Medical apparatus for the therapeutic treatment of an insufficient cardiac valve

Abstract

The present invention relates to a medical apparatus for the therapeutic treatment of an insufficient cardiac valve ( 3 a , 3 b ). The aim of the present invention is to specify a medical apparatus which enables the therapeutic treatment of an insufficient cardiac valve, such as, for example, the mitral valve ( 3 a ) or the tricuspid valve ( 3 b ), which is arranged between a ventricle ( 1 a, 1 b ) and an atrium ( 2 a , 2 b ) of the heart, in a manner as simple as possible and as gentle as possible for the patient in a minimally invasive intervention. For this purpose, the medical apparatus according to the present invention comprises at least one valve means ( 10 ) which is designed to prevent in the implanted condition of the medical apparatus a systolic venous reflex return of blood from the atrium ( 2 a, 2 b ) of the heart into at least one vein ( 4 a, 4 a′, 4 b, 4 b′, 4 c, 4 c ′) which belongs to a venous system ( 4 ) which leads into the atrium ( 2 a, 2 b ) of the heart.

1 - 45 . (canceled) 
     
     
         46 . An apparatus comprising:
 a first stent including a first valve coupled to a proximal end of the first stent, the proximal end of the first stent having a smaller diameter than a distal end of the first stent, wherein the first stent is configured for implantation in a first vein leading to an atrium of a heart such that, when implanted, the proximal end of the first stent extends into a portion of the atrium, and the distal end of the first stent extends into a portion of the first vein; and   a second stent directionally opposed to the first stent, the second stent including a second valve coupled to a proximal end of the second stent, the proximal end of the second stent having a smaller diameter than a distal end of the second stent, wherein the second stent is configured for implantation in a second vein leading to the atrium such that, when implanted, the proximal end of the second stent extends into a portion of the atrium, and the distal end of the second stent extends into a portion of the second vein.   
     
     
         47 . The apparatus of  claim 46 , wherein:
 the first valve, when implanted, permits blood flow towards the atrium from the first vein, and prevents blood flow from the atrium to the first vein; and   the second valve, when implanted, permits blood flow towards the atrium from the second vein, and prevents blood flow from the atrium to the second vein.   
     
     
         48 . The apparatus of  claim 46 , wherein each of the first stent and the second stent is expandable from a collapsed configuration to an expanded configuration, such that, a fully-expanded diameter of the proximal end of the first stent is smaller than a fully-expanded diameter of the distal end of the first stent, and a fully-expanded diameter of the proximal end of the second stent is smaller than a fully-expanded diameter of the distal end of the second stent. 
     
     
         49 . The apparatus of  claim 48 , wherein at least one of the first stent and the second stent includes a self-expandable material. 
     
     
         50 . The apparatus of  claim 48 , wherein at least one of the first stent and the second stent is balloon expandable. 
     
     
         51 . The apparatus of  claim 46 , further comprising a bracing element connecting the first stent to the second stent, the bracing element extending across the atrium. 
     
     
         52 . The apparatus of  claim 46 , further including a plurality of bracing elements connecting the proximal end of the first stent to the proximal end of the second stent, wherein each bracing element extends across the atrium. 
     
     
         53 . The apparatus of  claim 46 , wherein the first stent is structurally unconnected from the second stent. 
     
     
         54 . The apparatus of  claim 46 , wherein each of the first valve and the second valve includes a biological material or a synthetic material. 
     
     
         55 . The apparatus of  claim 54 , wherein at least one of the first valve and the second valve includes animal tissue. 
     
     
         56 . The apparatus of  claim 46 , wherein the distal end of the first stent extends into a portion of a third vein when implanted, and wherein the distal end of the second stent extends into a portion of a fourth vein when implanted. 
     
     
         57 . The apparatus of  claim 56 , wherein
 the first valve, when implanted, permits blood flow towards the atrium from the first vein and the third vein, and prevents blood flow from the atrium to the first vein and the third vein; and   the second valve, when implanted, permits blood flow towards the atrium from the second vein and the fourth vein, and prevents blood flow from the atrium to the second vein and the fourth vein.   
     
     
         58 . The apparatus of  claim 46 , wherein the first stent is configured to provide a larger radial force at the distal end of the first stent than at the proximal end of the first stent when expanded, and wherein the second stent is configured to provide a larger radial force at the distal end of the second stent than at the proximal end of the second stent when expanded. 
     
     
         59 . The apparatus of  claim 46 , further including:
 a third stent having a third valve coupled thereto, the third stent configured for implantation in a third vein leading to the atrium such that, when implanted, a proximal end of the third stent extends into a portion of the atrium, and a distal end of the third stent extends into a portion of the third vein; and   a fourth stent, having a fourth valve coupled thereto, the fourth stent configured for implantation in a fourth vein leading to the atrium such that, when implanted, a proximal end of the fourth stent extends into a portion of the atrium and a distal end of the fourth stent extends into a portion of the fourth vein.   
     
     
         60 . The apparatus of  claim 59 , wherein:
 the first, second, third, and fourth valves permit blood flow toward the atrium from a respective one of the first, second, third, and fourth veins; and   the first, second, third, and fourth valves prevent blood flow from the atrium to a respective one of the first, second, third, and fourth veins.   
     
     
         61 . The apparatus of  claim 60 , wherein the distal end of the first stent extends into a portion of a third vein when implanted, and wherein the distal end of the second stent extends into a portion of a fourth vein when implanted. 
     
     
         62 . The apparatus of  claim 59 , further including:
 a first bracing element coupled to the first and second stents;   a second bracing element coupled to the third and fourth stents;   a third bracing element coupled to the first and third stents; and   a fourth bracing element coupled to the second and fourth stents.   
     
     
         63 . An apparatus comprising:
 a first stent configured for implantation relative to a first pulmonary vein and a third pulmonary vein, each of the first and third pulmonary veins leading into the atrium, the first stent including a first valve; and   a second stent configured for implantation relative to a second pulmonary vein and a fourth pulmonary vein, each of the second and fourth pulmonary veins leading into the atrium, the second stent including a second valve;   wherein the first valve, when implanted, permits blood flow towards the atrium from each of the first and third pulmonary veins, and prevents blood flow from the atrium to each of the first and third pulmonary veins; and   wherein the second valve, when implanted, permits blood flow towards the atrium from each of the second and fourth pulmonary veins, and prevents blood flow from the atrium to each of the second and fourth pulmonary veins.   
     
     
         64 . An apparatus comprising:
 an expandable first stent including a first valve, the first stent configured for implantation in a first vein leading to an atrium of a heart such that, when implanted, a proximal end of the first stent protrudes into a portion of the atrium, and a distal end of the first stent extends into a portion of the first vein, wherein a fully-expanded diameter of the proximal end of the first stent is smaller than a fully-expanded diameter of the distal end of the first stent; and   an expandable second stent directionally opposed to the first stent, the second stent including a second valve and being configured for implantation in a second vein leading to the atrium such that, when implanted, a proximal end of the second stent protrudes into a portion of the atrium, and a distal end of the second stent extends into a portion of the second vein, wherein a fully-expanded diameter of the proximal end of the second stent is smaller than a fully-expanded diameter of the distal end of the second stent.   
     
     
         65 . The apparatus of  claim 64 , wherein the first valve is attached to the proximal end of the first stent such that, when implanted, at least a portion of the first valve extends into the atrium, and wherein the second valve is attached to the proximal end of the second stent such that, when implanted, at least a portion of the second valve extends into the atrium.