公开(公告)号：US20080097593A1

公开(公告)日：2008-04-24

申请号：US11959206

申请日：2007-12-18

申请人： Steven Bolling ,  Richard Rhee

发明人： Steven Bolling ,  Richard Rhee

IPC分类号： A61F2/24

CPC分类号： A61F2/2448 ,  A61F2/2445

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

摘要翻译： 植入环形成形术环以纠正二尖瓣环的疾病的方法，其不仅重塑环形，而且重新配置邻近的左心室肌壁。 环可以是连续的，并且由相对刚性的材料制成，例如Stellite。 该环具有至少在后侧三维的大致椭圆形状。 环的后部从相邻的侧面向上升起或向上弯曲，从而使天然环的后方比原来的健康形状更远。 在这样做的同时，环也向上拉动心室壁，这有助于减轻充血性心力衰竭的一些影响。 此外，环的后部和前部中的一个或两个也可以向内弯曲。 所述方法包括将前部的环形成形环抵靠环空前部和后部抵靠环形后部固定，使得环后部升高并且还可以径向向内拉动环后隙，并纠正二尖瓣反流。

公开(公告)号：US20050049698A1

公开(公告)日：2005-03-03

申请号：US10968323

申请日：2004-10-18

申请人： Steven Bolling ,  Richard Rhee

发明人： Steven Bolling ,  Richard Rhee

IPC分类号： A61F2/24

CPC分类号： A61F2/2448 ,  A61F2/2445

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

摘要翻译： 植入环形成形术环以纠正二尖瓣环的疾病的方法，其不仅重塑环形，而且重新配置邻近的左心室肌壁。 环可以是连续的，并且由相对刚性的材料制成，例如Stellite。 该环具有至少在后侧三维的大致椭圆形状。 环的后部从相邻的侧面向上升起或向上弯曲，从而使天然环的后方比原来的健康形状更远。 在这样做的同时，环也向上拉动心室壁，这有助于减轻充血性心力衰竭的一些影响。 此外，环的后部和前部中的一个或两个也可以向内弯曲。 所述方法包括将瓣膜成形术环与前部部分抵靠环形前部方面固定，并且后部部分抵靠环空后方固定，使得环后部部分升高并且也可以径向向内拉动环后环，并纠正二尖瓣反流。

公开(公告)号：US20060015002A1

公开(公告)日：2006-01-19

申请号：US11142078

申请日：2005-05-31

申请人： Shahram Moaddeb ,  Samuel Shaolian ,  Emanuel Shaoulian ,  Richard Rhee ,  Steven Anderson

发明人： Shahram Moaddeb ,  Samuel Shaolian ,  Emanuel Shaoulian ,  Richard Rhee ,  Steven Anderson

IPC分类号： A61F2/00

CPC分类号： A61B17/00234 ,  A61B17/06166 ,  A61B17/0644 ,  A61B17/068 ,  A61B2017/00243 ,  A61B2017/00867 ,  A61B2017/06052

摘要： Systems, methods and devices are provided for treating heart failure patients suffering from various levels of heart dilation. Such heart dilation is treated by reshaping the heart anatomy with the use of shape memory elements. Such reshaping changes the geometry of portions of the heart, particularly the right or left ventricles, to increase contractibility of the ventricles thereby increasing the stroke volume which in turn increases the cardiac output of the heart. The shape memory elements have an original shape and at least one memory shape. The elements are implanted within the heart tissue or attached externally and/or internally to a surface of the heart when in the original shape. The elements are then activated to transition from the original shape to one of the at least one memory shapes. Transitioning of the elements cause the associated heart tissue areas to readjust position, such as to decrease the width of the ventricles. Such repositioning is maintained over time by the elements, allowing the damaging effects of heart dilation to slow in progression or reverse.

公开(公告)号：US20050182487A1

公开(公告)日：2005-08-18

申请号：US11106421

申请日：2005-04-14

申请人： Patrick McCarthy ,  Richard Rhee ,  Stefan Schreck

发明人： Patrick McCarthy ,  Richard Rhee ,  Stefan Schreck

IPC分类号： A61F2/24

CPC分类号： A61F2/2445 ,  A61F2/2448 ,  A61F2/2466 ,  A61F2230/0091 ,  A61F2250/0029 ,  A61F2250/0036 ,  A61F2250/0037 ,  Y10S623/90

摘要： An annuloplasty ring having a three-dimensional discontinuous form generally arranged about an axis with two free ends that are axially offset. The ring is particularly suited for repair of the tricuspid valve, and more closely conforms to the annulus shape. The ring is more flexible in bending about radially extending axes than about the central axis. The ring may have an inner structural support covered by a pliable sleeve and/or a fabric tube. The structural support may have a varying cross-section, such as a C-shaped cross-section in a mid-section between two free ends and a rectangular cross-section at the free ends. A deliver template having a mounting ring with about the same shape as the ring facilitates implant, and may be releasably attached to a delivery handle. The deliver template may include a plurality of cutting guides for releasably attaching the annuloplasty ring thereto while presenting maximum outer surface area of the ring. The template may have an outwardly-facing groove to receive and retain the ring.

摘要翻译： 具有三维不连续形状的瓣环成形术环通常围绕具有轴向偏移的两个自由端的轴线布置。 该环特别适用于修复三尖瓣，并且更接近于环形。 环绕径向延伸的轴弯曲比围绕中心轴更弯曲。 环可以具有由柔韧的套筒和/或织物管覆盖的内部结构支撑。 结构支撑件可以具有变化的横截面，例如两个自由端之间的中间部分中的C形横截面和在自由端处的矩形横截面。 具有与环具有大致相同形状的安装环的输送模板便于植入，并且可以可释放地附接到递送手柄。 递送模板可以包括多个切割引导件，用于可释放地将瓣环成形术环附接到其上，同时具有环的最大外表面面积。 模板可以具有向外的凹槽以接收和保持环。

公开(公告)号：US20050171601A1

公开(公告)日：2005-08-04

申请号：US11095982

申请日：2005-03-30

申请人： Delos Cosgrove ,  Stefan Schreck ,  Richard Rhee

发明人： Delos Cosgrove ,  Stefan Schreck ,  Richard Rhee

IPC分类号： A61F2/24

CPC分类号： A61F2/2445 ,  A61F2/2466

摘要： An annuloplasty repair segment and template for heart valve annulus repair. The elongate flexible template may form a distal part of a holder that also has a proximal handle. Alternatively, the template may be releasably attached to a mandrel that slides within a delivery sheath, the template being released from the end of the sheath to enable manipulation by a surgeon. A tether connecting the template and mandrel may also be provided. The template may be elastic, temperature responsive, or multiple linked segments. The template may be aligned with the handle and form a two- or three-dimensional curve out of alignment with the handle such that the annuloplasty repair segment attached thereto conforms to the curve. The template may be actively or passively converted between its straight and curved positions. The combined holder and ring is especially suited for minimally-invasive surgeries in which the combination is delivered to an implantation site through a small access incision with or without a cannula, or through a catheter passed though the patient's vasculature.

摘要翻译： 用于心脏瓣膜环修复的瓣膜成形术修复部分和模板。 细长的柔性模板可以形成也具有近端手柄的保持器的远端部分。 或者，模板可以可释放地附接到在输送护套内滑动的心轴，模板从护套的端部释放以允许外科医生进行操纵。 还可以提供连接模板和心轴的系绳。 模板可以是弹性的，温度敏感的或多个链接的段。 模板可以与手柄对准并且形成与手柄对准的二维或三维曲线，使得附接到其上的瓣膜成形术修复段符合曲线。 模板可以在其直线位置和弯曲位置之间被主动地或被动地转换。 组合的保持器和环特别适用于微创手术，其中组合通过具有或不具有插管的小切口切口或通过穿过患者脉管系统的导管递送至植入部位。

公开(公告)号：US20070067027A1

公开(公告)日：2007-03-22

申请号：US11520981

申请日：2006-09-13

申请人： Shahram Moaddeb ,  Richard Rhee ,  Steve Anderson

发明人： Shahram Moaddeb ,  Richard Rhee ,  Steve Anderson

IPC分类号： A61F2/24

CPC分类号： A61F2/2448 ,  A61F2/2466 ,  A61F2250/0004

摘要： Systems, methods and devices are provided for activation of an adjustable annuloplasty device. The devices may include a catheter system for percutaneously activating an adjustable annuloplasty device, including a handle assembly, a shaft assembly having at least one fluid lumen, and a distal element. The shaft assembly extends between the handle assembly and the distal element, the distal element being in fluid communication with the handle assembly via the at least one fluid lumen. The distal element includes an elongated core having a first port and an expandable member. The core extends through the expandable member and the expandable member is movable between a collapsed position and an inflated position. The distal element has a preset shape in the inflated position, having a long axis that is curvilinear. A surface of the distal element extends along the long axis and is configured to conform to a curvilinear surface of the annuloplasty device. In some arrangements, the annuloplasty device includes a ring, and the circumference of the annuloplasty device is a circumference of the ring.

摘要翻译： 提供了用于激活可调节瓣环成形术装置的系统，方法和装置。 装置可以包括用于经皮激活可调节瓣环成形术装置的导管系统，包括手柄组件，具有至少一个流体腔的轴组件和远端元件。 轴组件在手柄组件和远侧元件之间延伸，远端元件通过至少一个流体腔与手柄组件流体连通。 远侧元件包括具有第一端口和可扩张构件的细长芯。 芯延伸穿过可膨胀构件，并且可膨胀构件可在折叠位置和膨胀位置之间移动。 远侧元件在充气位置具有预设的形状，具有曲线的长轴。 远侧元件的表面沿着长轴延伸并且构造成符合瓣环成形术装置的曲线表面。 在一些布置中，瓣环成形术装置包括环，并且瓣环成形术装置的圆周是环的圆周。

公开(公告)号：US20060015003A1

公开(公告)日：2006-01-19

申请号：US11142127

申请日：2005-05-31

申请人： Shahram Moaddes ,  Samuel Shaolian ,  Emanuel Shaoulian ,  Richard Rhee ,  Steven Anderson

发明人： Shahram Moaddes ,  Samuel Shaolian ,  Emanuel Shaoulian ,  Richard Rhee ,  Steven Anderson

IPC分类号： A61N2/10 ,  A61F2/02 ,  A61B17/34

CPC分类号： A61F2/2481 ,  A61B17/3468 ,  A61B2017/00876 ,  A61F2/2478 ,  A61F2/2487 ,  A61F2002/249 ,  A61F2210/009 ,  A61N2/00

摘要： Systems, methods and devices are provided for treating heart failure patients suffering from various levels of heart dilation. Heart dilation treated by reshaping the heart anatomy with the use of magnetic forces. Such reshaping changes the geometry of portions of the heart, particularly the right or left ventricles, to increase contractibility of the ventricles thereby increasing the stroke volume which in turn increases the cardiac output of the heart. The magnetic forces are applied with the use of one or more magnetic elements which are implanted within the heart tissue or attached externally and/or internally to a surface of the heart. The various charges of the magnetic forces interact causing the associated heart tissue areas to readjust position, such as to decrease the width of the ventricles. Such repositioning is maintained over time by the force of the magnetic elements, allowing the damaging effects of heart dilation to slow in progression or reverse.

摘要翻译： 提供了用于治疗患有各种心脏扩张水平的心力衰竭患者的系统，方法和装置。 通过使用磁力重塑心脏解剖结构治疗的心脏扩张。 这种重塑改变了心脏的部分的几何形状，特别是右心室或左心室，以增加心室的收缩性，从而增加了行程体积，从而增加了心脏的心输出量。 使用一个或多个植入心脏组织内或附着在心脏外表面和/或内部的磁性元件施加磁力。 磁力的各种电荷相互作用，使相关的心脏组织区域重新调整位置，例如减小心室的宽度。 这种重新定位通过磁性元件的力量随着时间的推移而保持，从而允许心脏扩张的破坏性影响进展缓慢或逆转。

公开(公告)号：US06350281B1

公开(公告)日：2002-02-26

申请号：US09396124

申请日：1999-09-14

申请人： Richard Rhee

发明人： Richard Rhee

IPC分类号： A61F206

CPC分类号： A61F2/2496 ,  A61B5/1076

摘要： A sizer measures a valve annulus to determine a size of an artificial heart valve to be sewn in the valve annulus during heart-valve replacement surgery. The sizer includes a support member and a resilient member. The support member has a size corresponding to the size of one of a plurality of artificial heart valves. The resilient member is disposed about the support member and has a resiliency substantially equal to the resiliency of a sewing ring of the artificial heart valve. Accordingly, when a surgeon inserts the sizer into a valve annulus, the resilient member conforms to the shape of the valve annulus much like the sewing ring will conform when positioned in the annulus and sewn in place. The surgeon is therefore able to determine more accurately the size of the annulus and, thereafter, to select a properly sized artificial valve.

摘要翻译： 在心脏瓣膜置换手术期间，分级器测量瓣膜环以确定要缝合在瓣膜环中的人造心脏瓣膜的尺寸。 定径器包括支撑构件和弹性构件。 支撑构件的尺寸对应于多个人造心脏瓣膜之一的尺寸。 弹性构件设置在支撑构件周围，并且具有基本上等于人造心脏瓣膜的缝合环的弹性的弹性。 因此，当外科医生将定量器插入阀环时，弹性构件与阀环的形状一致，非常类似于缝合环在定位于环形空间并缝合就位时将符合。 因此，外科医生能够更准确地确定环的尺寸，此后，选择适当尺寸的人造瓣膜。

公开(公告)号：US06231601B1

公开(公告)日：2001-05-15

申请号：US09468715

申请日：1999-12-21

申请人： Keith Myers ,  Ross Bartholomew ,  Robert J. Todd ,  Carl Swindle ,  Charles Weyrauch ,  Richard Rhee ,  Jane Li ,  Jerry Jackman ,  Victor Packham

发明人： Keith Myers ,  Ross Bartholomew ,  Robert J. Todd ,  Carl Swindle ,  Charles Weyrauch ,  Richard Rhee ,  Jane Li ,  Jerry Jackman ,  Victor Packham

IPC分类号： A47F1306

CPC分类号： A61F2/2466

摘要： A method of surgery including bending a multi-purpose surgical implement handle that has proximal and distal ends. A gripping section is located toward the proximal end, and an attachment section is located toward the distal end. An adjusting section is interposed between the gripping section and the attachment section. The adjusting section may be bent by a human user at virtually any discrete location along the section. The adjusting section may include an increased-adjustability portion which is easier to bend than other portions of the adjusting section. The method includes attaching a surgical implement to the attaching section of the handle, and bending the adjusting section at least once prior to inserting the implement through a surgical opening to a surgical field. The method further may include bending the adjusting section more than once to form multiple bends therein.

摘要翻译： 一种手术方法，包括弯曲具有近端和远端的多用途外科手术器具手柄。 抓握部分朝向近端定位，并且附接部分朝向远端定位。 调整部分夹在夹持部分和附接部分之间。 调整部分可以由人类用户在实际上沿着该部分的任何离散位置弯曲。 调节部可以包括比调节部的其他部分更容易弯曲的增加调节部。 该方法包括将手术器械附接到手柄的附接部分，并且在将工具通过手术开口插入外科手术区域之前，将调节部分弯曲至少一次。 该方法还可以包括多次弯曲调节部分以在其中形成多个弯曲部。

公开(公告)号：US6162172A

公开(公告)日：2000-12-19

申请号：US16489

申请日：1998-01-30

申请人： Delos M. Cosgrove ,  Norma L. Lowe ,  Keith Myers ,  Richard Rhee

发明人： Delos M. Cosgrove ,  Norma L. Lowe ,  Keith Myers ,  Richard Rhee

IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B19/00

CPC分类号： A61B17/0293 ,  A61B2017/00243 ,  A61B2090/306

摘要： Surgical apparatus and associated methods of use are provided for retracting tissue around an incision. The apparatus includes a member having an inner peripheral surface and an outer peripheral surface. An adjustable aperture is definable within the inner peripheral surface as the member is adjusted between a compressed condition in which the aperture is substantially closed and an expanded condition in which the aperture is substantially open. The apparatus is positioned within a surgical incision in the compressed condition, and is adjusted to the expanded condition in situ to define an opening within the incision through the aperture whereby a surgical field may be viewed and/or accessed.

摘要翻译： 提供手术设备和相关联的使用方法用于缩回切口周围的组织。 该装置包括具有内周面和外周面的部件。 当孔被基本上封闭的压缩状态和开口基本上打开的扩张状态之间调节构件时，在内周表面内可定义可调节孔。 该装置位于处于压缩状态的手术切口内，并且在原位调整到扩张状态，以在切口内通过孔限定开口，从而可以观察和/或访问外科视野。