摘要:
A prosthetic heart valve can comprise a stent frame radially movable between a contracted configuration and a maximum expanded configuration. The stent assembly can comprise a plurality of longitudinally extending jack strut assemblies, wherein each jack strut assembly comprises a proximal jack strut comprising a distal surface, a distal jack strut comprising a proximal surface, and a jack screw connecting the proximal jack strut and the distal jack strut. The proximal surface of each distal jack strut does not contact the distal surface of each respective proximal jack strut when the stent assembly is in the contracted configuration. The proximal surface of each distal jack strut contacts the distal surface of each respective proximal jack strut when the stent assembly is in the maximum expanded configuration.
摘要:
An assembly includes a prosthetic heart valve and a delivery apparatus. The prosthetic heart valve has a plurality of pivotably connected struts and one or more adjustable elements rotatably coupled to the struts. Rotating the adjustable elements in a first direction relative to the struts radially expands the prosthetic heart valve. Rotating the adjustable elements in a second direction relative to the struts radially contracts the prosthetic heart valve. The delivery apparatus includes one or more motors, one or more drive wires coupled to the motors, and a memory. The drive wires are coupled to the adjustable elements of the prosthetic heart valve. The motors are configured to rotate the drive wires and the adjustable elements to expand and contract the prosthetic heart valve. The memory is configured for storing one or more characteristics of the motors, the drive wires, or the prosthetic heart valve.
摘要:
Sealable and repositionable implant devices are provided with features that increase the ability of implants such as endovascular grafts and valves to be precisely deployed or re-deployed, with better in situ accommodation to the local anatomy of the targeted recipient anatomic site, and/or with the ability for post-deployment adjustment to accommodate anatomic changes that might compromise the efficacy of the implant. A surgical implant includes an implant body and a selectively adjustable assembly attached to the implant body, the assembly having adjustable elements and being operable to cause a configuration change in a portion of the implant body and, thereby, permit implantation of the implant body within an anatomic orifice to effect a seal therein under normal physiological conditions.
摘要:
A mitral valve implant includes a force-expanding mitral valve lattice having an interior orifice and a self-expanding valve trampoline attached at the interior orifice of the force-expanding mitral valve lattice. The mitral valve lattice is self-expandable to a first configuration and force expandable from the first configuration to a second configuration. The configurations can be circular or D-shaped. The mitral valve lattice comprises jack screws adjusting configurations of the mitral valve lattice. The valve trampoline has a cylindrical central region comprising valve leaflets. An outwardly flaring implant skirt is attached to the mitral valve lattice exterior. Wall-retaining wires are attached to the mitral valve lattice, are petal-shaped, and have a pre-set, radially outward, memory shape. The wires and skirt impart a force on a respective side of the native mitral valve when the mitral valve lattice is expanded within an annulus of the native mitral valve.
摘要:
A prosthetic heart valve includes a frame, a valve, and an expansion element. The frame is movable between contracted and expanded configurations and includes first struts and second struts non-hingedly coupled together. The second struts are configured to pivot relative to the first struts as the frame moves between the contracted and expanded configurations. The valve is coupled to the frame and includes leaflets. The expansion element extends through a lumen of the first struts. The expansion element is slidable relative to the lumen of the first struts and is configured to move the frame incrementally from the contracted configuration and the expanded configuration and from the expanded configuration to the contracted configuration.
摘要:
A method of implanting a replacement mitral valve can include expanding a replacement mitral valve to a first expanded configuration. The replacement mitral valve can include a force-expanding mitral valve lattice and a self-expanding valve trampoline lattice. The mitral valve lattice has an inflow end portion and an outflow end portion, and the valve trampoline lattice is attached to the outflow end portion of the mitral valve lattice. The method can also include rotating a plurality of jack screws connected to the mitral valve lattice. The jack screws can be configured to expand the mitral valve lattice from the first expanded configuration to a second expanded configuration.
摘要:
A delivery apparatus can include a handle portion and at least one rotatable drive shaft. The handle portion can have an actuation mechanism with a motor. The rotatable drive shaft can have a proximal end portion and a distal end portion. The proximal end portion of the rotatable drive shaft can be coupled to the motor, and the distal end portion of the rotatable drive shaft can be configured to be releasably coupled to a prosthetic heart valve. The actuation mechanism can be configured to control and monitor expansion of the prosthetic heart valve and to control and monitor torque of the motor.
摘要:
A method of implanting a replacement mitral valve can include expanding a replacement mitral valve to a first expanded configuration. The replacement mitral valve can include a force-expanding mitral valve lattice and a self-expanding valve trampoline lattice. The mitral valve lattice has an inflow end portion and an outflow end portion, and the valve trampoline lattice is attached to the outflow end portion of the mitral valve lattice. The method can also include rotating a plurality of jack screws connected to the mitral valve lattice. The jack screws can be configured to expand the mitral valve lattice from the first expanded configuration to a second expanded configuration.
摘要:
A method for implanting a stent includes contracting a self-expanding/forcibly-expanding stent of a shape-memory material set to a given shape to a reduced implantation size with a delivery system having drive wires. The stent has a selectively adjustable assembly with adjustable elements operatively connected to the drive wires such that, when the adjustable elements are adjusted by the drive wires, a configuration change in at least a portion of the self-expanding stent occurs. The contracted stent is inserted into a native annulus in which the stent is to be implanted. The drive wires are rotated with the delivery system to forcibly expand the stent into the native annulus. While rotating the drive wires, a torque applied to the drive wires is determined with the delivery system. Rotation of the drive wires is stopped based upon a value of the determined torque.
摘要:
A delivery apparatus can include a handle portion and at least one rotatable drive shaft. The handle portion has an actuation mechanism. The actuation mechanism includes a motor and one or more actuators. The rotatable drive shaft has a proximal end portion and a distal end portion. The proximal end portion is coupled to the motor, and the distal end portion is configured to be releasably coupled to a prosthetic heart valve. The actuation mechanism is configured to control and monitor expansion of the prosthetic heart valve. The handle is configured for actuating the actuation mechanism, tracking a response of native tissue when the prosthetic heart valve is in contact with the native tissue, and stopping expansion of the prosthetic heart valve once a rate of change of expansion of the prosthetic heart valve declines below a threshold.