Patent Application
20230122698
An embodiment of the present disclosure relates to a closure system comprising a closure device for closing a hole or duct in a tissue related to a cardiac disease. In addition, an embodiment of the present disclosure relates to a manufacturing method of a closure device.
In cardiac diseases such as atrial septal defect, ventricular septal defect, patent ductus arteriosus, patent foramen ovale, etc., a hole or duct is formed in a tissue such as atrial septum, pulmonary artery, etc. A closure device is used as a tool for closing the hole or duct. For example, Patent Literature 1 discloses a method of closing a hole using a mesh structure formed of woven metal wires. When pushed out from a catheter inserted in a heart, the mesh structure can expand like a disc in the heart.
Patent Literature 1: JP 6661539 B
Non patent Literature 1: Zahid Amin, Echocardiographic Predictors of Cardiac Erosion After Amplatzer Septal Occluder Placement, Catheterization and Cardiovascular Interventions (2014) 83:84-92
Non Patent Literature 2: Tadaaki Abe; Shinya Tsukano; Yuko Tosaka, Pericardial tamponade due to erosion of a Figulla Flex II device after closure of an atrial septal defect, Catheter Cardiovasc Interv. (2019) 94:1003-1005.
Non Patent Literature 3: Masataka Kitano; Satoshi Yazaki; Hisashi Sugiyama; Shin-ichi Ohtsuki; Hideshi Tomita, Risk Factors and Predictors of Cardiac Erosion Discovered from 12 Japanese Patients Who Developed Erosion After Atrial Septal Defect Closure Using Amplatzer Septal Occluder, Pediatric Cardiology (2020) 41:297-308
Non Patent Literature 4: Preetham Kumar; James L. Orford; Jonathan M. Tobis, Two cases of pericardial tamponade due to nitinol wire fracture of a gore septal occluder, Catheter Cardiovasc Interv. (2020) 96:219-224.
The use of the mesh structure limits a planar shape of the closure device. This may make it difficult to properly close a hole or duct, depending on a position and a shape of the hole or duct.
For example, Non Patent Literatures 1 to 4 introduce examples in which a hole of atrial septal defect is closed by using an Amplatzer septal occluder (hereinafter referred to also as ASO). The ASO comprises a mesh structure formed of woven metal wires. Non Patent Literatures 1 to 3 report a mechanical damage (referred to also as erosion), such as cardiac perforation formed in a tissue, which is caused by contact with the ASO. Non Patent Literature 4 reports that some of the metal wires in the mesh structure were damaged, which results in erosion. If breeding or the like occurs because of the erosion, there is a risk of cardiac tamponade. The cardiac tamponade is a state in which a heart is unable to sufficiently dilate due to increase in inner pressure of cardiac sac caused by increase in cardiac sac fluid.
The object of the present disclosure is to provide a closure device and a closure system capable of effectively solving such a problem.
An embodiment of the present disclosure is a closure system for closing a hole or duct in a tissue related to a cardiac disease, comprising:
a catheter having an internal diameter D1 [mm]; and
a closure device to be delivered to the hole or duct in the tissue through the catheter;
wherein:
the closure device comprises: a first plate including a first center part, and a first extension part extending around the first center part and containing a resin having elastic restorability; and a waist part connected to the first center part;
the elastic restorability is a property by which the first extension part returns from a state in which the first extension part is folded such that surface portions of the first extension part face to each other, to a state in which the first extension part is extended around the first center part;
the first extension part has a thickness A1 [mm];
the waist part has a maximum dimension T1 [mm] in a plan view; and
the internal diameter D1 of the catheter is larger than 2×A1+T1.
In the closure system according to the present disclosure, the first extension part may have a maximum dimension B1 [mm] in a plan view, and
A1/B1 may be 1/50 or more.
In the closure system according to the present disclosure, the first plate may include a base layer extending around the first center part and containing fluororesin, polyester, polyamide, urethane, silicone, or polyetherketone, and
a thickness of the base layer may be 50% or more of the thickness A1 of the overall first plate.
In the closure system according to the present disclosure, the first extension part may have a tensile strength between 20 MPa or more and 150 MPa or less.
In the closure system according to the present disclosure, the first extension part may include, in a plan view, a first portion, and a second portion having a shape asymmetric to the first portion with respect to a center of the first center part.
The closure system according to the present disclosure may comprise a second plate connected to the waist part, wherein
the second plate may comprise a second center part connected to the waist part, and a second extension part extending around the second center part and containing a resin having elastic restorability.
In the closure system according to the present disclosure, the second extension part may have a thickness A2 [mm], and
the internal diameter D1 of the catheter may be larger than 2×A1+2×A2+T1.
The closure system according to the present disclosure may comprise an IC chip embedded in the resin.
In the closure system according to the present disclosure, the IC chip may include a power generating element that generates electric power using pulses of a heart.
In the closure system according to the present disclosure, the first plate may comprise a surface layer containing a fluororesin.
In the closure system according to the present disclosure, the first plate may comprise a plurality of projections positioned on a contact surface facing the tissue.
In the closure system according to the present disclosure, the first extension part may comprise a linearly running reinforcement part.
In the closure system according to the present disclosure, the cardiac disease may be atrial septal defect, ventricular septal defect, patent ductus arteriosus, or patent foramen ovale.
The closure system according to the present disclosure may comprise a handle for operating the closure device.
In the closure system according to the present disclosure, the closure device may include a marker provided on the first plate, and
the handle may include a lever that controls a rotational angle of the first plate.
An embodiment of the present disclosure is a manufacturing method of a closure device for closing a hole or duct in a tissue related to a cardiac disease, wherein:
the closure device comprises a first plate to cover the hole or duct;
the first plate comprises a first center part, and a first extension part extending around the first center part and containing a resin having elastic restorability;
the elastic restorability is a property by which the first extension part returns from a state in which the first extension part is folded such that surface portions of the first extension part face to each other, to a state in which the first extension part is extended around the first center part;
the manufacturing method comprises a producing step that produces the closure device based on information on a shape and a position of the hole or duct in the tissue; and
the producing step comprises a first plate designing step using a learning model that is trained with a training data in such a manner that the information on the shape and the position of the hole or duct in the tissue are inputted to the learning model, and that the learning model outputs design information including a planar shape, a thickness, and a material of the first extension part, wherein the training data includes shapes and positions of holes or ducts in tissues of patients having cardiac disease as input objects, and wherein the training data includes design information including planar shapes, thicknesses, and materials of first extension parts as output values.
In the manufacturing method according to the present disclosure, the producing step may comprise a first plate producing step that produces the first plate by means of a 3D printer.
In the manufacturing method according to the present disclosure, the first extension part may have a thickness A1 [mm] and a maximum dimension B1 [mm] in a plan view, and
A1/B1 may be 1/50 or more.
In the manufacturing method according to the present disclosure, the first plate may contain fluororesin, polyester, polyamide, urethane, silicone, or polyetherketone.
In the manufacturing method according to the present disclosure, the closure device may comprise a waist part connected to the second center part, and a second plate connected to the waist part,
the second plate may comprise a second center part connected to the waist part, and a second extension part extending around the second center part and containing a resin having elastic restorability, and
the producing step may comprise a second plate designing step using a learning model that is trained with training data in such a manner that the information on the shape and the position of the hole or duct in the tissue are inputted to the learning model, and that the learning model outputs design information including a planar shape, a thickness, and a material of the second extension part, wherein the training data includes shapes and positions of holes or ducts in tissues of patients having cardiac disease as input objects, and wherein the training data includes design information including planar shapes, thicknesses, and materials of second extension parts as output values.
The present disclosure can provide a closure device and a closure system capable of appropriately various holes or ducts.
A closure device according to the present disclosure is described in detail with reference to the drawings. An embodiment described below is a mere example, and the present disclosure is not construed as limited to the embodiment. In the drawings to which the reference is made in this embodiment, the same or similar reference numeral is given to parts that are identical or have similar functions, and repeated description may be omitted. Dimensional proportions in the drawings may differ from actual proportions for the sake of explanation, and some components may be omitted from the drawings.
(Closure System)
The closure device 20, which is in a folded state, is inserted into the catheter 11, and is delivered to the arterial duct 73. After having been delivered to the arterial duct 73 or the aorta 71, the closure device 20 is pushed out from the catheter 11 by the delivery cable 12. After having been pushed out from the catheter 11, the closure device 20 can unfold and elastically restore to its extending state as shown in
(Closure Device)
The closure device 20 is described in detail. The closure device 20 at least comprises a first plate 30 to cover the arterial duct 73. The closure device 20 may comprise a waist part 50 to be installed in the arterial duct 73. The waist part 50 may include a joint 51 joined to the delivery cable 12. The joint 51 includes an opening into which the delivery cable 12 is inserted, for example. The opening of the joint 51 may have a structure for facilitating attachment to the delivery cable 12 and detachment from the delivery cable 12. For example, threads may be formed on a wall surface of the opening of the joint 51.
(First Plate)
The first plate 30 is described in detail. As shown in
A shape of the first plate 30 in a plan view is described. “Plan view” means that the closure device 20 is seen along a normal direction of the contact surface 31 or the non-contact surface 32. In the example shown in
As shown in
The elastic restorability is described with reference to
First, as shown in the left side of
Following thereto, the force F1 is removed from the first plate 30. Thus, as shown in the right side of
As shown by a reference numeral L1 in
The elastic restorability of the first extension part 34 can be realized by various methods. For example, the elastic restorability can be realized by appropriately setting a relationship between a thickness A1 [mm] of the first extension part 34 and the maximum dimension B1 [mm] of the first extension part 34 in a plan view. A1/B1 is, for example, 1/50 or more, may be 1/30 or more, or may be 1/20 or more. On the other hand, the first plate 30 having an excessively large thickness A1 is hard to fold, which makes it difficult to deliver the closure device 20 through the catheter 11. In consideration of this point, A1/B1 may be 1/3 or less, may be 1/5 or less, or may be 1/10 or less. As described below, the elastic restorability of the first extension part 34 may be realized based on a mechanical property such as tensile strength.
As shown in
As shown in
In
In
Next, a structure of the non-contact surface 32 of the first plate 30 is described.
As shown in
A width W1 of the reinforcement part 35 is, for example, 1 mm or more, may be 3 mm or more, or may be 5 mm or more. In addition, the width W1 of the reinforcement part 35 is, for example, 20 mm or less, may be 15 mm or less, or may be 10 mm or less.
Next, a layer structure of the first plate 30 is described with reference to
The base layer 63 contains a biocompatible material having suitable elasticity. For example, the base layer 63 contains fluororesins, polyesters, polyamides, urethanes, silicones, polyetherketones, or other biocompatible polymers, and combinations thereof.
Examples of fluororesins include polytetrafluoroethylene (PTFE), tetrafluoroethylene hexafluoropropylene copolymer (FEP), tetrafluoroethylene ethylene copolymer (ETFE), tetrafluoroethylene ethylene copolymer (PVDF), etc.
Examples of polyesters include polyethylene terephthalate, polyester-based elastomers (TPEE), etc. Elastomer is a material which is soft and fluid when heated, and returns to a rubbery state when cooled.
Examples of polyamides include PC12, polyamide elastomers (TPAE), etc.
Urethanes are compounds with urethane bonds formed by reaction of alcohols and isocyanates. Examples of urethanes include polyurethane elastomers (TPU), etc.
Silicones are silicone rubber (SR), etc., for example.
Examples of polyetherketones include polyetheretherketone (PEEK), etc.
As shown in
Examples of biocompatible materials are the following biocompatible polymers.
ePTFE (porous material), fluororesin such as PTFE, polyamides, urethane-based polymers, PEEK
Examples of biodegradable materials are the following biodegradable polymers.
Lactide Cabrolactan Copolymers, ePTFE+[Collagen/Extracellular Matrix]
As shown in
For example, the second surface layer 65 contains fluororesins, polyesters, polyamides, urethanes, or other biocompatible polymers, and combinations thereof.
Examples of fluororesins include ePTFE, PTFE, FEP, ETFE, etc.
Examples of polyamides include PC12, polyamide elastomers (TPAE), etc.
As shown in
The fiber 66 preferably has a tensile strength higher than the base layer 63. Examples of the fibers 66 include carbon fibers, aramid fibers, polyparaphenylene benzobisoxazole, polyarylate, nylon, ultra high molecular weight polyethylene fibers, etc.
A height H1 of the reinforcement part 35 is, for example, 1 mm or more, may be 3 mm or more, and may be 5 mm or more. In addition, the height H1 of the reinforcement part 35 is, for example, 20 mm or less, may be 15 mm or less, or may be 10 mm or less.
Preferable mechanical properties of the first extension part 34 are described.
A tensile strength of the first extension part 34 is, for example, 20 MPa or more, may be 25 MPa or more, or may be 30 MPa or more. In addition, the tensile strength of the first extension part 34 is, for example, 150 MPa or less, may be 130 MPa or less, may be 100 MPa or less, or may be 80 MPa or less.
A tensile rupture strain of the first extension part 34 is, for example, 50% or more, may be 80% or more, may be 100% or more, or may be 150% or more. In addition, the tensile rupture strain of the first extension part 34 is, for example, 550% or less, may be 450% or less, may be 400% or less, or may be 300% or less.
The tensile strength and the tensile rupture strain of the first extension part 34 are measured in line with JIS K 7161. As shown by one-dot chain lines indicated by a reference numeral 30S in
A layer structure of the waist part 50 may be entirely the same as the layer structure of the first plate 30, may be partially the same, or may be different therefrom. For example, the waist part 50 may include a layer integrally formed by the same material as that of the base layer 63 of the first plate 30.
As shown in
The IC chip 36 has a sensor function, for example. For example, the IC chip 36 can function as a heart rate sensor that electrically measures pulses of the heart 1.
The IC chip 36 may have a radar function. For example, the IC chip 36 may include a transceiver that transmits and receives radio waves. This allows an object around the closure device 20 to be detected.
The IC chip 36 may have a function of detecting sound. For example, the IC chip 36 may include a sound pickup microphone that detects sound, and a converter that converts detected sound to an electric signal.
Since the IC chip 36 is embedded in the resin, detachment of the IC chip 36 from the closure device 20 can be suppressed. Data obtained by the IC chip 36 are transmitted to an external apparatus by wireless communication or the like.
The IC chip 36 may include a power generating element 36a. The power generating element 36a generates electric power using pulses of the heart 1, for example. The use of the power generating element 36a allows a continuous operation of the IC chip 36 over a long period of time.
(Manufacturing Method of Closure Device)
Next, a manufacturing method of the closure device 20 is described with reference to
Following thereto, a producing step that produces the closure device 20 is performed based on the information on the shape and the position of the arterial duct 73. The producing step may include a step of designing and producing a part of the closure device 20 in accordance with the measuring result of the shape and the position of the arterial duct 73. For example, as shown in
In the first plate designing step S2, design information of the first extension part 34 may be generated based on a learning model. For example, the design information of the first extension part 34 can be obtained by inputting the shape and the position of the arterial duct 73, which are obtained in the measuring step S1, to a computer comprising a learning model. The design information includes at least one of a planar shape, a thickness, and a material of the first extension part 34. The design information may include any two of the planar shape, the thickness, and the material of the first extension part 34. The design information may include the planar shape, the thickness, and the material of the first extension part 34.
A learning model of the first plate 30 can be obtained by means of a computer trained by a training data. The training data includes shapes and positions of holes or ducts in tissues of patients having cardiac disease as input objects. The training data includes the aforementioned design information of the first extension part 34 as output values. Input to the learning model may further include other information such as an inner diameter of the catheter 11, a coefficient of friction of the catheter 11, etc.
Input to the computer comprising the learning model may include physical characteristics of a patient, such as a height, a weight, etc. Input to the computer comprising the learning model may include information such as patient's age, gender, etc. The computer may output the design information based on prediction of future changes that may occur in a tissue such as a heart. For example, when a patient is determined as a child from the input information, the computer may output the design information based on prediction of growth that may occur in a tissue of a heart, etc. This allows the closure device 20 to properly function after the patient has grown.
The first plate producing step S3 may produce the first plate 30 by means of a 3D printer. This allows the closure device 20 to be quickly produced based on the information obtained in the measuring step S1.
The producing step may include a waist part designing step and a waist part producing step. Similarly to the first plate designing step S2, the waist part designing step may generate design information of the waist part 50 based on a learning model. In this case, the learning model may use, as an input, information on a thickness in the tissue of the aorta 71, etc. Similarly to the first plate producing step S3, the waist part producing step may produce the waist part 50 by means of a 3D printer.
In a treatment, such as ASO, which uses a conventional closure device, a closure device suited to a patient is selected depending on a shape of a cardiac disease of a patient. For example, suppose that lineups of a conventional closure device prepare closure devices every 1 mm in diameter. When a diameter of a hole of a cardiac disease is 19.3 mm, a closure device having a diameter of 20 mm is used. Namely, a ready-made closure device is used. This may result in erosion because of the excessive dimension of the closure device.
On the other hand, when the closure device 20 is produced by means of a 3D printer, the closure device 20 can have a shape corresponding to a shape of a cardiac disease of a patient. Namely, a custom-made closure device 20 can be provided. Thus, there is less possibility that the closure device 20 has an excessive dimension. This can suppress a problem such as erosion. A resolution of a 3D printer is, for example, 500 μm or less. Thus, the dimension of the closure device 20 can have an accuracy of 500 μm. The resolution of a 3D printer may be 300 μm or less, may be 100 μm or less, or may be 50 μm or less.
The producing step such as the first plate designing step may be realized by a software running on a computer. By installing a program in a computer, for example, the computer may execute the first plate designing step using a learning model.
The program may be pre-installed on a computer when the computer is shipped. Alternatively, the program may be installed on the computer after it has been shipped by using a computer readable non-transitory storage medium in which the program is stored. A type of the storage medium is not particularly limited, and various types may be considered.
Namely, the storage medium may be a portable storage medium such as a magnetic disk or an optical disk, a fixed storage medium such as a hard disk and a memory, etc. The program may be distributed via a communication line such as an internet. When the program is distributed via a communication line, a storage medium storing the program according to this embodiment is at least temporarily present on a server for distribution.
(Using Method of Closure Device)
Next, a using method of the closure device 20 is described with reference to
First, the catheter 11 is inserted into a body. Then, as shown in
As shown in
As shown in
Following thereto, as shown in
In this embodiment, the first plate 30 of the closure device 20 comprises the first extension part 34 containing a resin having elastic restorability. Thus, the first plate 30 of the closure device 20, which is delivered in the folded state, can elastically restore to its extending shape. Thus, the first plate 30 can close the arterial duct 73. As compared with the use of a conventional mesh structure, the first plate 30 has a higher degree of freedom in the planar shape, and is easy to manufacture. For example, the first plate 30 having a desired shape can be quickly produced by means of a 3D printer. Thus, the first plate 30 suited for various shapes of the arterial duct 73 can be easily provided. This can suppress generation of erosion, which may be caused by an excessive dimension of the closure device 20.
This embodiment can close a cardiac disease of the arterial duct 73 or the like without using a mesh structure made of metal wires. Since the closure device 20 includes no mesh structure, generation of erosion, which may be caused by damaged metal wire, can be suppressed.
By suppressing erosion, dangerous conditions such as cardiac tamponade can be suppressed.
The above embodiment can be variously modified. Modification examples are described below, with reference to the drawings according to need. In the following description and the drawings used in the following description, the same reference numeral as that used for the part that can be structure in the same way as in the above embodiment, and redundant description is omitted. In addition, when the effect obtained in the above embodiment is obtained in the modification examples, its description may be omitted.
(Modification Example of Closure System)
(Modification Example of Cardiac Disease)
The above embodiment shows the example in which the patent ductus arteriosus is treated using the closure device 20. However, the cardiac disease in which the closure device 20 is used is not limited to the patent ductus arteriosus. For example, another cardiac disease, such as atrial septal defect, ventricular septal defect, patent foramen ovale, etc., may be treated using the closure device 20.
The heart 1 includes a left atrium 2, a right atrium 3, an atrial septum 4, a left ventricle 5, a right ventricle 6, and a interventricular septum 7, which are positioned inside an atrial wall 1a. The atrial septum 4 is positioned between the left atrium 2 and the right atrium 3. The interventricular septum 7 is positioned between the left ventricle 5 and the right ventricle 6. In the example shown in
As shown in
As shown in
Similarly to the first extension part 34, the second extension part 44 contains a resin having elastic restorability. Thus, the second extension part 44 can return from a state in which the second extension part 44 is folded such that surface portions of the second extension part 44 face to each other, to a state in which the second extension part 44 is extended around the second center part 43.
An outer edge 40e of the second plate 40 is preferably free of hard material such as a metal. For example, the outer edge 40e is preferably formed of a resin such as the aforementioned biocompatible material. This can suppress generation of erosion in the tissue, which may be caused by contact between the tissue and the outer edge 40e.
A layer structure of the second extension part 44 may be similar to the layer structure of the first extension part 34. For example, the second extension part 44 comprises at least the aforementioned base layer 63. The second extension part 44 may include the aforementioned first surface layer 64 forming the contact surface 41. In addition, the second extension part 44 may include the aforementioned second surface layer 65 forming the non-contact surface 42.
Since preferable mechanical properties of the second extension part 44 are similar to those of the first extension part 34, description is omitted.
Next, a manufacturing method of the closure device 20 of
Following thereto, a producing step that produces the closure device 20 is performed based on the information on the shape and the position of the hole 4a. The producing step may include the aforementioned first plate designing step S2 and the first plate producing step S3. In addition, the producing step may include a second plate designing step and a second plate producing step.
Similarly to the first plate designing step S2, the second plate designing step may generate design information of the second extension part 44 based on a learning model. For example, the design information of the second extension part 44 can be obtained by inputting the shape and the position of the arterial duct 73, which are obtained in the measuring step S1, to a computer comprising a learning model. The design information includes at least one of a planar shape, a thickness, and a material of the second extension part 44. The design information may include any two of the planar shape, the thickness, and the material of the second extension part 44. The design information may include the planar shape, the thickness, and the material of the second extension part 44.
A learning model of the second plate 40 can be obtained by means of a computer trained by a training data. The training data includes shapes and positions of holes or ducts in tissues of patients having cardiac disease as input objects. The training data includes the aforementioned design information of the second extension part 44 as output values. Input to the learning model may further include other information such as an inner diameter of the catheter 11, a coefficient of friction of the catheter 11, etc.
Similarly to the first plate producing step S3, the second plate producing step may produce the second plate 40 by means of a 3D printer.
The producing step may include a waist part designing step and a waist part producing step. Similarly to the first plate designing step S2, the waist part designing step may generate design information of the waist part 50 based on a learning model. In this case, the learning model may use, as an input, information of a thickness of the tissue such as the atrial septum 4. Similarly to the first plate producing step S3, the waist part producing step may produce the waist part 50 by means of a 3D printer.
Next, a using method of the closure device 20 of
First, the catheter 11 is inserted from a blood vessel at the base of a leg. Then, as shown in
The internal diameter D1 of the catheter 11 may be larger than 2×A1+2×A2+T1. A1 is a thickness of the first extension part 34 of the first plate 30. A2 is a thickness of the second extension part 44 of the second plate 40. T1 is a maximum dimension of the waist part 50 in a plan view. When the internal diameter D1 is larger than 2×A1+2×A2+T1, compression of the waist part 50 in the radial direction of the catheter 11 can be suppressed. This can reduce a frictional force between the inner wall of the catheter 11 and the closure device 20, whereby the closure device 20 can be easily moved inside the catheter 11.
As shown in
Following thereto, as shown in
As compared with the use of a conventional mesh structure, the closure device 20 in this modification example also has a higher degree of freedom in the planar shape, and is easy to manufacture. For example, the first plate 30 and the second plate 40 each having a desired shape can be quickly produced by means of a 3D printer. Thus, the first plate 30 and the second plate 40 which are suited for various shapes of the hole 4a of the atrial septum 4 can be easily provided. This can suppress generation of erosion, which may be caused by an excessive dimension of the closure device 20. In addition, since the closure device 20 includes no mesh structure, generation of erosion, which may be caused by damaged metal wire, can be suppressed.
(Modification Example of Closure System)
When the closure device 20 is positioned inside the catheter 11, the waist part 50 of the closure device 20 comprising the first plate 30 and the second plate 40 may be compressed in the radial direction, although not shown. Namely, the internal diameter D1 of the catheter 11 may be smaller than 2×A1+2×A2+T1. In this case, similarly to the example shown in
(Modification Example of Hole Position)
An example in which the hole 4a is positioned close to the atrial wall 1a, as shown in
On the other hand, since the first plate 30 has a high degree of freedom in the planar shape, this patent application can provide a closure device 20 as shown in
In
Similarly to the first plate 30, the second plate 40 has a high degree of freedom in the planar shape. As shown in
(Modification Example of Manufacturing Method of Closure Device)
Although the above embodiment shows the example in which the closure device 20 is designed based on a learning model, the closure device 20 may be designed using another method. For example, a person may design the closure device 20 based on experience.
In addition, although the above embodiment shows the example in which the closure device 20 is produced by means of a 3D printer, the closure device 20 may be produced using another method. For example, the closure device 20 may be produced by a molding method such as sheet molding.
(Modification Example of Cardiac Disease)
The above embodiment shows the example in which the ventricular septal defect is treated using the closure device 20. However, the cardiac disease in which the closure device 20 is used is not limited to the ventricular septal defect. For example, another cardiac disease, such as atrial septal defect, patent ductus arteriosus, patent foramen ovale, etc., may be treated using the closure device 20.
(Modification Example of Closure Device)
In this modification example, the first plate 30 includes a first marker 38. The first marker 38 is positioned on the first portion 34a, for example. While the closure device 20 is being inserted in the body, the position of the first portion 34a can be determined by detecting the first marker 38 by means of echo or the like. Thus, a rotational angle of the first plate 30 can be calculated, for example.
The first marker 38 can have any structure, as long as the position of the marker 38 can be detected from outside the body by an inspection method such as echo. For example, the first marker 38 may have a structure raised from a surface of the first plate 30. Alternatively, the first marker 38 may have a structure recessed from the surface of the first plate 30. The first marker 38 may contain a material, such as a metal, which is different from that of an element surrounding the first marker 38.
Any driving mechanism for rotating the closure device 20 will do. For example, the closure device 20 may be rotated by rotating the delivery cable 12 or the catheter 11.
Although not shown, the closure device 20 may include a plurality of markers.
For example, the first plate 30 may include, in addition to the first marker 38 positioned on the first portion 34a, a second marker positioned on the second portion 34b. The first marker 38 and the second marker may be different from each other in shape, dimension, material, etc.
Alternatively, the first plate 30 may include 12 markers that are equidistantly arranged along a circumference, similarly to hour marks on a clock.
Although not shown, an IC chip, a microactuator, a marker, etc., may be provided on a component of the closure system 10, which is other than the closure device 20. For example, the catheter 11, the delivery cable 12, etc., may include an IC chip, a microactuator, a marker, etc.
(Modification Example of Using Method of Closure Device)
The above embodiment shows the example in which the closure device 20 is delivered into the heart 1 through the catheter 11. However, the means for delivering the closure device 20 to the heart 1 is not limited to the catheter 11. For example, the hear 1 may be surgically cut, and the closure device 20 may be delivered into the heart 1 through an incision. In this case, the closure device 20 may be sutured to the tissue using a thread and a needle.
In this modification example, since the first extension part 34 has the elastic restorability, the closure device 20 can be passed through the incision, with the first extension part 34 being in the folded state. In addition, the first extension part 34 can be easily adhered to the tissue by means of the elasticity of the first extension part 34. In addition, since the first extension part 34 has high degree of freedom in the planar shape, a hole or duct in a tissue related to a cardiac disease can be appropriately closed.
Some modification examples on the above embodiment have been described, it goes without saying that the modification examples can be suitably combined and applied.
| Number | Date | Country | Kind |
|---|---|---|---|
| 2020-107299 | Jun 2020 | JP | national |
This application is a continuation application of International Application No. PCT/JP2021/22181, filed on Jun. 10, 2021, which claims the benefit of priority from Japanese Patent Application No. 2020-107299, filed on Jun. 22, 2020. The entire contents of these applications are incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| Parent | PCT/JP2021/022181 | Jun 2021 | US |
| Child | 18069738 | US |
