CN101091675B - Atrioventricular valve bracket of artificial valve of dual discal straps - Google Patents
Atrioventricular valve bracket of artificial valve of dual discal straps Download PDFInfo
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- CN101091675B CN101091675B CN2007100440143A CN200710044014A CN101091675B CN 101091675 B CN101091675 B CN 101091675B CN 2007100440143 A CN2007100440143 A CN 2007100440143A CN 200710044014 A CN200710044014 A CN 200710044014A CN 101091675 B CN101091675 B CN 101091675B
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Abstract
The present invention relates to a kind of bidiscoid antrioventricular valve scaffold with artificial valve. Said bidiscoid scaffold is made up by using shape memory alloy filament through a certain weaving process. It is divided into right atrial discoid face, intermediate waist portion and right ventricular discoid face, the right atrial discoid face and right ventricular discoid face are made into the form of horn mouth, the diameter of said horn mouth is greater than that of intermediate waist portion, the height of the waist portion is half of diameter of waist portion, the diameter of right atrial discoid face is identical to that of right ventricular discoid face, and said valve is formed from wave-shaped valve ring and valve leaf. Besides, said invention also provides the concrete structure of said wave-shaped valve ring and valve leaf.
Description
Technical field
The present invention relates to a kind of heart atrioventricular valves (A V valves) support, especially a kind of atrioventricular valve bracket of artificial valve of dual discal straps device.
Background technology
The Tricuspid valve disease is common clinically a kind of valvular heart disease, and tricuspid incompetence is far away more than tricuspid stenosis, and functional tricuspid incompetence is the most common clinically.Surgical operation is still the main means of treatment functional tricuspid insufficiency at present, and its cardinal principle is the tricuspid annulus of dwindling expansion.Based on Tri An, the tricuspid valve replacement not only causes conduction block easily in the various art formulas, and long-term effect is poor, and mechanical prosthetic valve also relates to inconveniences such as postoperative anticoagulant, so use less clinically.Tri An or replacement operation technology the year comparatively ripe; but still need the long-term effect of extracorporeal circulation, postoperative all not good in the art; and this type of patient has secular right heart insufficiency medical history; part patient mitral lesion effectively rescued and pulmonary artery pressure under normal or higher slightly situation; tricuspid incompetence still appears; Shou Shu risk is very big once more; for avoiding the bigger open chest surgery of wound, people expect to find a kind of Wicresoft means to treat such disease always.Some researcheres have carried out some new trials to percutaneous cardiac valve replacement technology in recent years, wherein 2005, the Tricuspid valve support that uses such as Boudjemline are fixed with the venous valve of cattle has successfully carried out the percutaneous replacement of tricuspid valve to 8 sheep, for new direction has been opened up in the treatment of functional tricuspid regurgitation.(Boudjemline Y, Agnoletti G, Bonnet D, eral.Steps toward the percutaneous replacement ofatrioventricular valves an experimental study[J] .J Am Coll Cardiol.2005,46 (2): 360-365.), further experimentation is well afoot also.Compare with surgical operation, the percutaneous prosthetic valve replacement need not out breast and extracorporeal circulation support, is that a kind of wound is little, complication is few, postoperative rehabilitation is fast, the acceptable Therapeutic Method of patient.
At present, the band valve Tricuspid valve support that uses in the experiment is formed by double plate shape support and the bovine jugular vein lobe that is sewn on the support, and support is the Nitinol net, has waist to connect in the middle of two dishes, fresh bovine jugular vein valve by the direct sutured of line at waist.During implantation support packed in the corresponding conduit, utilize delivery sheath to deliver to the right atrioventricular valve mouth by jugular vein again, discharge support, self Tricuspid valve is squeezed between support and the cardiac muscle, the bovine jugular vein valve in the support substitutes the function of former valve.The jugular vein valve of cattle directly is sewn on the support waist wall in the existing band valve Tricuspid valve support, therefore what the size of bovine jugular vein diameter must be with waist diameter is big or small identical, if both can not mate the normally closed that all can influence valve, this has just limited the making space of support, people can not freely make the support of corresponding size according to the ultrasonic tricuspid annulus size of surveying, and must consider getable bovine jugular vein size simultaneously.The double plate diameter of this support is far longer than waist diameter simultaneously, though in order to fixedly secure support, because the ventricle card is excessive, may cause the ventricle card not open fully smoothly simultaneously, perhaps has influence on outflow tract of right ventricle after opening; Same right room is also bigger, influences vital tissues such as orifice of coronary sinus in the atrium, Koch triangle, and the vein valve of Niu Zishen is very soft, so directly be sewn to it on tube wall, not only the difficulty of sewing up increases, and valve is difficult to sew up in one plane the normal function that opens and closes of influence.The nickel-titanium metal silk of the existing support of making is thinner in addition, and under heart relaxed situation about contracting repeatedly, the tinsel frangibility affected the treatment.
Summary of the invention
The present invention will provide a kind of atrioventricular valve bracket of artificial valve of dual discal straps, is used to solve existing band valve Tricuspid valve support and can causes the ventricle card not open fully smoothly, perhaps has influence on outflow tract of right ventricle after opening; And very softish cattle vein valve directly is sewn on the tube wall, not only the difficulty of sewing up increases, and valve is difficult to sew up in one plane the normal function that opens and closes of influence; The nickel-titanium metal silk of support is thinner, under heart relaxes situation about contracting repeatedly, and the tinsel frangibility, the technical problem that affects the treatment, and this support is drawn materials conveniently, making is easy, volume is little, be beneficial to conveying, function near physiological status.
For achieving the above object, the technical solution used in the present invention is as follows:
A kind of atrioventricular valve bracket of artificial valve of dual discal straps, by double plate shape support and place the valve in it to form, be characterized in: double plate shape support is formed by the shape-memory alloy wire braiding, and be divided into right atrium card, intermediary waist and three parts of right ventricle card, wherein, the right atrium card is a distal end, right atrium card and right ventricle card all are bell mouth shape, the horn mouth diameter is greater than middle waist diameter, waist height is half of waist diameter, the right atrium card is identical with the diameter of right ventricle card, is fixed in AO after utilizing implantation; Valve is made up of wavy valve annulus and lobe leaf, wavy valve annulus curves three circular arcs and forms a circle by shape memory power alloy silk is folding, be the SANYE flap, the diameter of wavy valve annulus is identical with waist diameter, and crown height is identical with waist height, and the lobe leaf is made into flexible flaps by the animal pericardium that takes off the cell processing, the lobe leaf adheres to its edge and uses suturing with thread management on the curved metal silk of wavy valve annulus, another side is free, forms three first quarter moon holes, promptly makes valve; Wavy valve annulus places the waist of double plate shape support, and arc is protruding in the right ventricle card, and the waist of suturing with thread management in double plate shape support used at three arcual middle parts respectively.
The mammal pericardium of making the lobe leaf is Cor Caprae seu ovis bag or Cor Sus domestica bag; The shape-memory alloy wire of double plate shape support is the niti-shaped memorial alloy silk, and the alloy filament diameter is 0.18mm; Right atrium card and right ventricle card diameter are 30mm, and waist diameter is 20mm; The shape-memory alloy wire of wavy valve annulus is a sub-thread niti-shaped memorial alloy silk, and its alloy filament diameter is 0.25mm; Angle is 35 °-70 ° between adjacent two folding bent arcs of wavy valve annulus.
The invention has the beneficial effects as follows:
1, double plate shape support of the present invention forms with the shape-memory alloy wire braiding, therefore double plate shape cradle wall is thin submissive, compression easily, be convenient to insert conduit, simultaneously because Nitinol has the better elastic morphotropism, heart is when shrinking diastole, and support also can be out of shape thereupon, can avoid the complication such as conduction block of pressing lobe ring surrounding tissue to cause because of card.
2, double plate shape support of the present invention, the diameter of two cards is moderate, right room card has been avoided the excessive influence to the coronary sinus opening of diameter, right ventricle's card size to fit, can not have influence on moderator band, can not cause the right bundle branch conduction abnormalities, far away apart from supraventricular crest, can not have influence on the efferent tract of right ventricle.
3, valve material of the present invention is the pericardial tissue of animal, than external animal jugular vein lobe, draws materials easily, can avoid the restriction of animal jugular vein size arbitrarily according to the valve of the corresponding size of atrioventricular valve ring size design.
4, valve of the present invention is made up of the lobe leaf in valve annulus and pericardium source, lobe leaf sutured forms three first quarter moon holes that size is identical on valve annulus, so valve integral body is not yielding in operation, lobe leaf free edge is involutory all the time good, has guaranteed the good function of valve.
Description of drawings
Fig. 1 is an overall structure sketch map of the present invention;
Fig. 2 is the vertical view of Fig. 1;
Fig. 3 is a double plate shape supporting structure sketch map;
Fig. 4 is that wavy valve annulus structure is launched sketch map;
Fig. 5 is the lobe impeller structure sketch map of valve;
Fig. 6 is a user mode sketch map of the present invention;
Fig. 7 is the sketch map of the lobe leaf of valve when opening.
The specific embodiment
Below in conjunction with specific embodiment, further set forth the present invention.Should be understood that these embodiment only to be used to the present invention is described and be not used in and limit the scope of the invention.Should be understood that in addition those skilled in the art can make various changes or modifications the present invention after the content of having read the present invention's instruction, these equivalent form of values fall within the application's appended claims institute restricted portion equally.
As Fig. 1,2, shown in 3, the present invention is by double plate shape support 1 and place the artificial valve 2 in it to form, double plate shape support 1 is formed by the shape-memory alloy wire braiding, be divided into right atrium card 1.1,1.3 3 parts of intermediary waist 1.2 and right ventricle card, wherein, right atrium card 1.1 is a distal end, 1.3 on right atrium card 1.1 and right ventricle dish all are bell mouth shape, and the horn mouth diameter is greater than middle waist 1.2 diameters, and waist 1.2 highly is half of waist 1.2 diameters, right atrium card 1.2 is identical with the diameter of right ventricle card 1.3, is fixed in AO after utilizing implantation.
Valve 2 is made up of wavy valve annulus 2.1 and lobe leaf 2.2, valve annulus 2.1 (shown in Figure 4) curves three circular arcs and forms a circle by shape-memory alloy wire is folding, be the SANYE flap, the diameter of wavy valve annulus 2.1 is identical with waist 1.2 diameters, crown height is highly identical with waist 1.2, and angle is 35 °-70 ° between adjacent two folding bent arcs of wavy valve annulus 2.1.
As shown in Figure 5, lobe leaf 2.2 is made into flexible flaps by the mammal pericardium that takes off the cell processing, and the mammal pericardium can be Cor Caprae seu ovis bag or Cor Sus domestica bag or other materials that is fit to.
Lobe leaf 2.2 adheres to its edge and uses suturing with thread management on the curved metal silk of wavy valve annulus 2.1, and another side is free, forms three first quarter moon holes, promptly makes valve 2; Wavy valve annulus 2.1 places the waist 1.2 of double plate shape support 1, and arc is protruding uses the waist 1.2 of suturing with thread management in double plate shape support 1 respectively to 1.1, three arcual middle parts of right ventricle card.
The shape-memory alloy wire of making double plate shape support 1 is the niti-shaped memorial alloy silk, and the shape-memory alloy wire of making wavy valve annulus 2.1 is a sub-thread niti-shaped memorial alloy silk.
When implanting, routinely double plate shape band valve Tricuspid valve support of the present invention is compressed in the conduit, utilize delivery sheath to deliver to the right atrioventricular orifice place again by jugular vein, discharge support, support resiles, right ventricle card 1.3 is clamped self tricuspid annulus with right atrium card 1.1 as the sandwich spline structure, and original tricuspid annulus is compressed between the double plate of support, and the pericardium valve in the support substitutes the function of former pathological changes valve.During heart contraction, the free edge of valve 2 is drawn close closure (shown in Figure 2) to the centre, the occlude blood heart that backflows.During diastole, the free edge of valve 2 is upwards dug and is opened (shown in Figure 7), and the atrium blood flow flows into through valve 2 from right atrium card 1.1 and enters ventricle (shown in Figure 6) from 1.3 outflows of right ventricle dish.
Embodiment:
Double plate shape support 1 usefulness niti-shaped memorial alloy silk is made, alloy filament diameter 0.18mm, weave with the netting mould earlier, after finishing, braiding utilizes the compacting of support mould again, heat treatment, typing at last, its right room face 1.1 diameters are 30mm, waist diameter 20mm, waist 1.2 long 10mm, chamber card 1.3 diameter 30mm again.
Wavy valve bracket 2.1 usefulness sub-thread niti-shaped memorial alloy silks are made, and alloy filament diameter 0.25mm utilizes lobe ring mould to be folded into three identical arc-shaped structures, arc length 28mm.Lobe leaf 2.2 is to pack work with fresh Cor Caprae seu ovis, remove surface impurity routinely, 0.25% trypsinization goes cell to handle, giving 0.6% glutaraldehyde soaked after 48 hours, PBS liquid washes repeatedly, the valve mould that utilization prepares, with pericardium be trimmed to three block sizes identical with lobe leaf valve bracket coupling.Be incorporated on the valve bracket of sub-thread nitinol alloy wire making needle gage 1mm with the 7-0PROLENE linear slit.Valve is placed the waist 1.2 of double plate shape support 1.2, and arc opening is protruding in the right ventricle of support card, with the 4-0PROLENE line with the valve bracket sutured in the waist 1.2 of double plate shape support 1.
Claims (7)
1. atrioventricular valve bracket of artificial valve of dual discal straps, by double plate shape support (1) with place the valve (2) in it to form, it is characterized in that, described double plate shape support (1) is formed by the super-elastic shape memory alloy wire braiding, and be divided into right atrium card (1.1), (1.3) three parts of intermediary waist (1.2) and right ventricle card, wherein, right atrium card (1.1) is a distal end, right atrium card (1.1) and right ventricle card (1.3) all are bell mouth shape, the horn mouth diameter is greater than middle waist (1.2) diameter, waist (1.2) highly is half of waist (1.2) diameter, right atrium card (1.1) is identical with the diameter of right ventricle card (1.3), is fixed in AO after utilizing implantation; Described valve (2) is made up of wavy valve annulus (2.1) and lobe leaf (2.2), wavy valve annulus (2.1) curves three circular arcs and forms a circle by shape-memory alloy wire is folding, be the SANYE flap, the diameter of wavy valve annulus (2.1) is identical with waist (1.2) diameter, crown height is highly identical with waist (1.2), lobe leaf (2.2) is made into flexible flaps by the animal pericardium that takes off the cell processing, lobe leaf (2.2) adheres to its edge and uses suturing with thread management on the curved metal silk of wavy valve annulus (2.1), another side is free, form three first quarter moon holes, promptly make valve (2); Wavy valve annulus (2.1) places the waist (1.2) of double plate shape support (1), and arc is protruding in right ventricle card (1.3), and the waist (1.2) of suturing with thread management in double plate shape support (1) used at three arcual middle parts respectively.
2. atrioventricular valve bracket of artificial valve of dual discal straps according to claim 1 is characterized in that, described lobe leaf (2.2) adopts the mammal pericardium.
3. atrioventricular valve bracket of artificial valve of dual discal straps according to claim 2 is characterized in that, described mammal pericardium is Cor Caprae seu ovis bag or Cor Sus domestica bag.
4. atrioventricular valve bracket of artificial valve of dual discal straps according to claim 1 is characterized in that, the shape-memory alloy wire of described double plate shape support (1) is the niti-shaped memorial alloy silk, and the alloy filament diameter is 0.18mm.
5. atrioventricular valve bracket of artificial valve of dual discal straps according to claim 1 is characterized in that, described right atrium card (1.1) and right ventricle card (1.3) diameter are 30mm, and waist (1.2) diameter is 20mm.
6. atrioventricular valve bracket of artificial valve of dual discal straps according to claim 1 is characterized in that, the shape-memory alloy wire of described wavy valve annulus (2.1) is a sub-thread niti-shaped memorial alloy silk, and its alloy filament diameter is 0.25mm.
7. atrioventricular valve bracket of artificial valve of dual discal straps according to claim 1 is characterized in that, angle is 35 °-70 ° between adjacent two folding bent arcs of described wavy valve annulus (2.1).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2007100440143A CN101091675B (en) | 2007-07-19 | 2007-07-19 | Atrioventricular valve bracket of artificial valve of dual discal straps |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2007100440143A CN101091675B (en) | 2007-07-19 | 2007-07-19 | Atrioventricular valve bracket of artificial valve of dual discal straps |
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| Publication Number | Publication Date |
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| CN101091675A CN101091675A (en) | 2007-12-26 |
| CN101091675B true CN101091675B (en) | 2010-06-16 |
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| CN2007100440143A Expired - Fee Related CN101091675B (en) | 2007-07-19 | 2007-07-19 | Atrioventricular valve bracket of artificial valve of dual discal straps |
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| CN101091675A (en) | 2007-12-26 |
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