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An assembly for holding a substantially flexible suture guide of predetermined length in a substantially taut position used to achieve a suture line having a dimension equal to the length of the suture guide, such as the circumference about a heart valve annulus. The assembly includes a rigid suture guide holder having a surface against which the length of suture guide is releasably positioned. The guide holder can have a shape or geometry, such as a circumference or circumferential segment, equivalent to the shape or geometry of the intended suture line. The shape of the guide holder can therefore be selected to hold the suture guide in the shape most advantageous to placing the desired suture line. The assembly further includes a mechanism for releasably binding the suture guide to the surface of the holder and a detachable handle extendibly attached to the holder by means of a lanyard so that the handle can be detached to afford an unobstructed view of the surgical site, but...

InventeursDelos M. Cosgrove, Than Nguyen
Cessionnaire d'origineEdwards Lifesciences Corporation
Classification américaine actuelle623/211; 623/904
Classification internationale: A61F 224

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Citations

Brevet cité Date de dépôt Date de délivrance Cessionnaire d'origine Titre
US337697315 juil. 19669 avr. 1968PACKAGE FOR SURGICAL SUTURES
US340901323 oct. 19655 nov. 1968INSTRUMENT FOR INSERTING ARTIFICIAL HEART VALVES
US357181519 sept. 196823 mars 1971SUTURE RING FOR HEART VALVE
US35871154 mai 19662 juin 1971IMPLANT TOOLS THEREFOR
US36561854 févr. 19701972CARDIAC VALVULAR SUPPORT PROSTHESIS
US38287878 sept. 19721 août 1974COLLET FOR HOLDING HEART VALVE
US404297912 juil. 197623 août 1977Valvuloplasty ring and prosthetic method
US40558619 avr. 19761 nov. 1977Rhone-Poulenc IndustriesSupport for a natural human heart valve
US410612926 août 197715 août 1978American Hospital Supply CorporationSupported bioprosthetic heart valve with compliant orifice ring
US416404616 mai 197714 août 1979Valve prosthesis
US418563629 déc. 197729 janv. 1980Albert Einstein College of Medicine of Yeshiva UniversitySuture organizer, prosthetic device holder, and related surgical procedures
US421766522 juin 197619 août 1980Societe d'Utilisation Scientifique et Industrielle du Froid - UsifroidProsthesis for use in valvuloplasty
US436412628 juil. 198121 déc. 1982Vascor, Inc.Heart valve with removable cusp protector band
US448944614 juil. 198225 déc. 1984Heart valve prosthesis
US44922293 sept. 19828 janv. 1985Suture guide holder
US450639413 janv. 198326 mars 1985Molrose Management, Ltd.Cardiac valve prosthesis holder
US45854637 janv. 198529 avr. 1986Nippon Furnace Kogyo Co., Ltd.Concentrator and feeder of sludge for system to recover resources from sludge
US460291125 janv. 198529 juil. 1986General Resorts S.A.Adjustable ringprosthesis
US465521810 oct. 19857 avr. 1987Blagoveschensky Gosudarstuvenny Meditsinsky InstitutProsthetic valve holder
US467955616 avr. 198614 juil. 1987Shiley Inc.Releasable holder and method of use
US468388330 avr. 19854 août 1987Hemex Scientific, Inc.Two-piece heart valve holder/rotator
US470225023 janv. 198627 oct. 1987Galil Advanced Technologies Ltd.Surgical implement particularly useful for suturing prosthetic valves
US47432534 mars 198610 mai 1988Suture rings for heart valves and method of securing same to heart valves
US475049227 févr. 198514 juin 1988Richards Medical CompanyAbsorbable suture apparatus, method and installer
US47597587 déc. 198426 juil. 1988Prosthetic heart valve
US486560025 août 198112 sept. 1989Baxter International Inc.Mitral valve holder
US491116426 avr. 198827 mars 1990Surgical tool and method of use
US501148117 juil. 198930 avr. 1991Medtronic, Inc.Holder for annuloplasty ring
US504113030 nov. 198920 août 1991Baxter International Inc.Flexible annuloplasty ring and holder
US529030013 janv. 19931 mars 1994Baxter International Inc.Flexible suture guide and holder
US535042025 mai 199327 sept. 1994Baxter International Inc.Flexible annuloplasty ring and holder
US54963362 févr. 19945 mars 1996Baxter International Inc.Flexible suture guide and holder
US56834027 juin 19954 nov. 1997Baxter International Inc.Flexible suture guide and holder

Revendications

1. A holder in combination with an annuloplasty ring, comprising:

an annuloplasty ring;
a rigid body defining at least a partial circumferential edge about which the annuloplasty ring may be fitted, the body having a visibility window defined within the circumferential edge;
a plurality of cutting guides formed in the body adjacent the circumferential edge; and
a plurality of sutures tautly attaching the annuloplasty ring about the circumferential edge, both ends of each suture being secured to the rigid body with a middle portion threaded through the annuloplasty ring.

2. The combination of claim 1, wherein the plurality of cutting guides are evenly spaced about the rigid body circumferential edge so that the annuloplasty ring is tautly attached about the circumferential edge in a uniform manner.

3. The combination of claim 1, wherein the rigid body is generally formed in a plane, and the cutting guides extend generally normal to the plane.

4. The combination of claim 3, wherein the cutting guides each comprises a raised platform having a first groove formed therein across which one of the sutures passes.

5. The combination of claim 4, wherein the cutting guides each further comprises a second groove extending generally perpendicular to the first groove.

6. The combination of claim 5, wherein the second groove of each cutting guide is deeper than the first groove.

7. The combination of claim 1, further including apertures formed in the circumferential edge and disposed so that the sutures extend generally from the rigid body through an inner circumference of the annuloplasty ring so that the outer circumference of the annuloplasty ring is unobstructed to aid in implantation.

8. The combination of claim 1, wherein the rigid body comprises a planar member extending generally in a plane within the circumferential edge, and wherein the visibility window comprises an opening formed in the planar member.

9. The combination of claim 8, wherein there are a plurality of visibility windows formed in the planar member by spokes extending from the circumferential edge to a central location.

10. The combination of claim 9, further including a hub joining the spokes at the central location, the hub being adapted to attach to a handle for manipulating the holder.

11. The combination of claim 10, further including a handle coupled to the hub and formed to be gripped during the placement of sutures through the annuloplasty ring.

12. The combination of claim 11, further including a tether extendibly tethering the handle to the body.

13. The combination of claim 12, wherein the tether comprises a spool of a length of filamentous material secured at one end to the body and at an opposite end to the handle.

14. The combination of claim 13, wherein the handle includes a spool housing having a cavity for housing the spool.

15. The combination of claim 1, wherein the circumferential edge is a groove.

16. The combination of claim 1, wherein the circumferential edge is a trough.

17. The combination of claim 1, wherein the circumferential edge is a depression.

18. The combination of claim 1, wherein the circumferential edge is a channel.

19. The combination of claim 1, wherein the circumferential edge is generally flat.

20. A substantially rigid holder in combination with an annuloplasty ring, comprising:

a flexible annuloplasty ring;
a body having an outer edge for holding the flexible annuloplasty ring in a plane around the outer edge;
at least one thread releasably retaining the annuloplasty ring around the outer edge in a taut fashion;
a thread guide on the body spaced from the plane of the annuloplasty ring and including a surface supporting the thread, the thread guide having a cutting guide groove opening at the surface for insertion of a cutting tool therein to cut the thread and thereby release the annuloplasty ring from the holder.

21. The holder of claim 20, wherein the thread guide includes a raised platform having the thread supporting surface and the cutting guide groove.

22. The holder of claim 20, wherein the thread guide includes a second groove receiving the thread, the second groove being defined by surfaces including the thread supporting surface.

23. The holder of claim 22, wherein the cutting guide groove is deeper than the second groove.

24. The holder of claim 22, wherein the cutting guide groove and second groove are substantially perpendicular to each other.

25. The holder of claim 20, wherein an end of the cutting guide groove is closed to stop movement of the tool in an insertion direction.

26. The holder of claim 20, further including:

a plurality of apertures formed in the outer edge;
a plurality of the thread guides formed in the body adjacent the outer edge; and
wherein there are a plurality of the threads passing through the apertures and releasably attaching the annuloplasty ring about the outer edge.

27. The holder of claim 26, wherein the apertures are disposed so that the sutures extend generally from the body through an inner circumference of the annuloplasty ring so that the outer circumference of the annuloplasty ring is unobstructed to aid in implantation.

28. The holder of claim 26, wherein both ends of each thread are secured to the rigid body with a middle portion threaded through the annuloplasty ring.

29. The holder of claim 20, further including a ring mounting surface, the annuloplasty ring being tautly positioned against the ring mounting surface by the thread.

30. The holder of claim 29, wherein the ring mounting surface comprises an outwardly facing channel into which the annuloplasty ring is at least partially fitted.

31. The holder of claim 30, wherein the outwardly facing channel comprises a groove against which the annuloplasty ring is releasably retained by the thread, and wherein the thread is affixed at both ends to the body with a first portion passing through the annuloplasty ring and a second portion passing across the thread guide, the thread being subdivided into two pieces when a cutting tool is inserted in the thread guide, each piece of the thread remaining affixed at one end to the body, with a free portion being pulled from within the annuloplasty ring by displacing the holder away from the annuloplasty ring, thereby releasing the ring from the groove.

32. The holder of claim 20, further including a handle coupled to the body and formed to be gripped during the placement of sutures through the annuloplasty ring.

33. The holder of claim 32, wherein a second thread releasably couples the body to the handle.

34. The holder of claim 33, including a member positioned between the handle and the body and having a handle release groove accessible by a cutting tool to enable the tool to cut the second thread and un-couple the handle from the body.

35. The holder of claim 34, wherein the member includes a raised platform on the body, the platform including the handle release groove.

36. The holder of claim 32, further including a tether extendibly tethering the handle to the body.

37. The holder of claim 36, wherein the tether comprises a spool of a length of filamentous material secured at one end to the body and at an opposite end to the handle.

38. The holder of claim 37, wherein the handle includes a spool housing having a cavity for housing the spool.

39. The holder of claim 38, wherein the spool housing includes first and second opposed slots for receiving dog ears provided on the spool.

40. The combination of claim 20, wherein the outer edge is a groove.

41. The combination of claim 20, wherein the outer edge is a trough.

42. The combination of claim 20, wherein the outer edge is a depression.

43. The combination of claim 20, wherein the outer edge is a channel.

44. The combination of claim 20, wherein the outer edge is generally flat.

45. A holder in combination with an annuloplasty ring, comprising:

an annuloplasty ring;
a body having an outer circumferential edge shaped to match the shape of a healthy anatomical heart valve annulus;
a plurality of apertures in the body spaced around the circumferential edge;
a plurality of cutting guides spaced around the circumferential edge; and
a plurality of sutures securing the annuloplasty ring to the circumferential edge of the body, each suture being secured at both ends to the body and being threaded therebetween through a first aperture, through the annuloplasty ring, through a second aperture, across one of the cutting guides, through a third aperture, again through the annuloplasty ring, and through a fourth aperture.

46. The holder of claim 45, wherein the plurality of cutting guides are evenly spaced about the rigid body circumferential edge so that the annuloplasty ring is tautly attached about the circumferential edge in a uniform manner.

47. The holder of claim 45, further including a handle coupled to the body and formed to be gripped during the placement of sutures through the annuloplasty ring.

48. The holder of claim 47, further including a tether extendibly tethering the handle to the body.

49. The holder of claim 48, wherein the tether comprises a spool of a length of filamentous material secured at one end to the body and at an opposite end to the handle.

50. The holder of claim 49, wherein the handle includes a spool housing having a cavity for housing the spool.

51. The combination of claim 45, wherein the circumferential edge is a groove.

52. The combination of claim 45, wherein the circumferential edge is a trough.

53. The combination of claim 45, wherein the circumferential edge is a depression.

54. The combination of claim 45, wherein the circumferential edge is a channel.

55. The combination of claim 45, wherein the circumferential edge is generally flat.