BR102016027541A2 - SURGICAL TREATMENT SYSTEM FOR HEART VALVES TO EASILY THE OPERATING ACT ORGANIZING SURGICAL WIRE, EASYING THE SURGICAL PRESENTATION OF THE HEART STRUCTURES TO BE TREATED - Google Patents

Abstract

heart valve surgical treatment system to facilitate the operative act by organizing the surgical threads, facilitating the surgical presentation of the cardiac structures to be treated. assistive device for cardiovascular surgery, which is a surgical instrument, to be used during cardiac surgeries, because during the operations of cardiac valves, mitral, aortic and tricuspid, the valve replacement procedure, that is, when a Valve prosthesis To treat valve incompetence, it is necessary to use a large number of surgical threads to fix the prosthesis in the valve ring so as not to allow retrograde blood to escape.

Description

(54) Title: SYSTEM OF SURGICAL TREATMENT OF HEART VALVES TO FACILITATE THE OPERATING ACT ORGANIZING THE SURGICAL WIRES, FACILITATING THE SURGICAL PRESENTATION OF THE HEART STRUCTURES TO BE TREATED (51) Int. A61B 17/072; A61B 17/00 (52) CPC: A61F 2/2427, A61B 17/072, A61B 2017/00243, A61F 2/2409, A61F 2220/005 (73) Owner (s): MÁRIO CÉSAR SANTOS DE ABREU (72) Inventor (s): MÁRIO CÉSAR SANTOS DE ABREU (57) Abstract: SURGICAL TREATMENT SYSTEM FOR HEART VALVES TO FACILITATE THE OPERATING ACT ORGANIZING THE SURGICAL WIRES, FACILITATING THE SURGICAL PRESENTATION OF THE STRUCTURES. Auxiliary device for cardiovascular surgery, which is a surgical instrument, to be used during cardiac surgeries, because during cardiac, mitral, aortic and tricuspid valve operations, the valve exchange procedure, that is, at the moment when an implant is implanted valve prosthesis to treat valve incompetence, it is necessary to use a large number of surgical wires to fix the prosthesis to the valve ring so as not to allow blood to escape retrograde.

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SYSTEM OF SURGICAL TREATMENT OF HEART VALVES TO FACILITATE THE OPERATING ACT ORGANIZING THE SURGICAL WIRES, FACILITATING THE SURGICAL PRESENTATION OF THE HEART STRUCTURES TO BE TREATED

BRIEF PRESENTATION [001] The present invention describes the Auxiliary Apparatus for Cardiovascular Surgery (AACCV) - CARDIO-CARROUSEL, which is a surgical instrument, to be used during cardiac surgeries, especially the valve ones, with the main purpose of facilitating these surgeries, since During cardiac, mitral, aortic and tricuspid valve operations, the valve replacement procedure, that is, when a valve prosthesis is implanted to treat valve incompetence, the use of a large number of surgical wires is necessary for fixation of the prosthesis to the valve ring in such a way as not to allow blood to escape retrograde.

[002] In these surgeries, several separate points are used, ranging from a minimum of 12 threads to 18 or more than twenty threads. These wires, after being fixed in the valve ring, must be fixed in the surgical field in an organized way, and arranged so that they can be later fixed and tied, keeping the prosthesis in an adequate position, and without the possibility of reflux, or detachment of the valve ring [003] Thus (AACCV) CARDIO-CARROUSEL during this operation, becomes an instrument of great importance during these surgeries interfering in the systematization of the operation making the procedure very simple and agile allowing the easy integration of the team components, as well as synchronization, decreasing up to 3 times the time needed for valve replacement. The average time is between 40 to 80 minutes, sometimes even longer, but with the AACCV - CARDIO-CARROUSEL, we reach 12 to 20 minutes, the time needed for valve replacement.

[0001] This surgical instrument makes it possible to maintain the order of the wires in an orderly manner, to provide support for the fixation of different types of prostheses, to facilitate the passage of surgical wires, fixing and maintaining surgical structures

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2/6 (anatomical repairs) as borders of the atria, ventricles, aorta, pulmonary artery, allowing the necessary exposure of the heart valves.

[005] In addition to these functions, the instrument serves as an aid in measuring angles, facilitates the marking of important valve commissures in the positioning of heart valves, allows different tractions at the edges of the structures. It still finds application in the training rooms of surgeons serving as a support for the use of hearts for training of surgeries such as valve plastics, and especially valve changes.

FIELD OF APPLICATION [006] The present invention will be applied in the area of cardiac surgeries, mainly the valvular ones, with the main purpose of facilitating these surgeries, because during the operations of cardiac, mitral, aortic and tricuspid valves, it is necessary to use a large number surgical wires for fixing the prosthesis to the valve ring so as not to allow blood to escape retrograde, also preventing wire tangles, and fixing structures. STATE OF THE TECHNIQUE [007] Annually specialists nationally and internationally, meet to discuss to discuss advances in the surgical treatment of heart valve diseases. These advances will influence the new techniques for performing cardiac valve replacement, allowing a better evolution of patients from the general point of view, often clearly interfering in mortality and morbidity rates. [008] Therefore, the creation of surgical instruments that allow the handling of cardiac structures, bringing less operative risk, will help in performing the surgery and will influence a chain of events since the length of hospitalization of patients, exposure to risks during hospitalization, shorter length of stay. cardiac arrest, significantly decreasing the operative risk, and complications related to the length of hospital stay, such as the risk of nosocomial infections, bleeding due to coagulopathies, and even cardiac function.

[009] The matter is quite complex and the constant updating of the surgical treatment techniques of the heart valves positively influence the surgical results. Therefore, surgeons must be updated to be able to use more and more advanced resources in the treatment of patients, especially

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3/6 cardiopathies. So during the congresses, the experts put their opinions, their techniques, and results.

COMPARING THE INVENTION WITH THE STATE OF THE TECHNIQUE [010] The present invention deals with the technique of performing cardiac valve replacement, bringing as main advantage the organization of surgical threads during valve replacement surgeries, preventing tangles of the threads, and speeding up the act operative.

[011] Rheumatic heart disease is still very common in this area, which clearly interferes with heart valve health. Patients suffering outbreaks of rheumatic disease end up suffering complications from the inflammatory process generated in the heart and mainly affecting the heart valves. This inflammatory process will lead to valve disease (mitral, aortic and tricuspid), making the number of cardiac operations for surgical treatment of aortic and tricuspid mitral valves still very common, despite advances in minimally invasive techniques.

[012] All advances in surgical technique and in understanding the pathophysiology of heart valve dysfunction have led to better results. Seen as a development beyond measures of morbidity and mortality, health-related quality of life outcome measures (HRQoL) are becoming increasingly popular. These measures are important because complications resulting from routine (ie, low risk) operations on the mitral valve are uncommon and other outcome markers are needed.

[013] Surgeons are increasingly operating on asymptomatic patients and will need to prove that HRQoL is not impacted. New minimally invasive technologies and transcatheter will also need to demonstrate satisfactory results from HRQOL (HEALTH RELATED QUALITY OF LIFE) before widespread use.

[014] This systematic review (Tan MKH, Jarral OA, Thong EHE, Kidher E, Uppal R, Punjabi PP et al. Quality of life after mitral valve intervention. Interact CardioVasc Thorac Surg 2016; doi: 10.1093 / icvts / ivw312), provides an overview of all available literature detailing HRQOL in patients receiving mitral valve interventions. In the 43 included studies, 6865 patients underwent procedures that ranged from open replacement to percutaneous repair using devices such as MitraClip Clip Delivery System (Abbott Vascular, Santa Clara, CA,

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USA). Most studies performed baseline HRQoL assessment, allowing for postoperative comparison.

[015] Although the underlying literature has deficiencies, most studies have an acceptable HRQoL after intervention that is comparable to that of corresponding general populations. Specific patient-specific factors (eg, female gender, renal dysfunction) and specific surgical factors (eg, replacement instead of repair, high transmission gradient) that predispose patients to weaker long-term HRQOL results have been identified. These factors are important for clinicians to be developing strategies to maximize their HRQoL results.

[016] Future randomized studies would benefit from HRQOL measurements at specific time points to allow for large-scale comparisons. The establishment of a common HRQoL instrument for use in mitral valve intervention studies can support detailed comparisons between specific techniques. Physical activity monitors, physiological biomarkers and radiological markers could also be used as innovative indicators of functional outcome.

THE INVENTION [017] The present invention deals with a device to assist during the heart valve exchange procedure. The auxiliary device for cardiovascular surgery, consists of a stainless steel ring to be placed on the patient's chest during valve replacement surgery.

[018] In the upper part of the rim, 12 steel springs made of steel of 1 mm in diameter, with an external diameter of 6 mm, an internal diameter of 4 mm, and a total length of 42.5 mm are attached. The springs are fixed at their ends to the ring with steel rivets through holes that fix the horizontal ring of the springs on the rim surface. Each spring has 02 steel rivets securing them to the rim, one at each end of the spring. The spacing of the springs is 14 mm.

[019] The steel ring is the base for the springs, consisting of a stainless steel circle, 2.5 cm wide, with an internal diameter of 20 cm, and an external diameter of 25 cm. Therefore, the steel disk is 5 cm wide. On the outer edge of the steel rim, marks are printed with the graduation every 2.5 degrees, marks

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5/6 prints of 15, 30, 45, 60, 75, 90, 105, 120, 135, 150, 165, 180,195, 210, 225, 240, 255, 270, 285, 300, 315, 330, 345, 360 degrees.

[020] The springs fixed on the circumference of the circle have marks equidistant every 30 degrees, on the outside. Close to the edge, springs were fixed, arranged at 30-degree intervals, as auxiliary devices, for fixing surgical wires, and intermediate marking at 30-degree points. In this way, we have marked points across the circle, equidistant from 15 degrees. In four (04) of these points, we have four holes, two (02) for fixing the metal rods, where the prostheses to be implanted can be fixed, as, for example, in the aortic valve changes, in which the prosthesis is fixed with the valve holder, dispensing the first assistant to keep the prosthesis in position for the passage of the wires for fixation in the aortic ring. Two holes will be used to fix the instrument in the surgical field.

[021] It is a surgical instrument, to be used during cardiac surgeries, mainly the valvular ones, having as main purpose to facilitate these surgeries, because during the operations of cardiac, mitral, aortic and tricuspid valves, the valve exchange procedure, that is, When a valve prosthesis is implanted to treat valve incompetence, it is necessary to use a large number of surgical wires to fix the prosthesis to the valve ring so as not to allow blood to escape retrograde. These strands, once tied, will fix the prosthesis in the respective ring (mitral, aortic, tricuspid).

[022] In these surgeries, several separate points are used, ranging from a minimum of 12 threads to 18 or more than twenty threads. These wires, after being fixed in the valve ring, must be fixed in the surgical field in an organized way, and arranged so that they can be later fixed and tied, keeping the prosthesis in an appropriate position.

[023] Thus, the AACCV - CARDIO-CARROUSEL during this operation, becomes an instrument of great importance in these surgeries, interfering in the systematization of the operation, making the procedure very simple and allowing the easy integration of the team components, as well as the synchronization, and agility of the procedure, reducing up to 3 times the time needed for valve replacement. [024] This surgical instrument makes it possible to maintain the arrangement of the wires in an orderly manner, provide support for the fixation of different types of prostheses,

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6/6 passage of surgical wires, fixing and maintaining tensioned surgical structures (anatomical repairs) such as borders of the atria, ventricles, aorta, pulmonary artery, allowing the necessary exposure of the heart valves.

[025] In addition to these functions, the instrument serves as an aid in the measurement of angles, facilitates the marking of important valve commissures in the positioning of heart valves, and allows different tractions at the edges of the structures. It still finds application in the training rooms of surgeons serving as a support for the use of hearts, assisting in the training of cardiac surgeries such as valve plastics, and valve replacements mainly.

DESCRIPTION OF THE FIGURES [026] The objects and advantages of the present invention will become more evident from the following detailed description of an embodiment of the invention and accompanying drawings as a non-limiting example, in which:

FIG. 1 illustrates the rim (CARDIO-CARROUSEL) without screws containing 4 holes for the holder rods, marking the angles on the outer edge and a tab on the bottom to fix it to the surgical field;

FIG. 2 illustrates the 1 - Rods and 2 - Holder on the rim for fixing the prosthesis that will be sutured in the valve ring; holder that positions it correctly to suture it and correctly fit it in the aortic ring;

FIG. 3 illustrates the prosthesis attached to the aortic ring.

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Claims (6)

1) SYSTEM OF SURGICAL TREATMENT OF HEART VALVES TO FACILITATE THE OPERATING ACT ORGANIZING THE SURGICAL WIRES, FACILITATING THE SURGICAL PRESENTATION OF THE HEART STRUCTURES TO BE TREATED, characterized by understanding a surgical instrument with the main purpose of being a surgical instrument, mainly to assist in the primary surgery, facilitate these surgeries. 2) SYSTEM OF SURGICAL TREATMENT OF HEART VALVES TO FACILITATE THE OPERATING ACT ORGANIZING THE SURGICAL WIRES, FACILITATING THE SURGICAL PRESENTATION OF THE HEART STRUCTURES TO BE TREATED, in accordance with the surgical aid, characterized by the steel appliance, characterized by stainless steel to be placed on the patient's chest during valve replacement surgery. 3) SYSTEM OF SURGICAL TREATMENT OF HEART VALVES TO FACILITATE THE OPERATING ACT ORGANIZING THE SURGICAL WIRES, FACILITATING THE SURGICAL PRESENTATION OF THE HEART STRUCTURES TO BE TREATED, according to claim 1, characterized by the steel structure, characterized by consisting of a stainless steel circle, 2.5 cm wide, with an internal diameter of 20 cm, and an external diameter of 25 cm. Therefore, the steel disk is 5 cm wide. On the outer edge of the steel rim, marks are printed with the graduation every 2.5 degrees, printed marks of 15, 30, 45, 60, 75, 90, 105, 120, 135, 150, 165, 180,195, 210, 225 , 240, 255, 270, 285, 300, 315, 330, 345, 360 degrees. 4) SYSTEM OF SURGICAL TREATMENT OF HEART VALVES TO FACILITATE THE OPERATING ACT ORGANIZING THE SURGICAL WIRES, FACILITATING THE SURGICAL PRESENTATION OF THE HEART STRUCTURES TO BE TREATED, in accordance with the claims that are in the molds that are characterized by the steel structures, steel rivets through holes that secure the horizontal spring ring to the Petition 870160069761, of 11/23/2016, p. 14/16 2/2 rim surface, with 02 steel rivets securing them to the rim, one at each end of the spring, with 14 mm spacing between the springs. 5) SYSTEM OF SURGICAL TREATMENT OF HEART VALVES TO FACILITATE THE OPERATING ACT ORGANIZING THE SURGICAL WIRES, FACILITATING THE SURGICAL PRESENTATION OF THE HEART STRUCTURES TO BE TREATED, in accordance with the entire claim, characterized by 15 points, characterized by equal points in four (04) of these points, we have four holes, two (02) for fixing the metal rods, where the prostheses to be implanted can be fixed. 6) SYSTEM OF SURGICAL TREATMENT OF HEART VALVES TO FACILITATE THE OPERATING ACT ORGANIZING THE SURGICAL WIRES, FACILITATING THE SURGICAL PRESENTATION OF THE HEART STRUCTURES TO BE TREATED, in accordance with the two claims, characterized by four being characterized by where the prostheses to be implanted in the aortic valve changes can be fixed, in which the prosthesis is fixed with the valve holder, dispensing or facilitating the work of the first assistant to keep the prosthesis in position for the passage of the wires for fixation in the aortic ring in the aortic ring. Two holes will be used to fix the instrument in the surgical field. Petition 870160069761, of 11/23/2016, p. 15/16 1/3