AORTIC ANNULOPLASTY RING

摘要

An annuloplasty ring to resize a dilated aortic root during valve sparing surgery includes a scalloped space frame having three trough sections connected to define three crest sections. The annuloplasty ring is mounted outside the aortic root, and extends in height between a base plane and a spaced apart commissure plane of the aortic root. At least two adjacent trough sections are coupled by an annulus-restraining member or tether that limits the maximum deflection of the base of the annuloplasty ring. In use, the tether is preferably located in proximity to the base plane of the aortic root. The annuloplasty ring is movable between a first, substantially conical configuration occurring during a diastolic phase of the cardiac cycle, and a second, substantially cylindrical configuration occurring during a systolic phase of the cardiac cycle.

主权项

1. A device for the surgical repair of an aortic valve of a patient, the aortic valve defining a valve axis and contained within a generally tubular aortic root, the aortic valve including a plurality of valve leaflets connected to the aortic root, the leaflets each having a free margin portion movable as a function of the different phases of the cardiac cycle between a first leaflet position in which the aortic valve is exposed to a diastolic phase of the cardiac cycle and in which the leaflet free margins are in an approximated spatial relationship to restrict blood flow through the aortic valve and a second leaflet position in which the aortic valve is exposed to a systolic phase of the cardiac cycle and in which the leaflet free margins are in a spaced apart relationship to allow blood flow through the aortic valve, said device comprising:
an annular ring, said annular ring having a scalloped profile and being configured and sized for placement externally around said aortic root, said annular ring including three generally U-shaped members connected to each other at three crest fittings and arranged around a ring axis to form a closed-ring configuration, said U-shaped members each having a base portion and an upper portion adjacent said three crest fittings, said annular ring defining a first diameter proximate said base portion and constructed to allow circumferential movement of said base portions closer to one another such that said annular ring defines a second diameter proximate said base portion being smaller than said first diameter, one of said crest fittings being configured as a demountable crest fitting including two mating fitting members, said closed-ring configuration transformable into an open-ring configuration when said two mating fitting members are disassembled; and an annulus-restraining member, said annulus-restraining member including three brace members, in said closed-ring configuration each of said brace members extending between and coupling one pair of two adjacent U-shaped members at a location proximate said base portions of said two adjacent U-shaped members, one of said brace members being configured as a demountable brace member able to be decoupled from one of said U-shaped members of said two adjacent U-shaped members in said open-ring configuration, said demountable brace member extending between the pair of two adjacent U-shaped members joined at said upper portions by said demountable crest fitting; whereby, in use, when said annular ring is in said closed-ring configuration, under influence of the different phases of the cardiac cycle, said annulus-restraining member is constructed to; 1) allow inward displacement of said U-shaped members toward said ring axis, the inward displacement occurring substantially without restraint from said annulus-restraining member and resulting in circumferential movement of said base portions of said U-shaped members closer to one another, and 2) limits maximum displacement of said base portions of said U-shaped members away from said ring axis in order to constrain the maximum size of the aortic root so as to promote coaptation of the leaflet free margins during the diastolic phase of the cardiac cycle.