ASSEMBLIES FOR STERILIZING A WET STORED PROSTHETIC HEART VALVE
20260124030 ยท 2026-05-07
Inventors
- David Clarke (Loughrea, IE)
- Karina Doyle (Galway, IE)
- Paul Devereux (Tuam, IE)
- Gerry Kearns (Galway, IE)
- Padraigh JENNINGS (Summerhill, IE)
- Constantino Fiuza (Galway, IE)
- Stephen MONTGOMERY (Galway, IE)
Cpc classification
B65D81/22
PERFORMING OPERATIONS; TRANSPORTING
A61L2202/181
HUMAN NECESSITIES
A61F2/0095
HUMAN NECESSITIES
A61F2/2427
HUMAN NECESSITIES
B65D81/18
PERFORMING OPERATIONS; TRANSPORTING
A61F2/00
HUMAN NECESSITIES
International classification
A61F2/00
HUMAN NECESSITIES
A61F2/24
HUMAN NECESSITIES
B65D81/18
PERFORMING OPERATIONS; TRANSPORTING
Abstract
Aspects of the disclosure relate to wet transcatheter prosthetic heart valve or other implant packaging and assemblies in which a prosthetic heart valve or other implant is loaded into a first portion of a delivery device and positioned within a container in which sterilizing fluid is retained to sterilize interior portions of the container as well as provide moisture to prevent the implant from drying out. The disclosure also relates to methods of sterilizing the disclosed assemblies. Some disclosed methods include at least two sterilizing steps and adjustment of a mechanical seal member or formation of multiple seals so that areas proximate the seals are also sterilized during the sterilization process.
Claims
1. An assembly comprising: a storage container comprising: a first portion configured to receive a distal end of a spindle, and configured to receive an implant carried by the spindle; and a second portion comprising an open end configured to establish a fluid-tight connection with an open end of the first portion, and the second portion comprising an aperture configured to receive the spindle carrying the implant; and a seal configured to provide a fluid-tight interface between the second portion and the spindle carrying the implant, wherein the fluid-tight connection of the open end of the second portion with the open end of the first portion and the fluid-tight interface between the second portion and the spindle is configured to provide a fluid-tight sterile storage area for an implant carried by the spindle within the fluid-tight sterile storage area.
2. The assembly of claim 1, further comprising a lid connected to the second portion, wherein the lid is configured to compress the seal to provide the fluid-tight interface between the second portion and the spindle.
3. The assembly of claim 2, wherein the lid is threadedly connected to the second portion, and configured to be threadedly tightened to compress the seal to provide the fluid tight interface between the second portion and the spindle.
4. The assembly of claim 1, wherein the open end of the second portion is configured to be threadedly connected to the open end of the first portion, wherein a threaded connection between the open end of the second portion and the open end of the first portion is configured to be tightened to provide the fluid-tight connection.
5. A method of sterilizing an implant with the assembly of claim 1 comprising: mounting the seal on the second portion of the storage container; inserting a spindle through the aperture of the second portion with the seal circumscribing the spindle; mounting an implant on the spindle; filling a reservoir of the first portion of the storge container with sterilization fluid; inserting the distal tip of the spindle and implant mount on the spindle into the reservoir to suspend the implant within he sterilization fluid; and providing a fluid-tight connection between the open end of the second portion and the open end of the first portion.
6. The method of claim 5, wherein, after inserting the spindle through the aperture of the second portion, further comprising compressing the seal to provide the fluid-tight interface between the second portion and the spindle carrying the implant.
7. The method of claim 5, wherein, after inserting the spindle through the aperture of the second portion, further comprising: connecting a lid to the second portion with the spindle extending through an aperture of the lid; and tightening the lid to compress the seal to provide a fluid-tight interface between the second portion and the spindle carrying the implant.
8. A method of sterilizing an implant comprising: filling a reservoir of a first portion of a storage container with a volume of sterilization fluid; mounting an annular seal on a second portion of a storage container; inserting a spindle through an aperture of the second portion of the storage container and an aperture of the annular seal; mounting an implant on the spindle; submerging a distal portion of the spindle and mounted implant in the volume of sterilization fluid; and providing a fluid-tight connection between the open end of the second portion and the open end of the first portion.
9. The method of claim 8, further comprising compressing the seal to provide a fluid-tight interface between the second portion and the spindle carrying the implant.
10. The method of claim 8, further comprising: connecting a lid to the second portion with the spindle extending through an aperture of the lid; and tightening the lid to compress the seal to provide a fluid-tight interface between the second portion and the spindle carrying the implant.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION
[0035] Specific embodiments of the present disclosure are now described with reference to the figures, wherein like reference numbers indicate identical or functionally similar elements. The terms distal and proximal are used in the following description with respect to a position or direction relative to the treating clinician. Distal or distally are a position distant from or in a direction away from the clinician. Proximal and proximally are a position near or in a direction toward the clinician. As used herein with reference to an implanted prosthetic heart valve, the terms distal and outflow are understood to mean downstream to the direction of blood flow, and the terms proximal or inflow are understood to mean upstream to the direction of blood flow.
[0036] As referred to herein, stented transcatheter prosthetic heart valves useful with and/or as part of the various systems, devices and methods of the present disclosure may assume a wide variety of different configurations, such as a bioprosthetic heart valve having tissue leaflets or a synthetic heart valve having polymeric, metallic or tissue-engineered leaflets, and can be specifically configured for replacing any of the four valves of the human heart. Thus, the stented prosthetic heart valve useful with the systems, devices, and methods of the present disclosure can be generally used for replacement of a native aortic, mitral, pulmonic or tricuspid valve, or to replace a failed bioprosthesis, such as in the area of an aortic valve or mitral valve, for example.
[0037] In general terms, the stented prosthetic heart valves of the present disclosure include a stent or stent frame having an internal lumen maintaining a valve structure (tissue or synthetic), with the stent frame having a normal, expanded condition or arrangement and collapsible to a compressed condition or arrangement for loading within a delivery device. The stent frame is normally constructed to self-deploy or self-expand when released from the delivery device. For example, the stents or stent frames are support structures that comprise a number of struts or wire segments arranged relative to each other to provide a desired compressibility and strength to the prosthetic heart valve. The struts or wire segments are arranged such that they are capable of self-transitioning from a compressed or collapsed condition to a normal, radially expanded condition. The struts or wire segments can be formed from a shape memory material, such as a nickel titanium alloy (e.g., nitinol). The stent frame can be laser-cut from a single piece of material, or can be assembled from a number of discrete components.
[0038] With the above understanding in mind, one simplified, non-limiting example of a stented prosthetic heart valve 10 useful with systems, devices and methods of the present disclosure is illustrated in
[0039] The valve structure 14 can assume a variety of forms, and can be formed, for example, from one or more biocompatible synthetic materials, synthetic polymers, autograft tissue, homograft tissue, xenograft tissue, or one or more other suitable materials. In some embodiments, the valve structure 14 can be formed, for example, from bovine, porcine, equine, ovine and/or other suitable animal tissues. In some embodiments, the valve structure 14 can be formed, for example, from heart valve tissue, pericardium, and/or other suitable tissue. In some embodiments, the valve structure 14 can include or form one or more leaflets 16. For example, the valve structure 14 can be in the form of a tri-leaflet valve, a bi-leaflet valve, or another suitable valve. In some constructions, the valve structure 14 can comprise two or three leaflets that are fastened together at enlarged lateral end regions to form commissural joints, with the unattached edges forming coaptation edges of the valve structure 14. The leaflets 16 can be fastened to a skirt that in turn is attached to the frame 12. The upper ends of the commissure points can define an inflow portion 18 corresponding to a first or inflow end 20 of the prosthetic heart valve 10. The opposite end of the valve can define an outflow portion 22 corresponding to a second or outflow end 24 of the prosthetic heart valve 10. As shown, the stent frame 12 can have a lattice or cell-like structure, and optionally forms or provides crowns 26 and/or eyelets 28 (or other shapes) at the outflow and inflow ends 20, 24.
[0040] With the one exemplary construction of
[0041] With the above understanding of the stented prosthetic heart valves in mind, one embodiment of a delivery device 50 for percutaneously delivering the prosthesis or an alternate implant is shown in simplified form in
[0042] Various features of the components 52-58 reflected in
[0043] In some embodiments, the delivery sheath assembly 52 defines proximal and distal ends 80, 82, and includes the capsule 62 and an outer shaft 84. The delivery sheath assembly 52 can be akin to a catheter, defining a lumen 86 (referenced generally) that extends from the distal end 82 through the capsule 62 and at least a portion of the outer shaft 84. The lumen 86 can be open at the proximal end 80 (e.g., the outer shaft 84 can be a tube). The capsule 62 extends distally from the outer shaft 84, and in some embodiments has a more stiffened construction (as compared to a stiffness of the outer shaft 84) that exhibits sufficient radial or circumferential rigidity to overtly resist the expected expansive forces of the stented prosthetic heart valve (not shown) when compressed within the capsule 62. For example, the outer shaft 84 can be a polymer tube embedded with a metal braiding, whereas the capsule 62 includes a laser-cut metal tube that is optionally embedded within a polymer covering. Alternatively, the capsule 62 and the outer shaft 84 can have a more uniform or even homogenous construction (e.g., a continuous polymer tube). Regardless, the capsule 62 is constructed to compressively retain the stented prosthetic heart valve at a predetermined diameter when loaded within the capsule 62, and the outer shaft 84 serves to connect the capsule 62 with the handle assembly 58. The outer shaft 84 (as well as the capsule 62) is constructed to be sufficiently flexible for passage through a patient's vasculature, yet exhibits sufficient longitudinal rigidity to effectuate desired axial movement of the capsule 62. In other words, proximal retraction of the outer shaft 84 is directly transferred to the capsule 62 and causes a corresponding proximal retraction of the capsule 62. In other embodiments, the outer shaft 84 is further configured to transmit a rotational force or movement onto the capsule 62.
[0044] The inner shaft assembly 54 can have various constructions appropriate for supporting the delivery sheath assembly 52, including indirectly supporting the spindle 56 (and a stented prosthetic heart valve disposed thereon) relative to the capsule 62. In some embodiments, the inner shaft assembly 54 includes an intermediate shaft or tube 90 and a proximal shaft or tube 92. The intermediate tube 90 is optionally formed of a flexible polymer material (e.g., PEEK), and is sized to be slidably received within the delivery sheath assembly 52. The intermediate tube 90 serves as a transition to the deflection assembly 60, and in some embodiments is a flexible polymer tubing (e.g., PEEK) having a diameter slightly less than that of the proximal tube 92. The proximal tube 92 can have a more rigid construction, configured for robust assembly with the handle assembly 58, such as a metal hypotube. Other constructions are also envisioned. For example, in other embodiments, the intermediate and proximal tubes 90, 92 are integrally formed as a single, homogenous tube or shaft. Regardless, the inner shaft assembly 54 forms or defines at least one lumen (not shown) sized, for example, to slidably receive a guide wire (not shown).
[0045] The spindle 56 includes an inner support shaft 74 and a tip 76. The inner support shaft 74 is sized to be slidably received within the lumen 86 of the delivery sheath assembly 52, and is configured for mounting to the deflection assembly 60. The inner support shaft 74 can be a flexible polymer tube embedded with a metal braid. Other constructions are also acceptable so long as the inner support shaft 74 exhibits sufficient structural integrity to support a loaded, compressed stented prosthetic heart valve or other implant (not shown). The tip 76 forms or defines a nose cone having a distally tapering outer surface adapted to promote atraumatic contact with bodily tissue. The tip 76 can be fixed or slidable relative to the inner support shaft 74. The spindle 56 can define a continuous lumen (not shown) sized to slidably receive an auxiliary component such as a guide wire (not shown).
[0046] The handle assembly 58 generally includes a housing 66 and one or more actuator mechanisms 68 (referenced generally). The housing 66 maintains the actuator mechanism(s) 68, with the handle assembly 58 configured to facilitate sliding movement of the delivery sheath assembly 52 relative to other components (e.g., the inner shaft assembly 54, the spindle 56). The housing 66 can have any shape or size appropriate for convenient handling by a user.
[0047] With the above general explanations of exemplary embodiments of the components 52-58 in mind, the present disclosure provides many assemblies for storing prosthetic heart valves in a wet (generally submerged within sterilization fluid) state either with or without part of a delivery device (e.g., the spindle 56 of the delivery device 50). The disclosed embodiments are configured to allow for sterilization of the assembly. In the embodiments disclosed herein, the prosthetic heart valves can either be stored in either the expanded or compressed condition.
[0048] One embodiment of an assembly 100 is illustrated in
[0049] One example method of sterilizing the assembly 100 is generally outlined in
[0050] The dry sterilization techniques discloses herein, include, but are not limited to, gas-based techniques known in the art such as ethylene oxide (EtO). Such dry sterilization techniques also include radiation-based sterilization techniques including, but not limited to electron beam sterilization.
[0051] The seal member 110 can include heat shrink wrap or mechanical seal. If a mechanical seal, the seal member 110 can be formed by repositioning the seal member 110. In other embodiments, the first and second seals can be formed be formed by different seal members.
[0052] A second assembly 200 is schematically illustrated in
[0053] The assembly 200 further includes a sealing piece 210 that can be removably connected to the storage container 202 via a threaded connection 212 (generally referenced). The sealing piece 210 includes a body 214 made of a non-porous material and a joining seal 216 configured to both secure the sealing piece 210 to the storage container 202 and create a liquid-tight seal between the body 214, the spindle 56 and the storage container 202 proximate the opening 204. In one optional embodiment, the joining seal 216 can be of the type illustrated in
[0054] Attached to the sealing piece 210 via a threaded connection 222 (generally referenced, see also
[0055] One method of sterilizing the assembly of
[0056] Referring now also to
[0057] One method of sterilizing the assembly 300 can be summarized as follows. In such an example method the Tuohy Borst seal 316 can be positioned in placed as generally illustrated in
[0058] After sterilization of the interior of the assembly 300, the first Tuohy Borst piece 318 is rotated relative to the storage container 302 to drive the first Tuohy Borst piece 318 against the Tuohy Borst seal 316 as is generally depicted in
[0059] To sterilize additional portions of the assembly 300, the stop cock port 366 is opened and the sterilization fluid is drained from the sterilization container 330. The sterilization container 330 and lid 340 are removed via an optional two-piece 346a, 346b lid 340 configuration as shown in
[0060] Turning now also to
[0061] The first stage of assembly 400 of the embodiment of
[0062] Next, the prosthetic valve 10 is attached to the spindle 56. The Tyvek or similar material seal 430 is prepared and placed on the second section 413 such that the exposed threads are covered. The first section 403 is filled with a sterilizing fluid F (e.g., glutaraldehyde or the like). The sterilizing fluid can be effective for both sterilizing the contents of the first section 403 and also preventing the prosthetic valve 10 from drying out. This assembly (including elements 410, 470, 428, 472, 413 and 430) is slid proximally towards a distal tip of the spindle 56.
[0063] To assemble and seal the assembly 400, the prosthetic valve 10 is put into the sterilizing solution and the second section 413 is screwed onto the assembly, sealing the second section 413 such that assembly 400 lies between the threads of the first section 403 and the second section 413. The lid cap 410 is then tightened compressing the seal 428 such that the first section 403 is sealed preventing the sterilizing solution from escaping the first section 403.
[0064] To begin the sterilization process, the assembly 400 is sealed within a gas permeable sealed tray or gas permeable pouch (not shown) and then sterilized with ethylene oxide (EtO) gas or the like. The Tyvek or similar material seals (430, 470, 472) allow the ingress of the sterilant into the threaded areas of the assembly 400 while preventing the escape of the sterilizing fluid F contained within the first section 403. The use of the Tyvek seals allows for this sterilization process to sterilize areas which otherwise would not be sterilized either by the dry sterilization techniques (e.g., EtO gas) or glutaraldehyde. Unsterile sections of the spindle 56 or the container 402 would make the spindle 56 unusable as the risk of non-sterile contamination to the end user is expected.
[0065] Tyvek has outstanding moisture resistance and is a particularly beneficial material for seals 430, 470, 472. When water or other water-based fluids are in contact with Tyvek such fluids do not wet the surface or spread; the water simply remains as droplets on the surface. Tyvek is hydrophobic and does not absorb moisture. In addition to its moisture resistance, another advantage of Tyvek is that a high moisture vapor transmission rate (MVTR) can be achieved. This is particularly important for an EtO sterilization process where water is introduced as a vapor because moisture enhances the effectiveness of EtO as a sterilant.
[0066] Although the present disclosure has been described with reference to preferred embodiments, workers skilled in the art will recognize that changes can be made in form and detail without departing from the spirit and scope of the present disclosure.