Medical instrument, ring prosthesis, stent and stented valve

Abstract

A prosthesis includes a tube with a proximal and distal flange around the tube. The distal and proximal flanges have a radial position, projecting radially outward to clamp tissue between the flanges. The flanges include distal flange feet and proximal flange feet. The distal and proximal flange feet bend from the radial position, against a pre-tension of the memory material, to an extended position, in which the distal and proximal flange feet extend in the longitudinal direction of the tube and are fixable there, returning when released to the radial position urged by the pre-tension. The flange feet have on inner sides a filling to increase the clamping force. The flange feet have a concave-curved part extending from the fixed ends of the flange feet. The hollow side of the concave faces the proximal and/or distal flange and the filling is provided in the hollow side of the concave.

1 . An atrioventricular valve prosthesis for attachment in a valve passage surrounded by tissue, the atrioventricular valve prosthesis comprising:
 a tubular valve support frame with an open grid structure, said support frame having a proximal end facing in a proximal direction, a distal end facing in a distal direction, an axial center line extending in an axial direction of the support frame, and an outside surface, the proximal end and distal end being spaced apart from one another along the axial direction, and the outside surface being defined as a surface of the support frame facing away from the axial center line;   a heart valve provided inside said support frame;   an annular series of proximal anchors surrounding said support frame, each of said proximal anchors having one secured outer end secured to said support frame and one free outer end; and   an annular series of distal anchors surrounding said support frame, each of said distal anchors having one secured outer end secured to said support frame and one free outer end;   wherein said support frame is expansible from a compressed configuration to an expanded configuration;   wherein in said expanded configuration said support frame has an enlarged extent relative to said compressed configuration in a radial direction that is perpendicular to said axial direction;   wherein said proximal anchors and said distal anchors are configured to move from a first condition associated to said compressed configuration of said support frame to a second condition associated to said expanded configuration of said support frame, such that said proximal anchors and said distal anchors extend radially outwardly of said support frame in said second condition to a greater extent than in said first condition, said proximal anchors and said distal anchors being in the first condition when navigating the prosthesis to an intended location in a body of a patient;   wherein said secured outer ends of said annular series of proximal anchors and said secured outer ends of said annular series of distal anchors are, viewed along said axial direction, provided at positions intermediate said proximal end and said distal end of said support frame, such that said secured outer ends of the proximal anchors and of the distal anchors are arranged spaced apart from the proximal end of said support frame as well as from the distal end of said support frame; and   wherein said proximal anchors and said distal anchors lie, when said proximal anchors and said distal anchors are in said first condition, in the axial direction along the outside surface of said support frame with the free outer ends of the proximal anchors pointing in the proximal direction and with the free outer ends of the distal anchors pointing in the distal direction such that, when the proximal anchors and distal anchors move from the first condition to the second condition, the proximal and distal anchors move towards each other to clamp surrounding tissue located between the proximal and distal anchors.   
     
     
         2 . An atrioventricular valve prosthesis, comprising:
 a tubular valve support frame with an open grid structure, said support frame having a proximal end facing in a proximal direction, a distal end facing in a distal direction, an axial center line extending in an axial direction of the support frame, and an outside surface, the proximal end and distal end being spaced apart from one another along the axial direction, and the outside surface being defined as a surface of the support frame facing away from the axial center line;   a heart valve provided inside said support frame;   a proximal anchor annularly surrounding said support frame, said proximal anchor having one secured outer end secured to said support frame and one free outer end; and   a distal anchor annularly surrounding said support frame, said distal anchor having one secured outer end secured to said support frame and one free outer end;   wherein said support frame is expansible from a compressed configuration to an expanded configuration, wherein in said expanded configuration said support frame has an enlarged extent relative to said compressed configuration in a radial direction that is perpendicular to said axial direction;   wherein said proximal anchor and said distal anchor are configured to move from a first condition associated to said compressed configuration to a second condition associated to said expanded configuration, such that said proximal anchor and said distal anchor extend radially outwardly of said support frame in said second condition to a greater extent than in said first condition, said proximal anchor and said distal anchor being in the first condition when navigating the prosthesis to an intended location in a body of a patient;   wherein said secured outer end of said annular proximal anchor and said secured outer end of said annular distal anchor are, viewed along said axial direction, provided at positions intermediate said proximal end and said distal end of said support frame, such that said secured outer end of the proximal anchor and of the distal anchor are arranged spaced apart from the proximal end of said support frame as well as from the distal end of said support frame; and   wherein said proximal anchor and said distal anchor lie, when said proximal anchor and said distal anchor are in said first condition, in the axial direction along the outside surface of said support frame with the free outer end of the proximal anchor pointing in the proximal direction and with the free outer end of the distal anchor pointing in the distal direction such that, when the proximal anchor and distal anchor move from the first condition to the second condition, the proximal and distal anchors move towards each other to clamp surrounding tissue between the proximal and distal anchors.   
     
     
         3 . A method of implanting an atrioventricular valve prosthesis in a passage between an atrium and a ventricle, the method comprising steps of:
 navigating the prosthesis of  claim 1 , having said support frame in said compressed configuration and said proximal anchors and said distal anchors in said first condition, to the passage;   inserting said prosthesis into the passage;   expanding said support frame to said expanded configuration; and   attaching said prosthesis to tissue surrounding the passage by bending said proximal anchors and said distal anchors towards each other from said first condition to said second condition and clamping the tissue surrounding the passage between said proximal anchors and said distal anchors.   
     
     
         4 . An assembly comprising a prosthesis according to  claim 2  and a mechanical obstacle holding the proximal and distal anchors in the first condition,
 wherein the mechanical obstacle is movable with respect to the support frame to release the proximal and distal anchors for moving the proximal and distal anchors from the first condition to the second condition.