Instrument for the surgical removal of a defective heart valve

• US 8,979,878 B2
• Filed: 01/29/2008
• Issued: 03/17/2015
• Est. Priority Date: 02/01/2007
• Status: Active Grant

• Current Assignee: Endosmart Gesellschaft Fur Innovative Medizintechnik MbH
• Original Assignee: Endosmart Gesellschaft Fur Medizintechnik Mbh
• Inventors: Fischer, Harald, Hauck, Florian
• Primary Examiner(s): Holwerda, Kathleen
• Assistant Examiner(s): SIMPSON, SARAH A
• Application Number:
  US12/021,396
• Publication Number:
  US 20080188880A1
• Time in Patent Office: 2,604 Days
• Field of Search: 606/170, 606/167, 606/159, 623/2.11
• 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, cutting elements aligned opposite one another to cut out a defective heart valve positioned between the body members,

the cutting elements of the body members having a radially collapsed position, in which 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 an advancing end of the instrument comprises the contact protective sheath fitted to the elongated member, the sheath being narrow in diameter, is moved through the defective heart valve 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 have a radially expanded position, so that 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 a 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 each having a center, the cutting ring halves being joined to one another on the end to form a circular cutting ring by means of a single-axis hinge joint that is comprised of diametrically disposed hinge members having aligned respective hinge axes that together define a common swivel axis, 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 diameter required in the radially expanded state,

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

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

around the common swivel axis folding between the radially collapsed position and the radially expanded position.

2. The instrument according to claim 1, wherein the second 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 first 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 a diameter of the cutting ring of one body member is slightly larger than a diameter of the 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 the body members having a radially collapsed position, in which their radial distance from the instrument axis becomes smaller, for the surgical introduction of the instrument into the surgical field, the cutting elements of each of the body members being formed of two semicircular cutting ring halves, each having a center and which are joined to one another on the end to form a circular cutting ring by means of a single-axis hinge joint that is comprised of diametrically disposed hinge members having aligned respective hinge axes that together define a common swivel axis, 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 a semicircle diameter required in the radially expanded state, wherein the hinge axes of the respective hinge members of the cutting ring halves are aligned perpendicular to the axis of the elongated member and each respective hinge member is attached by means of a head end of an elastically deformable first fish joint that is resistant to extension and compression, the first fish joints each constructed of a flat material strip, extending in the longitudinal direction of the elongated member and each is mounted at the elongated member by the foot end thereof, and wherein each cutting ring half is held by means of another elastically deformable second-fish joint that is resistant to extension and compression, the second fish joints each constructed of a flat material strip, extending in the longitudinal direction of the elongated member and mounted on the elongated member by a foot end thereof, the head end of which is connected to the center of 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 relative swivel movement of the cutting ring halves around the common swivel axis folding between the radially collapsed position and the radially expanded position.

8. The instrument according to claim 7, wherein the second 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 first 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 a diameter of the cutting ring of one body member is slightly larger than a diameter of the 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.

14. 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, a cutting element on each of the body members, the body members being able to move axially relative to one another in such a way that the respective cutting elements are aligned opposite one another to cut out a defective heart valve positioned between the body members;

the cutting elements of the body members having a radially collapsed position, in which their radial distance from the instrument axis becomes smaller, for the surgical introduction of the instrument into the surgical field;

two contact protective sheaths fitted to the elongated member, the contact sheaths having an engages position relative to the body members in which the cutting elements are collapsed and a disengaged position in which the contact sheath is pulled off axially from the body members, the contact sheaths movable axially to the engaged position and onto the respective body members to radially collapse the body members;

an advancing end of the instrument is movable through the defective heart valve 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 sheaths in their disengaged position being pulled off axially from the body members so that the cutting elements of the body members have a radially expanded position;

wherein the cutting elements of each of the body members are formed of two semicircular cutting ring halves each having a center, the ring halves being joined to one another at respective ends thereof to form a circular cutting ring by means of opposed single-axis hinge joints that are comprised of diametrically disposed hinge members having aligned respective hinge axes that together define a common swivel axis, 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 both of the hinge members of the circular cutting rings are aligned perpendicular to the axis of the elongated member;

each said body member also including two pairs of elastically deformable fish joints that are each resistant to extension and compression and that are each constructed of a flat material strip, the fish joints extending in the longitudinal direction of the elongated member and each being mounted at the elongated member at a foot end thereof;

said pairs of elastically deformable fish joints including;

a first pair of the elastically deformable fish joints being mounted on the elongated member at the foot end thereof, the head end of which is connected to the respective hinge joints of the hinge members of the semicircular-shaped cutting ring halves, the foot end of which are mounted to an axially sliding member;

a second pair of the elastically deformable fish joints being mounted on the elongated member at the foot end thereof, the head end of which is connected to the center of the semicircle on the semicircular-shaped cutting ring halves, the foot end of which are mounted in a stationary manner to the elongated member;

wherein the elastically deformable fish joints are constructed and arranged for a relative swivel movement of the cutting ring halves of almost 90°

around the common swivel axis folding between the radially collapsed position and the radially expanded position.

15. The instrument according to claim 14 wherein the elastically deformable fish joints are constructed and arranged for a relative swivel movement of the cutting ring halves of almost 90°

around an axis running crosswise to the fish joints.

16. The instrument according to claim 14, including a pair of sliding blocks for holding the foot end of respective first pair of elastically deformable fish joints, and a pair of bearing blocks for holding the foot end of respective second pair of elastically deformable fish joints.

17. The instrument according to claim 14, wherein the contact protective sheaths are moved axially onto the fish joints toward each other in order to collapse the body members, and are moved in the opposite direction away from each other in order to expand the body members.

18. The instrument according to claim 14, wherein a diameter of the cutting ring of one body member is slightly larger than a diameter of the 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.

19. The instrument according to claim 14, wherein the body members with their cutting rings can rotate relative to one another in such a way that the defective heart valve is cut out by a rotating-punching process.

20. The instrument according to claim 14 wherein the elastically deformable flat material strip is of superelastic Nitinol.