JPH10174714A - Heart assisting device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a heart assisting device which allows the immediate ceasing thoracotomy right after mounting to a patient and does not require the rethoracotomy at the time of removal. SOLUTION: This heart assisting device 1 has a balloon 10 which is dilated and contracted by the gas fed and discharged via a first tube 12 and a holder 14 which is dilated and contracted by the water fed and discharged via a second tube 16. The pulsation of the heart may be assisted by compressing the ventricle from the outer side by the balloon 10. At the time of removing the device from the patient, the balloon 10 is first put into the shrunk state and the first tube 12 is pulled. The balloon 10 is then separated from the holder 14 and is removed outside the body. In succession, the holder 14 is removed outside the body when the second tube 16 is pulled in the state of shrinking the holder 14.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a heart assisting device for assisting the pulsation of a heart by compressing the heart from outside.

[0002]

2. Description of the Related Art Conventionally, assisting the heart function has been performed by compressing the heart from the outside, and several heart assisting devices used for this purpose have already been proposed in academic societies and the like. . This type of heart assist device
For example, it comprises a balloon that expands when a fluid is supplied to the inside and contracts when the fluid is discharged, and a tube that forms a supply and discharge path for the fluid supplied to the balloon. By expanding the balloon, pressure was applied from the outside of the ventricle, and the load on the heart when the ventricle was contracted could be reduced.

[0003] Some of these types of cardiac assist devices include a cup-shaped holder capable of accommodating a ventricle part inside the heart assist device. Is held on the outer periphery of the heart and the balloon is expanded in the gap between the heart and the holder, so that the heart can be sufficiently compressed even with a relatively small balloon.

[0004]

However, in the above-mentioned conventional heart assist device, the chest cannot be closed until the device is removed after the heart assist device is opened and the device is removed from the heart.
Alternatively, if the chest is closed, it is necessary to perform a thoracotomy again to remove the device, and in any case, the burden on the patient becomes extremely large, which is a serious problem in practical use.

SUMMARY OF THE INVENTION The present invention has been made to solve the above-mentioned problem, and an object of the present invention is to provide a heart assisting device which can close a chest immediately after being attached to a patient, and does not need to restart the chest upon removal. It is in.

[0006]

Means for Solving the Problems and Effects of the Invention In order to achieve the above object, the invention according to claim 1 expands when a fluid is supplied to the inside, while the fluid inside is discharged. A balloon that contracts and a lumen communicating with the interior of the balloon, the lumen serving as a supply / drainage path for the fluid, and a balloon that compresses the heart from the outside when the balloon is expanded. A heart assisting device comprising a holder capable of holding the balloon at a possible position, wherein the balloon is configured to be separated from the holder when an external force is applied.

According to such a heart assist device, when an external force is applied while the balloon is deflated,
The balloon separates from the holder. Here, as a portion to which an external force is applied, for example, it may be applied directly to the balloon, for example, the tube may be directly pulled, or a string or a wire may be connected to the balloon separately from the tube. Alternatively, the string, wire, or the like may be pulled. In this case, it is preferable that the balloon and the holder are bonded to each other with such a strength that the balloon, the string, the wire, and the like are separated only by pulling. In addition, an external force may be applied to a bonding portion between the balloon and the holder. Specifically, for example, a string or a wire is tied to the bonding portion between the balloon and the holder, and the string or the wire is pulled. Then, the bonded portion may be broken.

[0008] When the balloon is separated from the holder by applying an external force in this manner, the balloon and the balloon are pulled out of the patient's body, and the balloon and the balloon are removed from the gap left for introducing the tube into the body. The tube can be withdrawn. Therefore, with the heart assist device configured as described above, the chest can be closed immediately after performing the thoracotomy and attaching to the patient, and further, it is not necessary to perform the thoracotomy again upon removal. Therefore, the burden on the patient is greatly reduced.

Incidentally, in the conventionally proposed cardiac assist device, a cup-shaped holder made of hard plastic is used as a holder, but when the same holder is employed in the above-mentioned cardiac assist device, the chest is not opened. Since the holder cannot be removed, the holder is left inside the patient. However, the holding position of the holder is outside the heart, and does not particularly adversely affect the patient.

On the other hand, if it is desired to remove the holder without performing a thoracotomy, the following configuration can be adopted. That is, the heart assist device according to claim 2 has a balloon that expands when a fluid is supplied to the inside, and contracts when the fluid inside is discharged, and a lumen communicating with the inside of the balloon, A heart assisting device including a tube having a lumen serving as a supply / discharge path of the fluid, and a holder capable of holding the balloon at a position where the balloon can compress the heart from the outside when the balloon is expanded; Wherein the holder has a contractible structure.

Here, the contractible structure means a structure in which the outer dimensions can be reduced by crushing, folding, or winding the holder by forming the holder from a film or a net. I just need. However,
If the balloon expands as the balloon expands, such as a rubber membrane, the effect of compressing the heart is impaired by the balloon, so if the holder is expanded to the desired shape, the holder will not expand further. It is better to be.

According to such a heart assisting device, when the holder is pulled out of the patient through, for example, a cord or a wire, when the tube is drawn into the gap left for introducing the tube into the body, The holder is retracted into the gap while contracting, and the holder can be pulled out of the body as it is.

In the heart assisting apparatus according to the second aspect, if the balloon is deflated together with the holder, the balloon can be removed integrally with the holder, so that the balloon and the holder are inseparable. No problem. However, a structure in which the balloon is separated from the holder when an external force is applied may be adopted as in the device according to claim 1, in which case, only the balloon is removed as described above, and then the balloon is removed. Since it is only necessary to remove the holder, it is necessary to remove the balloon twice, compared to the method of removing the balloon integrally with the holder.However, since the structure to be extracted at a time is smaller, a smaller gap is required. There is an advantage that it can be removed just by leaving it.

In the case of the heart assisting device according to the second aspect, if the holder has a contractible structure,
Although a specific structure is not particularly limited, for example, as described in claim 3, the holder expands when a filler is introduced into the inside to have a shape at the time of use, and when the filler is led out from the inside. As long as it can be contracted, the holder can be hardened to the extent that it can maintain its shape at the time of use simply by introducing the filler inside the holder. On the other hand, since the holder can be softened to the extent that it can be shrunk just by drawing out the filler from the inside of the holder,
Withdrawal from the human body is possible even from a small gap.

In addition, as a structure which expands when a filler is introduced into the inside and becomes a shape in use, for example, a cup-shaped holder is formed by a double resin film, and when a fluid is introduced into a gap between the films, the cup-shaped holder is formed. A flexible tube is fixed in a spiral shape to the outer surface or inner surface of a cup-shaped holder formed by a resin film, or a fluid is introduced into the tube, or into the tube. By inserting a wire or the like, it is possible to consider a case where the tube expands spirally and the entire holder is deployed in a cup shape.

Further, as for the holder having a simply shrinkable structure, a holder in which a resin film is formed into a cup shape may be considered in addition to the holder according to the third aspect. And can be used to construct a heart assist device according to claim 2.

[0017]

Next, an embodiment of the present invention will be described with reference to an example. As shown in FIG. 1, the heart assisting device 1 expands when helium gas is supplied to the inside 10a, and contracts when helium gas is discharged from the inside 10a.
Has a lumen 12a communicating with the interior 10a of the
2a includes a first tube 12 made of polyurethane serving as a helium gas supply / discharge path, and the balloon 10 is disposed inside a cup-shaped holder 14 capable of accommodating a ventricle portion. The holder 14 is made of polyurethane and has an inner portion 14a.
Is expanded when water is supplied thereto, and contracts when water in the interior 14a is discharged. The holder 14 has a lumen 16a communicating with the interior 14a of the holder 14, and the lumen 16a Is connected to a second tube 16 made of polyurethane, which serves as a water supply / discharge path.

Of these, the balloon 10 has a shape in which the central portion is narrowed so that the positions 10b and 10c corresponding to the right and left ventricles are most easily expanded and the position 10d corresponding to the coronary artery is not expanded. And the holder 14, when the first tube 12 is strongly pulled,
4 is adhered with such a strength as to be separated therefrom.

The holder 14 can be expanded into a shape for use as shown by introducing water into the interior 14a. When the water is drawn out from the interior, the holder 14 is contracted so as to be folded. You will be in a state to gain. The heart assisting device 1 configured as described above is usually mounted on a patient's heart by performing a thoracotomy. When installing, the second
Water (physiological saline) is injected into the inside 14a of the holder 14 via the tube 16, and the holder 14 is developed into a desired shape. Further, a driving device capable of supplying and discharging helium gas is connected to the first tube 12, and the inside 10 a of the balloon 10 is depressurized through the first tube 12 to reduce the pressure of the balloon 1.
0 is contracted. Then, the ventricle part is balloon 10
The mounting position of the heart assisting device 1 is adjusted so that compression can be performed.

After the mounting is completed, the driving device is operated to supply and discharge helium gas, so that the balloon 10 is driven in accordance with the heartbeat. Note that the driving device for driving the balloon 10 in this way is exactly the same as the driving device used in IABP and the like, and a description thereof will be omitted.

When the driving of the balloon 10 is started, the balloon 10 is deflated during the diastole of the heart, and FIG.
As shown in (1), a lot of blood is inhaled into the right ventricle RV and the left ventricle LV which are not compressed by the balloon 10. On the other hand, during the systole of the heart, the balloon 10 is inflated, and compresses the right ventricle RV and the left ventricle LV from outside, as shown in FIG. Thereby, the right ventricle RV
And the blood inside the left ventricle LV is delivered, and the work of the right ventricle RV and the left ventricle LV at this time is reduced as compared with the case where no assistance is performed.

After confirming the start of the assisted circulation, the chest of the patient is closed to complete the thoracotomy, and the heart assist device 1 is left in the patient. After that, when the patient's condition recovers, the heart assisting device 1 is removed. At this time, first, as shown in FIG.
Is contracted and the holder 14 is left in the patient's body,
The balloon 10 and the first tube 12 are withdrawn from the patient. When the first tube 12 is pulled from outside the body, the adhesive strength between the holder 14 and the balloon 10
The balloon 10 has a strength enough to come off from 4,
The balloon 10 can be separated from the holder 14 by pulling the first tube 12 as indicated by the arrow in the figure. Since the balloon 10 is folded small when passing through the gap in which the first tube 12 is inserted, the balloon 10 can be easily pulled out of the body.

Subsequently, as shown in FIG. 4, the water in the holder 14 is discharged through the second tube 16, whereby the holder 14 is contracted, and the holder 14 is pulled out from the patient's body. Since the holder 14 is folded small when passing through the gap in which the second tube 16 is inserted, the holder 14 can be easily pulled out of the body.

As described above, according to the above-mentioned heart assisting apparatus 1, it is possible to immediately close the chest after performing the thoracotomy and attaching it to a patient, and to perform the thoracotomy again upon removing the chest. Since it disappears, the burden on the patient is greatly reduced. As described above, the embodiments of the present invention have been described. However, the embodiments of the present invention can be variously considered in addition to the above-described example. Hereinafter, useful modifications will be described.

For example, the holder 14 develops into a cup shape when water is introduced between the outer membrane and the inner membrane, but as shown in FIG. Alternatively, if a flexible tube 22 is bonded to the outside in a spiral shape to form a holder, the tube 22
By introducing water into the tube, the tube 22 can be expanded by water pressure and the cup 20 can be expanded, so that the balloon 10 as described above may be arranged inside the tube 22 to constitute a heart assist device. In addition, such a spiral tube 22
If so, it becomes possible to insert a flexible wire in addition to water, so that the cup 20 can be developed using the wire.

It should be noted that a holder having such a deployment mechanism can be easily mounted on the heart, but can be mounted on the heart without the deployment mechanism. For example, the cup shown in FIG. Since the holder 20 can be used as a holder without providing the tube 22, the deploying mechanism may be omitted, particularly when the holder needs to be contracted smaller.

In the description of the heart assisting apparatus 1, the balloon 10 or the holder 14 has been described simply as being pulled out of the body. However, for example, the balloon 10 or the holder 14 may be pulled inside. A tube having a lumen having dimensions is once inserted into the body around the first tube 12 and the second tube 16, the balloon 10 and the holder 14 are drawn into the tube, and then the tube is pulled out of the body. It may be.

Further, if the deploying mechanism as described above is provided, there is a possibility that the holder can be folded down together with the balloon, inserted into the body, and deployed inside the body, so that the holder can be mounted on the heart. It is expected that it can be worn without complicated thoracotomy.

[Brief description of the drawings]

FIG. 1 is a longitudinal sectional view of a heart assist device shown as an embodiment.

FIG. 2 shows a use state of the heart assist device, and (a)
FIG. 4 is an explanatory view of a state in which the balloon is deflated, and FIG. 4B is an explanatory view of a state in which the balloon is expanded.

FIG. 3 is an explanatory view showing a state in which a balloon is removed.

FIG. 4 is an explanatory view showing a state in which a holder is removed.

FIG. 5 is a perspective view showing a modified example of the holder.

[Explanation of symbols]

1 ... heart assist device, 10 ... balloon, 12 ...
-1st tube, 14 ... Holder, 16 ... 2nd tube.

 ────────────────────────────────────────────────── ─── Continued on the front page (72) Inventor Katsumi Kanda 2-3-4 Wakamizu, Chikusa-ku, Nagoya-shi, Aichi

Claims (3)

[Claims] 1. A balloon, which expands when a fluid is supplied to the inside, and contracts when the fluid inside is discharged, and a lumen communicating with the inside of the balloon, wherein the lumen supplies the fluid. A heart assisting device including a tube serving as a discharge path, and a holder capable of holding the balloon at a position where the balloon can compress the heart from the outside when the balloon is expanded, wherein the balloon has an external force. A heart assisting device having a structure for separating the holder from the holder when actuated. 2. A balloon, which expands when a fluid is supplied to the inside, and contracts when the fluid inside is discharged, and a lumen communicating with the inside of the balloon, wherein the lumen supplies the fluid. A heart assisting device comprising: a tube serving as a discharge path; and a holder capable of holding the balloon at a position where the balloon can compress the heart from outside when the balloon is expanded. A heart assist device characterized in that it has a possible structure. 3. The heart assisting device according to claim 2, wherein the holder expands into a shape in use when a filler is introduced therein, and contracts when the filler is drawn out from the interior. A heart assist device characterized by becoming.