CN103431931B - Lung arterial support and there is the pulmonary artery valve replacement device of this lung arterial support - Google Patents
Lung arterial support and there is the pulmonary artery valve replacement device of this lung arterial support Download PDFInfo
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- CN103431931B CN103431931B CN201310257705.7A CN201310257705A CN103431931B CN 103431931 B CN103431931 B CN 103431931B CN 201310257705 A CN201310257705 A CN 201310257705A CN 103431931 B CN103431931 B CN 103431931B
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- 210000004072 lung Anatomy 0.000 title claims abstract description 54
- 210000001147 pulmonary artery Anatomy 0.000 title claims abstract description 39
- 238000005452 bending Methods 0.000 claims abstract description 4
- 239000011800 void material Substances 0.000 claims description 9
- 230000017531 blood circulation Effects 0.000 abstract description 14
- 210000004204 blood vessel Anatomy 0.000 abstract description 11
- 230000004888 barrier function Effects 0.000 abstract description 7
- 230000000694 effects Effects 0.000 abstract description 7
- 210000005241 right ventricle Anatomy 0.000 description 8
- 230000002861 ventricular Effects 0.000 description 5
- 241000282894 Sus scrofa domesticus Species 0.000 description 4
- 230000018109 developmental process Effects 0.000 description 4
- 238000006073 displacement reaction Methods 0.000 description 4
- 230000006698 induction Effects 0.000 description 4
- 230000002685 pulmonary effect Effects 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 240000007643 Phytolacca americana Species 0.000 description 3
- 235000009074 Phytolacca americana Nutrition 0.000 description 3
- 206010037448 Pulmonary valve incompetence Diseases 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 201000010298 pulmonary valve insufficiency Diseases 0.000 description 3
- 208000002330 Congenital Heart Defects Diseases 0.000 description 2
- 206010011703 Cyanosis Diseases 0.000 description 2
- 208000031481 Pathologic Constriction Diseases 0.000 description 2
- 210000000038 chest Anatomy 0.000 description 2
- 239000011247 coating layer Substances 0.000 description 2
- 208000028831 congenital heart disease Diseases 0.000 description 2
- 238000002513 implantation Methods 0.000 description 2
- 230000036262 stenosis Effects 0.000 description 2
- 208000037804 stenosis Diseases 0.000 description 2
- 230000001154 acute effect Effects 0.000 description 1
- 239000000654 additive Substances 0.000 description 1
- 230000000996 additive effect Effects 0.000 description 1
- 206010003119 arrhythmia Diseases 0.000 description 1
- 230000006793 arrhythmia Effects 0.000 description 1
- 210000000481 breast Anatomy 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 230000004087 circulation Effects 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 229910003460 diamond Inorganic materials 0.000 description 1
- 239000010432 diamond Substances 0.000 description 1
- 238000007599 discharging Methods 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 210000003191 femoral vein Anatomy 0.000 description 1
- 230000006870 function Effects 0.000 description 1
- 230000008717 functional decline Effects 0.000 description 1
- 230000012447 hatching Effects 0.000 description 1
- 210000005003 heart tissue Anatomy 0.000 description 1
- 238000001727 in vivo Methods 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 239000007769 metal material Substances 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 231100000915 pathological change Toxicity 0.000 description 1
- 230000036285 pathological change Effects 0.000 description 1
- 230000037361 pathway Effects 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 210000003102 pulmonary valve Anatomy 0.000 description 1
- 230000008439 repair process Effects 0.000 description 1
- 210000005245 right atrium Anatomy 0.000 description 1
- 230000007480 spreading Effects 0.000 description 1
- 208000021182 supravalvular pulmonary stenosis Diseases 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
- 238000011282 treatment Methods 0.000 description 1
- 210000000591 tricuspid valve Anatomy 0.000 description 1
Abstract
The invention discloses a kind of lung arterial support and there is the pulmonary artery valve replacement device of this lung arterial support, described lung arterial support, comprise the support rack of tubulose, and be connected to and support the axial two ends of rack and expanded radially be inflow segment and the outflow section of enlarging, the contiguous section position of flowing out of described support rack has the some first module lattice distributed around circumference, described outflow section is formed by around supporting the circumferential some positioning strips distributed successively of rack, the middle part of each positioning strip is towards outflow direction bending, the two ends of each positioning strip are connected with the summit of the first module lattice of two separately.Described pulmonary artery valve replacement device, comprises described lung arterial support, and is fixed on the prosthetic valve of described support rack inside.Lung arterial support of the present invention, not easily damages blood vessel, and less to the barrier effect of blood flow.
Description
Technical field
The present invention relates to technical field of medical instruments, particularly relate to a kind of lung arterial support and there is the pulmonary artery valve replacement device of this lung arterial support.
Background technology
The cyanotic congenital heart disease patient of stenosis of right ventricular outflow tract, needs to open breast heart under infant or child implement extracorporeal circulation in early days and entangles and control art.
Modal in the cyanotic congenital heart disease of stenosis of right ventricular outflow tract is Fa Luoshi tetra logy (TOF).Child medical center, Shanghai data display TOF operation most commonly encountered diseases people's age is 6 months ~ 3 years old, and this age level surgical patient accounts for 74% of total operation number.Classical operation comprises VSD and repairs, right ventricular outflow tract obstruction and pulmonary artery (lobe ring and valve) narrow releasing.
Usually, major part Fa Luoshi tetra logy merges supravalvular pulmonary stenosis (main pulmonary artery is narrow with pulmo arterial bifurcation), mainly to adopt from outflow tract of right ventricle (RVOT) across valve of pulmonary trunk to main pulmonary artery (MPA) and pulmo arterial bifurcation (LPA and RPA) sticking patch expansion urethroptasty.The display of child medical center, Shanghai data: in April, 1999 to 2011 year December, 1999,2000, calendar year 2001,2002,2003,2005,2007,2009,2011 total 9 years statistical number totally 1851 examples transferred in all TOF surgical patient records, wherein do this type of sticking patch expansion urethroptasty and had 1569 examples, account for sum 84.76%.
The sticking patch used in operation, can not comply with the growth of human body, is easy to produce narrow or valve pathological changes again, and with advancing age, the state of an illness can be more and more heavier.In addition, due to without valve, the concurrent serious pulmonary incompetence (PR) of postoperative meeting.The PR of severe can cause right ventricular volume load to roll up, and right ventricle chamber can be caused for a long time to expand in the past, and right ventricle shrinks ejection function decline thereupon, and patient moving tolerance obviously declines, and even occurs arrhythmia.The prompting of foreign study data is as right ventricle End-diastolic volume/body surface area (RV EDV Index) > 150ml/m
2time, patient even can die suddenly.Therefore, needs of patients accepts open chest surgery again and inserts new artificial lung arterial valve.But not only operating difficulty of more than secondary or secondary performing the operation is large, and has higher danger and mortality rate.
Application interventional treatments implanting pulmonary artery valve replacement device not only effectively terminates and Pulmonicly to backflow in a large number, improves lung tissue blood circulation and right ventricular function reaches therapeutic purposes, and avoids open chest surgery again.
Pulmonary artery valve replacement device of the prior art, the network be made up of memory metal material, and make in this support can unidirectional opening SANYE valve form, Figure 10 shows a kind of lung arterial support of existing pulmonary artery valve replacement device, in netted shape of a saddle cylindrical structure, network structure is made up of the rhombus of rule, this lung arterial support is positioned at the top that pulmonary artery is the rhombus of circumference distribution near the end, one end of pulmonary artery branch, sharp-pointed and fine and close, in support dispose procedure, blood vessel is very easily poked in sharp-pointed top, add operating difficulty and operation risk, this place's rhombus composition of lung arterial support is fine and close in addition, strong to the barrier effect of blood flow, have impact on Pulmonic blood flow to flow out to smoothly in pulmo arterial branch.
Summary of the invention
The invention provides a kind of lung arterial support, not easily blood vessel is damaged, and less to the barrier effect of blood flow.
A kind of lung arterial support, comprise the support rack of tubulose, and be connected to and support the axial two ends of rack and expanded radially be inflow segment and the outflow section of enlarging, the contiguous section position of flowing out of described support rack has the some first module lattice distributed around circumference, described outflow section is formed by around supporting the circumferential some positioning strips distributed successively of rack, the middle part of each positioning strip is towards outflow direction bending, and the two ends of each positioning strip are connected with the summit of the first module lattice of two separately.
After lung arterial support expands in human body, the radial support power of support (lung arterial support) can make it be fixed on blood vessel, now, the inflow segment of lung arterial support is positioned at outflow tract of right ventricle, and the section of outflow is positioned at the position of the contiguous pulmonary artery branch of main pulmonary artery substantially, inflow segment and outflow Duan Juncheng enlarging, not easily be shifted downwards with the motion of heart after lung arterial support is implanted, and the middle part of each positioning strip is all towards outflow direction bending, support can be made effectively to be supported on main pulmonary artery position.After particular design is carried out to outflow section, void region can be formed between positioning strip and support rack, and the two ends of positioning strip are connected with the summit of the first module lattice of two separately, not only the quantity of required positioning strip is few, and the area of void region is larger, reduce the resistance that support causes blood flow, what guarantee blood flow was unimpeded flows into pulmonary artery branch from main pulmonary artery, and the outflow section of this structure not easily pokes main pulmonary artery or pulmonary artery branch.
Preferably, described outflow section is less than or equal to inflow segment at support rack development length axially.Flow out section shorter at support rack development length axially, reduce further the barrier effect to blood flow, also effectively prevent and flow out section and to stab blood vessel.Preferably, described outflow section is 1:1 ~ 2.5 supporting rack development length axially with the ratio of inflow segment.
Usually, and the first module lattice quantity at interval is more between two first module lattice that positioning strip is connected, the area of void region is larger, but the steadiness of support location can be subject to certain impact, therefore, preferably, first module lattice are separated with between described two first module lattice separately.
Further preferred, each positioning strip and support between rack and surround void region, described void region is surrounded by the base of W shape and the top margin that limited by positioning strip, and the two ends of positioning strip are connected across the two-end-point place on W shape base.
The shape of first module lattice there is no strict demand, and can be rhombus, ellipse, irregularly shaped etc., because support is in compressive state before not discharging, be the compression performance improving support, first module lattice can adopt rhombus.
Preferably, described positioning strip is bent into obtuse angle or circular arc.Compare with right angle with acute angle, the positioning strip of obtuse angle or circular arc not easily pokes blood vessel, can more effectively avoid support to damage blood vessel.
Preferably, all positioning strips all wrap up rete.Rete can adopt Cor Sus domestica peplos or other soft films to make, and can positioning strip be avoided further to damage blood vessel.
Preferably, the bore of described inflow segment is greater than the bore flowing out section.Not only meet the physiological anatomic architecture of patient, can also prevent valve from flowing to main pulmonary artery.Be appreciated that this place's bore all with respective largest diameter place for benchmark.
Preferred further, the relative aperture of described outflow section and inflow segment is 1:1.05 ~ 1.5.
Preferably, the end of described inflow segment has the some second unit lattice around circumference distribution, and the quantity of second unit lattice is greater than positioning strip.The quantity of positioning strip is few, makes the structure of inflow segment sparse, weakens the barrier effect of support to blood flow.
For ease of being fixed in induction system by support, the summit of described second unit lattice is with connector.
Preferably, the summit of two second unit lattice that position is relative is with U-shaped latch fitting.Be easy to install, and U-shaped latch fitting is level and smooth, survivable outflow tract of right ventricle heart tissue structure.
Preferred further, the base of described U-shaped latch fitting is straight flange.
Present invention also offers a kind of pulmonary artery valve replacement device, comprise described lung arterial support, and be fixed on the prosthetic valve of described support rack inside.
Wherein, the support rack of described lung arterial support and the equal overlay film of inflow segment, can the weak link of Enforcement surgery sticking patch.
Prosthetic valve can make the inwall at lung arterial support, existing additive method also can be adopted to carry out installation and fix.
If there is no specified otherwise in the present invention, when describing the structure of lung arterial support and pulmonary artery valve replacement device, all refer to the structure under complete spreading state in human body.
The present invention carries out appropriate design to the lung arterial support especially section of outflow, avoids in the implantation process of support stab main pulmonary artery or pulmonary artery branch blood vessel, greatly reduces operating difficulty, evaded operation risk.
Lung arterial support of the present invention effectively reduces the barrier effect to blood flow, ensure that blood flow is unimpeded, and lung arterial support is installed firmly, and location is firmly not easily shifted in vivo.
Accompanying drawing explanation
Fig. 1 is the perspective view of lung arterial support of the present invention;
Fig. 2 is the front view of the lung arterial support shown in Fig. 1;
Fig. 3 is the upward view of the lung arterial support shown in Fig. 2;
Fig. 4 is the top view of the lung arterial support shown in Fig. 2;
Fig. 5 is the perspective view of one of them angle of pulmonary artery valve replacement device of the present invention;
Fig. 6 is the perspective view of another angle of pulmonary artery valve replacement device shown in Fig. 5;
Fig. 7 is the pulmonary artery valve replacement device front view shown in Fig. 5;
Fig. 8 is the pulmonary artery valve replacement device upward view shown in Fig. 7;
Fig. 9 is the pulmonary artery valve replacement device top view shown in Fig. 7;
Figure 10 is the structural representation of lung arterial support in prior art;
Wherein, 1-supports rack; 2-flows out section; 3-inflow segment; 4-positioning strip;
5-first module lattice; 6-second unit lattice; 7-U shape latch fitting; 8-prosthetic valve.
Detailed description of the invention
Below in conjunction with specific embodiment, the present invention is further explained.
Fig. 1 ~ Fig. 4 shows the structure of the present embodiment lung arterial support, comprises and supports rack 1, inflow segment 3 and flow out section 1.
Support rack 1 in a tubular form, be made up of continuous print rhombus, certainly also can be made up of oval, irregularly shaped, not strict requirement, as long as the support force and the compliance that ensure lung arterial support.The diameter and the length that support rack 1 can adopt stock size, also can customize targetedly according to the concrete condition of patient.
Outflow section 2 is connected to one end of support rack 1 axis and expanded radially is enlarging, and flowing out section 2 supporting rack development length axially with the ratio of inflow segment is 1:2.2.Support contiguous section 2 position of flowing out of rack 1 and have 12 the first module lattice 5 distributed around circumference, these first module lattice 5 assume diamond in shape.Flow out section 2 to be made up of six positioning strips 4, these six positioning strips 4 distribute successively around the circumference supporting rack 1, the two ends of each positioning strip 4 are all connected with the summit of two first module lattice 5 separately, first module lattice 5 are separated with between these two first module lattice 5 separately, the middle part of each positioning strip 4 is bent into obtuse angle towards outflow direction, and the angle at obtuse angle is 120 °.Thus, six void region are surrounded between positioning strip 4 and support rack 1.All positioning strips 4 all wrap up Cor Sus domestica coating layer, are only described (other positioning strip situations are identical with it) for example with a positioning strip in Fig. 1, fill the portion envelops Cor Sus domestica coating layer of hatching.
Inflow segment 3 is connected to the other end supporting rack 1 axis, inflow segment 3 also expanded radially is enlarging, with respective largest diameter place for benchmark, the bore of inflow segment 3 is greater than the bore flowing out section 2, and this inflow segment 3 is 1.3:1 with the relative aperture of outflow section 2, meets the physiological anatomic architecture of patient, inflow segment and outflow section play main supporting role, can be firm be positioned at implantation position, and support rack and can bear less distortion, be conducive to keeping desirable valve structure.
The end of inflow segment 3 has 12 second unit lattice 6 around circumference distribution, the area of second unit lattice 6 is greater than first module lattice 5, for ease of support installing in induction system, as shown in Figure 6, the summit of two second unit lattice 6 that position is relative does not show with in U-shaped latch fitting 7(Fig. 1 ~ 4), the base of this U-shaped latch fitting 7 is straight flange.
The present embodiment additionally provides a kind of pulmonary artery valve replacement device, as shown in Fig. 5 ~ Fig. 9, comprises lung arterial support and prosthetic valve 8.
Lung arterial support can adopt structure recited above, is the weak link of Enforcement surgery sticking patch, and the support rack 1 of lung arterial support and inflow segment 3 all overlay films, film can adopt Cor Sus domestica peplos, and the inside supporting rack 1 is sewed with prosthetic valve 8.
The lung arterial support of the present embodiment can adopt self-expansion type Ultimum Ti to make, and need not discharge valve, relieve patient ' s burden by foley's tube.For the displacement apparatus of valve of pulmonary trunk shown in Fig. 5, during use, valve of pulmonary trunk displacement apparatus is fixed in special induction system, first puncture femoral vein, induction system carries valve of pulmonary trunk displacement apparatus, from the entrance of blood vessel through postcava, right atrium, Tricuspid valve, right ventricle, walk to main pulmonary artery, pulmonary artery branch is adjusted to suitable position, pulmonary artery valve replacement device is discharged gradually, after lung arterial support expands in human body, the radial support power of support can make it be fixed on blood vessel, now, flow out the crossover sites that the enlarging of section positioning strip is positioned at the contiguous pulmonary artery branch of main pulmonary artery, prevent lung arterial support from gliding by cardiac motion signals influencing, the area of void region is large, guarantee blood flow is unimpeded, and the outflow section of this structure not easily pokes main pulmonary artery or pulmonary artery branch, reduce the barrier effect to blood flow.The inflow segment enlarging of lung arterial support is positioned at outflow tract of right ventricle, is not easily shifted after lung arterial support is implanted by the impact of blood flow.Obvious, when carrying out cusps of pulmonary valve displacement, also other operation pathway can be adopted.
Claims (10)
1. a lung arterial support, comprise the support rack of tubulose, and be connected to and support the axial two ends of rack and expanded radially be inflow segment and the outflow section of enlarging, the contiguous section position of flowing out of described support rack has the some first module lattice distributed around circumference, it is characterized in that, described outflow section is formed by around supporting the circumferential some positioning strips distributed successively of rack, the middle part of each positioning strip is towards outflow direction bending, and the two ends of each positioning strip are connected with the summit of the first module lattice of two separately.
2. lung arterial support as claimed in claim 1, is characterized in that, described outflow section is less than or equal to inflow segment at support rack development length axially.
3. lung arterial support as claimed in claim 1, it is characterized in that, each positioning strip and support between rack and surround void region, described void region is surrounded by the base of W shape and the top margin that limited by positioning strip, and the two ends of positioning strip are connected across the two-end-point place on W shape base.
4. lung arterial support as claimed in claim 1, is characterized in that, be separated with first module lattice between described two first module lattice separately.
5. lung arterial support as claimed in claim 1, it is characterized in that, described positioning strip is bent into obtuse angle or circular arc.
6. lung arterial support as claimed in claim 1, it is characterized in that, all positioning strips all wrap up rete.
7. lung arterial support as claimed in claim 1, is characterized in that, the bore of described inflow segment is greater than the bore flowing out section.
8. lung arterial support as claimed in claim 1, is characterized in that, the end of described inflow segment has the some second unit lattice around circumference distribution, and the quantity of second unit lattice is greater than positioning strip.
9. lung arterial support as claimed in claim 8, it is characterized in that, the summit of described second unit lattice is with connector.
10. a pulmonary artery valve replacement device, is characterized in that, comprises the lung arterial support as described in any one of right 1 ~ 9, and is fixed on the prosthetic valve of described support rack inside.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310257705.7A CN103431931B (en) | 2013-06-25 | 2013-06-25 | Lung arterial support and there is the pulmonary artery valve replacement device of this lung arterial support |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310257705.7A CN103431931B (en) | 2013-06-25 | 2013-06-25 | Lung arterial support and there is the pulmonary artery valve replacement device of this lung arterial support |
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| Publication Number | Publication Date |
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| CN103431931A CN103431931A (en) | 2013-12-11 |
| CN103431931B true CN103431931B (en) | 2015-10-28 |
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| CN201310257705.7A Active CN103431931B (en) | 2013-06-25 | 2013-06-25 | Lung arterial support and there is the pulmonary artery valve replacement device of this lung arterial support |
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Families Citing this family (8)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN104720936B (en) * | 2015-03-26 | 2017-07-07 | 杭州启明医疗器械有限公司 | Valve bracket using safety and the valve replacement device with the valve bracket |
| CN104720937B (en) * | 2015-03-26 | 2017-09-26 | 杭州启明医疗器械有限公司 | Reduce the valve bracket of reduction length and the valve replacement device with the valve bracket |
| US9895222B2 (en) * | 2015-08-17 | 2018-02-20 | Venus Medtech (Hangzhou) Inc. | Aortic replacement valve |
| CN105287051B (en) * | 2015-09-30 | 2017-10-10 | 复旦大学附属中山医院 | A kind of aortic valve prosthesis's loop system being implanted into through peripheral arterial approach |
| US10561495B2 (en) | 2017-01-24 | 2020-02-18 | 4C Medical Technologies, Inc. | Systems, methods and devices for two-step delivery and implantation of prosthetic heart valve |
| US11857441B2 (en) | 2018-09-04 | 2024-01-02 | 4C Medical Technologies, Inc. | Stent loading device |
| US11931253B2 (en) | 2020-01-31 | 2024-03-19 | 4C Medical Technologies, Inc. | Prosthetic heart valve delivery system: ball-slide attachment |
| CN113648533A (en) * | 2021-08-26 | 2021-11-16 | 复旦大学 | Transcatheter implanted flexible dual lumen accessory device for providing circulatory power to a Fontan patient |
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| CN103431931A (en) | 2013-12-11 |
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| COR | Change of bibliographic data | ||
| CP03 | Change of name, title or address | ||
| CP03 | Change of name, title or address |
Address after: 310051 311, 3 building, 2 building, 88 Jiangling Road, Binjiang District, Hangzhou, Zhejiang. Patentee after: Hangzhou Qiming Medical Devices Co., Ltd. Address before: 310000 East Building 201, Tax Youyou Building, 3738 Nanhuan Road, Binjiang District, Hangzhou City, Zhejiang Province Patentee before: Hangzhou Qiming Medical Device Co., Ltd. |