WO1996040009A1 - Suture protector for prosthetic heart valve - Google Patents

Suture protector for prosthetic heart valve Download PDF

Info

Publication number
WO1996040009A1
WO1996040009A1 PCT/US1996/009372 US9609372W WO9640009A1 WO 1996040009 A1 WO1996040009 A1 WO 1996040009A1 US 9609372 W US9609372 W US 9609372W WO 9640009 A1 WO9640009 A1 WO 9640009A1
Authority
WO
WIPO (PCT)
Prior art keywords
suture
cuff
guard
closed position
suture guard
Prior art date
Application number
PCT/US1996/009372
Other languages
French (fr)
Inventor
Guy Vanney
Kurt D. Krueger
Michael J. Girard
Original Assignee
St. Jude Medical, Inc.
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 St. Jude Medical, Inc. filed Critical St. Jude Medical, Inc.
Priority to AU63797/96A priority Critical patent/AU6379796A/en
Publication of WO1996040009A1 publication Critical patent/WO1996040009A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart 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
    • A61F2/2409—Support rings therefor, e.g. for connecting valves to tissue

Definitions

  • the present invention relates to prosthetic heart valves. More specifically, the present invention relates to a shield or guard for covering a suture knot and suture cuff used with a heart valve prosthesis.
  • Heart valve prostheses are used to replace natural heart valves.
  • Prosthetic heart valves include both mechanical heart valves and tissue or bioprosthetic heart valves.
  • a valving member is carried in an orifice body or housing.
  • the valving member typically comprises a mechanical occluder such as a leaflet movable between an open and a closed position.
  • tissue valve the valving member comprises tissue movable between an open and a closed position.
  • Such prosthetic heart valve prostheses require the orifice to be attached to the tissue annulus left as a result of the surgical excision of the existing valve from the patient's heart.
  • a sewing or suture cuff is attached to the valve orifice and is used by a surgeon to suture the prosthesis to the heart tissue.
  • Such attachment requires the ends of the suture to be knotted and cut. Following attachment, the suture knots are exposed to blood flow which can cause postoperative complications, prosthesis thrombosis, thromboembolism, excessive tissue ingrowth, or interfere with operation of the valve mechanism.
  • the concept of covering heart tissue/valve attachment sutures is not new. The concept was described in 1964 in German Patent Application 1180087, entitled “ARTIFICIAL HEART VALVE, " by Dr.
  • a heart valve prosthesis includes an orifice housing having a lumen formed therethrough.
  • An occluder carried in the orifice housing is movable in the housing between an open position allowing flow through the lumen and a closed position in which flow through the lumen is blocked.
  • a suture cuff is coupled to the orifice housing and extends around an outer circumference of the orifice housing. The suture cuff is used for attaching the heart valve prosthesis to the tissue annulus left in the heart of a patient as a result of the surgical excision of the existing heart valve.
  • a suture extends through the heart tissue annulus and the suture cuff.
  • FIG. 1 is a top perspective view of a mechanical heart valve suitable for application of the suture guard techniques set forth herein.
  • Figure 2A is a cross-sectional view showing a suture guard in accordance with one embodiment.
  • Figure 2B is a cross-sectional view showing a suture guard in accordance with one embodiment.
  • Figure 3A is a cross-sectional view showing a suture guard in accordance with another embodiment.
  • Figure 3B is a cross-sectional view showing a suture guard in accordance with another embodiment.
  • Figure 4A is a cross-sectional view showing a suture guard in accordance with another embodiment .
  • Figure 4B is a cross-sectional view showing a suture guard in accordance with another embodiment.
  • Figure 5A is a cross-sectional view showing a suture guard in accordance with another embodiment .
  • Figure 5B is a cross-sectional view showing a suture guard in accordance with another embodimen .
  • Figure 6A is a cross-sectional view of a suture guard in accordance with another embodiment .
  • Figure 6B is a cross-sectional view of a suture guard in accordance with another embodiment.
  • Figure 6C is a top perspective view of a spring for use with the suture guard shown in Figures 6A and 6B.
  • Figure 7A is a cross-sectional view of a suture guard in accordance with another embodiment .
  • Figure 7B is a cross-sectional view of a suture guard in accordance with another embodiment.
  • Figure 8A is a cross-sectional view of a suture guard in accordance with another embodiment.
  • Figure 8B is a cross-sectional view of a suture guard in accordance with another embodiment .
  • Figure 9A is a cross-sectional view of a suture guard in accordance with another embodiment .
  • Figure 9B is a cross-sectional view of a suture guard in accordance with another embodiment.
  • Figure 10 is a perspective view showing a spring for retaining a suture cuff in accordance with one embodiment.
  • Figure 11A is a cross-sectional view of a suture guard in accordance with another embodiment .
  • Figure 11B is a cross-sectional view of a suture guard in accordance with another embodiment .
  • Figure 12A is a cross-sectional view of a suture guard in accordance with another embodiment .
  • Figure 12B is a cross-sectional view of a suture guard in accordance with another embodiment.
  • Figure 13A is a cross-sectional view of a suture guard in accordance with another embodiment.
  • Figure 13B is a cross-sectional view of a suture guard in accordance with another embodiment .
  • Figure 13C is a top perspective view of a member for maintaining a suture guard in a closed position in accordance with the invention.
  • Figure 14A is a cross-sectional view of a suture guard in accordance with another embodiment.
  • Figure 14B is a cross-sectional view of a suture guard in accordance with another embodiment .
  • Figure 15A is a cross-sectional view of a suture guard using a drawstring technique .
  • Figure 15B is a cross-sectional view of a suture guard using a drawstring technique.
  • Figure 15C is a top plan view of the suture guard of Figures 15A and 15B in an open position.
  • Figure 15D is a top plan view of a suture guard of Figures 15A and 15B in a closed position.
  • Figure 16A is a are cross-sectional view of a suture guard using a drawstring technique.
  • Figure 16B is a are cross-sectional view of a suture guard using a drawstring technique.
  • Figure 16C is a top plan view of the suture guard of Figures 16A and 16B in an open position.
  • Figure 16D is a top plan view of a suture guard of Figures 16A and 16B in a closed position.
  • a suture guard for use with a heart valve prosthesis is set forth herein which includes an additional flange integral to the proximal side of a sewing or suture cuff. This flange provides a flap of cuff material on the proximal side of the suture cuff which acts as a suture guard and allows a surgeon to cover the suture and suture knots.
  • One suitable heart valve prosthesis is described in U.S. Patent No. 4,276,658, entitled "HEART VALVE PROSTHESIS,” assigned to St. Jude Medical, Inc., of St. Paul, Minnesota.
  • FIG. 1 is a top perspective view of a mechanical heart valve prosthesis 10.
  • Prosthesis 10 is shown generically and the suture guard techniques described hereinafter may be implemented on prosthesis 10, for example.
  • Prosthesis 10 includes orifice housing or body 12.
  • Sewing ring or suture cuff 14 extends around the outer circumference of orifice 12 and is used for attaching valve 10 to the heart tissue annulus that remains when the existing valve of the patient is surgically excised.
  • Orifice 12 includes pivot guards 16 which provide pivots 20 for occluder leaflets 18.
  • a lumen is formed through orifice 12.
  • Occluders 18 move between an open position (not shown), which allows blood flow through the lumen of orifice 12, and a closed position as shown in Figure 1 which blocks flow therethrough.
  • Figures 2A and 2B are cross-sectional views of a portion of orifice 12 coupled to a suture cuff 30 carried in orifice seat 32 formed in the outer circumference of orifice 12.
  • suture cuffs are attached to the valve orifice using any known appropriate technique. For example, the diameter of the cuff may be reduced such that the cuff is secured in a recess which extends around the circumference of the orifice.
  • Figure 2A shows a suture knot 34 proximate suture cuff 30.
  • a suture guard 36 is shown in Figure 2A in an open position. Suture guard 36 is shown as a flap extending from an inner radius 33 of cuff 30 which is positioned over suture knot 34.
  • Suture guard 36 is moved to the position shown in Figure 2A during attachment of cuff 30 to the heart tissue annulus of the patient.
  • suture guard 36 is shown in a closed position in which guard 36 covers suture knot 34 and suture cuff 30.
  • a small secondary suture 38 maintains suture guard 36 in the closed position.
  • Secondary suture 38 is formed of a thinner suture material than the primary suture, and does not require the strength of the primary suture of suture knot 34 used to attach cuff 30 to the tissue annulus. Further, fewer secondary sutures 38 are required to maintain suture guard 36 in a closed position than to secure valve 10 to the tissue annulus.
  • FIGS 3A and 3B show cross-sectional views of another suture guard embodiment.
  • a suture guard 40 is positioned on the outer radius 43 of cuff 30 and is shown as being formed integral with cuff 30. This differs from the embodiment of Figures 2A and 2B in which suture shield 38 is positioned on an inner radius 33 of cuff 30.
  • Figure 3A shows suture guard 40 in an open position in which suture knot 34 is exposed.
  • suture guard 40 has been folded over to cover suture cuff 30 and suture knot 34.
  • a smaller secondary suture knot 42 is used to maintain suture guard 40 in the closed position in Figure 3B, similar to Figure 2B.
  • a biocompatible adhesive is placed between suture guard 40 of Figures 3A and 3B, or suture guard 36 of Figures 2A and 2B, and suture cuff 30.
  • This adhesive replaces secondary suture 38 and secures guard 40 in the closed position.
  • the suture guard is formed of a compliant material, such as woven polyester or polytetrafluoroethylene (PTFE) .
  • PTFE polytetrafluoroethylene
  • a biocompatible glue or fibrin glue may be used to secure the suture guard in the closed position.
  • the secondary sutures 38 and 42 may not be required.
  • hook and loop fasteners commonly known as Velcro ® .
  • the hook portion of the fastener is located on either the under side of the suture guard or the proximal side of the cuff.
  • the loop is located on the opposite mating surface as the hook.
  • FIGS 4A and 4B show cross-sectional views of a suture guard 52 in accordance with another embodiment.
  • Suture guard 52 is formed integral with and extends from suture cuff 50 and is folded over as shown in Figure 4B to cover suture cuff 50 and suture knot 34.
  • a barbed fastener 54 is placed through suture guard 52 by a surgeon and into cuff 50 as shown in Figure 4B.
  • Barbed fastener 54 includes a barbed point 56 which locks fastener 54 in cuff 50.
  • suture guard 52 is shown as extending from an interior radius of cuff 50 in Figures 4A and 4B, in an alternative embodiment suture guard 52 extends from an exterior radius similar to Figures 3A and 3B.
  • Figures 5A and 5B are cross-sectional views which show variations on the embodiment of Figures 4A and 4B.
  • barbed fastener 54 is embedded in the distal end of suture guard 52.
  • the advantage of this technique is that closing of the suture guard 52 as shown in Figure 5B is faster and easier for the surgeon, and the thrombolic complications associated with additional exposed fastener material are eliminated.
  • the barbed fasteners 54 are integral with suture guard 52 for an added measure of safety. Barbed fasteners 54 may be constructed as independent objects or attached to a continuous flexible ring.
  • One technique for maintaining the suture guard in a closed position is to spring load the suture guard. This may be particularly useful in the case of smaller aortic valves in which it may be difficult to attach the free end of the suture guard to the cuff.
  • a spring or flexible member may be placed on the interior or exterior of the suture guard. In the relaxed position, the spring would maintain the suture guard in a closed position covering the sutures, suture knots and suture cuff without requiring any other securing mechanism.
  • the spring can be moved into a position which exposes the proximal side of the suture cuff (i.e., an open position) allowing the suture cuff to be sutured to the heart tissue annulus by the surgeon.
  • Figures 6A and 6B show cross-sectional views of a suture guard 60 in accordance with another embodiment which utilizes a spring element 62, as shown in Figure 6C, to maintain the suture guard 60 in a closed position.
  • Figure 6C is a top perspective view of wire formed spring element 62 in the closed position shown in Figure 6B.
  • Figures 6A and 6B show suture guard 60 which carries wire formed spring 62 therein as shown in Figure 6C.
  • Spring 62 includes circumferential portion 64, radial portion 65 and axial portion 66. Radial portion 65 extends into the suture guard 60 and is visible in the cross sections of Figures 6A and 6B.
  • the axial portion 66 of spring 62 extends in an axial direction along orifice 12 and is positioned between cuff 68 and orifice seat 32 of orifice 12.
  • Wire formed spring 62 is captured within suture guard 60, and is fixed to orifice 12 along axial portion 66.
  • Preferable materials for wire formed spring 62 include polymers such as acetal, Elgiloy (cobalt-chrome alloy) and MP35N (cobalt-nickel alloy) .
  • FIGS 7A and 7B are cross-sectional views of a spring loaded suture guard 70 in accordance with another embodiment.
  • suture guard 70 extends from cuff 72 proximate suture knot 34.
  • An angled spring member 74 is carried in suture guard 70 and cuff 72.
  • a lower portion 76 of spring member 74 is captured in cuff 72 while a movable portion 78 is captured in suture guard 70.
  • Spring 70 is biased to the closed position shown in Figure 7B.
  • One advantage of this embodiment is that force from spring 70 is applied proximate both sides of suture knot 34 and thus tightly shields knot 34.
  • FIGS 8A and 8B show cross-sectional views of a spring-loaded suture guard in accordance with another embodiment.
  • Suture guard 80 extends from suture cuff 82 proximate suture knot 34 to cover suture knot 34 and suture cuff 82.
  • a wire formed spring 84 is carried in guard 80 and cuff 82.
  • Figure 8B shows guard 80 positioned over knot 34 by spring 84.
  • Fixed end 86 of spring 84 is attached to retaining ring 88.
  • Retaining ring 88 secures cuff 82 in orifice seat 32 of orifice 12.
  • Such a ring 88 may be employed in the other embodiments set forth herein. Attachment of fixed portion 86 to retaining ring 88 may be through any appropriate technique such as biocompatible adhesive bonding or welding.
  • FIGS 9A and 9B show cross-sectional views of a spring-loaded suture shield in accordance with another embodiment.
  • Suture guard 90 extends from cuff 92 proximate suture knot 34.
  • a coiled spring 94 is carried in suture guard 90 and cuff 92, and is biased to the closed position shown in Figure 9B.
  • a fixed end 96 of spring 94 is secured against orifice seat 32 by suture attachment windings 98.
  • a coiled spring is advantageous because deflection of the spring member is less likely to cause permanent deformation from the original biased shape of the spring.
  • FIG 10 is an isometric view of a spring 100 for use with a suture guard in a manner similar to that shown in Figures 6A through 9B.
  • Spring 100 includes axial or fixed portions 102 which carry arms 104. Arms 104 are movable between an open position (see Figure 6A) and a closed position (see Figure 6B) covering the suture knot. Attachment of spring 100 to orifice 12 would occur at the fixed or axial portion 102 of spring 100.
  • FIGS 11A and 11B are cross-sectional views of suture guard 110 in accordance with another embodiment.
  • Suture guard 110 extends from an inner radius of cuff 112 and carries spring member 114 at its distal end.
  • Spring member 114 is an annular spring extending around an outer circumference of suture guard 110.
  • Spring member 114 is biased to a shape which has a diameter greater than or equal to the diameter formed by suture guard 110 in the closed position of Figure 11B. This causes suture guard 110 to be held in the closed position of Figure 11B thereby covering suture cuff 112 suture knot 34.
  • FIGS 12A and 12B are cross-sectional views of suture guard 120 in accordance with another embodiment similar to the embodiment of Figures 11A and 11B.
  • Suture guard 120 extends from the outer diameter of a suture cuff 122 proximate suture knot 34.
  • the proximal end of suture guard 120 carries annular spring 124.
  • Annular spring 124 is biased to a shape which has a diameter smaller than or equal to the outer diameter of orifice 12. This causes spring 124 to maintain suture guard 120 in the closed position shown in Figure
  • FIGS 13A and 13B show cross-sectional views of suture guard 150 in accordance with another embodiment.
  • Suture guard 150 extends from suture cuff 152 attached to orifice 12 at orifice seat 32.
  • Spring insert 154 is carried in suture guard 150 and cuff 152. Insert 154 is secured against orifice seat 32 with suture windings 156.
  • Figure 13C is a top perspective view of insert 154.
  • Insert 154 includes fixed portion 158 and movable portions 160 which is used to cover suture cuff 152 and suture knot 34. Movable portions 160 are separated by gaps 162 which allow movable portions 160 to be deflected radially outward. Insert 154 is biased to the closed position shown in Figure 13B such that suture guard 150 covers suture knot 34.
  • FIGs 14A and 14B show another embodiment in which a spring element suture guard 170 directly covers knot 34 and suture cuff 172.
  • Suture guard 170 may be formed similar to insert 154 shown in Figure 13C. This ernbodiment may be advantageous if tissue growth is not desired or to control tissue growth.
  • guard 170 can be formed of a material which does not promote tissue ingrowth such as metals or polymers.
  • guard 170 may be formed of a material which promotes controlled tissue ingrowth such as a polymer impregnated with a biologically responsive chemical.
  • adjacent portions 160 shown in Figure 13C overlap each other such that in the radially outward position the entire suture cuff is completely covered.
  • Attachment of the fixed portion of the springs set forth herein may be through any appropriate technique.
  • suture windings, retainer rings, stiffening rings or stents may be employed.
  • the members are manufactured from biocompatible materials such as metals or polymers, for example.
  • the spring member can be replaced with a malleable material.
  • the initial shape of the material is in the open position. After a surgeon has fixed the valve to the heart tissue, the surgeon pushes or forms the malleable material over the suture and suture knots. This may be accomplished by either using the surgeon's finger or a tool. Further, a malleable material may be employed in the embodiments of Figures
  • Suitable examples of malleable materials include polymers or metals such as tantalum or titanium.
  • the embodiments set forth in Figures 3 through 14 may be manufactured from materials which are temperature responsive. In these materials, a change in temperature causes the suture guard to move to the closed position.
  • materials which have this quality For example, Nitinol ® , manufactured by Minnesota Mining & Manufacturing Company of St. Paul, Minnesota, and heat polymer materials such as heat- shrink polyester may be employed.
  • Nitinol ® is a nickel titanium alloy which can be deformed and which will remain in the deformed shape until heat is applied. In the present invention, the material would be deformed such that the suture guard is in the open position. After suturing is complete, the surgeon applies heat to activate the material causing the guard to assume its closed position.
  • FIGS 15A through 15D show such a drawstring technique.
  • Figures 15A and 15B are cross-sectional views showing suture guard 200 extending from the outer radius of suture cuff 202.
  • a drawstring 204 extends through the proximal end of suture guard 200.
  • Figure 15B in the closed position suture guard 200 covers knot 34.
  • Figure 15C is a top perspective view of suture guard 200 in the open position, as depicted in Figure 15A. In this position, cuff 202 is exposed allowing the surgeon to form suture knots 34.
  • Figures 16A through 16D show another technique using drawstrings to implement a suture guard.
  • Figures 16A and 16B are cross-sectional views showing suture guard 220 extending from the inner radius of suture cuff 222.
  • Drawstring 224 is carried through the proximal end of suture guard 220 and extends into the outer radius of suture cuff 222.
  • Figure 16B drawstring 224 is tightened thereby closing suture guard 220.
  • Figure 16C is a top perspective view showing orifice 12 having suture guard 220 in an open position. As shown in Figure 16C, drawstrings 224 loop through suture guard 220 and suture cuff 222.
  • suture guard 220 is moved to the closed position as shown in the perspective view of Figure 16D. After cinching drawstrings 224, the drawstrings are knotted thereby securing suture guard 220 in the closed position as shown in Figure 16D.
  • the drawstring embodiments are advantageous because the suturing techniques are familiar and expected by surgeons.
  • magnets may be employed in the suture cuff and suture guard to maintain the suture guard in a closed position.
  • the suture guard set forth herein is formed of biocompatible materials.
  • the suture guard set forth herein provides a two-flange system which allows a surgeon to attach the valve using a preferred method of placing the attachment portion of the cuff on the proximal side of the native heart tissue annulus.
  • the suture guard can be used with any suturing technique such as everted mattress sutures, non-everting mattress sutures, figure of eight sutures or continuous sutures.
  • the suture guard is formed integral with the cuff/valve assembly.
  • the suture guard is easily manufactured and can be easily used by surgeons with their preferred attachment methods.
  • the suture guard can be adapted and implemented with most existing heart valve prostheses. Some of the embodiments are self-actuated and will engage the suture knot upon release by the surgeon.
  • the suture guard tends to be flexible because it lies on the attachment portion of the cuff and therefore has the ability to conform to the irregularities commonly encountered in native heart tissue.

Abstract

An artificial heart valve prosthesis for use in a heart includes an orifice defining a lumen therethrough for blood flow. An occluder is carried in the orifice and is movable between an open position which allows blood flow through the lumen and a closed position in which flow through the lumen is blocked. A suture cuff coupled to the orifice extends around an outer circumference of the orifice and is used for attaching the heart valve to a heart tisssue annulus using sutures. The sutures are knotted proximate the suture cuff to secure the cuff to the annulus. A suture guard is coupled to the suture cuff and is movable between an open position in which the suture knot is exposed and a closed position in which the suture, suture knot and suture cuff are covered.

Description

SUTURE PROTECTOR FOR PROSTHETIC HEART VALVE
FIELD OF THE INVENTION The present invention relates to prosthetic heart valves. More specifically, the present invention relates to a shield or guard for covering a suture knot and suture cuff used with a heart valve prosthesis. BACKGROUND OF THE INVENTION Heart valve prostheses are used to replace natural heart valves. Prosthetic heart valves include both mechanical heart valves and tissue or bioprosthetic heart valves. In both types, a valving member is carried in an orifice body or housing. In a mechanical heart valve, the valving member typically comprises a mechanical occluder such as a leaflet movable between an open and a closed position. In a tissue valve, the valving member comprises tissue movable between an open and a closed position.
Such prosthetic heart valve prostheses require the orifice to be attached to the tissue annulus left as a result of the surgical excision of the existing valve from the patient's heart. Typically, a sewing or suture cuff is attached to the valve orifice and is used by a surgeon to suture the prosthesis to the heart tissue. Such attachment requires the ends of the suture to be knotted and cut. Following attachment, the suture knots are exposed to blood flow which can cause postoperative complications, prosthesis thrombosis, thromboembolism, excessive tissue ingrowth, or interfere with operation of the valve mechanism. The concept of covering heart tissue/valve attachment sutures is not new. The concept was described in 1964 in German Patent Application 1180087, entitled "ARTIFICIAL HEART VALVE, " by Dr. Wolfgang Seidel. This publication describes a method of attaching heart valves to the native heart tissue annulus. The attachment method uses a ring, which is partially covered with fabric and has protruding "clips." The orifice and occluder are then placed within the clips. The publication mentions the benefit of covering the suture ends and suture knots to reduce thrombus and thrombo-embolic events. The publication primarily focuses on the valve attachment and the use of solid rings.
A more recent patent application, WO 89/00841, by Lillehei, Wang and Brendzel, entitled "PROTECTIVE SHIELD FOR PROSTHETIC HEART VALVES," was published in 1989. The description in this application is of a protective shield which is annular or ring-shaped to fit over a circular valve base and cover an annular sewing ring. The reference mentions methods of installing the ring and various geometries for this ring. The reference describes a separate attachment ring which is attached using sutures, friction, adhesive, a snap fit, hooks, Velcro® or conical friction.
Another patent describing sutures and suture knots is U.S. Patent 3,996,623, issued December 14, 1976, to Robert Raster, entitled "METHOD OF IMPLANTING A PROSTHETIC DEVICE AND SUTURING MEMBER THEREFOR. " This reference discusses a cuff configuration which has two cuff flanges. The native heart tissue annulus is captured in the space provided between the two flanges. The cuff has a flexible cured polymer core which provides resilience to the cuff flanges. The surgeon attaches the distal flange to the distal side of the native tissue with sutures and knots. The suture knots would be located on the proximal side of the tissue annulus. While the cuff/valve is being secured to the native tissue with sutures and knots, the proximal cuff is held "open." After the valve is secured, the proximal flange is released to the closed position. The cuff is secured to the orifice using heat shrink material. This method of attachment has not been readily accepted by surgeons. The current preferred method of attachment is to use a single flanged cuff which is placed on the proximal side of the native tissue annulus. SUMMARY OF THE INVENTION
A heart valve prosthesis includes an orifice housing having a lumen formed therethrough. An occluder carried in the orifice housing is movable in the housing between an open position allowing flow through the lumen and a closed position in which flow through the lumen is blocked. A suture cuff is coupled to the orifice housing and extends around an outer circumference of the orifice housing. The suture cuff is used for attaching the heart valve prosthesis to the tissue annulus left in the heart of a patient as a result of the surgical excision of the existing heart valve. A suture extends through the heart tissue annulus and the suture cuff. Opposite ends of the sutures are knotted on top of the suture cuff thereby securing the suture cuff to the heart tissue annulus. A suture shield is coupled to the suture cuff and is movable between an open position in which a suture knot is exposed, and a closed position in which the suture knot and suture cuff are covered. BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 is a top perspective view of a mechanical heart valve suitable for application of the suture guard techniques set forth herein.
Figure 2A is a cross-sectional view showing a suture guard in accordance with one embodiment. Figure 2B is a cross-sectional view showing a suture guard in accordance with one embodiment.
Figure 3A is a cross-sectional view showing a suture guard in accordance with another embodiment. Figure 3B is a cross-sectional view showing a suture guard in accordance with another embodiment.
Figure 4A is a cross-sectional view showing a suture guard in accordance with another embodiment .
Figure 4B is a cross-sectional view showing a suture guard in accordance with another embodiment.
Figure 5A is a cross-sectional view showing a suture guard in accordance with another embodiment .
Figure 5B is a cross-sectional view showing a suture guard in accordance with another embodimen . Figure 6A is a cross-sectional view of a suture guard in accordance with another embodiment .
Figure 6B is a cross-sectional view of a suture guard in accordance with another embodiment.
Figure 6C is a top perspective view of a spring for use with the suture guard shown in Figures 6A and 6B.
Figure 7A is a cross-sectional view of a suture guard in accordance with another embodiment .
Figure 7B is a cross-sectional view of a suture guard in accordance with another embodiment.
Figure 8A is a cross-sectional view of a suture guard in accordance with another embodiment.
Figure 8B is a cross-sectional view of a suture guard in accordance with another embodiment . Figure 9A is a cross-sectional view of a suture guard in accordance with another embodiment .
Figure 9B is a cross-sectional view of a suture guard in accordance with another embodiment. Figure 10 is a perspective view showing a spring for retaining a suture cuff in accordance with one embodiment.
Figure 11A is a cross-sectional view of a suture guard in accordance with another embodiment .
Figure 11B is a cross-sectional view of a suture guard in accordance with another embodiment .
Figure 12A is a cross-sectional view of a suture guard in accordance with another embodiment . Figure 12B is a cross-sectional view of a suture guard in accordance with another embodiment.
Figure 13A is a cross-sectional view of a suture guard in accordance with another embodiment.
Figure 13B is a cross-sectional view of a suture guard in accordance with another embodiment .
Figure 13C is a top perspective view of a member for maintaining a suture guard in a closed position in accordance with the invention.
Figure 14A is a cross-sectional view of a suture guard in accordance with another embodiment.
Figure 14B is a cross-sectional view of a suture guard in accordance with another embodiment .
Figure 15A is a cross-sectional view of a suture guard using a drawstring technique . Figure 15B is a cross-sectional view of a suture guard using a drawstring technique.
Figure 15C is a top plan view of the suture guard of Figures 15A and 15B in an open position.
Figure 15D is a top plan view of a suture guard of Figures 15A and 15B in a closed position.
Figure 16A is a are cross-sectional view of a suture guard using a drawstring technique.
Figure 16B is a are cross-sectional view of a suture guard using a drawstring technique. Figure 16C is a top plan view of the suture guard of Figures 16A and 16B in an open position.
Figure 16D is a top plan view of a suture guard of Figures 16A and 16B in a closed position. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
A suture guard for use with a heart valve prosthesis is set forth herein which includes an additional flange integral to the proximal side of a sewing or suture cuff. This flange provides a flap of cuff material on the proximal side of the suture cuff which acts as a suture guard and allows a surgeon to cover the suture and suture knots. One suitable heart valve prosthesis is described in U.S. Patent No. 4,276,658, entitled "HEART VALVE PROSTHESIS," assigned to St. Jude Medical, Inc., of St. Paul, Minnesota.
Figure 1 is a top perspective view of a mechanical heart valve prosthesis 10. Prosthesis 10 is shown generically and the suture guard techniques described hereinafter may be implemented on prosthesis 10, for example. Prosthesis 10 includes orifice housing or body 12. Sewing ring or suture cuff 14 extends around the outer circumference of orifice 12 and is used for attaching valve 10 to the heart tissue annulus that remains when the existing valve of the patient is surgically excised. Orifice 12 includes pivot guards 16 which provide pivots 20 for occluder leaflets 18. A lumen is formed through orifice 12. Occluders 18 move between an open position (not shown), which allows blood flow through the lumen of orifice 12, and a closed position as shown in Figure 1 which blocks flow therethrough.
Figures 2A and 2B are cross-sectional views of a portion of orifice 12 coupled to a suture cuff 30 carried in orifice seat 32 formed in the outer circumference of orifice 12. As used herein, suture cuffs are attached to the valve orifice using any known appropriate technique. For example, the diameter of the cuff may be reduced such that the cuff is secured in a recess which extends around the circumference of the orifice. Figure 2A shows a suture knot 34 proximate suture cuff 30. A suture guard 36 is shown in Figure 2A in an open position. Suture guard 36 is shown as a flap extending from an inner radius 33 of cuff 30 which is positioned over suture knot 34. Suture guard 36 is moved to the position shown in Figure 2A during attachment of cuff 30 to the heart tissue annulus of the patient. In Figure 2B, suture guard 36 is shown in a closed position in which guard 36 covers suture knot 34 and suture cuff 30. A small secondary suture 38 maintains suture guard 36 in the closed position. Secondary suture 38 is formed of a thinner suture material than the primary suture, and does not require the strength of the primary suture of suture knot 34 used to attach cuff 30 to the tissue annulus. Further, fewer secondary sutures 38 are required to maintain suture guard 36 in a closed position than to secure valve 10 to the tissue annulus.
Figures 3A and 3B show cross-sectional views of another suture guard embodiment. In Figures 3A and 3B, a suture guard 40 is positioned on the outer radius 43 of cuff 30 and is shown as being formed integral with cuff 30. This differs from the embodiment of Figures 2A and 2B in which suture shield 38 is positioned on an inner radius 33 of cuff 30. Figure 3A shows suture guard 40 in an open position in which suture knot 34 is exposed. In Figure 3B, suture guard 40 has been folded over to cover suture cuff 30 and suture knot 34. A smaller secondary suture knot 42 is used to maintain suture guard 40 in the closed position in Figure 3B, similar to Figure 2B.
In another embodiment, a biocompatible adhesive is placed between suture guard 40 of Figures 3A and 3B, or suture guard 36 of Figures 2A and 2B, and suture cuff 30. This adhesive replaces secondary suture 38 and secures guard 40 in the closed position. Typically, the suture guard is formed of a compliant material, such as woven polyester or polytetrafluoroethylene (PTFE) . A biocompatible glue or fibrin glue may be used to secure the suture guard in the closed position. In this embodiment, the secondary sutures 38 and 42 may not be required.
Another alternative method for fastening the suture guard to the cuff is using hook and loop fasteners, commonly known as Velcro®. In this embodiment, the hook portion of the fastener is located on either the under side of the suture guard or the proximal side of the cuff. The loop is located on the opposite mating surface as the hook. When the suture guard is maneuvered into place so the knots are covered, the hook and loop fasteners take hold and prevent the guard from revealing the knots.
Figures 4A and 4B show cross-sectional views of a suture guard 52 in accordance with another embodiment. Suture guard 52 is formed integral with and extends from suture cuff 50 and is folded over as shown in Figure 4B to cover suture cuff 50 and suture knot 34. A barbed fastener 54 is placed through suture guard 52 by a surgeon and into cuff 50 as shown in Figure 4B.
Barbed fastener 54 includes a barbed point 56 which locks fastener 54 in cuff 50. Although suture guard 52 is shown as extending from an interior radius of cuff 50 in Figures 4A and 4B, in an alternative embodiment suture guard 52 extends from an exterior radius similar to Figures 3A and 3B.
Figures 5A and 5B are cross-sectional views which show variations on the embodiment of Figures 4A and 4B. In Figures 5A and 5B, barbed fastener 54 is embedded in the distal end of suture guard 52. The advantage of this technique is that closing of the suture guard 52 as shown in Figure 5B is faster and easier for the surgeon, and the thrombolic complications associated with additional exposed fastener material are eliminated. Additionally, the barbed fasteners 54 are integral with suture guard 52 for an added measure of safety. Barbed fasteners 54 may be constructed as independent objects or attached to a continuous flexible ring.
One technique for maintaining the suture guard in a closed position is to spring load the suture guard. This may be particularly useful in the case of smaller aortic valves in which it may be difficult to attach the free end of the suture guard to the cuff. A spring or flexible member may be placed on the interior or exterior of the suture guard. In the relaxed position, the spring would maintain the suture guard in a closed position covering the sutures, suture knots and suture cuff without requiring any other securing mechanism. The spring can be moved into a position which exposes the proximal side of the suture cuff (i.e., an open position) allowing the suture cuff to be sutured to the heart tissue annulus by the surgeon. Figures 6A and 6B show cross-sectional views of a suture guard 60 in accordance with another embodiment which utilizes a spring element 62, as shown in Figure 6C, to maintain the suture guard 60 in a closed position. Figure 6C is a top perspective view of wire formed spring element 62 in the closed position shown in Figure 6B. Figures 6A and 6B show suture guard 60 which carries wire formed spring 62 therein as shown in Figure 6C. Spring 62 includes circumferential portion 64, radial portion 65 and axial portion 66. Radial portion 65 extends into the suture guard 60 and is visible in the cross sections of Figures 6A and 6B. The axial portion 66 of spring 62 extends in an axial direction along orifice 12 and is positioned between cuff 68 and orifice seat 32 of orifice 12. Wire formed spring 62 is captured within suture guard 60, and is fixed to orifice 12 along axial portion 66. Preferable materials for wire formed spring 62 include polymers such as acetal, Elgiloy (cobalt-chrome alloy) and MP35N (cobalt-nickel alloy) .
Figures 7A and 7B are cross-sectional views of a spring loaded suture guard 70 in accordance with another embodiment. In Figures 7A and 7B, suture guard 70 extends from cuff 72 proximate suture knot 34. An angled spring member 74 is carried in suture guard 70 and cuff 72. A lower portion 76 of spring member 74 is captured in cuff 72 while a movable portion 78 is captured in suture guard 70. Spring 70 is biased to the closed position shown in Figure 7B. One advantage of this embodiment is that force from spring 70 is applied proximate both sides of suture knot 34 and thus tightly shields knot 34.
Figures 8A and 8B show cross-sectional views of a spring-loaded suture guard in accordance with another embodiment. Suture guard 80 extends from suture cuff 82 proximate suture knot 34 to cover suture knot 34 and suture cuff 82. A wire formed spring 84 is carried in guard 80 and cuff 82. Figure 8B shows guard 80 positioned over knot 34 by spring 84. Fixed end 86 of spring 84 is attached to retaining ring 88. Retaining ring 88 secures cuff 82 in orifice seat 32 of orifice 12. Such a ring 88 may be employed in the other embodiments set forth herein. Attachment of fixed portion 86 to retaining ring 88 may be through any appropriate technique such as biocompatible adhesive bonding or welding.
Figures 9A and 9B show cross-sectional views of a spring-loaded suture shield in accordance with another embodiment. Suture guard 90 extends from cuff 92 proximate suture knot 34. A coiled spring 94 is carried in suture guard 90 and cuff 92, and is biased to the closed position shown in Figure 9B. A fixed end 96 of spring 94 is secured against orifice seat 32 by suture attachment windings 98. A coiled spring is advantageous because deflection of the spring member is less likely to cause permanent deformation from the original biased shape of the spring.
Figure 10 is an isometric view of a spring 100 for use with a suture guard in a manner similar to that shown in Figures 6A through 9B. Spring 100 includes axial or fixed portions 102 which carry arms 104. Arms 104 are movable between an open position (see Figure 6A) and a closed position (see Figure 6B) covering the suture knot. Attachment of spring 100 to orifice 12 would occur at the fixed or axial portion 102 of spring 100.
Figures 11A and 11B are cross-sectional views of suture guard 110 in accordance with another embodiment. Suture guard 110 extends from an inner radius of cuff 112 and carries spring member 114 at its distal end. Spring member 114 is an annular spring extending around an outer circumference of suture guard 110. Spring member 114 is biased to a shape which has a diameter greater than or equal to the diameter formed by suture guard 110 in the closed position of Figure 11B. This causes suture guard 110 to be held in the closed position of Figure 11B thereby covering suture cuff 112 suture knot 34.
Figures 12A and 12B are cross-sectional views of suture guard 120 in accordance with another embodiment similar to the embodiment of Figures 11A and 11B. Suture guard 120 extends from the outer diameter of a suture cuff 122 proximate suture knot 34. The proximal end of suture guard 120 carries annular spring 124. Annular spring 124 is biased to a shape which has a diameter smaller than or equal to the outer diameter of orifice 12. This causes spring 124 to maintain suture guard 120 in the closed position shown in Figure
12B thereby covering suture knot 34 and suture cuff 122.
Figures 13A and 13B show cross-sectional views of suture guard 150 in accordance with another embodiment. Suture guard 150 extends from suture cuff 152 attached to orifice 12 at orifice seat 32. Spring insert 154 is carried in suture guard 150 and cuff 152. Insert 154 is secured against orifice seat 32 with suture windings 156. Figure 13C is a top perspective view of insert 154. Insert 154 includes fixed portion 158 and movable portions 160 which is used to cover suture cuff 152 and suture knot 34. Movable portions 160 are separated by gaps 162 which allow movable portions 160 to be deflected radially outward. Insert 154 is biased to the closed position shown in Figure 13B such that suture guard 150 covers suture knot 34.
Figures 14A and 14B show another embodiment in which a spring element suture guard 170 directly covers knot 34 and suture cuff 172. Suture guard 170 may be formed similar to insert 154 shown in Figure 13C. This ernbodiment may be advantageous if tissue growth is not desired or to control tissue growth. For example, guard 170 can be formed of a material which does not promote tissue ingrowth such as metals or polymers. Alternatively, guard 170 may be formed of a material which promotes controlled tissue ingrowth such as a polymer impregnated with a biologically responsive chemical. In another embodiment which is not shown, adjacent portions 160 shown in Figure 13C overlap each other such that in the radially outward position the entire suture cuff is completely covered.
Attachment of the fixed portion of the springs set forth herein may be through any appropriate technique. For example, suture windings, retainer rings, stiffening rings or stents may be employed. The members are manufactured from biocompatible materials such as metals or polymers, for example.
In the embodiments of Figures 6A through 10 and 13A through 14B, the spring member can be replaced with a malleable material. The initial shape of the material is in the open position. After a surgeon has fixed the valve to the heart tissue, the surgeon pushes or forms the malleable material over the suture and suture knots. This may be accomplished by either using the surgeon's finger or a tool. Further, a malleable material may be employed in the embodiments of Figures
6A through 9B. Suitable examples of malleable materials include polymers or metals such as tantalum or titanium.
The embodiments set forth in Figures 3 through 14 may be manufactured from materials which are temperature responsive. In these materials, a change in temperature causes the suture guard to move to the closed position. There are numerous materials which have this quality. For example, Nitinol®, manufactured by Minnesota Mining & Manufacturing Company of St. Paul, Minnesota, and heat polymer materials such as heat- shrink polyester may be employed. Nitinol® is a nickel titanium alloy which can be deformed and which will remain in the deformed shape until heat is applied. In the present invention, the material would be deformed such that the suture guard is in the open position. After suturing is complete, the surgeon applies heat to activate the material causing the guard to assume its closed position. Application of heat by warmed cardioplegia solution causes the material to deform to its original heat-set condition. This provides a quick and easy technique for the surgeon to cover the suture and suture knots. A polyester heat shrink material which contracts radially inward to a closed position may also be employed. For example, this could be used in the embodiment shown in Figures 12A and 12B
Another technique for restraining the suture guard is through the use of drawstring sutures. Using this techniques, sutures are placed within the proximal end, with respect to the surgeon, of the suture guard. Figures 15A through 15D show such a drawstring technique. Figures 15A and 15B are cross-sectional views showing suture guard 200 extending from the outer radius of suture cuff 202. A drawstring 204 extends through the proximal end of suture guard 200. As shown in Figure 15B, in the closed position suture guard 200 covers knot 34. Figure 15C is a top perspective view of suture guard 200 in the open position, as depicted in Figure 15A. In this position, cuff 202 is exposed allowing the surgeon to form suture knots 34. After suturing is complete, the surgeon pulls drawstring 204 to move suture guard 200 to the position shown in Figure 15D. In Figure 15D, drawstring 204 has been tightened causing guard 200 to be pulled inward, thereby covering suture knots 34. Knot 206 is formed from drawstring 204 and may be placed under suture guard 200 thereby covering knot 206. Note that in Figures 15C and 15D, pivot guards and occluder leaflets have not been shown for simplicity.
Figures 16A through 16D show another technique using drawstrings to implement a suture guard. Figures 16A and 16B are cross-sectional views showing suture guard 220 extending from the inner radius of suture cuff 222. Drawstring 224 is carried through the proximal end of suture guard 220 and extends into the outer radius of suture cuff 222. As shown in Figure 16B, drawstring 224 is tightened thereby closing suture guard 220. Figure 16C is a top perspective view showing orifice 12 having suture guard 220 in an open position. As shown in Figure 16C, drawstrings 224 loop through suture guard 220 and suture cuff 222. As the surgeon pulls drawstrings 224, suture guard 220 is moved to the closed position as shown in the perspective view of Figure 16D. After cinching drawstrings 224, the drawstrings are knotted thereby securing suture guard 220 in the closed position as shown in Figure 16D. The drawstring embodiments are advantageous because the suturing techniques are familiar and expected by surgeons.
In another embodiment, magnets may be employed in the suture cuff and suture guard to maintain the suture guard in a closed position. The suture guard set forth herein is formed of biocompatible materials.
The suture guard set forth herein provides a two-flange system which allows a surgeon to attach the valve using a preferred method of placing the attachment portion of the cuff on the proximal side of the native heart tissue annulus. The suture guard can be used with any suturing technique such as everted mattress sutures, non-everting mattress sutures, figure of eight sutures or continuous sutures. The suture guard is formed integral with the cuff/valve assembly. The suture guard is easily manufactured and can be easily used by surgeons with their preferred attachment methods. The suture guard can be adapted and implemented with most existing heart valve prostheses. Some of the embodiments are self-actuated and will engage the suture knot upon release by the surgeon. The suture guard tends to be flexible because it lies on the attachment portion of the cuff and therefore has the ability to conform to the irregularities commonly encountered in native heart tissue.
Although the present invention has been described with reference to preferred embodiments, workers skilled in the art will recognize that changes may be made in form and detail without departing from the spirit and scope of the invention. For example, although the specification has discussed mechanical heart valves, the techniques set forth herein are also applicable to tissue valves (bioprostheses) . In addition, typical materials are described in many of the preferred embodiments. However, applicable materials shall not be limited to those mentioned. Applicable material include any biocompatible polymer, metal or other material that provides the mechanical characteristics described for the embodiments.

Claims

WHAT IS CLAIMED IS:
1. A heart valve prosthesis, comprising; an orifice housing providing a lumen therethrough; an occluder movable in the orifice housing between an open position allowing flow through the lumen and a closed position in which flow through the lumen is blocked; a suture cuff coupled to the orifice housing for attaching the prosthesis to a heart tissue annulus, wherein a suture extends through the tissue annulus and the suture cuff and is knotted thereon; and a suture guard coupled to the suture cuff movable between an open position in which the suture knot is exposed and a closed position covering the suture, suture knot and suture cuff .
2. The heart valve prosthesis of claim 1 including an adhesive securing the suture guard in the closed position.
3. The heart valve prosthesis of claim 1 including a barb coupled to the suture guard which secures the suture guard to the suture cuff in the closed position.
PCT/US1996/009372 1995-06-07 1996-06-07 Suture protector for prosthetic heart valve WO1996040009A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU63797/96A AU6379796A (en) 1995-06-07 1996-06-07 Suture protector for prosthetic heart valve

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US08/487,497 1995-06-07
US08/487,497 US5571175A (en) 1995-06-07 1995-06-07 Suture guard for prosthetic heart valve

Publications (1)

Publication Number Publication Date
WO1996040009A1 true WO1996040009A1 (en) 1996-12-19

Family

ID=23935964

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1996/009372 WO1996040009A1 (en) 1995-06-07 1996-06-07 Suture protector for prosthetic heart valve

Country Status (4)

Country Link
US (2) US5571175A (en)
AU (1) AU6379796A (en)
WO (1) WO1996040009A1 (en)
ZA (1) ZA964886B (en)

Families Citing this family (300)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DK124690D0 (en) 1990-05-18 1990-05-18 Henning Rud Andersen FAT PROTECTION FOR IMPLEMENTATION IN THE BODY FOR REPLACEMENT OF NATURAL FLEET AND CATS FOR USE IN IMPLEMENTING A SUCH FAT PROTECTION
US6241747B1 (en) 1993-05-03 2001-06-05 Quill Medical, Inc. Barbed Bodily tissue connector
US8795332B2 (en) 2002-09-30 2014-08-05 Ethicon, Inc. Barbed sutures
US6402780B2 (en) 1996-02-23 2002-06-11 Cardiovascular Technologies, L.L.C. Means and method of replacing a heart valve in a minimally invasive manner
US5843178A (en) * 1996-06-20 1998-12-01 St. Jude Medical, Inc. Suture guard for annuloplasty ring
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
EP0850607A1 (en) 1996-12-31 1998-07-01 Cordis Corporation Valve prosthesis for implantation in body channels
US5931855A (en) 1997-05-21 1999-08-03 Frank Hoffman Surgical methods using one-way suture
US6613059B2 (en) 1999-03-01 2003-09-02 Coalescent Surgical, Inc. Tissue connector apparatus and methods
US6641593B1 (en) 1998-06-03 2003-11-04 Coalescent Surgical, Inc. Tissue connector apparatus and methods
US6945980B2 (en) 1998-06-03 2005-09-20 Medtronic, Inc. Multiple loop tissue connector apparatus and methods
CN1867068A (en) 1998-07-14 2006-11-22 联合视频制品公司 Client-server based interactive television program guide system with remote server recording
US6200341B1 (en) * 1998-09-25 2001-03-13 Sulzer Carbomedics Inc. Mechanical heart valve assembly with super-elastic lock wire
US8118822B2 (en) 1999-03-01 2012-02-21 Medtronic, Inc. Bridge clip tissue connector apparatus and methods
US6695859B1 (en) 1999-04-05 2004-02-24 Coalescent Surgical, Inc. Apparatus and methods for anastomosis
BR0010096A (en) * 1999-04-28 2002-02-19 St Jude Medical Cardiac valve prosthesis, kit, process to connect a cardiac valve prosthesis to a patient, and a fastener applicator to implant a cardiac valve prosthesis
US6287339B1 (en) * 1999-05-27 2001-09-11 Sulzer Carbomedics Inc. Sutureless heart valve prosthesis
US6241765B1 (en) * 1999-07-15 2001-06-05 Sulzer Carbomedics Inc. Stapled heart prosthesis and method of installing same
US6319280B1 (en) 1999-08-03 2001-11-20 St. Jude Medical, Inc. Prosthetic ring holder
US8529583B1 (en) 1999-09-03 2013-09-10 Medtronic, Inc. Surgical clip removal apparatus
US6926730B1 (en) 2000-10-10 2005-08-09 Medtronic, Inc. Minimally invasive valve repair procedure and apparatus
US6709457B1 (en) * 1999-11-24 2004-03-23 St. Jude Medical, Inc. Attachment of suture cuff to prosthetic heart valve
US6409759B1 (en) * 1999-12-30 2002-06-25 St. Jude Medical, Inc. Harvested tissue heart valve with sewing rim
US6551332B1 (en) 2000-03-31 2003-04-22 Coalescent Surgical, Inc. Multiple bias surgical fastener
US6454799B1 (en) 2000-04-06 2002-09-24 Edwards Lifesciences Corporation Minimally-invasive heart valves and methods of use
US8366769B2 (en) 2000-06-01 2013-02-05 Edwards Lifesciences Corporation Low-profile, pivotable heart valve sewing ring
JP2004506469A (en) 2000-08-18 2004-03-04 アトリテック，　インコーポレイテッド Expandable implantable device for filtering blood flow from the atrial appendage
WO2002019951A1 (en) 2000-09-07 2002-03-14 Viacor, Inc. Fixation band for affixing a prosthetic heart valve to tissue
US6918917B1 (en) * 2000-10-10 2005-07-19 Medtronic, Inc. Minimally invasive annuloplasty procedure and apparatus
US6716244B2 (en) * 2000-12-20 2004-04-06 Carbomedics, Inc. Sewing cuff assembly for heart valves
US6733525B2 (en) 2001-03-23 2004-05-11 Edwards Lifesciences Corporation Rolled minimally-invasive heart valves and methods of use
US7556646B2 (en) 2001-09-13 2009-07-07 Edwards Lifesciences Corporation Methods and apparatuses for deploying minimally-invasive heart valves
US8623077B2 (en) 2001-06-29 2014-01-07 Medtronic, Inc. Apparatus for replacing a cardiac valve
US8771302B2 (en) 2001-06-29 2014-07-08 Medtronic, Inc. Method and apparatus for resecting and replacing an aortic valve
US7056331B2 (en) 2001-06-29 2006-06-06 Quill Medical, Inc. Suture method
US7544206B2 (en) 2001-06-29 2009-06-09 Medtronic, Inc. Method and apparatus for resecting and replacing an aortic valve
US6848152B2 (en) 2001-08-31 2005-02-01 Quill Medical, Inc. Method of forming barbs on a suture and apparatus for performing same
US7097659B2 (en) * 2001-09-07 2006-08-29 Medtronic, Inc. Fixation band for affixing a prosthetic heart valve to tissue
US6893460B2 (en) * 2001-10-11 2005-05-17 Percutaneous Valve Technologies Inc. Implantable prosthetic valve
US7201771B2 (en) 2001-12-27 2007-04-10 Arbor Surgical Technologies, Inc. Bioprosthetic heart valve
US7578843B2 (en) 2002-07-16 2009-08-25 Medtronic, Inc. Heart valve prosthesis
US7172625B2 (en) * 2002-07-16 2007-02-06 Medtronic, Inc. Suturing rings for implantable heart valve prostheses
US7959674B2 (en) 2002-07-16 2011-06-14 Medtronic, Inc. Suture locking assembly and method of use
US6773450B2 (en) 2002-08-09 2004-08-10 Quill Medical, Inc. Suture anchor and method
US7175652B2 (en) * 2002-08-20 2007-02-13 Cook Incorporated Stent graft with improved proximal end
EP1592367B1 (en) 2002-08-28 2016-04-13 HLT, Inc. Method and device for treating diseased valve
US8066724B2 (en) 2002-09-12 2011-11-29 Medtronic, Inc. Anastomosis apparatus and methods
US8100940B2 (en) 2002-09-30 2012-01-24 Quill Medical, Inc. Barb configurations for barbed sutures
US20040088003A1 (en) 2002-09-30 2004-05-06 Leung Jeffrey C. Barbed suture in combination with surgical needle
US8105345B2 (en) 2002-10-04 2012-01-31 Medtronic, Inc. Anastomosis apparatus and methods
US8551162B2 (en) 2002-12-20 2013-10-08 Medtronic, Inc. Biologically implantable prosthesis
US7399315B2 (en) 2003-03-18 2008-07-15 Edwards Lifescience Corporation Minimally-invasive heart valve with cusp positioners
US7624487B2 (en) 2003-05-13 2009-12-01 Quill Medical, Inc. Apparatus and method for forming barbs on a suture
US7500944B2 (en) * 2003-06-27 2009-03-10 Ethicon Endo-Surgery, Inc. Implantable band with attachment mechanism
US7951067B2 (en) * 2003-06-27 2011-05-31 Ethicon Endo-Surgery, Inc. Implantable band having improved attachment mechanism
US20050002984A1 (en) * 2003-06-27 2005-01-06 Byrum Randal T. Implantable band with attachment mechanism having dissimilar material properties
US20040267292A1 (en) * 2003-06-27 2004-12-30 Byrum Randal T. Implantable band with transverse attachment mechanism
US7182769B2 (en) 2003-07-25 2007-02-27 Medtronic, Inc. Sealing clip, delivery systems, and methods
US20050043749A1 (en) 2003-08-22 2005-02-24 Coalescent Surgical, Inc. Eversion apparatus and methods
US8021421B2 (en) 2003-08-22 2011-09-20 Medtronic, Inc. Prosthesis heart valve fixturing device
US8394114B2 (en) 2003-09-26 2013-03-12 Medtronic, Inc. Surgical connection apparatus and methods
US20050075725A1 (en) 2003-10-02 2005-04-07 Rowe Stanton J. Implantable prosthetic valve with non-laminar flow
US7556647B2 (en) 2003-10-08 2009-07-07 Arbor Surgical Technologies, Inc. Attachment device and methods of using the same
ITBO20030631A1 (en) * 2003-10-23 2005-04-24 Roberto Erminio Parravicini VALVULAR PROSTHETIC EQUIPMENT, IN PARTICULAR FOR HEART APPLICATIONS.
US7879047B2 (en) 2003-12-10 2011-02-01 Medtronic, Inc. Surgical connection apparatus and methods
CN101947146B (en) 2003-12-23 2014-08-06 萨德拉医学公司 Relocatable heart valve
US8840663B2 (en) 2003-12-23 2014-09-23 Sadra Medical, Inc. Repositionable heart valve method
US8182528B2 (en) 2003-12-23 2012-05-22 Sadra Medical, Inc. Locking heart valve anchor
US11278398B2 (en) 2003-12-23 2022-03-22 Boston Scientific Scimed, Inc. Methods and apparatus for endovascular heart valve replacement comprising tissue grasping elements
US7329279B2 (en) 2003-12-23 2008-02-12 Sadra Medical, Inc. Methods and apparatus for endovascularly replacing a patient's heart valve
US8828078B2 (en) 2003-12-23 2014-09-09 Sadra Medical, Inc. Methods and apparatus for endovascular heart valve replacement comprising tissue grasping elements
US20050137687A1 (en) 2003-12-23 2005-06-23 Sadra Medical Heart valve anchor and method
US8603160B2 (en) 2003-12-23 2013-12-10 Sadra Medical, Inc. Method of using a retrievable heart valve anchor with a sheath
US9526609B2 (en) 2003-12-23 2016-12-27 Boston Scientific Scimed, Inc. Methods and apparatus for endovascularly replacing a patient's heart valve
US20050137694A1 (en) 2003-12-23 2005-06-23 Haug Ulrich R. Methods and apparatus for endovascularly replacing a patient's heart valve
US7959666B2 (en) 2003-12-23 2011-06-14 Sadra Medical, Inc. Methods and apparatus for endovascularly replacing a heart valve
US7445631B2 (en) 2003-12-23 2008-11-04 Sadra Medical, Inc. Methods and apparatus for endovascularly replacing a patient's heart valve
US20120041550A1 (en) 2003-12-23 2012-02-16 Sadra Medical, Inc. Methods and Apparatus for Endovascular Heart Valve Replacement Comprising Tissue Grasping Elements
US8579962B2 (en) 2003-12-23 2013-11-12 Sadra Medical, Inc. Methods and apparatus for performing valvuloplasty
US8343213B2 (en) 2003-12-23 2013-01-01 Sadra Medical, Inc. Leaflet engagement elements and methods for use thereof
US7780725B2 (en) 2004-06-16 2010-08-24 Sadra Medical, Inc. Everting heart valve
US7381219B2 (en) 2003-12-23 2008-06-03 Sadra Medical, Inc. Low profile heart valve and delivery system
US9005273B2 (en) 2003-12-23 2015-04-14 Sadra Medical, Inc. Assessing the location and performance of replacement heart valves
EP2664282B1 (en) 2004-05-14 2017-06-21 Ethicon, LLC Suture devices
JP2008506497A (en) * 2004-07-19 2008-03-06 セント ジュード メディカル インコーポレイテッド Heart valve support and lid lining system and method
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
US7331991B2 (en) * 2005-02-25 2008-02-19 California Institute Of Technology Implantable small percutaneous valve and methods of delivery
US8083793B2 (en) * 2005-02-28 2011-12-27 Medtronic, Inc. Two piece heart valves including multiple lobe valves and methods for implanting them
US7717955B2 (en) * 2005-02-28 2010-05-18 Medtronic, Inc. Conformable prosthesis for implanting two-piece heart valves and methods for using them
US20060206203A1 (en) * 2005-03-10 2006-09-14 Jun Yang Valvular support prosthesis
US7513909B2 (en) 2005-04-08 2009-04-07 Arbor Surgical Technologies, Inc. Two-piece prosthetic valves with snap-in connection and methods for use
US7962208B2 (en) 2005-04-25 2011-06-14 Cardiac Pacemakers, Inc. Method and apparatus for pacing during revascularization
US8211169B2 (en) 2005-05-27 2012-07-03 Medtronic, Inc. Gasket with collar for prosthetic heart valves and methods for using them
US7780723B2 (en) 2005-06-13 2010-08-24 Edwards Lifesciences Corporation Heart valve delivery system
EP1919397B1 (en) * 2005-07-13 2013-01-02 Medtronic, Inc. Two-piece percutaneous prosthetic heart valves
JP4982502B2 (en) * 2005-12-07 2012-07-25 メドトロニック，インコーポレイテッド Coupling system for a two-piece heart valve assembly
US20070213813A1 (en) 2005-12-22 2007-09-13 Symetis Sa Stent-valves for valve replacement and associated methods and systems for surgery
US7967857B2 (en) 2006-01-27 2011-06-28 Medtronic, Inc. Gasket with spring collar for prosthetic heart valves and methods for making and using them
CN101415379B (en) 2006-02-14 2012-06-20 萨德拉医学公司 Systems for delivering a medical implant
US20080275550A1 (en) * 2006-02-24 2008-11-06 Arash Kheradvar Implantable small percutaneous valve and methods of delivery
US7780724B2 (en) * 2006-02-24 2010-08-24 California Institute Of Technology Monolithic in situ forming valve system
US7727276B2 (en) * 2006-04-14 2010-06-01 Machiraju Venkat R System and method for heart valve replacement
WO2007130881A2 (en) 2006-04-29 2007-11-15 Arbor Surgical Technologies, Inc. Multiple component prosthetic heart valve assemblies and apparatus and methods for delivering them
US9408607B2 (en) 2009-07-02 2016-08-09 Edwards Lifesciences Cardiaq Llc Surgical implant devices and methods for their manufacture and use
WO2008016578A2 (en) 2006-07-31 2008-02-07 Cartledge Richard G Sealable endovascular implants and methods for their use
US9585743B2 (en) 2006-07-31 2017-03-07 Edwards Lifesciences Cardiaq Llc Surgical implant devices and methods for their manufacture and use
US8236045B2 (en) * 2006-12-22 2012-08-07 Edwards Lifesciences Corporation Implantable prosthetic valve assembly and method of making the same
WO2008091493A1 (en) * 2007-01-08 2008-07-31 California Institute Of Technology In-situ formation of a valve
US8915943B2 (en) 2007-04-13 2014-12-23 Ethicon, Inc. Self-retaining systems for surgical procedures
US7896915B2 (en) 2007-04-13 2011-03-01 Jenavalve Technology, Inc. Medical device for treating a heart valve insufficiency
US9566178B2 (en) 2010-06-24 2017-02-14 Edwards Lifesciences Cardiaq Llc Actively controllable stent, stent graft, heart valve and method of controlling same
DE102007043830A1 (en) 2007-09-13 2009-04-02 Lozonschi, Lucian, Madison Heart valve stent
JP5628673B2 (en) 2007-09-26 2014-11-19 セント ジュード メディカル インコーポレイテッド Foldable prosthetic heart valve
EP2550978B1 (en) 2007-09-27 2014-04-30 Ethicon, LLC A system for cutting a retainer in a suture
US9532868B2 (en) 2007-09-28 2017-01-03 St. Jude Medical, Inc. Collapsible-expandable prosthetic heart valves with structures for clamping native tissue
ES2887787T3 (en) 2007-12-14 2021-12-27 Edwards Lifesciences Corp Leaflet Attachment Frame for a Prosthetic Valve
US8916077B1 (en) 2007-12-19 2014-12-23 Ethicon, Inc. Self-retaining sutures with retainers formed from molten material
WO2009086172A2 (en) 2007-12-19 2009-07-09 Angiotech Pharmaceuticals, Inc. Self-retaining sutures with heat-contact mediated retainers
US8118834B1 (en) 2007-12-20 2012-02-21 Angiotech Pharmaceuticals, Inc. Composite self-retaining sutures and method
US8615856B1 (en) 2008-01-30 2013-12-31 Ethicon, Inc. Apparatus and method for forming self-retaining sutures
US8875607B2 (en) 2008-01-30 2014-11-04 Ethicon, Inc. Apparatus and method for forming self-retaining sutures
ES2706295T3 (en) 2008-02-21 2019-03-28 Ethicon Llc Method and apparatus for raising retainers in self-retaining sutures
US8216273B1 (en) 2008-02-25 2012-07-10 Ethicon, Inc. Self-retainers with supporting structures on a suture
US9044318B2 (en) 2008-02-26 2015-06-02 Jenavalve Technology Gmbh Stent for the positioning and anchoring of a valvular prosthesis
WO2011104269A1 (en) 2008-02-26 2011-09-01 Jenavalve Technology Inc. Stent for the positioning and anchoring of a valvular prosthesis in an implantation site in the heart of a patient
US8641732B1 (en) 2008-02-26 2014-02-04 Ethicon, Inc. Self-retaining suture with variable dimension filament and method
ES2400494T3 (en) 2008-02-29 2013-04-10 Edwards Lifesciences Corporation Expandable element to deploy a prosthetic device
US9241792B2 (en) 2008-02-29 2016-01-26 Edwards Lifesciences Corporation Two-step heart valve implantation
US8177836B2 (en) 2008-03-10 2012-05-15 Medtronic, Inc. Apparatus and methods for minimally invasive valve repair
WO2009129251A2 (en) 2008-04-15 2009-10-22 Angiotech Pharmaceuticals, Inc. Self-retaining sutures with bi-directional retainers or uni-directional retainers
US20090276040A1 (en) 2008-05-01 2009-11-05 Edwards Lifesciences Corporation Device and method for replacing mitral valve
US9061119B2 (en) 2008-05-09 2015-06-23 Edwards Lifesciences Corporation Low profile delivery system for transcatheter heart valve
PT3263070T (en) 2008-06-06 2020-01-07 Edwards Lifesciences Corp Low profile transcatheter heart valve
US8323335B2 (en) 2008-06-20 2012-12-04 Edwards Lifesciences Corporation Retaining mechanisms for prosthetic valves and methods for using
EP3025681B1 (en) 2008-07-15 2017-02-01 St. Jude Medical, Inc. Collabsible and re-expandable prosthetic heart valve cuff designs and complementary technological applications
US8652202B2 (en) 2008-08-22 2014-02-18 Edwards Lifesciences Corporation Prosthetic heart valve and delivery apparatus
JP5607639B2 (en) 2008-10-10 2014-10-15 サドラ メディカル インコーポレイテッド Medical devices and systems
US8790387B2 (en) 2008-10-10 2014-07-29 Edwards Lifesciences Corporation Expandable sheath for introducing an endovascular delivery device into a body
US8690936B2 (en) 2008-10-10 2014-04-08 Edwards Lifesciences Corporation Expandable sheath for introducing an endovascular delivery device into a body
EP2352440B1 (en) 2008-11-03 2019-02-20 Ethicon LLC Length of self-retaining suture and device for using the same
US8905961B2 (en) * 2008-12-19 2014-12-09 St. Jude Medical, Inc. Systems, apparatuses, and methods for cardiovascular conduits and connectors
US20100217382A1 (en) 2009-02-25 2010-08-26 Edwards Lifesciences Mitral valve replacement with atrial anchoring
US8518060B2 (en) 2009-04-09 2013-08-27 Medtronic, Inc. Medical clip with radial tines, system and method of using same
US8668704B2 (en) 2009-04-24 2014-03-11 Medtronic, Inc. Medical clip with tines, system and method of using same
US8449599B2 (en) 2009-12-04 2013-05-28 Edwards Lifesciences Corporation Prosthetic valve for replacing mitral valve
EP2509538B1 (en) 2009-12-08 2017-09-20 Avalon Medical Ltd. Device and system for transcatheter mitral valve replacement
WO2011090628A2 (en) 2009-12-29 2011-07-28 Angiotech Pharmaceuticals, Inc. Bidirectional self-retaining sutures with laser-marked and/or non-laser marked indicia and methods
US8795354B2 (en) 2010-03-05 2014-08-05 Edwards Lifesciences Corporation Low-profile heart valve and delivery system
NZ702869A (en) 2010-05-04 2016-05-27 Ethicon Llc Self-retaining systems having laser-cut retainers
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
CA2801271C (en) 2010-06-11 2018-10-30 Ethicon, Llc Suture delivery tools for endoscopic and robot-assisted surgery and methods
AU2011275468B2 (en) 2010-07-09 2014-02-06 Highlife Sas Transcatheter atrio-ventricular valve prosthesis
EP2595569A4 (en) 2010-07-23 2016-02-24 Edwards Lifesciences Corp Retaining mechanisms for prosthetic valves
CA2808673C (en) 2010-09-10 2019-07-02 Symetis Sa Valve replacement devices, delivery device for a valve replacement device and method of production of a valve replacement device
CN105380730B (en) 2010-10-05 2018-08-17 爱德华兹生命科学公司 Heart valve prosthesis
PT3626208T (en) 2010-10-05 2021-04-22 Edwards Lifesciences Corp Prosthetic heart valve
CA2816326C (en) 2010-11-03 2020-12-15 Ethicon, Llc Drug-eluting self-retaining sutures and methods relating thereto
MX342984B (en) 2010-11-09 2016-10-19 Ethicon Llc Emergency self-retaining sutures and packaging.
US9155619B2 (en) 2011-02-25 2015-10-13 Edwards Lifesciences Corporation Prosthetic heart valve delivery apparatus
AU2012230716B2 (en) 2011-03-23 2016-05-19 Ethicon Llc Self-retaining variable loop sutures
EP2520251A1 (en) 2011-05-05 2012-11-07 Symetis SA Method and Apparatus for Compressing Stent-Valves
US9289282B2 (en) 2011-05-31 2016-03-22 Edwards Lifesciences Corporation System and method for treating valve insufficiency or vessel dilatation
US20130172931A1 (en) 2011-06-06 2013-07-04 Jeffrey M. Gross Methods and devices for soft palate tissue elevation procedures
WO2013009975A1 (en) 2011-07-12 2013-01-17 Boston Scientific Scimed, Inc. Coupling system for medical devices
US8795357B2 (en) 2011-07-15 2014-08-05 Edwards Lifesciences Corporation Perivalvular sealing for transcatheter heart valve
US9119716B2 (en) 2011-07-27 2015-09-01 Edwards Lifesciences Corporation Delivery systems for prosthetic heart valve
US9668859B2 (en) 2011-08-05 2017-06-06 California Institute Of Technology Percutaneous heart valve delivery systems
CA2957442C (en) 2011-08-11 2019-06-04 Tendyne Holdings, Inc. Improvements for prosthetic valves and related inventions
US9827093B2 (en) 2011-10-21 2017-11-28 Edwards Lifesciences Cardiaq Llc Actively controllable stent, stent graft, heart valve and method of controlling same
US8951243B2 (en) 2011-12-03 2015-02-10 Boston Scientific Scimed, Inc. Medical device handle
EP4049626A1 (en) 2011-12-09 2022-08-31 Edwards Lifesciences Corporation Prosthetic heart valve having improved commissure supports
US9827092B2 (en) 2011-12-16 2017-11-28 Tendyne Holdings, Inc. Tethers for prosthetic mitral valve
US8805418B2 (en) 2011-12-23 2014-08-12 United Video Properties, Inc. Methods and systems for performing actions based on location-based rules
US10172708B2 (en) 2012-01-25 2019-01-08 Boston Scientific Scimed, Inc. Valve assembly with a bioabsorbable gasket and a replaceable valve implant
EP3424469A1 (en) 2012-02-22 2019-01-09 Syntheon TAVR, LLC Actively controllable stent, stent graft and heart valve
US9883941B2 (en) 2012-06-19 2018-02-06 Boston Scientific Scimed, Inc. Replacement heart valve
WO2014022124A1 (en) 2012-07-28 2014-02-06 Tendyne Holdings, Inc. Improved multi-component designs for heart valve retrieval device, sealing structures and stent assembly
WO2014021905A1 (en) 2012-07-30 2014-02-06 Tendyne Holdings, Inc. Improved delivery systems and methods for transcatheter prosthetic valves
US20140067048A1 (en) 2012-09-06 2014-03-06 Edwards Lifesciences Corporation Heart Valve Sealing Devices
WO2014081796A1 (en) 2012-11-21 2014-05-30 Edwards Lifesciences Corporation Retaining mechanisms for prosthetic heart valves
US9132007B2 (en) 2013-01-10 2015-09-15 Medtronic CV Luxembourg S.a.r.l. Anti-paravalvular leakage components for a transcatheter valve prosthesis
US9675451B2 (en) 2013-02-01 2017-06-13 Medtronic CV Luxembourg S.a.r.l. Anti-paravalvular leakage component for a transcatheter valve prosthesis
US10413401B2 (en) 2013-02-01 2019-09-17 Medtronic CV Luxembourg S.a.r.l. Anti-paravalvular leakage component for a transcatheter valve prosthesis
US9439763B2 (en) 2013-02-04 2016-09-13 Edwards Lifesciences Corporation Prosthetic valve for replacing mitral valve
US9168129B2 (en) 2013-02-12 2015-10-27 Edwards Lifesciences Corporation Artificial heart valve with scalloped frame design
WO2014144247A1 (en) 2013-03-15 2014-09-18 Arash Kheradvar Handle mechanism and functionality for repositioning and retrieval of transcatheter heart valves
US9486306B2 (en) 2013-04-02 2016-11-08 Tendyne Holdings, Inc. Inflatable annular sealing device for prosthetic mitral valve
US10463489B2 (en) 2013-04-02 2019-11-05 Tendyne Holdings, Inc. Prosthetic heart valve and systems and methods for delivering the same
US11224510B2 (en) 2013-04-02 2022-01-18 Tendyne Holdings, Inc. Prosthetic heart valve and systems and methods for delivering the same
US10478293B2 (en) 2013-04-04 2019-11-19 Tendyne Holdings, Inc. Retrieval and repositioning system for prosthetic heart valve
TR201816620T4 (en) 2013-05-20 2018-11-21 Edwards Lifesciences Corp Heart valve prosthesis delivery device.
US9610159B2 (en) 2013-05-30 2017-04-04 Tendyne Holdings, Inc. Structural members for prosthetic mitral valves
CN108814772B (en) 2013-06-25 2020-09-08 坦迪尼控股股份有限公司 Thrombus management and structural compliance features for prosthetic heart valves
AU2014296087B2 (en) 2013-08-01 2019-08-01 Tendyne Holdings, Inc. Epicardial anchor devices and methods
WO2015023579A1 (en) 2013-08-12 2015-02-19 Mitral Valve Technologies Sa Apparatus and methods for implanting a replacement heart valve
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
WO2015058039A1 (en) 2013-10-17 2015-04-23 Robert Vidlund Apparatus and methods for alignment and deployment of intracardiac devices
EP3656353A1 (en) 2013-10-28 2020-05-27 Tendyne Holdings, Inc. Prosthetic heart valve and systems for delivering the same
US9526611B2 (en) 2013-10-29 2016-12-27 Tendyne Holdings, Inc. Apparatus and methods for delivery of transcatheter prosthetic valves
US9913715B2 (en) 2013-11-06 2018-03-13 St. Jude Medical, Cardiology Division, Inc. Paravalvular leak sealing mechanism
CA2934975A1 (en) 2013-11-11 2015-05-14 Edwards Lifesciences Cardiaq Llc Systems and methods for manufacturing a stent frame
US9622863B2 (en) 2013-11-22 2017-04-18 Edwards Lifesciences Corporation Aortic insufficiency repair device and method
US10098734B2 (en) 2013-12-05 2018-10-16 Edwards Lifesciences Corporation Prosthetic heart valve and delivery apparatus
WO2015120122A2 (en) 2014-02-05 2015-08-13 Robert Vidlund Apparatus and methods for transfemoral delivery of prosthetic mitral valve
US9986993B2 (en) 2014-02-11 2018-06-05 Tendyne Holdings, Inc. Adjustable tether and epicardial pad system for prosthetic heart valve
CN106068109B (en) 2014-03-10 2019-07-23 坦迪尼控股股份有限公司 Device and method for positioning and monitoring the tether load of prosthetic mitral valve
US10154904B2 (en) 2014-04-28 2018-12-18 Edwards Lifesciences Corporation Intravascular introducer devices
US10195025B2 (en) 2014-05-12 2019-02-05 Edwards Lifesciences Corporation Prosthetic heart valve
US9532870B2 (en) 2014-06-06 2017-01-03 Edwards Lifesciences Corporation Prosthetic valve for replacing a mitral valve
US10195026B2 (en) 2014-07-22 2019-02-05 Edwards Lifesciences Corporation Mitral valve anchoring
US10058424B2 (en) 2014-08-21 2018-08-28 Edwards Lifesciences Corporation Dual-flange prosthetic valve frame
US10016272B2 (en) 2014-09-12 2018-07-10 Mitral Valve Technologies Sarl Mitral repair and replacement devices and methods
US10213307B2 (en) 2014-11-05 2019-02-26 Medtronic Vascular, Inc. Transcatheter valve prosthesis having an external skirt for sealing and preventing paravalvular leakage
US9901445B2 (en) 2014-11-21 2018-02-27 Boston Scientific Scimed, Inc. Valve locking mechanism
JP6826035B2 (en) 2015-01-07 2021-02-03 テンダイン ホールディングス，インコーポレイテッド Artificial mitral valve, and devices and methods for its delivery
WO2016115375A1 (en) 2015-01-16 2016-07-21 Boston Scientific Scimed, Inc. Displacement based lock and release mechanism
US9861477B2 (en) 2015-01-26 2018-01-09 Boston Scientific Scimed Inc. Prosthetic heart valve square leaflet-leaflet stitch
WO2016126524A1 (en) 2015-02-03 2016-08-11 Boston Scientific Scimed, Inc. Prosthetic heart valve having tubular seal
US9788942B2 (en) 2015-02-03 2017-10-17 Boston Scientific Scimed Inc. Prosthetic heart valve having tubular seal
CN107896484B (en) 2015-02-05 2020-09-08 坦迪尼控股股份有限公司 Expandable epicardial pad and delivery devices and methods therefor
US10426617B2 (en) 2015-03-06 2019-10-01 Boston Scientific Scimed, Inc. Low profile valve locking mechanism and commissure assembly
US10285809B2 (en) 2015-03-06 2019-05-14 Boston Scientific Scimed Inc. TAVI anchoring assist device
US10080652B2 (en) 2015-03-13 2018-09-25 Boston Scientific Scimed, Inc. Prosthetic heart valve having an improved tubular seal
US10327896B2 (en) 2015-04-10 2019-06-25 Edwards Lifesciences Corporation Expandable sheath with elastomeric cross sectional portions
US10792471B2 (en) 2015-04-10 2020-10-06 Edwards Lifesciences Corporation Expandable sheath
US10064718B2 (en) 2015-04-16 2018-09-04 Edwards Lifesciences Corporation Low-profile prosthetic heart valve for replacing a mitral valve
JP6694948B2 (en) 2015-04-16 2020-05-20 テンダイン ホールディングス，インコーポレイテッド Device and method for delivery, repositioning and retrieval of a transcatheter prosthetic valve
US10010417B2 (en) 2015-04-16 2018-07-03 Edwards Lifesciences Corporation Low-profile prosthetic heart valve for replacing a mitral valve
CN107530168B (en) 2015-05-01 2020-06-09 耶拿阀门科技股份有限公司 Device and method with reduced pacemaker ratio in heart valve replacement
WO2017004377A1 (en) 2015-07-02 2017-01-05 Boston Scientific Scimed, Inc. Adjustable nosecone
US10195392B2 (en) 2015-07-02 2019-02-05 Boston Scientific Scimed, Inc. Clip-on catheter
US9974650B2 (en) 2015-07-14 2018-05-22 Edwards Lifesciences Corporation Prosthetic heart valve
US10179041B2 (en) 2015-08-12 2019-01-15 Boston Scientific Scimed Icn. Pinless release mechanism
US10136991B2 (en) 2015-08-12 2018-11-27 Boston Scientific Scimed Inc. Replacement heart valve implant
US10327894B2 (en) 2015-09-18 2019-06-25 Tendyne Holdings, Inc. Methods for delivery of prosthetic mitral valves
US10470876B2 (en) 2015-11-10 2019-11-12 Edwards Lifesciences Corporation Transcatheter heart valve for replacing natural mitral valve
US10376364B2 (en) 2015-11-10 2019-08-13 Edwards Lifesciences Corporation Implant delivery capsule
CN108430391B (en) 2015-12-03 2020-09-08 坦迪尼控股股份有限公司 Frame features for prosthetic mitral valves
CN108366859B (en) 2015-12-28 2021-02-05 坦迪尼控股股份有限公司 Atrial capsular bag closure for prosthetic heart valves
US10342660B2 (en) 2016-02-02 2019-07-09 Boston Scientific Inc. Tensioned sheathing aids
US10179043B2 (en) 2016-02-12 2019-01-15 Edwards Lifesciences Corporation Prosthetic heart valve having multi-level sealing member
US10888420B2 (en) 2016-03-14 2021-01-12 Medtronic Vascular, Inc. Stented prosthetic heart valve having a wrap and delivery devices
WO2017165842A1 (en) 2016-03-24 2017-09-28 Edwards Lifesciences Corporation Delivery system for prosthetic heart valve
US10470877B2 (en) 2016-05-03 2019-11-12 Tendyne Holdings, Inc. Apparatus and methods for anterior valve leaflet management
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
US10583005B2 (en) 2016-05-13 2020-03-10 Boston Scientific Scimed, Inc. Medical device handle
US10201416B2 (en) 2016-05-16 2019-02-12 Boston Scientific Scimed, Inc. Replacement heart valve implant with invertible leaflets
WO2017218375A1 (en) 2016-06-13 2017-12-21 Tendyne Holdings, Inc. Sequential delivery of two-part prosthetic mitral valve
WO2017218817A1 (en) * 2016-06-15 2017-12-21 Children's National Medical Center Expanding-collapsing sewing ring to facilitate ventricular assist device implantation and explantation
CN109640887B (en) 2016-06-30 2021-03-16 坦迪尼控股股份有限公司 Prosthetic heart valve and apparatus and method for delivering same
EP3484411A1 (en) 2016-07-12 2019-05-22 Tendyne Holdings, Inc. Apparatus and methods for trans-septal retrieval of prosthetic heart valves
US11096781B2 (en) 2016-08-01 2021-08-24 Edwards Lifesciences Corporation Prosthetic heart valve
US10973631B2 (en) 2016-11-17 2021-04-13 Edwards Lifesciences Corporation Crimping accessory device for a prosthetic valve
US10463484B2 (en) 2016-11-17 2019-11-05 Edwards Lifesciences Corporation Prosthetic heart valve having leaflet inflow below frame
US10603165B2 (en) 2016-12-06 2020-03-31 Edwards Lifesciences Corporation Mechanically expanding heart valve and delivery apparatus therefor
US11229456B2 (en) 2016-12-15 2022-01-25 Wright Medical Technology, Inc. Knotless syndesmosis system
US10813749B2 (en) * 2016-12-20 2020-10-27 Edwards Lifesciences Corporation Docking device made with 3D woven fabric
US10993710B2 (en) 2016-12-21 2021-05-04 Wright Medical Technology, Inc. Syndesmosis construct
US11654023B2 (en) 2017-01-23 2023-05-23 Edwards Lifesciences Corporation Covered prosthetic heart valve
US11185406B2 (en) 2017-01-23 2021-11-30 Edwards Lifesciences Corporation Covered prosthetic heart valve
US11013600B2 (en) 2017-01-23 2021-05-25 Edwards Lifesciences Corporation Covered prosthetic heart valve
JP7094965B2 (en) 2017-01-27 2022-07-04 イエナバルブ テクノロジー インク Heart valve imitation
US11135056B2 (en) 2017-05-15 2021-10-05 Edwards Lifesciences Corporation Devices and methods of commissure formation for prosthetic heart valve
CN110650711B (en) 2017-05-22 2022-04-01 爱德华兹生命科学公司 Valve anchors and methods of installation
US20210401571A9 (en) 2017-05-31 2021-12-30 Edwards Lifesciences Corporation Sealing member for prosthetic heart valve
US11026785B2 (en) 2017-06-05 2021-06-08 Edwards Lifesciences Corporation Mechanically expandable heart valve
US10869759B2 (en) 2017-06-05 2020-12-22 Edwards Lifesciences Corporation Mechanically expandable heart valve
WO2018226915A1 (en) 2017-06-08 2018-12-13 Boston Scientific Scimed, Inc. Heart valve implant commissure support structure
US11154399B2 (en) 2017-07-13 2021-10-26 Tendyne Holdings, Inc. Prosthetic heart valves and apparatus and methods for delivery of same
US10918473B2 (en) 2017-07-18 2021-02-16 Edwards Lifesciences Corporation Transcatheter heart valve storage container and crimping mechanism
CN111163729B (en) 2017-08-01 2022-03-29 波士顿科学国际有限公司 Medical implant locking mechanism
IL301081A (en) 2017-08-11 2023-05-01 Edwards Lifesciences Corp Sealing element for prosthetic heart valve
US11083575B2 (en) 2017-08-14 2021-08-10 Edwards Lifesciences Corporation Heart valve frame design with non-uniform struts
US10932903B2 (en) 2017-08-15 2021-03-02 Edwards Lifesciences Corporation Skirt assembly for implantable prosthetic valve
US10939996B2 (en) 2017-08-16 2021-03-09 Boston Scientific Scimed, Inc. Replacement heart valve commissure assembly
US10898319B2 (en) 2017-08-17 2021-01-26 Edwards Lifesciences Corporation Sealing member for prosthetic heart valve
US10973628B2 (en) 2017-08-18 2021-04-13 Edwards Lifesciences Corporation Pericardial sealing member for prosthetic heart valve
US10722353B2 (en) 2017-08-21 2020-07-28 Edwards Lifesciences Corporation Sealing member for prosthetic heart valve
JP7291124B2 (en) 2017-08-28 2023-06-14 テンダイン ホールディングス，インコーポレイテッド Heart valve prosthesis with tethered connections
US10973629B2 (en) 2017-09-06 2021-04-13 Edwards Lifesciences Corporation Sealing member for prosthetic heart valve
US11147667B2 (en) 2017-09-08 2021-10-19 Edwards Lifesciences Corporation Sealing member for prosthetic heart valve
US11246625B2 (en) 2018-01-19 2022-02-15 Boston Scientific Scimed, Inc. Medical device delivery system with feedback loop
JP7055882B2 (en) 2018-01-19 2022-04-18 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 Guidance mode indwelling sensor for transcatheter valve system
US11147668B2 (en) 2018-02-07 2021-10-19 Boston Scientific Scimed, Inc. Medical device delivery system with alignment feature
WO2019165394A1 (en) 2018-02-26 2019-08-29 Boston Scientific Scimed, Inc. Embedded radiopaque marker in adaptive seal
US11318011B2 (en) 2018-04-27 2022-05-03 Edwards Lifesciences Corporation Mechanically expandable heart valve with leaflet clamps
CN112399836A (en) 2018-05-15 2021-02-23 波士顿科学国际有限公司 Replacement heart valve commissure assemblies
US10561367B1 (en) 2018-05-21 2020-02-18 Apple, Inc. Electronic devices having adjustable fabric
US11241310B2 (en) 2018-06-13 2022-02-08 Boston Scientific Scimed, Inc. Replacement heart valve delivery device
KR20210082188A (en) 2018-10-19 2021-07-02 에드워즈 라이프사이언시스 코포레이션 Artificial heart valve with non-cylindrical frame
WO2020123486A1 (en) 2018-12-10 2020-06-18 Boston Scientific Scimed, Inc. Medical device delivery system including a resistance member
US11278402B2 (en) 2019-02-21 2022-03-22 Medtronic, Inc. Prosthesis for transcatheter delivery having an infolding longitudinal segment for a smaller radially compressed profile
WO2020198273A2 (en) 2019-03-26 2020-10-01 Edwards Lifesciences Corporation Prosthetic heart valve
US11439504B2 (en) 2019-05-10 2022-09-13 Boston Scientific Scimed, Inc. Replacement heart valve with improved cusp washout and reduced loading
US11583397B2 (en) 2019-09-24 2023-02-21 Medtronic, Inc. Prosthesis with anti-paravalvular leakage component including a one-way valve
EP3831343B1 (en) 2019-12-05 2024-01-31 Tendyne Holdings, Inc. Braided anchor for mitral valve
US11648114B2 (en) 2019-12-20 2023-05-16 Tendyne Holdings, Inc. Distally loaded sheath and loading funnel
US11951002B2 (en) 2020-03-30 2024-04-09 Tendyne Holdings, Inc. Apparatus and methods for valve and tether fixation
WO2021257774A1 (en) 2020-06-18 2021-12-23 Edwards Lifesciences Corporation Crimping methods
WO2022039853A1 (en) 2020-08-19 2022-02-24 Tendyne Holdings, Inc. Fully-transseptal apical pad with pulley for tensioning

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE1180087B (en) * 1964-03-26 1964-10-22 Dr Wolfgang Seidel Prosthetic heart valve
US3996623A (en) * 1974-07-30 1976-12-14 Kaster Robert L Method of implanting a prosthetic device and suturing member therefor
WO1989000841A1 (en) * 1987-07-27 1989-02-09 St. Jude Medical, Inc. Protective shield for prosthetic heart valves

Family Cites Families (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3546710A (en) * 1965-12-11 1970-12-15 Valery Ivanovich Shumakov Cardiac valve prosthesis for sutureless fixation
US3574865A (en) * 1968-08-08 1971-04-13 Michigan Instr Inc Prosthetic sutureless heart valve
US3625220A (en) * 1969-10-07 1971-12-07 Horizon Ind Ltd Extendible suture guard
US4084268A (en) * 1976-04-22 1978-04-18 Shiley Laboratories, Incorporated Prosthetic tissue heart valve
US4276658A (en) * 1977-11-02 1981-07-07 St. Jude Medical, Inc. Heart valve prosthesis
US4233690A (en) * 1978-05-19 1980-11-18 Carbomedics, Inc. Prosthetic device couplings
US4665906A (en) * 1983-10-14 1987-05-19 Raychem Corporation Medical devices incorporating sim alloy elements
GB9312666D0 (en) * 1993-06-18 1993-08-04 Vesely Ivan Bioprostetic heart valve

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE1180087B (en) * 1964-03-26 1964-10-22 Dr Wolfgang Seidel Prosthetic heart valve
US3996623A (en) * 1974-07-30 1976-12-14 Kaster Robert L Method of implanting a prosthetic device and suturing member therefor
WO1989000841A1 (en) * 1987-07-27 1989-02-09 St. Jude Medical, Inc. Protective shield for prosthetic heart valves

Also Published As

Publication number Publication date
ZA964886B (en) 1997-02-11
AU6379796A (en) 1996-12-30
US5571175A (en) 1996-11-05
US5843179A (en) 1998-12-01

Similar Documents

Publication Publication Date Title
US5571175A (en) Suture guard for prosthetic heart valve
US5843178A (en) Suture guard for annuloplasty ring
US5178633A (en) Suture ring for heart valve prosthesis
US5766240A (en) Rotatable suturing ring for prosthetic heart valve
US7641687B2 (en) Attachment of a sewing cuff to a heart valve
US6716244B2 (en) Sewing cuff assembly for heart valves
US5397346A (en) Prosthetic heart valve with sewing ring
US6241765B1 (en) Stapled heart prosthesis and method of installing same
EP1303234B1 (en) Heart valve holder for constricting the valve commissures
EP1610727B1 (en) Heart valve prosthesis
US6217611B1 (en) Modular heart valve prothesis
US4506394A (en) Cardiac valve prosthesis holder
EP1542623B1 (en) Suturing ring for implantable heart valve prostheses
US5876436A (en) Rotatable cuff assembly for a heart valve prosthesis
JP4928036B2 (en) Artificial heart valve with rotating cuff
EP0477325B1 (en) Bioprosthetic heart valve with elastic commissures
EP2901967B1 (en) Rapid deployment prosthetic heart valve
US6312465B1 (en) Heart valve prosthesis with a resiliently deformable retaining member
US8512396B2 (en) Device for treating a blood circulation conduit
AU2001282885A1 (en) Heart valve holder for constricting the valve commissures
WO1989000841A1 (en) Protective shield for prosthetic heart valves
CN113395948B (en) Prosthetic heart valve with suture looping prevention member
JP2023504327A (en) heart valve belt

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AL AM AT AU AZ BB BG BR BY CA CH CN CZ DE DK EE ES FI GB GE HU IL IS JP KE KG KP KR KZ LK LR LS LT LU LV MD MG MK MN MW MX NO NZ PL PT RO RU SD SE SG SI SK TJ TM TR TT UA UG UZ VN AM AZ BY KG KZ MD RU TJ TM

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): KE LS MW SD SZ UG AT BE CH DE DK ES FI FR GB GR IE IT LU MC NL PT SE BF BJ CF CG CI CM GA GN

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)
REG Reference to national code

Ref country code: DE

Ref legal event code: 8642

REG Reference to national code

Ref country code: DE

Ref legal event code: 8642

122 Ep: pct application non-entry in european phase
NENP Non-entry into the national phase

Ref country code: CA