CN101926663A - Conveyor for J-shaped muscular ventricular septal defect amplatzer - Google Patents
Conveyor for J-shaped muscular ventricular septal defect amplatzer Download PDFInfo
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- CN101926663A CN101926663A CN 201010258582 CN201010258582A CN101926663A CN 101926663 A CN101926663 A CN 101926663A CN 201010258582 CN201010258582 CN 201010258582 CN 201010258582 A CN201010258582 A CN 201010258582A CN 101926663 A CN101926663 A CN 101926663A
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- septal defect
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Abstract
The invention provides a conveyor for a J-shaped muscular ventricular septal defect amplatzer, which can help quickly and safely release an amplatzer in a heart operation. The conveyor is characterized in that: the conveyor is made of a hollow smooth metallic tube bent at an angle; the head end(the exit) is of J-shaped bending, the bending angle is between 75 and 100 degrees, the length after bending is 2 to 5 centimeters, and the length before bending is 15 to 25 centimeters; the hollow inner diameter is 4 to 8 millimeters; and the tail end(the entrance) is a wing-shaped handle, and the direction of the handle is the same as the bending direction of the head end. The conveyor releases the amplatzer mainly in a pulling mode, and the disposable conveyor is made of a plastic guide tube, and internally lined with metallic wires, which makes the head end conveniently bent, the angle is changed according to the shape of the heart, so that the conveyor can adapt to the patients with various heart shapes. The conveyor can visually release the amplatzer in the narrow heart ventricle, thereby solving the problem that the straight type amplatzer conveyor can be bent so as to adapt to various hearts, saving occluding time, ensuring firm and stable occluding, avoiding cut of the heart ventricle and the like.
Description
Affiliated technical field:
The present invention relates to a kind of muscular ventricular septal defect stopper conveyer device, especially can accessory heart in the operation fast, the safe release stopper.
Background technology:
Ventricular septal heart defect is common congenital heart disease, at neonate sickness rate about 0.2%, account for the cardiopathic 20%-30% of child, in ventricular septal defect, part is a muscular ventricular septal defect, it is damaged mostly to be " the Swiss Cheese sample " that be positioned at girder portion greatly, and part is that the efferent tract pars muscularis is damaged and inflow road pars muscularis is damaged.Because heart is the circular cone build, girder portion is positioned at the tip of heart, and the space is narrow and small, is difficult for finding, is difficult to sew up.Merge the patient of multiple ventricular septal defects, often a bigger ventricular septal defect can be arranged in the film perimembranous.
During operation on heart; for needs to Cardioprotective; need reduce the damage of cardiac incision as far as possible; the operative incision more options right atrium otch of ventricular septal defect repair; can expose most of film perimembranous ventricular septal defects fully; but because muscular ventricular septal defect is general and film perimembranous ventricular septal defect is separated by more than 1 to 2 centimeter, lay respectively at the apex of the heart, flow into road, three directions of efferent tract.Therapeutic Method the earliest is at the most important left ventricle otch of human body, seeking ventricular septal defect mouth sticking patch at the left ventricle face repairs, but postoperative is because the damage of left ventricle otch, patient tends to take place left heart sorrow and exhausts, mortality rate is up to 50%, for avoiding this fatal complication, the doctor from the puncture of right ventricle otch, uses straight shape to get involved puncture needle and sheath pipe by the blood vessel interventional technique when heart beating at present, use and push seal wire, put into Amplatzer shutoff umbrella, in the sheath pipe, push the shutoff umbrella with rigid steel wire, arrive left chamber face after, return the sheath pipe and discharge left chamber face umbrella, after blocking interventricular septum, continue to return the sheath pipe, discharge right ventricle's face umbrella, two umbrellas folder closes, and reaches the purpose of close chamber's septal defect.Someone attempts not cutting ventricle, by right room otch, attempt straight shape sheath canal curvature is placed the shutoff umbrella, but, at first to use steel wire to do guiding, the first level of straight shape stopper is entered the right ventricle by right room, turn to 90 degree then downwards, enter left chamber, because angle of bend often surpasses 90 degree, rigid straight shape pusher can't be crooked, the direction of inlet chamber septal defect tilts often, be not operation under direct-view when discharging left chamber face umbrella, operation is wasted time and energy, and often causes contusion, perforation and the failure of release shutoff umbrella of cardiac muscle.
Summary of the invention:
The inventor invents a kind of bending delivery device, and tractive discharges the method for stopper, overcome the above problems fully, eliminate ventricle otch and wound, drawback such as time-consuming, only need a kind of apparatus, finish inserting of Amplatzer shutoff umbrella, only need conventional atrium otch, can all muscular ventricular septal defects of shutoff.
This device is mainly made by the smooth metallic conduit of a kind of hollow of particular curve.Head end (outlet) is the bending of " J " shape, and angle of bend is 75 to spend between 100 degree, and the length of crooked back (pass interventricular septum and arrive the left ventricle part) is 2 to 5 centimeters, crooked before the craspedodrome partial-length be the 15-25 centimetre.Inner hollow diameter 4-8mm.This device tail end (inlet) is the wing handle, it settles the orientation consistent with head end sweep direction, and energy is as the handle of controlling, rotate this device, but perforate makes marks on the handle of bending direction, with the guide of this perforate as bending direction, this device as " Figure of description one ".Its disposable (ONE USE) but disposal type is a plastic conduit, but the moulding silk of interior lining metal so that suitable crooked head end, or changes the carrier shape according to heart shape, at any time to adapt to different patients' heart shape, as " Figure of description two ".Bury moulding tinsel in the plastic conduit wall, sectional view is as " Figure of description three ".
The specific embodiment: the technical solution adopted for the present invention to solve the technical problems is as follows:
" J " shape muscular ventricular septal defect stopper conveyer device operational approach.
One, stopper is prepared
Use silk thread that AMPLATZER shutoff umbrella two ends are connected, conventional Amplatzer shutoff umbrella can directly use garden pin band silk suture knotting, and (left chamber face silk thread is slip-knot, the convenient dismounting), Amplatzer shutoff umbrella can extend after guaranteeing tractive two silk threads, the state in the shutoff umbrella income sheath pipe can occur.The silk thread that will be connected with left chamber face penetrates from " J " shape muscular ventricular septal defect stopper inlet, pass after the head end outlet, elongate Amplatzer shutoff umbrella, Amplatzer shutoff umbrella is drawn in " J " shape muscular ventricular septal defect stopper, in the head end outlet after Amplatzer shutoff umbrella being pulled to bending (keeping the recovery state), the silk thread that connects two umbrella covers of Amplatzer shutoff umbrella by pulling, try and pull out two umbrella covers that discharge Amplatzer shutoff umbrella respectively, guarantee to discharge, reclaim smoothly.As " Figure of description four "
Two, set up left and right ventricles guiding " passage "
After the conventional extracorporeal circulation, right atrium otch, cardiac arrest state, the tractive tricuspid orifice, by film perimembranous ventricular septal defect or interatrial septum otch, pass mitral orifice, detect muscular ventricular septal defect the position and with the relation of left ventricle, papillary muscles of right ventricle and chordae tendineae.Use right angle forceps by detecting the position of muscular ventricular septal defect, from a muscular ventricular septal defect of maximum, right angle forceps is leant out right ventricle, clamp another guiding silk thread under the direct-view, to guide silk thread after right ventricle's face ventricular septal defect opening is introduced ventricular septal defect, to pass from the left ventricle face, pull out outside the heart, set up left and right ventricles guiding " passage ".As " Figure of description five "
Three, connect stopper
With the left and right ventricles guide line that passes ventricular septal defect with prepare after stopper right ventricle face umbrella connecting line be connected.As " Figure of description six "
Four, insert " J " shape muscular ventricular septal defect stopper conveyer device
1, along setting up good left and right ventricles guiding " passage ", utilize its silk thread traction, from the perimembranous ventricular septal defect mouth, in the walking of left chamber, put into " J " shape muscular ventricular septal defect stopper conveyer device, behind muscular ventricular septal defect, outlet is passed muscular ventricular septal defect, this carrier arrives right ventricle.Check that left and right ventricles does not all have valve, chordae tendineae or papillary muscles with conveyer device and guide silk thread tractive mutually.As " Figure of description seven "
2, smaller for heart, or perimembranous ventricular septal defect and muscular ventricular septal defect are at a distance of too near, unfavorable placement carrier, also can look at straight down and place stopper, after head end enters muscular ventricular septal defect from right ventricle towards left ventricle from right ventricle, enter left chamber tailing edge stopper bending point rotation head end, make head end point to the Bicuspid valve opening direction, chamber, tractive left side face umbrella, wait for that left chamber face umbrella discharges after, return carrier, left chamber face umbrella blocks interventricular septum.Hold left chamber face guiding silk thread subsequently, discharge right ventricle's face umbrella, last two the guiding silk threads that are sewn on the Amplatzer shutoff umbrella of removing successively.As " Figure of description eight "
Five, discharge Amplatzer shutoff umbrella
Left hand is controlled " J " shape muscular ventricular septal defect stopper conveyer device, utilization is connected the guiding silk thread at Amplatzer shutoff umbrella two ends, right hand tractive right ventricle face guiding silk thread, discharge right ventricle's umbrella of Amplatzer shutoff umbrella at right ventricle's face, hold right ventricle's face guiding silk thread subsequently, withdraw from carrier,, seek and visit valve, chordae tendineae and papillary muscles not damaged and tractive after the release respectively at the left chamber umbrella of left chamber face release Amplatzer shutoff umbrella.As " Figure of description nine "
If six to detect shutoff umbrella waist littler than muscular ventricular septal defect, can sew up with the gap zone pad and dwindle damaged mouthful, and be fixed on the stopper waist, film perimembranous ventricular septal defect can use conventional method to repair.
This real beneficial effect of the invention is: static lower at heart, in narrow and small ventricle, direct-view discharges the Amplatzer plugging umbrella, solving straight shape plugging umbrella conveying device can not the crooked drawback that adapts to different hearts, avoid a plurality of damaged mouthful one by one seams is closed, simplified the shutoff step, save the shutoff time, and can guarantee that shutoff is firm and stable, avoid the otch of ventricle etc. The method that tractive discharges the Amplatzer plugging umbrella has changed traditional steel wire guiding, hard straight steel wire pushes the mode that discharges, and avoids the damage to cardiac muscle, makes the shutoff of muscular ventricular septal defect simple, and effectively.
Description of drawings
The present invention is further described below in conjunction with drawings and Examples.
Fig. 1 is: structure chart of the present invention.1. tail end (inlet) is 2. located the wing handle, 3. corner, 4. head end (outlet)
Fig. 2 is: " J " but shape muscular ventricular septal defect stopper send conveying device disposable disposal type structural map.Dotted line buries moulding tinsel in being
Fig. 3 is: Fig. 2 " J " but shape muscular ventricular septal defect stopper send the disposable disposal type of conveying device cross section structural map.
Fig. 4 is: Amplatzer shutoff umbrella is taken in photo in kind of the present invention
Fig. 5 is: damaged and damaged of pars muscularis is set up the practical operation photo of silk thread " guide passage " in heart film week
Fig. 6 is: with the practical operation photo that is connected with " guide passage " silk thread after Amplatzer shutoff umbrella income apparatus of the present invention
Fig. 7 is: the 1. sketch map of multiple ventricular septal defects
2. " J " shape muscular ventricular septal defect stopper send conveying device from film week damaged enter left ventricle after, head end is worn back right ventricle, is convenient to release right ventricle face umbrella earlier
Fig. 8 is:. " J " shape muscular ventricular septal defect stopper send conveying device from pars muscularis is damaged enter left ventricle after, by the rotation plugging device, the head end opening is pointed to the mitral orifice direction, so that chamber, tractive left side face umbrella discharges left ventricle face umbrella earlier.
Fig. 9 is: 1. Amplatzer shutoff umbrella discharges the damaged sketch map of back shutoff pars muscularis
2. Amplatzer shutoff umbrella discharges the damaged ultrasonic examination photo of back shutoff pars muscularis
Figure 10 is: the shutoff umbrella discharges the principle exploded view, and arrow is the direction of tractive.
Claims (5)
1. the present invention relates to a kind of " J " shape muscular ventricular septal defect stopper conveyer device, especially can accessory heart in the operation fast, the safe release stopper.It is characterized in that: this device is mainly made by the smooth metallic conduit of a kind of hollow of particular curve, change the carrier shape according to heart shape, to adapt to different patients' heart shape, head end (outlet) is the bending of " J " shape, angle of bend be 75 spend to 100 the degree between, length after the bending is 2 to 5 centimeters, and crooked preceding craspedodrome partial-length is the 15-25 centimetre.Inner hollow diameter 4-8mm.This device tail end (inlet) is the wing handle, and it settles the orientation consistent with head end sweep direction, but perforate makes marks on the handle of bending direction, with the guide of this perforate as bending direction.Main " tractive " mode of using of this device discharges Amplatzer shutoff umbrella.
2. " J " according to claim 1 shape muscular ventricular septal defect stopper conveyer device head end (outlet) is the bending of " J " shape, angle of bend be 75 spend to 100 the degree between, length after the bending is 2 to 5 centimeters, and crooked preceding craspedodrome partial-length is the 15-25 centimetre.Inner hollow diameter 4-8mm.The head end bending can be made into 75 degree respectively according to different angles, 90 degree, fixed combination such as 100 degree.
3. the disposable conveyer device head end of " J " according to claim 1 shape muscular ventricular septal defect stopper can be a plastic production, and parcel can plasticity in the plastics copper or aluminum metal silk are so that change shape as required.
4. this device tail end (inlet) of " J " according to claim 1 shape muscular ventricular septal defect stopper conveyer device is the wing handle, it settles the orientation consistent with head end sweep direction, but perforate makes marks on the handle of bending direction, with the guide of this perforate as bending direction.
5. this device of " J " according to claim 1 shape muscular ventricular septal defect stopper conveyer device, main use " tractive " mode discharges Amplatzer shutoff umbrella the muscular ventricular septal defect in the ventricular septal defect of pilosity is carried out shutoff.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 201010258582 CN101926663A (en) | 2010-08-15 | 2010-08-15 | Conveyor for J-shaped muscular ventricular septal defect amplatzer |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 201010258582 CN101926663A (en) | 2010-08-15 | 2010-08-15 | Conveyor for J-shaped muscular ventricular septal defect amplatzer |
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| CN101926663A true CN101926663A (en) | 2010-12-29 |
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| CN 201010258582 Pending CN101926663A (en) | 2010-08-15 | 2010-08-15 | Conveyor for J-shaped muscular ventricular septal defect amplatzer |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108209984A (en) * | 2018-01-12 | 2018-06-29 | 上海交通大学医学院附属上海儿童医学中心 | For the guide wire of muscular ventricular septal defect Hybrid therapy and its positioning and conveying device |
| CN112401947A (en) * | 2020-11-24 | 2021-02-26 | 李建朝 | Spherical ball structure plugging device for extracardiac operation and use method thereof |
| CN113558681A (en) * | 2021-07-26 | 2021-10-29 | 宁波市第一医院 | Adjustable-bending left atrial appendage occluder conveying system and using method |
| CN114305535A (en) * | 2021-12-29 | 2022-04-12 | 武汉大学中南医院 | Device suitable for patients with patent foramen ovale |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN2780121Y (en) * | 2005-04-19 | 2006-05-17 | 解启莲 | Interventricular diaphragm peripheral defect sealing device |
| CN201012089Y (en) * | 2007-03-12 | 2008-01-30 | 金磊 | Plugging tool conveyer for heart surgery |
| 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 |
| CN201101545Y (en) * | 2007-09-07 | 2008-08-20 | 邢泉生 | Conveyer for heart septal defect plugging device |
| CN101332101A (en) * | 2008-07-22 | 2008-12-31 | 广州知光生物科技有限公司 | Sella bottom hole blocking device |
-
2010
- 2010-08-15 CN CN 201010258582 patent/CN101926663A/en active Pending
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2780121Y (en) * | 2005-04-19 | 2006-05-17 | 解启莲 | Interventricular diaphragm peripheral defect sealing device |
| CN201012089Y (en) * | 2007-03-12 | 2008-01-30 | 金磊 | Plugging tool conveyer for heart surgery |
| 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 |
| CN201101545Y (en) * | 2007-09-07 | 2008-08-20 | 邢泉生 | Conveyer for heart septal defect plugging device |
| CN101332101A (en) * | 2008-07-22 | 2008-12-31 | 广州知光生物科技有限公司 | Sella bottom hole blocking device |
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108209984A (en) * | 2018-01-12 | 2018-06-29 | 上海交通大学医学院附属上海儿童医学中心 | For the guide wire of muscular ventricular septal defect Hybrid therapy and its positioning and conveying device |
| CN112401947A (en) * | 2020-11-24 | 2021-02-26 | 李建朝 | Spherical ball structure plugging device for extracardiac operation and use method thereof |
| CN112401947B (en) * | 2020-11-24 | 2023-08-08 | 李建朝 | Spherical structure plugging device for extracardiac operation and application method thereof |
| CN113558681A (en) * | 2021-07-26 | 2021-10-29 | 宁波市第一医院 | Adjustable-bending left atrial appendage occluder conveying system and using method |
| CN113558681B (en) * | 2021-07-26 | 2022-07-15 | 宁波市第一医院 | Bendable left atrial appendage occluder conveying system and using method |
| CN114305535A (en) * | 2021-12-29 | 2022-04-12 | 武汉大学中南医院 | Device suitable for patients with patent foramen ovale |
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Open date: 20101229 |