[go: up one dir, main page]

WO2020192599A1 - Heart valve stent and prosthesis thereof - Google Patents

Heart valve stent and prosthesis thereof Download PDF

Info

Publication number
WO2020192599A1
WO2020192599A1 PCT/CN2020/080529 CN2020080529W WO2020192599A1 WO 2020192599 A1 WO2020192599 A1 WO 2020192599A1 CN 2020080529 W CN2020080529 W CN 2020080529W WO 2020192599 A1 WO2020192599 A1 WO 2020192599A1
Authority
WO
WIPO (PCT)
Prior art keywords
ear
grab
heart valve
stent
grasping
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/CN2020/080529
Other languages
French (fr)
Chinese (zh)
Inventor
石若璘
阳明
陈国明
李�雨
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Shanghai Microport Cardioflow Medtech Co Ltd
Original Assignee
Shanghai Microport Cardioflow Medtech Co Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Shanghai Microport Cardioflow Medtech Co Ltd filed Critical Shanghai Microport Cardioflow Medtech Co Ltd
Publication of WO2020192599A1 publication Critical patent/WO2020192599A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A61F2/2418Scaffolds therefor, e.g. support stents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2442Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2454Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
    • A61F2/2457Chordae tendineae prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2442Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2466Delivery devices therefor

Definitions

  • the invention relates to an interventional medical device, in particular to a heart valve stent and its prosthesis.
  • the heart contains four heart chambers, the left atrium and left ventricle are on the left side of the heart, and the right atrium and right ventricle are on the right side of the heart.
  • the atrium and the ventricle form the ventricular inflow tract
  • the left ventricle and the aorta form the left ventricular outflow tract
  • the right ventricle and the pulmonary artery form the right ventricular outflow tract.
  • the valve has a problem, the hemodynamics of the heart changes and the heart functions abnormally, which is called valvular heart disease.
  • the mitral valve also known as the mitral valve, is located in the left ventricular inflow tract.
  • the main structure is the mitral valve complex, including the mitral valve annulus, leaflets, chordae and papillary muscles. Some documents also include the ventricular wall.
  • the mitral valve annulus is the dense connective tissue around the left atrium and ventricular orifice. Its anterior annulus is composed of part of the aortic valve in the left ventricular outflow tract without coronary annulus, part of the left coronary annulus, and left and right fiber triangles. , The posterior annulus is the attachment of the posterior leaflet.
  • the anterior mitral valve leaflet is the fiber extension of the aortic valve, which forms the left ventricular inflow tract with the posterior valve leaflet, and forms the left ventricular outflow tract corresponding to the cardiac septum.
  • the chordae of the mitral valve as a supporting device connecting the mitral valve leaflets and the myocardium, is distributed between the valve leaflets and the myocardium.
  • the subvalvular structure of the mitral valve plays an important role in maintaining the structure and function of the left heart.
  • the tricuspid valve is the atrioventricular valve of the right heart. Its structure is similar to that of the mitral valve. It also contains leaflets, annulus, chordae, papillary muscles and myocardium. Therefore, the heart valve prosthesis structure that replaces the native mitral valve can also be used to replace the native tricuspid valve, and the size of the prosthetic valve varies according to the size of the native valve.
  • the original annulus of the mitral valve has a larger diameter, and accordingly, the leaflet area of the artificial valve is also larger.
  • the larger the leaflet area the worse the fatigue resistance of the valve prosthesis.
  • the area of the valve leaflet is large, the size of the stent required is correspondingly large, and the diameter of the catheter used to deliver the valve prosthesis will also be large, which increases the difficulty of delivery and the risk of vascular damage.
  • the structure of the atrioventricular valve assembly is complicated. If the height of the prosthetic valve is too high, it will affect the original heart structure and heart function, cause chordae rupture, touch papillary muscles and other heart tissue abnormalities, and easily cause left ventricular outflow tract obstruction , Induce adverse postoperative effects.
  • SAM Systolic anterior motion
  • the technical problem to be solved by the present invention is to provide a heart valve stent and its prosthesis.
  • the valve leaflet of the valve prosthesis has a small diameter, the valve has good fatigue resistance, and can reduce the difficulty of delivery and the risk of vascular damage.
  • a heart valve stent which includes a stent body, the stent body has an inflow channel and an outflow channel connected axially, and the inflow channel and the outflow channel are mutually connected Consisting of connected grid structure units, the stent body is provided with an ear grasping structure extending toward the proximal end of the inflow channel, the proximal end of the inflow channel is turned outward, and the proximal end of the ear grasping structure and the A gap is formed between the inflow channels.
  • the outer diameter of the distal end of the outflow channel is smaller than the outer diameter of the proximal end of the inflow channel.
  • the ear grab structure includes a front grab ear and a back grab ear, the front grab ear and the back grab ear are unevenly distributed along the bracket body in the circumferential direction, and the front grab ear
  • the range of the central angle distributed in the circumferential direction is 10° ⁇ 120° or/and 240°-350°; the range of the central angle distributed in the circumferential direction of the rear grasping ear is 30°-330°.
  • the ear grab structure further includes an anterior lobe grabbing ear, the central angle of the anterior lobe grabbing ear in the circumferential direction ranges from 330° to 30°; the anterior lobe grabbing ear is set toward one side of the stent body Barbed or serrated.
  • the ear grab structure is a cantilever structure with a fixed end and a free end, the fixed end of the ear grab structure is located on the outflow tract, and the free end of the ear grab structure and the inflow tract are formed between Crevice.
  • the ear grasping structure is a rod-shaped structure, the fixed end is located at the end of the outflow tract, and the free end is spherical or ellipsoidal.
  • the ear grasping structure includes a front grasping ear and a rear grasping ear, the free end of the front grasping ear is folded outward; the free end of the rear grasping ear is folded inward.
  • the ear-grasping structure and the bracket body are formed integrally; or the ear-grasping structure and the bracket body are connected by riveting, welding or snapping.
  • both ends of the ear grab structure are respectively fixed on the bracket body, and the ear grab structure and the grid structure unit of the bracket body form a closed structure.
  • the outer diameter of the proximal port of the inflow channel is 35-75mm, the rigidity of the inflow channel is greater than the rigidity of the outflow channel; the height of the outflow channel in the axial direction is 5-20mm, and the outer diameter is 21-55mm.
  • a heart valve prosthesis including a heart valve stent and a valve, the valve being fixedly arranged on the inner surface of the stent body, and the heart valve stent is The above-mentioned heart valve stent.
  • the present invention has the following beneficial effects: the heart valve stent and its prosthesis provided by the present invention replace the interference fit of the existing stent body by clamping the native valve leaflets by the ear grasping structure and the inflow tract mesh ( Oversize) anchoring method makes the main body of the outflow tract, namely the suture area of the valve leaflet, have a smaller outer diameter.
  • the anti-fatigue performance of the valve leaflet with a smaller outer diameter will be improved.
  • the diameter of the catheter adapted to the delivery system of the present invention can also be set smaller, which reduces the difficulty of delivery and the risk of vascular damage.
  • the subvalvular height of the heart valve stent required by the smaller outer diameter of the leaflet is smaller, the interference of the stent to the subvalvular tissues of the heart (such as papillary muscles, ventricular wall, etc.) is solved, and the heart function and the anti-fatigue performance of the stent are obtained improve.
  • the reduction in the axial height of the stent reduces the obstruction of the left ventricular outflow tract (LVOTO).
  • setting the anterior leaflet grasping ears can fix the free leaflets and reduce the possibility of blocking the left ventricular outflow tract due to pre-systolic leaflet movement (SAM).
  • SAM pre-systolic leaflet movement
  • the inflow flange shape fit assists the clamping of the ear-grasping structure, reducing the risk of paravalvular leakage.
  • Fig. 1 is a structural schematic diagram of the front view direction of a heart valve prosthesis in an embodiment of the present invention
  • FIG. 2 is a schematic structural view of the heart valve prosthesis in the top view direction in the embodiment of the present invention.
  • FIG. 3 is a schematic diagram of the overall structure of the heart valve stent in the embodiment of the present invention.
  • Figure 4 (a) is a schematic diagram of the circumferential distribution of the ear grasping structure on the heart valve stent in an embodiment of the present invention
  • Figure 4 (b) is a schematic diagram of the angular distribution of the ear grasping structure in the circumferential direction;
  • Figure 5 is a schematic cross-sectional view of the native valve
  • Fig. 6 is a schematic diagram of the use state of the heart valve prosthesis after implantation in the human body in the embodiment of the present invention.
  • Fig. 7 is a partial enlarged schematic diagram of A in Fig. 6.
  • the heart valve prosthesis provided in this embodiment is an artificial heart valve prosthesis implanted via a catheter, which is mainly used to replace heart valves.
  • the heart valve prosthesis provided by the present invention has the characteristics of small size and good fatigue resistance.
  • the valve prosthesis structure provided by the present invention can be matched and designed according to the original heart structure, so that the original heart valve can be completely replaced, the damage to the subvalvular structure is small, and the risk of obstruction of the outflow tract is low.
  • proximal means the end close to the operator during the operation;
  • distal means the end away from the operator;
  • outward means the direction away from the central axis of the stent body;
  • inward means the direction close to the central axis of the stent body.
  • the term “or” is usually used in the meaning including “and/or”, unless the content clearly indicates otherwise.
  • the heart valve prosthesis 1 includes a heart valve stent, a skirt 20, and a valve 30.
  • the heart valve stent includes a stent body 10 that has an inflow channel 101 and an outflow channel 102 that are axially connected. The outflow channel 102 is based on the direction of blood flow.
  • the inflow channel 101 corresponds to the part where blood flows into the heart valve prosthesis during valve operation
  • the outflow channel 102 corresponds to the part where blood flows out of the heart valve prosthesis during valve operation.
  • the stent body 10 is composed of structural units whose axial shape can be changed, such as grid-like structural units or wave-shaped structural units.
  • the axial direction is composed of at least one row of structural units connected to each other in the circumferential direction, and there are multiple rows of units in the axial direction. They can be connected directly or indirectly to each other.
  • the grid-like structural unit is a triangular, rhombic, pentagonal, hexagonal, drop-shaped structural unit that can form a closed shape.
  • the stent body 10 is provided with a grabbing ear structure for anchoring and a hanging ear 106 for matching with the conveying system.
  • the grabbing structure is divided into a front side grabbing ear 103, a back side grabbing ear 104 and a front lobe grabbing ear 105 according to the structure and function.
  • the ear catching structure is arranged on the stent body 10 and extends outward toward the proximal end 101A of the inflow channel, preferably from the end of the outflow channel 102 toward the proximal end 101A of the inflow channel.
  • the hanging ear 106 is located on the end of the inflow channel 101 or/and the end of the outflow channel 102, except for the end of the outflow channel occupied by the ear grasping structure.
  • the inflow channel 101 is outward in shape, that is, the port of the inflow channel 101 is turned outward, and its maximum outer diameter is larger than the annulus diameter of the native valve, preferably 35-75 mm, and its rigidity is higher than that of the outflow channel 102.
  • the effect of this arrangement is that at least a part of the inflow channel 101 can be located above the annulus of the native valve to form an inflow channel flange 1011 whose outer contour fits the anatomy of the annulus and atrial wall.
  • the inflow channel flange 1011 is sutured
  • the skirt 20 can prevent paravalvular leakage.
  • a gap is formed between the inflow flange 1011 and the proximal end of the ear grasping structure, which can clamp the myocardial wall or the native valve leaflet for anchoring.
  • the cross-section of the main body of the inflow channel 101 can be circular, D-shaped or elliptical, and has an annulus shape that matches the mitral valve, preferably D-shaped or elliptical.
  • a skirt 20 is sutured on the stent inflow channel 101 to prevent paravalvular leakage.
  • the stent outflow tract 102 is located on the hemodynamic outflow tract side of the native valve.
  • the outer diameter of the distal end 102B of the outflow tract is smaller than the outer diameter of the proximal end 101A of the inflow tract.
  • the height of the stent outflow channel 102 in the axial direction is preferably 5-20 mm, and its outer diameter is preferably 21-55 mm.
  • the body of the outflow tract 102 is composed of a closed grid structure unit, which provides attachment points for the valve leaflets, but does not provide support for the stent.
  • this embodiment compared with the existing outflow tract structure that provides support for the stent, this embodiment
  • the outer diameter of the outflow channel 102 is smaller, and the smaller outer diameter of the outflow channel reduces the diameter of the valve leaflet, which correspondingly improves the fatigue resistance of the valve leaflet, while reducing the axial height of the outflow channel 102, subvalvular interference and left ventricle
  • LVOTO outflow tract obstruction
  • the ear grab structure is divided into the front side grab ear 103, the front lobe grab ear 105 and the back side grab ear 104.
  • the front lobe grab ear 105 can be selected according to needs.
  • the ear grasping structure is unevenly distributed in the circumferential direction.
  • the angle of distribution the present invention has no special restrictions. It needs to be adapted according to the anatomical structure of the human body.
  • Figure 4(a) only shows one of the embodiments.
  • Figure 4(b) is a schematic diagram of the angular distribution of the ear-grasping structure in the circumferential direction. Please refer to Figure 4(b), where the radius of the ray is used as the starting edge of the central angle.
  • the front side ear-grasping 103 The angle of the central angle distributed in the circumferential direction is 10° ⁇ 120°, preferably 30° ⁇ 50°; or/and 240° ⁇ 350°, preferably 260° ⁇ 280°; can be set on one side or/and both sides of the bracket ; Preferably on both sides.
  • the central angle of the rear grasping ear 104 in the circumferential direction is 30° ⁇ 330°, preferably 100° ⁇ 260°.
  • the central angle of the anterior lobe grasping ear 105 in the circumferential direction is 330°-30°, preferably 350°-10°. There are no special restrictions on the number of the three.
  • the front grasping ear 103 extends from the stent body 10, preferably from the middle part of the cell grid on the outflow tract 102 or the end of the outflow tract 102 to extend outward toward the proximal end 101A of the inflow tract;
  • the front gripping ear 103 has a fixed end 103A and a free end 103B, and the free end 103B is away from the bracket body 10 and the fixed end 103A, and faces the inflow channel 101 direction.
  • the height of the front gripping ear 103 in the axial direction is adjusted according to the height of the outflow channel 102 in the axial direction to match the shape of the inflow channel 101.
  • the specific value is not specified in the present invention, and is generally 0-10mm.
  • the clamping position of the front grasping ear 103 is preferably the front lateral commissure (CL) region and the posterior medial commissure (CM) region shown in FIG. 5.
  • the anchoring site of the posterior grasping ear 104 is the P area of the posterior mitral valve leaflet in FIG. 5, that is, within the range of P1, P2L, P2M, and P3.
  • the anchoring method is the posterior grasping ear 104 It cooperates with the inflow flange 1011 to form a clamping force.
  • Figures 6 and 7. After the rear grasping ear 104 is attached to the myocardial wall 21, a clamping force is formed between the inflow flange 1011 and the corresponding flap is clamped. Ring structure (Myocardial shelf).
  • the clamping and anchoring force provided by the combination of the anterior grasping ear 103 and the posterior grasping ear 104 reduces the radial support force required by the heart valve prosthesis at the native valve annulus, and reduces the risk of tearing the native valve annulus.
  • the valve prosthesis can have a smaller diameter, which improves the fatigue resistance of the valve prosthesis.
  • the front leaf grasping ear 105 is mainly used to limit the native valve leaflet, and it can be set or not set as needed. Please refer to FIG. 5, the anterior leaf grasping ear 105 is located in the area A2 (ie, A2L and A2M) of the anterior leaflet A of the mitral valve. The anterior leaf grasping ear 105 has a limiting effect on the native valve leaflets. The original leaflet is sandwiched between the anterior leaf grasping ear 105 and the inflow flange 1011.
  • the anterior leaf grasping ear 105 and the native valve leaflet fitting position (that is, the position where the inflow flange 1011 needs to be clamped together) has a certain degree of roughness. If barbed or serrated, the anterior leaflet The friction force between the cantilever structure of the grab ear 105 and the valve leaflet improves the anchoring stability.
  • the ear-grasping structure and the bracket body 10 can be integrally processed, or they can be connected by any means such as riveting, welding, snapping, etc., which can be connected stably.
  • the ear grasping structure is a cantilever structure, and the gap between the free end of the cantilever and the inflow flange 1011 is selected according to the anatomical dimensions of the annulus and the myocardial wall to provide the pre-tightening force required to clamp the myocardial wall 21.
  • the cantilever has strong rigidity to ensure that it will not deform and cause falling off when clamping the myocardial wall 21.
  • strong rigidity means that the cantilever does not deform or fall off, and there is no specific numerical limit.
  • the cantilever structure is a rod-shaped structure, and the fixed point between each cantilever structure and the stent body 10 is one position, and the fixed point is located on the grid of the outflow channel 102 or the end of the outflow channel 102, and its free end It is spherical, ellipsoidal and other shapes without obvious edges and corners.
  • the free end 103B of the anterior grasping ear 103 outwards, as shown in FIGS. 3 and 5, to facilitate the fitting of the inflow flange 1011 on the anterolateral commissure CL area of the mitral valve outside L and the mitral valve inside M
  • the posterior medial commissure CM region sandwiches the myocardial wall 21.
  • the free end of the posterior grasping ear 104 is facing inward, as shown in Figures 3 and 5, in order to clamp the valve prosthesis on the myocardial wall 21 in the P2 (ie P2M and P2L) area of the posterior mitral valve leaflet P to prevent damage Myocardial tissue.
  • the free end of the front leaf grasping ear 105 is outward, as shown in FIGS. 3 and 5, which facilitates the engagement of the valve leaflet in the A2 area with the inflow flange 1011.
  • the ear grab structure and the grid unit of the bracket body 10 form a closed structure.
  • the closed structure is different from the cantilever structure. Both ends of the ear grab structure are fixed on the bracket body 10 without free ends.
  • the proximal end of the closed structure cooperates with the inflow flange 1011 to provide clamping force to the myocardial wall 21.
  • the distal end of the closed structure can also provide a certain supporting force to the valve stent, reducing the size of the stent outflow tract 102.
  • the hanging ear 106 is used to match the delivery system for transporting the heart valve prosthesis to realize the loading and release of the valve prosthesis.
  • the hanging ear 106 is the structure where the valve prosthesis finally leaves the delivery system. Therefore, the hanging ear 106 is located at the end of the inflow tract 101 or/and the outflow tract 102.
  • the ear-grasping structure front-side grasping ear 103, back-side grasping ear 104, anterior leaf Grasping ear 105) except for the end of the outflow tract occupied.
  • the ears 106 can be distributed at the end of the inflow tract 101, and the outflow tract 102 is released first during the corresponding release process; the ears 106 can also be distributed in the outflow At the end of the channel 102, the inflow channel 101 is released first during the corresponding release process; the lugs 106 can also be distributed at the end of the outflow channel and the end of the inflow channel.
  • the corresponding release process is a two-way release. You can choose to release one lug first. Finally, release the mounting ears on both sides at the same time.
  • the stent body 10 is covered with a skirt 20 made of pericardium or other biocompatible polymer materials.
  • the skirt 20 cooperates with the valve 30 to form a single blood flow channel.
  • the valve 30 is arranged on the inner surface of the stent body 10.
  • the skirt 20 is sewn on the inner or outer surface of the inlet flange 1011.
  • the stent body 10 is made of a metal material that has memory characteristics (that is, has self-expansion performance) and is biocompatible, and is preferably made by cutting a nickel-titanium alloy tube.
  • the outer diameter of the metal tube is preferably 5-15 mm, and the finalized diameter can be selected according to the actual needs of the heart valve stent.
  • the heart valve prosthesis provided in this embodiment clamps the native valve leaflets through the cooperation between the ear grasping structure and the inflow tract mesh Achieve anchoring.
  • This anchoring method allows the main body of the outflow tract, namely the valve leaflet suture area, to have a smaller outer diameter, and the smaller outer diameter of the valve leaflet will improve its fatigue resistance.
  • the diameter of the catheter adapted to the delivery system of the present invention will also be improved. It can be set smaller, which reduces the difficulty of delivery and the risk of vascular damage.
  • the smaller outer diameter of the valve leaflet requires a smaller subvalvular height of the stent.
  • the interference of the stent on the subvalvular tissues of the heart is solved, and the heart function and the anti-fatigue performance of the stent are also improved.
  • the reduced axial height of the stent reduces the obstruction of the left ventricular outflow tract (LVOTO).
  • the anterior leaflet grasping ear 105 can fix the free leaflets, which reduces the possibility of blocking the left ventricular outflow tract due to the occurrence of systolic anterior leaflet movement (SAM).
  • SAM systolic anterior leaflet movement
  • the fitting shape of the inflow flange 1011 assists in clamping with the ear-grasping structure, which reduces the risk of paravalvular leakage.

Landscapes

  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

A heart valve stent and a prosthesis (1) thereof, the heart valve stent comprising a stent main body (10), the stent main body (10) having an axially-connected inflow tract (101) and outflow tract (102), the inflow tract (101) and outflow tract (102) each comprising interconnected mesh structure units; the stent main body (10) having disposed thereon a claw tab structure extending in the direction of a proximal end (101A) of the inflow tract (101), the proximal end (101A) of the inflow tract (101) folding outward, and a clamping gap being formed between a proximal end of the claw tab structure and the inflow tract (101). The leaflet diameter of a heart valve prosthesis (1) being relatively small, and a valve (30) having relatively good fatigue resistance; being able to avoid or reduce the phenomena of outflow tract (102) obstruction and paravalvular leak; a catheter diameter of an adapted conveyance system being relatively small, thus reducing conveyance difficulty and the risk of vascular injury; simultaneously being able to reduce the phenomenon of systolic anterior leaflet motion (SAM), thus reducing the risk of left ventricular outflow tract blockage.

Description

一种心脏瓣膜支架及其假体Heart valve support and its prosthesis 技术领域Technical field

本发明涉及一种介入式医疗器械,尤其涉及一种心脏瓣膜支架及其假体。The invention relates to an interventional medical device, in particular to a heart valve stent and its prosthesis.

背景技术Background technique

心脏含有四个心腔,左心房与左心室位于心脏左侧,右心房与右心室位于心脏右侧。心房与心室间形成心室流入道,左心室与主动脉形成左室流出道,右心室与肺动脉形成右室流出道。在室流入道和室流出道处存在具有“单向阀”功能的瓣膜,保证心腔内血液的正常流动。当该瓣膜出现问题时,心脏血液动力学改变,心脏功能异常,称为瓣膜性心脏病。The heart contains four heart chambers, the left atrium and left ventricle are on the left side of the heart, and the right atrium and right ventricle are on the right side of the heart. The atrium and the ventricle form the ventricular inflow tract, the left ventricle and the aorta form the left ventricular outflow tract, and the right ventricle and the pulmonary artery form the right ventricular outflow tract. There are valves with "one-way valve" function at the ventricular inflow tract and ventricular outflow tract to ensure the normal flow of blood in the heart cavity. When the valve has a problem, the hemodynamics of the heart changes and the heart functions abnormally, which is called valvular heart disease.

随着社会经济的发展和人口的老龄化,瓣膜性心脏病的发病率明显增加,研究表明75岁以上的老年人群瓣膜性心脏病发病率高达13.3%。外科手术治疗仍是重度瓣膜病变患者的首选治疗手段,但对于高龄、合并多器官疾病、有开胸手术史以及心功能较差的患者,手术风险大,外科手术死亡率高,甚至部分患者失去了手术机会。经导管瓣膜置入/修复术则具有无需开胸、创伤小、患者恢复快等优点,受到了专家学者的广泛关注。With the development of social economy and the aging of the population, the incidence of valvular heart disease has increased significantly. Studies have shown that the incidence of valvular heart disease in the elderly over 75 years old is as high as 13.3%. Surgical treatment is still the first choice for patients with severe valvular disease. However, for patients with advanced age, multiple organ diseases, a history of thoracotomy, and poor cardiac function, the risk of surgery is high, surgical mortality is high, and even some patients lose The opportunity for surgery. Transcatheter valve placement/repair has the advantages of no need to open the chest, less trauma, and quicker recovery of patients, and has attracted wide attention from experts and scholars.

二尖瓣又称僧帽瓣,位于左心室流入道,主要结构为二尖瓣复合体,包括二尖瓣瓣环、瓣叶、腱索和乳头肌,部分文献中也包含心室壁。二尖瓣瓣环是左心房室口周围的致密结缔组织,其前瓣环是由位于左室流出道的主动脉瓣的部分无冠瓣环、部分左冠瓣环以及左、右纤维三角组成,后瓣环是后叶附着部。二尖瓣前瓣叶是主动脉瓣的纤维延伸,与后瓣叶形成左室流入道,与心间隔对应形成左室流出道。二尖瓣的腱索作为连接二尖瓣瓣叶与心肌的支撑装置,分布在瓣叶与心肌之间,二尖瓣的瓣下结构对维持左心结构及功能起着重要作用。The mitral valve, also known as the mitral valve, is located in the left ventricular inflow tract. The main structure is the mitral valve complex, including the mitral valve annulus, leaflets, chordae and papillary muscles. Some documents also include the ventricular wall. The mitral valve annulus is the dense connective tissue around the left atrium and ventricular orifice. Its anterior annulus is composed of part of the aortic valve in the left ventricular outflow tract without coronary annulus, part of the left coronary annulus, and left and right fiber triangles. , The posterior annulus is the attachment of the posterior leaflet. The anterior mitral valve leaflet is the fiber extension of the aortic valve, which forms the left ventricular inflow tract with the posterior valve leaflet, and forms the left ventricular outflow tract corresponding to the cardiac septum. The chordae of the mitral valve, as a supporting device connecting the mitral valve leaflets and the myocardium, is distributed between the valve leaflets and the myocardium. The subvalvular structure of the mitral valve plays an important role in maintaining the structure and function of the left heart.

三尖瓣作为右心脏的房室瓣,其结构与二尖瓣类似,也包含瓣叶、瓣环、腱索、乳头肌及心肌。因此替换原生二尖瓣的心脏瓣膜假体结构也可以应用于代替原生三尖瓣,根据原生瓣膜尺寸不同假体瓣膜尺寸不同。The tricuspid valve is the atrioventricular valve of the right heart. Its structure is similar to that of the mitral valve. It also contains leaflets, annulus, chordae, papillary muscles and myocardium. Therefore, the heart valve prosthesis structure that replaces the native mitral valve can also be used to replace the native tricuspid valve, and the size of the prosthetic valve varies according to the size of the native valve.

虽然二尖瓣置换领域发展迅速,但是在瓣膜假体的设计上存在一些公认的难题:Although the field of mitral valve replacement is developing rapidly, there are some recognized problems in the design of valve prostheses:

1、相较于主动脉瓣,二尖瓣的原生瓣环直径较大,相应地,人工瓣膜的瓣叶面积也要很大。瓣叶面积越大,瓣膜假体的耐疲劳性能越差。同时,瓣叶面积大,需要支架的尺寸也相应较大,用于输送瓣膜假体的导管直径也会很大,增加了输送的难度和血管损伤的风险。1. Compared with the aortic valve, the original annulus of the mitral valve has a larger diameter, and accordingly, the leaflet area of the artificial valve is also larger. The larger the leaflet area, the worse the fatigue resistance of the valve prosthesis. At the same time, the area of the valve leaflet is large, the size of the stent required is correspondingly large, and the diameter of the catheter used to deliver the valve prosthesis will also be large, which increases the difficulty of delivery and the risk of vascular damage.

2、房室瓣组合体结构复杂,如果假体瓣膜瓣下高度过高会影响原生心脏结构与心脏功能,发生腱索断裂,触碰乳头肌等心脏组织异常,同时易引起左室流出道阻塞,诱发不良的术后影响。2. The structure of the atrioventricular valve assembly is complicated. If the height of the prosthetic valve is too high, it will affect the original heart structure and heart function, cause chordae rupture, touch papillary muscles and other heart tissue abnormalities, and easily cause left ventricular outflow tract obstruction , Induce adverse postoperative effects.

3、由于存在未固定的游离瓣叶,可能发生收缩期前瓣叶移动(Systolic anterior motion, SAM)导致左室流出道堵塞。SAM是指心室收缩期,由于心脏的搏动,导致未被固定的原生瓣叶发生运动。3. Due to the existence of unfixed free leaflets, pre-systolic leaflet movement (Systolic anterior motion, SAM) may lead to blockage of the left ventricular outflow tract. SAM refers to the systolic period of the ventricle. Due to the beating of the heart, the unfixed native valve leaflets move.

4、支架的锚固困难,存在移位的风险。4. It is difficult to anchor the stent and there is a risk of displacement.

技术问题technical problem

本发明所要解决的技术问题是提供一种心脏瓣膜支架及其假体,瓣膜假体的瓣叶直径较小,瓣膜的耐疲劳性较好,同时能够降低输送难度和血管损伤的风险。The technical problem to be solved by the present invention is to provide a heart valve stent and its prosthesis. The valve leaflet of the valve prosthesis has a small diameter, the valve has good fatigue resistance, and can reduce the difficulty of delivery and the risk of vascular damage.

技术解决方案Technical solutions

本发明为解决上述技术问题而采用的技术方案是提供一种心脏瓣膜支架,其包括支架主体,所述支架主体具有轴向相连的流入道和流出道,所述流入道和流出道均由相互连接的网格结构单元组成,所述支架主体上设置有朝流入道近端方向延伸的抓耳结构,所述流入道的近端向外翻折,所述抓耳结构的近端和所述流入道之间形成有夹缝。The technical solution adopted by the present invention to solve the above technical problems is to provide a heart valve stent, which includes a stent body, the stent body has an inflow channel and an outflow channel connected axially, and the inflow channel and the outflow channel are mutually connected Consisting of connected grid structure units, the stent body is provided with an ear grasping structure extending toward the proximal end of the inflow channel, the proximal end of the inflow channel is turned outward, and the proximal end of the ear grasping structure and the A gap is formed between the inflow channels.

优选地,所述流出道的远端外径小于所述流入道的近端外径。Preferably, the outer diameter of the distal end of the outflow channel is smaller than the outer diameter of the proximal end of the inflow channel.

优选地,所述抓耳结构包括前侧抓耳和后侧抓耳,所述前侧抓耳和后侧抓耳沿着所述支架主体在周向上不均匀分布,所述前侧抓耳在周向上分布的圆心角角度范围为10°~120°或/和 240°-350°;所述后侧抓耳在周向上分布的圆心角角度范围为30°~330°。Preferably, the ear grab structure includes a front grab ear and a back grab ear, the front grab ear and the back grab ear are unevenly distributed along the bracket body in the circumferential direction, and the front grab ear The range of the central angle distributed in the circumferential direction is 10°~120° or/and 240°-350°; the range of the central angle distributed in the circumferential direction of the rear grasping ear is 30°-330°.

优选地,所述抓耳结构还包括前叶抓耳,所述前叶抓耳在周向上分布的圆心角角度范围为330°~30°;所述前叶抓耳朝向支架主体的一侧设置有倒刺或锯齿。Preferably, the ear grab structure further includes an anterior lobe grabbing ear, the central angle of the anterior lobe grabbing ear in the circumferential direction ranges from 330° to 30°; the anterior lobe grabbing ear is set toward one side of the stent body Barbed or serrated.

优选地,所述抓耳结构为悬臂结构,具有固定端和自由端,所述抓耳结构的固定端位于所述流出道上,所述抓耳结构的自由端和所述流入道之间形成有夹缝。Preferably, the ear grab structure is a cantilever structure with a fixed end and a free end, the fixed end of the ear grab structure is located on the outflow tract, and the free end of the ear grab structure and the inflow tract are formed between Crevice.

优选地,所述抓耳结构为杆状结构,所述固定端位于所述流出道的末端,所述自由端为球形或椭球型。Preferably, the ear grasping structure is a rod-shaped structure, the fixed end is located at the end of the outflow tract, and the free end is spherical or ellipsoidal.

优选地,所述抓耳结构包括前侧抓耳和后侧抓耳,所述前侧抓耳的自由端向外翻折;所述后侧抓耳的自由端向内翻折。Preferably, the ear grasping structure includes a front grasping ear and a rear grasping ear, the free end of the front grasping ear is folded outward; the free end of the rear grasping ear is folded inward.

优选地,所述抓耳结构与所述支架主体一体加工成型;或所述抓耳结构与所述支架主体之间采用铆接、焊接或卡扣的方式进行连接。Preferably, the ear-grasping structure and the bracket body are formed integrally; or the ear-grasping structure and the bracket body are connected by riveting, welding or snapping.

优选地,所述抓耳结构的两端分别固定在所述支架主体上,所述抓耳结构与所述支架主体的所述网格结构单元形成封闭结构。Preferably, both ends of the ear grab structure are respectively fixed on the bracket body, and the ear grab structure and the grid structure unit of the bracket body form a closed structure.

优选地,所述流入道的近端端口外径为35-75mm,所述流入道的刚度大于所述流出道的刚度;所述流出道在轴向上的高度为5-20mm,外径为21-55mm。Preferably, the outer diameter of the proximal port of the inflow channel is 35-75mm, the rigidity of the inflow channel is greater than the rigidity of the outflow channel; the height of the outflow channel in the axial direction is 5-20mm, and the outer diameter is 21-55mm.

本发明为解决上述技术问题而采用的另一技术方案是提供一种心脏瓣膜假体,包括心脏瓣膜支架和瓣膜,所述瓣膜固定设置在所述支架主体的内表面,所述心脏瓣膜支架为上述心脏瓣膜支架。Another technical solution adopted by the present invention to solve the above-mentioned technical problems is to provide a heart valve prosthesis, including a heart valve stent and a valve, the valve being fixedly arranged on the inner surface of the stent body, and the heart valve stent is The above-mentioned heart valve stent.

有益效果Beneficial effect

本发明对比现有技术有如下的有益效果:本发明提供的心脏瓣膜支架及其假体,通过抓耳结构与流入道网格对原生瓣叶的夹合,替代现有支架主体过盈配合(Oversize)的锚固方式,使得流出道主体,即瓣叶缝合区,有着较小的外径。较小外径的瓣叶其抗疲劳性能将会提升,同时适配本发明的输送系统的导管直径也可以设置的较小,降低了输送难度和血管损伤的风险。较小外径的瓣叶所要求的心脏瓣膜支架的瓣下高度更小,支架对心脏的瓣下组织(如乳头肌,心室壁等)的干涉得到解决,心脏功能以及支架的抗疲劳性能得到改善。支架的轴向高度降低又减少了对左室流出道阻塞(LVOTO)。特别是,设置前叶抓耳可固定游离瓣叶,减小发生收缩期前瓣叶移动(SAM)导致堵塞左室流出道的可能。另外,流入道法兰形状贴合辅助配合抓耳结构的夹合,减小了瓣周漏的风险。Compared with the prior art, the present invention has the following beneficial effects: the heart valve stent and its prosthesis provided by the present invention replace the interference fit of the existing stent body by clamping the native valve leaflets by the ear grasping structure and the inflow tract mesh ( Oversize) anchoring method makes the main body of the outflow tract, namely the suture area of the valve leaflet, have a smaller outer diameter. The anti-fatigue performance of the valve leaflet with a smaller outer diameter will be improved. At the same time, the diameter of the catheter adapted to the delivery system of the present invention can also be set smaller, which reduces the difficulty of delivery and the risk of vascular damage. The subvalvular height of the heart valve stent required by the smaller outer diameter of the leaflet is smaller, the interference of the stent to the subvalvular tissues of the heart (such as papillary muscles, ventricular wall, etc.) is solved, and the heart function and the anti-fatigue performance of the stent are obtained improve. The reduction in the axial height of the stent reduces the obstruction of the left ventricular outflow tract (LVOTO). In particular, setting the anterior leaflet grasping ears can fix the free leaflets and reduce the possibility of blocking the left ventricular outflow tract due to pre-systolic leaflet movement (SAM). In addition, the inflow flange shape fit assists the clamping of the ear-grasping structure, reducing the risk of paravalvular leakage.

附图说明Description of the drawings

图1为本发明实施例中心脏瓣膜假体前视方向的结构示意图;Fig. 1 is a structural schematic diagram of the front view direction of a heart valve prosthesis in an embodiment of the present invention;

图2为本发明实施例中心脏瓣膜假体俯视方向的结构示意图;2 is a schematic structural view of the heart valve prosthesis in the top view direction in the embodiment of the present invention;

图3为本发明实施例中心脏瓣膜支架的整体结构示意图;3 is a schematic diagram of the overall structure of the heart valve stent in the embodiment of the present invention;

图4(a)为本发明实施例中心脏瓣膜支架上抓耳结构的周向分布示意图,图4(b)为抓耳结构在周向上的角度分布示意图;Figure 4 (a) is a schematic diagram of the circumferential distribution of the ear grasping structure on the heart valve stent in an embodiment of the present invention, and Figure 4 (b) is a schematic diagram of the angular distribution of the ear grasping structure in the circumferential direction;

图5为原生瓣膜的截面示意图;Figure 5 is a schematic cross-sectional view of the native valve;

图6为本发明实施例中心脏瓣膜假体植入人体后的使用状态示意图;Fig. 6 is a schematic diagram of the use state of the heart valve prosthesis after implantation in the human body in the embodiment of the present invention;

图7为图6中A处的局部放大示意图。Fig. 7 is a partial enlarged schematic diagram of A in Fig. 6.

 To

图中:In the picture:

Figure 273185dest_path_image001
Figure 273185dest_path_image001

本发明的实施方式Embodiments of the invention

下面结合附图和实施例对本发明作进一步的描述。The present invention will be further described below in conjunction with the drawings and embodiments.

本实施例提供的心脏瓣膜假体,为一款经导管植入的人工心脏瓣膜假体,主要用于置换心脏瓣膜,本发明提供的心脏瓣膜假体具有尺寸小,耐疲劳特性好的特点,且本发明提供的瓣膜假体结构可以根据原生心脏结构进行匹配设计,从而可以完全替换原生心脏瓣膜,对瓣下结构损伤小,对流出道阻塞风险低。The heart valve prosthesis provided in this embodiment is an artificial heart valve prosthesis implanted via a catheter, which is mainly used to replace heart valves. The heart valve prosthesis provided by the present invention has the characteristics of small size and good fatigue resistance. In addition, the valve prosthesis structure provided by the present invention can be matched and designed according to the original heart structure, so that the original heart valve can be completely replaced, the damage to the subvalvular structure is small, and the risk of obstruction of the outflow tract is low.

为了更加清楚地描述本发明的结构特征,采用“近端”、“远端”“向外”“向内”作为方位词,其中“近端”表示在手术过程中靠近操作者的一端;“远端”表示远离操作者的一端;“向外”表示远离支架主体中心轴的方向;“向内”表示靠近支架主体中心轴的方向。术语“或”通常是以包括“和/或”的含义而进行使用的,除非内容另外明确指出外。In order to describe the structural features of the present invention more clearly, "proximal", "distal", "outward" and "inward" are used as orientation words, where "proximal" means the end close to the operator during the operation; "Distal" means the end away from the operator; "outward" means the direction away from the central axis of the stent body; "inward" means the direction close to the central axis of the stent body. The term "or" is usually used in the meaning including "and/or", unless the content clearly indicates otherwise.

请参见图1、图2和图3,心脏瓣膜支架及其假体具有压握状态和膨胀状态两种形态,本发明中如无特殊强调,均为对心脏瓣膜支架或其假体膨胀状态下的特征描述。心脏瓣膜假体1包括心脏瓣膜支架、裙边20和瓣膜30,心脏瓣膜支架包括支架主体10,支架主体10具有轴向连接的流入道101和流出道102,根据血流的方向,流出道102位于流入道101的下游,流入道101对应于瓣膜操作时血液流入心脏瓣膜假体的部分,流出道102对应于瓣膜操作时血液流出心脏瓣膜假体的部分。支架主体10由网格状结构单元或波浪形结构单元等轴向形态可进行变化的结构单元组成,轴向上由至少一排的周向上彼此相互连接的结构单元组成,轴向上多排单元间可彼此直接连接或间接连接。较佳地,所述网格状结构单元为三角形、菱形、五边形、六边形、水滴形等可形成封闭形状的结构单元。Please refer to Figure 1, Figure 2 and Figure 3, the heart valve stent and its prosthesis have two forms, the pressed state and the expanded state. Unless otherwise emphasized in the present invention, the heart valve stent or its prosthesis is in the expanded state Characteristic description. The heart valve prosthesis 1 includes a heart valve stent, a skirt 20, and a valve 30. The heart valve stent includes a stent body 10 that has an inflow channel 101 and an outflow channel 102 that are axially connected. The outflow channel 102 is based on the direction of blood flow. Located downstream of the inflow channel 101, the inflow channel 101 corresponds to the part where blood flows into the heart valve prosthesis during valve operation, and the outflow channel 102 corresponds to the part where blood flows out of the heart valve prosthesis during valve operation. The stent body 10 is composed of structural units whose axial shape can be changed, such as grid-like structural units or wave-shaped structural units. The axial direction is composed of at least one row of structural units connected to each other in the circumferential direction, and there are multiple rows of units in the axial direction. They can be connected directly or indirectly to each other. Preferably, the grid-like structural unit is a triangular, rhombic, pentagonal, hexagonal, drop-shaped structural unit that can form a closed shape.

支架主体10上设置有用于锚固的抓耳结构和用于与输送系统匹配的挂耳106,抓耳结构根据结构与功能分为前侧抓耳103、后侧抓耳104和前叶抓耳105,抓耳结构设置在支架主体10上,并朝流入道近端101A方向向外延伸,优选由流出道102的末端朝流入道近端101A方向向外延伸。挂耳106位于流入道101的末端或/和流出道102的末端上,抓耳结构所占用的流出道末端除外。The stent body 10 is provided with a grabbing ear structure for anchoring and a hanging ear 106 for matching with the conveying system. The grabbing structure is divided into a front side grabbing ear 103, a back side grabbing ear 104 and a front lobe grabbing ear 105 according to the structure and function. The ear catching structure is arranged on the stent body 10 and extends outward toward the proximal end 101A of the inflow channel, preferably from the end of the outflow channel 102 toward the proximal end 101A of the inflow channel. The hanging ear 106 is located on the end of the inflow channel 101 or/and the end of the outflow channel 102, except for the end of the outflow channel occupied by the ear grasping structure.

流入道101在形态上外翻,即流入道101的端口向外翻折,其最大外径大于原生瓣膜的瓣环直径,优选35-75mm,其刚度较流出道102的刚度更高。对于流入道101轴向上的高度数值没有特别的限定,只要满足解剖都可以,优选2mm-12mm。这样设置的作用是:流入道101的至少一部分可以位于原生瓣膜的瓣环以上,形成流入道法兰1011,其外轮廓贴合瓣环及心房壁解剖结构,一方面流入道法兰1011上缝合裙边20后可以防止瓣周漏,另一方面流入道法兰1011与抓耳结构的近端之间形成有夹缝,可夹持心肌壁或原生瓣叶以实现锚固。流入道101的主体横截面可以为圆形、D型或椭圆,为配合二尖瓣的瓣环形状,优选D型或椭圆。支架流入道101上缝合有裙边20,以防止瓣周漏。The inflow channel 101 is outward in shape, that is, the port of the inflow channel 101 is turned outward, and its maximum outer diameter is larger than the annulus diameter of the native valve, preferably 35-75 mm, and its rigidity is higher than that of the outflow channel 102. There is no particular limitation on the height value of the inflow channel 101 in the axial direction, as long as it satisfies the anatomy, preferably 2mm-12mm. The effect of this arrangement is that at least a part of the inflow channel 101 can be located above the annulus of the native valve to form an inflow channel flange 1011 whose outer contour fits the anatomy of the annulus and atrial wall. On the one hand, the inflow channel flange 1011 is sutured The skirt 20 can prevent paravalvular leakage. On the other hand, a gap is formed between the inflow flange 1011 and the proximal end of the ear grasping structure, which can clamp the myocardial wall or the native valve leaflet for anchoring. The cross-section of the main body of the inflow channel 101 can be circular, D-shaped or elliptical, and has an annulus shape that matches the mitral valve, preferably D-shaped or elliptical. A skirt 20 is sutured on the stent inflow channel 101 to prevent paravalvular leakage.

支架流出道102位于原生瓣膜的血液动力学的流出道侧。流出道远端102B的外径小于流入道近端101A外径。支架流出道102轴向上高度优选5-20mm,其外径优选21-55mm。流出道102的本体由封闭网格结构单元构成,为瓣叶提供了附着点,但不为支架提供支撑力,因此,相较于现有的为支架提供支撑力的流出道结构,本实施例的流出道102外径较小,较小的流出道外径减小了瓣叶直径,相应地提高了瓣叶的耐疲劳性能,同时降低了流出道102的轴向高度、瓣下干涉以及左室流出道阻碍(LVOTO)的风险。The stent outflow tract 102 is located on the hemodynamic outflow tract side of the native valve. The outer diameter of the distal end 102B of the outflow tract is smaller than the outer diameter of the proximal end 101A of the inflow tract. The height of the stent outflow channel 102 in the axial direction is preferably 5-20 mm, and its outer diameter is preferably 21-55 mm. The body of the outflow tract 102 is composed of a closed grid structure unit, which provides attachment points for the valve leaflets, but does not provide support for the stent. Therefore, compared with the existing outflow tract structure that provides support for the stent, this embodiment The outer diameter of the outflow channel 102 is smaller, and the smaller outer diameter of the outflow channel reduces the diameter of the valve leaflet, which correspondingly improves the fatigue resistance of the valve leaflet, while reducing the axial height of the outflow channel 102, subvalvular interference and left ventricle The risk of outflow tract obstruction (LVOTO).

请参见图4(a),抓耳结构根据结构与功能分为前侧抓耳103、前叶抓耳105与后侧抓耳104,前叶抓耳105根据需要选择是否设置。在周向上抓耳结构呈不均匀的分布。对于分布的角度,本发明没有特殊的限制,要根据人体解剖结构做适配,图4(a)仅显示了其中一种实施方式。图4(b)为抓耳结构在周向上的角度分布示意图,请参见图4(b),以其中以半径所在的射线作为圆心角的起始边计算,一般来说,前侧抓耳103在周向上分布的圆心角角度在10°~120°,优选30°~50°;或/和 240°~350°,优选260°~280°;可设置在支架的一侧或/和两侧;优选为两侧。后侧抓耳104在周向上分布的圆心角角度30°~330°,优选100°~260°。前叶抓耳105在周向上分布的圆心角角度为330°~30°,优选350°~10°。三者的数量均没有特殊的限定。Please refer to Figure 4(a). According to the structure and function, the ear grab structure is divided into the front side grab ear 103, the front lobe grab ear 105 and the back side grab ear 104. The front lobe grab ear 105 can be selected according to needs. The ear grasping structure is unevenly distributed in the circumferential direction. As for the angle of distribution, the present invention has no special restrictions. It needs to be adapted according to the anatomical structure of the human body. Figure 4(a) only shows one of the embodiments. Figure 4(b) is a schematic diagram of the angular distribution of the ear-grasping structure in the circumferential direction. Please refer to Figure 4(b), where the radius of the ray is used as the starting edge of the central angle. Generally speaking, the front side ear-grasping 103 The angle of the central angle distributed in the circumferential direction is 10°~120°, preferably 30°~50°; or/and 240°~350°, preferably 260°~280°; can be set on one side or/and both sides of the bracket ; Preferably on both sides. The central angle of the rear grasping ear 104 in the circumferential direction is 30°~330°, preferably 100°~260°. The central angle of the anterior lobe grasping ear 105 in the circumferential direction is 330°-30°, preferably 350°-10°. There are no special restrictions on the number of the three.

请继续参见图3和图4,前侧抓耳103由支架主体10上延伸出来,优选由流出道102上的单元网格中部或流出道102的末端朝向流入道近端101A方向向外延伸;前侧抓耳103具有固定端103A和自由端103B,且自由端103B远离支架主体10与固定端103A,朝向流入道101方向。前侧抓耳103轴向上的高度根据流出道102轴向上的高度调整,以做到配合流入道101的形状,具体数值本发明没有特殊的规定,一般为0-10mm,贴合夹持左室流出道两侧的心室壁结构。前侧抓耳103的夹持位置优选图5中所示的前外侧连合(CL)区域与后内侧连合(CM)区域。Please continue to refer to FIGS. 3 and 4, the front grasping ear 103 extends from the stent body 10, preferably from the middle part of the cell grid on the outflow tract 102 or the end of the outflow tract 102 to extend outward toward the proximal end 101A of the inflow tract; The front gripping ear 103 has a fixed end 103A and a free end 103B, and the free end 103B is away from the bracket body 10 and the fixed end 103A, and faces the inflow channel 101 direction. The height of the front gripping ear 103 in the axial direction is adjusted according to the height of the outflow channel 102 in the axial direction to match the shape of the inflow channel 101. The specific value is not specified in the present invention, and is generally 0-10mm. The ventricular wall structure on both sides of the left ventricular outflow tract. The clamping position of the front grasping ear 103 is preferably the front lateral commissure (CL) region and the posterior medial commissure (CM) region shown in FIG. 5.

请继续参见图5,后侧抓耳104的锚固位点为图5中二尖瓣后叶P区域,即P1、P2L、P2M、P3的区域范围内,锚固的实现方式为后侧抓耳104和流入道法兰1011配合形成夹持力,请参见图6和7,后侧抓耳104贴合心肌壁21后和流入道法兰1011之间形成夹持力,从而实现夹合相应的瓣环结构(Myocardial shelf)。前侧抓耳103和后侧抓耳104相结合提供的夹持锚固力,降低了心脏瓣膜假体在原生瓣环处所需的径向支撑力,降低了撕裂原生瓣环的风险。同时使得瓣膜假体可以拥有较小的直径,提升了瓣膜假体的耐疲劳性能。Please continue to refer to FIG. 5, the anchoring site of the posterior grasping ear 104 is the P area of the posterior mitral valve leaflet in FIG. 5, that is, within the range of P1, P2L, P2M, and P3. The anchoring method is the posterior grasping ear 104 It cooperates with the inflow flange 1011 to form a clamping force. Please refer to Figures 6 and 7. After the rear grasping ear 104 is attached to the myocardial wall 21, a clamping force is formed between the inflow flange 1011 and the corresponding flap is clamped. Ring structure (Myocardial shelf). The clamping and anchoring force provided by the combination of the anterior grasping ear 103 and the posterior grasping ear 104 reduces the radial support force required by the heart valve prosthesis at the native valve annulus, and reduces the risk of tearing the native valve annulus. At the same time, the valve prosthesis can have a smaller diameter, which improves the fatigue resistance of the valve prosthesis.

前叶抓耳105主要用于对原生瓣叶进行限位,根据需要可以设置也可以不设置。请参照图5,前叶抓耳105位于二尖瓣前叶A中的A2(即A2L和A2M)区域。前叶抓耳105对原生瓣叶具有限位的作用,将原生瓣叶夹合在前叶抓耳105与流入道法兰1011之间,一方面降低了收缩期前叶运动(SAM)导致左室流出道堵塞(LVOTO)的风险,另一方面增强了假体瓣膜与原生瓣环之间的密封性,减小了瓣周漏发生的可能性。优选地,前叶抓耳105与原生瓣叶贴合位置(即需要配合流入道法兰1011夹合的位置)侧具有一定的粗糙度,如设置有倒刺或设置成锯齿状,增加前叶抓耳105的悬臂结构与瓣叶间的摩擦力,提高锚固稳定性。The front leaf grasping ear 105 is mainly used to limit the native valve leaflet, and it can be set or not set as needed. Please refer to FIG. 5, the anterior leaf grasping ear 105 is located in the area A2 (ie, A2L and A2M) of the anterior leaflet A of the mitral valve. The anterior leaf grasping ear 105 has a limiting effect on the native valve leaflets. The original leaflet is sandwiched between the anterior leaf grasping ear 105 and the inflow flange 1011. On the one hand, it reduces the systolic anterior leaflet movement (SAM) and causes the left The risk of ventricular outflow tract obstruction (LVOTO), on the other hand, enhances the sealing between the prosthetic valve and the original annulus, reducing the possibility of paravalvular leakage. Preferably, the anterior leaf grasping ear 105 and the native valve leaflet fitting position (that is, the position where the inflow flange 1011 needs to be clamped together) has a certain degree of roughness. If barbed or serrated, the anterior leaflet The friction force between the cantilever structure of the grab ear 105 and the valve leaflet improves the anchoring stability.

抓耳结构与支架主体10可以一体加工而成,或者两者间采用铆接、焊接、卡扣等任何可以稳定连接的方式进行连接。The ear-grasping structure and the bracket body 10 can be integrally processed, or they can be connected by any means such as riveting, welding, snapping, etc., which can be connected stably.

优选地,抓耳结构为悬臂结构,根据瓣环与心肌壁的解剖尺寸选取悬臂自由端与流入道法兰1011之间的夹缝间隙,以提供夹合心肌壁21所需的预紧力,同时该悬臂具有较强的刚度以保证在夹合心肌壁21时不会形变导致脱落,此处“较强的刚度”指的是满足悬臂不会形变脱落,没有具体的数值限定。作为可选项,所述悬臂结构为杆状结构,每个悬臂结构与支架主体10的固定点为1个位置,该固定点位于流出道102的网格上或流出道102的末端,其自由端为球形、椭球形等无明显棱角的形状。优选地,前侧抓耳103的自由端103B向外,如图3和5所示,便于配合流入道法兰1011在二尖瓣外侧L的前外侧连合CL区域和二尖瓣内侧M的后内侧连合CM区域夹合心肌壁21。后侧抓耳104的自由端向内,如图3和5所示,是为了在二尖瓣后叶P的P2(即P2M和P2L)区域将瓣膜假体卡在心肌壁21上,防止损伤心肌组织。前叶抓耳105的自由端向外,如图3和5所示,便于配合流入道法兰1011在A2区域夹合瓣叶。Preferably, the ear grasping structure is a cantilever structure, and the gap between the free end of the cantilever and the inflow flange 1011 is selected according to the anatomical dimensions of the annulus and the myocardial wall to provide the pre-tightening force required to clamp the myocardial wall 21. The cantilever has strong rigidity to ensure that it will not deform and cause falling off when clamping the myocardial wall 21. Here, "stronger rigidity" means that the cantilever does not deform or fall off, and there is no specific numerical limit. As an option, the cantilever structure is a rod-shaped structure, and the fixed point between each cantilever structure and the stent body 10 is one position, and the fixed point is located on the grid of the outflow channel 102 or the end of the outflow channel 102, and its free end It is spherical, ellipsoidal and other shapes without obvious edges and corners. Preferably, the free end 103B of the anterior grasping ear 103 outwards, as shown in FIGS. 3 and 5, to facilitate the fitting of the inflow flange 1011 on the anterolateral commissure CL area of the mitral valve outside L and the mitral valve inside M The posterior medial commissure CM region sandwiches the myocardial wall 21. The free end of the posterior grasping ear 104 is facing inward, as shown in Figures 3 and 5, in order to clamp the valve prosthesis on the myocardial wall 21 in the P2 (ie P2M and P2L) area of the posterior mitral valve leaflet P to prevent damage Myocardial tissue. The free end of the front leaf grasping ear 105 is outward, as shown in FIGS. 3 and 5, which facilitates the engagement of the valve leaflet in the A2 area with the inflow flange 1011.

在另一实施方式中,抓耳结构与支架主体10的网格单元形成封闭结构,封闭结构不同于悬臂结构,抓耳结构的两端都固定在支架主体10上,没有自由端。封闭结构的近端与流入道法兰1011配合,提供对心肌壁21的夹持力。另外,封闭结构的远端也可以对瓣膜支架提供一定的支撑力,减少支架流出道102的尺寸。In another embodiment, the ear grab structure and the grid unit of the bracket body 10 form a closed structure. The closed structure is different from the cantilever structure. Both ends of the ear grab structure are fixed on the bracket body 10 without free ends. The proximal end of the closed structure cooperates with the inflow flange 1011 to provide clamping force to the myocardial wall 21. In addition, the distal end of the closed structure can also provide a certain supporting force to the valve stent, reducing the size of the stent outflow tract 102.

挂耳106用于匹配运输心脏瓣膜假体的输送系统,实现瓣膜假体的装载与释放。挂耳106为瓣膜假体最后脱离输送系统的结构,所以挂耳106位于流入道101或/和流出道102的末端上,抓耳结构(前侧抓耳103、后侧抓耳104、前叶抓耳105)所占用的流出道末端除外。具体而言,根据瓣膜假体的植入方式与输送系统的功能不同,挂耳106可以分布于流入道101的末端,对应的释放过程中先释放流出道102;挂耳106也可以分布于流出道102的末端,对应的释放过程中先释放流入道101;挂耳106也可以分布于流出道末端和流入道末端,对应的释放过程为双向释放,可选择先释放一侧挂耳也可选择最后同时释放两侧挂耳。The hanging ear 106 is used to match the delivery system for transporting the heart valve prosthesis to realize the loading and release of the valve prosthesis. The hanging ear 106 is the structure where the valve prosthesis finally leaves the delivery system. Therefore, the hanging ear 106 is located at the end of the inflow tract 101 or/and the outflow tract 102. The ear-grasping structure (front-side grasping ear 103, back-side grasping ear 104, anterior leaf Grasping ear 105) except for the end of the outflow tract occupied. Specifically, depending on the implantation method of the valve prosthesis and the function of the delivery system, the ears 106 can be distributed at the end of the inflow tract 101, and the outflow tract 102 is released first during the corresponding release process; the ears 106 can also be distributed in the outflow At the end of the channel 102, the inflow channel 101 is released first during the corresponding release process; the lugs 106 can also be distributed at the end of the outflow channel and the end of the inflow channel. The corresponding release process is a two-way release. You can choose to release one lug first. Finally, release the mounting ears on both sides at the same time.

支架主体10覆盖有由心包或其他生物相容的高分子材料制造成的裙边20,裙边20配合瓣膜30形成单一的血液流向通道,优选地,瓣膜30设置在支架主体10的内表面,裙边20缝制在流入道法兰1011的内表面或外表面。The stent body 10 is covered with a skirt 20 made of pericardium or other biocompatible polymer materials. The skirt 20 cooperates with the valve 30 to form a single blood flow channel. Preferably, the valve 30 is arranged on the inner surface of the stent body 10. The skirt 20 is sewn on the inner or outer surface of the inlet flange 1011.

支架主体10采用具有记忆特性(即具有自膨胀性能)且与生物相容性的金属材料制成,优选采用镍钛合金管材切割制造而成。金属管材的外径优选为5~15mm,可根据心脏瓣膜支架的实际需要选取定型后的直径尺寸。The stent body 10 is made of a metal material that has memory characteristics (that is, has self-expansion performance) and is biocompatible, and is preferably made by cutting a nickel-titanium alloy tube. The outer diameter of the metal tube is preferably 5-15 mm, and the finalized diameter can be selected according to the actual needs of the heart valve stent.

综上,与现有支架主体过盈配合(Oversize)的锚固方式不同,本实施例提供的心脏瓣膜假体是通过抓耳结构与流入道网格之间的配合对原生瓣叶进行夹合来实现锚固。这种锚固方式使得流出道主体,即瓣叶缝合区,有着较小的外径,而较小外径的瓣叶其抗疲劳性能将会提升,同时适配本发明的输送系统的导管直径也可以设置的较小,降低了输送难度和血管损伤的风险。较小外径的瓣叶对应要求支架的瓣下高度更小,支架对心脏的瓣下组织(如乳头肌,心室壁等)的干涉得到解决,心脏功能以及支架的抗疲劳性能也得到改善。支架的轴向高度降低减少了对左室流出道阻塞(LVOTO)。特别是设置前叶抓耳105可固定游离的瓣叶,减小了发生收缩期前瓣叶移动(SAM)导致堵塞左室流出道的可能。另外,流入道法兰1011的贴合形状辅助配合抓耳结构进行夹合,减小了瓣周漏的风险。In summary, unlike the existing stent body with an oversize anchoring method, the heart valve prosthesis provided in this embodiment clamps the native valve leaflets through the cooperation between the ear grasping structure and the inflow tract mesh Achieve anchoring. This anchoring method allows the main body of the outflow tract, namely the valve leaflet suture area, to have a smaller outer diameter, and the smaller outer diameter of the valve leaflet will improve its fatigue resistance. At the same time, the diameter of the catheter adapted to the delivery system of the present invention will also be improved. It can be set smaller, which reduces the difficulty of delivery and the risk of vascular damage. The smaller outer diameter of the valve leaflet requires a smaller subvalvular height of the stent. The interference of the stent on the subvalvular tissues of the heart (such as papillary muscles, ventricular wall, etc.) is solved, and the heart function and the anti-fatigue performance of the stent are also improved. The reduced axial height of the stent reduces the obstruction of the left ventricular outflow tract (LVOTO). In particular, the anterior leaflet grasping ear 105 can fix the free leaflets, which reduces the possibility of blocking the left ventricular outflow tract due to the occurrence of systolic anterior leaflet movement (SAM). In addition, the fitting shape of the inflow flange 1011 assists in clamping with the ear-grasping structure, which reduces the risk of paravalvular leakage.

虽然本发明已以较佳实施例揭示如上,然其并非用以限定本发明,任何本领域技术人员,在不脱离本发明的精神和范围内,当可作些许的修改和完善,因此本发明的保护范围当以权利要求书所界定的为准。Although the present invention has been disclosed as above in preferred embodiments, it is not intended to limit the present invention. Any person skilled in the art can make some modifications and improvements without departing from the spirit and scope of the present invention. Therefore, the present invention The scope of protection shall be as defined in the claims.

Claims (11)

一种心脏瓣膜支架,其特征在于,其包括支架主体,所述支架主体具有轴向相连的流入道和流出道,所述流入道和流出道均由相互连接的网格结构单元组成,所述支架主体上设置有朝流入道近端方向延伸的抓耳结构,所述流入道的近端向外翻折,所述抓耳结构的近端和所述流入道之间形成有夹缝。A heart valve stent, which is characterized in that it comprises a stent body, the stent body has an inflow channel and an outflow channel that are axially connected, and both the inflow channel and the outflow channel are composed of interconnected grid structure units. The stent body is provided with an ear grab structure extending toward the proximal end of the inflow channel, the proximal end of the inflow channel is turned outward, and a gap is formed between the proximal end of the ear grab structure and the inflow channel. 如权利要求1所述的心脏瓣膜支架,其特征在于,所述流出道的远端外径小于所述流入道的近端外径。The heart valve stent according to claim 1, wherein the outer diameter of the distal end of the outflow tract is smaller than the outer diameter of the proximal end of the inflow tract. 如权利要求1所述的心脏瓣膜支架,其特征在于,所述抓耳结构包括前侧抓耳和后侧抓耳,所述前侧抓耳和后侧抓耳沿着所述支架主体在周向上不均匀分布,所述前侧抓耳在周向上分布的圆心角角度范围为10°~120°或/和 240°-350°;所述后侧抓耳在周向上分布的圆心角角度范围为30°~330°。The heart valve stent according to claim 1, wherein the ear grab structure comprises a front grab ear and a back grab ear, and the front grab ear and the back grab ear are arranged around the stent body. Distributed upward unevenly, the central angle range of the front gripping ear in the circumferential direction is 10°~120° or/and 240°-350°; the central angle angle range of the rear gripping ear distributed in the circumferential direction It is 30°~330°. 如权利要求3所述的心脏瓣膜支架,其特征在于,所述抓耳结构还包括前叶抓耳,所述前叶抓耳在周向上分布的圆心角角度范围为330°~30°;所述前叶抓耳朝向支架主体的一侧设置有倒刺或锯齿。The heart valve stent according to claim 3, wherein the grasping ear structure further comprises an anterior leaf grasping ear, and the central angle of the anterior leaf grasping ear in the circumferential direction ranges from 330° to 30°; The front leaf grabbing ear is provided with barbs or serrations on the side facing the bracket body. 如权利要求1所述的心脏瓣膜支架,其特征在于,所述抓耳结构为悬臂结构,具有固定端和自由端,所述抓耳结构的固定端位于所述流出道上,所述抓耳结构的自由端和所述流入道之间形成有夹缝。The heart valve stent according to claim 1, wherein the ear grab structure is a cantilever structure with a fixed end and a free end, the fixed end of the ear grab structure is located on the outflow tract, and the ear grab structure A gap is formed between the free end of the tube and the inflow channel. 如权利要求5所述的心脏瓣膜支架,其特征在于,所述抓耳结构为杆状结构,所述固定端位于所述流出道的末端,所述自由端为球形或椭球型。The heart valve stent according to claim 5, wherein the ear grasping structure is a rod-shaped structure, the fixed end is located at the end of the outflow tract, and the free end is spherical or ellipsoidal. 如权利要求5所述的心脏瓣膜支架,其特征在于,所述抓耳结构包括前侧抓耳和后侧抓耳,所述前侧抓耳的自由端向外翻折;所述后侧抓耳的自由端向内翻折。The heart valve stent according to claim 5, wherein the ear grab structure comprises a front grab ear and a back grab ear, and the free end of the front grab ear is turned outward; the back grab Fold the free end of the ear inward. 如权利要求1所述的心脏瓣膜支架,其特征在于,所述抓耳结构与所述支架主体一体加工成型;或所述抓耳结构与所述支架主体之间采用铆接、焊接或卡扣的方式进行连接。The heart valve stent according to claim 1, wherein the ear grab structure and the stent body are integrally processed and formed; or the ear grab structure and the stent body are riveted, welded or snapped. Way to connect. 如权利要求1所述的心脏瓣膜支架,其特征在于,所述抓耳结构的两端分别固定在所述支架主体上,所述抓耳结构与所述支架主体的所述网格结构单元形成封闭结构。The heart valve stent according to claim 1, wherein the two ends of the ear grasping structure are respectively fixed on the stent body, and the ear grasping structure is formed with the grid structure unit of the stent body. Closed structure. 如权利要求1所述的心脏瓣膜支架,其特征在于,所述流入道的近端端口外径为35-75mm,所述流入道的刚度大于所述流出道的刚度;所述流出道在轴向上的高度为5-20mm,外径为21-55mm。The heart valve stent according to claim 1, wherein the outer diameter of the proximal port of the inflow channel is 35-75mm, the rigidity of the inflow channel is greater than the rigidity of the outflow channel; The upward height is 5-20mm, and the outer diameter is 21-55mm. 一种心脏瓣膜假体,包括心脏瓣膜支架和瓣膜,所述瓣膜固定设置在所述支架主体的内表面,其特征在于,所述心脏瓣膜支架为权利要求1-10任一项所述的心脏瓣膜支架。A heart valve prosthesis, comprising a heart valve stent and a valve, the valve being fixedly arranged on the inner surface of the stent body, wherein the heart valve stent is the heart according to any one of claims 1-10 Valve stent.
PCT/CN2020/080529 2019-03-22 2020-03-21 Heart valve stent and prosthesis thereof Ceased WO2020192599A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN201910223986.1 2019-03-22
CN201910223986.1A CN111714250B (en) 2019-03-22 2019-03-22 Heart valve support and prosthesis thereof

Publications (1)

Publication Number Publication Date
WO2020192599A1 true WO2020192599A1 (en) 2020-10-01

Family

ID=72563596

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CN2020/080529 Ceased WO2020192599A1 (en) 2019-03-22 2020-03-21 Heart valve stent and prosthesis thereof

Country Status (2)

Country Link
CN (1) CN111714250B (en)
WO (1) WO2020192599A1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2829409C2 (en) * 2021-09-30 2024-10-30 Дженскеа Сайнтифик Ко., Лтд. Prosthetic heart valve, made with possibility of attachment to natural valve leaflet

Families Citing this family (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022022574A1 (en) * 2020-07-28 2022-02-03 北京迈迪顶峰医疗科技股份有限公司 Prosthetic valve
CN114469444B (en) * 2020-11-12 2025-04-11 沛嘉医疗科技(苏州)有限公司 Valve stents and valve prostheses
WO2022141679A1 (en) * 2020-12-28 2022-07-07 上海臻亿医疗科技有限公司 Artificial valve prosthesis
CN114795367A (en) * 2021-01-27 2022-07-29 上海纽脉医疗科技有限公司 Tissue clamping device and tissue repair equipment
CN113730036A (en) * 2021-09-30 2021-12-03 宁波健世科技股份有限公司 Heart valve prosthesis capable of being anchored with autologous valve leaflet
CN113730039A (en) * 2021-10-08 2021-12-03 广东脉搏医疗科技有限公司 Stent valve
CN114028030B (en) * 2021-11-09 2023-02-28 上海臻亿医疗科技有限公司 artificial heart valve
CN218420135U (en) * 2022-04-24 2023-02-03 上海微创心通医疗科技有限公司 Valve stent and valve prosthesis
CN116999207A (en) * 2022-04-29 2023-11-07 上海微创心通医疗科技有限公司 Valve stent, valve prosthesis and valve prosthesis system
CN115227451B (en) * 2022-06-30 2025-07-15 上海翰凌医疗器械有限公司 A transcatheter valve replacement device and stent thereof
CN115317196B (en) * 2022-08-01 2025-12-09 上海翰凌医疗器械有限公司 Transcatheter replacement valve device and stent thereof
CN115177407B (en) * 2022-07-08 2025-11-25 金仕生物科技(常熟)有限公司 Left ventricular outflow tract stent and delivery system
CN119587219B (en) * 2024-11-18 2025-11-25 四川大学华西医院 Bidirectionally loadable artificial valves

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2777616A1 (en) * 2013-03-14 2014-09-17 CardiAQ Valve Technologies, Inc. Prosthesis for atraumatically grasping intralumenal tissue
US9480560B2 (en) * 2009-09-29 2016-11-01 Edwards Lifesciences Cardiaq Llc Method of securing an intralumenal frame assembly
CN106456328A (en) * 2014-05-19 2017-02-22 爱德华兹生命科学卡迪尔克有限责任公司 Replacement mitral valve with annular flap
WO2019016366A1 (en) * 2017-07-20 2019-01-24 The Provost, Fellows, Foundation Scholars, & The Other Members Of Board, Of The College Of The Holy & Undiv. Trinity Of Queen El A stented valve
CN209091745U (en) * 2018-10-30 2019-07-12 上海微创心通医疗科技有限公司 Split type heart valve bracket and its prosthese
CN209122540U (en) * 2018-10-11 2019-07-19 上海微创心通医疗科技有限公司 A kind of valve bracket and prosthetic heart valve
CN111035472A (en) * 2018-10-11 2020-04-21 上海微创心通医疗科技有限公司 Valve support and prosthetic heart valve
CN111110398A (en) * 2018-10-30 2020-05-08 上海微创心通医疗科技有限公司 Split type heart valve support and prosthesis thereof

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9308087B2 (en) * 2011-04-28 2016-04-12 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
US9078747B2 (en) * 2011-12-21 2015-07-14 Edwards Lifesciences Corporation Anchoring device for replacing or repairing a heart valve
CN104274259B (en) * 2014-10-30 2016-06-01 宁波健世生物科技有限公司 The artificial valve prosthese of a kind of band lobe leaf clamping device
EP3302364B2 (en) * 2015-06-04 2023-05-10 Epygon Atrio-ventricular valve stent with native leaflet grasping and holding mechanism
EP3531977B1 (en) * 2016-10-28 2024-06-26 St. Jude Medical, Cardiology Division, Inc. Prosthetic mitral valve
EP3568108A1 (en) * 2017-01-11 2019-11-20 Mitrassist Medical Ltd. Multi-level cardiac implant
CN208388805U (en) * 2017-09-29 2019-01-18 上海微创心通医疗科技有限公司 Heart valve prosthesis
CN109199640B (en) * 2018-10-24 2020-06-12 宁波健世生物科技有限公司 Artificial valve prosthesis
CN210301307U (en) * 2019-03-22 2020-04-14 上海微创心通医疗科技有限公司 Heart valve support and prosthesis thereof

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9480560B2 (en) * 2009-09-29 2016-11-01 Edwards Lifesciences Cardiaq Llc Method of securing an intralumenal frame assembly
EP2777616A1 (en) * 2013-03-14 2014-09-17 CardiAQ Valve Technologies, Inc. Prosthesis for atraumatically grasping intralumenal tissue
CN106456328A (en) * 2014-05-19 2017-02-22 爱德华兹生命科学卡迪尔克有限责任公司 Replacement mitral valve with annular flap
WO2019016366A1 (en) * 2017-07-20 2019-01-24 The Provost, Fellows, Foundation Scholars, & The Other Members Of Board, Of The College Of The Holy & Undiv. Trinity Of Queen El A stented valve
CN209122540U (en) * 2018-10-11 2019-07-19 上海微创心通医疗科技有限公司 A kind of valve bracket and prosthetic heart valve
CN111035472A (en) * 2018-10-11 2020-04-21 上海微创心通医疗科技有限公司 Valve support and prosthetic heart valve
CN209091745U (en) * 2018-10-30 2019-07-12 上海微创心通医疗科技有限公司 Split type heart valve bracket and its prosthese
CN111110398A (en) * 2018-10-30 2020-05-08 上海微创心通医疗科技有限公司 Split type heart valve support and prosthesis thereof

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2829409C2 (en) * 2021-09-30 2024-10-30 Дженскеа Сайнтифик Ко., Лтд. Prosthetic heart valve, made with possibility of attachment to natural valve leaflet

Also Published As

Publication number Publication date
CN111714250A (en) 2020-09-29
CN111714250B (en) 2025-11-21

Similar Documents

Publication Publication Date Title
WO2020192599A1 (en) Heart valve stent and prosthesis thereof
CN108156805B (en) Mitral valve assembly
US10779935B2 (en) Cardiac stent-valve and delivery device for such a valve
CN111772878B (en) Heart valve prosthesis
JP6290860B2 (en) Heart valve prosthesis
CN108261257B (en) Valve prosthesis and delivery method
CN111110403A (en) Heart valve device with anchoring ring and using method thereof
WO2019052305A1 (en) Valve stent and valve prosthesis
BR102015024747B1 (en) IMPLANTABLE DEVICE TO TREAT MITRAL VALVE REGURGITATION
CN212382790U (en) A heart valve device with an anchoring ring
WO2019128583A1 (en) Cardiac valve prosthesis and stent thereof
CN111643223B (en) Grafts to repair or replace the heart's own valves
CN210301307U (en) Heart valve support and prosthesis thereof
CN114028030B (en) artificial heart valve
CN112022439A (en) Artificial heart valve
CN111772879B (en) An artificial heart valve
CN114041904A (en) A tricuspid valve prosthesis suitable for transcatheter
CN115153961A (en) A valve support and valve prosthesis comprising the valve support
CN117100458A (en) Valve prosthesis device with selectively distributed barbs
EP3960128A1 (en) Heart valve prosthesis
WO2025039492A1 (en) Valve prosthesis device having segmented tapered structure
CN111904664A (en) Tricuspid valve prosthesis
WO2023206710A1 (en) Valve stent and valve prosthesis
CN212395131U (en) Artificial heart valve
EP3960129A1 (en) Prosthetic heart valve

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 20780073

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 20780073

Country of ref document: EP

Kind code of ref document: A1