WO2003041617A1 - Mitral valve annuloplasty ring for molding left ventricle geometry - Google Patents

Mitral valve annuloplasty ring for molding left ventricle geometry Download PDF

Info

Publication number
WO2003041617A1
WO2003041617A1 PCT/US2002/036242 US0236242W WO03041617A1 WO 2003041617 A1 WO2003041617 A1 WO 2003041617A1 US 0236242 W US0236242 W US 0236242W WO 03041617 A1 WO03041617 A1 WO 03041617A1
Authority
WO
WIPO (PCT)
Prior art keywords
ring
posterior
sides
anterior
annuloplasty ring
Prior art date
Application number
PCT/US2002/036242
Other languages
French (fr)
Inventor
Steven F. M. D. Bolling
Richard S. Rhee
Original Assignee
Edwards Lifesciences Corporation
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 Edwards Lifesciences Corporation filed Critical Edwards Lifesciences Corporation
Priority to CA2467766A priority Critical patent/CA2467766C/en
Priority to AU2002340469A priority patent/AU2002340469B2/en
Priority to AT02778834T priority patent/ATE539704T1/en
Priority to JP2003543504A priority patent/JP4235554B2/en
Priority to EP02778834A priority patent/EP1443877B1/en
Publication of WO2003041617A1 publication Critical patent/WO2003041617A1/en

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
    • A61F2/2442Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2445Annuloplasty rings in direct contact with the valve annulus
    • A61F2/2448D-shaped rings
    • 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
    • A61F2/2445Annuloplasty rings in direct contact with the valve annulus

Definitions

  • the present invention relates generally to medical devices, specifically to an annuloplasty ring and related procedure for surgically reconstructing and molding the mitral valve annulus of a patient's heart. More specifically, this invention relates to a mitral valve repair device and corresponding technique that involve over-correcting defects in the mitral valve annulus so as to remodel the left- ventricular geometric relationship.
  • CHF Congestive heart failure
  • MR Secondaiy mitral regurgitation
  • MR a complication of end-stage cardiomyopathy
  • CHF and end-stage heart disease it is only applicable to a small percentage of patients because of the small number of available donor hearts and surgical risks for weaker patients. Accordingly, alternative medical and surgical strategies are evolving to treat such conditions.
  • the mitral annulus 20 represents the junction of the fibrous and muscular tissue that joins the left atrium LA and left ventricle LV.
  • the average human mitral annular cross-sectional area is 5-11 cm 2 .
  • the mitral valve is a bicuspid valve having a large posterior leaflet 22 that coapts or meets with a smaller anterior leaflet 24.
  • the anterior aspect 26 of the annulus which is in continuity with the fibrous skeleton of the heart, has limited flexibility, whereas the posterior aspect 28 of the annulus, which is not attached to any rigid surrounding structures, has more flexibility.
  • the mitral annulus 20 lies generally in a datum plane 30 (Fig.
  • aortic valve 34 at an angle with respect to a datum plane 32 in which the aortic valve 34 is generally oriented.
  • These datum planes 30, 32 can be defined as being perpendicular to the average blood flow through the respective valves.
  • the mitral annulus 20 assumes a generally elliptical shape as shown in Fig. IB, and is able to contract and decrease in diameter, whereas, in diastole, it assumes a more circular shape and opens to permit blood to fill the left ventricle LV.
  • Annular flexibility allows for increased leaflet coaptation during systole and increased annular orifice area during diastole.
  • MR In MR, dilation typically occurs along the more flexible posterior aspect 28 of the annulus, as seen in Figs.2A and 2B. Some patients experiencing a drop h of the posterior aspect 28 of the mitral valve annulus, as seen in Fig. 2A, and consequent relaxation of the posterior muscle wall 36 of the left ventricle LV. Fig. 2B illustrates the lengthening of the anterior-posterior dimension 38 and subsequent loss of coaptation between the posterior and anterior leaflets 22, 24. MR leads to a cycle of continuing volume overload of the already dilated left ventricle LV, progression of annular dilation, increased left ventricle wall tension, increasing degrees of MR and worsening CHF.
  • the regurgitant volume ejected into the left atrium LA is dependent upon mitral orifice size, ventricular/atrial pressure gradient and heart rate.
  • the regurgitant flow into the left atrium LA increases left atrial pressure, which leads to atrial enlargement and an increase in compliance, and decreases forward systemic flow.
  • Left atrial pressures rise during systole and decline in diastole.
  • Figs. 3A and 3B illustrate the use of a Carpentier-Edwards PHYSIO annuloplasty ring 40 to restore the original healthy shape of the mitral annulus 20.
  • the ring 40 is typically semi-rigid and planar and restores the primary anterior- posterior dimension 38' of the mitral annulus 20.
  • Annuloplasty rings have also been developed in various shapes and configurations over the years in an effort to correct MR and other conditions which reduce the functioning of the valve.
  • Carpentier, et al. in U.S. Patent No. 4,055,861 disclosed two semi-rigid supports for heart valves, one of which being closed (or D-shaped) and the other being open (or C-shaped). In the closed configuration, the ring is generally flat about an anterior-posterior plane, and has a convex posterior side and a generally straight anterior side.
  • U.S. Patent Nos. 5,104,407, 5,201,880, and 5,607,471 disclose closed annuloplasty rings that are bowed slightly upward on their anterior side.
  • the anterior aspect 26 of the mitral annulus is fibrous and thus relatively inflexible (at least in comparison to the posterior aspect 28), the upward curve in the anterior side of each ring conforms the ring more closely to the anatomical contour of the mitral annulus, and thus reduces undue deformation of the annulus.
  • the present invention provides a number of annuloplasty rings for implantation in a mitral valve annulus that correct both the annulus and help mitigate the effects of congestive heart failure.
  • the invention provides an annuloplasty ring that has a generally oval-shaped ring body defining an anterior portion, a posterior portion opposite the anterior portion, right and left sides between the anterior and posterior portions, and transition segments between the sides and the posterior portion.
  • the ring body is oriented about a central axis having an upward direction and a downward direction, the downward direction corresponding to the direction of blood flow through the mitral valve annulus.
  • the ring has, in plan view perpendicular to the central axis, a longer dimension along a major axis than a shorter dimension along a minor axis, and the posterior portion rises upward from the adjacent transition segments to an axial position higher than the highest axial position of the anterior portion.
  • the posterior portion extends radially inward from the adjacent transition segments to a radial position along the minor axis that is closer to the central axis than an imaginary posterior projection in plan view of the sides toward each other.
  • the posterior portion extends radially inward from the adj acent transition segments to a radial position that is about 30-50% closer to the central axis than the imaginary posterior projection of the sides toward each other.
  • the ring is substantially saddle-shaped with the sides curving upward between the anterior portion and adjacent transition segments.
  • the right and left sides may rise to axial positions above the highest axial position of the anterior portion.
  • the posterior portion rises upward from the adjacent transition segments to an axial position approximately equal to or above the highest axial positions of the right and left sides.
  • the ring may be generally planar except for the posterior portion which rises to an elevated axial position.
  • the sides and transition segments are generally curvilinear and the junctures between adjacent sides and transition segments are generally rounded.
  • the posterior portion desirably also extends radially inward from the adjacent sides to a radial position along the minor axis that is closer (preferably about 30-50% closer) to the central axis than an imaginary posterior projection in plan view of the sides toward each other.
  • the ring body is preferably comprised of a material having a high modulus of elasticity that will substantially resist distortion when subjected to the stress imparted thereon when the ring is implanted in the mitral valve annulus of an operating human heart.
  • the ring can be comprised of a ceramic material such as Stellite, titanium, Elgiloy, graphite, ceramic, hardened plastics, composite, or Nitinol ® materials.
  • the annuloplasty ring may further comprise an outer sewing sheath surrounding the ring body, the sewing sheath being formed of a material that will permit the passage of sutures therethrough for securing to ring to a mitral annulus.
  • the present invention also provides a mitral annuloplasty ring comprising a ring body made of a material having a high modulus of elasticity that will substantially resist distortion when subjected to the stress imparted thereon when the ring is implanted in the mitral valve annulus of an operating human heart.
  • the ring body is oriented about a central axis having an upward direction and a downward direction corresponding to the direction of blood flow through the mitral valve annulus, and has a posterior bow that extends both radially inward and axially upward.
  • ring body has an anterior portion, a posterior portion opposite the anterior portion, right and left sides between the anterior and posterior portions, and transition segments between the sides and the posterior portion.
  • the ring body may be substantially saddle-shaped with the sides curving upward between the anterior portion and adjacent transition segments.
  • a mid-section of the posterior portion bows upward from the adjacent transition segments to an axial position higher than the highest axial position of either of the right or left sides.
  • the right and left sides each may rise upward from the adjacent transition segments to an axial position above the highest axial position of the posterior portion.
  • Fig. 1 A is a cross-sectional view along an anterior-posterior plane through the left side of a heart illustrating healthy aortic and mitral valves and annuluses;
  • Fig. IB is a plan view of a healthy mitral valve and annulus
  • Fig. 2A is a cross-sectional view along an anterior-posterior plane through the left side of a heart illustrating a condition in the mitral valve that leads to mitral regurgitation (MR);
  • MR mitral regurgitation
  • Fig. 2B is a plan view of the mitral valve of Fig. 2A;
  • Fig. 3A is a cross-sectional view along an anterior-posterior plane through the left side of a heart illustrating the implantation of a conventional annuloplasty ring to restore the mitral valve to its healthy configuration;
  • Fig. 3B is a plan view of the restored mitral valve of Fig. 3 A;
  • Fig. 4A is a cross-sectional view along an anterior-posterior plane tlirough the left side of a heart illustrating the implantation of an annuloplasty ring of the present invention to restore the mitral valve to an over compensated position that will foster LV remodeling;
  • Fig. 4B is a plan view of the restored mitral valve of Fig. 4A;
  • Fig. 5 is a perspective view of an inner support for an annuloplasty ring of the present invention.
  • Figs. 6A-6C are top plan, front elevational, and side elevational views, respectively, of the annuloplasty ring of Figure 5;
  • FIGS. 7A-7B are front and side elevational views, respectively, of an alternative annuloplasty ring of the present invention
  • Figs. 8A-8C are perspective, front elevational, and side elevational views of a further alternative annuloplasty ring of the present invention
  • Figs. 9A-9D are various views of a further exemplary annuloplasty ring of the present invention.
  • Figs. 10A-10D are various views of a still further exemplary annuloplasty ring of the present invention.
  • Figs. 11 A- 11 C are various views of another exemplary annuloplasty ring of the present invention.
  • CHF congestive heart failure
  • MR secondary mitral regurgitation
  • the ring when implanted not only modifies the circumference of the mitral annulus as do existing annuloplasty rings, but it also elevates and/or reconfigures the posterior portion of the mitral annulus so as to mold and re-shape the geometry of the left ventricle.
  • FIGS. 4A and 4B a first exemplary mitral annuloplasty ring 50 of the present invention is shown implanted in the mitral annulus 20.
  • the posterior aspect 28 of the mitral annulus rises axially upward by a distance z from the datum plane 32 of the annulus when healthy.
  • the anterior-posterior dimension 38 of the mitral annulus has been reduced by the annuloplasty ring 50.
  • These two corrections to the mitral annulus are accomplished by a specially shaped posterior portion 52 of the annuloplasty ring 50, and because the ring is made relatively rigid.
  • the left ventricular wall 36 is molded and re-shaped, which helps mitigate some of the effects of CHF.
  • the degree to which a mid-section of the posterior portion 52 rises depends on multiple variables including specific patient pathology and the overall ring size, but it is projected that for applications in most adult sized hearts the preferable rise will be about 3-5 millimeters.
  • this configuration is not intended to follow the natural curvature of the mitral annulus. Rather, when the annuloplasty ring 50 is implanted in a mitral annulus, the "over-correcting" upward curvature of the ring 50 imparts a unique shape to the annulus that has the effect of molding and reshaping both the mitral annulus and the left ventricle. It is believed that this molding and reshaping of the geometry of the left ventricle will reduce the severity of CHF which in turn will reduce strain on the mitral valve and corresponding MR (and vice versa). In other words, this ring provides an annular solution to address ventricular pathology.
  • FIG. 5 illustrates orthogonal axes wherein the Z-axis lies along of the axis of blood flow through the ring when implanted, and the X- and Y-axes generally define the datum plane 32 as mentioned above.
  • the positive Z direction illustrated in Figure 5 is the "upward” direction
  • the negative Z direction is the "downward” direction
  • the ring is designed to be implanted in a mitral annulus such that blood will flow in the downward direction.
  • the X-axis extends across the ring in the anterior- posterior direction illustrating a minor axis dimension 54.
  • the X-axis typically lies in a plane of symmetry of the ring 50 such that the left side and right side are identical.
  • the Y-axis extends across the long dimension of the ring 50 such that a major axis dimension 56 is defined.
  • the ratio of the minor axis dimension 54 to the major axis dimension 56 is about 3:4.
  • such a ring configuration may be considered oval or elliptical.
  • the annuloplasty ring 50 includes the specially shaped posterior portion 52, an anterior portion 60, and a pair of generally symmetric side portions 62a, 62b. As can be seen from the perspective of Fig. 5, two relatively sharply curved transition segments 64a, 64b join either side of the posterior portion 52 to the side portions 62a, 62b.
  • Fig. 6B shows that the transition segments 64a, 64b are located at the lowest points about the ring 50 when in its "horizontal" orientation over an X-Y reference plane 70.
  • a mid-section of the shaped posterior portion 52 arcs upward between the transition segments 64a, 64b and has its highest point on the X-Z plane.
  • the two side portions 62a, 62b arc gently upward from the respective transition segments 64a, 64b and then gradually curve downward into a blended transition with the anterior portion 60.
  • the anterior portion 60 exhibits a slight upward bow centered along the X-Z plane, and preferably rises to the same height as the shaped posterior portion 52.
  • the overall contour of ring 50 around its periphery is undulating or serpentine. If a three-dimensional surface were drawn across the open middle of the ring to conform as much as possible to the periphery of the ring 50, that surface would be somewhat saddle-shaped with upward bows along the Y-Z and X-Z planes.
  • the extent of upward curvature for the ride and left side portions 62a, 62b may reach as high, or higher, than that of the posterior portion 52, but do not necessarily need to extend this high. This too will depend on multiple factors including patient pathology.
  • the difference in elevation between the shaped posterior portion 52 and the adjacent transition segments 64a, 64b is shown at ZA in Fig. 6B.
  • the subscript "A" refers to the point A around the ring 50 periphery as indicated in Fig. 6A.
  • the midpoint of the anterior portion 60 is denoted at B, while the points along the side portions 62a, 62b that lie on the Y-Z plane are denoted at C.
  • the lowest points in the transition segments 64a, 64b are denoted at D, while lowest points along the anterior portion 60 are denoted at E.
  • the elevational at each of these points is represented as ZA, Z B , Z , ZQ, and z E . It should be noted also that the elevations are as measured to the bottom of the ring 50, although the thickness of the ring means that the overall height is somewhat greater.
  • z D is at zero.
  • Z A may be substantially greater than either z B or Zc
  • Z B is desirably larger than zc.
  • Figures 5-6C also illustrate a second aspect of the present invention, namely that a mid-section of the posterior portion 52 extends inward to a radial position that is closer to the central axis than if the right and left side portions 62a, 62b projected smoothly toward one another. This too results in a reshaping effect on the mitral annulus, which in turn reshapes the left ventricle geometry.
  • a phantom projection or extension 72 of the two side portions 62a, 62b is indicated. This arcuate imaginary extension 72 has been drawn to illustrate the inward bow of the shaped posterior portion 52.
  • the posterior portion 52 diverges inward from this imaginary ring projection, which represents conventional oval-shaped rings of the prior art. o Specifically, the posterior portion 52 bows inward at point A a distance indicated as A. AS with the axial correction noted above, the degree to which the posterior portion 52 extends inward will depend on multiple variables, but it is preferable that the im e ⁇ nost position of the posterior side be about 30-50% closer to the central axis than the arcuate imaginary extension 72. Of course, the distance A 5 varies depending on the overall size of the ring 50.
  • the posterior portion 52 causes the posterior portion 28 of the mitral annulus 20 to elevate above the datum plane 32 the distance z.
  • This shift in the mitral annulus 28 0 places the left ventricular wall 36 in greater tension than nonnal and helps re-shape and recondition that wall to help rectify the detrimental effects of CHF.
  • the ring 50 elevate the posterior portion 28 of the mitral annulus 20, but it also pulls that side of the annulus radially inward, as indicated in Fig. 4B.
  • the anterior-posterior dimension 38" is shown reduced from its normal 5 dimension (the normal dimension is essentially represented in Fig. 3B as 38').
  • Figs. 7A and 7B show front and side elevational views of an alternative annuloplasty ring 100 of the present invention that shares some of features of the annuloplasty ring 50 described above.
  • the overall contour of ring 100 bows upward along the Y-Z plane as indicated in Fig. 7B, and a mid-section of a posterior portion 102 is both upwardly (see Fig. 7 A) and inwardly (see Fig. 7B) displaced from an imaginary continuation of the side portions of the ring.
  • the ring 100 does not have a serpentine configuration as with the earlier-described ring 50, instead the profile from the front lies generally in a single arc with the posterior portion 102 elevated relatively suddenly therefrom.
  • Fig. 7B shows that the middle segment 104 of the anterior side of the ring also bows inwardly from the adjacent sides to a radial position along the X-axis that is closer to the central axis than an imaginary anterior projection in plan view of the adjacent sides toward each other.
  • the inward curve of the anterior segment 104 further reduces the dimension of the repaired annulus in the anterior-posterior plane, and contributes to pulling the posterior aspect of the annulus inward and at the same time conditioning the left ventricular wall.
  • Figs. 8A-8C illustrate a generally planar annuloplasty ring 110 of the present invention having an anterior portion 112, an opposing posterior portion 114, and left and right sides 116a, 116b.
  • a mid-section of a posterior portion 114 is substantially the same as the posterior portion 102 in Figs. 7A and 7B such that it bows inward and upward.
  • the anterior portion 112 bows inwardly, although the entire periphery of the ring 110 except for the posterior portion 114 lies in a plane.
  • Figs. 9A-9D illustrate an alternative annuloplasty ring 130 of the present invention that, as viewed in plan view in Fig. 9B, is symmetric both about the X-Z plane and the Y-Z plane.
  • the ring 130 is not symmetric in elevation, as seen in Figs. 9C and 9D, wherein a mid-section of a posterior portion 132 rises upward and curves inward.
  • the entire ring 130 lies in a plane except for the posterior portion 132.
  • the particular configuration of the posterior portion 132 helps re-shape the mitral annulus and recondition the left ventricular wall.
  • an anterior portion 132 also bows inward to help reduce the size of the mitral annulus in the anterior-posterior direction.
  • bows inward refers to the diversion of the particular portion from an imaginary curve that would continue the oval peripheral plan view of the ring.
  • Figs. 10A-10D show another ring 150 the present invention that is nearly identical to the ring shown in Figs. 9A-9D, except for a posterior portion 152.
  • a mid-section of the posterior portion 152 rises at sharp transitions 154 from the rest of the ring 150 which is planar.
  • a short upward segment 156 connects a middle, inwardly curved segment 158 to each of the transitions 154.
  • This embodiment of the ring 150 thus illustrates that specially shaped portions around the periphery do not necessarily have to join with the remainder of the ring in gentle blended curves.
  • Figs. 11A-11C are plan, front elevational, and side elevational views, respectively, of a still further annuloplasty ring 170 that is generally oval-shaped about a major axis 172 and a minor axis 174.
  • the points A, B, C, D and E are located in the same places as described above with respect to Fig. 6A-6C.
  • a mid- section 176 of a posterior portion of the ring 170 bows upward and inward.
  • the elevation ZA above a datum plane 178 is seen in Fig. 1 IB, while the magnitude of inward bow A is seen in Fig. 11 A.
  • the sides 180a, 180b also bow upward a distance zc as indicated in Fig. 11 B .
  • an anterior portion 182 bows upward a distance Z B and inward a distance X ⁇ .
  • the mid- section 176 forms a plateau 184 in the Z-direction centered about the minor axis 174 and having a dimension y as seen in Fig. 1 IB.
  • the dimension y is desirably about 2 mm.
  • This plateau 184 helps prevent ldnking of a tubular fabric or other suture-permeable covering over the posterior portion because of the greater upward and inward bow in comparison to other rings described herein.
  • Exemplary dimensions for a 28 mm ring 170 include the following relations: 0 ⁇ z B ⁇ ZA, and preferably,
  • ZA about 7 mm.
  • the inward bow A is desirably about 40% of the distance along the minor axis from point B to point I regardless of the ring size.
  • Point I is the location of the mid-point of an imaginary posterior projection in plan view of the sides 180a, 180b toward each other.
  • the anterior inward bow B is desirably about 1 mm.
  • the ideal degree to which the posterior and/or anterior sides are molded inward and upward according this invention depend on multiple factors. Preferably however, these features will be exaggerated to an extent that the mifral annulus is "over-corrected.”
  • a important factor of this invention is that the mitral annulus not be just repaired to its natural, pre-diseased state, but that the annulus actually be reduced past that point to an extent that will significantly affect the geometry of the left ventricle.
  • the annuloplasty rings herein are desirably made of a single inner member as illustrated, covered with a suture-permeable outer layer.
  • the annuloplasty ring of the present invention must be quite stiff. It must substantially retain its shape in opposition to the stresses that will be imparted by muscles of the heart through out each beating cycle. Accordingly, this ring must be made from a material having a relatively high modulus of elasticity.
  • the inner member as shown may be machined or molded of Stellite, polished, and then covered with a polyterapthalate fabric. Alternatively, an intermediate silicone sleeve around the inner member may be used.
  • Stellite provides a desired rigidity to best facilitate reshaping of the annulus and left ventricle, although more commonly used materials such as titanium, Elgiloy, graphite, ceramic, hardened plastics, or Nitinol ® may be substituted.
  • the ring also preferably includes an outer sewing sheath that permits it to be sutured into the mitral annulus.
  • the sewing sheath should be sufficiently porous and/or flexible to permit sutures to be passed therethrough, but it must not be so flexible as to counteract the stiffness requirements discussed above. Because the ring will be under such loads, it will also be necessary to insert more sutures in the sewing sheath than for more flexible rings (to reduce the loads on individual sutures). For example, if traditional rings require in the neighborhood of 8 to 10 stitches around the circumference, the present annuloplasty ring might require as many as 20-30 or more. It will be understood by those of skill in the art that the embodiments described above can be incorporated individually or in combination.
  • each aspect will have the desired effect of and reshaping the mitral annulus and left ventricle, it is the re-shaping of the posterior side that will have the greatest effect of molding and re-shaping the left ventricle.
  • the aspect of extending the anterior side radially inward will preferably not be used unless the posterior side has also been configured as described herein.

Abstract

An annuloplasty ring for correcting maladies of the mitral annulus that not only reshapes the annulus but also reconfigures the adjacent left ventricular muscle wall. The ring may be continuous and is made of a relatively rigid material, such as Stellite. The ring has a generally oval shape that is three-dimensional at least on the posterior side. A posterior portion of the ring rises or bows upward from adjacent sides to pull the posterior aspect of the native annulus farther up than its original, healthy shape. In doing so, the ring also pulls the ventricular wall upward which helps mitigate some of the effects of congestive heart failure. Further, one or both of the posterior and anterior portions of the ring may also bow inward.

Description

MITRAL VALVE ANNULOPLASTY RING FOR MOLDING LEFT VENTRICLE GEOMETRY
RELATED PATENT APPLICATIONS
Priority is herewith claimed under 35 U.S. C. §119(e) from copending Provisional Patent Application No.: 60/332,353, filed November 13, 2001, entitled "Mitral Valve Annuloplasty Ring for Molding Left Ventricle Geometry". The disclosure of this Provisional Patent Application is incorporated by reference herein in its entirety.
FIELD OF THE INVENTION The present invention relates generally to medical devices, specifically to an annuloplasty ring and related procedure for surgically reconstructing and molding the mitral valve annulus of a patient's heart. More specifically, this invention relates to a mitral valve repair device and corresponding technique that involve over-correcting defects in the mitral valve annulus so as to remodel the left- ventricular geometric relationship.
BACKGROUND OF THE INVENTION Congestive heart failure (CHF) is a leading cause of hospitalization and death in the United States, and its incidence is increasing. Secondaiy mitral regurgitation (MR), a complication of end-stage cardiomyopathy, refers to the backflow of blood from the left ventricle to the left atrium resulting from imperfections in the mitral valve. When the mitral valve allows blood to flow backward into the left atrium, the left ventricle must pump progressively harder to circulate blood throughout the body, which in turn promotes CHF. While heart transplantation is considered a standard treatment for select patients with severe
CHF and end-stage heart disease, it is only applicable to a small percentage of patients because of the small number of available donor hearts and surgical risks for weaker patients. Accordingly, alternative medical and surgical strategies are evolving to treat such conditions.
As seen in Figs. 1 A and IB, the mitral annulus 20 represents the junction of the fibrous and muscular tissue that joins the left atrium LA and left ventricle LV. The average human mitral annular cross-sectional area is 5-11 cm2. The mitral valve is a bicuspid valve having a large posterior leaflet 22 that coapts or meets with a smaller anterior leaflet 24. The anterior aspect 26 of the annulus, which is in continuity with the fibrous skeleton of the heart, has limited flexibility, whereas the posterior aspect 28 of the annulus, which is not attached to any rigid surrounding structures, has more flexibility. For the purpose of discussion, the mitral annulus 20 lies generally in a datum plane 30 (Fig. 1 A) at an angle with respect to a datum plane 32 in which the aortic valve 34 is generally oriented. These datum planes 30, 32 can be defined as being perpendicular to the average blood flow through the respective valves. During systole the mitral annulus 20 assumes a generally elliptical shape as shown in Fig. IB, and is able to contract and decrease in diameter, whereas, in diastole, it assumes a more circular shape and opens to permit blood to fill the left ventricle LV. Annular flexibility allows for increased leaflet coaptation during systole and increased annular orifice area during diastole.
In MR, dilation typically occurs along the more flexible posterior aspect 28 of the annulus, as seen in Figs.2A and 2B. Some patients experiencing a drop h of the posterior aspect 28 of the mitral valve annulus, as seen in Fig. 2A, and consequent relaxation of the posterior muscle wall 36 of the left ventricle LV. Fig. 2B illustrates the lengthening of the anterior-posterior dimension 38 and subsequent loss of coaptation between the posterior and anterior leaflets 22, 24. MR leads to a cycle of continuing volume overload of the already dilated left ventricle LV, progression of annular dilation, increased left ventricle wall tension, increasing degrees of MR and worsening CHF. In MR, the regurgitant volume ejected into the left atrium LA is dependent upon mitral orifice size, ventricular/atrial pressure gradient and heart rate. The regurgitant flow into the left atrium LA increases left atrial pressure, which leads to atrial enlargement and an increase in compliance, and decreases forward systemic flow. Left atrial pressures rise during systole and decline in diastole.
Figs. 3A and 3B illustrate the use of a Carpentier-Edwards PHYSIO annuloplasty ring 40 to restore the original healthy shape of the mitral annulus 20. The ring 40 is typically semi-rigid and planar and restores the primary anterior- posterior dimension 38' of the mitral annulus 20.
Various other interventions have been used to alter the size of the regurgitant orifice area. An increase in preload or afterload, or a decrease in contractility, results in dilation of the LV and an increase in regurgitant orifice area. The complex relationship between mitral annular area and leaflet coaptation may explain why some studies have found that performing a "valvular" repair, with an undersized flexible annuloplasty ring, has helped with a "muscular" problem of the left ventricle. For example, in a study conducted between 1993-1999 at the University of Michigan, 92 patients with end-stage cardiomyopathy and refractory MR underwent mitral valve repair with an "undersized" annuloplasty rings having a circumference smaller than that of the patient's annulus in its natural, pre-diseased state.
Annuloplasty rings have also been developed in various shapes and configurations over the years in an effort to correct MR and other conditions which reduce the functioning of the valve. For example, Carpentier, et al. in U.S. Patent No. 4,055,861 disclosed two semi-rigid supports for heart valves, one of which being closed (or D-shaped) and the other being open (or C-shaped). In the closed configuration, the ring is generally flat about an anterior-posterior plane, and has a convex posterior side and a generally straight anterior side. U.S. Patent Nos. 5,104,407, 5,201,880, and 5,607,471 disclose closed annuloplasty rings that are bowed slightly upward on their anterior side. Because the anterior aspect 26 of the mitral annulus is fibrous and thus relatively inflexible (at least in comparison to the posterior aspect 28), the upward curve in the anterior side of each ring conforms the ring more closely to the anatomical contour of the mitral annulus, and thus reduces undue deformation of the annulus.
It should be noted here that correction of the aortic annulus requires a considerably different ring then with a mitral annulus. For example, U.S. Patent Nos. 5,258,021 and 6,231,602 disclose sinusoidal or so-called "scalloped" annuloplasty rings that follow the up-and-down shape of the three cusp aortic annulus. Such rings would not be suitable for correcting a bicuspid valve deficiency.
While good results in the treatment of CHF and MR have been obtained in the preliminary applications of the above-described methods and apparatuses, it is believed that these results can be significantly improved. Specifically, it would be desirable to produce a mitral annuloplasty ring that can re-shape the mitral annulus in a way that will significantly repair the geometric configuration of the left ventricle wall beyond that which has been observed with undersized rings.
Summary of the Invention The present invention provides a number of annuloplasty rings for implantation in a mitral valve annulus that correct both the annulus and help mitigate the effects of congestive heart failure. In one aspect, the invention provides an annuloplasty ring that has a generally oval-shaped ring body defining an anterior portion, a posterior portion opposite the anterior portion, right and left sides between the anterior and posterior portions, and transition segments between the sides and the posterior portion. The ring body is oriented about a central axis having an upward direction and a downward direction, the downward direction corresponding to the direction of blood flow through the mitral valve annulus. The ring has, in plan view perpendicular to the central axis, a longer dimension along a major axis than a shorter dimension along a minor axis, and the posterior portion rises upward from the adjacent transition segments to an axial position higher than the highest axial position of the anterior portion. Desirably, the posterior portion extends radially inward from the adjacent transition segments to a radial position along the minor axis that is closer to the central axis than an imaginary posterior projection in plan view of the sides toward each other. Preferably, the posterior portion extends radially inward from the adj acent transition segments to a radial position that is about 30-50% closer to the central axis than the imaginary posterior projection of the sides toward each other. In accordance with a one embodiment of the present invention, the ring is substantially saddle-shaped with the sides curving upward between the anterior portion and adjacent transition segments. The right and left sides may rise to axial positions above the highest axial position of the anterior portion. The posterior portion rises upward from the adjacent transition segments to an axial position approximately equal to or above the highest axial positions of the right and left sides. Alternatively, the ring may be generally planar except for the posterior portion which rises to an elevated axial position. In another embodiment, the sides and transition segments are generally curvilinear and the junctures between adjacent sides and transition segments are generally rounded. The posterior portion desirably also extends radially inward from the adjacent sides to a radial position along the minor axis that is closer (preferably about 30-50% closer) to the central axis than an imaginary posterior projection in plan view of the sides toward each other. The ring body is preferably comprised of a material having a high modulus of elasticity that will substantially resist distortion when subjected to the stress imparted thereon when the ring is implanted in the mitral valve annulus of an operating human heart. For example, the ring can be comprised of a ceramic material such as Stellite, titanium, Elgiloy, graphite, ceramic, hardened plastics, composite, or Nitinol® materials. The annuloplasty ring may further comprise an outer sewing sheath surrounding the ring body, the sewing sheath being formed of a material that will permit the passage of sutures therethrough for securing to ring to a mitral annulus. The present invention also provides a mitral annuloplasty ring comprising a ring body made of a material having a high modulus of elasticity that will substantially resist distortion when subjected to the stress imparted thereon when the ring is implanted in the mitral valve annulus of an operating human heart. The ring body is oriented about a central axis having an upward direction and a downward direction corresponding to the direction of blood flow through the mitral valve annulus, and has a posterior bow that extends both radially inward and axially upward. Desirably, ring body has an anterior portion, a posterior portion opposite the anterior portion, right and left sides between the anterior and posterior portions, and transition segments between the sides and the posterior portion. The ring body may be substantially saddle-shaped with the sides curving upward between the anterior portion and adjacent transition segments. In a preferred embodiment, a mid-section of the posterior portion bows upward from the adjacent transition segments to an axial position higher than the highest axial position of either of the right or left sides. Also, the right and left sides each may rise upward from the adjacent transition segments to an axial position above the highest axial position of the posterior portion.
Brief Description of the Drawings
Fig. 1 A is a cross-sectional view along an anterior-posterior plane through the left side of a heart illustrating healthy aortic and mitral valves and annuluses;
Fig. IB is a plan view of a healthy mitral valve and annulus; Fig. 2A is a cross-sectional view along an anterior-posterior plane through the left side of a heart illustrating a condition in the mitral valve that leads to mitral regurgitation (MR);
Fig. 2B is a plan view of the mitral valve of Fig. 2A;
Fig. 3A is a cross-sectional view along an anterior-posterior plane through the left side of a heart illustrating the implantation of a conventional annuloplasty ring to restore the mitral valve to its healthy configuration;
Fig. 3B is a plan view of the restored mitral valve of Fig. 3 A;
Fig. 4A is a cross-sectional view along an anterior-posterior plane tlirough the left side of a heart illustrating the implantation of an annuloplasty ring of the present invention to restore the mitral valve to an over compensated position that will foster LV remodeling;
Fig. 4B is a plan view of the restored mitral valve of Fig. 4A;
Fig. 5 is a perspective view of an inner support for an annuloplasty ring of the present invention;
Figs. 6A-6C are top plan, front elevational, and side elevational views, respectively, of the annuloplasty ring of Figure 5;
Figs. 7A-7B are front and side elevational views, respectively, of an alternative annuloplasty ring of the present invention; Figs. 8A-8C are perspective, front elevational, and side elevational views of a further alternative annuloplasty ring of the present invention;
Figs. 9A-9D are various views of a further exemplary annuloplasty ring of the present invention;
Figs. 10A-10D are various views of a still further exemplary annuloplasty ring of the present invention; and
Figs. 11 A- 11 C are various views of another exemplary annuloplasty ring of the present invention.
DESCRIPTION OF THE PREFERRED EMBODIMENTS. Applicant has determined that congestive heart failure (CHF) and secondary mitral regurgitation (MR) can be addressed with a new generation mitral annuloplasty ring. The ring when implanted not only modifies the circumference of the mitral annulus as do existing annuloplasty rings, but it also elevates and/or reconfigures the posterior portion of the mitral annulus so as to mold and re-shape the geometry of the left ventricle.
The attached figures illustrate several exemplary embodiments of the annuloplasty ring of the present invention, which can be described as being continuous and having an anterior side, a posterior side and right and left sides. All of the sides are generally curvilinear with no specific demarcations to indicate abrupt transitions therebetween. Rather, smooth transitional sections between the adjacent sides provide curvilinear connections that give the ring a generally rounded (i.e., oval) configuration. With reference to Figs. 4A and 4B, a first exemplary mitral annuloplasty ring 50 of the present invention is shown implanted in the mitral annulus 20. As seen in Figure 4A, the posterior aspect 28 of the mitral annulus rises axially upward by a distance z from the datum plane 32 of the annulus when healthy. In addition, as seen in Figure 4B, the anterior-posterior dimension 38 of the mitral annulus has been reduced by the annuloplasty ring 50. These two corrections to the mitral annulus are accomplished by a specially shaped posterior portion 52 of the annuloplasty ring 50, and because the ring is made relatively rigid. Because of the elevation of the posterior aspect 28 of the mitral annulus, the left ventricular wall 36 is molded and re-shaped, which helps mitigate some of the effects of CHF. The degree to which a mid-section of the posterior portion 52 rises depends on multiple variables including specific patient pathology and the overall ring size, but it is projected that for applications in most adult sized hearts the preferable rise will be about 3-5 millimeters. Unlike prior annuloplasty rings, this configuration is not intended to follow the natural curvature of the mitral annulus. Rather, when the annuloplasty ring 50 is implanted in a mitral annulus, the "over-correcting" upward curvature of the ring 50 imparts a unique shape to the annulus that has the effect of molding and reshaping both the mitral annulus and the left ventricle. It is believed that this molding and reshaping of the geometry of the left ventricle will reduce the severity of CHF which in turn will reduce strain on the mitral valve and corresponding MR (and vice versa). In other words, this ring provides an annular solution to address ventricular pathology.
The exemplary annuloplasty ring 50 of Figs. 4 A and 4B is shown in more detail in Figs. 5-6C. For purpose of orientation, Fig. 5 illustrates orthogonal axes wherein the Z-axis lies along of the axis of blood flow through the ring when implanted, and the X- and Y-axes generally define the datum plane 32 as mentioned above. It will further be understood that the positive Z direction illustrated in Figure 5 is the "upward" direction, the negative Z direction is the "downward" direction, and the ring is designed to be implanted in a mitral annulus such that blood will flow in the downward direction.
As seen in Fig. 6A, the X-axis extends across the ring in the anterior- posterior direction illustrating a minor axis dimension 54. The X-axis typically lies in a plane of symmetry of the ring 50 such that the left side and right side are identical. The Y-axis extends across the long dimension of the ring 50 such that a major axis dimension 56 is defined. As with many conventional rings, the ratio of the minor axis dimension 54 to the major axis dimension 56 is about 3:4. Although not geometrically precise, such a ring configuration may be considered oval or elliptical.
As seen in Fig. 6 A, the annuloplasty ring 50 includes the specially shaped posterior portion 52, an anterior portion 60, and a pair of generally symmetric side portions 62a, 62b. As can be seen from the perspective of Fig. 5, two relatively sharply curved transition segments 64a, 64b join either side of the posterior portion 52 to the side portions 62a, 62b.
With reference also to Figs. 6B and 6C, the relative elevations in the Z-axis of the various portions of the ring 50 are shown in Fig. 5. Fig. 6B shows that the transition segments 64a, 64b are located at the lowest points about the ring 50 when in its "horizontal" orientation over an X-Y reference plane 70. A mid-section of the shaped posterior portion 52 arcs upward between the transition segments 64a, 64b and has its highest point on the X-Z plane. Likewise, the two side portions 62a, 62b arc gently upward from the respective transition segments 64a, 64b and then gradually curve downward into a blended transition with the anterior portion 60. As seen in the background of Fig. 6B, the anterior portion 60 exhibits a slight upward bow centered along the X-Z plane, and preferably rises to the same height as the shaped posterior portion 52. The overall contour of ring 50 around its periphery is undulating or serpentine. If a three-dimensional surface were drawn across the open middle of the ring to conform as much as possible to the periphery of the ring 50, that surface would be somewhat saddle-shaped with upward bows along the Y-Z and X-Z planes. (To further illustrate the overall shape of the ring 50, it somewhat resembles a molded potato chip sold under the Pringles brand.) The extent of upward curvature for the ride and left side portions 62a, 62b may reach as high, or higher, than that of the posterior portion 52, but do not necessarily need to extend this high. This too will depend on multiple factors including patient pathology. The difference in elevation between the shaped posterior portion 52 and the adjacent transition segments 64a, 64b is shown at ZA in Fig. 6B. The subscript "A" refers to the point A around the ring 50 periphery as indicated in Fig. 6A. The midpoint of the anterior portion 60 is denoted at B, while the points along the side portions 62a, 62b that lie on the Y-Z plane are denoted at C. The lowest points in the transition segments 64a, 64b are denoted at D, while lowest points along the anterior portion 60 are denoted at E. The elevational at each of these points is represented as ZA, ZB, Z , ZQ, and zE. It should be noted also that the elevations are as measured to the bottom of the ring 50, although the thickness of the ring means that the overall height is somewhat greater. When viewed with reference to the plane 70, zD is at zero. In this embodiment, ZA = zB = z , but, as will be described below, ZA may be substantially greater than either zB or Zc, and ZB is desirably larger than zc.
Figures 5-6C also illustrate a second aspect of the present invention, namely that a mid-section of the posterior portion 52 extends inward to a radial position that is closer to the central axis than if the right and left side portions 62a, 62b projected smoothly toward one another. This too results in a reshaping effect on the mitral annulus, which in turn reshapes the left ventricle geometry. 5 With reference again to Fig. 6 A, a phantom projection or extension 72 of the two side portions 62a, 62b is indicated. This arcuate imaginary extension 72 has been drawn to illustrate the inward bow of the shaped posterior portion 52. That is, the posterior portion 52 diverges inward from this imaginary ring projection, which represents conventional oval-shaped rings of the prior art. o Specifically, the posterior portion 52 bows inward at point A a distance indicated as A. AS with the axial correction noted above, the degree to which the posterior portion 52 extends inward will depend on multiple variables, but it is preferable that the im eπnost position of the posterior side be about 30-50% closer to the central axis than the arcuate imaginary extension 72. Of course, the distance A 5 varies depending on the overall size of the ring 50.
With reference again to Figs. 4A and 4B, the effect of the inward and upward posterior portion 52 of the ring 50 as implanted can be seen. In Fig. 4A, the posterior portion 52 causes the posterior portion 28 of the mitral annulus 20 to elevate above the datum plane 32 the distance z. This shift in the mitral annulus 28 0 places the left ventricular wall 36 in greater tension than nonnal and helps re-shape and recondition that wall to help rectify the detrimental effects of CHF. Furthermore, not only does the ring 50 elevate the posterior portion 28 of the mitral annulus 20, but it also pulls that side of the annulus radially inward, as indicated in Fig. 4B. The anterior-posterior dimension 38" is shown reduced from its normal 5 dimension (the normal dimension is essentially represented in Fig. 3B as 38').
Figs. 7A and 7B show front and side elevational views of an alternative annuloplasty ring 100 of the present invention that shares some of features of the annuloplasty ring 50 described above. For example, the overall contour of ring 100 bows upward along the Y-Z plane as indicated in Fig. 7B, and a mid-section of a posterior portion 102 is both upwardly (see Fig. 7 A) and inwardly (see Fig. 7B) displaced from an imaginary continuation of the side portions of the ring. As seen best from the front in Fig. 7A, the ring 100 does not have a serpentine configuration as with the earlier-described ring 50, instead the profile from the front lies generally in a single arc with the posterior portion 102 elevated relatively suddenly therefrom.
Fig. 7B shows that the middle segment 104 of the anterior side of the ring also bows inwardly from the adjacent sides to a radial position along the X-axis that is closer to the central axis than an imaginary anterior projection in plan view of the adjacent sides toward each other. The inward curve of the anterior segment 104 further reduces the dimension of the repaired annulus in the anterior-posterior plane, and contributes to pulling the posterior aspect of the annulus inward and at the same time conditioning the left ventricular wall.
Figs. 8A-8C illustrate a generally planar annuloplasty ring 110 of the present invention having an anterior portion 112, an opposing posterior portion 114, and left and right sides 116a, 116b. A mid-section of a posterior portion 114 is substantially the same as the posterior portion 102 in Figs. 7A and 7B such that it bows inward and upward. As in the earlier version, the anterior portion 112 bows inwardly, although the entire periphery of the ring 110 except for the posterior portion 114 lies in a plane.
Figs. 9A-9D illustrate an alternative annuloplasty ring 130 of the present invention that, as viewed in plan view in Fig. 9B, is symmetric both about the X-Z plane and the Y-Z plane. The ring 130 is not symmetric in elevation, as seen in Figs. 9C and 9D, wherein a mid-section of a posterior portion 132 rises upward and curves inward. As with the embodiment of Figs. 8 A-8C, the entire ring 130 lies in a plane except for the posterior portion 132. Again, the particular configuration of the posterior portion 132 helps re-shape the mitral annulus and recondition the left ventricular wall. Moreover, an anterior portion 132 also bows inward to help reduce the size of the mitral annulus in the anterior-posterior direction. As explained above, the term "bows inward" refers to the diversion of the particular portion from an imaginary curve that would continue the oval peripheral plan view of the ring.
Figs. 10A-10D show another ring 150 the present invention that is nearly identical to the ring shown in Figs. 9A-9D, except for a posterior portion 152. As seen best in Figs. IOC and 10D, a mid-section of the posterior portion 152 rises at sharp transitions 154 from the rest of the ring 150 which is planar. Rather than a gentle upward and inward curvature, a short upward segment 156 connects a middle, inwardly curved segment 158 to each of the transitions 154. This embodiment of the ring 150 thus illustrates that specially shaped portions around the periphery do not necessarily have to join with the remainder of the ring in gentle blended curves.
Figs. 11A-11C are plan, front elevational, and side elevational views, respectively, of a still further annuloplasty ring 170 that is generally oval-shaped about a major axis 172 and a minor axis 174. The points A, B, C, D and E are located in the same places as described above with respect to Fig. 6A-6C. A mid- section 176 of a posterior portion of the ring 170 bows upward and inward. The elevation ZA above a datum plane 178 is seen in Fig. 1 IB, while the magnitude of inward bow A is seen in Fig. 11 A. The sides 180a, 180b also bow upward a distance zc as indicated in Fig. 11 B . Finally, an anterior portion 182 bows upward a distance ZB and inward a distance Xβ. In this embodiment, ZA ≠ ZB ≠ Zc- The mid- section 176 forms a plateau 184 in the Z-direction centered about the minor axis 174 and having a dimension y as seen in Fig. 1 IB. The dimension y is desirably about 2 mm. This plateau 184 helps prevent ldnking of a tubular fabric or other suture-permeable covering over the posterior portion because of the greater upward and inward bow in comparison to other rings described herein.
Exemplary dimensions for a 28 mm ring 170 include the following relations: 0 < zB < ZA, and preferably,
0.10 Z < zB 0.20 zA, and more preferably, zB = about 0.14 zA.
Furthermore: zc > zB, and,
0 < zc < ZA, and preferably,
0.20 zA < zc < 0.40 ZA, and more preferably, zc = about 0.28 zA.
Finally,
3 mm < ZA < 8 mm, and preferably, ZA = about 7 mm.
These relations and exemplary dimensions may be suitable for all sizes of rings, or may be scaled up or down proportionally.
The inward bow A is desirably about 40% of the distance along the minor axis from point B to point I regardless of the ring size. Point I is the location of the mid-point of an imaginary posterior projection in plan view of the sides 180a, 180b toward each other. The anterior inward bow B is desirably about 1 mm.
The ideal degree to which the posterior and/or anterior sides are molded inward and upward according this invention depend on multiple factors. Preferably however, these features will be exaggerated to an extent that the mifral annulus is "over-corrected." In other words, a important factor of this invention is that the mitral annulus not be just repaired to its natural, pre-diseased state, but that the annulus actually be reduced past that point to an extent that will significantly affect the geometry of the left ventricle. Initial studies suggest that the inward and/or upward corrections for the posterior side be about 30-50% beyond that which would bring the annulus to its pre-diseased state.
The annuloplasty rings herein are desirably made of a single inner member as illustrated, covered with a suture-permeable outer layer. As opposed to flexible amiuloplasty rings that are designed simply to reduce the circumference of the mitral annulus, the annuloplasty ring of the present invention must be quite stiff. It must substantially retain its shape in opposition to the stresses that will be imparted by muscles of the heart through out each beating cycle. Accordingly, this ring must be made from a material having a relatively high modulus of elasticity. For example, the inner member as shown may be machined or molded of Stellite, polished, and then covered with a polyterapthalate fabric. Alternatively, an intermediate silicone sleeve around the inner member may be used. Stellite provides a desired rigidity to best facilitate reshaping of the annulus and left ventricle, although more commonly used materials such as titanium, Elgiloy, graphite, ceramic, hardened plastics, or Nitinol® may be substituted.
The ring also preferably includes an outer sewing sheath that permits it to be sutured into the mitral annulus. The sewing sheath should be sufficiently porous and/or flexible to permit sutures to be passed therethrough, but it must not be so flexible as to counteract the stiffness requirements discussed above. Because the ring will be under such loads, it will also be necessary to insert more sutures in the sewing sheath than for more flexible rings (to reduce the loads on individual sutures). For example, if traditional rings require in the neighborhood of 8 to 10 stitches around the circumference, the present annuloplasty ring might require as many as 20-30 or more. It will be understood by those of skill in the art that the embodiments described above can be incorporated individually or in combination. While each aspect will have the desired effect of and reshaping the mitral annulus and left ventricle, it is the re-shaping of the posterior side that will have the greatest effect of molding and re-shaping the left ventricle. The aspect of extending the anterior side radially inward will preferably not be used unless the posterior side has also been configured as described herein.
It will also be readily apparent that re-shaping the mitral valve annulus with the present annuloplasty ring will cause the mitral leaflets to coapt in a new location. However, those of skill in the art will recognize that this slight realignment of the leaflets is acceptable, and often even preferable.
It will be appreciated by those of skill in the relevant art that various modifications or changes may be made to the examples and embodiments of the invention described in this provisional application, without departing from the intended spirit and scope of the invention, hi this regard, the particular embodiments of the invention described herein are to be understood as examples of the broader inventive concept disclosed in this application.

Claims

WHAT IS CLAIMED IS:
1. An amiuloplasty ring for implantation in a mitral valve annulus, said amiuloplasty ring comprising: a generally oval-shaped ring body having an anterior portion, a posterior portion opposite the anterior portion, right and left sides between the anterior and posterior portions, and transition segments between the sides and the posterior portion; wherein the ring body is oriented about a central axis having an upward direction and a downward direction, the downward direction corresponding to the direction of blood flow tlirough the mitral valve annulus, the ring having in plan view perpendicular to the central axis a longer dimension along a major axis than a shorter dimension along a minor axis; and, wherein a mid-section of the posterior portion rises upward from the adjacent transition segments to an axial position higher than the highest axial position of the anterior portion.
2. The annuloplasty ring of claim 1, wherein the posterior portion extends radially inward from the adjacent transition segments to a radial position along the minor axis that is closer to the central axis than an imaginary posterior projection in plan view of the sides toward each other.
3. The annuloplasty ring of claim 2, wherein the posterior portion extends radially inward from the adjacent transition segments to a radial position that is about 30-50% closer to the central axis than the imaginary posterior projection in plan view of the sides toward each other.
4. The annuloplasty ring of claim 1 , wherein the ring is substantially saddle-shaped with the sides curving upward between the anterior portion and adjacent fransition segments.
5. The annuloplasty ring of claim 4, wherein the right and left sides each rise upward from the adjacent fransition segments to an axial position above the highest axial position of the anterior portion.
6. The annuloplasty ring of claim 4, wherein the posterior portion rises upward from the adjacent transition segments to an axial position above the highest axial positions of either of the right or left sides.
7. The annuloplasty ring of claim 4, wherein the right and left sides each rise upward from the adjacent transition segments to an axial position above the highest axial positions of the posterior portion.
8. The annuloplasty ring of claim 1, wherein the ring is generally planar except for the posterior portion.
9. The annuloplasty ring of claim 1 wherein the sides and transition segments are generally curvilinear and the junctures between adjacent sides and transition segments are generally rounded.
10. The annuloplasty ring of claim 1, wherein the posterior portion extends radially inward from the adjacent sides to a radial position along the minor axis that is closer to the central axis than an imaginary posterior projection in plan view of the sides toward each other.
11. The annuloplasty ring of claim 10, wherein the posterior portion extends radially inward from the adjacent sides to a radial position along the minor axis that is about 30-50%o closer to the central axis than the imaginary posterior projection in plan view of the sides toward each other.
12. The annuloplasty ring of claim 1, wherein the ring body is comprised of a material having a high modulus of elasticity that will substantially resist distortion when subjected to the sfress imparted thereon when the ring is implanted in the mitral valve annulus of an operating human heart.
13. The annuloplasty ring of claim 12, wherein the ring is comprised of a ceramic material.
14. The annuloplasty ring of claim 13 , wherein the ring is comprised of Stellite.
15. The amiuloplasty ring of claim 1 further comprising a outer sewing sheath surrounding the ring body, the sewing sheath being formed of a material that will permit the passage of sutures therethrough.
16. A mitral annuloplasty ring, comprising: a ring body made of a material having a high modulus of elasticity that will substantially resist distortion when subjected to the stress imparted thereon when the ring is implanted in the mitral valve annulus of an operating human heart, wherein the ring body is oriented about a central axis having an upward direction and a downward direction, the downward direction corresponding to the direction of blood flow through the mitral valve annulus, the ring body having a posterior bow that extends both radially inward and axially upward.
17. The mitral amiuloplasty ring of claim 16 , wherein the ring body has an anterior portion, a posterior portion opposite the anterior portion, right and left sides between the anterior and posterior portions, and transition segments between the sides and the posterior portion, and wherein the ring body is substantially saddle-shaped with the sides curving upward between the anterior portion and adjacent transition segments.
18. The mifral amiuloplasty ring of claim 17, wherein a mid-section of the posterior portion bows upward from the adjacent transition segments to an axial position higher than the highest axial position of either of the right or left sides.
19. The mifral annuloplasty ring of claim 17, wherein the right and left sides each rise upward from the adjacent fransition segments to an axial position above the highest axial position of the posterior portion.
20. The mifral annuloplasty ring of claim 16, wherein the ring body is generally planar except for the posterior bowed portion.
21. The mifral annuloplasty ring of claim 16, wherein the ring body has an anterior portion, a posterior portion opposite the anterior portion, right and left sides between the anterior and posterior portions, and transition segments between the sides and the posterior portion, and wherein the posterior portion extends radially inward from the adjacent transition segments to a radial position along the minor axis that is closer to the central axis than an imaginary posterior projection in plan view of the sides toward each other.
22. The mitral annuloplasty ring of claim 21, wherein the posterior portion extends radially inward from the adjacent fransition segments to a radial position that is about 30-50% closer to the central axis than the imaginary posterior projection in plan view of the sides toward each other.
23. The mifral amiuloplasty ring of claim 16, wherein the ring body has an anterior portion, a posterior portion opposite the anterior portion, right and left sides between the anterior and posterior portions, and transition segments between the sides and the posterior portion, and wherein the posterior portion extends radially inward from the adjacent sides to a radial position along the minor axis that is closer to the central axis than an imaginary posterior projection in plan view of the sides toward each other.
24. The mitral annuloplasty ring of claim 23, wherein the posterior portion extends radially inward from the adjacent sides to a radial position along the minor axis that is about 30-50% closer to the central axis than the imaginary posterior projection in plan view of the sides toward each other.
25. The mitral annuloplasty ring of claim 16, wherein the ring body is comprised of a ceramic material.
26. The mifral annuloplasty ring of claim 25, wherein the ring body is comprised of Stellite.
PCT/US2002/036242 2001-11-13 2002-11-12 Mitral valve annuloplasty ring for molding left ventricle geometry WO2003041617A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
CA2467766A CA2467766C (en) 2001-11-13 2002-11-12 Mitral valve annuloplasty ring for molding left ventricle geometry
AU2002340469A AU2002340469B2 (en) 2001-11-13 2002-11-12 Mitral valve annuloplasty ring for molding left ventricle geometry
AT02778834T ATE539704T1 (en) 2001-11-13 2002-11-12 ANNULOPLASTING RING FOR MITRAL VALVE FOR SHAPING THE LEFT CHAMBER OF THE HEART GEOMETRY
JP2003543504A JP4235554B2 (en) 2001-11-13 2002-11-12 Annuloplasty ring of mitral valve for shaping left ventricular structure
EP02778834A EP1443877B1 (en) 2001-11-13 2002-11-12 Mitral valve annuloplasty ring for molding left ventricle geometry

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US33235301P 2001-11-13 2001-11-13
US60/332,353 2001-11-13
US10/267,272 2002-10-09
US10/267,272 US6805710B2 (en) 2001-11-13 2002-10-09 Mitral valve annuloplasty ring for molding left ventricle geometry

Publications (1)

Publication Number Publication Date
WO2003041617A1 true WO2003041617A1 (en) 2003-05-22

Family

ID=26952339

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2002/036242 WO2003041617A1 (en) 2001-11-13 2002-11-12 Mitral valve annuloplasty ring for molding left ventricle geometry

Country Status (7)

Country Link
US (3) US6805710B2 (en)
EP (1) EP1443877B1 (en)
JP (1) JP4235554B2 (en)
AT (1) ATE539704T1 (en)
AU (1) AU2002340469B2 (en)
CA (1) CA2467766C (en)
WO (1) WO2003041617A1 (en)

Cited By (22)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2007507309A (en) * 2003-10-03 2007-03-29 エドワーズ ライフサイエンシーズ コーポレイション Annuloplasty ring for repair of abnormal mitral valve
WO2007050506A1 (en) 2005-10-26 2007-05-03 St. Jude Medical, Inc. Saddle-shaped mitral valve annuloplasty prostheses with asymmetry, and related methods
WO2007089625A1 (en) * 2006-02-02 2007-08-09 Edwards Lifesciences Corporation Annuloplasty ring for mitral valve prolapse
JP2007535371A (en) * 2004-04-29 2007-12-06 エドワーズ ライフサイエンシーズ コーポレイション Annuloplasty ring for mitral valve prolapse
WO2008070232A2 (en) * 2006-09-01 2008-06-12 Edwards Lifesciences Corporation Saddle-shaped annuloplasty ring
WO2009094496A1 (en) * 2008-01-25 2009-07-30 Medtronic, Inc. Set of annuloplasty devices with varying anterior-posterior ratios and related methods
WO2009113748A1 (en) * 2008-03-13 2009-09-17 Sciencity Co., Ltd An apparatus for mitral lifting annuloplaty
US7879087B2 (en) 2006-10-06 2011-02-01 Edwards Lifesciences Corporation Mitral and tricuspid annuloplasty rings
US8114155B2 (en) 2001-08-28 2012-02-14 Edwards Lifesciences Corporation Annuloplasty ring with offset free ends
US8163011B2 (en) 2006-10-06 2012-04-24 BioStable Science & Engineering, Inc. Intra-annular mounting frame for aortic valve repair
US8216304B2 (en) 2005-03-23 2012-07-10 Edwards Lifesciences Corporation Annuloplasty ring and holder combination
US8591576B2 (en) 2006-05-15 2013-11-26 Edwards Lifesciences Ag Method for altering the geometry of the heart
US8764821B2 (en) 2007-02-09 2014-07-01 Edwards Lifesciences Corporation Degenerative vavlular disease specific annuloplasty ring sets
US8915960B2 (en) 2010-08-31 2014-12-23 Edwards Lifesciences Corporation Physiologic tricuspid annuloplasty ring
US8932350B2 (en) 2010-11-30 2015-01-13 Edwards Lifesciences Corporation Reduced dehiscence annuloplasty ring
US9101472B2 (en) 2007-09-07 2015-08-11 Edwards Lifesciences Corporation Active holder for annuloplasty ring delivery
US9125742B2 (en) 2005-12-15 2015-09-08 Georgia Tech Research Foundation Papillary muscle position control devices, systems, and methods
US9149359B2 (en) 2001-08-28 2015-10-06 Edwards Lifesciences Corporation Three-dimensional annuloplasty ring
US9161835B2 (en) 2010-09-30 2015-10-20 BioStable Science & Engineering, Inc. Non-axisymmetric aortic valve devices
US9937041B2 (en) 2008-05-13 2018-04-10 Edwards Lifesciences Corporation Physiologically harmonized tricuspid annuloplasty ring
US10039531B2 (en) 2005-12-15 2018-08-07 Georgia Tech Research Corporation Systems and methods to control the dimension of a heart valve
US10166101B2 (en) 2001-05-17 2019-01-01 Edwards Lifesciences Corporation Methods for repairing mitral valves

Families Citing this family (304)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7883539B2 (en) 1997-01-02 2011-02-08 Edwards Lifesciences Llc Heart wall tension reduction apparatus and method
FR2768324B1 (en) 1997-09-12 1999-12-10 Jacques Seguin SURGICAL INSTRUMENT FOR PERCUTANEOUSLY FIXING TWO AREAS OF SOFT TISSUE, NORMALLY MUTUALLY REMOTE, TO ONE ANOTHER
US6332893B1 (en) 1997-12-17 2001-12-25 Myocor, Inc. Valve to myocardium tension members device and method
US6736845B2 (en) * 1999-01-26 2004-05-18 Edwards Lifesciences Corporation Holder for flexible heart valve
US20040044350A1 (en) * 1999-04-09 2004-03-04 Evalve, Inc. Steerable access sheath and methods of use
ATE484241T1 (en) * 1999-04-09 2010-10-15 Evalve Inc METHOD AND DEVICE FOR HEART VALVE REPAIR
US7811296B2 (en) * 1999-04-09 2010-10-12 Evalve, Inc. Fixation devices for variation in engagement of tissue
US7226467B2 (en) 1999-04-09 2007-06-05 Evalve, Inc. Fixation device delivery catheter, systems and methods of use
US10327743B2 (en) 1999-04-09 2019-06-25 Evalve, Inc. Device and methods for endoscopic annuloplasty
US6752813B2 (en) * 1999-04-09 2004-06-22 Evalve, Inc. Methods and devices for capturing and fixing leaflets in valve repair
US8216256B2 (en) 1999-04-09 2012-07-10 Evalve, Inc. Detachment mechanism for implantable fixation devices
US7510572B2 (en) * 2000-09-12 2009-03-31 Shlomo Gabbay Implantation system for delivery of a heart valve prosthesis
US6723038B1 (en) 2000-10-06 2004-04-20 Myocor, Inc. Methods and devices for improving mitral valve function
US6602286B1 (en) 2000-10-26 2003-08-05 Ernst Peter Strecker Implantable valve system
EP1363559A4 (en) 2001-02-05 2008-10-01 Viacor Inc Apparatus and method for reducing mitral regurgitation
US6656221B2 (en) * 2001-02-05 2003-12-02 Viacor, Inc. Method and apparatus for improving mitral valve function
US6786924B2 (en) * 2001-03-15 2004-09-07 Medtronic, Inc. Annuloplasty band and method
US6955689B2 (en) * 2001-03-15 2005-10-18 Medtronic, Inc. Annuloplasty band and method
US6890353B2 (en) 2001-03-23 2005-05-10 Viacor, Inc. Method and apparatus for reducing mitral regurgitation
US7186264B2 (en) 2001-03-29 2007-03-06 Viacor, Inc. Method and apparatus for improving mitral valve function
ITMI20011012A1 (en) * 2001-05-17 2002-11-17 Ottavio Alfieri ANNULAR PROSTHESIS FOR MITRAL VALVE
US7052487B2 (en) 2001-10-26 2006-05-30 Cohn William E Method and apparatus for reducing mitral regurgitation
US20080154359A1 (en) * 2001-11-01 2008-06-26 Salgo Ivan S Non-planar cardiac vascular support prosthesis
US6824562B2 (en) 2002-05-08 2004-11-30 Cardiac Dimensions, Inc. Body lumen device anchor, device and assembly
US7635387B2 (en) * 2001-11-01 2009-12-22 Cardiac Dimensions, Inc. Adjustable height focal tissue deflector
US6805710B2 (en) * 2001-11-13 2004-10-19 Edwards Lifesciences Corporation Mitral valve annuloplasty ring for molding left ventricle geometry
US6575971B2 (en) * 2001-11-15 2003-06-10 Quantum Cor, Inc. Cardiac valve leaflet stapler device and methods thereof
US6976995B2 (en) 2002-01-30 2005-12-20 Cardiac Dimensions, Inc. Fixed length anchor and pull mitral valve device and method
US6908478B2 (en) * 2001-12-05 2005-06-21 Cardiac Dimensions, Inc. Anchor and pull mitral valve device and method
US7179282B2 (en) 2001-12-05 2007-02-20 Cardiac Dimensions, Inc. Device and method for modifying the shape of a body organ
US6764510B2 (en) 2002-01-09 2004-07-20 Myocor, Inc. Devices and methods for heart valve treatment
US7125420B2 (en) 2002-02-05 2006-10-24 Viacor, Inc. Method and apparatus for improving mitral valve function
US7048754B2 (en) * 2002-03-01 2006-05-23 Evalve, Inc. Suture fasteners and methods of use
US6719786B2 (en) * 2002-03-18 2004-04-13 Medtronic, Inc. Flexible annuloplasty prosthesis and holder
US7118595B2 (en) * 2002-03-18 2006-10-10 Medtronic, Inc. Flexible annuloplasty prosthesis and holder
US7007698B2 (en) 2002-04-03 2006-03-07 Boston Scientific Corporation Body lumen closure
US6752828B2 (en) 2002-04-03 2004-06-22 Scimed Life Systems, Inc. Artificial valve
US7608103B2 (en) * 2002-07-08 2009-10-27 Edwards Lifesciences Corporation Mitral valve annuloplasty ring having a posterior bow
US8758372B2 (en) 2002-08-29 2014-06-24 St. Jude Medical, Cardiology Division, Inc. Implantable devices for controlling the size and shape of an anatomical structure or lumen
US7175660B2 (en) * 2002-08-29 2007-02-13 Mitralsolutions, Inc. Apparatus for implanting surgical devices for controlling the internal circumference of an anatomic orifice or lumen
CA2502967A1 (en) 2002-10-24 2004-05-06 Boston Scientific Limited Venous valve apparatus and method
US7112219B2 (en) 2002-11-12 2006-09-26 Myocor, Inc. Devices and methods for heart valve treatment
US7316708B2 (en) * 2002-12-05 2008-01-08 Cardiac Dimensions, Inc. Medical device delivery system
US6945957B2 (en) 2002-12-30 2005-09-20 Scimed Life Systems, Inc. Valve treatment catheter and methods
DE10301023A1 (en) * 2003-01-13 2004-07-22 Medos Medizintechnik Ag Implant, in particular ring for heart valve, designed in curved and asymmetric shape
US7314485B2 (en) * 2003-02-03 2008-01-01 Cardiac Dimensions, Inc. Mitral valve device using conditioned shape memory alloy
US7510573B2 (en) * 2003-03-25 2009-03-31 Shlomo Gabbay Sizing apparatus
US20040220654A1 (en) 2003-05-02 2004-11-04 Cardiac Dimensions, Inc. Device and method for modifying the shape of a body organ
US10667823B2 (en) 2003-05-19 2020-06-02 Evalve, Inc. Fixation devices, systems and methods for engaging tissue
US8052751B2 (en) * 2003-07-02 2011-11-08 Flexcor, Inc. Annuloplasty rings for repairing cardiac valves
US20050004665A1 (en) * 2003-07-02 2005-01-06 Lishan Aklog Annuloplasty rings and methods for repairing cardiac valves
AU2004258950B2 (en) * 2003-07-23 2010-11-04 Viacor, Inc. Method and apparatus for improving mitral valve function
US8128681B2 (en) 2003-12-19 2012-03-06 Boston Scientific Scimed, Inc. Venous valve apparatus, system, and method
US9526616B2 (en) * 2003-12-19 2016-12-27 Cardiac Dimensions Pty. Ltd. Mitral valve annuloplasty device with twisted anchor
US7854761B2 (en) 2003-12-19 2010-12-21 Boston Scientific Scimed, Inc. Methods for venous valve replacement with a catheter
EP1722711A4 (en) 2004-02-27 2009-12-02 Aortx Inc Prosthetic heart valve delivery systems and methods
US7938856B2 (en) 2004-05-14 2011-05-10 St. Jude Medical, Inc. Heart valve annuloplasty prosthesis sewing cuffs and methods of making same
JP2007537794A (en) * 2004-05-14 2007-12-27 セント ジュード メディカル インコーポレイテッド System and method for holding an annuloplasty ring
US7452376B2 (en) * 2004-05-14 2008-11-18 St. Jude Medical, Inc. Flexible, non-planar annuloplasty rings
US20050256568A1 (en) * 2004-05-14 2005-11-17 St. Jude Medical, Inc. C-shaped heart valve prostheses
CA2566666C (en) 2004-05-14 2014-05-13 Evalve, Inc. Locking mechanisms for fixation devices and methods of engaging tissue
US20050278022A1 (en) * 2004-06-14 2005-12-15 St. Jude Medical, Inc. Annuloplasty prostheses with improved anchoring structures, and related methods
EP1913900A1 (en) * 2004-06-29 2008-04-23 SIEVERS, Hans-Hinrich, Dr. Implant with a ring-shaped base plate
US7758638B2 (en) * 2004-07-13 2010-07-20 Ats Medical, Inc. Implant with an annular base
US8012202B2 (en) 2004-07-27 2011-09-06 Alameddine Abdallah K Mitral valve ring for treatment of mitral valve regurgitation
US7566343B2 (en) 2004-09-02 2009-07-28 Boston Scientific Scimed, Inc. Cardiac valve, system, and method
US8052592B2 (en) 2005-09-27 2011-11-08 Evalve, Inc. Methods and devices for tissue grasping and assessment
JP5124274B2 (en) 2004-09-27 2013-01-23 エヴァルヴ インコーポレイテッド Method and apparatus for grasping and evaluating tissue
BRPI0404380C1 (en) * 2004-10-14 2008-07-15 Malavazi Vedacoes Ind Ltda housed mechanical seal enhancements for progressive cavity pumps
US7575594B2 (en) * 2004-12-30 2009-08-18 Sieracki Jeffrey M Shock dampening biocompatible valve
AU2006206254B2 (en) 2005-01-20 2012-02-09 Cardiac Dimensions Pty. Ltd. Tissue shaping device
DE102005003632A1 (en) 2005-01-20 2006-08-17 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Catheter for the transvascular implantation of heart valve prostheses
US20060173490A1 (en) 2005-02-01 2006-08-03 Boston Scientific Scimed, Inc. Filter system and method
US7854755B2 (en) 2005-02-01 2010-12-21 Boston Scientific Scimed, Inc. Vascular catheter, system, and method
US7878966B2 (en) 2005-02-04 2011-02-01 Boston Scientific Scimed, Inc. Ventricular assist and support device
US7780722B2 (en) 2005-02-07 2010-08-24 Boston Scientific Scimed, Inc. Venous valve apparatus, system, and method
US7670368B2 (en) 2005-02-07 2010-03-02 Boston Scientific Scimed, Inc. Venous valve apparatus, system, and method
EP3967269A3 (en) 2005-02-07 2022-07-13 Evalve, Inc. Systems and devices for cardiac valve repair
US8470028B2 (en) * 2005-02-07 2013-06-25 Evalve, Inc. Methods, systems and devices for cardiac valve repair
US7867274B2 (en) 2005-02-23 2011-01-11 Boston Scientific Scimed, Inc. Valve apparatus, system and method
US20060206203A1 (en) * 2005-03-10 2006-09-14 Jun Yang Valvular support prosthesis
WO2006097931A2 (en) 2005-03-17 2006-09-21 Valtech Cardio, Ltd. Mitral valve treatment techniques
US7575595B2 (en) * 2005-03-23 2009-08-18 Edwards Lifesciences Corporation Annuloplasty ring and holder combination
AU2006230162B2 (en) * 2005-03-25 2011-09-29 St. Jude Medical, Cardiology Division, Inc. Methods and apparatus for controlling the internal circumference of an anatomic orifice or lumen
US8864823B2 (en) * 2005-03-25 2014-10-21 StJude Medical, Cardiology Division, Inc. Methods and apparatus for controlling the internal circumference of an anatomic orifice or lumen
US7722666B2 (en) 2005-04-15 2010-05-25 Boston Scientific Scimed, Inc. Valve apparatus, system and method
US8012198B2 (en) 2005-06-10 2011-09-06 Boston Scientific Scimed, Inc. Venous valve, system, and method
US8236051B2 (en) * 2005-06-27 2012-08-07 The Cleveland Clinic Foundation Apparatus for placement in the annulus of a tricuspid valve
US8685083B2 (en) * 2005-06-27 2014-04-01 Edwards Lifesciences Corporation Apparatus, system, and method for treatment of posterior leaflet prolapse
US20060293698A1 (en) * 2005-06-28 2006-12-28 Medtronic Vascular, Inc. Retainer device for mitral valve leaflets
US8951285B2 (en) 2005-07-05 2015-02-10 Mitralign, Inc. Tissue anchor, anchoring system and methods of using the same
US7776084B2 (en) * 2005-07-13 2010-08-17 Edwards Lifesciences Corporation Prosthetic mitral heart valve having a contoured sewing ring
US7569071B2 (en) 2005-09-21 2009-08-04 Boston Scientific Scimed, Inc. Venous valve, system, and method with sinus pocket
US8764820B2 (en) 2005-11-16 2014-07-01 Edwards Lifesciences Corporation Transapical heart valve delivery system and method
EP1959867A2 (en) 2005-12-15 2008-08-27 Georgia Technology Research Corporation Systems and methods for enabling heart valve replacement
US20070213813A1 (en) 2005-12-22 2007-09-13 Symetis Sa Stent-valves for valve replacement and associated methods and systems for surgery
US7799038B2 (en) 2006-01-20 2010-09-21 Boston Scientific Scimed, Inc. Translumenal apparatus, system, and method
US7749266B2 (en) 2006-02-27 2010-07-06 Aortx, Inc. Methods and devices for delivery of prosthetic heart valves and other prosthetics
US8147541B2 (en) 2006-02-27 2012-04-03 Aortx, Inc. Methods and devices for delivery of prosthetic heart valves and other prosthetics
US8454683B2 (en) * 2006-04-12 2013-06-04 Medtronic Vascular, Inc. Annuloplasty device having a helical anchor and methods for its use
US7699892B2 (en) 2006-04-12 2010-04-20 Medtronic Vascular, Inc. Minimally invasive procedure for implanting an annuloplasty device
US8585594B2 (en) 2006-05-24 2013-11-19 Phoenix Biomedical, Inc. Methods of assessing inner surfaces of body lumens or organs
WO2007143049A1 (en) 2006-06-02 2007-12-13 Medtronic, Inc. Annuloplasty prosthesis with in vivo shape identification and related methods of use
WO2007143077A2 (en) 2006-06-02 2007-12-13 Medtronic, Inc. Annuloplasty ring and method
CA2657442A1 (en) 2006-06-20 2007-12-27 Aortx, Inc. Prosthetic heart valves, support structures and systems and methods for implanting the same
CN101506538A (en) 2006-06-20 2009-08-12 奥尔特克斯公司 Torque shaft and torque drive
CA2657446A1 (en) 2006-06-21 2007-12-27 Aortx, Inc. Prosthetic valve implantation systems
US11285005B2 (en) 2006-07-17 2022-03-29 Cardiac Dimensions Pty. Ltd. Mitral valve annuloplasty device with twisted anchor
US11259924B2 (en) 2006-12-05 2022-03-01 Valtech Cardio Ltd. Implantation of repair devices in the heart
JP2010511469A (en) 2006-12-05 2010-04-15 バルテック カーディオ,リミティド Segmented ring placement
US9974653B2 (en) 2006-12-05 2018-05-22 Valtech Cardio, Ltd. Implantation of repair devices in the heart
EP2111189B1 (en) * 2007-01-03 2017-04-05 St. Jude Medical, Cardiology Division, Inc. Implantable devices for controlling the size and shape of an anatomical structure or lumen
WO2008091493A1 (en) 2007-01-08 2008-07-31 California Institute Of Technology In-situ formation of a valve
US20100249920A1 (en) * 2007-01-08 2010-09-30 Millipede Llc Reconfiguring heart features
US20100121433A1 (en) * 2007-01-08 2010-05-13 Millipede Llc, A Corporation Of Michigan Reconfiguring heart features
US9192471B2 (en) 2007-01-08 2015-11-24 Millipede, Inc. Device for translumenal reshaping of a mitral valve annulus
EP3488822B1 (en) * 2007-01-26 2020-10-21 Medtronic, Inc. Annuloplasty device for tricuspid valve repair
US9381084B2 (en) 2007-01-26 2016-07-05 Medtronic, Inc. Annuloplasty device for tricuspid valve repair
WO2008097589A1 (en) 2007-02-05 2008-08-14 Boston Scientific Limited Percutaneous valve, system, and method
US9427215B2 (en) 2007-02-05 2016-08-30 St. Jude Medical, Cardiology Division, Inc. Minimally invasive system for delivering and securing an annular implant
US11660190B2 (en) 2007-03-13 2023-05-30 Edwards Lifesciences Corporation Tissue anchors, systems and methods, and devices
US7896915B2 (en) 2007-04-13 2011-03-01 Jenavalve Technology, Inc. Medical device for treating a heart valve insufficiency
US8529620B2 (en) * 2007-05-01 2013-09-10 Ottavio Alfieri Inwardly-bowed tricuspid annuloplasty ring
US7931685B2 (en) * 2007-05-22 2011-04-26 Drake Daniel H Method and system for treatment of regurgitating heart valves
WO2009009371A2 (en) * 2007-07-06 2009-01-15 The General Hospital Corporation System and method for intraventricular treatment
US8828079B2 (en) 2007-07-26 2014-09-09 Boston Scientific Scimed, Inc. Circulatory valve, system and method
US8216303B2 (en) * 2007-11-19 2012-07-10 The Cleveland Clinic Foundation Apparatus and method for treating a regurgitant heart valve
US7892276B2 (en) 2007-12-21 2011-02-22 Boston Scientific Scimed, Inc. Valve with delayed leaflet deployment
US9044318B2 (en) 2008-02-26 2015-06-02 Jenavalve Technology Gmbh Stent for the positioning and anchoring of a valvular prosthesis
BR112012021347A2 (en) 2008-02-26 2019-09-24 Jenavalve Tecnology Inc stent for positioning and anchoring a valve prosthesis at an implantation site in a patient's heart
US8382829B1 (en) 2008-03-10 2013-02-26 Mitralign, Inc. Method to reduce mitral regurgitation by cinching the commissure of the mitral valve
US20100131057A1 (en) 2008-04-16 2010-05-27 Cardiovascular Technologies, Llc Transvalvular intraannular band for aortic valve repair
US11013599B2 (en) 2008-04-16 2021-05-25 Heart Repair Technologies, Inc. Percutaneous transvalvular intraannular band for mitral valve repair
US20100121435A1 (en) 2008-04-16 2010-05-13 Cardiovascular Technologies, Llc Percutaneous transvalvular intrannular band for mitral valve repair
US20100121437A1 (en) 2008-04-16 2010-05-13 Cardiovascular Technologies, Llc Transvalvular intraannular band and chordae cutting for ischemic and dilated cardiomyopathy
US10456259B2 (en) 2008-04-16 2019-10-29 Heart Repair Technologies, Inc. Transvalvular intraannular band for mitral valve repair
US11083579B2 (en) 2008-04-16 2021-08-10 Heart Repair Technologies, Inc. Transvalvular intraanular band and chordae cutting for ischemic and dilated cardiomyopathy
US8262725B2 (en) * 2008-04-16 2012-09-11 Cardiovascular Technologies, Llc Transvalvular intraannular band for valve repair
US7972370B2 (en) * 2008-04-24 2011-07-05 Medtronic Vascular, Inc. Stent graft system and method of use
US8152844B2 (en) 2008-05-09 2012-04-10 Edwards Lifesciences Corporation Quick-release annuloplasty ring holder
EP2296744B1 (en) 2008-06-16 2019-07-31 Valtech Cardio, Ltd. Annuloplasty devices
US9314335B2 (en) * 2008-09-19 2016-04-19 Edwards Lifesciences Corporation Prosthetic heart valve configured to receive a percutaneous prosthetic heart valve implantation
US8287591B2 (en) * 2008-09-19 2012-10-16 Edwards Lifesciences Corporation Transformable annuloplasty ring configured to receive a percutaneous prosthetic heart valve implantation
US20100152844A1 (en) * 2008-12-15 2010-06-17 Couetil Jean-Paul A Annuloplasty ring with directional flexibilities and rigidities to assist the mitral annulus dynamics
US10517719B2 (en) 2008-12-22 2019-12-31 Valtech Cardio, Ltd. Implantation of repair devices in the heart
US8715342B2 (en) 2009-05-07 2014-05-06 Valtech Cardio, Ltd. Annuloplasty ring with intra-ring anchoring
US8926697B2 (en) 2011-06-23 2015-01-06 Valtech Cardio, Ltd. Closed band for percutaneous annuloplasty
US9011530B2 (en) 2008-12-22 2015-04-21 Valtech Cardio, Ltd. Partially-adjustable annuloplasty structure
CN102341063B (en) 2008-12-22 2015-11-25 瓦尔泰克卡迪欧有限公司 Adjustable annuloplasty device and governor motion thereof
US8147542B2 (en) 2008-12-22 2012-04-03 Valtech Cardio, Ltd. Adjustable repair chords and spool mechanism therefor
US8241351B2 (en) 2008-12-22 2012-08-14 Valtech Cardio, Ltd. Adjustable partial annuloplasty ring and mechanism therefor
US8808368B2 (en) 2008-12-22 2014-08-19 Valtech Cardio, Ltd. Implantation of repair chords in the heart
US8545553B2 (en) 2009-05-04 2013-10-01 Valtech Cardio, Ltd. Over-wire rotation tool
US8940044B2 (en) 2011-06-23 2015-01-27 Valtech Cardio, Ltd. Closure element for use with an annuloplasty structure
EP2389121B1 (en) * 2009-01-22 2020-10-07 St. Jude Medical, Cardiology Division, Inc. Post-operative adjustment tool, minimally invasive attachment apparatus, and adjustable tricuspid ring
EP2381896B1 (en) * 2009-01-22 2015-10-21 St. Jude Medical, Cardiology Division, Inc. Magnetic docking system for the long term adjustment of an implantable device
US8353956B2 (en) 2009-02-17 2013-01-15 Valtech Cardio, Ltd. Actively-engageable movement-restriction mechanism for use with an annuloplasty structure
US9968452B2 (en) 2009-05-04 2018-05-15 Valtech Cardio, Ltd. Annuloplasty ring delivery cathethers
US8523881B2 (en) 2010-07-26 2013-09-03 Valtech Cardio, Ltd. Multiple anchor delivery tool
US8439970B2 (en) * 2009-07-14 2013-05-14 Edwards Lifesciences Corporation Transapical delivery system for heart valves
EP2477555B1 (en) 2009-09-15 2013-12-25 Evalve, Inc. Device for cardiac valve repair
US8277502B2 (en) 2009-10-29 2012-10-02 Valtech Cardio, Ltd. Tissue anchor for annuloplasty device
US8940042B2 (en) 2009-10-29 2015-01-27 Valtech Cardio, Ltd. Apparatus for guide-wire based advancement of a rotation assembly
US9011520B2 (en) 2009-10-29 2015-04-21 Valtech Cardio, Ltd. Tissue anchor for annuloplasty device
US10098737B2 (en) 2009-10-29 2018-10-16 Valtech Cardio, Ltd. Tissue anchor for annuloplasty device
US9180007B2 (en) 2009-10-29 2015-11-10 Valtech Cardio, Ltd. Apparatus and method for guide-wire based advancement of an adjustable implant
US8734467B2 (en) 2009-12-02 2014-05-27 Valtech Cardio, Ltd. Delivery tool for implantation of spool assembly coupled to a helical anchor
US8870950B2 (en) 2009-12-08 2014-10-28 Mitral Tech Ltd. Rotation-based anchoring of an implant
US20110160849A1 (en) * 2009-12-22 2011-06-30 Edwards Lifesciences Corporation Bimodal tricuspid annuloplasty ring
US8449608B2 (en) * 2010-01-22 2013-05-28 Edwards Lifesciences Corporation Tricuspid ring
US9107749B2 (en) 2010-02-03 2015-08-18 Edwards Lifesciences Corporation Methods for treating a heart
US8579964B2 (en) 2010-05-05 2013-11-12 Neovasc Inc. Transcatheter mitral valve prosthesis
US8790394B2 (en) 2010-05-24 2014-07-29 Valtech Cardio, Ltd. Adjustable artificial chordeae tendineae with suture loops
CN103002833B (en) 2010-05-25 2016-05-11 耶拿阀门科技公司 Artificial heart valve and comprise artificial heart valve and support through conduit carry interior prosthese
WO2011149274A2 (en) 2010-05-26 2011-12-01 고려대학교 산학협력단 Magnetic tunnel junction device having amorphous buffer layers that are magnetically connected together and that have perpendicular magnetic anisotropy
US11653910B2 (en) 2010-07-21 2023-05-23 Cardiovalve Ltd. Helical anchor implantation
CN103153231A (en) * 2010-08-02 2013-06-12 鲁杰罗·德保利斯 Annuloplasty band for a simplified approach to mitral valvuloplasty for degenerative diseases
BR112013004115B1 (en) 2010-08-24 2021-01-05 Edwards Lifesciences Corporation annuloplasty ring
US20120053680A1 (en) 2010-08-24 2012-03-01 Bolling Steven F Reconfiguring Heart Features
JP6006218B2 (en) * 2010-09-30 2016-10-12 バイオステイブル サイエンス アンド エンジニアリング インコーポレイテッド Aortic valve device
EP2621407B1 (en) * 2010-09-30 2018-01-17 Biostable Science & Engineering, Inc. Intra-annular mounting frame for aortic valve repair
US9198756B2 (en) 2010-11-18 2015-12-01 Pavilion Medical Innovations, Llc Tissue restraining devices and methods of use
WO2012068541A2 (en) 2010-11-18 2012-05-24 Pavilion Medical Innovations Tissue restraining devices and methods of use
WO2012094406A1 (en) 2011-01-04 2012-07-12 The Cleveland Clinic Foundation Apparatus and method for treating a regurgitant heart valve
US8845717B2 (en) 2011-01-28 2014-09-30 Middle Park Medical, Inc. Coaptation enhancement implant, system, and method
US8888843B2 (en) 2011-01-28 2014-11-18 Middle Peak Medical, Inc. Device, system, and method for transcatheter treatment of valve regurgitation
US9381082B2 (en) 2011-04-22 2016-07-05 Edwards Lifesciences Corporation Devices, systems and methods for accurate positioning of a prosthetic valve
US9554897B2 (en) 2011-04-28 2017-01-31 Neovasc Tiara Inc. Methods and apparatus for engaging a valve prosthesis with tissue
US9308087B2 (en) 2011-04-28 2016-04-12 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
EP2520250B1 (en) * 2011-05-04 2014-02-19 Medtentia International Ltd Oy Medical device for a cardiac valve implant
US10792152B2 (en) 2011-06-23 2020-10-06 Valtech Cardio, Ltd. Closed band for percutaneous annuloplasty
US9918840B2 (en) 2011-06-23 2018-03-20 Valtech Cardio, Ltd. Closed band for percutaneous annuloplasty
US9668859B2 (en) 2011-08-05 2017-06-06 California Institute Of Technology Percutaneous heart valve delivery systems
US8945177B2 (en) 2011-09-13 2015-02-03 Abbott Cardiovascular Systems Inc. Gripper pusher mechanism for tissue apposition systems
US8920493B2 (en) 2011-09-16 2014-12-30 St. Jude Medical, Cardiology Division, Inc. Systems and methods for holding annuloplasty rings
US8858623B2 (en) 2011-11-04 2014-10-14 Valtech Cardio, Ltd. Implant having multiple rotational assemblies
US9724192B2 (en) 2011-11-08 2017-08-08 Valtech Cardio, Ltd. Controlled steering functionality for implant-delivery tool
US9345573B2 (en) 2012-05-30 2016-05-24 Neovasc Tiara Inc. Methods and apparatus for loading a prosthesis onto a delivery system
US10849755B2 (en) 2012-09-14 2020-12-01 Boston Scientific Scimed, Inc. Mitral valve inversion prostheses
US10543088B2 (en) 2012-09-14 2020-01-28 Boston Scientific Scimed, Inc. Mitral valve inversion prostheses
WO2014052818A1 (en) 2012-09-29 2014-04-03 Mitralign, Inc. Plication lock delivery system and method of use thereof
EP3730084A1 (en) 2012-10-23 2020-10-28 Valtech Cardio, Ltd. Controlled steering functionality for implant-delivery tool
US10376266B2 (en) 2012-10-23 2019-08-13 Valtech Cardio, Ltd. Percutaneous tissue anchor techniques
US9730793B2 (en) 2012-12-06 2017-08-15 Valtech Cardio, Ltd. Techniques for guide-wire based advancement of a tool
US10543085B2 (en) 2012-12-31 2020-01-28 Edwards Lifesciences Corporation One-piece heart valve stents adapted for post-implant expansion
SG11201504768QA (en) 2012-12-31 2015-07-30 Edwards Lifesciences Corp Surgical heart valves adapted for post implant expansion
US20150351906A1 (en) 2013-01-24 2015-12-10 Mitraltech Ltd. Ventricularly-anchored prosthetic valves
US9724084B2 (en) 2013-02-26 2017-08-08 Mitralign, Inc. Devices and methods for percutaneous tricuspid valve repair
US9687346B2 (en) 2013-03-14 2017-06-27 Edwards Lifesciences Corporation Multi-stranded heat set annuloplasty rings
US10449333B2 (en) 2013-03-14 2019-10-22 Valtech Cardio, Ltd. Guidewire feeder
US10149757B2 (en) 2013-03-15 2018-12-11 Edwards Lifesciences Corporation System and method for transaortic delivery of a prosthetic heart valve
CN105283214B (en) 2013-03-15 2018-10-16 北京泰德制药股份有限公司 Translate conduit, system and its application method
US9744037B2 (en) 2013-03-15 2017-08-29 California Institute Of Technology Handle mechanism and functionality for repositioning and retrieval of transcatheter heart valves
US9572665B2 (en) 2013-04-04 2017-02-21 Neovasc Tiara Inc. Methods and apparatus for delivering a prosthetic valve to a beating heart
JP6563394B2 (en) 2013-08-30 2019-08-21 イェーナヴァルヴ テクノロジー インコーポレイテッド Radially foldable frame for an artificial valve and method for manufacturing the frame
US10070857B2 (en) 2013-08-31 2018-09-11 Mitralign, Inc. Devices and methods for locating and implanting tissue anchors at mitral valve commissure
US10299793B2 (en) 2013-10-23 2019-05-28 Valtech Cardio, Ltd. Anchor magazine
US10166098B2 (en) 2013-10-25 2019-01-01 Middle Peak Medical, Inc. Systems and methods for transcatheter treatment of valve regurgitation
US9610162B2 (en) 2013-12-26 2017-04-04 Valtech Cardio, Ltd. Implantation of flexible implant
US10454024B2 (en) 2014-02-28 2019-10-22 Micron Technology, Inc. Memory cells, methods of fabrication, and memory devices
US9572666B2 (en) 2014-03-17 2017-02-21 Evalve, Inc. Mitral valve fixation device removal devices and methods
US10390943B2 (en) 2014-03-17 2019-08-27 Evalve, Inc. Double orifice device for transcatheter mitral valve replacement
US9281466B2 (en) 2014-04-09 2016-03-08 Micron Technology, Inc. Memory cells, semiconductor structures, semiconductor devices, and methods of fabrication
US9687345B2 (en) 2014-05-29 2017-06-27 Edwards Lifesciences Cardiaq Llc Prosthesis, delivery device and methods of use
CA2958061A1 (en) 2014-06-18 2015-12-23 Middle Peak Medical, Inc. Mitral valve implants for the treatment of valvular regurgitation
CN107072784B (en) 2014-06-24 2019-07-05 中峰医疗公司 System and method for anchoring implantation material
US9180005B1 (en) 2014-07-17 2015-11-10 Millipede, Inc. Adjustable endolumenal mitral valve ring
CN106714732A (en) * 2014-09-08 2017-05-24 梅德坦提亚国际有限公司 Annuloplasty implant
WO2016059639A1 (en) 2014-10-14 2016-04-21 Valtech Cardio Ltd. Leaflet-restraining techniques
US9349945B2 (en) 2014-10-16 2016-05-24 Micron Technology, Inc. Memory cells, semiconductor devices, and methods of fabrication
US9768377B2 (en) 2014-12-02 2017-09-19 Micron Technology, Inc. Magnetic cell structures, and methods of fabrication
US10188392B2 (en) 2014-12-19 2019-01-29 Abbott Cardiovascular Systems, Inc. Grasping for tissue repair
WO2016125160A1 (en) 2015-02-05 2016-08-11 Mitraltech Ltd. Prosthetic valve with axially-sliding frames
CN107530166B (en) 2015-02-13 2020-01-31 魅尔皮德股份有限公司 Valve replacement using a rotating anchor
US20160256269A1 (en) 2015-03-05 2016-09-08 Mitralign, Inc. Devices for treating paravalvular leakage and methods use thereof
US10524912B2 (en) 2015-04-02 2020-01-07 Abbott Cardiovascular Systems, Inc. Tissue fixation devices and methods
SG10202010021SA (en) 2015-04-30 2020-11-27 Valtech Cardio Ltd Annuloplasty technologies
JP6767388B2 (en) 2015-05-01 2020-10-14 イェーナヴァルヴ テクノロジー インコーポレイテッド Devices and methods to reduce the proportion of pacemakers in heart valve replacement
US10314707B2 (en) 2015-06-09 2019-06-11 Edwards Lifesciences, Llc Asymmetric mitral annuloplasty band
US10376673B2 (en) 2015-06-19 2019-08-13 Evalve, Inc. Catheter guiding system and methods
US10238494B2 (en) 2015-06-29 2019-03-26 Evalve, Inc. Self-aligning radiopaque ring
WO2017004374A1 (en) 2015-07-02 2017-01-05 Edwards Lifesciences Corporation Integrated hybrid heart valves
WO2017004369A1 (en) 2015-07-02 2017-01-05 Edwards Lifesciences Corporation Hybrid heart valves adapted for post-implant expansion
US10667815B2 (en) 2015-07-21 2020-06-02 Evalve, Inc. Tissue grasping devices and related methods
US10413408B2 (en) 2015-08-06 2019-09-17 Evalve, Inc. Delivery catheter systems, methods, and devices
US10335275B2 (en) 2015-09-29 2019-07-02 Millipede, Inc. Methods for delivery of heart valve devices using intravascular ultrasound imaging
US10238495B2 (en) 2015-10-09 2019-03-26 Evalve, Inc. Delivery catheter handle and methods of use
US9592121B1 (en) 2015-11-06 2017-03-14 Middle Peak Medical, Inc. Device, system, and method for transcatheter treatment of valvular regurgitation
JP6892446B2 (en) 2015-11-17 2021-06-23 ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. Implantable equipment and delivery system to reshape the heart valve annulus
US10751182B2 (en) 2015-12-30 2020-08-25 Edwards Lifesciences Corporation System and method for reshaping right heart
WO2017117370A2 (en) 2015-12-30 2017-07-06 Mitralign, Inc. System and method for reducing tricuspid regurgitation
EP3407835A4 (en) 2016-01-29 2019-06-26 Neovasc Tiara Inc. Prosthetic valve for avoiding obstruction of outflow
US10531866B2 (en) 2016-02-16 2020-01-14 Cardiovalve Ltd. Techniques for providing a replacement valve and transseptal communication
EP4183371A1 (en) 2016-05-13 2023-05-24 JenaValve Technology, Inc. Heart valve prosthesis delivery system and method for delivery of heart valve prosthesis with introducer sheath and loading system
US20200146854A1 (en) 2016-05-16 2020-05-14 Elixir Medical Corporation Methods and devices for heart valve repair
US10702274B2 (en) 2016-05-26 2020-07-07 Edwards Lifesciences Corporation Method and system for closing left atrial appendage
US10736632B2 (en) 2016-07-06 2020-08-11 Evalve, Inc. Methods and devices for valve clip excision
GB201611910D0 (en) 2016-07-08 2016-08-24 Valtech Cardio Ltd Adjustable annuloplasty device with alternating peaks and troughs
US10828150B2 (en) * 2016-07-08 2020-11-10 Edwards Lifesciences Corporation Docking station for heart valve prosthesis
WO2018029680A1 (en) 2016-08-10 2018-02-15 Mitraltech Ltd. Prosthetic valve with concentric frames
US11071564B2 (en) 2016-10-05 2021-07-27 Evalve, Inc. Cardiac valve cutting device
US10722356B2 (en) 2016-11-03 2020-07-28 Edwards Lifesciences Corporation Prosthetic mitral valve holders
US10363138B2 (en) 2016-11-09 2019-07-30 Evalve, Inc. Devices for adjusting the curvature of cardiac valve structures
US10398553B2 (en) 2016-11-11 2019-09-03 Evalve, Inc. Opposing disk device for grasping cardiac valve tissue
US10426616B2 (en) 2016-11-17 2019-10-01 Evalve, Inc. Cardiac implant delivery system
CA3042588A1 (en) 2016-11-21 2018-05-24 Neovasc Tiara Inc. Methods and systems for rapid retraction of a transcatheter heart valve delivery system
US10779837B2 (en) 2016-12-08 2020-09-22 Evalve, Inc. Adjustable arm device for grasping tissues
US10314586B2 (en) 2016-12-13 2019-06-11 Evalve, Inc. Rotatable device and method for fixing tricuspid valve tissue
AU2017382273A1 (en) 2016-12-22 2019-08-08 Heart Repair Technologies, Inc. Percutaneous delivery systems for anchoring an implant in a cardiac valve annulus
WO2018138658A1 (en) 2017-01-27 2018-08-02 Jenavalve Technology, Inc. Heart valve mimicry
US10548731B2 (en) 2017-02-10 2020-02-04 Boston Scientific Scimed, Inc. Implantable device and delivery system for reshaping a heart valve annulus
US10390953B2 (en) 2017-03-08 2019-08-27 Cardiac Dimensions Pty. Ltd. Methods and devices for reducing paravalvular leakage
US10653524B2 (en) 2017-03-13 2020-05-19 Polares Medical Inc. Device, system, and method for transcatheter treatment of valvular regurgitation
CA3056423A1 (en) 2017-03-13 2018-09-20 Polares Medical Inc. Device, system, and method for transcatheter treatment of valvular regurgitation
US10478303B2 (en) 2017-03-13 2019-11-19 Polares Medical Inc. Device, system, and method for transcatheter treatment of valvular regurgitation
US11045627B2 (en) 2017-04-18 2021-06-29 Edwards Lifesciences Corporation Catheter system with linear actuation control mechanism
US11065119B2 (en) 2017-05-12 2021-07-20 Evalve, Inc. Long arm valve repair clip
US10856984B2 (en) 2017-08-25 2020-12-08 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
US10835221B2 (en) 2017-11-02 2020-11-17 Valtech Cardio, Ltd. Implant-cinching devices and systems
US11135062B2 (en) 2017-11-20 2021-10-05 Valtech Cardio Ltd. Cinching of dilated heart muscle
WO2019145947A1 (en) 2018-01-24 2019-08-01 Valtech Cardio, Ltd. Contraction of an annuloplasty structure
EP3743014B1 (en) 2018-01-26 2023-07-19 Edwards Lifesciences Innovation (Israel) Ltd. Techniques for facilitating heart valve tethering and chord replacement
USD944398S1 (en) 2018-06-13 2022-02-22 Edwards Lifesciences Corporation Expanded heart valve stent
CA3106104A1 (en) 2018-07-12 2020-01-16 Valtech Cardio, Ltd. Annuloplasty systems and locking tools therefor
CN112437651B (en) * 2018-07-30 2024-01-16 爱德华兹生命科学公司 Minimally Invasive Low Strain Annuloplasty Ring
CA3116168A1 (en) 2018-11-01 2020-05-07 Edwards Lifesciences Corporation Implant holder assembly with actuator for heart valve repair and replacement
WO2020092422A1 (en) 2018-11-01 2020-05-07 Edwards Lifesciences Corporation Annuloplasty ring assembly with detachable handle
WO2020092409A1 (en) 2018-11-01 2020-05-07 Edwards Lifesciences Corporation Annuloplasty ring assembly including a ring holder with a flexible shaft
WO2020093172A1 (en) 2018-11-08 2020-05-14 Neovasc Tiara Inc. Ventricular deployment of a transcatheter mitral valve prosthesis
JP2022521835A (en) 2019-03-25 2022-04-12 ラミナー インコーポレイテッド Devices and systems for treating the left atrial appendage
CA3135753C (en) 2019-04-01 2023-10-24 Neovasc Tiara Inc. Controllably deployable prosthetic valve
AU2020271896B2 (en) 2019-04-10 2022-10-13 Neovasc Tiara Inc. Prosthetic valve with natural blood flow
CN114025813A (en) 2019-05-20 2022-02-08 内奥瓦斯克迪亚拉公司 Introducer with hemostatic mechanism
US11311376B2 (en) 2019-06-20 2022-04-26 Neovase Tiara Inc. Low profile prosthetic mitral valve
EP3996630A1 (en) * 2019-07-11 2022-05-18 Medtentia International Ltd Oy Annuloplasty device
WO2021084407A1 (en) 2019-10-29 2021-05-06 Valtech Cardio, Ltd. Annuloplasty and tissue anchor technologies
EP4076284A1 (en) 2019-12-16 2022-10-26 Edwards Lifesciences Corporation Valve holder assembly with suture looping protection
EP4099950A1 (en) 2020-02-06 2022-12-14 Edwards Lifesciences Corporation Enhanced flexibility annuloplasty bands
WO2022026219A1 (en) 2020-07-30 2022-02-03 Edwards Lifesciences Corporation Adjustable annuloplasty ring and delivery system
AU2021400419A1 (en) 2020-12-14 2023-06-29 Cardiac Dimensions Pty. Ltd. Modular pre-loaded medical implants and delivery systems
US11464634B2 (en) 2020-12-16 2022-10-11 Polares Medical Inc. Device, system, and method for transcatheter treatment of valvular regurgitation with secondary anchors
WO2022192151A1 (en) 2021-03-09 2022-09-15 Edwards Lifesciences Corporation Annuloplasty ring and tether adjustment system
US11759321B2 (en) 2021-06-25 2023-09-19 Polares Medical Inc. Device, system, and method for transcatheter treatment of valvular regurgitation
WO2024026048A1 (en) * 2022-07-27 2024-02-01 The Board Of Trustees Of The Leland Stanford Junior University Devices and methods for tricuspid valve annuloplasty

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5104407A (en) * 1989-02-13 1992-04-14 Baxter International Inc. Selectively flexible annuloplasty ring
FR2708458A1 (en) * 1993-08-03 1995-02-10 Seguin Jacques Prosthetic ring for cardiac surgery.
WO2001019292A1 (en) * 1999-09-17 2001-03-22 Cardiac Concepts, Inc. Mitral valve annuloplasty ring and method

Family Cites Families (85)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL143127B (en) 1969-02-04 1974-09-16 Rhone Poulenc Sa REINFORCEMENT DEVICE FOR A DEFECTIVE HEART VALVE.
FR2306671A1 (en) 1975-04-11 1976-11-05 Rhone Poulenc Ind VALVULAR IMPLANT
FR2298313A1 (en) 1975-06-23 1976-08-20 Usifroid LINEAR REDUCER FOR VALVULOPLASTY
US4164046A (en) 1977-05-16 1979-08-14 Cooley Denton Valve prosthesis
DE3230858C2 (en) 1982-08-19 1985-01-24 Ahmadi, Ali, Dr. med., 7809 Denzlingen Ring prosthesis
CA1303298C (en) 1986-08-06 1992-06-16 Alain Carpentier Flexible cardiac valvular support prosthesis
IT1218951B (en) 1988-01-12 1990-04-24 Mario Morea PROSTHETIC DEVICE FOR SURGICAL CORRECTION OF TRICUSPIDAL INSUFFICENCE
US5041130A (en) 1989-07-31 1991-08-20 Baxter International Inc. Flexible annuloplasty ring and holder
US5290300A (en) 1989-07-31 1994-03-01 Baxter International Inc. Flexible suture guide and holder
US5064431A (en) 1991-01-16 1991-11-12 St. Jude Medical Incorporated Annuloplasty ring
US5306296A (en) 1992-08-21 1994-04-26 Medtronic, Inc. Annuloplasty and suture rings
US5201880A (en) 1992-01-27 1993-04-13 Pioneering Technologies, Inc. Mitral and tricuspid annuloplasty rings
US5258021A (en) 1992-01-27 1993-11-02 Duran Carlos G Sigmoid valve annuloplasty ring
CA2127701C (en) 1992-01-27 1999-06-15 John T. M. Wright Annuloplasty and suture rings
US5972030A (en) 1993-02-22 1999-10-26 Heartport, Inc. Less-invasive devices and methods for treatment of cardiac valves
US5450860A (en) 1993-08-31 1995-09-19 W. L. Gore & Associates, Inc. Device for tissue repair and method for employing same
US5765418A (en) 1994-05-16 1998-06-16 Medtronic, Inc. Method for making an implantable medical device from a refractory metal
US5593435A (en) 1994-07-29 1997-01-14 Baxter International Inc. Distensible annuloplasty ring for surgical remodelling of an atrioventricular valve and nonsurgical method for post-implantation distension thereof to accommodate patient growth
US6217610B1 (en) 1994-07-29 2001-04-17 Edwards Lifesciences Corporation Expandable annuloplasty ring
JPH11514546A (en) 1995-11-01 1999-12-14 セント ジュード メディカル,インコーポレイテッド Bioabsorbable annuloplasty prosthesis
WO1997019655A1 (en) * 1995-12-01 1997-06-05 Medtronic, Inc. Annuloplasty prosthesis
US5855601A (en) * 1996-06-21 1999-01-05 The Trustees Of Columbia University In The City Of New York Artificial heart valve and method and device for implanting the same
WO1998010719A1 (en) 1996-09-13 1998-03-19 Medtronic, Inc. Prosthetic heart valve with suturing member having non-uniform radial width
EP0860151A1 (en) 1997-02-25 1998-08-26 Naqeeb Khalid Cardiac valvular support prosthesis
US5776189A (en) 1997-03-05 1998-07-07 Khalid; Naqeeb Cardiac valvular support prosthesis
US6024918A (en) * 1998-03-13 2000-02-15 Medtronic, Inc. Method for attachment of biomolecules to surfaces of medical devices
US6143024A (en) 1998-06-04 2000-11-07 Sulzer Carbomedics Inc. Annuloplasty ring having flexible anterior portion
US6019739A (en) 1998-06-18 2000-02-01 Baxter International Inc. Minimally invasive valve annulus sizer
US6159240A (en) 1998-08-31 2000-12-12 Medtronic, Inc. Rigid annuloplasty device that becomes compliant after implantation
US6102945A (en) 1998-10-16 2000-08-15 Sulzer Carbomedics, Inc. Separable annuloplasty ring
DE19910233A1 (en) 1999-03-09 2000-09-21 Jostra Medizintechnik Ag Anuloplasty prosthesis
EP1034763B1 (en) 1999-03-10 2005-07-27 Delta Tooling Co., Ltd. Locking device
US6183512B1 (en) 1999-04-16 2001-02-06 Edwards Lifesciences Corporation Flexible annuloplasty system
US6231602B1 (en) * 1999-04-16 2001-05-15 Edwards Lifesciences Corporation Aortic annuloplasty ring
US6187040B1 (en) 1999-05-03 2001-02-13 John T. M. Wright Mitral and tricuspid annuloplasty rings
US6602289B1 (en) 1999-06-08 2003-08-05 S&A Rings, Llc Annuloplasty rings of particular use in surgery for the mitral valve
CN1243520C (en) 2000-01-14 2006-03-01 维亚科公司 Tissue annuloplasty band and apparatus and method for fashioning, sizing and implanting the same
US6402781B1 (en) 2000-01-31 2002-06-11 Mitralife Percutaneous mitral annuloplasty and cardiac reinforcement
US6797002B2 (en) 2000-02-02 2004-09-28 Paul A. Spence Heart valve repair apparatus and methods
ITPC20000013A1 (en) * 2000-04-13 2000-07-13 Paolo Ferrazzi INTROVENTRICULAR DEVICE AND RELATED METHOD FOR THE TREATMENT AND CORRECTION OF MYOCARDIOPATHIES.
US6368348B1 (en) 2000-05-15 2002-04-09 Shlomo Gabbay Annuloplasty prosthesis for supporting an annulus of a heart valve
US6419695B1 (en) 2000-05-22 2002-07-16 Shlomo Gabbay Cardiac prosthesis for helping improve operation of a heart valve
US6406493B1 (en) 2000-06-02 2002-06-18 Hosheng Tu Expandable annuloplasty ring and methods of use
US6419696B1 (en) 2000-07-06 2002-07-16 Paul A. Spence Annuloplasty devices and related heart valve repair methods
US6602288B1 (en) 2000-10-05 2003-08-05 Edwards Lifesciences Corporation Minimally-invasive annuloplasty repair segment delivery template, system and method of use
US6918917B1 (en) 2000-10-10 2005-07-19 Medtronic, Inc. Minimally invasive annuloplasty procedure and apparatus
US6955689B2 (en) 2001-03-15 2005-10-18 Medtronic, Inc. Annuloplasty band and method
US6786924B2 (en) 2001-03-15 2004-09-07 Medtronic, Inc. Annuloplasty band and method
US6619291B2 (en) 2001-04-24 2003-09-16 Edwin J. Hlavka Method and apparatus for catheter-based annuloplasty
US7037334B1 (en) 2001-04-24 2006-05-02 Mitralign, Inc. Method and apparatus for catheter-based annuloplasty using local plications
US6800090B2 (en) 2001-05-14 2004-10-05 Cardiac Dimensions, Inc. Mitral valve therapy device, system and method
ITMI20011012A1 (en) 2001-05-17 2002-11-17 Ottavio Alfieri ANNULAR PROSTHESIS FOR MITRAL VALVE
US7935145B2 (en) 2001-05-17 2011-05-03 Edwards Lifesciences Corporation Annuloplasty ring for ischemic mitral valve insuffuciency
US6858039B2 (en) 2002-07-08 2005-02-22 Edwards Lifesciences Corporation Mitral valve annuloplasty ring having a posterior bow
US6726716B2 (en) 2001-08-24 2004-04-27 Edwards Lifesciences Corporation Self-molding annuloplasty ring
US6749639B2 (en) * 2001-08-27 2004-06-15 Mayo Foundation For Medical Education And Research Coated prosthetic implant
US6908482B2 (en) 2001-08-28 2005-06-21 Edwards Lifesciences Corporation Three-dimensional annuloplasty ring and template
US7367991B2 (en) 2001-08-28 2008-05-06 Edwards Lifesciences Corporation Conformal tricuspid annuloplasty ring and template
US6749630B2 (en) 2001-08-28 2004-06-15 Edwards Lifesciences Corporation Tricuspid ring and template
US7125421B2 (en) 2001-08-31 2006-10-24 Mitral Interventions, Inc. Method and apparatus for valve repair
US20060020336A1 (en) 2001-10-23 2006-01-26 Liddicoat John R Automated annular plication for mitral valve repair
US6949122B2 (en) 2001-11-01 2005-09-27 Cardiac Dimensions, Inc. Focused compression mitral valve device and method
US6805710B2 (en) 2001-11-13 2004-10-19 Edwards Lifesciences Corporation Mitral valve annuloplasty ring for molding left ventricle geometry
WO2003105670A2 (en) 2002-01-10 2003-12-24 Guided Delivery Systems, Inc. Devices and methods for heart valve repair
CA2473305A1 (en) * 2002-01-14 2003-07-17 Feneglobe Systems Limited Corner key for connecting profiles together and frame work assembly
US6719786B2 (en) 2002-03-18 2004-04-13 Medtronic, Inc. Flexible annuloplasty prosthesis and holder
US7118595B2 (en) 2002-03-18 2006-10-10 Medtronic, Inc. Flexible annuloplasty prosthesis and holder
US7166124B2 (en) * 2002-03-21 2007-01-23 Providence Health System - Oregon Method for manufacturing sutureless bioprosthetic stent
US7608103B2 (en) 2002-07-08 2009-10-27 Edwards Lifesciences Corporation Mitral valve annuloplasty ring having a posterior bow
US6966924B2 (en) 2002-08-16 2005-11-22 St. Jude Medical, Inc. Annuloplasty ring holder
US7175660B2 (en) 2002-08-29 2007-02-13 Mitralsolutions, Inc. Apparatus for implanting surgical devices for controlling the internal circumference of an anatomic orifice or lumen
US7087064B1 (en) 2002-10-15 2006-08-08 Advanced Cardiovascular Systems, Inc. Apparatuses and methods for heart valve repair
US7431726B2 (en) 2003-12-23 2008-10-07 Mitralign, Inc. Tissue fastening systems and methods utilizing magnetic guidance
US8206439B2 (en) 2004-02-23 2012-06-26 International Heart Institute Of Montana Foundation Internal prosthesis for reconstruction of cardiac geometry
US7294148B2 (en) 2004-04-29 2007-11-13 Edwards Lifesciences Corporation Annuloplasty ring for mitral valve prolapse
US7938856B2 (en) 2004-05-14 2011-05-10 St. Jude Medical, Inc. Heart valve annuloplasty prosthesis sewing cuffs and methods of making same
US7452376B2 (en) 2004-05-14 2008-11-18 St. Jude Medical, Inc. Flexible, non-planar annuloplasty rings
JP2007537794A (en) 2004-05-14 2007-12-27 セント ジュード メディカル インコーポレイテッド System and method for holding an annuloplasty ring
US20050256568A1 (en) 2004-05-14 2005-11-17 St. Jude Medical, Inc. C-shaped heart valve prostheses
US20050278022A1 (en) 2004-06-14 2005-12-15 St. Jude Medical, Inc. Annuloplasty prostheses with improved anchoring structures, and related methods
US7713298B2 (en) 2004-06-29 2010-05-11 Micardia Corporation Methods for treating cardiac valves with adjustable implants
EP1768611A4 (en) 2004-07-15 2009-11-18 Micardia Corp Implants and methods for reshaping heart valves
US8034102B2 (en) 2004-07-19 2011-10-11 Coroneo, Inc. Aortic annuloplasty ring
US8012202B2 (en) * 2004-07-27 2011-09-06 Alameddine Abdallah K Mitral valve ring for treatment of mitral valve regurgitation
US7160975B2 (en) 2004-08-02 2007-01-09 Bayer Materialscience Llc Methacrylates as stabilizers for polymer polyols

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5104407A (en) * 1989-02-13 1992-04-14 Baxter International Inc. Selectively flexible annuloplasty ring
US5104407B1 (en) * 1989-02-13 1999-09-21 Baxter Int Selectively flexible annuloplasty ring
FR2708458A1 (en) * 1993-08-03 1995-02-10 Seguin Jacques Prosthetic ring for cardiac surgery.
WO2001019292A1 (en) * 1999-09-17 2001-03-22 Cardiac Concepts, Inc. Mitral valve annuloplasty ring and method

Cited By (39)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10166101B2 (en) 2001-05-17 2019-01-01 Edwards Lifesciences Corporation Methods for repairing mitral valves
US8114155B2 (en) 2001-08-28 2012-02-14 Edwards Lifesciences Corporation Annuloplasty ring with offset free ends
US9149359B2 (en) 2001-08-28 2015-10-06 Edwards Lifesciences Corporation Three-dimensional annuloplasty ring
US9414922B2 (en) 2001-08-28 2016-08-16 Edwards Lifesciences Corporation Three-dimensional annuloplasty ring
US10188518B2 (en) 2001-08-28 2019-01-29 Edwards Lifesciences Corporation Annuloplasty ring with variable cross-section
JP2007507309A (en) * 2003-10-03 2007-03-29 エドワーズ ライフサイエンシーズ コーポレイション Annuloplasty ring for repair of abnormal mitral valve
JP2007535371A (en) * 2004-04-29 2007-12-06 エドワーズ ライフサイエンシーズ コーポレイション Annuloplasty ring for mitral valve prolapse
JP4642841B2 (en) * 2004-04-29 2011-03-02 エドワーズ ライフサイエンシーズ コーポレイション Annuloplasty ring for mitral valve prolapse
US7951196B2 (en) 2004-04-29 2011-05-31 Edwards Lifesciences Corporation Annuloplasty ring for mitral valve prolapse
US8216304B2 (en) 2005-03-23 2012-07-10 Edwards Lifesciences Corporation Annuloplasty ring and holder combination
WO2007050506A1 (en) 2005-10-26 2007-05-03 St. Jude Medical, Inc. Saddle-shaped mitral valve annuloplasty prostheses with asymmetry, and related methods
US8123802B2 (en) 2005-10-26 2012-02-28 St. Jude Medical, Cardiology Division, Inc. Saddle-shaped mitral valve annuloplasty prostheses with asymmetry, and related methods
US10039531B2 (en) 2005-12-15 2018-08-07 Georgia Tech Research Corporation Systems and methods to control the dimension of a heart valve
US9125742B2 (en) 2005-12-15 2015-09-08 Georgia Tech Research Foundation Papillary muscle position control devices, systems, and methods
US10010419B2 (en) 2005-12-15 2018-07-03 Georgia Tech Research Corporation Papillary muscle position control devices, systems, and methods
WO2007089625A1 (en) * 2006-02-02 2007-08-09 Edwards Lifesciences Corporation Annuloplasty ring for mitral valve prolapse
US8591576B2 (en) 2006-05-15 2013-11-26 Edwards Lifesciences Ag Method for altering the geometry of the heart
WO2008070232A3 (en) * 2006-09-01 2008-08-28 Edwards Lifesciences Corp Saddle-shaped annuloplasty ring
WO2008070232A2 (en) * 2006-09-01 2008-06-12 Edwards Lifesciences Corporation Saddle-shaped annuloplasty ring
US7879087B2 (en) 2006-10-06 2011-02-01 Edwards Lifesciences Corporation Mitral and tricuspid annuloplasty rings
US8382828B2 (en) 2006-10-06 2013-02-26 Edwards Lifesciences Corporation Mitral annuloplasty rings
US10130462B2 (en) 2006-10-06 2018-11-20 BioStable Science & Engineering, Inc. Intra-annular mounting frame for aortic valve repair
US8163011B2 (en) 2006-10-06 2012-04-24 BioStable Science & Engineering, Inc. Intra-annular mounting frame for aortic valve repair
US9844434B2 (en) 2006-10-06 2017-12-19 BioStable Science & Engineering, Inc. Intra-annular mounting frame for aortic valve repair
US9011529B2 (en) 2007-02-09 2015-04-21 Edwards Lifesciences Corporation Mitral annuloplasty rings with sewing cuff
US8764821B2 (en) 2007-02-09 2014-07-01 Edwards Lifesciences Corporation Degenerative vavlular disease specific annuloplasty ring sets
US9101472B2 (en) 2007-09-07 2015-08-11 Edwards Lifesciences Corporation Active holder for annuloplasty ring delivery
US11576784B2 (en) 2007-09-07 2023-02-14 Edwards Lifesciences Corporation Active holder for annuloplasty ring delivery
US10842629B2 (en) 2007-09-07 2020-11-24 Edwards Lifesciences Corporation Active holder for annuloplasty ring delivery
WO2009094496A1 (en) * 2008-01-25 2009-07-30 Medtronic, Inc. Set of annuloplasty devices with varying anterior-posterior ratios and related methods
US8961598B2 (en) 2008-01-25 2015-02-24 Medtronic, Inc. Set of annuloplasty devices with varying anterior-posterior ratios and related methods
KR100960700B1 (en) 2008-03-13 2010-05-31 주식회사 사이언씨티 An Apparatus for Mitral Lifting Annuloplaty
WO2009113748A1 (en) * 2008-03-13 2009-09-17 Sciencity Co., Ltd An apparatus for mitral lifting annuloplaty
US11903830B2 (en) 2008-05-13 2024-02-20 Edwards Lifesciences Corporation Physiologically harmonized repair of tricuspid valve
US9937041B2 (en) 2008-05-13 2018-04-10 Edwards Lifesciences Corporation Physiologically harmonized tricuspid annuloplasty ring
US8915960B2 (en) 2010-08-31 2014-12-23 Edwards Lifesciences Corporation Physiologic tricuspid annuloplasty ring
US9814574B2 (en) 2010-09-30 2017-11-14 BioStable Science & Engineering, Inc. Non-axisymmetric aortic valve devices
US9161835B2 (en) 2010-09-30 2015-10-20 BioStable Science & Engineering, Inc. Non-axisymmetric aortic valve devices
US8932350B2 (en) 2010-11-30 2015-01-13 Edwards Lifesciences Corporation Reduced dehiscence annuloplasty ring

Also Published As

Publication number Publication date
CA2467766A1 (en) 2003-05-22
CA2467766C (en) 2012-02-07
ATE539704T1 (en) 2012-01-15
JP4235554B2 (en) 2009-03-11
EP1443877A1 (en) 2004-08-11
US20050049698A1 (en) 2005-03-03
AU2002340469B2 (en) 2007-08-30
US6805710B2 (en) 2004-10-19
US20030093148A1 (en) 2003-05-15
JP2005508702A (en) 2005-04-07
US20080097593A1 (en) 2008-04-24
US7329280B2 (en) 2008-02-12
US8236050B2 (en) 2012-08-07
EP1443877B1 (en) 2012-01-04

Similar Documents

Publication Publication Date Title
US6805710B2 (en) Mitral valve annuloplasty ring for molding left ventricle geometry
AU2002340469A1 (en) Mitral valve annuloplasty ring for molding left ventricle geometry
US11903830B2 (en) Physiologically harmonized repair of tricuspid valve
US10166101B2 (en) Methods for repairing mitral valves
CA2539459C (en) Annuloplasty rings for repair of abnormal mitral valves
JP5734178B2 (en) Annuloplasty ring and method for repairing a heart valve
EP2068770B1 (en) Saddle-shaped annuloplasty ring
US11938027B2 (en) Asymmetric mitral annuloplasty band
US20120172983A1 (en) Methods of repairing an abnormal mitral valve
US20220370200A1 (en) Enhanced flexibility annuloplasty bands

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AE AG AL AM AT AU AZ BA BB BG BR BY BZ CA CH CN CO CR CU CZ DE DK DM DZ EC EE ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MA MD MG MK MN MW MX MZ NO NZ OM PH PL PT RO RU SC SD SE SG SI SK SL TJ TM TN TR TT TZ UA UG UZ VC VN YU ZA ZM ZW

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): GH GM KE LS MW MZ SD SL SZ TZ UG ZM ZW AM AZ BY KG KZ MD RU TJ TM AT BE BG CH CY CZ DE DK EE ES FI FR GB GR IE IT LU MC NL PT SE SK TR BF BJ CF CG CI CM GA GN GQ GW ML MR NE SN TD TG

121 Ep: the epo has been informed by wipo that ep was designated in this application
DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
WWE Wipo information: entry into national phase

Ref document number: 2003543504

Country of ref document: JP

WWE Wipo information: entry into national phase

Ref document number: 2002340469

Country of ref document: AU

WWE Wipo information: entry into national phase

Ref document number: 2467766

Country of ref document: CA

WWE Wipo information: entry into national phase

Ref document number: 2002778834

Country of ref document: EP

WWP Wipo information: published in national office

Ref document number: 2002778834

Country of ref document: EP