DEVICE FOR REALIZING OR PREPARING MITRAL ANNULOPLASTY BY TRANSFEMORAL PATHWAY

专利摘要:
The device (1) is intended to be positioned in a sealed introducer disposed in a femoral vein to enter the left atrium (4) of the heart (3) through its septal wall (5). The device comprises an assembly adapted to cooperate with a handle subject to control means for actuating the assembly for the establishment and fixing of a reinforcing ring (7) on the mitral ring (2) , said assembly is arranged at the end of a handling rod (6) and comprises: - a support member (8) comprising a plurality of arms (8a) pivotally connected to the end of the rod ( 6) so as to pass, under the action of the control means, a folded position along the rod (6) to an extended position spaced from the rod (6) to bear under the mitral ring (2). ) uniformly distributed along the periphery of the mitral valve; - a counter-support member (12) comprising a plurality of arms (12a), at the free end of which is arranged the reinforcing ring (7), the arms (12a) are pivotally connected to a support ( 13) arranged coaxially with the rod (6) so as to pass, under the action of the control means, a folded position along the rod (6) to an extended position spaced apart from the rod (6) to realize counter-support on the mitral ring and position the reinforcement ring (7); suture extraction means for fixing the reinforcing ring (7) on the mitral ring.
公开号:FR3060292A1
申请号:FR1662559
申请日:2016-12-15
公开日:2018-06-22
发明作者:Marco Vola；Bernard Pain
申请人:Cminov；
IPC主号:

专利说明:

(57) | _ _e device (1) is intended to be positioned in a sealed introducer disposed in a femoral vein to enter the left atrium (4) of the heart (3) through its septal wall (5).
The device comprises an assembly capable of cooperating with a handle subject to control means for actuating the assembly for the establishment and fixing of a reinforcement ring (7) on the mitral ring (2) , said assembly is arranged at the end of a manipulation rod (6) and comprises:
- a support member (8) comprising a plurality of arms (8a) pivotally connected to the end of the rod (6) so as to pass, under the action of the control means, from a folded position along the rod (6) in a deployed position away from the rod (6) to bear under the mitral ring (2) uniformly distributed along the periphery of the mitral valve;
- a counter-support member (12) comprising a plurality of arms (12a), at the free end of which the reinforcing ring (7) is arranged, the arms (12a) are pivotally connected to a support ( 13) arranged coaxially with the rod (6) so as to pass, under the action of the control means, from a folded position along the rod (6) to a deployed position spaced from the rod (6) to achieve the counter-support on the mitral ring and position the reinforcement ring (7);
- Suture extraction means to fix the reinforcement ring (7) on the mitral ring.
ι device for performing or preparing a mitral annuloplasty by route
TRANSFEMORALE
TECHNICAL AREA
The invention relates to a device for performing or preparing a transfemoral annuloplasty of the mitral valve of a heart.
In other words, the purpose of annuloplasty is to reduce the caliber of the mitral ring by shortening, by plicating the attachment of the small valve, the point of support being taken between the commissures. By commissure, we mean narrowing of the perimeter of the posterior part of the mitral ring by performing on it plicatures by points, with as a result, a reduction in the anteroposterior and laterolateral diameter of the mitral valve.
The invention also finds an advantageous application for the installation, on the mitral ring, of a preventive ring, said to be of preparation or of attachment, intended to subsequently receive a mitral valve implant.
PRIOR STATE OF THE ART
A mitral annuloplasty is performed as a means of correcting a mitral leak, the mechanism of which is a dilation of the mitral ring (with loss of coaptation of the valvular banks) or, in addition to the correction of the leak with another mechanism, (mitral valve prolapse) to increase coaptation of the posterior mitral valve compared to the anterior mitral valve
A mitral annuloplasty is a long and cumbersome operation that requires the opening of one of the heart cardiac cavities and the rib cage with extracorporeal blood circulation.
A known solution in the prior art is to use the transapical route, that is to say to pass directly at the apex of the heart. A solution of this type emerges for example from the teaching of document WO 2014/147336.
This document describes a device intended to be positioned in a sealed introducer arranged in the thoracic cavity between two ribs to enter the left ventricle passing through the apex of the heart. The device comprises a body equipped with a handle and at least one control member capable of acting on an assembly for the establishment and fixing of a braid at the mitral ring by means of elements of suture. This device is advantageous in that the assembly has means capable of allowing the extraction of the suture through the mitral ring while being able to grip the braid and anchor on the periphery of the mitral ring under a pinching effect of said suture by exerting two opposite pressure support forces.
The fixation of the implant relative to the mitral ring is improved by exerting an opposing support force and a counter-support force to perform a perforation with precision and a passage of an anchoring material in a relatively short time. short and without weakening the adjacent tissue.
However, this type of device can still be improved. Indeed, the device of the prior art is designed to pass through the thoracic cavity between two ribs to enter the left ventricle via the apex of the heart, and thus requires a heavy and invasive surgical intervention.
STATEMENT OF THE INVENTION
The invention is intended to remedy the drawbacks of the state of the art in a safe, simple, efficient and rational manner.
The problem which the invention proposes to solve is to facilitate the operation of mitral annuloplasty.
To this end, a device has been developed to perform or prepare a transfemoral annuloplasty of the mitral valve, and intended to be positioned in a sealed introducer placed in a femoral vein to penetrate into the left atrium of the heart. passing through its septal wall.
According to the invention, the device comprises an assembly capable of cooperating with a handle subject to control means for actuating the assembly for the establishment and fixing of a reinforcement ring, for example made of textile, on the mitral ring. The assembly is arranged at the end of a handling rod and includes:
a support member comprising a plurality of arms pivotally connected to the end of the rod so as to pass, under the action of the control means, from a folded position along the rod to a deployed position spaced from the rod to bear under the mitral ring uniformly distributed along the periphery of the mitral valve;
- a counter-support member comprising a plurality of arms, at the free end of which the reinforcing ring is arranged, the arms are pivotally connected to a support arranged coaxially with the rod so as to pass under the action of the control means, from a folded position along the rod to a deployed position spaced from the rod to provide the abutment on the mitral ring and position the reinforcement ring;
- means capable of allowing the extraction of sutures to fix the reinforcement ring on the mitral ring.
In this way, and advantageously, the device according to the invention makes it possible, in combination with a handle and actuating means which are not part of the invention, to carry out the operation of mitral annuloplasty by the transfemoral route up through the vena cava. The operation is light and minimally invasive. The active whole of the device navigates in the vena cava where the blood pressure is relatively low. The device also makes it possible to prepare a subsequent annuloplasty operation by allowing the installation of a reinforcement ring in the form of a preventive ring, called a preparation or attachment ring, intended to subsequently receive a mitral valve implant. .
According to other advantageous characteristics of the invention, taken individually or in combination:
the arms of the support member and / or of the counter-support member pass simultaneously or selectively from the folded position to the deployed position; the arms of the support member and / or of the counter-support member are disposed inside a sheath in the folded position, and are pushed out of the sheath and are self-expanding in the deployed position ;
the arms of the support member and / or of the counter-support member each include a radiopaque and / or ultrasound marker;
the arms of the support member and / or of the counter-support member are telescopic; the means capable of allowing the extraction of staples comprise a plurality of arms pivotally connected to a support disposed coaxially with the rod so as to pass, under the action of the control means, from a folded position along the rod in a deployed position spaced from the rod in correspondence with the arms of the counter-support member, each arm internally comprises a staple capable of being extracted to anchor itself on the periphery of the mitral valve and fix the reinforcement ring;
each arm of the support member is curved, articulated or flexible to facilitate its passage through the cords of the mitral valve;
the end of each arm of the support member may be made up of several branches, able to move apart from one another after the passage of the cords of the mitral valve to form several support points under the mitral ring ; each arm of the support member internally comprises a clip capable of being extracted to pass through the mitral valve and fix the reinforcement ring;
the free end of each arm of the support member comprises a piece of felt or teflon textile intended to be pressed under the mitral valve and to be fixed by the clips against the support of the reinforcing ring.
BRIEF DESCRIPTION OF THE DRAWINGS
Other characteristics and advantages of the invention will emerge clearly from the description which is produced below, by way of indication and in no way limiting, with reference to the appended schematic figures in which:
- Figure 1 illustrates a heart and the introduction, in the left atrium of the heart, of a support member of the device according to a first embodiment of the invention;
- Figure 2 illustrates in detail of the support member of Figure 1, in the folded position;
- Figure 3 illustrates the heart and the deployment of the support member and its positioning in support under the mitral valve;
- Figure 4 illustrates in detail the support member in the deployed position;
- Figure 5 illustrates the heart and the deployment of a support member of the device, for the positioning of a reinforcing ring on the mitral ring against the support of the support member;
FIG. 6 illustrates the extraction of the needles arranged inside the arms of the support member, making it possible to release sutures for fixing the reinforcement ring; Figure 7 illustrates the release of sutures through the needles of Figure 6;
FIG. 8 illustrates the disengagement between the arms of the counter-support member and the reinforcement ring, in particular by sliding of a carriage; FIG. 9 illustrates the withdrawal of the counter-support member;
FIG. 10 illustrates the heart and the withdrawal of the counter-support member according to FIG. 9;
Figure 11 illustrates the heart and the removal of the support member;
Figure 12 illustrates the heart with the reinforcing ring attached to the mitral ring;
FIG. 13 illustrates a heart and the introduction, in the left atrium of the heart, of a support member of the device according to a second embodiment of the invention FIG. 14 illustrates in detail of the member support of Figure 13, in the folded position;
FIG. 15 illustrates the core and the deployment of the support member and its positioning in support under the mitral valve, with pieces of textile in felt or teflon placed at the end of the arms of the support member and plated under the mitral ring;
FIG. 16 illustrates in detail the support member in the deployed position;
FIG. 17 illustrates the heart and the deployment of the device's counter-support member, for the positioning of a reinforcement ring on the mitral ring against the support of the support member;
FIG. 18 illustrates in detail the counter-support member and the support member in the deployed positions;
FIG. 19 illustrates the heart and the deployment of the arms that the suture extraction means comprise, in correspondence with the arms of the counter-support member; FIG. 20 illustrates in detail the deployment of the arms of the extraction means in accordance with FIG. 19;
Figure 21 illustrates the removal of the suture extraction means, after release of said sutures and fixing of the reinforcement ring on the mitral ring; FIG. 22 illustrates the withdrawal of the counter-support member;
Figure 23 illustrates the removal of the support member;
FIG. 24 illustrates the heart with the reinforcing ring fixed on the mitral ring in counter-support with the pieces of textile plated on the other side of the mitral ring for its protection;
Figures 25, 26 and 27 illustrate, in perspective, different possible embodiments of the sutures for fixing the reinforcing ring.
DETAILED PRESENTATION OF THE INVENTION
The device (1) according to the invention makes it possible to carry out a surgical operation, called mitral annuloplasty, consisting in repairing the mitral ring (2) of the heart (3) of a patient suffering from a mitral leak. The device also makes it possible to prepare a subsequent annuloplasty operation by allowing the installation of a reinforcement ring in the form of a preventive ring, called a preparation or attachment ring, intended to subsequently receive a mitral valve implant. .
The device (1) according to the invention is intended to be positioned in a sealed introducer of any known and appropriate type (not shown) and with a diameter less than or equal to 8 mm, placed in a femoral vein to ascend and penetrate into the left atrium (4) of the heart (3) passing through its septal wall (5).
The device (1) comprises a rod (6) for handling, at the end of which is arranged an assembly for the establishment and fixing of a reinforcement ring (7), for example made of textile, at the level of the mitral valve. The other end of the rod (6) is intended to cooperate with a handle subject to control means, not shown, for example in the form of a trigger, for actuation of the assembly.
The device (1) according to the invention makes it possible, under radiographic control, after having ascended the vena cava, to make the assembly penetrate into the left atrium (4) of the heart (3) by passing through the septal wall ( 5). Then, when the assembly is located in the left atrium (4) of the heart (3), it is able to pass through the mitral valve to come to deploy on the ventricle side below said mitral valve and to take support under the 'mitral ring (2).
From this concept, two embodiments have been produced, namely a first embodiment illustrated in FIGS. 1 to 12 in which the reinforcement ring (7) is fixed by the underside of the mitral valve, and a second embodiment illustrated in Figures 13 to 24 in which the reinforcing ring (7) is fixed by the top of the mitral valve.
With reference to FIGS. 1 to 4, and 13 to 16, in the two embodiments, the assembly comprises a support member (8) comprising a plurality of arms (8a) pivotally connected to a warhead ( 9) disposed at the end of the rod (6). The rounded end of the warhead (9) is a-traumatic. The arms (8a) are articulated and pivotally mounted to pass, under the action of the control means, from a folded position (Fig. 2 or Fig. 14) along the rod (6) to a deployed position (Fig 4 or Fig. 16), like an umbrella, spaced from the rod (6).
Then, by pulling on the rod (6) and the support member (8), the arms (8a) naturally find their way through the cords of the mitral valve to come to be placed just below the mitral ring (2) of the mitral valve, in the angle formed by the leaflets and the cardiac wall, to bear therewith in a uniformly distributed manner along the periphery of the mitral valve, and to exert pressure thereon, see FIG. 3 or Fig. 15. In order to facilitate the passage of the arms (8a) of the support member (8) through the cords of the mitral valve, each arm can extend in a curved direction or be flexible so as to be able to adopt a curved position . It is also possible to break the length of each arm (8a) by a point of articulation allowing the folding of the arm (8a) around said point of articulation. According to another embodiment, not illustrated, the end of each arm (8a) can be made up of several branches, able to move away from each other after the passage of the strings of the mitral valve to form several points of support under the mitral ring.
In the second embodiment of the invention, each of the free ends of the arms (8a) of the support member (8) is shaped, for example in the form of a loop, for each receiving a piece of textile (10) felt or teflon, known to those skilled in the art under the English term "pledget". The textile pieces (10) are intended to be pressed under the mitral ring (2) and to be fixed by sutures (11) against the support of the reinforcing ring (7), as will be described lower.
In both embodiments, the arms (8a) of the support member (8) are deployed manually, either all together, or selectively and independently of each other to more easily pass the strings of the device mitral and adapt to the geometry of the mitral ring (2). To adapt more to the geometry of the mitral ring (2), which is not necessarily circular, the arms (8a) are telescopic to present different lengths.
According to a first variant, the arms (8a) can be deployed by mechanical means (not shown) which include the control means. For example, screwing a thumb wheel can deploy the arms (8a). In another variant, the arms (8a) are self-expanding and are inserted into a sheath (not shown) when they are in the folded position, and are extracted from said sheath in the deployed position. The a-traumatic warhead (9) can act as a sheath. In this latter configuration, the arms (8a) are connected in an articulated manner to a support, such as a socket, mounted to slide on the rod (6) so as to be housed in the warhead (9) in the folded position of the arms ( 8a).
Referring to Figures 5 to 10, and 17 to 21, the assembly comprises a counter-support member (12) comprising a plurality of arms (12a), at the free end of which the reinforcing ring (7) is held. More specifically, each arm (12a) has a free end forming a fork (12b), see FIG. 9, the ends of which are shaped as hooks for holding the reinforcement ring (7). With reference to FIGS. 7A and 8A, each arm (12a) internally includes a slide (12c) extended by a spatula (12d). The slide (12c) is subject to means (not shown), such as a cable for example, making it possible to slide the slide (12c) inside the arm (12a) so as to pass the spatula (12d ) from a position for locking the reinforcement ring (7) in which it is located under the latter (FIG. 7A), to a position released for releasing the reinforcement ring (7) (FIG. 8A) . The spatula (12d) is in the form of two parallel fingers defining between them a passage for a needle as will be described below.
The arms (12a) of the counter-support member (12) are pivotally connected to a support (13), such as a bushing, arranged coaxially with the rod (6) and mounted with sliding capacity along of it. The arms (12a) of the counter-support member (12) are articulated and pivotally mounted so as to pass, under the action of the control means, from a folded position along the rod (6) to a deployed position spaced from the rod (6) to provide the counter-support on the mitral ring (2) and position the reinforcement ring (7) in back pressure and in line with the arms (8a) of the member d 'support (8). In the same way as for the arms (8a) of the support member (8), the arms (12a) of the counter-support member (12) can be deployed simultaneously or selectively and independently of each other. of the others, to be telescopic, and to be self-expanding and arranged in a sheath in their folded position.
From the above, the arms (8a) of the support member (8) and the arms (12a) of the counter-support member (12) open like an umbrella and come in correspondence on either side of the mitral ring (2) to form a support / counter-support. This characteristic then makes it possible to pierce the mitral ring (2) in a simple, ideal and traction-free manner to fix the reinforcement ring (7), as will be described below, by means (14). suture extraction (11).
As mentioned above, the two embodiments presented differ in the technique of fixing the reinforcing ring (7).
According to the first embodiment, and with reference to Figures 6 to 9, the reinforcement ring (7) is fixed from below the mitral valve and the sutures (11) are extracted from the arms (8a) of the support member (8) which thus form the means (14) for extracting sutures (11). For this purpose, each arm (8a) internally comprises a needle (15) mounted with the ability to move in translation to extend beyond the free end of the arms (8a), and release the sutures (11) to fix the reinforcement ring. (7). The needles (15) are shaped to allow the engagement, guidance and maintenance of the sutures (11) projecting from the needle (15).
According to a first example of implementation, the needles (15) are intended to be extracted to pierce the mitral ring (2) and protrude from the top face of the mitral ring (2), opening out at the inside of the fingers (12d) and forks (12b) of the arms (12a) corresponding to the counter-support member (12). Then, each suture (11) in the form of a thread (lia) made of a shape memory material will automatically, after being released from the needle (15), be deformed to create an anchoring loop around of the reinforcement ring (7) and in the thickness of the mitral ring (2) to allow the fixing of said reinforcement ring (7) on the mitral ring (2).
According to a second example of implementation, the needles (15) do not pierce the mitral ring (2) and deliver sutures (11) in the form of staples (11b) which are shaped as a point to pass through them even the mitral ring (2) and the reinforcement ring (7), and which include anchoring parts (11c), such as tapered ends, to prevent the withdrawal of said staples (11b) and lock the fixing of the reinforcement ring (7) on ίο the mitral ring (2). Examples of the various staples (1 lb) and the wire (11a) are illustrated in FIGS. 25 to 27.
According to the second embodiment, and with reference to Figures 17 to 21, the reinforcement ring (7) is fixed from above the mitral ring (2). To this end, in this embodiment the means (14) for extracting sutures (11) comprise a plurality of arms (14a) pivotally connected to a support (15), such as a socket, arranged coaxially with the rod (6) so as to pass, under the action of the control means, from a folded position along the rod (6) to a deployed position spaced from the rod (6).
When the arms (14a) of the extraction means (14) are in the deployed position, they are in correspondence with the arms (12a) of the counter-support member (12). To allow the fixing of the reinforcement ring (7), each arm (14a) internally comprises, and in the same manner as for the first embodiment, a needle (15) for delivering a suture in the form of a wire (11a) or a clip (11b) provided to anchor on the periphery of the mitral valve and fix the reinforcement ring (7) there. The operation is identical and has not been described again. In this embodiment, the sutures (11) fix the textile pieces (10) in reinforcement and against the support of the reinforcement ring (7), and on the other side of the mitral ring (2). The textile pieces (10) form reinforcements for the sutures (11), so that the tension of the suture (11) is distributed over the entire textile piece (10), and not directly on the ring mitral (2). The textile pieces (10) provide protection against trauma due to the tension of the suture (11).
In the same way as for the arms (8a) of the support member (8) or the arms (12a) of the counter-support member (12), the arms (14a) of the means (14) d extraction can be deployed simultaneously or selectively and independently of each other, be telescopic, and be self-expanding and arranged in a sheath in their folded position.
With reference to FIG. 20, the free end of each arm (14a) that the extraction means (14) comprise is connected to the support element (15) by a link (16) to form a stable support during the operation of suturing and fixing the reinforcement ring (O3060292
Referring to Figures 10 to 12, and 21 to 24, when the reinforcement ring (7) is finally fixed, and the spatulas (12d) have been removed to release the reinforcement ring (7), the various elements of the set are each in turn passed into their folded position and are one to one extract from the heart (3). We can see, figure 12 and 24, the reinforcement ring (7) fixed on the mitral ring (2).
The reinforcement ring (7) constitutes a prosthetic implant capable of reducing the caliber of the mitral ring (2) in order to reduce or even eliminate mitral leaks. According to another important characteristic, the reinforcing ring (7) is subject to a means (not shown) capable of making it possible to reduce its circumference after its positioning and fixing on the periphery of the mitral ring (2), as indicated. For example, these means consist of a pull cord freely mounted in translation and free sliding in the central core of the reinforcing ring (7) to allow, under a pulling effect, to ensure the gathering of the 'ring and, therefore, the decrease in its diameter. These provisions are particularly important to allow after fixing the reinforcing ring (7) under the conditions indicated, to perfectly adapt the diameter of the implant, ensuring that there is no longer any leakage.
For this purpose, the surgeon removes the device (1), and only protrude from the introducer, the two ends of the wire (lia) which constitutes the axial core of the ring. Under radio control, by exerting a simple fraction on the wire, it concomitantly causes the tightening of the valve ring. After finding the right tension for the right diameter, the wire can be crimped with a knot or clip, then cut.
The characteristics of the device (1) according to the invention provide numerous advantages over existing solutions. Going through the transfemoral route reduces the duration and invasiveness of the operation. With a two-dimensional ultrasound section of the atrioventricular junction, it is possible to visualize the desired enclosure of the device (1) on the small mitral valve on the ventricular side. The implementation is guided by the very anatomy of the tissues and the resistance that the operator perceives in the abutment position of the support member (8) and the counter-support member (12)
It should also be noted that the device (1) makes it possible to exert two opposite support and counter-support forces to perforate the tissues and pass the anchoring sutures (11) without risk of weakening said tissue by eliminating any risk of groping. In other words, the tissue of the mitral ring (2) and the adjacent tissues are perforated more effectively in one go with optimal hold of the sutures (11).
Finally, note that the arms (8a) of the support member (8) and / or the arms (12a) of the counter-support member (12) and / or the arms (14a) of the means (14 ) of extraction each include a radiopaque and / or ultrasound marker allowing the surgeon to perform a 2D or 3D control of their position as the operation progresses.

权利要求:
Claims (7)
[1" id="c-fr-0001]
Claims
Device (1) for performing or preparing a transfemoral annuloplasty of the mitral valve of a heart (3), and intended to be positioned in a sealed introducer arranged in a femoral vein to penetrate into the left atrium (4) of the heart (3) passing through its septal wall (5), characterized in that it comprises an assembly able to cooperate with a handle subject to control means for actuating the assembly for the establishment and fixing a reinforcement ring (7) on the mitral ring (2), said assembly is arranged at the end of a manipulation rod (6) and comprises:
- a support member (8) comprising a plurality of arms (8a) pivotally connected to the end of the rod (6) so as to pass, under the action of the control means, from a folded position along the rod (6) in a deployed position away from the rod (6) to bear under the mitral ring (2) uniformly distributed along the periphery of the mitral valve;
- a counter-support member (12) comprising a plurality of arms (12a), at the free end of which the reinforcing ring (7) is arranged, the arms (12a) are pivotally connected to a support ( 13) arranged coaxially with the rod (6) so as to pass, under the action of the control means, from a folded position along the rod (6) to a deployed position spaced from the rod (6) to achieve the counter-support on the mitral ring and position the reinforcement ring (7);
- Means (14) for extracting sutures (11) to fix the reinforcement ring (7) on the mitral ring.
Device (1) according to claim 1, characterized in that the arms (8a) of the support member (8) and / or the arms (12a) of the counter-support member (12) are connected pivotally to the support (13) arranged coaxially with the rod (6) so as to pass under the action of the control means simultaneously or selectively and independently of each other from the folded position to the deployed position.
Device (1) according to claim 1, characterized in that the arms (8a) of the support member (8) and / or the arms (12a) of the counter-support member (12) are arranged at inside a sleeve in the folded position, and are pushed out of the sleeve and are self-expanding in the deployed position.
[2" id="c-fr-0002]
4. Device (1) according to claim 1, characterized in that the arms (8a) of the support member (8) and / or the arms (12a) of the counter-support member (12) comprise each a radiopaque and / or ultrasound marker.
[3" id="c-fr-0003]
5 5. Device (1) according to claim 1, characterized in that the arms (8a) of the support member (8) and / or the arms (12a) of the support member (12) are telescopic.
[4" id="c-fr-0004]
6. Device (1) according to claim 1, characterized in that the means (14) for extracting sutures (11) comprise a plurality of arms (14a) connected to
10 pivotally to a support (15) arranged coaxially with the rod (6) so as to pass, under the action of the control means, from a folded position along the rod (6) to a deployed position separated from the rod (6) in correspondence with the arms (12a) of the counter-support member (12), each arm (14a) internally comprises a suture (11) capable of being extracted to anchor on the periphery of the mitral valve
15 and attach the reinforcement ring (7) to it.
[5" id="c-fr-0005]
7. Device (1) according to claim 1, characterized in that each arm (8a) of the support member (8) is curved, articulated or flexible to facilitate its passage through the cords of the mitral valve.
[6" id="c-fr-0006]
8. Device (1) according to claim 1, characterized in that the end of each arm (8a) may consist of several branches, capable of moving away from one another after the passage of the cords of the mitral valve for form several support points under the mitral ring.
[7" id="c-fr-0007]
9. Device (1) according to claim 1, characterized in that each arm (8a) of the support member (8) internally comprises a suture (11) capable of being extracted to pass through the mitral ring (2) and fix the reinforcement ring (7).
30 10. Device (1) according to claim 6, characterized in that the free end of each arm (8a) of the support member (8) comprises a piece of textile (10), made of felt or Teflon , intended to be pressed under the mitral ring (2) and to be fixed by sutures (11) in reinforcement and against the support of the reinforcement ring (7).
8a

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EP3223721B1|2020-04-29|Device for treating a body tissue, and associated treatment kit

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WO2016008859A1|2016-01-21|Device for the endovascular treatment of a heart valve in preparation for a percutaneous valve replacement

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FR3006884A1|2014-12-19|ATRAUMATIC DEVICE FOR INTRODUCING A HOLLOW TUBULAR ELEMENT IN A BIOLOGICAL ORGAN

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FR3056098A1|2018-03-23|IMPLANTABLE DEVICE FOR CONFORMING AN INTRACORPORAL WALL, AND TREATMENT NECESSARY THEREFOR

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FR3101241A1|2021-04-02|device for placing and fixing a reinforcement implant on a mitral valve of a heart, with shape memory and transfemoral sutures

同族专利:

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公开号 | 公开日

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FR3060292B1|2019-01-25|

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EP3554423A1|2019-10-23|

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IL267339D0|2019-08-29|

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US11020230B2|2021-06-01|

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EP3554423B1|2020-08-05|

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US20200100898A1|2020-04-02|

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WO2018109329A1|2018-06-21|

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FR3060292B1|2016-12-15|2019-01-25|Cmi'nov|DEVICE FOR REALIZING OR PREPARING MITRAL ANNULOPLASTY BY TRANSFEMORAL PATHWAY|

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US20200188092A1|2018-12-13|2020-06-18|Medtronic Vascular, Inc.|Heart valve repair|US9345573B2|2012-05-30|2016-05-24|Neovasc Tiara Inc.|Methods and apparatus for loading a prosthesis onto a delivery system|

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US20200146854A1|2016-05-16|2020-05-14|Elixir Medical Corporation|Methods and devices for heart valve repair|

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FR3060292B1|2016-12-15|2019-01-25|Cmi'nov|DEVICE FOR REALIZING OR PREPARING MITRAL ANNULOPLASTY BY TRANSFEMORAL PATHWAY|

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法律状态:
2017-12-23| PLFP| Fee payment|Year of fee payment: 2 |

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2018-06-22| PLSC| Search report ready|Effective date: 20180622 |

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2019-12-27| PLFP| Fee payment|Year of fee payment: 4 |

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2020-12-28| PLFP| Fee payment|Year of fee payment: 5 |

优先权:

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申请号 | 申请日 | 专利标题

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FR1662559|2016-12-15|

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FR1662559A|FR3060292B1|2016-12-15|2016-12-15|DEVICE FOR REALIZING OR PREPARING MITRAL ANNULOPLASTY BY TRANSFEMORAL PATHWAY|FR1662559A| FR3060292B1|2016-12-15|2016-12-15|DEVICE FOR REALIZING OR PREPARING MITRAL ANNULOPLASTY BY TRANSFEMORAL PATHWAY|

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PCT/FR2017/053444| WO2018109329A1|2016-12-15|2017-12-07|Device for performing or preparing for a mitral valve annuloplasty by a transfemoral approach|

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US16/469,201| US11020230B2|2016-12-15|2017-12-07|Device for performing or preparing for a mitral valve annuloplasty by a transfemoral approach|

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EP17822385.5A| EP3554423B1|2016-12-15|2017-12-07|Device for performing or preparing for a mitral valve annuloplasty by a transfemoral approach|

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IL267339A| IL267339D0|2016-12-15|2019-06-13|Device for performing or preparing for a mitral valve annuloplasty by a transfemoral approach|