INSTRUMENT FOR THE SURGICAL REMOVAL OF A DEFECTIVE HEART VALVE

• US 20080188880A1
• Filed: 01/29/2008
• Published: 08/07/2008
• Est. Priority Date: 02/01/2007
• Status: Active Grant

• Current Assignee: Endosmart Gesellschaft Fur Innovative Medizintechnik MbH
• Original Assignee: Endosmart Gesellschaft Fur Innovative Medizintechnik MbH
• Inventors: Fischer, Harald, Hauck, Florian
• Granted Patent: US 8,979,878 B2
• Time in Patent Office: Days
• US Class Current: 606/170
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61F 2/24 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

Abstract

An instrument for the surgical removal of a defective heart valve. The instrument has elements that can be collapsed, in which the instrument cutting elements are collapsed when the instrument is introduced into the surgical field and are covered by means of contact protective sheaths. The instrument cutting elements are formed as cutting ring halves that can fold in around a hinge axis, these cutting ring halves being elastically deformable during the folding-in process, whereby their deformation is achieved by fish joints that also serve to aid in mutually moving the contact protective sheaths onto each of two body members.

Claims

1. An instrument for the surgical removal of a defective heart valve, comprising:

two body members arranged coaxially and at a distance to one another at or on an elongated member, these body members being able to move axially relative to one another by means of the elongated member in such a way that their instrument cutting elements aligned opposite one another cut out a defective heart valve positioned between the body members,

the cutting elements of the body members can be radially collapsed, i.e., their radial distance from the instrument axis becomes smaller, for the surgical introduction of the instrument into the surgical field, and there is a contact protective sheath fitted to the elongated member, which is narrow in diameter, and which can be moved axially onto the body members having the radially collapsed cutting elements, so that the advancing (distal) end of the instrument comprising the contact protective sheath fitted to the elongated member, the sheath being narrow in diameter, is moved through the defective heart valve by the width of the piece until it is in a position in which one body member is found on one side of the defective heart valve and the other body member is found on the other side of the defective heart valve,

the contact protective sheath is pulled off axially from the body members in this position and the cutting elements of the body members can be radially expanded, i.e., their radial distance from the instrument axis is increased up to a diameter that corresponds to the diameter of the defective heart valve to be cut out and to the diameter of the new heart valve that is subsequently to be inserted surgically,

wherein the cutting elements of each of the body members are formed of two semicircular cutting ring halves, which are joined to one another on the end to form a circular cutting ring by means of a single-axis hinge joint, wherein each half of the cutting ring is made of an elastically deformable flat material strip and each is pre-shaped true to size in edge-wise format to the semicircle diameter required in the radially expanded state,

wherein the hinge axes of the cutting ring halves are aligned perpendicular to the axis of the elongated member and each is attached by means of the head end of an elastically deformable fish joint that is resistant to extension and compression, the fish joints extending in the longitudinal direction of the elongated member and each is mounted at the elongated member by its foot end,

and wherein each cutting ring half is held by means of another elastically deformable fish joint that is resistant to extension and compression, extending in the longitudinal direction of the elongated member and mounted on the elongated member by its foot end, the head end of which is coupled to the center of the semicircle on the semicircular-shaped cutting ring halves in the extended state, whereby this coupling and/or the elastically deformable fish joint of the cutting ring halves permits conducting a swivel movement of almost 90°

around an axis running crosswise to the fish joint.

2. The instrument according to claim 1, wherein the fish joints, the head ends of which are coupled to the center of the cutting ring halves, are mounted in a stationary manner by their respective foot ends to the elongated member,

and the fish joints, the head ends of which attach the hinge axes, are mounted so that they can be axially moved and stopped by their respective foot ends at or on the elongated member.

3. The instrument according to claim 1, wherein each body member possesses its own contact protective sheath, which is mounted onto the fish joints which are assigned to the respective body members, and which can be moved axially onto these fish joints and opposite to the contact protective sheath of the other body member.

4. The instrument according to claim 1,wherein the diameter of cutting ring of one body member is slightly larger than the diameter of cutting ring of the other body member, such that both cutting rings engage in one another with the formation of a narrow shearing gap when cutting out the defective heart valve positioned between them.

5. The instrument according to claim 1, wherein the body members with their cutting rings can rotate relative to one another in such a way that the defective heart valve will be cut out by a rotating-punching process.

6. The instrument according to claim 1, wherein the elastically deformable flat material strip is of superelastic Nitinol.

7. An instrument for the surgical removal of a defective heart valve comprising, an elongated member, two body members each having cutting elements and arranged coaxially and at a distance to one another at or on the elongated member, these body members being able to move axially relative to one another by means of the elongated member in such a way that the cutting elements aligned opposite one another cut out a defective heart valve positioned between the body members, the cutting elements of each of the body members being formed of two semicircular cutting ring halves, which are joined to one another on the end to form a circular cutting ring by means of a single-axis hinge joint, wherein each half of the cutting ring is made of an elastically deformable flat material strip and each is pre-shaped true to size in edge-wise format to the semicircle diameter required in the radially expanded state, wherein the hinge axes of the cutting ring halves are aligned perpendicular to the axis of the elongated member and each is attached by means of the head end of an elastically deformable fish joint that is resistant to extension and compression, the fish joints extending in the longitudinal direction of the elongated member and each is mounted at the elongated member by its foot end, and wherein each cutting ring half is held by means of another elastically deformable fish joint that is resistant to extension and compression, extending in the longitudinal direction of the elongated member and mounted on the elongated member by its foot end, the head end of which is coupled to the center of the semicircle on the semicircular-shaped cutting ring halves in the extended state, whereby this coupling and/or the elastically deformable fish joint of the cutting ring halves permits conducting a swivel movement around an axis running crosswise to the fish joint.

8. The instrument according to claim 7, wherein the fish joints, the head ends of which are coupled to the center of the cutting ring halves, are mounted in a stationary manner by their respective foot ends to the elongated member, and wherein the fish joints, the head ends of which attach the hinge axes, are mounted so that they can be axially moved and stopped by their respective foot ends at or on the elongated member.

9. The instrument according to claim 7, wherein each body member possesses its own contact protective sheath, which is mounted onto the fish joints which are assigned to the respective body members, and which can be moved axially onto these fish joints and opposite to the contact protective sheath of the other body member.

10. The instrument according to claim 7, wherein the diameter of cutting ring of one body member is slightly larger than the diameter of cutting ring of the other body member, such that both cutting rings engage in one another with the formation of a narrow shearing gap when cutting out the defective heart valve positioned between them.

11. The instrument according to claim 7, wherein the body members with their cutting rings can rotate relative to one another in such a way that the defective heart valve will be cut out by a rotating-punching process.

12. The instrument according to claim 7 wherein the elastically deformable flat material strip is of superelastic Nitinol.

13. The instrument according to claim 7 wherein the cutting ring halves permits conducting a swivel movement of almost 90°

around an axis running crosswise to the fish joint.