Valve apparatus, system and method

Information

  • Patent Grant
  • 9370419
  • Patent Number
    9,370,419
  • Date Filed
    Tuesday, November 30, 2010
    14 years ago
  • Date Issued
    Tuesday, June 21, 2016
    8 years ago
Abstract
A venous valve with a frame and a cover on the frame for unidirectional flow of a liquid through the valve.
Description
FIELD OF THE INVENTION

The present invention relates generally to apparatus, systems, and methods for use in a lumen; and more particularly to a valve apparatus, systems, and methods for use in the vasculature system.


BACKGROUND OF THE INVENTION

The venous system of the legs uses valves and muscles as part of the body's pumping mechanism to return blood to the heart. Venous valves create one way flow to prevent blood from flowing away from the heart. When valves fail, blood can pool in the lower legs resulting in swelling and ulcers of the leg. The absence of functioning venous valves can lead to chronic venous insufficiency.


Techniques for both repairing and replacing the valves exist, but are tedious and require invasive surgical procedures. Direct and indirect valvuoplasty procedures are used to repair damaged valves. Transposition and transplantation are used to replace an incompetent valve. Transposition involves moving a vein with an incompetent valve to a site with a competent valve. Transplantation replaces an incompetent valve with a harvested valve from another venous site. Prosthetic valves can be transplanted into the venous system, but current devices are not successful enough to see widespread usage.





BRIEF DESCRIPTION OF THE DRAWINGS


FIGS. 1A-1B illustrate an embodiment of a valve.



FIG. 1C illustrates a cross-sectional view of the valve illustrated in FIG. 1A taken along plane 1C-1C.



FIG. 1D illustrates a cross-sectional view of the valve illustrated in FIG. 1B taken along plane 1D-1D.



FIGS. 2A-2D illustrate segment views of embodiments of a cover.



FIGS. 3A-3B illustrate a valve in an expanded and a collapsed state.



FIG. 4 illustrates an embodiment of a system that includes a valve.



FIG. 5 illustrates an embodiment of a system that includes a valve.



FIG. 6 illustrates an embodiment of a system that includes a valve.





DETAILED DESCRIPTION

Embodiments of the present invention are directed to an apparatus, system, and method for valve replacement or augmentation. For example, the apparatus can include a valve that can be used to replace or augment an incompetent valve in a body lumen. Embodiments of the valve can include a frame and cover that can be implanted through minimally-invasive techniques into the body lumen. In one example, embodiments of the apparatus, system, and method for valve replacement or augmentation may help to maintain antegrade blood flow, while decreasing retrograde blood flow in a venous system of individuals having venous insufficiency, such as venous insufficiency in the legs.


The figures herein follow a numbering convention in which the first digit or digits correspond to the drawing figure number and the remaining digits identify an element or component in the drawing. Similar elements or components between different figures may be identified by the use of similar digits. For example, 110 may reference element “10” in FIG. 1, and a similar element may be referenced as 210 in FIG. 2. As will be appreciated, elements shown in the various embodiments herein can be added, exchanged, and/or eliminated so as to provide a number of additional embodiments of valve. In addition, discussion of features and/or attributes for an element with respect to one Fig. can also apply to the element shown in one or more additional Figs.



FIGS. 1A-1D and 3A-3B provide illustrations of various embodiments of a valve of the present invention. Generally, the valve can be implanted within the fluid passageway of a body lumen, such as for replacement or augmentation of a valve structure within the body lumen (e.g., a venous valve). In one embodiment, the valve of the present invention may be beneficial to regulate the flow of a bodily fluid through the body lumen in a single direction.



FIGS. 1A-1D illustrate one embodiment of a venous valve 100. Venous valve 100 includes a frame 102, a first leaflet 104 and a second leaflet 106 formed from a cover 108, where the frame 102 and the leaflets 104 and 106 can resiliently radially collapse and expand, as will be discussed herein. Among other things, the frame 102 and the leaflets 104 and 106 define a lumen 110 of the valve 100. The lumen 110 allows for, among other things, fluid (e.g., blood) to move through the valve 100.


The frame 102 also includes a first end 112 and a second end 114. The first end 112 and the second end 114 define a length of the frame 102 and of the valve 100. In one embodiment, the length of valve 100 can have a number of values. As will be appreciated, the length of valve 100 can be determined based upon the location into which the valve 100 is to be implanted. In other words, the length of the valve 100 can be patient specific. Examples of values for the length include 4 millimeters to 30 millimeters.


The frame 102 further includes an outer surface 116 and an inner surface 118 opposite the outer surface 116. In one embodiment, the cover 108 can be located over at least a portion of the outer surface 116 of the frame 102. For example, the cover 108 can extend around a perimeter of the frame 102 so as to cover the outer surface 116 of the frame 102. In other words, the cover 108 can extend over the outer surface 116 of the frame 102 so as to limit, or eliminate, exposed portions of the outer surface 116 of the frame 102. In an additional embodiment, the cover 108 can be located over at least a portion of the inner surface 118 of the frame 102. A further embodiment includes the cover 108 located over at least a portion of the outer surface 116 and the inner surface 118.


The leaflets 104 and 106 further include surfaces defining a reversibly sealable opening 120 for unidirectional flow of a liquid through the lumen 110 of the valve 100. For example, the surfaces of the leaflets 104 and 106 can be deflectable between a closed configuration in which fluid flow through the lumen 110 can be restricted and an open configuration in which fluid flow through the lumen 110 can be permitted.


The cover 108 further includes a physical configuration that provides support to the shape and structure of the leaflets 104 and 106. As used herein, physical configurations that provide “support” can include structures and/or members that are integrated into and/or a part of the material that composes the cover 108 that help to maintain a pre-implant shape and size of the leaflets of the valve.


The physical configuration that provides support to the leaflets 104 and 106 can be provided in a number of ways. For example, the cover 108 can include a matrix 122 reinforced with flexible support members 124 to provide a composite structure for the leaflets 104 and 106. The flexible support members 124 can be integrated into the matrix 122 so as to help prevent deformation of the original size and shape of the leaflets 104 and 106 that may occur over time through such processes as material stretch, creep, and stress relaxation. So, for example, the integrated flexible support members 124 can be oriented to provide circumferential support to the first leaflet and the second leaflet 104 and 106.


In one embodiment, the cover 108 can have a multi-layer configuration in which at least one layer of the integrated flexible support members 124 can be integrated and/or laminated between at least one layer of the matrix 122 material. For example, as illustrated in FIGS. 1A-1D, the cover 108 includes one or more layers of the flexible support members 124 and one or more layers of the matrix 122 that contribute to enhanced mechanical and handling properties of the cover 108. As discussed herein, the layers of the flexible support members 124 can be positioned to lie in a number of different relationships to each other. For example, the layers of the flexible support members 124 can lie in coplanar relations to one another, where the layers can have a number of angular relations to one another (e.g., orthogonal relation to each other). Other configurations are also possible.


As illustrated, the leaflets 104 and 106 can also have an integrated configuration in which the flexible support members 124 are positioned within the matrix 122 material of the leaflets 104 and 106. Although the cover 108 is illustrated as having the flexible support members 124 disposed substantially in the center of a cross section of the matrix 122, it is understood that the flexible support members 124 can be disposed at a number of locations within the cover 108.


In addition, different combinations of materials (discussed herein) can be used for one or more of the flexible support members 124 and/or the matrix 122 material. For example, the flexible support members 124 of the same structure and chemistry or different structures and chemistries can be overlaid on top of one another to and combined with the matrix 122 material to fabricate a cover 108 having the desired mechanical strength and physical properties. In an additional embodiment, the cover 108 forming the leaflets 104 and 106 can have a configuration in which the matrix 122 can be formed of a first material and the flexible support members 124 can be formed of a second material different than the first material. For example, the leaflets 104 and 106 can include a top layer of the matrix 122 of the first material and a bottom layer of the matrix 122 of first material coupled to the top layer of the first material. The flexible support members 124 of the leaflets 104 and 106 can then be positioned to lie between the top and bottom layers of the first material. The matrix 122 can be integrated with the flexible support members 124 in such a way that the material of the matrix 122 penetrates through openings between the flexible support members 124 to interlock the matrix 122 and the flexible support members 124. Surfaces of adjacent layers of the matrix 122 material can also interlock with one another, regardless of whether the layers of the matrix 122 are separated by a layer of the flexible support members 124 or whether they are made from the same or different materials.


In an additional embodiment, the flexible support members 124 can include a number of forms that contribute to both the mechanical and handling properties of the cover 108. Examples of such forms for the flexible support members 124 include, but are not limited to, those selected from the group consisting of weaves, braids, meshes, knits, warped knitted (i.e., lace-like), matted, coils (continuous helically wound coils or individually positioned coils), rings, ribbons (individual or continuous), and non-woven structures including electrostatically spun fibers or fiber compositions of polymers, polymers and other materials such as various copolymers.


In addition, mechanical properties of the cover 108 can be altered by changing the density, form, and/or texture of the flexible support members 124 in one or more locations of the cover 108. Examples of suitable structures used to create the flexible support members 124 can include, for example, monofilaments, yarns, threads, braids, or bundles of fibers.


Regardless of its configuration, the composite structure of the cover 108 should possess a burst strength adequate to withstand pressures imposed by blood moving in the circulation system. In addition, the cover 108 can be sufficiently thin and pliable so as to permit radially-collapsing of the leaflets 104 and 106 portion of the valve 100 to allow the valve 100 to provide the reversibly sealable opening 120 and for delivery by catheter to a location within a body lumen. As discussed herein, different portions of the matrix 122 and/or the flexible support members 124 may be made from different materials. Adequate strength and physical properties are developed in the cover 108 through the selection of materials used to form the matrix 122 and the flexible support members 124, and the manufacturing process used to join them.


By way of example, both the matrix 122 and the flexible support members 124 can be formed of a number of materials. For example, the matrix 122 and/or the flexible support members 124 can be formed of, by way of illustration and not by limitation, thermoplastic and thermo-set polymers. Examples of these polymers include polyolefins such as polyethylene and polypropylene, polyesters such as Dacron, polyethylene terephthalate and polybutylene terephthalate, vinyl halide polymers such as polyvinyl chloride (PVC), polyvinylacetate such as ethyl vinyl acetate (EVA), polyurethanes, polymethylmethacrylate, pellethane, polyamides such as nylon 4, nylon 6, nylon 66, nylon 610, nylon 11, nylon 12 and polycaprolactam, polyaramids (e.g., KEVLAR), polystyrene-polyisobutylene-polystyrene (SIBS), segmented poly(carbonate-urethane), Rayon, fluoropolymers such as polytetrafluoroethylene (PTFE or TFE) or expanded polytetrafluoroethylene (ePTFE), ethylene-chlorofluoroethylene (ECTFE), fluorinated ethylene propylene (FEP), polychlorotrifluoroethylene (PCTFE), polyvinylfluoride (PVF), or poly vinylidenefluoride (PVDF), natural biopolymers such as cellulose, chitin, keratin, silk, and collagen, explanted veins, decellularized basement membrane materials, submucosa materials such as small intestine submucosa (SIS) or umbilical vein, or other naturally occurring extracellular matrix (ECM), and other autologous or allogeneic biological materials either treated by crosslinking or not, and mixtures and copolymers thereof. SIS and ECM materials can be autologous, allogeneic or xenograft material derived from mammals, including source, such as human, cattle, sheep, and porcine. As will be appreciated, blends or mixtures of two or more of the materials provided herein are possible. For example, SIBS can be blended with one or more basement membrane materials.


Each of the polymers noted herein may be used in conjunction with radioopaque filler materials such as barium sulfate, bismuth trioxide, bismuth carbonate, powdered tungsten, powdered tantalum, or the like so that the location of the matrix 122 and/or the flexible support members 124 may be radiographically visualized within the human body.


In another embodiment of the present invention, the polymers and blends that are used to form the composite can be used as a drug delivery matrix. To form this matrix, the polymer can be mixed with a therapeutic agent or the agent can be applied to the surface or otherwise delivered from the material. The variety of different therapeutic agents that can be used in conjunction with the polymers of the present invention is vast. In general, therapeutic agents which may be administered via the pharmaceutical compositions of the invention include, without limitation: antiinfectives such as antibiotics and antiviral agents; analgesics and analgesic combinations; anti-inflammatory agents; hormones such as steroids; and naturally derived or genetically engineered proteins, polysaccharides, glycoproteins, or lipoproteins, anti-thrombotic agents, anti Pt agents, anti-immunogenic agents, anti-mitotic agents, anti proliferative agents, and angiogenic agents. Matrix formulations may be formulated by mixing one or more therapeutic agents with the polymer. The therapeutic agent may be present as a liquid, a finely divided solid, or any other appropriate physical form. Typically, but optionally, the matrix will include one or more additives, such as diluents, carriers, excipients, stabilizers or the like. Additionally, radioopaque markers may be added to the composite to allow imaging of the composite after implantation.


In an additional embodiment, the flexible support members 124 can be formed of ceramics, and/or metals. Suitable ceramics for the flexible support members 124 include those formed from basalt (solidified volcanic lava), and sold under the trade identifier “Sudaglass.” In one embodiment, the basalt can be mechanically crushed to provide the basalt in a fibrous form having a predetermined size of 9 to 17 microns in length. The basalt in the fibrous form can be blended with one or more of the polymers noted herein (e.g., SIBS, or polyolefins) so as to distribute the basalt in the fibrous form through the polymer matrix. In one embodiment, the basalt polymer composite can include 0.1 percent (wt.) basalt in the fibrous form. As will be appreciated, other weight percentage of basalt in the fibrous form relative polymer are possible.


The flexible support members 124 can also be formed of other nanostructures, such as carbon nanotubules. For example, carbon nano-tubules can be blended with one or more of the polymers noted herein (e.g., SIBS) so as to distribute the carbon nano-tubules through the polymer matrix. In one embodiment, the carbon nano-tubule polymer composite can include from 0.1 percent to 20 percent (wt.) carbon nano-tubules. As will be appreciated, other weight percentage of carbon nano-tubules relative polymer are possible.


The flexible support members 124 can also be formed of metals and/or metal alloys. For example, suitable metals and/or metal alloys for the flexible support members 124 include, but are not limited to, medical grade stainless steels (304, 306, 308, 316L, 318, etc.), gold, platinum, platinum alloys, palladium, rhodium, tungsten, tungsten alloys, cobalt chrome, titanium and titanium alloys, and other metal alloys such as those composed of titanium/nickel and sold under the trade identifier “Nitinol.”


Heat treatment of the Nitinol alloy may also be desirable. An example of such a heat treatment includes, but is not limited to, placing the Nitinol in its desired shape onto a mandrel. The Nitinol is then heated to a temperature of 650°-750° F. for a predetermined time (e.g., two (2) to five (5) minutes), possibly (but not necessarily) annealing the constituent Nitinol. After heat treatment, the flexible support members 124 retain their shape and the Nitinol alloy retains its super-elastic properties.


The support members 124 can also include a variety of cross-sectional configurations. For example, the support members 124 can have one or more of a round (e.g., circular, oval, and/or elliptical), “ribbon” configuration with rectangular geometries with an aspect ratio of at least 0.5 (thickness/width) having perpendicular sides, one or more convex sides, or one or more concave sides; semi-circular; triangular; tubular; I-shaped; T-shaped; and trapezoidal. Theses embodiment, however, are not limited to the present examples as other cross-sectional geometries are also possible. With respect to “braid,” the term can include tubular constructions in which the flexible support members 124 making up the construction are woven radially in an in-and-out fashion as they cross to form a tubular member defining a single lumen. The braid can also be constructed of flexible support members 124 of different widths. Changes in the braid can allow for pocket formation and the shape of the leaflets 104 and 106, as discussed herein. Such pocket formation can allow the valve leaflet, in one embodiment, to not assume an absolutely planar or cylindrical shape but instead form a pocket or cupped depression that is more efficient at forming a seal between the two leaflets. This rounded shape adjacent the sinus region of the valve cusp can help allow the valve cusp to be rinsed by blood as the leaflet closes.



FIGS. 2A-2D illustrate embodiments for a variety of configurations for the cover 208. The embodiments illustrated in FIGS. 2A-2D are segment views (i.e., partial views) used to provide a non-limiting illustration of different configurations of the matrix 222 and the flexible support members 224 used in the cover 208. For example, FIG. 2A illustrates an embodiment in which the matrix 122 includes a first layer 201 and a second layer 203 of material positioned around the flexible support members 224. As illustrated in FIG. 2A, the flexible support members 224 have a knit configuration.


In an additional embodiment, FIG. 2B illustrates an embodiment in which the matrix 222 includes the first layer 201 and the second layer 203 of material positioned around a first course 205 of the flexible support members 224. The embodiment illustrated in FIG. 2B further includes a second course 207 of the flexible support members 224 positioned between the second layer 203 and a third layer 209 of the matrix 222. As illustrated, the first course 205 and the second course 207 of the flexible support members 224 in FIG. 2b have a woven configuration. As will be appreciated, different configurations of the flexible support members 224 (e.g., one flexible support member course having a knit configuration and one flexible support member course having a coil configuration) could be combined in the cover 204.



FIG. 2C illustrates another embodiment of the cover 208 that includes the matrix 222 surrounding the flexible support members 224 in a continuous helically wound coil configuration. As will be appreciated, the layers of the matrix 122 material can have all, some or none of the layers of the same or chemical composition. Similarly, the flexible support members 224 can have same or different configuration and/or chemical composition. In addition, mechanical properties of the cover 208 can be altered by changing the density, form, and/or texture of the flexible support members 224.



FIG. 2D illustrates another embodiment of the cover 208 that includes the matrix 222 that includes a distribution of the flexible support members 224. In one embodiment, the distribution of the flexible support members 224 can include a distribution of the nanostructures (e.g., basalt, and/or carbon nanotubules), as discussed herein. As will be appreciated, the layers of the matrix 122 material can have all, some or none of the layers of the same or chemical composition. Similarly, the flexible support members 224 can have same or different configuration and/or chemical composition. In addition, mechanical properties of the cover 208 can be altered by changing the density, form, and/or texture of the flexible support members 224.


Referring again to FIGS. 1A-1D, the fibers used in the flexible support members 124 may be made using a variety of processes that provide fibers with the desired properties (such as modulus, tensile strength, elongation etc.). Those skilled in the art of fiber processing are well versed in the art of extrusion, paste extrusion and stretching, solution spinning, electrostatic spinning, along with other fiber processing techniques, which may be used to provide polymer based fibers. These fibers may be oriented or drawn using conventional process to provide the desired degree of modulus, strength, and elongation. Generally, a fiber orientation process is used to improve the properties of the reinforcing fibers. The fibers can be oriented using a variety of drawing technologies such as single, multiple or continuous drawing steps with or without heating zones and/or relaxation. Additionally, these fibers may be post treated with various annealing, scouring, coating or surface treatment steps.


As will be appreciated, the cover 108 can be formed in any number of ways. For example, the embodiments of the cover 108 can be made by injecting, pouring, casting, or otherwise placing the matrix 122 material (e.g., a polymer solution) into a mold set-up comprised of a mold and the flexible support members 124. Alternatively, the embodiments of the cover 108 can be made by blending, or mixing, the matrix 122 material (e.g., a polymer) with flexible support members 124 (e.g., the carbon nano-tubules, or fibrous Basalt) before or during the injecting, pouring, or casting process into the mold.


The general processing steps include the selection of the materials from which the matrix 122 and the flexible support members 124 are made. In one embodiment, the cover 108 can generally be formed by use of compression molding in the mold set-up under a dry inert environment (for example, under nitrogen and/or argon) or under vacuum, at high enough temperatures, pressures, and long enough residence times (with proper cooling) to consolidate the composite. Alternately, the cover 108 composite can be formed by use of an autoclave, under a dry inert environment or under vacuum, at high enough temperatures and long enough residence times to consolidate the composite. Proper consolidation condition should provide a composite with no voids therein.


The flexible support members 124 are generally ceramic and/or polymeric (e.g., semi-crystalline polymers) while the matrix 122 materials are generally either amorphous or semi-crystalline polymers. In conventional composites, such as glass or carbon reinforced composites, the flexible support members 124 are not affected by consolidation temperature of the matrix 122. In addition, some or all of the fibers of the flexible support members 124 can be restrained during the consolidation process. The flexible support members 124 can be restrained during the heat treatment or the consolidation in a variety of ways, including, but not limited to, mechanical clamps or rack systems. This allows a reduction or a minimization in relaxation of fiber orientation. Additionally restraining the flexible support members 124 will control or avoid shrinkage of the flexible support members 124 during heat treatment and/or consolidation.


In an alternative embodiment, the matrix 122 material can be extruded or formed into a tubing of appropriate size and thickness. The material of the matrix 122 can then be cross-linked to raise the melt temperature of the resulting tube. The tube can then inflated and stretched to give the included polymer a specific molecular orientation. The tube of the matrix 122 material can then be placed over the combination of an inner layer of the matrix 122 material and the flexible support members 124 and the material of the matrix 122 heat-shrunk around the flexible support members 124. Alternatively, the flexible support members 124 can be dipped into molten material of the matrix 122 to form the cover 108. In yet another embodiment, suitable adhesive for the selected materials can be used to bond the matrix 122 material to additional layers of the matrix 122 material and to layers of the flexible support members 124. In an additional embodiment, the matrix 122 can be co-processed with the flexible support members 124 (e.g., nanostructures or fibrous basalt) so as to distribute the flexible support members 124 through the matrix 122.


In addition to the cover 108, the frame 102 too can be formed from a wide variety of materials and in a wide variety of configurations. Generally, frame 102 can have a unitary structure with an open frame configuration. For example, the open frame configuration can include frame members 126 that define openings 128 across the frame 102 through which valve leaflets 104 and 106 formed by the cover 108 can radially-collapse and radially-expand, as will be described herein.


In addition, the first end 112 and the second end 114 each include a plurality of end portions 130 that lay on a common plane. The plurality of end portions 130, however, need not all lay on the common plane. In other words, it is possible that one or more of the end portions 130 of the frame 102 lay above and/or below the common plane.


While the frames illustrated herein, for example frame 102, are shown as having a circular configuration, other configurations are also possible. For example, the frame 102 could have an elliptical configuration. As such, the present invention should not be limited to the illustration of the frames, such as frame 102, provided herein.


As illustrated in FIGS. 1A-1D, the frame 102 can further include a first leaflet connection region 132 and a second leaflet connection region 134 adjacent the second end 114 of the frame 102. In the present example, the cover 108 can be coupled, as described more fully herein, to at least the first leaflet connection region 132 and the second leaflet connection region 134. The cover 108 so coupled can then move (e.g., pivot) relative the first leaflet connection region 132 and the second leaflet connection region 134 between an open valve configuration (illustrated in FIGS. 1A and 1C) and a closed valve configuration (illustrated in FIGS. 1B and 1D). As illustrated in the closed valve configuration (FIGS. 1B and 1D), the open frame configuration of frame 102 allows cover 108 to move through the openings 128 in creating the reversible sealable opening 120 of the valve 100.


As illustrated in FIGS. 1A-1D, the first leaflet connection region 132 and the second leaflet connection region 134 can be positioned opposite each other along a common axis. In addition, the first leaflet connection region 132 and the second leaflet connection region 134 can be radially symmetric around a longitudinal central axis 138 of the frame 102. As illustrated, the first leaflet connection region 132 and the second leaflet connection region 134 can be positioned approximately one hundred eighty (180) degrees relative each other around the longitudinal central axis 138 of the frame 102. As will be appreciated, the first leaflet connection region 132 and the second leaflet connection region 134 need not necessarily display an equally spaced symmetrical relationship as described above in order to practice the embodiments of the present invention. For example, the radial relationship can have the first leaflet connection region 132 and the second leaflet connection region 134 positioned at values greater than one hundred eighty (180) degrees and less than one hundred eighty (180) degrees relative each other around the longitudinal central axis 138 of the frame 102.


The frame 102 can have similar and/or different cross-sectional geometries along its length. The similarity and/or the differences in the cross-sectional geometries can be based on one or more desired functions to be elicited from each portion of the frame 102. For example, the frame 102 can have a similar cross-sectional geometry along its length. Examples of cross-sectional geometries include, but are not limited to, round (e.g., circular, oval, and/or elliptical), rectangular geometries having perpendicular sides, one or more convex sides, or one or more concave sides; semi-circular; triangular; tubular; I-shaped; T-shaped; and trapezoidal. These embodiments, however, are not limited to the present examples as other cross-sectional geometries are also possible. As such, the present invention should not be limited to the frames provided in the illustration herein.


The valve 100 can further include a radial support member 140. The radial support member 140 can include a number of different configurations, as will be described herein. For example, in the embodiment illustrated in FIGS. 1A-1D, the radial support member 140 couples the first leaflet connection region 132 and the second leaflet connection region 134. In addition to coupling the connection regions 132 and 134, the radial support member 140 can also serve to stabilize the relative positions of the connection regions 132 and 134 (e.g., limit relative fluctuations of the connection regions 132 and 134).


In the present embodiment, the radial support member 140 can be in the form of a tubular ring 142 that joins to the first leaflet connection region 132 and the second leaflet connection region 134. The valve 100 can further include a second tubular ring 144 located at the first end 112 of the frame 102. The tubular rings 142 and 144 can also move radially as the valve 100 radially collapses and expands. As will be appreciated, the valve 100 could further include additional tubular rings located at one or more positions along the frame 102. In an alternative embodiment, the radial support member can be provided to the frame 102 of the valve 100 due in part to dimensional relationships imparted to the frame 102 that are more fully described in co-pending U.S. patent application Ser. No. 11/150,331 to Hill et al. entitled “Venous Valve Frame, System, and Method”, which is hereby incorporated by reference in its entirety.


As illustrated, the cover 108 can be positioned over one or both of the radial support member 140 and the second tubular ring 144. As will be appreciated, the cover 108 need not extend to cover one or both of the radial support member 140 and the second tubular ring 144.


The compressible nature of the valve 100 can accommodate changes in body lumen size (e.g., diameter of the body lumen) by flexing to expand and/or contract to change the diameter of the frame 102. In one embodiment, the corner portions of the tubular rings 142 and 144, and the first leaflet connection region 132 and the second leaflet connection region 134 can act as springs to allow the valve 100 to resiliently radially collapse and expand. The frame 102 can also provide sufficient contact and expansion force with the surface of a body lumen wall to encourage fixation of the valve 100 and to prevent retrograde flow within the body lumen around the edges of the frame 102 and the surface of a lumen when combined with a closed state of the valve leaflets (described in more detail below) attached thereto. Anchoring elements (e.g., barbs) can also be included with valve 100, as will be discussed herein.



FIGS. 3A and 3B provide an example of the valve 300 in a collapsed state (FIG. 3A) and in an expanded state (FIG. 3B). As shown in FIGS. 3A and 3B, the valve 300 can travel between the collapsed and the expanded state along a radial travel path 346 (as shown in FIG. 3B), where there can be a change in a cross sectional area 348 of lumen 310. For example, the frame 302 can travel along the radial travel path 346 so as to change a width 350 of lumen 310. This can allow the valve 300 to react appropriately to the distension and contraction of a body lumen in which the valve 300 is placed. FIGS. 3A and 3B also provide an illustration of the valve 300 having a different configuration for the radial support members.


The embodiments of the frame discussed herein can also be constructed of one or more of a number of materials and in a variety of configurations. Generally, the frame embodiments can have a unitary structure with an open frame configuration. The frame can also be self-expanding. Examples of self-expanding frames include those formed from temperature-sensitive memory alloy (e.g., Nitinol) which changes shape at a designated temperature or temperature range. Alternatively, the self-expanding frames can include those having a spring-bias. In addition, the frame 102 can have a configuration that allows the frame embodiments be radially expandable through the use of a balloon catheter.


The embodiments of the frame, such as frame 102 in FIG. 1, can also be formed from one or more contiguous frame members. For example, the frame member of frame embodiments can be a single contiguous member. The single contiguous member can be bent around an elongate tubular mandrel to form the frame. The free ends of the single contiguous member can then be welded, fused, crimped, or otherwise joined together to form the frame. In an additional embodiment, the frame member of frame can be derived (e.g., laser cut, water cut) from a single tubular segment. In an alternative embodiment, methods of joining the frame member to create the elastic region include, but are not limited to, welding, gluing, and fusing the frame member. The frame can be heat set by a method as is typically known for the material which forms the frame.


The frame embodiments can be formed from a number of materials. For example, the frame can be formed from a biocompatible metal, metal alloy, polymeric material, or combination thereof. As discussed herein, the frame can be self-expanding or balloon expandable. In addition, the frame can be configured so as to have the ability to move radially between the collapsed state and the expanded state. To accomplish this, the material used to form the frame should exhibit a low elastic modulus and a high yield stress for large elastic strains that can recover from elastic deformations. Examples of suitable materials include, but are not limited to, medical grade stainless steel (e.g., 316L), titanium, tantalum, platinum alloys, niobium alloys, cobalt alloys, alginate, or combinations thereof. Additional frame embodiments may be formed from a shape-memory material, such as shape memory plastics, polymers, and thermoplastic materials which are inert in the body. Shaped memory alloys having superelastic properties generally made from ratios of nickel and titanium, commonly known as Nitinol, are also possible materials. Other materials are also possible.


The lumen 110 can include a number of sizes. For example, the size of the lumen can be determined based upon the type of body lumen and the body lumen size in which the valve is to be placed. In an additional example, there can also be a minimum value for the width for the frame that ensures that the frame will have an appropriate expansion force against the inner wall of the body lumen in which the valve is being placed. For example, the diameter can range from 4 mm to 20 mm. Other diameter values are also possible.


In one embodiment, the frame can further include one or more anchoring elements. For example, the one or more anchoring elements can include, but are not limited to, one or more barbs 152 projecting from the frame 102. The valve can further include one or more radiopaque markers (e.g., tabs, sleeves, welds). For example, one or more portions of the frame can be formed from a radiopaque material. Radiopaque markers can be attached to and/or coated onto one or more locations along the frame. Examples of radiopaque material include, but are not limited to, gold, tantalum, and platinum. The position of the one or more radiopaque markers can be selected so as to provide information on the position, location and orientation of the valve during its implantation.


As discussed herein, valve 100 further includes cover 108 having surfaces defining the reversibly sealable opening 120 for unidirectional flow of a liquid through the lumen 110. For the embodiment illustrated in FIGS. 1A-1D, the cover 108 extends over at least a portion of the frame 102 to the first leaflet connection region 132 and the second leaflet connection region 134. The cover 108 extends between the first leaflet connection region 132 and the second leaflet connection region 134 to provide the first valve leaflet 104 and the second valve leaflet 106 of the valve leaflets. The first valve leaflet 104 and the second valve leaflet 106 include surfaces defining the reversibly sealable opening 120 extending between the first leaflet connection region 132 and the second leaflet connection region 134 for unidirectional flow of a liquid through the valve 100.


As illustrated, the valve leaflets 104 and 106 include a region 154 of the cover 108 that can move relative the frame 102. The region 154 of the cover 108 can be unbound (i.e., unsupported) by the frame 102 and extends between the first leaflet connection region 132 and the second leaflet connection region 134 of the valve 100. This configuration permits the reversibly sealable opening 120 to open and close in response to the fluid pressure differential across the valve leaflets 104 and 106.


For example, under antegrade fluid flow (i.e., positive fluid pressure) from the first end 112 towards the second end 114 of the valve 100, the valve leaflets 104 and 106 can expand toward the inner surface 118 of the frame 102 to create an opening through which fluid is permitted to move. In one example, the valve leaflets 104 and 106 each expand to define a semi-tubular structure when fluid opens the reversibly sealable opening 120. An example of the open configuration for the valve is shown in FIGS. 1A and 1C.


Under a retrograde fluid flow from the second end 114 towards the first end 112, the valve leaflets can move relative the inner surface 118 as the valve leaflets begin to close. In one example, a pocket exists between the frame 102 and each of the valve leaflets. The pocket allows fluid from the retrograde flow to develop a lower pressure on a first major face 155 of the valve leaflets than on the second major face 157 of the valve leaflets causing the valve leaflets to begin to close. As fluid pressure develops on the pocket regions formed on the second major face 157, the valve leaflets collapse, closing the reversibly sealable opening 120, thereby restricting retrograde fluid flow through the valve 100. In the closed configuration, the valve leaflets can each have a concave structure when fluid closes the reversibly sealable opening 120. In one embodiment, the concave structure can be imparted to the valve leaflets due to the configuration of the flexible support members 124 and/or the matrix 122. An example of the closed configuration for the valve is shown in FIGS. 1B and 1D.


Valve 100 provides an embodiment in which the surfaces defining the reversibly sealable opening 120 provide a bi-leaflet configuration (i.e., a bicuspid valve) for valve 100. Although the embodiments in FIGS. 1A-1D illustrate and describe a bi-leaflet configuration for the valve of the present invention, designs employing a different number of valve leaflets (e.g., tri-leaflet valve) are possible. For example, additional connection points (e.g., three or more) could be used to provide additional valve leaflets (e.g., a tri-leaflet valve).


The valve leaflets can have a variety of sizes and shapes. For example, each of the valve leaflets can have a similar size and shape. Alternatively, each of the valve leaflets need not have a similar size and shape (i.e., the valve leaflets can have a different size and shape with respect to each other). In addition, each of the valve leaflets include sufficient excess material spanning frame 102 such that fluid pressure (e.g., antegrade flow) acting on the region 154 of the valve leaflets forces the valve 100 into an open configuration (FIGS. 1A and 1C). The valve leaflets further include arcuate edges 156 that are positioned adjacent each other along a substantially catenary curve between the leaflet connection regions 132 and 134 in the closed configuration (FIGS. 1B and 1D) of valve 100. Similarly, arcuate edges 156 can define opening 120 when the valve 100 is in the open configuration (FIGS. 1A and 1C).


In an additional embodiment, in the open configuration the portion of the cover 108 forming the valve leaflets 104 and 106 provides sufficient excess material spanning between the leaflet connection regions 132 and 134 to allow the leaflets to take on a semi-tubular structure, as shown in FIG. 1A, when fluid pressure opens the valve 100. In an additional embodiment, arcuate edges 156 of valve 100 can open to approximately the full inner diameter of a body lumen. Alternatively, the arcuate edges 156 of valve 100 can open to approximately a diameter that is less than the full inner of a body lumen. FIGS. 1A and 1C provide an illustration of this latter embodiment, where a space 163 can be present between the second major face 157 of the valve leaflets and the inner surface 118 of the frame 102.


Each of the regions 154 of the valve leaflets can further include a concave structure that allows the valve leaflets to better collect retrograde fluid flow to urge the valve leaflets towards the closed configuration. For example, as retrograde flow begins, the valve leaflets respond by moving towards the center of valve 100. As the valve leaflets approach the center of the leaflets make sufficient contact to effectively close valve 100 and restrict retrograde fluid flow.


As discussed herein, the cover 108 can be located over at least the outer surface 116 and the inner surface 118 of the frame 102 to form the valve leaflets 104 and 106 as described herein. Alternatively, the cover 108 can be located over the inner surface 118 of the frame 102, or the cover 108 can be located over the outer surface 116 of the frame 102 to form the valve leaflets 104 and 106 as described herein. Numerous techniques may be employed to laminate or bond cover 108 on the outer surface 116 and/or the inner surface 118 of the frame 102, including heat setting, adhesive welding, application of uniform force and other bonding techniques. Additionally, the cover 108 may be folded over the first end 112 of the frame 102 to provide the cover 108 on both the outer surface 116 and the inner surface 118. Cover 108 can also be joined to itself and/or the members 126 according to the methods described in U.S. Patent Application Publication US 2002/0178570 to Sogard et al., which is hereby incorporated by reference in its entirety.


The cover 108 can also be coupled to the connection regions so as to form the valve leaflets, as discussed herein. In one embodiment, the cover 108 can be in the form of a sheet or a sleeve of material, as discussed herein, which can be connected to the frame 102. Other forms, including intermediate forms, of the cover 108 are also possible.


The cover 108 can be coupled to the frame 102, including the connection regions 132 and 134, in a variety of ways so as to provide the various embodiments of the valve of the present invention. For example, a variety of fasteners can be used to couple the cover 108 to the frame 102 so as to form the valve 100. Suitable fasteners can include, but are not limited to, biocompatible staples, glues, sutures or combinations thereof. In an additional embodiment, the cover 108 can be coupled to the frame 102 through the use of heat sealing, solvent bonding, adhesive bonding, or welding cover 108 to either a portion of the cover 108 (i.e., itself) and/or the frame 102.


The cover 108, including the valve leaflets 104 and 106, may also be treated and/or coated with any number of surface or material treatments. For example, suitable bioactive agents which may be incorporated with or utilized together with embodiments of the present invention may include silver antimicrobial agents, metallic antimicrobial materials, growth factors, cellular migration agents, cellular proliferation agents, anti-coagulant substances, stenosis inhibitors, thrombo-resistant agents, antibiotic agents, anti-tumor agents, anti-proliferative agents, growth hormones, antiviral agents, anti-angiogenic agents, angiogenic agents, cholesterol-lowering agents, vasodilating agents, agents that interfere with endogenous vasoactive mechanisms, hormones, their homologs, derivatives, fragments, pharmaceutical salts and combinations thereof.


In the various embodiments of the present invention, the most useful bioactive agents can include those that modulate thrombosis, those that encourage cellular ingrowth, throughgrowth, and endothelialization, those that resist infection, and those that reduce calcification. For example, the cover 108 can be treated with one or more biologically active compounds and/or materials that may promote and/or inhibit endothelial, smooth muscle, fibroblast, and/or other cellular growth onto or into the cover 108, including the valve leaflets. Similarly, the cover 108 may be seeded and covered with cultured tissue cells (e.g., endothelial cells) derived from a either a donor or the host patient which are attached to the valve leaflets. The cultured tissue cells may be initially positioned to extend either partially or fully over the valve leaflets.


Cover 108, in addition to forming valve leaflets 104 and 106, can also be capable of inhibiting thrombus formation, as discussed herein. Additionally, cover 108 may either prevent or facilitate tissue ingrowth therethrough, as the particular application for the valve 100 may dictate. For example, cover 108 on the outer surface 116 may be formed from a porous material to facilitate tissue ingrowth therethrough, while cover 108 on the inner surface 118 may be formed from a material or a treated material which inhibits tissue ingrowth.


Cells can be associated with the present invention. For example, cells that have been genetically engineered to deliver bioactive proteins, such as the above mentioned growth factors or antibodies, to the implant site can be associated with the present invention. Cells can be of human origin (autologous or allogenic) or from an animal source (xenogenic). Cells can be pre-treated with medication or pre-processed such as by sorting or encapsulation. The delivery media can be formulated as needed to maintain cell function and viability.


Thrombo-resistant agents associated with the present invention can include, but are not limited to, the following: heparin, heparin sulfate, hirudin, hyaluronic acid, chondroitin sulfate, dermatin sulfate, keratin sulfate, PPack (detropyenylalanine praline arginine chloromethylketone), lytic agents, including urokinase and streptokinase, their homologs, analogs, fragments, derivatives and pharmaceutical salts thereof.


Anti-coagulants can include, but are not limited to, the following: D-Phe-Pro-Arg chloromethyl ketone, an ROD peptide-containing compound, heparain, antithrombin compounds, platelet receptor antagonists, anti-thrombin antibodies, anti-platelet receptor antibodies, aspirin, prostaglandin inhibitors, platelet inhibitors, tick antiplatelet peptides and combinations thereof.


Antibiotic agents can include, but are not limited to, the following agents: penicillins, cephalosportins, vancomycins, aminoglycosides, quinolonges, polymyxins, erythromycins, tetracyclines, chloraphenicols, clindamycins, lincomycins, sulfonamides, their homologs, analogs, derivatives, pharmaceutical salts and combinations thereof.


Anti-proliferative agents for use in the present invention can include, but are not limited to, the following: paclitaxel, sirolimus, everolimus, or monoclonal antibodies capable of blocking smooth muscle cell proliferation, related compounds, derivatives, and combinations thereof.


Vascular cell growth inhibitors can include, but are not limited to, the following: growth factor inhibitors, growth factor receptor antagonists, transcriptional repressors, translational repressors, replication inhibitors, inhibitory antibodies, antibodies directed against growth factors, bifunctional molecules consisting of a growth factor and a cytotoxin, bifunctional molecules consisting of a an antibody and a cytotoxin.


Vascular cell growth promoters can include, but are not limited to, transcriptional activators and transcriptional promoters. And, anti-inflammatory agents can include, but are not limited to, the following: dexametbasone, prednisolone, corticosterone, budesonide, estrogen, sulfasalazinemesalamne, and combinations thereof.



FIG. 4 illustrates one embodiment of a system 470. System 470 includes valve 400, as described herein, reversibly joined to catheter 472. The catheter 472 includes an elongate body 474 having a proximal end 476 and a distal end 478, where valve 400 can be located between the proximal end 476 and distal end 478. The catheter 472 can further include a lumen 480 longitudinally extending to the distal end 478. In one embodiment, lumen 480 extends between proximal end 476 and distal end 478 of catheter 472. The catheter 472 can further include a guidewire lumen 482 that extends within the elongate body 474, where the guidewire lumen 482 can receive a guidewire for positioning the catheter 472 and the valve 400 within a body lumen (e.g., a vein of a patient).


The system 470 can further include a deployment shaft 484 positioned within lumen 480, and a sheath 486 positioned adjacent the distal end 478. In one embodiment, the valve 400 can be positioned at least partially within the sheath 486 and adjacent the deployment shaft 484. The deployment shaft 484 can be moved within the lumen 478 to deploy valve 400. For example, deployment shaft 484 can be used to push valve 400 from sheath 486 in deploying valve 400.



FIG. 5 illustrates an additional embodiment of the system 570. The catheter 572 includes elongate body 574, lumen 580, a retraction system 588 and a retractable sheath 590. The retractable sheath 590 can be positioned over at least a portion of the elongate body 574, where the retractable sheath 590 can move longitudinally along the elongate body 574. The valve 500 can be positioned at least partially within the retractable sheath 590, where the retractable sheath 590 moves along the elongate body 574 to deploy the valve 500. In one embodiment, retraction system 588 includes one or more wires 592 coupled to the retractable sheath 590, where the wires are positioned at least partially within and extend through lumen 580 in the elongate body 574. Wires of the retraction system 588 can then be used to retract the retractable sheath 590 in deploying valve 500.



FIG. 6 illustrates an additional embodiment of the system 670. The catheter 672 includes elongate body 674, an inflatable balloon 694 positioned adjacent the distal end 678, and a lumen 680 longitudinally extending in the elongate body 674 of the catheter 672 from the inflatable balloon 694 to the proximal end 676. In the present example, the inflatable balloon 694 can be at least partially positioned within the lumen 606 of the valve 600. The inflatable balloon 694 can be inflated through the lumen 680 to deploy the valve 600.


The embodiments of the present invention further include methods for forming the valve of the present invention, as discussed herein. For example, the method of forming the valve can include forming the frame having the leaflet connection regions, as described. The method can include providing the radial support member, or members, on the frame for the leaflet connection regions. As discussed herein, the radial support member can include the tubular rings adjacent the leaflet connection regions. The method also includes providing the cover on the frame, where connecting the cover to the leaflet connection regions provides at least the first leaflet and the second leaflet of the valve having surfaces defining the reversibly sealable opening for unidirectional flow of a liquid through the valve.


In an additional example, the valve can be reversibly joined to the catheter, which can include a process of altering the shape of the valve from a first shape, for example an expanded state, to the compressed state, as described herein. For example, the valve can be reversibly joined with the catheter by positioning valve in the compressed state at least partially within the sheath of the catheter. In one embodiment, positioning the valve at least partially within the sheath of the catheter includes positioning the valve in the compressed state adjacent the deployment shaft of the catheter. In an another embodiment, the sheath of the catheter functions as a retractable sheath, where the valve in the compressed state can be reversibly joined with the catheter by positioning the valve at least partially within the reversible sheath of the catheter. In a further embodiment, the catheter can include an inflatable balloon, where the balloon can be positioned at least partially within the lumen of the valve, for example, in its compressed state.


The embodiments of the valve described herein may be used to replace, supplement, or augment valve structures within one or more lumens of the body. For example, embodiments of the present invention may be used to replace an incompetent venous valve and help to decrease backflow of blood in the venous system of the legs.


In one embodiment, the method of replacing, supplementing, and/or augmenting a valve structure can include positioning at least part of the catheter including the valve at a predetermined location within the lumen of a body. For example, the predetermined location can include a position within a body lumen of a venous system of a patient, such as a vein of a leg.


In one embodiment, positioning the catheter that includes the valve within the body lumen of a venous system includes introducing the catheter into the venous system of the patient using minimally invasive percutaneous, transluminal catheter based delivery system, as is known in the art. For example, a guidewire can be positioned within a body lumen of a patient that includes the predetermined location. The catheter, including valve, as described herein, can be positioned over the guidewire and the catheter advanced so as to position the valve at or adjacent the predetermined location. In one embodiment, radiopaque markers on the catheter and/or the valve, as described herein, can be used to help locate and position the valve.


The valve can be deployed from the catheter at the predetermined location in a number of ways, as described herein. In one embodiment, valve of the present invention can be deployed and placed in a number of vascular locations. For example, valve can be deployed and placed within a major vein of a patient's leg. In one embodiment, major veins include, but are not limited to, those of the peripheral venous system. Examples of veins in the peripheral venous system include, but are not limited to, the superficial veins such as the short saphenous vein and the greater saphenous vein, and the veins of the deep venous system, such as the popliteal vein and the femoral vein.


As discussed herein, the valve can be deployed from the catheter in a number of ways. For example, the catheter can include the retractable sheath in which valve can be at least partially housed, as discussed herein. Valve can be deployed by retracting the retractable sheath of the catheter, where the valve self-expands to be positioned at the predetermined location. In an additional example, the catheter can include a deployment shaft and sheath in which valve can be at least partially housed adjacent the deployment shaft, as discussed herein. Valve can be deployed by moving the deployment shaft through the catheter to deploy valve from the sheath, where the valve self-expands to be positioned at the predetermined location. In an additional embodiment, the valve can be deployed through the use of an inflatable balloon.


Once implanted, the valve can provide sufficient contact and expansion force against the body lumen wall to prevent retrograde flow between the valve and the body lumen wall. For example, the valve can be selected to have a larger expansion diameter than the diameter of the inner wall of the body lumen. This can then allow valve to exert a force on the body lumen wall and accommodate changes in the body lumen diameter, while maintaining the proper placement of valve. As described herein, the valve can engage the lumen so as to reduce the volume of retrograde flow through and around valve. It is, however, understood that some leaking or fluid flow may occur between the valve and the body lumen and/or through valve leaflets.


In addition, the use of both the radial support member and/or the support frame region of the valve can provide a self centering aspect to valve within a body lumen. In one embodiment, the self centering aspect resulting from the radial support member and/or the support frame region may allow valve to maintain a substantially coaxial alignment with the body lumen (e.g., such as a vein) as valve leaflets deflect between the open and closed configurations so as to better seal the reversible opening when valve is closed.


While the present invention has been shown and described in detail above, it will be clear to the person skilled in the art that changes and modifications may be made without departing from the scope of the invention. As such, that which is set forth in the foregoing description and accompanying drawings is offered by way of illustration only and not as a limitation. The actual scope of the invention is intended to be defined by the following claims, along with the full range of equivalents to which such claims are entitled.


In addition, one of ordinary skill in the art will appreciate upon reading and understanding this disclosure that other variations for the invention described herein can be included within the scope of the present invention. For example, the frame 102 and/or the cover 108 can be coated with a non-thrombogenic biocompatible material, as are known or will be known.


In the foregoing Detailed Description, various features are grouped together in several embodiments for the purpose of streamlining the disclosure. This method of disclosure is not to be interpreted as reflecting an intention that the embodiments of the invention require more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive subject matter lies in less than all features of a single disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description, with each claim standing on its own as a separate embodiment.

Claims
  • 1. A valve, comprising: a frame having a first leaflet connection region, a second leaflet connection region, and a longitudinal axis;a first leaflet coupled to the first leaflet connection region and the second leaflet connection region; anda second leaflet coupled to the first leaflet connection region and the second leaflet connection region, wherein the first leaflet and the second leaflet have integrated flexible support members to provide support to the first leaflet and the second leaflet, the first leaflet connection region and the second leaflet connection region having surfaces defining a reversibly sealable opening for unidirectional flow of a liquid through the valve,wherein each of the integrated flexible support members are circumferentially disposed about the longitudinal axis and support the first leaflet and the second leaflet;wherein the second material of the integrated flexible support members includes spun-fibers of a ceramic.
  • 2. The valve of claim 1, wherein the ceramic includes basalt.
  • 3. A valve, comprising: a frame having a first leaflet connection region, a second leaflet connection region, and a longitudinal axis;a first leaflet coupled to the first leaflet connection region and the second leaflet connection region; anda second leaflet coupled to the first leaflet connection region and the second leaflet connection region, wherein the first leaflet and the second leaflet have integrated flexible support members to provide support to the first leaflet and the second leaflet, the first leaflet connection region and the second leaflet connection region having surfaces defining a reversibly sealable opening for unidirectional flow of a liquid through the valve,wherein each of the integrated flexible support members are circumferentially disposed about the longitudinal axis and support the first leaflet and the second leaflet;wherein the integrated flexible support members are in a configuration selected from the group consisting of woven, matted, coiled, rings, braided and knitted.
  • 4. A system, comprising: a valve, wherein the valve includes:a frame having a first leaflet connection region, a second leaflet connection region, and a longitudinal axis;a first leaflet coupled to the first leaflet connection region and the second leaflet connection region;a second leaflet coupled to the first leaflet connection region and the second leaflet connection region, wherein the first leaflet and the second leaflet have integrated flexible support members to provide support to the first leaflet and the second leaflet, the first leaflet connection region and the second leaflet connection region having surfaces defining a reversibly sealable opening for unidirectional flow of a liquid through the valve,wherein each of the integrated flexible support members are circumferentially disposed about the longitudinal axis and support the first leaflet and the second leaflet; anda catheter including a proximal end and a distal end, the valve located between the proximal end and distal end of the catheter;wherein the first leaflet and the second leaflet are formed of a first material and the integrated flexible support members are formed of a second material;wherein the second material of the integrated flexible support members includes spun-fibers of a ceramic.
  • 5. A system, comprising: a valve, wherein the valve includes:a frame having a first leaflet connection region, a second leaflet connection region, and a longitudinal axis;a first leaflet coupled to the first leaflet connection region and the second leaflet connection region;a second leaflet coupled to the first leaflet connection region and the second leaflet connection region, wherein the first leaflet and the second leaflet have integrated flexible support members to provide support to the first leaflet and the second leaflet, the first leaflet connection region and the second leaflet connection region having surfaces defining a reversibly sealable opening for unidirectional flow of a liquid through the valve,wherein each of the integrated flexible support members are circumferentially disposed about the longitudinal axis and support the first leaflet and the second leaflet; anda catheter including a proximal end and a distal end, the valve located between the proximal end and distal end of the catheter;wherein the integrated flexible support members are in a configuration selected from the group consisting of woven, matted, coiled, rings, braided and knitted.
CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No. 11/063,681, filed Feb. 23, 2005, which is herein incorporated by reference.

US Referenced Citations (624)
Number Name Date Kind
3671979 Moulopoulos Jun 1972 A
4291420 Reul Sep 1981 A
4787901 Baykut Nov 1988 A
4872874 Taheri Oct 1989 A
4935030 Alonso Jun 1990 A
4994077 Dobben Feb 1991 A
5002567 Bona et al. Mar 1991 A
5141491 Bowald Aug 1992 A
5163953 Vince Nov 1992 A
5219355 Parodi et al. Jun 1993 A
5254127 Wholey et al. Oct 1993 A
5327774 Nguyen et al. Jul 1994 A
5332402 Teitelbaum Jul 1994 A
5370685 Stevens Dec 1994 A
5411552 Andersen et al. May 1995 A
5469868 Reger Nov 1995 A
5480423 Ravenscroft et al. Jan 1996 A
5500014 Quijano et al. Mar 1996 A
5545214 Stevens Aug 1996 A
5554185 Block et al. Sep 1996 A
5643208 Parodi Jul 1997 A
5693087 Parodi Dec 1997 A
5713953 Vallana et al. Feb 1998 A
5716370 Williamson, IV et al. Feb 1998 A
5735859 Fischell et al. Apr 1998 A
5741326 Solovay Apr 1998 A
5741333 Frid Apr 1998 A
5800506 Perouse Sep 1998 A
5824061 Quijano et al. Oct 1998 A
5879320 Cazenave Mar 1999 A
5895419 Tweden et al. Apr 1999 A
5910170 Reimink et al. Jun 1999 A
6010531 Donlon et al. Jan 2000 A
6042607 Williamson, IV et al. Mar 2000 A
6139575 Shu et al. Oct 2000 A
6287334 Moll et al. Sep 2001 B1
6312447 Grimes Nov 2001 B1
6355030 Aldrich et al. Mar 2002 B1
6402780 Williamson, IV et al. Jun 2002 B2
6419696 Ortiz et al. Jul 2002 B1
6425916 Garrison et al. Jul 2002 B1
6440164 DiMatteo et al. Aug 2002 B1
6451054 Stevens Sep 2002 B1
6454799 Schreck Sep 2002 B1
6461366 Seguin Oct 2002 B1
6503272 Duerig et al. Jan 2003 B2
6508833 Pavcnik et al. Jan 2003 B2
6564805 Garrison et al. May 2003 B2
6569196 Vesely May 2003 B1
6602286 Strecker Aug 2003 B1
6629534 St. Goar et al. Oct 2003 B1
6635085 Caffey et al. Oct 2003 B1
6666885 Moe Dec 2003 B2
6666886 Tranquillo et al. Dec 2003 B1
6669725 Scott Dec 2003 B2
6673109 Cox Jan 2004 B2
6676698 McGuckin, Jr. et al. Jan 2004 B2
6676702 Mathis Jan 2004 B2
6682558 Tu et al. Jan 2004 B2
6682559 Myers et al. Jan 2004 B2
6685739 DiMatteo et al. Feb 2004 B2
6692512 Jang Feb 2004 B2
6695866 Kuehn et al. Feb 2004 B1
6695878 McGuckin, Jr. et al. Feb 2004 B2
6709456 Langberg et al. Mar 2004 B2
6709457 Otte et al. Mar 2004 B1
6716241 Wilder et al. Apr 2004 B2
6716244 Klaco Apr 2004 B2
6719767 Kimblad Apr 2004 B1
6719784 Henderson Apr 2004 B2
6719786 Ryan et al. Apr 2004 B2
6719787 Cox Apr 2004 B2
6719788 Cox Apr 2004 B2
6719789 Cox Apr 2004 B2
6719790 Brendzel et al. Apr 2004 B2
6723038 Schroeder et al. Apr 2004 B1
6723122 Yang et al. Apr 2004 B2
6723123 Kazatchkov et al. Apr 2004 B1
6726715 Sutherland Apr 2004 B2
6726716 Marquez Apr 2004 B2
6726717 Alfieri et al. Apr 2004 B2
6730118 Spenser et al. May 2004 B2
6730121 Ortiz et al. May 2004 B2
6730122 Pan et al. May 2004 B1
6736845 Marquez et al. May 2004 B2
6736846 Cox May 2004 B2
6749630 McCarthy et al. Jun 2004 B2
6752813 Goldfarb et al. Jun 2004 B2
6752828 Thornton Jun 2004 B2
6755857 Peterson et al. Jun 2004 B2
6761734 Suhr Jul 2004 B2
6761735 Eberhardt et al. Jul 2004 B2
6764494 Menz et al. Jul 2004 B2
6764508 Roehe et al. Jul 2004 B1
6764509 Chinn et al. Jul 2004 B2
6764510 Vidlund et al. Jul 2004 B2
6767362 Schreck Jul 2004 B2
6769434 Liddicoat et al. Aug 2004 B2
6770083 Seguin Aug 2004 B2
6780200 Jansen Aug 2004 B2
6786924 Ryan et al. Sep 2004 B2
6786925 Buchanan et al. Sep 2004 B1
6790229 Berreklouw Sep 2004 B1
6790230 Beyersdorf et al. Sep 2004 B2
6790231 Liddicoat et al. Sep 2004 B2
6793673 Kowalsky et al. Sep 2004 B2
6797000 Simpson et al. Sep 2004 B2
6797001 Mathis et al. Sep 2004 B2
6797002 Spence et al. Sep 2004 B2
6802860 Cosgrove et al. Oct 2004 B2
6805710 Bolling et al. Oct 2004 B2
6805711 Quijano et al. Oct 2004 B2
6810882 Langberg et al. Nov 2004 B2
6821297 Snyders Nov 2004 B2
6824562 Mathis et al. Nov 2004 B2
6830584 Seguin Dec 2004 B1
6830585 Artof et al. Dec 2004 B1
6837902 Nguyen et al. Jan 2005 B2
6840246 Downing Jan 2005 B2
6840957 DiMatteo et al. Jan 2005 B2
6846324 Stobie Jan 2005 B2
6846325 Liddicoat Jan 2005 B2
6858039 McCarthy Feb 2005 B2
6869444 Gabbay Mar 2005 B2
6872226 Cali et al. Mar 2005 B2
6875224 Grimes Apr 2005 B2
6875230 Morita et al. Apr 2005 B1
6875231 Anduiza et al. Apr 2005 B2
6881199 Wilk et al. Apr 2005 B2
6881224 Kruse et al. Apr 2005 B2
6883522 Spence et al. Apr 2005 B2
6890352 Lentell May 2005 B1
6890353 Cohn et al. May 2005 B2
6893459 Macoviak May 2005 B1
6893460 Spenser et al. May 2005 B2
6896700 Lu et al. May 2005 B2
6902576 Drasler et al. Jun 2005 B2
6908478 Alferness et al. Jun 2005 B2
6908481 Cribier Jun 2005 B2
6911043 Myers et al. Jun 2005 B2
6913608 Liddicoat et al. Jul 2005 B2
6916338 Speziali Jul 2005 B2
6918917 Nguyen et al. Jul 2005 B1
6921407 Nguyen et al. Jul 2005 B2
6921811 Zamora et al. Jul 2005 B2
6926715 Hauck et al. Aug 2005 B1
6926730 Nguyen et al. Aug 2005 B1
6929653 Strecter Aug 2005 B2
6932838 Schwartz et al. Aug 2005 B2
6936067 Buchanan Aug 2005 B2
6939359 Tu et al. Sep 2005 B2
6942694 Liddicoat et al. Sep 2005 B2
6945957 Freyman Sep 2005 B2
6945978 Hyde Sep 2005 B1
6945996 Sedransk Sep 2005 B2
6945997 Huynh et al. Sep 2005 B2
6949122 Adams et al. Sep 2005 B2
6951571 Srivastava Oct 2005 B1
6951573 Dilling Oct 2005 B1
6955689 Ryan et al. Oct 2005 B2
6958076 Acosta et al. Oct 2005 B2
6962605 Cosgrove et al. Nov 2005 B2
6964682 Nguyen-Thien-Nhon et al. Nov 2005 B2
6964683 Kowalsky et al. Nov 2005 B2
6964684 Ortiz et al. Nov 2005 B2
6966925 Stobie Nov 2005 B2
6966926 Mathis Nov 2005 B2
6974464 Quijano et al. Dec 2005 B2
6974474 Pavcnik et al. Dec 2005 B2
6974476 McGuckin, Jr. et al. Dec 2005 B2
6976995 Mathis et al. Dec 2005 B2
6979350 Moll et al. Dec 2005 B2
6986775 Morales et al. Jan 2006 B2
6989027 Allen et al. Jan 2006 B2
6989028 Lashinski et al. Jan 2006 B2
6997950 Chawla Feb 2006 B2
6997951 Solem et al. Feb 2006 B2
7004176 Lau Feb 2006 B2
7007396 Rudko et al. Mar 2006 B2
7011669 Kimblad Mar 2006 B2
7011681 Vesely Mar 2006 B2
7011682 Lashinski et al. Mar 2006 B2
7018406 Seguin et al. Mar 2006 B2
7018407 Wright et al. Mar 2006 B1
7018408 Bailey et al. Mar 2006 B2
7022134 Quijano et al. Apr 2006 B1
7025780 Gabbay Apr 2006 B2
7033390 Johnson et al. Apr 2006 B2
7037333 Myers et al. May 2006 B2
7037334 Hlavka et al. May 2006 B1
7041128 McGuckin, Jr. et al. May 2006 B2
7041132 Quijano et al. May 2006 B2
7044966 Svanidze et al. May 2006 B2
7044967 Solem et al. May 2006 B1
7048754 Martin et al. May 2006 B2
7048757 Shaknovich May 2006 B2
7052487 Cohn et al. May 2006 B2
7052507 Wakuda et al. May 2006 B2
7063722 Marquez Jun 2006 B2
7066954 Ryan et al. Jun 2006 B2
7070616 Majercak et al. Jul 2006 B2
7077862 Vidlund et al. Jul 2006 B2
7081131 Thornton Jul 2006 B2
7087064 Hyde Aug 2006 B1
7089051 Jäverud et al. Aug 2006 B2
7090695 Solem et al. Aug 2006 B2
7195641 Palmaz et al. Mar 2007 B2
20010039450 Pavcnik et al. Nov 2001 A1
20020013571 Goldfarb et al. Jan 2002 A1
20020026216 Grimes Feb 2002 A1
20020082630 Menz et al. Jun 2002 A1
20020107565 Greenhalgh Aug 2002 A1
20020123802 Snyders Sep 2002 A1
20020151970 Garrison et al. Oct 2002 A1
20020183835 Taylor et al. Dec 2002 A1
20020183838 Liddicoat et al. Dec 2002 A1
20020188348 DiMatteo et al. Dec 2002 A1
20020198594 Schreck Dec 2002 A1
20030023303 Palmaz et al. Jan 2003 A1
20030050694 Yang et al. Mar 2003 A1
20030078652 Sutherland Apr 2003 A1
20030130729 Paniagua et al. Jul 2003 A1
20030153943 Michael et al. Aug 2003 A1
20030163194 Quijano et al. Aug 2003 A1
20030167071 Martin et al. Sep 2003 A1
20030171806 Mathis et al. Sep 2003 A1
20030199975 Gabbay Oct 2003 A1
20030229394 Ogle et al. Dec 2003 A1
20030229395 Cox Dec 2003 A1
20030233142 Morales et al. Dec 2003 A1
20030236568 Hojeibane et al. Dec 2003 A1
20030236569 Mathis et al. Dec 2003 A1
20040002719 Oz et al. Jan 2004 A1
20040003819 St. Goar et al. Jan 2004 A1
20040010305 Alferness et al. Jan 2004 A1
20040015230 Moll et al. Jan 2004 A1
20040015232 Shu et al. Jan 2004 A1
20040015233 Jansen Jan 2004 A1
20040019374 Hojeibane et al. Jan 2004 A1
20040019377 Taylor et al. Jan 2004 A1
20040019378 Hlavka et al. Jan 2004 A1
20040024447 Haverich Feb 2004 A1
20040024451 Johnson et al. Feb 2004 A1
20040024452 Kruse et al. Feb 2004 A1
20040030321 Fangrow, Jr. Feb 2004 A1
20040030381 Shu Feb 2004 A1
20040030382 St. Goar et al. Feb 2004 A1
20040030405 Carpentier et al. Feb 2004 A1
20040034380 Woolfson et al. Feb 2004 A1
20040034411 Quijano et al. Feb 2004 A1
20040039436 Spenser et al. Feb 2004 A1
20040039442 St. Goar et al. Feb 2004 A1
20040039443 Solem et al. Feb 2004 A1
20040044350 Martin et al. Mar 2004 A1
20040044365 Bachman Mar 2004 A1
20040044403 Bischoff et al. Mar 2004 A1
20040049207 Goldfarb et al. Mar 2004 A1
20040049211 Tremulis et al. Mar 2004 A1
20040049266 Anduiza et al. Mar 2004 A1
20040059351 Eigler et al. Mar 2004 A1
20040059411 Strecker Mar 2004 A1
20040059412 Lytle, IV et al. Mar 2004 A1
20040060161 Leal et al. Apr 2004 A1
20040073301 Donlon et al. Apr 2004 A1
20040073302 Rourke et al. Apr 2004 A1
20040078072 Tu et al. Apr 2004 A1
20040078074 Anderson et al. Apr 2004 A1
20040082910 Constantz et al. Apr 2004 A1
20040082923 Field Apr 2004 A1
20040082991 Nguyen et al. Apr 2004 A1
20040087975 Lucatero et al. May 2004 A1
20040088045 Cox May 2004 A1
20040088046 Speziali May 2004 A1
20040092858 Wilson et al. May 2004 A1
20040093060 Seguin et al. May 2004 A1
20040093070 Hojeibane et al. May 2004 A1
20040093080 Helmus et al. May 2004 A1
20040097979 Svanidze et al. May 2004 A1
20040098098 McGuckin, Jr. et al. May 2004 A1
20040098112 DiMatteo et al. May 2004 A1
20040102839 Cohn et al. May 2004 A1
20040102840 Solem et al. May 2004 A1
20040102842 Jansen May 2004 A1
20040106976 Bailey et al. Jun 2004 A1
20040106990 Spence et al. Jun 2004 A1
20040106991 Hopkins et al. Jun 2004 A1
20040111096 Tu et al. Jun 2004 A1
20040117009 Cali et al. Jun 2004 A1
20040122448 Levine Jun 2004 A1
20040122512 Navia et al. Jun 2004 A1
20040122513 Navia et al. Jun 2004 A1
20040122514 Fogarty et al. Jun 2004 A1
20040122515 Chu Jun 2004 A1
20040122516 Fogarty et al. Jun 2004 A1
20040127979 Wilson et al. Jul 2004 A1
20040127980 Kowalsky et al. Jul 2004 A1
20040127981 Rahdert et al. Jul 2004 A1
20040127982 Machold et al. Jul 2004 A1
20040133220 Lashinski et al. Jul 2004 A1
20040133267 Lane Jul 2004 A1
20040133273 Cox Jul 2004 A1
20040138742 Myers et al. Jul 2004 A1
20040138743 Myers et al. Jul 2004 A1
20040138744 Lashinski et al. Jul 2004 A1
20040138745 Macoviak et al. Jul 2004 A1
20040148018 Carpentier et al. Jul 2004 A1
20040148019 Vidlund et al. Jul 2004 A1
20040148020 Vidlund et al. Jul 2004 A1
20040153052 Mathis Aug 2004 A1
20040153146 Lashinski et al. Aug 2004 A1
20040153147 Mathis Aug 2004 A1
20040158321 Reuter et al. Aug 2004 A1
20040162610 Liska et al. Aug 2004 A1
20040167539 Kuehn et al. Aug 2004 A1
20040167620 Ortiz et al. Aug 2004 A1
20040172046 Hlavka et al. Sep 2004 A1
20040176839 Huynh et al. Sep 2004 A1
20040176840 Langberg et al. Sep 2004 A1
20040181238 Zarbatany et al. Sep 2004 A1
20040186444 Daly et al. Sep 2004 A1
20040186558 Pavcnik et al. Sep 2004 A1
20040186561 McGuckin, Jr. et al. Sep 2004 A1
20040186563 Lobbi Sep 2004 A1
20040186565 Schreck Sep 2004 A1
20040186566 Hindrichs et al. Sep 2004 A1
20040193191 Starksen et al. Sep 2004 A1
20040193253 Thorpe et al. Sep 2004 A1
20040193260 Alferness et al. Sep 2004 A1
20040199155 Mollenauer Oct 2004 A1
20040199183 Oz et al. Oct 2004 A1
20040199191 Schwartz Oct 2004 A1
20040204758 Eberhardt et al. Oct 2004 A1
20040206363 McCarthy et al. Oct 2004 A1
20040210240 Saint Oct 2004 A1
20040210301 Obermiller Oct 2004 A1
20040210303 Sedransk Oct 2004 A1
20040210304 Seguin et al. Oct 2004 A1
20040210305 Shu et al. Oct 2004 A1
20040210306 Quijano et al. Oct 2004 A1
20040210307 Khairkhahan Oct 2004 A1
20040215333 Duran et al. Oct 2004 A1
20040215339 Drasler et al. Oct 2004 A1
20040220654 Mathis et al. Nov 2004 A1
20040220657 Nieminen et al. Nov 2004 A1
20040225322 Garrison et al. Nov 2004 A1
20040225344 Hoffa et al. Nov 2004 A1
20040225348 Case et al. Nov 2004 A1
20040225352 Osborne et al. Nov 2004 A1
20040225353 McGuckin, Jr. et al. Nov 2004 A1
20040225354 Allen et al. Nov 2004 A1
20040225355 Stevens Nov 2004 A1
20040225356 Frater Nov 2004 A1
20040230117 Tosaya et al. Nov 2004 A1
20040230297 Thornton Nov 2004 A1
20040236411 Sarac et al. Nov 2004 A1
20040236418 Stevens Nov 2004 A1
20040236419 Milo Nov 2004 A1
20040243153 Liddicoat et al. Dec 2004 A1
20040243219 Fischer et al. Dec 2004 A1
20040243227 Starksen et al. Dec 2004 A1
20040243228 Kowalsky et al. Dec 2004 A1
20040243230 Navia et al. Dec 2004 A1
20040254600 Zarbatany et al. Dec 2004 A1
20040254636 Flagle et al. Dec 2004 A1
20040260276 Rudko et al. Dec 2004 A1
20040260317 Bloom et al. Dec 2004 A1
20040260322 Rudko et al. Dec 2004 A1
20040260389 Case et al. Dec 2004 A1
20040260390 Sarac et al. Dec 2004 A1
20040260393 Rahdert et al. Dec 2004 A1
20040260394 Douk et al. Dec 2004 A1
20040267357 Allen et al. Dec 2004 A1
20050004583 Oz et al. Jan 2005 A1
20050004667 Swinford et al. Jan 2005 A1
20050010285 Lambrecht et al. Jan 2005 A1
20050010287 Macoviak et al. Jan 2005 A1
20050015112 Cohn et al. Jan 2005 A1
20050021056 St. Goar et al. Jan 2005 A1
20050021136 Xie et al. Jan 2005 A1
20050027261 Weaver et al. Feb 2005 A1
20050027348 Case et al. Feb 2005 A1
20050027351 Reuter et al. Feb 2005 A1
20050027353 Alferness et al. Feb 2005 A1
20050033398 Seguin Feb 2005 A1
20050033419 Alferness et al. Feb 2005 A1
20050033446 Deem et al. Feb 2005 A1
20050038506 Webler et al. Feb 2005 A1
20050038507 Alferness et al. Feb 2005 A1
20050043790 Seguin Feb 2005 A1
20050043792 Solem et al. Feb 2005 A1
20050049679 Taylor et al. Mar 2005 A1
20050049692 Numamoto et al. Mar 2005 A1
20050049696 Siess et al. Mar 2005 A1
20050049697 Sievers Mar 2005 A1
20050054977 Laird et al. Mar 2005 A1
20050055079 Duran Mar 2005 A1
20050055087 Starksen Mar 2005 A1
20050055088 Liddicoat et al. Mar 2005 A1
20050055089 Macoviak et al. Mar 2005 A1
20050060029 Le et al. Mar 2005 A1
20050060030 Lashinski et al. Mar 2005 A1
20050065460 Laird Mar 2005 A1
20050065550 Starksen et al. Mar 2005 A1
20050065594 DiMatteo et al. Mar 2005 A1
20050065597 Lansac Mar 2005 A1
20050070998 Rourke et al. Mar 2005 A1
20050075584 Cali Apr 2005 A1
20050075659 Realyvasquez et al. Apr 2005 A1
20050075662 Pedersen et al. Apr 2005 A1
20050075712 Biancucci et al. Apr 2005 A1
20050075713 Biancucci et al. Apr 2005 A1
20050075717 Nguyen et al. Apr 2005 A1
20050075718 Nguyen et al. Apr 2005 A1
20050075719 Bergheim Apr 2005 A1
20050075720 Nguyen et al. Apr 2005 A1
20050075723 Schroeder et al. Apr 2005 A1
20050075724 Svanidze et al. Apr 2005 A1
20050075725 Rowe Apr 2005 A1
20050075726 Svanidze et al. Apr 2005 A1
20050075729 Nguyen et al. Apr 2005 A1
20050075730 Myers et al. Apr 2005 A1
20050075731 Artof et al. Apr 2005 A1
20050080483 Solem et al. Apr 2005 A1
20050085900 Case et al. Apr 2005 A1
20050085903 Lau Apr 2005 A1
20050085904 Lemmon Apr 2005 A1
20050090846 Pedersen et al. Apr 2005 A1
20050096735 Hojeibane et al. May 2005 A1
20050096738 Cali et al. May 2005 A1
20050096739 Cao May 2005 A1
20050096740 Langberg et al. May 2005 A1
20050101975 Nguyen et al. May 2005 A1
20050102026 Turner et al. May 2005 A1
20050107810 Morales et al. May 2005 A1
20050107811 Starksen et al. May 2005 A1
20050107812 Starksen et al. May 2005 A1
20050107872 Mensah et al. May 2005 A1
20050113910 Paniagua et al. May 2005 A1
20050119673 Gordon et al. Jun 2005 A1
20050119734 Spence et al. Jun 2005 A1
20050119735 Spence et al. Jun 2005 A1
20050125011 Spence et al. Jun 2005 A1
20050131438 Cohn Jun 2005 A1
20050137449 Nieminen et al. Jun 2005 A1
20050137450 Aronson et al. Jun 2005 A1
20050137451 Gordon et al. Jun 2005 A1
20050137676 Richardson et al. Jun 2005 A1
20050137681 Shoemaker et al. Jun 2005 A1
20050137682 Justino Jun 2005 A1
20050137685 Nieminen et al. Jun 2005 A1
20050137686 Salahieh et al. Jun 2005 A1
20050137688 Salahieh et al. Jun 2005 A1
20050137689 Salahieh et al. Jun 2005 A1
20050137690 Salahieh et al. Jun 2005 A1
20050137691 Salahieh et al. Jun 2005 A1
20050137692 Haug et al. Jun 2005 A1
20050137693 Haug et al. Jun 2005 A1
20050137694 Haug et al. Jun 2005 A1
20050137696 Salahieh et al. Jun 2005 A1
20050137697 Salahieh et al. Jun 2005 A1
20050137698 Salahieh et al. Jun 2005 A1
20050137699 Salahieh et al. Jun 2005 A1
20050137700 Spence et al. Jun 2005 A1
20050137701 Salahieh et al. Jun 2005 A1
20050137702 Haug et al. Jun 2005 A1
20050143807 Pavcnik et al. Jun 2005 A1
20050143809 Salahieh et al. Jun 2005 A1
20050143810 Dauner et al. Jun 2005 A1
20050143811 Realyvasquez Jun 2005 A1
20050149014 Hauck et al. Jul 2005 A1
20050149179 Mathis et al. Jul 2005 A1
20050149180 Mathis et al. Jul 2005 A1
20050149181 Eberhardt Jul 2005 A1
20050159810 Filsoufi Jul 2005 A1
20050159811 Lane Jul 2005 A1
20050165477 Anduiza et al. Jul 2005 A1
20050165478 Song Jul 2005 A1
20050171472 Lutter Aug 2005 A1
20050171601 Cosgrove et al. Aug 2005 A1
20050177227 Heim et al. Aug 2005 A1
20050177228 Solem et al. Aug 2005 A1
20050182483 Osborne et al. Aug 2005 A1
20050184122 Hlavka et al. Aug 2005 A1
20050187614 Agnew Aug 2005 A1
20050187616 Realyvasquez Aug 2005 A1
20050187617 Navia Aug 2005 A1
20050192606 Paul et al. Sep 2005 A1
20050192665 Spenser et al. Sep 2005 A1
20050197692 Pai et al. Sep 2005 A1
20050197693 Pai et al. Sep 2005 A1
20050197694 Pai et al. Sep 2005 A1
20050203549 Realyvasquez Sep 2005 A1
20050203605 Dolan Sep 2005 A1
20050203614 Forster et al. Sep 2005 A1
20050203615 Forster et al. Sep 2005 A1
20050203616 Cribier Sep 2005 A1
20050203617 Forster et al. Sep 2005 A1
20050203618 Sharkawy et al. Sep 2005 A1
20050216039 Lederman Sep 2005 A1
20050216077 Mathis et al. Sep 2005 A1
20050216078 Starksen et al. Sep 2005 A1
20050222675 Sauter Oct 2005 A1
20050222678 Lashinski et al. Oct 2005 A1
20050228422 Machold et al. Oct 2005 A1
20050228479 Pavcnik et al. Oct 2005 A1
20050228486 Case et al. Oct 2005 A1
20050228494 Marquez Oct 2005 A1
20050228495 Macoviak Oct 2005 A1
20050228496 Mensah et al. Oct 2005 A1
20050234541 Hunt et al. Oct 2005 A1
20050234546 Nugent et al. Oct 2005 A1
20050240200 Bergheim Oct 2005 A1
20050240202 Shennib et al. Oct 2005 A1
20050240255 Schaeffer Oct 2005 A1
20050240259 Sisken et al. Oct 2005 A1
20050240262 White Oct 2005 A1
20050244460 Alferiev et al. Nov 2005 A1
20050246013 Gabbay Nov 2005 A1
20050251251 Cribier Nov 2005 A1
20050256566 Gabbay Nov 2005 A1
20050261704 Mathis Nov 2005 A1
20050261759 Lambrecht et al. Nov 2005 A1
20050267493 Schreck et al. Dec 2005 A1
20050267560 Bates Dec 2005 A1
20050267565 Dave et al. Dec 2005 A1
20050267571 Spence et al. Dec 2005 A1
20050267573 Macoviak et al. Dec 2005 A9
20050267574 Cohn et al. Dec 2005 A1
20050272969 Alferness et al. Dec 2005 A1
20050273160 Lashinski et al. Dec 2005 A1
20050278015 Dave et al. Dec 2005 A1
20050283178 Flagle et al. Dec 2005 A1
20050288779 Shaoulian et al. Dec 2005 A1
20060000715 Whitcher et al. Jan 2006 A1
20060004439 Spenser et al. Jan 2006 A1
20060004442 Spenser et al. Jan 2006 A1
20060009841 McGuckin et al. Jan 2006 A1
20060009842 Huynh et al. Jan 2006 A1
20060013805 Hebbel et al. Jan 2006 A1
20060013855 Carpenter et al. Jan 2006 A1
20060015136 Besselink Jan 2006 A1
20060015178 Moaddeb et al. Jan 2006 A1
20060015179 Bulman-Fleming et al. Jan 2006 A1
20060020275 Goldfarb et al. Jan 2006 A1
20060020327 Lashinski et al. Jan 2006 A1
20060020332 Lashinski et al. Jan 2006 A1
20060020334 Lashinski et al. Jan 2006 A1
20060020335 Kowalsky et al. Jan 2006 A1
20060020336 Liddicoat Jan 2006 A1
20060025750 Starksen et al. Feb 2006 A1
20060025784 Starksen et al. Feb 2006 A1
20060025787 Morales et al. Feb 2006 A1
20060025854 Lashinski et al. Feb 2006 A1
20060025855 Lashinski et al. Feb 2006 A1
20060025856 Ryan et al. Feb 2006 A1
20060025857 Bergheim et al. Feb 2006 A1
20060030747 Kantrowitz et al. Feb 2006 A1
20060030866 Schreck Feb 2006 A1
20060030882 Adams et al. Feb 2006 A1
20060030885 Hyde Feb 2006 A1
20060036317 Vidlund et al. Feb 2006 A1
20060041305 Lauterjung Feb 2006 A1
20060041306 Vidlund et al. Feb 2006 A1
20060047297 Case Mar 2006 A1
20060047338 Jenson et al. Mar 2006 A1
20060047343 Oviatt et al. Mar 2006 A1
20060052804 Mialhe Mar 2006 A1
20060052867 Revuelta et al. Mar 2006 A1
20060058817 Starksen et al. Mar 2006 A1
20060058865 Case et al. Mar 2006 A1
20060058871 Zakay et al. Mar 2006 A1
20060058889 Case et al. Mar 2006 A1
20060064115 Allen et al. Mar 2006 A1
20060064116 Allen et al. Mar 2006 A1
20060064118 Kimblad Mar 2006 A1
20060064174 Zadno Mar 2006 A1
20060069400 Burnett et al. Mar 2006 A1
20060069430 Rahdert et al. Mar 2006 A9
20060074483 Schrayer Apr 2006 A1
20060074484 Huber Apr 2006 A1
20060074485 Realyvasquez Apr 2006 A1
20060085060 Campbell Apr 2006 A1
20060089708 Osse et al. Apr 2006 A1
20060095115 Bladillah et al. May 2006 A1
20060095125 Chinn et al. May 2006 A1
20060099326 Keogh et al. May 2006 A1
20060100697 Casanova May 2006 A1
20060100699 Vidlund et al. May 2006 A1
20060106278 Machold et al. May 2006 A1
20060106279 Machold et al. May 2006 A1
20060106456 Machold et al. May 2006 A9
20060111660 Wolf et al. May 2006 A1
20060111773 Rittgers et al. May 2006 A1
20060111774 Samkov et al. May 2006 A1
20060116572 Case Jun 2006 A1
20060116756 Solem et al. Jun 2006 A1
20060122686 Gilad et al. Jun 2006 A1
20060122692 Gilad et al. Jun 2006 A1
20060122693 Biadillah et al. Jun 2006 A1
20060127443 Helmus Jun 2006 A1
20060129235 Seguin et al. Jun 2006 A1
20060129236 McCarthy Jun 2006 A1
20060135476 Kutryk et al. Jun 2006 A1
20060135964 Vesely Jun 2006 A1
20060135967 Realyvasquez Jun 2006 A1
20060136044 Osborne Jun 2006 A1
20060136045 Flagle et al. Jun 2006 A1
20060136052 Vesely Jun 2006 A1
20060136054 Berg et al. Jun 2006 A1
20060142846 Pavcnik et al. Jun 2006 A1
20060142847 Shaknovich Jun 2006 A1
20060142848 Gabbay Jun 2006 A1
20060142854 Alferness et al. Jun 2006 A1
20060149358 Zilla et al. Jul 2006 A1
20060149360 Schwammenthal et al. Jul 2006 A1
20060149367 Sieracki Jul 2006 A1
20060149368 Spence Jul 2006 A1
20060161133 Laird et al. Jul 2006 A1
20060161248 Case et al. Jul 2006 A1
20060161250 Shaw Jul 2006 A1
20060167468 Gabbay Jul 2006 A1
20060167541 Lattouf Jul 2006 A1
20060167542 Quintessenza Jul 2006 A1
20060167543 Bailey et al. Jul 2006 A1
Foreign Referenced Citations (166)
Number Date Country
0 380 666 Aug 1990 EP
0 466 518 Jan 1992 EP
2 728 457 Jun 1996 FR
WO 8800459 Jan 1988 WO
WO 9015582 Dec 1990 WO
WO 9501669 Jan 1995 WO
WO 9619159 Jun 1996 WO
WO 9803656 Jan 1998 WO
WO 9846115 Oct 1998 WO
WO 9904724 Feb 1999 WO
WO 0067679 Nov 2000 WO
WO 0115650 Mar 2001 WO
WO 0117462 Mar 2001 WO
WO 03047468 Jun 2003 WO
WO 03084443 Oct 2003 WO
WO 2004019825 Mar 2004 WO
WO 2004021893 Mar 2004 WO
WO 2004023980 Mar 2004 WO
WO 2004082523 Mar 2004 WO
WO 2004082527 Mar 2004 WO
WO 2004030568 Apr 2004 WO
WO 2004030570 Apr 2004 WO
WO 2004032724 Apr 2004 WO
WO 2004032796 Apr 2004 WO
WO 2004037128 May 2004 WO
WO 2004037317 May 2004 WO
WO 2004039432 May 2004 WO
WO 2004043265 May 2004 WO
WO 2004043273 May 2004 WO
WO 2004043293 May 2004 WO
WO 2004045370 Jun 2004 WO
WO 2004045378 Jun 2004 WO
WO 2004045463 Jun 2004 WO
WO 2004047677 Jun 2004 WO
WO 2004060217 Jul 2004 WO
WO 2004060470 Jul 2004 WO
WO 2004062725 Jul 2004 WO
WO 2004066803 Aug 2004 WO
WO 2004066826 Aug 2004 WO
WO 2004069287 Aug 2004 WO
WO 2004075789 Sep 2004 WO
WO 2004080352 Sep 2004 WO
WO 2004082528 Sep 2004 WO
WO 2004082536 Sep 2004 WO
WO 2004082537 Sep 2004 WO
WO 2004082538 Sep 2004 WO
WO 2004082757 Sep 2004 WO
WO 2004084746 Oct 2004 WO
WO 2004084770 Oct 2004 WO
WO 2004089246 Oct 2004 WO
WO 2004089250 Oct 2004 WO
WO 2004089253 Oct 2004 WO
WO 2004091449 Oct 2004 WO
WO 2004091454 Oct 2004 WO
WO 2004093638 Nov 2004 WO
WO 2004093726 Nov 2004 WO
WO 2004093728 Nov 2004 WO
WO 2004093730 Nov 2004 WO
WO 2004093745 Nov 2004 WO
WO 2004093935 Nov 2004 WO
WO 2004096100 Nov 2004 WO
WO 2004103222 Dec 2004 WO
WO 2004103223 Dec 2004 WO
WO 2004105584 Dec 2004 WO
WO 2004105651 Dec 2004 WO
WO 2004112582 Dec 2004 WO
WO 2004112585 Dec 2004 WO
WO 2004112643 Dec 2004 WO
WO 2004112652 Dec 2004 WO
WO 2004112657 Dec 2004 WO
WO 2004112658 Dec 2004 WO
WO 2005000152 Jan 2005 WO
WO 2005002424 Jan 2005 WO
WO 2005002466 Jan 2005 WO
WO 2005004753 Jan 2005 WO
WO 2005007017 Jan 2005 WO
WO 2005007018 Jan 2005 WO
WO 2005007036 Jan 2005 WO
WO 2005007037 Jan 2005 WO
WO 2005009285 Feb 2005 WO
WO 2005009286 Feb 2005 WO
WO 2005009505 Feb 2005 WO
WO 2005009506 Feb 2005 WO
WO 2005011473 Feb 2005 WO
WO 2005011534 Feb 2005 WO
WO 2005011535 Feb 2005 WO
WO 2005013860 Feb 2005 WO
WO 2005018507 Mar 2005 WO
WO 2005021063 Mar 2005 WO
WO 2005023155 Mar 2005 WO
WO 2005025644 Mar 2005 WO
WO 2005027790 Mar 2005 WO
WO 2005027797 Mar 2005 WO
WO 2004030569 Apr 2005 WO
WO 2005034812 Apr 2005 WO
WO 2005039428 May 2005 WO
WO 2005039452 May 2005 WO
WO 2005046488 May 2005 WO
WO 2005046528 May 2005 WO
WO 2005046529 May 2005 WO
WO 2005046530 May 2005 WO
WO 2005046531 May 2005 WO
WO 2005048883 Jun 2005 WO
WO 2005049103 Jun 2005 WO
WO 2005051226 Jun 2005 WO
WO 2005055811 Jun 2005 WO
WO 2005055883 Jun 2005 WO
WO 2005058206 Jun 2005 WO
WO 2005065585 Jul 2005 WO
WO 2005065593 Jul 2005 WO
WO 2005065594 Jul 2005 WO
WO 2005070342 Aug 2005 WO
WO 2005070343 Aug 2005 WO
WO 2005072654 Aug 2005 WO
WO 2005072655 Aug 2005 WO
WO 2005079706 Sep 2005 WO
WO 2005082288 Sep 2005 WO
WO 2005082289 Sep 2005 WO
WO 2005084595 Sep 2005 WO
WO 2005087139 Sep 2005 WO
WO 2005087140 Sep 2005 WO
WO 2006000763 Jan 2006 WO
WO 2006000776 Jan 2006 WO
WO 2006002492 Jan 2006 WO
WO 2006004679 Jan 2006 WO
WO 2006005015 Jan 2006 WO
WO 2006009690 Jan 2006 WO
WO 2006011127 Feb 2006 WO
WO 2006012011 Feb 2006 WO
WO 2006012013 Feb 2006 WO
WO 2006012038 Feb 2006 WO
WO 2006012068 Feb 2006 WO
WO 2006012322 Feb 2006 WO
WO 2006019498 Feb 2006 WO
WO 2006026371 Mar 2006 WO
WO 2006026377 Mar 2006 WO
WO 2006026912 Mar 2006 WO
WO 2006027499 Mar 2006 WO
WO 2006028821 Mar 2006 WO
WO 2006029062 Mar 2006 WO
WO 2006031436 Mar 2006 WO
WO 2006031469 Mar 2006 WO
WO 2006032051 Mar 2006 WO
WO 2006034245 Mar 2006 WO
WO 2006035415 Apr 2006 WO
WO 2006041505 Apr 2006 WO
WO 2006044679 Apr 2006 WO
WO 2006048664 May 2006 WO
WO 2006050459 May 2006 WO
WO 2006050460 May 2006 WO
WO 2006054107 May 2006 WO
WO 2006054930 May 2006 WO
WO 2006055982 May 2006 WO
WO 2006060546 Jun 2006 WO
WO 2006063108 Jun 2006 WO
WO 2006063181 Jun 2006 WO
WO 2006063199 Jun 2006 WO
WO 2006064490 Jun 2006 WO
WO 2006065212 Jun 2006 WO
WO 2006065930 Jun 2006 WO
WO 2006066148 Jun 2006 WO
WO 2006066150 Jun 2006 WO
WO 2006069094 Jun 2006 WO
WO 2006070372 Jul 2006 WO
WO 2006073628 Jul 2006 WO
WO 2006076890 Jul 2006 WO
Related Publications (1)
Number Date Country
20110071625 A1 Mar 2011 US
Continuations (1)
Number Date Country
Parent 11063681 Feb 2005 US
Child 12957039 US