CN107049556A - Pourable distal end belt supporting frame artificial blood vessel and arch of aorta drop portion artificial blood vessel - Google Patents
Pourable distal end belt supporting frame artificial blood vessel and arch of aorta drop portion artificial blood vessel Download PDFInfo
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- CN107049556A CN107049556A CN201710357743.8A CN201710357743A CN107049556A CN 107049556 A CN107049556 A CN 107049556A CN 201710357743 A CN201710357743 A CN 201710357743A CN 107049556 A CN107049556 A CN 107049556A
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- CN
- China
- Prior art keywords
- blood vessel
- artificial blood
- distal end
- supporting frame
- pourable
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- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
- A61F2002/072—Encapsulated stents, e.g. wire or whole stent embedded in lining
Abstract
The invention discloses pourable distal end belt supporting frame artificial blood vessel and arch of aorta drop portion artificial blood vessel, wherein pourable distal end belt supporting frame artificial blood vessel includes:Soft artificial blood vessel's main body;Soft artificial blood vessel's main body saves internal fixed self-expanding metallic support away from heart one, and soft artificial blood vessel's main body does not have the self-expanding metallic support then close to a section of heart;And soft artificial blood vessel's main body formed at the section of heart one blood supply extracorporal circulatory system connection perfusion first perfusion branch.Aortic arch and drop portion anastomosis procedures are carried out under the conditions of low hypothermia during the present invention can perform the operation dissection of aorta, and surgical procedure is stopped into circulation time and is reduced to 1 2min, operation risk is greatly reduced, complication probability, patient's ICU holdup times and rehabilitation duration caused by operation is reduced.
Description
Technical field
The present invention relates to artificial blood vessel, more particularly to for treating the pourable remote of Stanford A type dissection of aorta
Heart end belt supporting frame artificial blood vessel and arch of aorta drop portion artificial blood vessel.
Background technology
As people's living standard is lifted, the disease such as hypertension, high fat of blood, diabetes, atherosclerosis rises year by year,
The incidence of dissection of aorta is also in rising trend.Dissection of aorta refers to that blood enters sustainer by aortic tunica intima breach
Wall and the separation for causing arterial wall, are one of most common arotic diseases, the Stanford A type dissection of aorta death rate is most
High arotic disease, the characteristics of with excessive risk, high concurrent disease, high mortality.
Current surgical operation therapy is the major programme for saving Stanford A type dissection of aorta patients.Early stage simple peace
Full treatment method is simple row aorta ascendens or part aorta ascendens valve replacement, is saved with eliminating the primary cut of aorta ascendens
For the purpose of life.With surgical technic, anesthesia, extracorporal circulatory system, Organoprotective(Such as:The heart, brain, lung, kidney etc.)With postoperative care etc.
Field obtains huge progress, and the scope that lesion vesselses are replaced in dissection of aorta operation progressively expands, perioperative complications
Incidence and the death rate decline earlier above.Current Stanford A types dissection of aorta requires to go to eliminate in addition to life is rescued, also
The many arterial disease tissues of amount prevent further expansion, reduce the even necrosis, and promote sustainer remote of internal organs ischemic insufficiency
The false intracavitary thrombosis in end and aorta wall remodeling, reduce postoperative complications, also provide facility for secondary operation.
Tradition " trunk " operation reported at first by Borst, the benefit of the operation be distal anastomosis mouth more firmly and be two
Stage operation provides facility.But artificial blood vessel is implanted into the true intracavitary difficulty of patient, it is to devise to have from exapnsion again in the industry
Property, the wrapped support " trunk " in artificial blood vessel distal end, artificial blood vessel end is wrapped in from exapnsion support " trunk ".At present
Treatment Stanford A type dissection of aorta, handles aortic arch and distal end descending aorta both at home and abroad, and row aorta bow is rebuild
Plus support trunk surgical procedure has been required to profound hypothermia (15-20 DEG C of nasopharynx temperature) and has stopped stopping to be circulated throughout at cyclic process, descending aorta
The journey time stops that circulation time is longer in more than 15min for patient, and operation risk is bigger, and its caused complication is general
Rate, ICU holdup times and rehabilitation duration and hospitalization cost can also increase therewith.
In consideration of it, the present inventor develops pourable distal end belt supporting frame artificial blood vessel and arch of aorta drop portion people for this
Work blood vessel, effectively solves above mentioned problem, and thus this case produces.
The content of the invention
It is an object of the invention to provide the artificial blood of pourable distal end belt supporting frame artificial blood vessel and arch of aorta drop portion
Pipe, greatly reduces surgical procedure and stops circulation time, reduces operation risk, reduces complication probability, patient ICU caused by operation
Holdup time and rehabilitation duration.
To achieve these goals, technical scheme is as follows:
Pourable distal end belt supporting frame artificial blood vessel, including:
Soft artificial blood vessel's main body;
Soft artificial blood vessel's main body saves internal fixed self-expanding metallic support, soft artificial blood vessel's main body away from heart one
A section close to heart does not have the self-expanding metallic support then;And
First perfusion point of the blood supply extracorporal circulatory system connection perfusion that soft artificial blood vessel's main body is formed at the section of heart one
Branch.
Optional further to improve, the first perfusion branch is with soft artificial blood vessel's main body close to heart one end end
Distance be 20-50mm.
Optional further to improve, the distance between the first perfusion branch and self-expanding metallic support are 10-20mm.
Optional further to improve, soft artificial blood vessel's main body is 100mm away from the length that heart one is saved.
Optional further to improve, the self-expanding metallic support is " w " shape metallic support with self-expanding function.
Optional further to improve, soft artificial blood vessel's main body and the first perfusion branch into Weaving type artificial blood vessel.
It is optional further to improve, a diameter of 28-40mm of soft artificial blood vessel's main body.
It is optional further to improve, the first perfusion a diameter of 6-10mm of branch, length is 50-100mm.
Arch of aorta drop portion artificial blood vessel, including proximal part Four branches aortic graft and pourable telecentricity as described above
Belt supporting frame artificial blood vessel is held, there is the proximal part Four branches aortic graft three branch artificial blood vessels and a blood supply to follow in vitro
Second perfusion branch of ring connection perfusion.
Arch of aorta drop portion artificial blood vessel, including pourable distal end belt supporting frame artificial blood vessel as described above;It is described
Distal end belt supporting frame artificial blood vessel continues to extend to form bow portion to heart direction close to the end that heart one is saved.
After such scheme, pourable distal end belt supporting frame artificial blood vessel of the invention and arch of aorta drop portion are artificial
Blood vessel, stops circulation without descending aorta, but be connected recovery with Cardiopulmonary bypass pipe by the first perfusion branch for a long time
Descending aorta blood circulation.And required low hypothermia stops circulate operation and is only that when the present invention is used, by pourable distal end
The bracket end of belt supporting frame artificial blood vessel is placed in the true chamber of descending aorta, and is released from the time needed for the support of expanding metal, general 1-
2min, is significantly less than existing more than Deep Hypothermia Circulatory Arrest 15min time, reduces operating difficulty and risk, reduces operation and draws
Complication probability, patient's ICU holdup times and rehabilitation duration and the medical expense risen.
Brief description of the drawings
Fig. 1 is the structural representation of the pourable distal end belt supporting frame artificial blood vessel of the present embodiment;
Fig. 2 is the structural representation after a kind of arch of aorta drop portion artificial blood vessel that the present embodiment is provided coincide with autologous vein;
Fig. 3 is the structural representation after another arch of aorta drop portion artificial blood vessel that the present embodiment is provided coincide with autologous vein
Figure.
Label declaration
Left subclavian artery 100, left common carotid artery 200, right common carotid artery 300, right subclavian artery 400, descending aorta 500,
Innominate artery 600;
Distal end belt supporting frame artificial blood vessel 10, soft artificial blood vessel's main body 1, self-expanding metallic support 2, the first perfusion branch 3, the nearly heart
Four branches aortic graft 20 is held, pincers 30, bow portion 40, the branch's autologous vein 50 of island three are blocked;
Length a, apart from b, apart from c.
Embodiment
In order to which technical scheme is explained further, the present invention is explained in detail below by specific embodiment
State.
As shown in figure 1, be the present invention disclose irrigate belt supporting frame artificial blood vessel 10, including soft artificial blood vessel's main body 1, from
Expanding metal support 2 and first irrigates branch 3.Soft artificial blood vessel's main body 1 is Weaving type artificial blood vessel, can be the artificial blood of terylene
Pipe, polytetrafluoroethylene (PTFE) artificial blood vessel etc., diameter is in 28-40mm, to be adapted to different crowds.Soft artificial blood vessel's main body 1 from by
The position of nearly heart is divided, and is divided into close to a section of heart and the section away from heart.
Self-expanding metallic support 2 is fixed on the inside that soft artificial blood vessel's main body 1 is saved away from heart one, soft artificial blood vessel's main body
1 saves then without self-expanding metallic support 2 close to the one of heart, and self-expanding metallic support 2 preferably is with self-expanding function
" w " shape metallic support, can be for Metal stent, 316L stainless steel stents etc..Wherein, soft artificial blood vessel's main body 1
It is 100mm away from the length a that heart one is saved.
First perfusion branch 3 is formed at soft artificial blood vessel's main body 1 at the section of heart one, for Cardiopulmonary bypass pipe
Connection, the first perfusion a diameter of 6-10mm of branch 3 preferably, length is 50-100mm.
Wherein as a preferred embodiment, the first perfusion branch 3 is with soft artificial blood vessel's main body 1 close to heart one end end
It is 20-50mm apart from b, is supplied with providing enough trimmings, Oversewing space with rebuilding the near of aortic arch Four branches aortic graft
Heart end Four branches aortic graft 20 coincide.
Wherein as another preferred embodiment, the distance between the first perfusion branch 3 and self-expanding metallic support 2 c are 10-
20mm.With reference to shown in Fig. 2, because with the end end suture operation of proximal part Four branches aortic graft 20 during, need to block soft artificial
Blood vessel main body 1 blocks 30 sandwiched positions of pincers as shown in Fig. 2 when being closed to prevent blocking pincers 30 from pressing from both sides close to one end of heart
Influence to self-expanding metallic support 2, therefore 10-20mm distance need to be reserved.
As shown in Fig. 2 the one of which arch of aorta drop portion artificial blood vessel that the present invention is disclosed, including people from branch of proximal part four
Work blood vessel 20 and pourable distal end belt supporting frame artificial blood vessel 10 as described above, proximal part Four branches aortic graft 20 has
Three branch artificial blood vessels and the second perfusion branch 201 of a blood supply extracorporal circulatory system connection.Three branch artificial blood vessels point
The object that Dui Ying do not suture is:Left subclavian artery 100, left common carotid artery 200 and innominate artery 600, wherein innominate artery 600
There are right common carotid artery 300 and right subclavian artery 400 in branch.
The chief surgical process of embodiment is:
Set up extracorporal circulatory system:After test tube of hepari, selection femoral artery or axillary artery intubation set up extracorporal circulatory system(The present embodiment is dynamic with stock
Exemplified by arteries and veins), the good side femoral arteriography of selection beating, if interlayer involves femoral artery, the true chamber of careful identification femoral artery
Femoral artery infusion pipe is inserted afterwards.Venous drainage pipe inserts the two parallel turns of tidal stream of ladder pipe using atrium, and anus temperature drop is to 30 DEG C.Dissociate nothing
After name artery, left subclavian artery, left common carotid artery and arch of aorta front and rear wall, artery pump line is routinely two-tube from single pump, its
In first infusion cannula set up extracorporal circulatory system through femoral arteriography, and second infusion cannula is used as the second perfusion branch 201
Intubation.
Aortic root, aorta ascendens and aortic arch proximal part processing procedure:Pincers 30 are blocked to block four points of proximal part
The two ends of branch artificial blood vessel 20, second intrusion pipe of the second perfusion branch 201 junctor outer circulation, first with the branch people of proximal part four
The identical left common carotid artery 200 of a wherein branch for work blood vessel 20, then coincide left subclavian artery 100 and innominate artery successively
600, second irrigates the Continuous Perfusion of branch 201 to ensure head blood circulation.Clamping of aorta, underwent coronary perfusion scheming
Liquid is protected, takes different modus operandis to handle according to aorta petal, coronary artery and aorta ascendens situation, then with proximal part
Four branches aortic graft 20 is close to one end end to end anastomosis of heart, and the proximal part of open proximal part Four branches aortic graft 20
Pincers 30 are blocked, recover heart blood supply.
Aortic arch distal end and descending aorta processing procedure:Stop first infusion cannula of insertion femoral artery infusion,
After aortic occlusion clamp, the arch of aorta is cut to left subclavian artery level, the distal end belt supporting frame people of suitable types is selected
Work blood vessel 10 a, section with self-expanding metallic support 2 inserts the true intracavitary of descending aorta 500, and is released from expanding metal
Support 2, first infusion cannula is transferred in the first perfusion branch 3, as shown in Fig. 2 blocking the folder of pincers 30 to close distal end band branch
The proximal part portion of frame artificial blood vessel 10, recovers the blood circulation of descending aorta 500.This process about takes 1-2min.Will be from swollen
Swollen metallic support 2 artificial blood vessel at the 10mm of heart end is fixed on autologous vein wall.
Outer end, the nearly heart of distal end belt supporting frame artificial blood vessel 10 of proximal part Four branches aortic graft 20 are trimmed afterwards
End and autologous descending aorta blood vessel 500, and suture is identical.
Open remaining block clamps 30, and rewarming ligatures first and irrigate perfusion branch 201 of branch 3 and second, recovers physiology respectively
Property blood circulation, withdraw extracorporal circulatory system, whole surgical procedure completed after closing chest.
As shown in figure 3, another arch of aorta drop portion artificial blood vessel that the present invention is disclosed, including can irrigate as described above
Distal end belt supporting frame artificial blood vessel 10, the end that the distal end belt supporting frame artificial blood vessel 10 is saved close to heart one is continued centripetal
Dirty direction extends to form bow portion 40.The difference of its surgical procedure and above-mentioned surgical procedure is essentially consisted in, and bow portion 40 is cut out
Breach, it is then that left subclavian artery 100, left common carotid artery 200 and innominate artery 600 is overall(It is commonly called as the branch of island three autologous
Blood vessel 50)The breach is sutured in, i.e., the aortic arch displacement that the branch's autologous vein 50 of island three is built again, due to being integral replacement
It coincide, therefore axillary artery intubation need to be selected to set up extracorporal circulatory system, to brain blood supply, rather than femoral artery.During this, same
The recovery blood circulation of descending aorta 500 need to be given by first perfusion branch 3.It is close to the first suture for irrigating branch 3 in Fig. 3
The suture of autologous descending aorta blood vessel 500 and distal end belt supporting frame artificial blood vessel 10, countercurrently goes out to prevent Hemostatic Oral Liquid at gap
Blood.
Above-described embodiment ensure that in surgical procedure, without being operated under Deep Hypothermia Circulatory Arrest.Using above-mentioned implementation
Required low hypothermia stops circulation and is only that during example, and a section of the distal end belt supporting frame artificial blood vessel 10 with self-expanding metallic support 2 is put
In the true chamber of descending aorta 500, and expanding metal support 2 is released from, time about 1-2min is significantly less than in current surgical procedure
More than Deep Hypothermia Circulatory Arrest 15min time, operation risk and difficulty are reduced, reduce complication probability caused by operation, suffer from
Person's ICU holdup times and rehabilitation duration.
" first " " second " described in text etc. is similar to state the meaning for being not necessarily referring to order, and is to distinguish close spy
Levy.
Presently preferred embodiments of the present invention is these are only, not to the restriction of protection scope of the present invention.All setting according to this case
The equivalent variations that meter thinking is done, each fall within the protection domain of this case.
Claims (10)
1. pourable distal end belt supporting frame artificial blood vessel, it is characterised in that including:
Soft artificial blood vessel's main body;
Soft artificial blood vessel's main body saves internal fixed self-expanding metallic support, soft artificial blood vessel's main body away from heart one
A section close to heart does not have the self-expanding metallic support then;And
First perfusion point of the blood supply extracorporal circulatory system connection perfusion that soft artificial blood vessel's main body is formed at the section of heart one
Branch.
2. pourable distal end belt supporting frame artificial blood vessel as claimed in claim 1, it is characterised in that:First perfusion point
Distance of the branch with soft artificial blood vessel's main body close to heart one end end is 20-50mm.
3. pourable distal end belt supporting frame artificial blood vessel as claimed in claim 1, it is characterised in that:First perfusion point
The distance between branch and self-expanding metallic support are 10-20mm.
4. pourable distal end belt supporting frame artificial blood vessel as claimed in claim 1, it is characterised in that:The soft artificial blood vessel
Main body is 100mm away from the length that heart one is saved.
5. pourable distal end belt supporting frame artificial blood vessel as claimed in claim 1, it is characterised in that:The self-expanding metal
Support is " w " shape metallic support with self-expanding function.
6. pourable distal end belt supporting frame artificial blood vessel as claimed in claim 1, it is characterised in that:The soft artificial blood vessel
Main body and the first perfusion branch into Weaving type artificial blood vessel.
7. pourable distal end belt supporting frame artificial blood vessel as claimed in claim 1, it is characterised in that:The soft artificial blood vessel
A diameter of 28-40mm of main body.
8. pourable distal end belt supporting frame artificial blood vessel as claimed in claim 1, it is characterised in that:First perfusion point
The a diameter of 6-10mm of branch, length is 50-100mm.
9. arch of aorta drop portion artificial blood vessel, it is characterised in that:Including proximal part Four branches aortic graft and such as claim 1-8
Described pourable distal end belt supporting frame artificial blood vessel;
There is the proximal part Four branches aortic graft three branch artificial blood vessels and a blood supply extracorporal circulatory system connection perfusion to use
Second perfusion branch.
10. arch of aorta drop portion artificial blood vessel, it is characterised in that:Including the pourable distal end as described in claim 1-8
Belt supporting frame artificial blood vessel;
The distal end belt supporting frame artificial blood vessel continues to extend to form bow portion to heart direction close to the end that heart one is saved.
Priority Applications (1)
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CN201710357743.8A CN107049556A (en) | 2017-05-19 | 2017-05-19 | Pourable distal end belt supporting frame artificial blood vessel and arch of aorta drop portion artificial blood vessel |
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CN201710357743.8A CN107049556A (en) | 2017-05-19 | 2017-05-19 | Pourable distal end belt supporting frame artificial blood vessel and arch of aorta drop portion artificial blood vessel |
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Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN107616856A (en) * | 2017-11-08 | 2018-01-23 | 吉林大学 | A kind of belt supporting frame artificial blood vessel and the application in Stanford A type dissection of aorta clinic operation formulas |
CN113499164A (en) * | 2021-07-12 | 2021-10-15 | 中国医学科学院阜外医院 | Elephant trunk support assembly capable of blocking blood and elephant trunk support implantation system |
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CN201026247Y (en) * | 2006-10-31 | 2008-02-27 | 许尚栋 | Complex of artificial blood vessel and artificial bracket blood vessel |
CN201939531U (en) * | 2010-12-30 | 2011-08-24 | 中国人民解放军第四军医大学 | Intraoperative stent |
CN103462727A (en) * | 2012-06-07 | 2013-12-25 | 刘健 | Terylene three-branch arcus aortae artificial blood vessel with self-expandable stent |
CN104161605A (en) * | 2014-08-18 | 2014-11-26 | 柳克祥 | Improved support artificial blood vessel |
CN104161606A (en) * | 2014-08-18 | 2014-11-26 | 柳克祥 | Artificial blood vessel with support |
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Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
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CN201026247Y (en) * | 2006-10-31 | 2008-02-27 | 许尚栋 | Complex of artificial blood vessel and artificial bracket blood vessel |
CN201939531U (en) * | 2010-12-30 | 2011-08-24 | 中国人民解放军第四军医大学 | Intraoperative stent |
CN103462727A (en) * | 2012-06-07 | 2013-12-25 | 刘健 | Terylene three-branch arcus aortae artificial blood vessel with self-expandable stent |
CN104161605A (en) * | 2014-08-18 | 2014-11-26 | 柳克祥 | Improved support artificial blood vessel |
CN104161606A (en) * | 2014-08-18 | 2014-11-26 | 柳克祥 | Artificial blood vessel with support |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN107616856A (en) * | 2017-11-08 | 2018-01-23 | 吉林大学 | A kind of belt supporting frame artificial blood vessel and the application in Stanford A type dissection of aorta clinic operation formulas |
CN113499164A (en) * | 2021-07-12 | 2021-10-15 | 中国医学科学院阜外医院 | Elephant trunk support assembly capable of blocking blood and elephant trunk support implantation system |
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