivery system, and the outflow end 114 of tubular graft 110 may be referred to as a distal end of graft 114 and a distal end of prosthetic valve device 100. The tubular graft 110 encloses or lines the frame 102 as would be known to one of ordinary skill in the art of prosthetic tissue valve construction. The tubular graft 110 may be a natural or biological material such as pericardium or another membranous tissue such as intestinal submucosa. Alternatively, the tubular graft 110 may be a knit or low-porosity woven fabric, such as polyester, Dacron fabric, or PTFE, which creates a one-way fluid passage when attached to the stent. In one embodiment, the tubular graft 110 may be a knit or woven polyester, such as a polyester or PTFE knit, which can be utilized when it is desired to provide a medium for tissue ingrowth and the ability for the fabric to stretch to conform to a curved surface or may instead be ultra-high molecular weight polyethylene (UHMWPE), cotton, or the like. Polyester velour fabrics may alternatively be used, such as when it is desired to provide a medium for tissue ingrowth on one side and a smooth surface on the other side. These and other appropriate cardiovascular fabrics are commercially available from Bard Peripheral Vascular, Inc. of Tempe, Ariz., for example.
[0049] The prosthetic valve component 108 is positioned or disposed within the center lumen 118 of the tubular graft 110. The prosthetic valve component 108 is attached to (i.e., affixed to, held by, retained by, etc.) the frame 102 along its ends and is sutured or otherwise attached within the frame 102 and/or the tubular graft 110. The prosthetic valve component 108 is capable of blocking flow in one direction to regulate flow there through via valve leaflets 109 that may form a bicuspid or tricuspid replacement valve. In the embodiment of
[0050] In this embodiment, the frame 102 has an expanded, longitudinally asymmetric hourglass configuration including three longitudinal sections of a relatively enlarged inflow end 104, a relatively enlarged outflow end 106, and a midsection 105 extending between the first and second ends 104, 106. The inflow end 104 may also be referred to herein as the proximal or first end, and the outflow end 106 may also be referred to herein as the distal or second end. The midsection 105 is generally cylindrical in shape with a smaller diameter than the inflow and outflow ends 104, 106. One advantage of the midsection 105 having a smaller diameter than the inflow and outflow ends 104, 106 is to allow at least a portion of the midsection 105 of the frame 102 to hold or retain the prosthetic valve component 108 in the central lumen 118 of the tubular graft 110, when the prosthetic valve component 108 has a smaller diameter than the lumen in which the prosthetic valve device 100 is to be placed. The larger diameters of the inflow and outflow ends 104, 106 allow the prosthetic valve device 100 to be secured in place in a tubular organ, or a valved anatomic site, having a diameter larger than that of the prosthetic valve component 108 but smaller than the expanded diameter of the inflow and outflow ends 104, 106. The inflow and outflow ends 104, 106 are flared, such that they gradually increase in diameter from where the inflow and outflow 104, 106 extend from the midsection 105.
[0051] The frame 102 includes a plurality of rows 120A, 120B, 120C, 120D, 120E, 120F, herein collectively referred to as rows 120. As will be described in more detail herein, the rows 120 are formed by at least two radially compressible stents or scaffolds that are coupled to the tubular graft 110 for supporting the tubular graft 110 and are operable to self-expand into apposition with an interior wall of a body vessel. The stents forming the rows 120 have sufficient radial spring force and flexibility to conformingly engage the prosthetic valve device 100 with the surrounding native anatomy, i.e., to provide a leak-resistant seal. In the embodiment depicted in
[0052] For description purposes only, the row that is coupled adjacent and proximate to the inflow end 112 of the tubular graft 110 is referred to herein as an inflow row 120A and the row that is coupled adjacent and proximate to the outflow end 114 of the tubular graft 110 is referred to herein as outflow row 120B. The frame 102 also includes a plurality of body rows 120C, 120D, 120E, 120F that are attached to the tubular graft 110 and disposed between the inflow row 120A and the outflow row 120B. A first body row 120C of the plurality of body rows is disposed directly adjacent to the inflow row 120A and a second body row 120D of the plurality of body rows is disposed directly adjacent to the outflow row 120B. The inflow end 104 of the frame 102 includes the inflow row 120A and the first body row 120C, the midsection 105 of the frame 102 includes the third body row 120E and the fourth body row 120F, and the outflow end 106 of the frame 102 includes the outflow row 120B and the second body row 120D. The third and fourth body rows 120E, 120F are longitudinally disposed between the first and second body rows 120C, 120D, and are oriented to extend substantially parallel to the longitudinal axis LA of the prosthetic valve device 100.
[0053]
[0054] The first set of crowns 122A of the inflow row 120A may be considered endmost inflow crowns and are disposed at the inflow end of the frame 102. The number of endmost inflow crowns may vary according to size and application and may range, for example, between 6-15 crowns. In an embodiment, the inflow row 120A has a total of nine endmost inflow crowns, as best shown in the end view of
[0055] Each pair of adjacent rows 120 of the frame 102 are attached to each other in a crown-to-crown configuration. More particularly, the second set of crowns 126A, 126C, 126D, 126E, 126F of each of the inflow row 120A and each body row of the plurality of body rows 120C, 120D, 120E, 120F is disposed against and attached to the first set of crowns of the row directly adjacent thereto by a plurality of axial suture loops extending over adjacent crowns as shown in
[0056] As stated above, the frame 102 includes the first longitudinal portion 130 and the second longitudinal portion 132 which is disposed axially adjacent to the first longitudinal portion 130. The first longitudinal portion 130 is directly beside or adjacent to the second longitudinal portion 132, but the portions do not overlap or overlay. In the embodiment of
[0057] In the embodiment of
[0058] Although the first longitudinal portion 130 is depicted as being formed from three individual or separate stents via a solid wire, in another embodiment hereof (not shown), one or more of the rows 120A, 120C, 120E may be cut from tubing and shape set into the desired configuration, with adjacent stents being subsequently sutured or otherwise attached to each other at abutting crowns. Further, in another embodiment hereof (not shown), all rows 120A, 120C, 120E may be constructed as a unitary component that is cut from tubing and shape set in the desired configuration.
[0059] The second longitudinal portion 132 is formed from a single elongated composite wire 133 having a first end 134A and a second end 134B opposing the first end.
[0060] As best shown on
[0061] The second longitudinal portion 132 forms the inductor 138 that is in electrical communication with the sensor 140, 240 and is configured to relay or output a signal or frequency 160, which is associated with the sensor 140, 240, to be received by an external detector 150 as described in more detail below with respect to
[0062] The sensor 140, 240 is configured to measure a flow parameter within the prosthetic valve device 100. The sensor 140, 240 may be a flexible pressure sensor configured to measure external pressure(s) caused by forces such as compression applied to the sensor 140, 240. The sensor 140, 240 is configured to convert capacitance into an electrical signal using four essential components: a flexible member, at least one electrode, a cavity, and a dielectric layer/substrate. The sensor 140 of
[0063] In operation, the sensor 140 is configured to measure pressure by detecting changes in electrical capacitance (i.e.., the ability to store electric charge) caused by movement of the diaphragm 142 through the cavity 146. The pressure within the space of the cavity 146 may be a vacuum, or more particularly an absolute pressure (i.e., perfect vacuum), or a relative pressure (i.e., atmospheric pressure corrected to sea-level conditions). When pressure is applied to the diaphragm 142, the diaphragm 142 and first electrode 144A move through the cavity 146 towards the second electrode 144B, thus reducing the distance between the diaphragm 142 and the second electrode 144B and reducing the size of the cavity 146. When the applied pressure is reduced or removed, the diaphragm 142 and first electrode 144A move through the cavity 146 away from the second electrode 144B, thus increasing the distance between the diaphragm 142 and the second electrode 144B and increasing the size of the cavity 146. The amount of pressure being applied at any given time varies, resulting in up and down or wobbling movement of the diaphragm 142. The diaphragm 142 moves between a neutral state in which no pressure is applied thereto (as exemplified in
[0064] The sensor 240 of
[0065] In operation, the sensor 240 is configured to measure pressure by detecting changes in electrical capacitance (i.e., the ability to store electric charge) caused by the movement of the diaphragm 242. The diaphragm 242 may be flexible, and composed of materials such as plastic, glass, silicon, or ceramic, for example. When pressure is applied to the diaphragm 242, the diaphragm 242 moves through the cavity 246 toward the conducting plate 244, thus reducing the distance between the diaphragm 242 and the conducting plate 244 and reducing the size of the cavity 246. When the applied pressure is reduced or removed, the diaphragm 242 moves through the cavity 246 away from the conducting plate 244, thus increasing the distance between the diaphragm 242 and the conducting plate 244 and increasing the size of the cavity 246. The amount of pressure being applied at any given time varies, resulting in a wobbling effect or movement of the diaphragm 242. When the size of the cavity 246 is reduced due to movement of the diaphragm 242, the capacity or capacitance of the sensor 240 decreases. Similarly, when the size of the cavity 246 is increased due to movement of the diaphragm 242, the capacity or capacitance of the sensor 240 increases. Stated another way, the electrical capacitance of the sensor 240 changes or varies as a result of movement of the diaphragm 242. The increase/decrease in electrical capacitance is received by the integrated circuit 245, which may be an oscillator or a resonant circuit, an LC circuit, a tank circuit, or a tuned circuit, for example. Upon receiving this change in capacitance, the integrated circuit 245 will experience a change in frequency generated as the signal or frequency 160 relative to the provided increase/decrease in electrical capacitance.
[0066]
[0067] In the embodiment of
[0068] Although a single sensor 140, 240 is depicted in the embodiment of
[0069] More particularly,
[0070] In another embodiment hereof, the first longitudinal portion of the prosthetic valve device may form a second inductor such that pressure measurements at the inflow and outflow ends of the prosthetic valve device may be monitored, thereby enabling gradient (i.e.., blood flow rate) calculations. More particularly,
[0071] The second longitudinal portion 832 is the same as the second longitudinal portion 132 described above and includes the single elongated composite wire 133 and the sensor 140, 240, which may be considered a first sensor in this embodiment. The second longitudinal portion 832 forms the inductor 138, which may be considered a first inductor in this embodiment, that is in electrical communication with the first sensor 140, 240 and is configured to relay or output a signal or frequency, which is associated with the first sensor 140, 240, to be received by an external detector as described above with respect to
[0072] In this embodiment, the first longitudinal portion 830 is also formed from a single elongated composite wire 833 and includes a sensor 840, which is the same as the sensor 140, 240 described above and may be considered a second sensor in this embodiment. The first longitudinal portion 830 forms an inductor 838, which may be considered a second inductor in this embodiment. The composite wire 833 has a first end 834A and a second end 834B opposing the first end. The composite wire 833 is the same construction as the composite wire 133 and includes the core 135 of a first material, the intermediate layer 136 of a second material, and the outer layer 137 of a third material. A first end 841A of the second sensor 840 is attached to the first end 834A of the composite wire 833 and a second end 841B of the second sensor 840 is attached to the second end 834B of the composite wire 833.
[0073] The first longitudinal portion 830 forms the second inductor 838 that is in electrical communication with the second sensor 840 and is configured to relay or output a signal or frequency, which is associated with the sensor 840, to be received by an external detector. To function as the second inductor 838, the composite wire 833 winds or spirals into a coiled stent having a plurality of windings, i.e.., each row 820A, 820C, 820E of the plurality of rows 820 is a winding of the coiled stent. Since the coiled stent includes three windings or rows, the composite wire 833 overlaps or overlays itself (or the sensor 840) at two locations 839A, 839B. However, since the composite wire 833 includes the outer layer 137 of an electrically insulative material, the core 135 of the composite wire 833 does not come into contact with itself at the two locations 839A, 839B as to not interfere with the operation or function of the second inductor 838. The overlapping portions of the composite wire 833 at the two locations 839A, 839B may be secured to each other via sutures and/or polymer adhesive.
[0074] The second inductor 838, formed by the coiled stent of the first longitudinal portion 830 as described above, generates an inductance L, or a change in electrical current therein. When the second sensor 840 experiences an increase or decrease in capacitance due to forces applied against the diaphragm as previously described herein with respect to the sensor 140, 240, the frequency of the integrated circuit changes, which in turn generates the inductance L of the second inductor 838 resulting in an output of the signal or frequency. The signal or frequency relayed or output by the second inductor 838 is intercepted, detected, or otherwise received by the external detector. The signal or frequency of the second inductor 838 is transmitted to the external detector through inductive coupling, such that the signal emitted from the second inductor 838 creates interference or inductance with the external detector.
[0075] The prosthetic valve device 800 thus includes the second sensor 840, in electrical communication with the second inductor 838, disposed at the inflow end 804 of the prosthetic valve device 800 and the first sensor 140, 240, in electrical communication with the first inductor 138, disposed at the outflow end 806 of the prosthetic valve device 800. Stated another way, the second sensor 840 is disposed closer to the inflow end 804 of the prosthetic valve device 800 and the first sensor 140, 240 is disposed closer to the outflow end 806 of the prosthetic valve device 800. By arranging the first sensor 140, 240 and the second sensor 840 in this manner, or in similar configurations where the first sensor 140, 240 and the second sensor 840 are separated from each other by a longitudinal distance, a gradient flow parameter (i.e., blood flow rate) may be measured between the first sensor 140, 240 and the second sensor 840, or a measured increase or decrease in blood pressure caused by the flowing fluid. More particularly, the flow parameter measured may be a gradient indicating a rise or drop in blood pressure between certain points on the prosthetic valve device 800 represented by the locations of the first sensor 140, 240 and the second sensor 840.
[0076] Another embodiment hereof is depicted in
[0077] The second longitudinal portion 932 is the same as the second longitudinal portion 132 described above and includes the single elongated composite wire 133 and the sensor 140, 240, which may be considered a first sensor in this embodiment. The second longitudinal portion 932 forms the inductor 138, which may be considered a first inductor in this embodiment, that is in electrical communication with the first sensor 140, 240 and is configured to relay or output a signal or frequency, which is associated with the first sensor 140, 240, to be received by an external detector as described above with respect to
[0078] Similar to the first longitudinal portion 130, the first longitudinal portion 930 includes rows 920A, 920C, 920E each of which is formed from an individual or separate stent. Each stent forming one of the rows 920A, 920C, 920E is manufactured or formed in its radially expanded or deployed configuration and is constructed from a wire that is shaped into a sinusoidal patterned ring. Each row 920A, 920C, 920E of the first longitudinal portion 930 is formed from a solid wire of a relatively strong, self-expanding material. In an embodiment, each row of the first longitudinal portion 930 is constructed from a self-expanding or spring material, including but not limited to nickel titanium alloys such as Nitinol.
[0079] The first longitudinal portion 932 also includes a sensor 940, which is the same as the sensor 140, 240 described above and may be considered a second sensor in this embodiment, and an inductor 938, which may be considered a second inductor in this embodiment. The sensor 940 is shown attached to and overlaying a strut of the first body row 920C, but this placement is exemplary. The sensor 940 may be attached to any portion of the frame 902 and/or the tubular graft 910.
[0080] Rather than being formed by a portion of the frame 902, the second inductor 938 is a coil having a plurality of windings coupled to the first longitudinal portion 932 of the frame 902. A first end of the coil/second inductor 938 is attached to a first end 941A of the sensor 940 and a second end of the coil/second inductor 938 is attached to a second end 941B of the sensor 940. The second inductor 938 is in electrical communication with the second sensor 940 and is configured to relay or output a signal or frequency, which is associated with the sensor 940, to be received by an external detector. In the depicted embodiment, the second inductor 938 encircles and is coupled to the first body row 920C of the first longitudinal portion 932 but may additionally and/or alternatively encircle the inflow row 920A and/or the third body row 920C. In an embodiment, the second conductor 938 is woven or braided through a tubular graft 910 of the prosthetic valve device 900 in order to be coupled thereto. More particularly, a flexible strand of electrically conductive material may be woven into the material of the tubular graft 910 in a coil shape or pattern to form the second inductor 938. In an embodiment, the strand of electrically conductive material may be stainless steel coated with a polymer such as Paralyne for insulation. In another embodiment, the strand of electrically conductive material may be platinum, copper, gold, nickel, aluminum, silver, and the like. Further, as an alternative to being woven into the tubular graft 910, the second inductor 938 may be secured to the tubular graft 910 and/or the stent forming one of the rows 920A, 920C, 920E via sutures, adhesive, and the like.
[0081] The second inductor 938 generates an inductance L, or a change in electrical current therein. When the second sensor 940 experiences an increase or decrease in capacitance due to forces applied against the diaphragm as previously described herein with respect to the sensor 140, 240, the frequency of the integrated circuit changes, which in turn generates the inductance L of the second inductor 938 resulting in an output of the signal or frequency. The signal or frequency relayed or output by the second inductor 938 is intercepted, detected, or otherwise received by the external detector. The signal or frequency of the second inductor 938 is transmitted to the external detector through inductive coupling, such that the signal emitted from the second inductor 938 creates interference or inductance with the external detector.
[0082] The prosthetic valve device 900 thus includes the second sensor 940, in electrical communication with the second inductor 938, disposed at the inflow end 904 of the prosthetic valve device 900 and the first sensor 140, 240, in electrical communication with the first inductor 138, disposed at the outflow end 906 of the prosthetic valve device 900. Stated another way, the second sensor 940 is disposed closer to the inflow end 904 of the prosthetic valve device 900 and the first sensor 140, 240 is disposed closer to the outflow end 906 of the prosthetic valve device 900. By arranging the first sensor 140, 240 and the second sensor 940 in this manner, or in similar configurations where the first sensor 140, 240 and the second sensor 940 are separated from each other by a longitudinal distance, a gradient flow parameter (i.e.., blood flow rate) may be measured between the first sensor 140, 240 and the second sensor 940, or a measured increase or decrease in pressure caused by the flowing fluid. More particularly, the flow parameter measured may be a gradient indicating a rise or drop in blood pressure between certain points on the prosthetic valve device 900 represented by the locations of the first sensor 140, 240 and the second sensor 940.
[0083] In the embodiment of
[0084] Another embodiment hereof is depicted in
[0085] The frame 1002 includes a plurality of rows 1020A, 1020B, 1020C, 1020D, 1020E, 1020F.
[0086] Each row 1020A, 1020B, 1020C, 1020D, 1020E, 1020F is formed from an individual or separate stent. Each stent forming one of the rows 1020A, 1020B, 1020C, 1020D, 1020E, 1020F is manufactured or formed in its radially expanded or deployed configuration and is constructed from a solid wire 1031 that is shaped into a sinusoidal patterned ring. Each row 1020A, 1020B, 1020C, 1020D, 1020E, 1020F is formed from the wire 1031 of a relatively strong, self-expanding material. In an embodiment, each row 1020A, 1020B, 1020C, 1020D, 1020E, 1020F is constructed from a self-expanding or spring material, including but not limited to nickel titanium alloys such as Nitinol.
[0087] The prosthetic valve device 1000 includes a first sensor 1040A, which is the same as the sensor 140, 240 described above, and a first inductor 1038A. The first sensor 1040A is shown attached to a strut of the second body row 1020D, but this placement is exemplary. The first sensor 1040A may be attached to any portion of the frame 1002 and/or the tubular graft 1010.
[0088] Rather than being formed by a portion of the frame 1002, the first inductor 1038A is a coil having a plurality of windings coupled to the frame 1002. A first end of the coil/first inductor 1038A is attached to a first end 1041A of the first sensor 1040A and a second end of the coil/first inductor 1038A is attached to a second end 1041B of the first sensor 1040A. The first inductor 1038A is in electrical communication with the first sensor 1040A and is configured to relay or output a signal or frequency, which is associated with the first sensor 1040A, to be received by an external detector. In the depicted embodiment, the first inductor 1038A encircles and is coupled to the second body row 1020D of the frame 1002 but may additionally and/or alternatively encircle the outflow row 1020B and/or the fourth body row 1020F. In an embodiment, the first conductor 1038A is woven or braided through a tubular graft 1010 of the prosthetic valve device 1000 in order to be coupled thereto. More particularly, a flexible strand of electrically conductive material may be woven into the material of the tubular graft 1010 in a coil shape or pattern to form the first inductor 1038A. In an embodiment, the strand of electrically conductive material may be stainless steel coated with a polymer such as Paralyne for insulation. In another embodiment, the strand of electrically conductive material may be platinum, copper, gold, nickel, aluminum, silver, and the like. Further, as an alternative to being woven into the tubular graft 1010, the first inductor 1038A may be secured to the tubular graft 1010 and/or the stent forming one of the rows 1020B, 1020D, 1020F via sutures, adhesive, and the like.
[0089] The first inductor 1038A generates an inductance L, or a change in electrical current therein. When the first sensor 1040A experiences an increase or decrease in capacitance due to forces applied against the diaphragm as previously described herein with respect to the sensor 140, 240, the frequency of the integrated circuit changes, which in turn generates the inductance L of the first inductor 1038A resulting in an output of the signal or frequency. The signal or frequency relayed or output by the first inductor 1038A is intercepted, detected, or otherwise received by the external detector. The signal or frequency of the first inductor 1038A is transmitted to the external detector through inductive coupling, such that the signal emitted from the first inductor 1038A creates interference or inductance with the external detector.
[0090] The prosthetic valve device 1000 also includes a second sensor 1040B, which is the same as the sensor 140, 240 described above, and a second inductor 1038B. The second sensor 1040B is shown attached to a strut of the first body row 1020C, but this placement is exemplary. The second sensor 1040B may be attached to any portion of the frame 1002 and/or the tubular graft 1010.
[0091] Rather than being formed by a portion of the frame 1002, the second inductor 1038B is a coil having a plurality of windings coupled to the frame 1002. A first end of the coil/second inductor 1038B is attached to a first end 1041C of the second sensor 1040B and a second end of the coil/second inductor 1038B is attached to a second end 1041D of the second sensor 1040B. The second inductor 1038B is in electrical communication with the second sensor 1040B and is configured to relay or output a signal or frequency, which is associated with the sensor 1040B, to be received by an external detector. In the depicted embodiment, the second inductor 1038B encircles and is coupled to the first body row 1020C of the frame 1002 but may additionally and/or alternatively encircle the inflow row 1020A and/or the third body row 1020E. In an embodiment, the second conductor 1038B is woven or braided through the tubular graft 1010 of the prosthetic valve device 1000 in order to be coupled thereto. More particularly, a flexible strand of electrically conductive material may be woven into the material of the tubular graft 1010 in a coil shape or pattern to form the second inductor 1038B. In an embodiment, the strand of electrically conductive material may be stainless steel coated with a polymer such as Paralyne for insulation. In another embodiment, the strand of electrically conductive material may be platinum, copper, gold, nickel, aluminum, silver, and the like. Further, as an alternative to being woven into the tubular graft 1010, the second inductor 1038 may be secured to the tubular graft 1038 and/or the stent forming one of the rows 1020A, 1020C, 1020E via sutures, adhesive, and the like.
[0092] The second inductor 1038B generates an inductance L, or a change in electrical current therein. When the second sensor 1040 experiences an increase or decrease in capacitance due to forces applied against the diaphragm as previously described herein with respect to the sensor 140, 240, the frequency of the integrated circuit changes, which in turn generates the inductance L of the second inductor 1038B resulting in an output of the signal or frequency. The signal or frequency relayed or output by the second inductor 1038B is intercepted, detected, or otherwise received by the external detector. The signal or frequency of the second inductor 1038B is transmitted to the external detector through inductive coupling, such that the signal emitted from the second inductor 1038B creates interference or inductance with the external detector.
[0093] The prosthetic valve device 1000 thus includes the second sensor 1040B, in electrical communication with the second inductor 1038B, disposed at the inflow end 1004 of the prosthetic valve device 1000 and the first sensor 1040A, in electrical communication with the first inductor 1038A, disposed at the outflow end 1006 of the prosthetic valve device 1000. Stated another way, the second sensor 1040B is disposed closer to the inflow end 1004 of the prosthetic valve device 1000 and the first sensor 1040A is disposed closer to the outflow end 1006 of the prosthetic valve device 1000. By arranging the first sensor 1040A and the second sensor 1040B in this manner, or in similar configurations where the first sensor 1040A and the second sensor 1040B are separated from each other by a longitudinal distance, a gradient flow parameter (i.e., blood flow rate) may be measured between the first sensor 1040A and the second sensor 1040B, or a measured increase or decrease in pressure caused by the flowing fluid. More particularly, the flow parameter measured may be a gradient indicating a rise or drop in blood pressure between certain points on the prosthetic valve device 1000 represented by the locations of the first sensor 1040A and the second sensor 1040B.
[0094] A variation of the prosthetic valve device 1000 is shown in
[0095] Turning now to the block diagram of
[0096] With reference to
[0097] With further reference to
[0098] Further provided is a method 1470 for measuring a flow parameter within the prosthesis or valve device 100 implanted within a body as described herein, the method as illustrated in
[0099] Although the sensors and inductors described herein are incorporated onto self-expanding prosthetic valve devices, such sensors and inductors may alternatively be incorporated onto balloon-expandable or mechanically expandable prosthetic valve devices. As such, the frame would alternatively be made from a plastically deformable material such that when expanded, the frame maintains its radially expanded configuration. Suitable plastically deformable materials include cobalt chromium alloys such as MP35N, which would be utilized in place of Nitinol is the self-expandable embodiments described herein.
[0100] The foregoing description has been presented for purposes of illustration and enablement and is not intended to be exhaustive or to limit the invention to the precise form disclosed. Other modifications and variations are possible in light of the above teachings. The embodiments and examples were chosen and described in order to best explain the principles of the invention and its practical application and to thereby enable others skilled in the art to best utilize the invention in various embodiments and various modifications as are suited to the particular use contemplated. It is intended that the appended claims be construed to include other alternative embodiments of the invention.
[0101] Embodiments of the present disclosure include the following examples.
[0102] In a first example, a prosthesis for implantation within a body or lumen includes a frame including a plurality of rows of struts and crowns formed between adjacent pairs of said struts. Each row has a first set of crowns and a second set of crowns with the first set of crowns being disposed closer to an inflow end of the prosthesis than the second set of crowns, the frame having a first longitudinal portion and a second longitudinal portion disposed axially adjacent to the first longitudinal portion. The second longitudinal portion forms at least two rows of the plurality of rows and the first longitudinal portion forms at least two rows of the plurality of rows. The second longitudinal portion is formed from a single composite wire having a first end and a second end opposing the first end. The composite wire has a core of a first material, an intermediate layer of a second material, and an outer layer of a third material. The third material is an electrically insulative material. A prosthetic valve component is disposed within the frame. At least one sensor is configured to measure a flow parameter within the prosthesis. A first end of the sensor is attached to the first end of the single component wire and a second end of the sensor is attached to the second end of the single composite wire. The second longitudinal portion forms an inductor configured to relay a signal to an external detector, the signal being associated with the at least one sensor.
[0103] In a second example, in the prosthesis according to any of the previous or subsequent examples herein, the first longitudinal portion forms three rows of the plurality of rows and the second longitudinal portion forms three rows of the plurality of rows.
[0104] In a third example, in the prosthesis according to any of the previous or subsequent examples herein, a length of the first longitudinal portion is substantially equal to a length of the second longitudinal portion.
[0105] In a fourth example, in the prosthesis according to any of the previous or subsequent examples herein, the second set of crowns of each row is disposed against and attached to the first set of crowns of an adjacent row by at least two axial suture loops extending over adjacent crowns.
[0106] In a fifth example, in the prosthesis according to any of the previous or subsequent examples herein, the first longitudinal portion includes an inflow end of the prosthesis and the second longitudinal portion includes an outflow end of the prosthesis.
[0107] In a sixth example, in the prosthesis according to any of the previous or subsequent examples herein, the first longitudinal portion is stronger than the second longitudinal portion.
[0108] In a seventh example, in the prosthesis according to any of the previous or subsequent examples herein, the first longitudinal portion includes an inflow stent disposed at the inflow end of the prosthesis and at least one body stent disposed between the second longitudinal portion and the inflow stent, each of the inflow stent and the at least one body stent being a sinusoidal patterned radially expandable ring that forms one row of the plurality of rows.
[0109] In an eighth example, in the prosthesis according to any of the previous or subsequent examples herein, each sinusoidal patterned radially expandable ring is composed of nitinol wire.
[0110] In a nineth example, in the prosthesis according to any of the previous or subsequent examples herein, the prosthetic valve component is disposed adjacent to a junction between the first longitudinal portion and the second longitudinal portion.
[0111] In a tenth example, in the prosthesis according to any of the previous or subsequent examples herein, the first longitudinal portion of the frame is formed from one or more solid wires of the second material.
[0112] In an eleventh example, in the prosthesis according to any of the previous or subsequent examples herein, the first material is platinum and the second material is nitinol.
[0113] In a twelfth example, in the prosthesis according to any of the previous or subsequent examples herein, the at least one sensor is a passive capacitive pressure sensor.
[0114] In a thirteenth example, in the prosthesis according to any of the previous or subsequent examples herein, the flow parameter is blood pressure.
[0115] In a fourteenth example, in the prosthesis according to any of the previous or subsequent examples herein, the at least one sensor includes a first sensor and the prosthesis further includes a second sensor. The flow parameter is a gradient between the first sensor and the second sensor.
[0116] In a fifteenth example, in the prosthesis according to any of the previous or subsequent examples herein, the second sensor is disposed closer to an inflow end of the prosthesis and the first sensor is disposed closer to an outflow end of the prosthesis.
[0117] In a sixteenth example, in the prosthesis according to any of the previous or subsequent examples herein, the at least one sensor is a compliant sensor or a rigid sensor.
[0118] In a seventeenth example, in the prosthesis according to any of the previous or subsequent examples herein, the at least one sensor includes a plurality of sensors and each sensor of the plurality of sensors is electrically coupled to the second longitudinal portion of the frame.
[0119] In an eighteenth example, in the prosthesis according to any of the previous or subsequent examples herein, the at least one sensor is wireless and batteryless.
[0120] In a nineteenth example, in the prosthesis according to any of the previous or subsequent examples herein, the external detector is configured to power the at least one sensor and communicate with the inductor.
[0121] In a twentieth example, in the prosthesis according to any of the previous or subsequent examples herein, the signal relayed by the inductor to the external detector is achieved through inductive coupling.
[0122] In a twenty-first example, in the prosthesis according to any of the previous or subsequent examples herein, the inductor is a first inductor and the at least one sensor is a first sensor. The first longitudinal portion is formed from a second single composite wire having a first end and a second end opposing the first end, the composite wire having a core of the first material, an intermediate layer of the second material, and an outer layer of the third material. The prosthesis further includes a second sensor electrically coupled to the first longitudinal portion of the frame, the second sensor being configured to measure the flow parameter within the prosthesis. A first end of the second sensor is attached to the first end of the second single component wire and a second end of the second sensor is attached to the second end of the second single composite wire. The first longitudinal portion forms a second inductor configured to relay a signal to the external detector, the signal being associated with the second sensor.
[0123] In a twenty-second example, in the prosthesis according to any of the previous or subsequent examples herein, the inductor is a first inductor and the at least one sensor is a first sensor. The prosthesis further includes a second sensor electrically coupled to the first longitudinal portion of the frame, the second sensor being configured to measure the flow parameter within the prosthesis. The prosthesis further includes a coil having a plurality of windings coupled to the first longitudinal portion of the frame and electrically coupled to the second sensor, the coil forming a second inductor configured to relay a signal to the external detector, the signal being associated with the second sensor.
[0124] In a twenty-third example, in the prosthesis according to any of the previous or subsequent examples herein, the coil is formed from stainless steel coated with a polymer.
[0125] In a twenty-fourth example, in the prosthesis according to any of the previous or subsequent examples herein, the coil has a sinusoidal configuration along its length.
[0126] In a twenty-fifth example, a prosthesis for implantation within a body or lumen includes a tubular graft defining a lumen that extends from an inflow end to an outflow end. A prosthetic valve component is disposed within the lumen of the tubular graft. A frame is attached to the tubular graft, the frame including an inflow stent attached to the inflow end of the tubular graft, an outflow stent attached to the outflow end of the tubular graft, and a plurality of body stents attached to the tubular graft and disposed between the inflow stent and the outflow stent. Each stent of the plurality of body stents, the inflow stent, and the outflow stent is a sinusoidal patterned radially expandable ring having a first set of crowns and a second set of crowns. The prosthesis also includes a coil having a plurality of windings. The coil is woven into the tubular graft to encircle a portion of the frame. At least one sensor is electrically coupled to the coil, the at least one sensor being configured to measure a flow parameter within the prosthesis. The coil forms an inductor configured to relay a signal to an external detector, the signal being associated with the at least one sensor.
[0127] In a twenty-sixth example, in the prosthesis according to any of the previous or subsequent examples herein, a first body stent of the plurality of body stents is disposed directly adjacent to the inflow stent and a second body stent of the plurality of body stents is disposed directly adjacent to the outflow stent. Each of the inflow stent, the outflow stent, and each stent of the plurality of body stents is a sinusoidal patterned radially expandable ring having a first set of crowns and a second set of crowns.
[0128] In a twenty-seventh example, in the prosthesis according to any of the previous or subsequent examples herein, each of the inflow stent, the outflow stent, and the plurality of body stents are composed of nitinol wire.
[0129] In a twenty-eighth example, in the prosthesis according to any of the previous or subsequent examples herein, the coil is formed from stainless steel coated with a polymer.
[0130] In a twenty-ninth example, in the prosthesis according to any of the previous or subsequent examples herein, the coil has a sinusoidal configuration along its length.
[0131] In a thirtieth example, in the prosthesis according to any of the previous or subsequent examples herein, the second set of crowns of each stent is disposed against and attached to the first set of crowns of an adjacent stent by at least two axial suture loops extending over adjacent crowns.
[0132] In a thirty-first example, in the prosthesis according to any of the previous or subsequent examples herein, the at least one sensor is a passive capacitive pressure sensor.
[0133] In a thirty-second example, in the prosthesis according to any of the previous or subsequent examples herein, the flow parameter is blood pressure.
[0134] In a thirty-third example, in the prosthesis according to any of the previous or subsequent examples herein, the at least one sensor includes a first sensor and the prosthesis further includes a second sensor. The flow parameter is a gradient between the first sensor and the second sensor.
[0135] In a thirty-fourth example, in the prosthesis according to any of the previous or subsequent examples herein, the second sensor is disposed closer to an inflow end of the prosthesis and the first sensor is disposed closer to an outflow end of the prosthesis.
[0136] In a thirty-fifth example, in the prosthesis according to any of the previous or subsequent examples herein, the at least one sensor is a compliant sensor or a rigid sensor.
[0137] In a thirty-sixth example, in the prosthesis according to any of the previous or subsequent examples herein, the at least one sensor includes a plurality of sensors, and each sensor of the plurality of sensors is electrically coupled to the coil.
[0138] In a thirty-seventh example, in the prosthesis according to any of the previous or subsequent examples herein, the at least one sensor is wireless and batteryless.
[0139] In a thirty-eighth example, in the prosthesis according to any of the previous or subsequent examples herein, the external detector is configured to power the at least one sensor and communicate with the inductor.
[0140] In a thirty-ninth example, in the prosthesis according to any of the previous or subsequent examples herein, the signal relayed by the inductor to the external detector is achieved through inductive coupling.
[0141] In a fortieth example, a method for measuring a flow parameter within a prosthesis of any of the preceding claims implanted within a lumen of a body includes measuring the flow parameter with at least one sensor. The flow parameter is communicated to the inductor in electrical communication with the at least one sensor. A signal associated with the at least one sensor is relayed via the inductor. The signal is received via an antenna of the external detector. The flow parameter measured by the at least one sensor is displayed on a display integral or connected to the external detector.
[0142] In a forty-first example, in the method according to any of the previous or subsequent examples herein, the flow parameter is blood pressure.
[0143] In a forty-second example, in the method according to any of the previous or subsequent examples herein, the flow parameter is a blood flow rate.
[0144] In a forty-third example, in the method according to any of the previous or subsequent examples herein, the method also includes the step of holding the external detector against an external surface of a patient having the prosthetic valve device implanted therein.
[0145] In a forty-fourth example, in the method according to any of the previous or subsequent examples herein, upon holding the external detector in place against the external surface, the external detector powers the at least one sensor.
[0146] In a forty-fifth example, in the method according to any of the previous or subsequent examples herein, the step of relaying the signal is achieved through inductive coupling between the inductor of the prosthetic valve and the antenna of the external device.