CN101011301A

CN101011301A - Support bracket for reducing left cardiac sinus mitral regurgitation and conveying appliance thereof

Info

Publication number: CN101011301A
Application number: CNA2007100200879A
Authority: CN
Inventors: 孔祥清
Original assignee: Individual
Current assignee: Individual
Priority date: 2007-02-12
Filing date: 2007-02-12
Publication date: 2007-08-08

Abstract

The invention relates to a support for reducing the reflux at left ventricular mitral valve with less hurt and without exploratory thoracotomy, and a relative transmitting device. The invention substantially comprises a support for increasing the radius of mitral valve curvature radius and a transmitting system for fixing two ends of support. The support is transmitted via the transmitting system into the spherical sinoauricular near the mitral valve, to function with the wall of spherical sinoauricular, to improve the curvature of spherical sinoauricular, and push forwards the back ring of mitral valve, to improve the combination of valve sharps and reduce the mitral valve reflux.

Description

Reduce left cardiac sinus mitral regurgitation support and conveyer device thereof

Technical field

The present invention relates to a kind of medical apparatus and instruments, especially a kind ofly be used for the treatment of cardiopathic medical apparatus and instruments, specifically a kind of can increase the annulus of mitral valve radius of curvature and improve lobe point combination and reduce mitral incompetence reduce left cardiac sinus mitral regurgitation usefulness support and conveyer device thereof.

Background technology

As everyone knows, the part blood reflux flowed into left atrium when mitral incompetence can make left ventricle shrink, and made the left atrium negative pressure increase; In order to compensate stroke volume, the left ventricle load also need increase simultaneously.Left atrium and left ventricle all increase because of volume increases gradually, cause atrioventricular ring to enlarge, and the expansion of atrioventricular ring is the more heavy degree of incompetence conversely.The cause of disease of mitral incompetence has a lot, but no matter its cause of disease how, the performance of mitral incompetence on pathology mainly is that atrioventricular ring has obvious expansion, and the patient of a lot of mitral incompetences mainly or only causes owing to the lobe ring extension of Bicuspid valve back.

At present, mitral valve repair is arranged, lobe circumferential weld contract art and valve replacement for the Therapeutic Method of mitral incompetence.Wherein, the valve repair art is applicable to that damaging valve is torn or the patient of rupture of chordae tendineae, and this kind method need be opened breast, and the surgical technic requirement is high, difficulty is big, thereby fewer usefulness; And the lobe circumferential weld contract art be only applicable to the valve pathological changes light, do not have calcification, valve energy better and the simple property incompetence person that obviously enlarges of lobe ring; Valve replacement then is the main method of treatment mitral incompetence, account for more than 80% of total operation number, be applicable to that simple property mitral incompetence or the most of mitral incompetence of mitral incompetence more than moderate has narrow case concurrently, available mechanical prosthetic valve or bioprosthetic valve are replaced operation.Yet mechanical prosthetic valve has the danger that produces thromboembolism, and needs to use anticoagulant; Though bioprosthetic valve can reduce the possibility that thromboembolism takes place, and the restriction in service life is arranged itself.

Above-mentioned three kinds of methods all need out the surgical operation of breast, all are attended by high M ﹠ M.Dangerous especially for the above-mentioned operation method of some patient, weak as elderly patients and left ventricular function, nephropathy, the serious calcification of aorta are arranged, before be the patient etc. of operation on heart.Therefore, be badly in need of a kind of increase the lobe point in conjunction with and the interventional therapy device that can reduce mitral incompetence for use.

Summary of the invention

It is big to the objective of the invention is the operation wound that exists at the Therapeutic Method of existing mitral incompetence, the problem that mortality rate is high, it is little to invent a kind of wound, risk is low need not that open chest surgery can reach therapeutic purposes reduce left cardiac sinus mitral regurgitation with support and conveyer device thereof.

Technical scheme of the present invention is:

A kind of left cardiac sinus mitral regurgitation support that reduces, it is characterized in that it is that a curvature is slightly larger than human body coronary sinus curvature, material is Nitinol or stainless elastic network(s) tubular structure, near be provided with on the end of delivery end with conveyer device on the hook hole that matches of hook, this elastic network(s) tubular body structure also satisfies following arbitrary condition at least:

(1) its outside is to be easy to crooked structure, and the inboard is for inflexibility or be difficult to crooked structure;

(2) mesh density of the interior lateral body of the close center of curvature is greater than the mesh density away from the center of curvature one side;

(3) mesh density at its two ends is less than the mesh density of interlude;

(4) the silk footpath at its two ends is thin, and the intermediate filament footpath is thick.

On described elastic network(s) tubular structure surface, also be welded with the connecting rod that matches with its shape, make its protection shape.

The quantity of the lip-deep connecting rod of described elastic network(s) tubular body structure is that two ends are few, and the centre is many, does not have connecting rod on the median plane.

A kind of left cardiac sinus mitral regurgitation that reduces is with the support conveyer device, it is characterized in that it by central shaft, be installed in central shaft one end the TIP head, be sleeved on the inner core tube of usefulness one nested rack on the central shaft and the sheath pipe that is sleeved on the inner core tube is formed, be provided with on the inner core tube one with support on hook hole being used for of matching the near-end of support is fixed on hook on the inner core tube, be provided with a usefulness one at central shaft near the position of TIP head rack far end be fixed on fixture on the central shaft.

The present invention has the following advantages:

The present invention is a kind of medical apparatus and instruments of brand-new treatment mitral incompetence, and it need not to carry out open chest surgery can reach therapeutic purposes, has series of advantages such as operation risk is little, expense is low, patient recovers soon, no postoperative complication.

When discharging support, can keep the sheath pipe motionless, push inner core and central shaft simultaneously forward, because far-end can not swell when the fixture at Tip head place can guarantee support release, simultaneously owing to have fixture on the inner core, so the near-end of this support can not swell, and has only mid portion to expand.Can see by radiography whether the support that expands has reduced mitral incompetence, if the bad support that is recoverable to of effect also discharges again, perhaps stent size is improper, is recoverable to support and reselects suitable support.

The present invention has the advantage that wound is little, risk is low, support can change near the natural curved shape of the coronary sinus the mitral leaflet, thereby can effectively improve the point combination of Bicuspid valve lobe and reduce mitral incompetence, support can be formed through laser engraving or braiding by Nitinol or rustless steel, and induction system comprises belled successively from the inside to the outside central shaft, inner core and sheath pipe.

Support of the present invention is to make through the method for laser engraving or braiding, its structure is that the two ends waveform is sparse, the mid portion waveform is intensive, there is small sircle hole the proximal end, and connecting rod quantity is more than two ends at the mid portion near the coronary sinus antetheca, or support two terminal filaments footpath is thin, and mid portion silk footpath is thick.In near when support is delivered to mitral leaflet via induction system the coronary sinus, and make the part that has connecting rod near the coronary sinus antetheca, because support has adopted above-mentioned asymmetric structure, therefore after interacting near the coronary sinus this support is placed into mitral leaflet and with the coronary sinus wall, support itself can form the bending of different curvature, meanwhile support has also changed near the natural curved shape of the coronary sinus the mitral leaflet, and move forward the PM ring, and improve lobe point combination thus and reduce mitral incompetence.

Induction system of the present invention, the far-end of its central shaft is connected with a Tip head, inner core links to each other by connector with the sheath pipe, the compressible support of inserting of the distal portions of inner core and sheath pipe, and inner core is provided with and prevents that the expansible fixed structure of this mount proximal end, Tip head place are provided with and prevent the expansible fixed structure of this rack far end.Fixture on the inner core can adopt the spike element, can tangle the circular hole of mount proximal end; The fixture at described Tip head place is a thin wall cylindrical tubes, or the cylindrical tube built-in has the circular ring structure that can mesh with the rack far end after the compression of sawtooth.

Description of drawings

Fig. 1 is the planar structure sketch map of support of the present invention;

Fig. 2 is the three dimensional structure sketch map of support of the present invention;

Fig. 3 a～3c is the structural representation of induction system of the present invention;

Fig. 4 is gapped mitral valve apparatus sketch map;

Fig. 5 is a support of the present invention sketch map when discharging;

Fig. 6 is the sketch map after support of the present invention discharges.

The specific embodiment

The present invention is further illustrated for following structure drawings and Examples.

The structural representation of the support of present embodiment as shown in Figure 1, 2.

A kind of left cardiac sinus mitral regurgitation support that reduces, it is that a curvature is slightly larger than human body coronary sinus curvature, so that being diminished, the curvature of coronary sinus reduces left cardiac sinus mitral regurgitation, this support is with adopting nitinol alloy wire or stainless steel silk to be woven into elastic network(s) tubular structure 5, also can adopt Nitinol pipe or stainless steel tube to carve this with laser forms, simultaneously near be provided with on the end 1 (being near-end) of delivery end with conveyer device on the hook hole 4 that matches of hook 10, this elastic network(s) tubular body structure 5 also satisfies following arbitrary condition at least:

(3) mesh density at its two ends 1,2 is less than the mesh density of interlude;

(4) the silk footpath at its two ends 1,2 is thin, and the intermediate filament footpath is thick.

In addition; in order to increase the crooked retentivity of support; the surface of elastic network(s) tubular body structure 5 on also be welded with the connecting rod 3 that matches with its shape, make its protection shape; the quantity of connecting rod 3 is that two ends are few; the centre is many; median plane M (being the both sides up and down that tangent plane is divided at the center of support) goes up no connecting rod 3, as shown in Figure 2.

Being used for of present embodiment sent into the conveyer device of human body shown in Fig. 3 a～3c with support.

A kind of left cardiac sinus mitral regurgitation that reduces is with the support conveyer device, it by central shaft 11, be installed in central shaft one end TIP 13, be sleeved on the inner core tube 9 of usefulness one nested rack 5 on the central shaft 11 and the sheath pipe 6 that is sleeved on the inner core tube 9 is formed, be provided with on the inner core tube 9 one with support on hook hole being used for of matching the near-end 1 of support 5 is fixed on hook 10 on the inner core tube 9, be provided with a usefulness one at central shaft 11 near the position of TIP 13 support 5 far-ends 2 be fixed on fixture 12 on the central shaft.Wherein central shaft 11, inner core tube 9 also should adopt the pliable material manufacturing, so that they can adapt to cardiovascular shape and be convenient to their moving in blood vessel.

The contrast accompanying drawing is further described below.

Fig. 1,2 shows support of the present invention, and the waveform 5 at its near-end 1 and far-end 2 places is sparse than mid portion, and the quantity of connecting rod 3 is some more than two ends at the mid portion near coronary sinus antetheca 15, and this external mount proximal end 1 place is provided with small sircle hole.Because support has adopted above-mentioned asymmetric structure, therefore after interacting near the coronary sinus this support is placed into mitral leaflet and with the coronary sinus wall, support itself can form the bending of different curvature, meanwhile support has also changed near the natural curved shape of the coronary sinus the mitral leaflet, and move forward the PM ring, and improve lobe point combination thus and reduce mitral incompetence.

Induction system comprises sheath pipe, inner core and central shaft from outside to inside successively, and its corresponding structural representation is respectively shown in Fig. 3 a, Fig. 3 b and Fig. 3 c.Wherein inner core 9 is provided with fixture 10, is used to tangle the hook hole 4 at mount proximal end 1 place, prevents that mount proximal end from discharging from the sheath pipe in pre-dispose procedure; Central shaft 11 front ends are provided with Tip 13 (the Tip head should be fixed on the central shaft again) after induction system assembles, be provided with another fixture 12 at Tip 13 near-ends and (can adopt a thin wall cylindrical tubes, or the cylindrical tube built-in has the circular ring structure that can mesh with the rack far end after the compression of sawtooth), the far-end that is used for fixing support prevents that rack far end breaks away from inner core 9 in pre-dispose procedure.In addition, this system also has a seal wire, is used to guide induction system to coronary sinus, and 7 among Fig. 3 a is control valve, and 8 is conduit.

Fig. 4 shows Bicuspid valve 16 structural representations with a center clearance 14, and Fig. 5 and Fig. 6 utilize present embodiment to improve the combination of lobe point, and reduce the sketch map of mitral incompetence.

During concrete operations, can be in advance with central shaft 11, inner core 9 and sheath pipe 6 from inside to outside successively socket get up fixing Tip 13 again, and being loaded between inner core 9 and the sheath pipe 6 after will support 5 elongating compression, and with fixture 10 mount proximal end is fixed, with fixture 12 rack far end is fixed simultaneously.Under x-ray fluoroscopy monitors, insert seal wire then, import along seal wire again and install the induction system that is fit to the size support in advance position near the coronary sinus the mitral leaflet 15 in advance through jugular vein or femoral venous puncture; Maintenance sheath pipe 6 is motionless, pushes inner core 9 forward and drive central shaft 11 to move forward together.Because the near-end 1 and the far-end 2 of support are fixed respectively, the near-end 1 and the far-end 2 of support can swollenly not held when therefore discharging.While promotes PM ring 17 forward simultaneously because the dissymmetrical structure of support makes that support becomes bending and changed the radius of curvature of coronary sinus after the interaction of support and coronary sinus wall, thereby can improve the combination of lobe point and reduce mitral incompetence.Radiography has shown the mitral incompetence complete obiteration, then continues to discharge support to near-end 1 and far-end 2 and swells fully.If it is remaining that radiography shows that mitral incompetence also has, because the support two ends do not break away from induction system as shown in Figure 5, thereby the position that can readjust support discharges support more fully until the backflow complete obiteration, and returns and remove induction system, as shown in Figure 6.

Claims

1, a kind of left cardiac sinus mitral regurgitation support that reduces, it is characterized in that it is that a curvature is slightly larger than human body coronary sinus curvature, material is Nitinol or stainless elastic network(s) tubular structure, near be provided with on the end of delivery end with conveyer device on the hook hole that matches of hook, this elastic network(s) tubular body structure also satisfies following arbitrary condition at least:

(3) mesh density at its two ends is less than the mesh density of interlude;

2, the left cardiac sinus mitral regurgitation support that reduces according to claim 1 is characterized in that also being welded with the connecting rod that matches with its shape, make its protection shape on described elastic network(s) tubular structure surface.

3, the left cardiac sinus mitral regurgitation support that reduces according to claim 2 is characterized in that the quantity of the lip-deep connecting rod of described elastic network(s) tubular body structure is that two ends are few, and the centre is many, does not have connecting rod on the median plane.

4, the described stent conveying device of a kind of claim 1, it is characterized in that it by central shaft, be installed in central shaft one end the TIP head, be sleeved on the inner core tube of usefulness one nested rack on the central shaft and the sheath pipe that is sleeved on the inner core tube is formed, be provided with on the inner core tube one with support on hook hole being used for of matching the near-end of support is fixed on hook on the inner core tube, be provided with a usefulness one at central shaft near the position of TIP head rack far end be fixed on fixture on the central shaft.