CN101849862B - Bougie conveying system used in transthoracic minimally invasive blockage repair of ventricular septal defect - Google Patents
Bougie conveying system used in transthoracic minimally invasive blockage repair of ventricular septal defect Download PDFInfo
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- CN101849862B CN101849862B CN2010101696676A CN201010169667A CN101849862B CN 101849862 B CN101849862 B CN 101849862B CN 2010101696676 A CN2010101696676 A CN 2010101696676A CN 201010169667 A CN201010169667 A CN 201010169667A CN 101849862 B CN101849862 B CN 101849862B
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- Prior art keywords
- bougie
- septal defect
- hard
- ventricular septal
- hard hollow
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- 208000001910 Ventricular Heart Septal Defects Diseases 0.000 title claims abstract description 20
- 201000003130 ventricular septal defect Diseases 0.000 title claims abstract description 20
- 210000000481 breast Anatomy 0.000 claims description 20
- 230000006698 induction Effects 0.000 claims description 19
- 238000003780 insertion Methods 0.000 claims description 9
- 230000037431 insertion Effects 0.000 claims description 9
- 208000002330 Congenital Heart Defects Diseases 0.000 abstract description 2
- 230000000903 blocking effect Effects 0.000 abstract description 2
- 230000001225 therapeutic effect Effects 0.000 abstract description 2
- 239000011148 porous material Substances 0.000 abstract 2
- 238000000034 method Methods 0.000 description 19
- 210000005240 left ventricle Anatomy 0.000 description 12
- 210000005241 right ventricle Anatomy 0.000 description 8
- 206010028980 Neoplasm Diseases 0.000 description 5
- 230000007812 deficiency Effects 0.000 description 4
- 239000007787 solid Substances 0.000 description 4
- 210000003813 thumb Anatomy 0.000 description 4
- 238000013459 approach Methods 0.000 description 3
- 239000008280 blood Substances 0.000 description 3
- 210000004369 blood Anatomy 0.000 description 3
- 230000017531 blood circulation Effects 0.000 description 2
- 238000007675 cardiac surgery Methods 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 210000003516 pericardium Anatomy 0.000 description 2
- 238000002604 ultrasonography Methods 0.000 description 2
- 241000167854 Bourreria succulenta Species 0.000 description 1
- 208000032843 Hemorrhage Diseases 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 235000019693 cherries Nutrition 0.000 description 1
- 210000000038 chest Anatomy 0.000 description 1
- 230000004087 circulation Effects 0.000 description 1
- 208000028831 congenital heart disease Diseases 0.000 description 1
- 239000002872 contrast media Substances 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 239000012467 final product Substances 0.000 description 1
- 238000002695 general anesthesia Methods 0.000 description 1
- 210000001503 joint Anatomy 0.000 description 1
- 238000002324 minimally invasive surgery Methods 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 230000005855 radiation Effects 0.000 description 1
- 210000001562 sternum Anatomy 0.000 description 1
- 238000002627 tracheal intubation Methods 0.000 description 1
- 230000002861 ventricular Effects 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
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Abstract
The invention discloses a novel bougie conveying system used in a transthoracic minimally invasive blockage repair of ventricular septal defect, which belongs to the field of minimally invasive surgical therapeutic devices of congenital heart diseases. The novel bougie conveying system consists of a hard hollow bougie, a soft guide wire, a conveying sheathing canal and a loading sheathing canal, wherein the inserting end of the hard hollow bougie is a round and smooth end socket, an axis pore passage is formed in the hard hollow bougie, and the soft guide wire can penetrate into the axis pore passage of the hard hollow bougie. Compared with the prior art, the bougie conveying system used in the transthoracic minimally invasive blockage repair of ventricular septal defect has the characteristics of simple operation, strong feasibility, high blocking success ratio and the like.
Description
Technical field
The present invention relates to congenital heart disease minimally invasive surgery therapeutic device field, specifically a kind of bougie induction system that is used for through breast Wicresoft shutoff ventricular septal defect (being called for short the chamber lacks) art.
Background technology
Adopting less invasive techniques directly to lack through breast shutoff chamber is the new technique that occurred in recent years.This technology has without extracorporeal circulation, and wound is little, and is painful little; Recover fast, the hospital stays is short, does not receive age limit; Need not roentgen radiation x and contrast agent, the dispose procedure controllability of stopper is good, and danger that blocking technology brings and complication can be launched characteristics such as rescue immediately on operating-table; But; The existing technology that lacks through breast Wicresoft shutoff chamber still has following deficiency: one of which, existing induction system need six parts such as the trocar, seal wire, expansion sheath pipe, delivery sheath, loading sheath pipe and butt joint knob, and operation consumptive material use amount is big; Its two, the course of conveying complex steps changes seal wire at the trocar, inserts expansion sheath pipe along seal wire, changes in the delivery sheath process again, and is hemorrhage more; Its three, the blood flow that the chamber lacks the place be from left ventricle to the right ventricle high velocity jet, and this specification requirement is operated through right ventricle, that is to say that soft seal wire will " be sailed against the current " could pass through the scarce entering in chamber left ventricle, navigability is poor, operating difficulties; Its four, the existing seal wire that utilizes is merely sought the method that the chamber lacks, soft seal wire receives the impact of inverse blood flow, it is indefinite to float, and lacks the process difficulty through the chamber.Wear out ventricle wall in the operating process, damage valvular danger.
In order to solve above-mentioned deficiency, the applicant designed a kind of " being used for the through conveyer device through breast Wicresoft shutoff ventricular septal defect art " (number of patent application: 201020014832.6).This technology is directly carried the delivery sheath inlet chamber with solid hard bougie and is lacked; Though overcome above-mentioned deficiency of the prior art to a certain extent, lack in the small-sized chamber of shutoff or the chamber lack membranous part tumor opening less (＜still have following problem 3mm) time: one of which because the hard bougie expands end and delivery sheath fit not tight (" step " arranged between hard bougie tip and delivery sheath); Often occur hard bougie head end (promptly expand end) inlet chamber lack; And the impenetrable problem of delivery sheath, it is shorter and smaller to add head end, enters not advance the chamber on earth to lack; Ultrasonicly can not make quite sure judgement, therefore just dare not firmly push carrier pipe and enter the room scarce; Its two, delivery sheath is harder, poor plasticity, when solid hard bougie carries delivery sheath and seeks the chamber and lack, the operation underaction.
Summary of the invention
Technical assignment of the present invention is the deficiency to above-mentioned prior art, provide a kind of simple to operate, feasibility strong, the shutoff success rate is high is used for the bougie induction system through breast Wicresoft shutoff ventricular septal defect art.
Technical assignment of the present invention is realized by following mode: be used for the bougie induction system through breast Wicresoft shutoff ventricular septal defect art; Constitute by hard hollow bougie, soft seal wire, delivery sheath and loading sheath pipe; The insertion end of said hard hollow bougie is slick and sly termination; Hard hollow bougie is provided with the duct, axle center, and said soft seal wire can penetrate the duct, axle center of hard hollow bougie.
Delivery sheath, load sheath pipe, soft seal wire structure and prior art in the structure of delivery sheath, loading sheath pipe, soft seal wire identical.
Operation can be provided with handle at the handheld terminal of hard hollow bougie for ease.
The external diameter of hard hollow bougie is preferably 0.8～3mm (like 1mm and 1.5mm etc.), and the axle center channel diameter is preferably 0.5～2mm (like 0.8mm and 1mm etc.).
Understand insertion depth for ease, can scale be set at hard hollow bougie middle part.
The insertion end of hard hollow bougie is preferably the slick and sly termination of protuberance, and the external diameter of the slick and sly termination of protuberance is 1～4mm.Preferred 1mm, 1.5mm, 2mm and four kinds of different models of 3mm.
Hard hollow bougie is preferably the plastic hollow bougie of hard.In the use, can the bougie insertion end be converted into certain radian, so that operation.
Be divided into child form (the about 10～20cm of total length, wherein the long 3cm of handle is good with total length 15～18cm) and two kinds of bougies of adult type (the about 15～25cm of total length, wherein the long 4cm of handle is good with total length 18～22cm) according to hard hollow bougie length difference.
Lack for bigger chamber, " being used for the through conveyer device through breast Wicresoft shutoff ventricular septal defect art " of applicant's design and of the present invention being used for can both lack than being easier to inlet chamber through the bougie induction system of breast Wicresoft shutoff ventricular septal defect art, accomplish shutoff.But, lack for less chamber, conveyer device of the present invention has bigger advantage, imbody in the following areas:
(1) in the operating process, hand-held merely hard hollow bougie operation is more flexible, light, explores more easily and insert the chamber to lack;
(2) after the bougie inlet chamber lacks, because left ventricular pressure power is high, have the BRB ejection in the duct immediately, the information that ability snatch bougie inlet chamber lacks;
(3) insert seal wire along the bougie duct and extract bougie and be easy to; Inlet chamber lacks with the seal wire ultrasonic development of left ventricle clear; When delivery sheath lacked opening part along the seal wire chamber of being inserted to, particularly under situation about meeting obstructions, the surgeon dared firmly to push the carrier pipe chamber of mistake and lacks into left ventricle;
(4) lack to merge patient thin, less membranous part tumor opening for big chamber; When bougie pushes up membranous part tumor surface; Sometimes difficultly judge whether bougie has got into that the chamber lacks or left ventricle; And send into soft system seal wire this moment along the bougie mesopore, if can get into left ventricle smoothly, explains that bougie has got into the chamber and lacked.If seal wire can not be sent into left ventricle along bougie, explain that bougie has pushed up on the membranous part tumor wall, need to lack the opening of membranous part tumor with the bougie chamber of exploration again, be more conducive to the doctor and make judgement and the subsequent operation that holds water;
When (five) operating, need only the opening that stops up hollow bougie handle end with thumb, can directly carry the carrier pipe inlet chamber and lack, have the same effect of solid hard bougie.
Description of drawings
Accompanying drawing 1 is the structural representation that is used for through the bougie induction system of breast Wicresoft shutoff ventricular septal defect art;
Accompanying drawing 2 is method for using sketch maps of soft seal wire and the plastic hollow bougie of hard in the induction system shown in Figure 1;
Accompanying drawing 3 is method for using sketch maps of soft seal wire and delivery sheath in the induction system shown in Figure 1;
Accompanying drawing 4 is delivery sheaths and the method for using sketch map that loads sheath pipe, push rod in the induction system shown in Figure 1.
The specific embodiment
Be used for through the bougie induction system of breast Wicresoft shutoff ventricular septal defect art do below at length explanation with specific embodiment to of the present invention with reference to Figure of description.
Embodiment:
Shown in accompanying drawing 1, of the present invention being used for through the bougie induction system of breast Wicresoft shutoff ventricular septal defect art by the plastic hollow bougie of hard 1, soft seal wire 2, delivery sheath 3 with load sheath pipe 4 and constitute.The insertion end of the plastic hollow bougie 1 of said hard is the slick and sly termination of protuberance; Handheld terminal is provided with handle 1-2; The middle part is provided with scale 1-3.The plastic hollow bougie 1 of hard is provided with duct, axle center 1-1.Soft seal wire 2 can penetrate duct, the axle center 1-1 of the plastic hollow bougie 1 of hard.
Be divided into child form (the about 10～20cm of total length, wherein the long 3cm of handle is good with total length 15～18cm) and two kinds of bougies of adult type (the about 15～25cm of total length, wherein the long 4cm of handle is good with total length 18～22cm) according to the plastic hollow bougie of hard length difference.The diameter of the plastic hollow bougie of hard is 1mm or 1.5mm; The diameter in duct, axle center is 0.8mm or 1mm; The external diameter of the slick and sly termination of protuberance is 1mm, 1.5mm, 2mm or 3mm.
Like accompanying drawing 2,3, shown in 4, specific operation process is:
The patient gets dorsal position, and after general anesthesia, tracheal intubation, with size and the position that the transesophageal ultrasonography measuring cell lacks, selected stopper model is included in and loaded the sheath pipe, and is subsequent use.Otch and entering pericardium process are technological identical with in the past, and promptly the little otch of breastbone center hypomere is about 2.5～5cm, and vertical bone hypomere 1/3 right against the chest cuts pericardium, suspention.The 1mg/kg heparinization behind the selected right ventricle point of puncture, is made " U " font mattress suture with 5-0 or 4-0Prolene band pad line in this place, and it is subsequent use that suture passes control blood sleeve pipe.
Lack the plastic hollow bougie 1 of hard that size is selected respective model according to the chamber.With sharp knife puncture right ventricle wall, rapidly the plastic hollow bougie 1 of hard is inserted the right ventricle chamber in central authorities that " U " word is sewed up, tighten up control blood sleeve pipe.The right hand is held bougie handle 1-2, and thumb is blocked the handle end of duct, axle center 1-1, under the transesophageal ultrasonography monitoring, the plastic hollow bougie of hard insertion chamber 1 is lacked, and gets into left ventricle.This moment, the handle end perforate of bougie had cherry blood ejection (if inlet chamber lacks the process difficulty, also can extract bougie 1, be inserted into the curved certain radian of end and send into, it is easier to make the chamber lack process) when removing thumb.Rapidly with the axle center duct 1-1 insertion left ventricle (like accompanying drawing 2) of soft seal wire 2 along bougie 1.
Extract the plastic hollow bougie 1 of hard, keep soft seal wire 2 in the chamber lacks.According to the size of selected stopper, select the delivery sheath 3 of respective model, delivery sheath 3 is inserted right ventricle along soft seal wire 2, lack through the chamber and send into left ventricle (like accompanying drawing 3).
Extract soft seal wire 2, fixedly delivery sheath 3 in the chamber lack with left ventricle in.Be threaded onto stopper on the push rod 5, and it is drawn in loading sheath pipe 4.To load sheath pipe 4 and dock, and push stopper and go into delivery sheath 3 (like accompanying drawing 4) with delivery sheath 3.Handle push rod 5 and delivery sheath 3, lack expansion, screens and the release that left and right ventricle both sides are accomplished the left and right umbrella of stopper successively in the chamber.Withdraw from push rod 5 and delivery sheath 3, ligation right ventricle suture is accomplished operation.
Can also directly utilize the plastic hollow bougie of hard to carry the delivery sheath inlet chamber for the scarce bigger patient in chamber and lack, an opening that only needs in the operating process to stop up duct, bougie axle center handle end with hand thumb gets final product.The method need not used seal wire, can further reduce medical treatment consumptive materials.Concrete operation method is with to utilize solid bougie to carry the method that the delivery sheath inlet chamber lacks identical.
Induction system of the present invention can also be applied to following aspect:
Carry out the scarce shutoff in chamber from left parasternal approach for cardiac surgery or cross-section breastbone;
The parasternal approach for cardiac surgery through the right side is carried out the chamber from right atrium-Tricuspid valve approach and is lacked shutoff;
Employing is under the breast ultrasonic guidance, through breast Wicresoft shutoff ventricular septal defect.
Claims (6)
1. be used for bougie induction system through breast Wicresoft shutoff ventricular septal defect art; It is characterized in that: constitute by hard hollow bougie, soft seal wire, delivery sheath and loading sheath pipe; The insertion end of said hard hollow bougie is slick and sly termination; Hard hollow bougie is provided with the duct, axle center, and said soft seal wire can penetrate the duct, axle center of hard hollow bougie.
2. the bougie induction system that is used for through breast Wicresoft shutoff ventricular septal defect art according to claim 1 is characterized in that the handheld terminal of said hard hollow bougie is provided with handle.
3. the bougie induction system that is used for through breast Wicresoft shutoff ventricular septal defect art according to claim 1 and 2, the external diameter that it is characterized in that said hard hollow bougie is 0.8～3mm, axle center channel diameter 0.5～2mm.
4. the bougie induction system that is used for through breast Wicresoft shutoff ventricular septal defect art according to claim 1 and 2 is characterized in that said hard hollow bougie middle part is provided with scale.
5. the bougie induction system that is used for through breast Wicresoft shutoff ventricular septal defect art according to claim 1 and 2 is characterized in that the slick and sly termination of the insertion end of said hard hollow bougie for protuberance, and the external diameter of the slick and sly termination of protuberance is 1～4mm.
6. the bougie induction system that is used for through breast Wicresoft shutoff ventricular septal defect art according to claim 1 and 2 is characterized in that said hard hollow bougie is the plastic hollow bougie of hard.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2010101696676A CN101849862B (en) | 2010-05-12 | 2010-05-12 | Bougie conveying system used in transthoracic minimally invasive blockage repair of ventricular septal defect |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2010101696676A CN101849862B (en) | 2010-05-12 | 2010-05-12 | Bougie conveying system used in transthoracic minimally invasive blockage repair of ventricular septal defect |
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| Publication Number | Publication Date |
|---|---|
| CN101849862A CN101849862A (en) | 2010-10-06 |
| CN101849862B true CN101849862B (en) | 2012-07-04 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN2010101696676A Expired - Fee Related CN101849862B (en) | 2010-05-12 | 2010-05-12 | Bougie conveying system used in transthoracic minimally invasive blockage repair of ventricular septal defect |
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Families Citing this family (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9445797B2 (en) * | 2012-09-13 | 2016-09-20 | Medtronic, Inc. | Percutaneous atrial and ventricular septal defect closure device |
| CN203169800U (en) * | 2013-04-25 | 2013-09-04 | 潘湘斌 | Treatment guide device |
| CN109223071B (en) * | 2018-10-30 | 2024-06-14 | 重庆医科大学附属第三医院(捷尔医院） | Minimally invasive surgery septal defect exposure device and method |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101172048A (en) * | 2007-09-07 | 2008-05-07 | 邢泉生 | Transthoracic minimally invasive heart ventricular septal defect plugging device conveying system and method thereof |
| CN101496730A (en) * | 2008-02-02 | 2009-08-05 | 先健科技(深圳)有限公司 | Flexible releasing conveying system |
| CN101554343A (en) * | 2009-04-14 | 2009-10-14 | 上海英诺伟医疗器械有限公司 | Method for blocking up obstacle in coelom and blocking device thereof |
| CN201642418U (en) * | 2010-05-12 | 2010-11-24 | 李红昕 | Bougie conveying system for transthoracic minimally invasive closure of ventricular septal defect |
-
2010
- 2010-05-12 CN CN2010101696676A patent/CN101849862B/en not_active Expired - Fee Related
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101172048A (en) * | 2007-09-07 | 2008-05-07 | 邢泉生 | Transthoracic minimally invasive heart ventricular septal defect plugging device conveying system and method thereof |
| CN101496730A (en) * | 2008-02-02 | 2009-08-05 | 先健科技(深圳)有限公司 | Flexible releasing conveying system |
| CN101554343A (en) * | 2009-04-14 | 2009-10-14 | 上海英诺伟医疗器械有限公司 | Method for blocking up obstacle in coelom and blocking device thereof |
| CN201642418U (en) * | 2010-05-12 | 2010-11-24 | 李红昕 | Bougie conveying system for transthoracic minimally invasive closure of ventricular septal defect |
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| CN101849862A (en) | 2010-10-06 |
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