CN104706389B - A kind of far-end is apart from adjustable bifurcated catheter - Google Patents
A kind of far-end is apart from adjustable bifurcated catheter Download PDFInfo
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- CN104706389B CN104706389B CN201510136762.9A CN201510136762A CN104706389B CN 104706389 B CN104706389 B CN 104706389B CN 201510136762 A CN201510136762 A CN 201510136762A CN 104706389 B CN104706389 B CN 104706389B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
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Abstract
The invention discloses a kind of far-end is apart from adjustable bifurcated catheter, including the first conduit, the second conduit and be arranged on two connecting rods between the first conduit and the second conduit, described first conduit and the second conduit adjacent distal end part surround quadric chain with described two connecting rods, and at least one adjustable length in described two connecting rods is in order to change the spacing of the first conduit and the second conduit.Far-end of the present invention is apart from adjustable bifurcated catheter, can be according to the difference needs of mitral annuluses contract by distance, in adjustment bifurcated catheter, the far-end distance of the first conduit and the second conduit, reaches optimal mitral annuluses contractive effect, mitigates the mitral incompetence symptom of patient.
Description
Technical field
The present invention relates to medical instruments field, a kind of far-end of specific design is apart from adjustable bifurcated catheter.
Background technology
Mitral incompetence (mitral regurgitation, MR) is a kind of common valvular heart disease, one, the U.S.
Research display, in crowd, mitral incompetence total incidence is 21.3%, is divided into four grades according to mitral incompetence degree：Gently
（1+）, in（2+）, middle heavy（3+）And severe（4+）, prevalence respectively 19.2%, 1.6%, 0.3% and 0.2%.
Mitral incompetence is divided into organic mitral incompetence (Degenerative Mitral Regurgitation, DMR)
With functional mitral regurgitation (Functional Mitral Regurgitation, FMR) two types, wherein feature two
Cusp reflux accounts for 70%.Organic mitral incompetence is because what the organic infringement of valve caused, functional mitral regurgitation
It is primarily due to chamber enlargement, cause leaflet incompetence to cause.
For functional mitral regurgitation, surgical operation particularly Mit An is functional mitral regurgitation
（FMR）Traditional standard treatments, it mainly passes through to implant suture or annuluss, partially or completely surrounds and reduces two
Cusp ring, reaches minimizing functional mitral regurgitation（FMR）Purpose.However, many patients are multiple because of advanced age, weakness, merging
Other diseases, previously have out breast history etc. be not resistant to perform the operation and do not possess open chest surgery condition, this some patients just loses handss
The chance of art treatment.
In recent ten years, people develop a series of side of percutaneous interventional functional mitral regurgitations (FMR) in succession
Method, main include percutaneous mitral valve replacement, percutaneous carry out to mitral leaflet stepping up, percutaneous mitral annuloplasty.Its
Middle percutaneous mitral annuloplasty principle is close with surgically principle, and more conforms to mitral anatomical structure.
Mitralign company have developed Mitralign percutaneous mitral annulus according to surgery plastic surgery for mitral valve principle
Bicuspid valve back lobe annulus are shunk by way of percutaneous are intervened, so that front lobe and back lobe are closed up, are reached by formation system
Eliminate or reduce the purpose of mitral incompetence.
The mitral annuluses formation system of Mitralign company, mainly in the position of Bicuspid valve back lobe P1 and P3, respectively
Setting up two anchor points, then two anchor points being carried out shrink locking by special constriction device, thus reaching contraction lobe
The purpose of ring.In this approach, the distance of two anchor points determines the degree of annulus contraction, needs the degree according to reflux
Determined with position, needed by transesophageal ultrasonography（TEE）Carry out careful calculating with art in the preoperative, judge to obtain annulus
Required locking distance and anchor point position, then select the bifurcated catheter of corresponding specification, two Tip of bifurcated catheter far-end divide
Not corresponding with two anchor points of P1 or P3 position.Mitral annuluses girth can be shortened by 1～3cm by the method, thus
Reach the effect eliminating or reducing FMR.
In above-mentioned Bicuspid valve percutaneous interventional procedure, calculate locking distance and positioning anchor point is most important, its shadow
Ring subsequent procedures operation and surgical effect.In prior art, the location technology of anchor point mainly has two ways：Directly positioning with
Bifurcated catheter technological orientation.
The first direct location technology is transesophageal ultrasonography (TEE) ultrasonic measurement, according to patient's mitral incompetence degree etc.
Situation, is calculated mitral annuluses contract by distance and anchor point, and using two separate conduits, approach directly refers to respectively
Anchor point position to mitral annuluses.This mode is no mutually constrained due to the far-end of two conduits, and operator is importing the
During two conduits are directed at the second anchor point position, it is difficult to accurately reach the contract by distance of requirement, and can because of operation not
Just, multiple alignment function occurs, cause the multiple point of puncture of annulus of mitral valve and because operating time lengthens the patient suffering causing.
Second bifurcated catheter location technology is transesophageal ultrasonography（TEE）Measurement, according to patient's mitral incompetence degree etc.
Situation, is calculated mitral annuluses contract by distance and high frequency seal wire point of puncture, using bifurcated catheter approach, the two of bifurcated catheter
Between root conduit, composition quadric chain is connected by connection member, determine Bicuspid valve lobe positioned at the length of the connecting rod of far-end
The contract by distance of two anchor points of ring P1 or P3 position.Which operationally has very big compared with the first direct location technology
Improve, for example user can be operated according to the bifurcated catheter that contract by distance chooses dimension in the preoperative；But should
Mode, because being in the rod member that the connecting rod of far-end is a regular length, determines the limitation of its contract by distance application, such as, right
It is 19mm in mitral annuluses optimal retraction distance, and bifurcated catheter only has a limited number of kind of specification, respectively：10mm、14mm、
17mm and 21mm, doctor can only select bifurcated catheter 17mm or 21mm in operation process, thus can be because of locking apart from mistake
Little or excessive, postoperative mitral incompetence degree is improved inconspicuous（For example by FMR reflux degree, 4 grades are reduced to 3 grades）, or shrink journey
Spend big and cause mitral stenosis.Also likely to be present such situation, because operator calculates contract by distance mistake, operation process
In imported the relatively large or less bifurcated catheter of specification, operator this specification bifurcated catheter can only be withdrawn from after again
Import a new spec bifurcated catheter, cause using of apparatus to waste.It is likely to appear in mitral annuluses repair process
Need two positions to be carried out lock to repair, but because the locking distance at two locking positions is different, at least need two sets of difference rule
The bifurcated catheter of lattice, increases the expense of patient.
For the shortcoming existing for two kinds of prior arts, need the both convenient use person's operations of R ＆ D design one kind, but permissible
According to the needs of different mitral annuluses contract by distance, carry out the bifurcated catheter of far-end distance adjustment, effectively reduce the FMR of patient
Degree.
Content of the invention
The invention provides a kind of far-end is apart from adjustable bifurcated catheter, can according to mitral annuluses contract by distance not
With needing, adjust the distance of bifurcated catheter far-end, reach optimal mitral annuluses contractive effect, the Bicuspid valve mitigating patient is anti-
Stream symptom.
A kind of far-end apart from adjustable bifurcated catheter, including the first conduit, the second conduit and be arranged on the first conduit and
Two connecting rods between second conduit, described first conduit and the second conduit adjacent distal end part are connected with described two
Bar surrounds quadric chain, and at least one adjustable length in described two connecting rods is in order to change the first conduit and the second conduit
Spacing.
In bifurcated catheter, the far-end of the first conduit and the second conduit corresponds to the two of a certain mitral annuluses punctured position respectively
Individual anchor point, the spacing of two anchor points determines the distance of mitral annuluses contraction, using the technical scheme of present invention offer,
It is capable of the first conduit and the far-end spacing of the second conduit is adjustable, adapt to different mitral annuluses contract by distance needs.
Described two connecting rods include：
Length-adjustable head rod, two ends are connected with the first conduit and the second conduit respectively；
The second fixing connecting rod of length, one end is slidably matched with the first conduit, and the other end is connected with the second conduit, the
Slidably one end is connected with traction piece to two connecting rods.
Preferably, described head rod compares the second connecting rod closer to far-end.When so arranging, it is more convenient for adjusting
The far-end distance of the first conduit and the second conduit.
Described traction piece is the 3rd conduit being slidably located in outside the first conduit, described second connecting rod slidably
End is fixed on the far-end of the 3rd conduit.
Traction piece draws the 3rd conduit and slides along the first conduit, and projected length on head rod for second connecting rod changes
Become, head rod adjustment length, to adapt to the shift in position of the second connecting rod, is finally reached change the first conduit and second and leads
The purpose of tube pitch.
After the far-end spacing adjustment of the first conduit and the second conduit finishes, need position is locked it is preferable that described
The near-end of the first conduit and the 3rd conduit is provided with the retaining mechanism cooperating.
Described retaining mechanism includes：
It is connected to the 3rd catheter proximal end and the threaded block around the first conduit；
It is filled in the tensioning pad between threaded block and the first conduit；
With the gland of threaded block screw thread cooperation, a part for this gland is to extend into be used between threaded block and the first conduit
The axial projection of extruding tensioning pad.Described gland carries the flange being in threaded block outer rim, and this flange is provided with and threaded block
The screw thread of cooperation.
After the far-end spacing adjustment of the first conduit and the second conduit finishes, rotary gland, axial projection extrudes tensioning pad
Piece, fills up threaded block and the gap of the first conduit after making tensioning pad deformation, stop the axial direction between threaded block and the first conduit
Slide.
In order to indicate the spacing size of the first conduit and the second conduit it is preferable that described first conduit and the 3rd conduit set
There is the positioning indicating mechanism cooperating.
Described positioning indicating mechanism includes：
Be fixed on first supravasal at least two surely develop point；
It is fixed on the 3rd supravasal dynamic development point.
Described fixed development o'clock is along the axial arranging of the first conduit, according to the spacing needing setting fixed development point, described dynamic aobvious
Shadow point is fixed on the far-end of the 3rd conduit.Indicate that the first conduit and second is led by the relative position of dynamic development point and fixed development point
The spacing of pipe.
Instruction for the first conduit and the second conduit relative position and the locking of relative position, present invention also offers
Second embodiment, in second embodiment, the near-end of described bifurcated catheter is provided with the control for driving traction piece
Mechanism.
When described traction piece is three conduit being slidably located in outside the first conduit, controlling organization is arranged on described
The near-end of three conduits, for drawing the 3rd conduit.
Described controlling organization includes：
The handle fixing with described first conduit phase；
The slide block assembly fixed with described traction piece phase and be slidably matched with handle.
Slide assemblies opposite handle slides, and drives traction piece to slide relative to the first conduit（Described traction piece is that slip is sheathed
During three conduit outside in the first conduit, that is, the 3rd conduit is driven to slide relative to the first conduit）, adjustment the second connecting rod is the
Projector distance on one connecting rod direction, head rod accordingly changes length, reaches adjustment the first conduit and the second conduit is remote
The purpose of end spacing.
Described handle is tubulose, and, axially through handle, described first conduit is solid with handle afterbody phase for described first conduit
Fixed, described traction piece is penetrated in handle and is fixed with slide block assembly phase.Described handle is provided with axially disposed slideway, described cunning
Block assembly includes：
It is arranged on the first slide block in slideway, described traction piece is fixed on the first slide block；
It is arranged on the second slide block outside slideway, carry between the first slide block and the second slide block at the opening of described slideway
By clamping part；
It is connected to the clamping screw between the first slide block and the second slide block.Described handle is provided with for indicating slide block assembly
The graduation mark of position.
When needing to control traction piece to slide relative to the first conduit（Described traction piece is to be slidably located in outside the first conduit
During three conduits, that is, the 3rd conduit is controlled to slide relative to the first conduit）, stir the second slide block, the graduation mark on handle is used
In the position indicating the second slide block, when the second slide block moves extremely required scale, that is, show the first conduit and the second conduit
Far-end spacing be adjusted in place, rotational lock bolt, make the first slide block and the second slide block clamping be subject to clamping part, realize position lock
Fixed.
Described head rod includes be slidably connected bar and the slip nipple of activity grafting cooperation, and be slidably connected bar and cunning
The pipe that is dynamically connected passes through one of corresponding in the first conduit and the second conduit connection of connection unit respectively.The two ends of the second connecting rod
Pass through connection unit respectively to be connected with the first conduit and the swing of the 3rd conduit.
Described connection unit is to be fixed on the first conduit or the second supravasal circumferential band, the two ends of head rod with right
It is fixedly connected between the circumferential band answered.
Far-end of the present invention, apart from adjustable bifurcated catheter, can be adjusted according to the difference needs of mitral annuluses contract by distance
The far-end distance of the first conduit and the second conduit in whole bifurcated catheter, reaches optimal mitral annuluses contractive effect, mitigates and suffers from
The mitral incompetence symptom of person.
Brief description
Fig. 1 is the schematic diagram of the first embodiment apart from adjustable bifurcated catheter for the far-end of the present invention；
Fig. 2 a is the partial enlarged drawing in Fig. 1；
Fig. 2 b is the A portion enlarged drawing in Fig. 2 a；
Fig. 3 is the partial enlarged drawing in Fig. 1；
Fig. 4 and Fig. 5 is applied to the schematic diagram of mitral valve surgery for the bifurcated catheter in Fig. 1.
Fig. 6 is the schematic diagram apart from the second embodiment of adjustable bifurcated catheter for the far-end of the present invention；
Fig. 7 a is the partial enlarged drawing in Fig. 6；
Fig. 7 b is the B-B direction sectional view in Fig. 7 a；
Fig. 8 is applied to the schematic diagram of mitral valve surgery for the bifurcated catheter in Fig. 6.
Specific embodiment
Below in conjunction with the drawings and specific embodiments, the present invention is described in detail.Described in literary composition, near-end refers near behaviour
One end of author position, described far-end is the one end away from operator position.Hereinafter percutaneous mitral is applied to using the present invention
Bifurcated catheter is illustrated, those of ordinary skill in the art is it is to be understood that this bifurcated catheter is used for percutaneous two point as a example prothesiss
Lobe prothesiss are used only as illustrating, and are not limitation of the present invention, the bifurcated catheter of the present invention, are including but not limited to used for two points
Lobe prothesiss, tricuspid valve repair procedures, interatrial septum prothesiss and patent foramen ovale prothesiss.
Embodiment 1
As shown in figure 1, the bifurcated catheter 1000 of the present embodiment includes lead sheath tube assembly 1100, coupling assembly 1200 and lock
Tight mechanism 1300, lead sheath tube assembly 1100 forms quadrilateral structure, lock with coupling assembly 1200 in lead sheath tube assembly 1100 far-end
Tight mechanism 1300 is located at lead sheath tube assembly 1100 near-end.
Lead sheath tube assembly 1100 includes the first conduit 1110, the second conduit 1120, the 3rd conduit 1130 and sheath 1140.
Each part of lead sheath tube assembly 1100 all has near-end, far-end and the elongated tube chamber proximally extending to far-end.
First conduit 1110 and the second conduit 1120 have identical or different external diameter, internal diameter, length（I.e. external diameter, internal diameter,
Any one in length can be identical or different）；3rd conduit 1130 internal diameter is more than the first conduit 1110 external diameter, and the 3rd leads
Pipe 1130 length is less than the first conduit 1110 length.Sheath 1140 internal diameter is more than the second conduit 1120 external diameter and the 3rd conduit 1130
External diameter sum, sheath 1140 length is less than the first conduit 1110, the second conduit 1120, the length of the 3rd conduit 1130.
For example in the present embodiment, the first conduit 1110, the second conduit 1120 have identical specification, and external diameter is
0.85mm, internal diameter is 0.5mm, and length is 1500mm；3rd conduit 1130 external diameter is 1.23mm, and internal diameter is 0.88mm, and length is
1000mm；Sheath 1140 external diameter is 2.9mm, and internal diameter is 2.6mm, and length is 600mm.
First conduit 1110 is contained in the 3rd conduit 1130 tube chamber, and the 3rd conduit 1130 and the second conduit 1120 are contained in sheath
In 1140 tube chambers, can axially opposed move between each part of lead sheath tube assembly 1100, each part has good submissive
Performance, for example, can be formed through the sizing of high temperature hot melt using pebax material.
Coupling assembly 1200 is included head rod 1210, the second connecting rod 1220 and is fixed even with the first conduit 1110
Connection unit 1232 that the connection unit 1231 connecing is fixedly connected with the 3rd conduit 1130, fixing with the second conduit 1120 respectively
The connection unit 1233 connecting and connection unit 1234, connection unit 1233 compares connection unit 1234 closer to the second conduit
1120 far-end.
The two ends of head rod 1210 pass through connection unit 1231 and connection unit 1233 respectively with the first conduit 1110
Far-end, the second conduit 1120 far-end connect；Connection unit 1232 and 1234 points of connection unit are passed through in second connecting rod 1220 two ends
Do not link together apart from far-end one segment length position with the 3rd conduit 1130 far-end, the second conduit 1120.
As shown in Figure 2 a, head rod 1210 includes be slidably connected bar 1211 and the slip nipple of grafting cooperation
1212, and fixed connecting rod 1213；Bar 1211 external diameter that is slidably connected is less than slip nipple 1212 internal diameter；Be slidably connected bar
1211 one end are linked together with the first conduit 1110 by connection unit 1231, and remainder is contained in slip nipple 1212
In, can be with relative motion between the axial direction of be slidably connected bar 1211 and slip nipple 1212；Fixed connecting rod 1213 one end and cunning
The pipe 1212 that is dynamically connected is fixed together（For example, as shown in Figure 2 b, welded together by welding procedure）, the other end is by connecting
Unit 1233 is linked together with the second conduit 1120.
Coupling assembly 1200 is formed using high intensity, highly elastic material processing and fabricating, such as be slidably connected in the present embodiment
Bar 1211, the second connecting rod 1220, fixed connecting rod 1213 are all using the titanium-nickel wire of a diameter of 0.4mm, slip nipple 1212
Using the stainless steel tube for 0.5mm for the internal diameter；Second connecting rod 1220 length is 20mm, and bar 1211 length that is slidably connected is 10mm,
The length of slip nipple 1212 is 7mm, and fixed connecting rod 1213 length is 3mm.
As shown in figure 1, the distance between connection unit 1233 and connection unit 1234 are 10mm, connection unit 1231, company
It is connected by high intensity between order unit 1232, connection unit 1233, connection unit 1234 and lead sheath tube assembly, coupling assembly
Medical adhesive.
As shown in figure 1, the first conduit 1110 distal portions include several points that surely develop（Each fixed development point is one
Marker ring）, as shown in figure 1, the present embodiment contains 4, respectively 1,2,3,4, four fixed development point non-equidistant arrangements, spacing
Can be adjusted according to needs；3rd conduit 1130 distal end contains 1 dynamic development point（One dynamic development point is one
Marker ring）, that is, 0.Marker ring plays development positioning, and accurate adjustment head rod 1210 opens the effect of distance, optional
With the good material of the developing performances such as gold, tantalum, the present embodiment selects tantalum.In the present embodiment, marker ring 0 aligns respectively
Marker ring 1,2,3,4, can make head rod 1210 opens distance respectively 10mm, 14mm, 17mm, 20mm, and that is, one
The regulation of 4 kinds of distances realized by part apparatus.
As shown in figure 3, the 3rd conduit 1130 near-end is connected with retaining mechanism 1300, retaining mechanism 1300 includes threaded block
1310th, gland 1320 and tensioning pad 1330, tensioning pad 1330 is located between threaded block 1310 and gland 1320, locks machine
The each part of structure be provided with axially through endoporus, the first conduit 1110 passes through this endoporus.
Tensioning pad 1330 is made using the yielding material of super-elasticity, for example with elastomeric material.Threaded block 1310 far-end
It is connected with the 3rd conduit 1130 near-end and is connected together, such as can adopt the gluing knot of high-strength medical.
Gland 1320 carries the flange being in threaded block 1310 outer rim, and flange is provided with the screw thread with threaded block 1310 cooperation,
Rotary gland 1320, extrudable tensioning pad 1330 deforms, and makes tensioning pad 1330 fill threaded block 1310 and the first conduit
Space between 1110, is changed into interference fit from gap cooperation, making can not phase between the first conduit 1110 and the 3rd conduit 1130
To motion.
The bifurcated catheter that the present embodiment provides is used for annulus anchor point during mitral valve repair（Locking point）P1, P2 position
Positioning, as shown in figure 4, first along through femoral artery-iliac artery-ventral aorta-thoracic aorta-aortic arch-aortic valve-left side
Ventricle sets up track, and first electrode seal wire 100 applies, by other assistive devices, the P1 point that high frequency electric punctures annulus of mitral valve 10,
First electrode seal wire 100 enters left atrium from left ventricle；By the first conduit 1110, the second conduit 1120, the 3rd conduit 1130 and
Its coupling assembly 1,200 one is closed up into sheath 1140 in the axial direction（Connection unit 1231 is in distalmost end）（Due to coupling assembly
1200 are formed using high intensity, highly elastic material processing and fabricating, the swing during holding together sheath 1140, at each junction point
The deformation relying on material itself can meet, and, with respect to the swing of the first conduit 1110, dependence is even for such as head rod 1210
The deformation of order unit 1231 meets）, and connection unit 1232 proximal part is taken in sheath 1140, then, first electrode is led
Silk 100 near-ends pass through the first conduit 1110 distal lumen, and bifurcated catheter pushes away along first electrode seal wire 100 and auxiliary guiding sheath
It is fed into the P1 position of left cardiac sinus mitral ring 10；Fix the first conduit 1110, sheath 1140, promote forward the second conduit
1120 so that coupling assembly 1200 is opened, until connection unit 1233 is near annulus of mitral valve 10 position.If preoperative counted by TEE
Calculation records annulus locking distance（I.e. distance between P1 and P2）For 10mm, promote forward the 3rd conduit 1130 and fix other lead sheaths
, so that marker ring 0 alignment marker ring 1, the second connecting rod 1220 is in the projection of head rod 1210 axial direction for tube assembly
Distance increases, and makes the second conduit 1120 away from the first conduit 1110 by tension force, and be slidably connected bar 1211 company of slip relatively simultaneously
Adapter 1212 produces axially-movable and makes to open distance for 10mm, and fine setting the second conduit 1120 makes its near-end connection unit 1233
P2 point near annulus of mitral valve 10；Then utilize retaining mechanism 1300 so that between the first conduit 1110 and the 3rd conduit 1130
It is unable to relative motion；Fixing lead sheath tube assembly, penetrates second electrode seal wire 200 to Bicuspid valve from the second conduit 1120 proximal lumen
At the P2 point of ring 10, second electrode seal wire 200 near-end connect high frequency electric puncture annulus of mitral valve 10, second electrode seal wire 200 from
Left ventricle enters left atrium.If preoperative by TEE calculate record annulus lock distance be 14mm, 17mm, 20mm, can adopt aforementioned
Same method, marker ring 2,3,4 that marker ring 0 is alignd respectively so that head rod 1210 extends, using locking machine
Structure 1300 so that head rod 1210 open distance respectively 14mm, 17mm, 20mm.
Fig. 5 makes marker ring 0 alignment marker ring 3 for regulation, and annulus locking distance is schematic diagram during 17mm.
Embodiment 2
As shown in fig. 6, the bifurcated catheter 2000 of the present embodiment includes lead sheath tube assembly 2100, coupling assembly 2200 and lock
Tight mechanism 2300.
Difference between the present embodiment and embodiment 1 is：Embodiment 1 retaining mechanism 1300 is by fixed development point and dynamic development
Being mutually matched between point, determines the development distance of head rod 1210, thus realizing positioning and locking function, and the present embodiment
Retaining mechanism 2300 to adjust the development distance of bifurcated catheter far-end head rod 2210 using the handle with continuous scale,
Realize the continuous adjustment of distance, be more beneficial for the operation of user.
As being 19mm for mitral annuluses optimal locking distance, contain during retaining mechanism 1300 using described in embodiment 1
Four marker rings, the locking distance that scalable obtains is 17mm or 20mm, thus can because of locking apart from too small or excessive,
Postoperative mitral reflux degree is caused to improve inconspicuous（For example by FMR reflux degree, 4 grades are reduced to 2 grades）Or mitral stenosis；And
Can be accurately positioned by the present embodiment retaining mechanism 2300 and realize mitral annuluses locking apart from 19mm, so that FMR reflux
Degree is reduced to 1 grade by 4 grades.
As shown in Fig. 7 a, Fig. 7 b, retaining mechanism 2300 includes：The handle 2310 mutually fixed with the first conduit 2110 and with
The slide block assembly 2320 that 3rd conduit 2130 is mutually fixed.Handle 2310 is tubulose, and the first conduit 2110 is axially through handle
2310, the first conduit 2110 is fixed with handle 2310 afterbody phase, and the 3rd conduit 2130 penetrates in handle 2310 and and slide block assembly
2320 mutually fix.
The graduation mark of 11 non-uniform Distribution is provided with handle 2310,10-20 integer arranges vertically.
Handle 2310 is provided with axially disposed slideway, and slide block assembly 2320 slides along slideway, and slide block assembly 2320 includes
First slide block 2321, the second slide block 2322 and clamping screw 2323；First slide block 2321 is arranged in the slideway of handle 2310, the
One slide block 2321 has internal cavity, and the 3rd conduit 2130 stretches in this cavity, and the first slide block 2321 is near with the 3rd conduit 2130
End is fixed together, for example, can adopt the medical glue bonding of high bond strength.
Second slide block 2322 is arranged in outside the slideway of handle 2310, carries positioned at the first slide block 2321 He at the opening of slideway
Between second slide block 2322 by clamping part, screwing bolts 2323 can make the first slide block 2321 and the second slide block 2322 clamping lever
2310 clamping part, makes to be unable to relative motion between the first slide block 2321, the second slide block 2322 and handle 2310.
Handle 2310 is fixed together with the first conduit 2110 proximally by counterpart 2340, for example can be using high viscous
The medical glue bonding of knotting strength；Handle 2310 far-end is linked together with the 3rd conduit 2130 by counterpart 2330, handle
It is fixedly connected between 2310 with counterpart 2330, the 3rd conduit 2130 can smooth shifting back and forth in the axial direction in counterpart 2330
Dynamic.
When the second slide block 2322 distal face is alignd with scale 10, achievable bifurcated catheter far-end bifurcated distance is 10mm；
In the same manner, when the second slide block 2322 distal face is alignd with scale 11,12 ... 20, achievable bifurcated catheter far-end bifurcated distance is
11mm、12mm……20mm.
As shown in figure 8, during being used for mitral valve repair for bifurcated catheter shown in Fig. 6, annulus locking point P1, P2 position
Position fixing process；If preoperative by TEE calculate record annulus lock distance be 19mm（I.e. distance between P1 and P2）, with embodiment 1
Operational approach, first electrode seal wire 100 and the first conduit 2110 are pre-filled with P1 position, fixed handle 2310, sheath
2140, unscrew clamping screw 2323, promote forward the second conduit 2120 so that coupling assembly 2200 is opened, until connection unit
2233 near annulus of mitral valve 10 position.Promote the second slide block 2322 and fix other lead sheath pipes so that the second slide block 2322 far-end
In the face of the scale 19 of neat handle 2310, the second connecting rod 2220 increases in head rod 2210 direction projection distance, by tension force
The second conduit 2120 is made to deviate from the first conduit 2110, the bar that is simultaneously slidably connected produces axially-movable distance relative to slip nipple
For 19mm, finely tune the second conduit 2120 and make its far-end 2233 near annulus of mitral valve P2 point；Then screw clamping screw 2323, make
Obtain and be unable to relative motion between the first conduit 2110 and the 3rd conduit 2130；Then lead sheath tube assembly 2100 distal portions are fixed,
Penetrate second electrode seal wire 200 from the second conduit 2120 proximal lumen to the P2 point of annulus of mitral valve 10, second electrode seal wire 200
Near-end is connected high frequency electric and is punctured annulus of mitral valve 10, and second electrode seal wire 200 enters left atrium from left ventricle.
Claims (12)
1. a kind of far-end is apart from adjustable bifurcated catheter, including the first conduit, the second conduit and be arranged on the first conduit and
Two connecting rods between two conduits, described first conduit and the second conduit adjacent distal end part and described two connecting rods
Surround quadric chain it is characterised in that described two connecting rods include：
Length-adjustable head rod, two ends are connected with the first conduit and the second conduit respectively；
The second fixing connecting rod of length, one end is slidably matched with the first conduit, and the other end is connected with the second conduit, second even
Slidably one end is connected with traction piece to extension bar.
2. far-end as claimed in claim 1 apart from adjustable bifurcated catheter it is characterised in that described traction piece be slide sheathed
The 3rd conduit outside in the first conduit, slidably one end is fixed on the far-end of the 3rd conduit to described second connecting rod.
3. far-end as claimed in claim 2 apart from adjustable bifurcated catheter it is characterised in that described first conduit and the 3rd is led
The near-end of pipe is provided with the retaining mechanism cooperating.
4. far-end as claimed in claim 2 apart from adjustable bifurcated catheter it is characterised in that described first conduit and the 3rd is led
Pipe is provided with the positioning indicating mechanism cooperating.
5. far-end as claimed in claim 1 apart from adjustable bifurcated catheter it is characterised in that the near-end of described bifurcated catheter sets
There is the controlling organization for driving traction piece.
6. far-end as claimed in claim 1 apart from adjustable bifurcated catheter it is characterised in that described head rod include live
Be slidably connected bar and the slip nipple of dynamic grafting cooperation, is slidably connected bar and slip nipple passes through connection unit and the respectively
One of corresponding connection in one conduit and the second conduit.
7. far-end as claimed in claim 3 apart from adjustable bifurcated catheter it is characterised in that described retaining mechanism includes：
It is connected to the 3rd catheter proximal end and the threaded block around the first conduit；
It is filled in the tensioning pad between threaded block and the first conduit；
With the gland of threaded block screw thread cooperation, a part for this gland is to extend into be used for extruding between threaded block and the first conduit
The axial projection of tensioning pad.
8. far-end as claimed in claim 4 apart from adjustable bifurcated catheter it is characterised in that described positioning indicating mechanism bag
Include：
Be fixed on first supravasal at least two surely develop point；
It is fixed on the 3rd supravasal dynamic development point.
9. far-end as claimed in claim 5 apart from adjustable bifurcated catheter it is characterised in that described controlling organization includes：
The handle fixing with described first conduit phase；
The slide block assembly fixed with described traction piece phase and be slidably matched with handle.
10. far-end as claimed in claim 9 apart from adjustable bifurcated catheter it is characterised in that described handle be tubulose, described
First conduit axially through handle, fixed with handle afterbody phase by described first conduit, described traction piece penetrate in handle and with
Slide block assembly phase is fixed.
11. far-ends as claimed in claim 9 are apart from adjustable bifurcated catheter it is characterised in that described handle is provided with vertically
The slideway of arrangement, described slide block assembly includes：
It is arranged on the first slide block in slideway, described traction piece is fixed on the first slide block；
It is arranged on the second slide block outside slideway, at the opening of described slideway, carry being subject between the first slide block and the second slide block
Clamping part；
It is connected to the clamping screw between the first slide block and the second slide block.
12. far-ends as claimed in claim 9 apart from adjustable bifurcated catheter it is characterised in that described handle be provided with for
Indicate the graduation mark of slide block assembly position.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510136762.9A CN104706389B (en) | 2015-03-26 | 2015-03-26 | A kind of far-end is apart from adjustable bifurcated catheter |
| PCT/CN2016/073700 WO2016150260A1 (en) | 2015-03-26 | 2016-02-05 | Bifurcate catheter with adjustable far-end distance |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510136762.9A CN104706389B (en) | 2015-03-26 | 2015-03-26 | A kind of far-end is apart from adjustable bifurcated catheter |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN104706389A CN104706389A (en) | 2015-06-17 |
| CN104706389B true CN104706389B (en) | 2017-03-01 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201510136762.9A Active CN104706389B (en) | 2015-03-26 | 2015-03-26 | A kind of far-end is apart from adjustable bifurcated catheter |
Country Status (2)
| Country | Link |
|---|---|
| CN (1) | CN104706389B (en) |
| WO (1) | WO2016150260A1 (en) |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104706389B (en) * | 2015-03-26 | 2017-03-01 | 诺琅医疗科技（上海）有限公司 | A kind of far-end is apart from adjustable bifurcated catheter |
| US11672661B2 (en) | 2019-08-22 | 2023-06-13 | Silara Medtech Inc. | Annuloplasty systems and methods |
Family Cites Families (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FR2743301B1 (en) * | 1996-01-05 | 1998-04-30 | Medicorp Sa | LEVER MICROCOMMISSUROTOME |
| CA2500512A1 (en) * | 2002-10-21 | 2004-05-06 | Mitralign Incorporated | Method and apparatus for performing catheter-based annuloplasty using local plications |
| US20080228265A1 (en) * | 2007-03-13 | 2008-09-18 | Mitralign, Inc. | Tissue anchors, systems and methods, and devices |
| US8968335B2 (en) * | 2010-10-27 | 2015-03-03 | Mitralign, Inc. | Hand operated device for controlled deployment of a tissue anchor and method of using the same |
| WO2014152503A1 (en) * | 2013-03-15 | 2014-09-25 | Mitralign, Inc. | Translation catheters, systems, and methods of use thereof |
| CN104706389B (en) * | 2015-03-26 | 2017-03-01 | 诺琅医疗科技（上海）有限公司 | A kind of far-end is apart from adjustable bifurcated catheter |
| CN204581360U (en) * | 2015-03-26 | 2015-08-26 | 诺琅医疗科技（上海）有限公司 | A kind of far-end is apart from adjustable bifurcated catheter |
-
2015
- 2015-03-26 CN CN201510136762.9A patent/CN104706389B/en active Active
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2016
- 2016-02-05 WO PCT/CN2016/073700 patent/WO2016150260A1/en active Application Filing
Also Published As
| Publication number | Publication date |
|---|---|
| WO2016150260A1 (en) | 2016-09-29 |
| CN104706389A (en) | 2015-06-17 |
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