Physiologically harmonized tricuspid annuloplasty ring

Abstract

A prosthetic tricuspid remodeling annuloplasty ring having two free ends that are upturned in the inflow direction to help avoid unnecessary leaflet abrasion. The free ends are desirably separated across a gap that is large enough to reduce the risk of passing sutures through the conductive system of the heart, yet not too large that support of the septal leaflet of the tricuspid annulus is degraded. The tricuspid ring may have four sequential segments looking from the inflow side and extending in a clockwise direction from a free end located adjacent the antero septal commissure after implant. The ring may define an inflow bulge in the first segment and / or an inflow bulge in the fourth segment that help the ring conform to the natural bulges created by the adjacent aorta, thereby reducing stress and the potential for ring dehiscence. Desirably, the ring has variable flexibility, either gradual and / or between or within different segments, so as to adapt or harmonize its 3-dimensional shape to each individual patient and, therefore, to significantly reduce the constraints on the annulus and adjacent structures, particularly the leaflets and the conduction tissue.

Description

FIELD OF THE INVENTION[0001]The present invention relates generally to medical devices and particularly to a tricuspid annuloplasty ring.BACKGROUND OF THE INVENTION[0002]In vertebrate animals, the heart is a hollow muscular organ having four pumping chambers: the left and right atria and the left and right ventricles, each provided with its own one-way valve. The natural heart valves are identified as the aortic, mitral (or bicuspid), tricuspid and pulmonary, and are each mounted in an annulus comprising dense fibrous rings attached either directly or indirectly to the atrial and ventricular muscle fibers. Each annulus defines a flow orifice.[0003]Heart valve disease is a widespread condition in which one or more of the valves of the heart fails to function properly. Diseased heart valves may be categorized as either stenotic, wherein the valve does not open sufficiently to allow adequate forward flow of blood through the valve, and / or incompetent, wherein the valve does not close c...

AI Technical Summary

Benefits of technology

[0023]In the ring having a gap of between 40%-50% of the long dimension, the ring body extends in a clockwise direction from the first free end, as seen looking at the inflow side thereof around a first segment, a second segment, a third segment, and a fourth segment that terminates in the second free end at a septal point. In one embodiment the ring body has an arcuate bulge out of the plane toward the inflow side at the first segment to accommodate an anatomical bulge of the aorta into the tricuspid annulus. In a further embodiment, the ring body has an arcuate bulge out of the plane toward the inflow side at the fourth segment. Still further, the ring body desirably has a varying flexibility and is stiffer adjacent the first free end than adjacent the second free end, or comprises at least one hinge point that is locally more flexible than adjacent segments.

[0024]In accordance with a still further aspect of the invention, a prosthetic tricuspid annuloplasty ring comprises an asymmetric generally ovoid ring body generally arranged in a plane and about an axis along an inflow-outflow direction with a first free end located adjacent an antero-septal commissure when implanted and a second free end located at a septal point. The ring body extends in a clockwise direction as seen looking at an inflow side from the first free end around a first segment, a second segment, a third segment, and a fourth segment that terminates in the second free end. The ring body has an arcuate bulge ou

Problems solved by technology

Diseased heart valves may be categorized as either stenotic, wherein the valve does not open sufficiently to allow adequate forward flow of blood through the valve, and / or incompetent, wherein the valve does not close completely, causing excessive backward flow of blood through the valve when the valve is closed.

Valve disease can be severely debilitating and even fatal if left untreated.

The descriptive terms used, however, are anatomically inaccurate.

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