CN108324352A - A kind of interventricular septum puncture instrument component and its interventional method - Google Patents
A kind of interventricular septum puncture instrument component and its interventional method Download PDFInfo
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- CN108324352A CN108324352A CN201711341570.7A CN201711341570A CN108324352A CN 108324352 A CN108324352 A CN 108324352A CN 201711341570 A CN201711341570 A CN 201711341570A CN 108324352 A CN108324352 A CN 108324352A
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3405—Needle locating or guiding means using mechanical guide means
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Abstract
A kind of interventricular septum puncture instrument component and its interventional method, including positioning sheath, puncture sheath, puncture seal wire and ventricle protector, after positioning sheath enters right ventricle, head can be bent, and withstand on the target site of puncture in interventricular septum, transatrial septal puncture approach simultaneously, ventricle protector is filled in spare at ventricular apex, it punctures seal wire and reaches site of puncture along positioning sheath and penetrate interventricular septum and enter left ventricle, the barrier of ventricle protector punctures after seal wire punctures interventricular septum and further pierces through ventricular posterior wall, it punctures sheath and passes through interventricular septum along seal wire is punctured by positioning sheath, into after left room, puncture sheath tube head can be further bent, the interventricular septum puncture instrument component of the present invention can ensure that puncture position is accurate, simultaneously prevent puncture when pierce through ventricle cause heart rear wall damage.
Description
Technical field
The invention belongs to biomedical apparatus fields, and in particular to a kind of interventricular septum puncture instrument component and its intervention side
Method.
Background technology
Mitral valve insufficiency is common heart disease, and general surgical procedures wound is big, and risk is high.Through intubation intervention technology
Repairing bicuspid valve has the characteristics that minimally invasive, safe, is ideal alternative medicine.Bicuspid valve uses warp through conduit recovery technique at present
The apex of the heart punctures or the path of transatrial septal puncture is treated, the former needs to enter thoracic cavity through surgical incision, but can carry out
The prosthesis such as diplopore, artificial cords, although the latter is implemented with diploporeization treatment without notch, through femoral venous puncture,
It can be difficult to repairing chordae tendineae, now it is badly in need of a kind of novel piercing assembly to overcome the above problem.
The pierced situation of heart rear wall occurs when used puncture instrument is not avoided that puncture in the prior art,
Application number 201410417903.X, in the earlier patent application file of entitled puncture needle component, outside the conveying wirerope that uses
It is connected with directional locator, the limit of the spatial position selection and puncture needle needle point direction of travel of puncture target spot is capable of by locator
It is fixed, but still cannot solve the problems, such as to prevent to pierce through heart rear wall when puncturing, therefore, it is badly in need of a set of interventricular septum puncture instrument component i.e.
It can ensure that puncture position is accurate, and can ensure that puncture needle will not impair cardiac rear wall when interventricular septum puncturing operation.
Invention content
In order to overcome the above problem, the present invention to pass through deformable positioning sheath localised puncture position, the taper of protector
Head cram at ventricular apex, can ensure that puncture position is accurate, at the same prevent puncture when pierce through ventricle cause heart rear wall damage.
The present invention provides following technical scheme：
A kind of interventricular septum puncture instrument component, including positioning sheath, puncture sheath, puncture seal wire, the positioning sheath
Both ends are respectively positioning end and handheld terminal, and sheath middle section has curvature, and thread bullet is equipped in the inner tubal wall of the positioning end
Spring can cause positioning end sheath Bending Deformation, the connecting rod of spring to be connected to the crooked knob being arranged on the handheld terminal, rotation
The crooked knob controls the positioning end Bending Deformation, and the positioning sheath positions interventricular septum puncture position；
The puncture sheath pipe diameter is less than positioning sheath, and it is respectively cutting tip and handheld terminal to puncture sheath both ends, described to wear
The inner tubal wall of barbed end is equipped with screw thread spring, and cutting tip sheath Bending Deformation, the connecting rod of spring can be caused to be connected to described hold
The crooked knob being arranged on end rotates the crooked knob and controls the cutting tip Bending Deformation, and the puncture sheath pipe is for wearing
Cross interventricular septum；
The puncture seal wire is inserted among puncture sheath when use, is punctured sheath and is inserted into positioning sheath, punctures seal wire
External high-frequency energy punctures sheath and enters purpose ventricle across interventricular septum along seal wire is punctured via tip for piercing through interventricular septum.
Further, puncture seal wire a diameter of 0.035 inch, head is that straight soft head or bending are disc-shaped, curved
Tune can stress stretch, after removing external force, restore bending on head, and seal wire outer surface is equal in addition to the part 5~20mm of both ends end to end
It is coated with insulating coating.
Further, interventricular septum puncture instrument component further includes ventricle protector, and the ventricle protector is by cone-shaped head
Portion is formed by connecting with push rod, and the cone-shaped head is gauze cone structure made of Nitinol braiding, is filled out inside cone
Filled with insulant；The ventricle protector, which can be taken in, to be loaded intrathecal and is sent into delivery conduit, by pushing and pulling the push rod
After so that cone-shaped head external extension in delivery conduit, the cone-shaped head is pushed out conduit, centrum shape is reverted to.
Further, a length of 40-80cm of the positioning sheath, a diameter of 10-28F, sheath bent intermediate angle are 30-
60 °, it is 1-5cm, head end bending angle that the distance of vertex to positioning end apex end at bending section, which is 3-15cm positioning end length,
It is 0-120 °.
Further, the puncture sheath pipe range is 50-100cm, and cutting tip length is 2-8cm, and cutting tip bending angle is
0-180 °, a diameter of 0.035 inch of the puncture seal wire.
Further, the cone-shaped head surface reticular structure is coated with insulation coating, and the push pole length is
100-180cm, a diameter of 6-7F of push rod, cone-shaped head maximum gauge are 4-10cm, and cone-shaped head length is 4-10cm.
Further, the cone-shaped head maximum gauge is 6cm, and cone-shaped head length is 5cm.
A kind of interventional method of interventricular septum puncture instrument component, includes the following steps：
Step is inserted into atrial septal puncture sheath once femoral vein, punctures atrial septum and enters atrium sinistrum indwelling seal wire, along seal wire
It is sent into delivery conduit and enters left ventricle arrival apex, ventricle protector income loading is intrathecal, sheath and delivery conduit will be loaded
Tail portion is connected, and is inserted into the ventricle protector, pushes the push rod forward, and cone-shaped head is made to stretch out delivery conduit,
The head of cone is expanded in left ventricular apex；
Step 2 is sent into pigtail catheter through right external jugular vein and enters right ventricle by tricuspid valve, and indwelling seal wire withdraws from pigtail
Conduit is sent into the positioning sheath along seal wire and enters right ventricle, the curvature of positioning end is adjusted by rotating the crooked knob,
Positioning port is withstood at the target puncture of interventricular septum；
Step 3 is inserted into expander in positioning sheath pipe, and expander is sent to the positioning port of positioning sheath, along expansion
Device, which is inserted into, punctures seal wire, in puncturing the external high-frequency energy in seal wire tail portion, so that seal wire head is penetrated interventricular septum and enters in left ventricle, lead
Silk is inserted into after penetrating interventricular septum in the cone-shaped head；Along seal wire push expander is punctured by interventricular septum, expand puncture orifice；
Step 4 exits expander, retains seal wire, is packed into expander punctures in sheath in vitro, will puncture sheath edge and lead
Silk is inserted into positioning sheath, and cutting tip is passed through to the puncture orifice of interventricular septum, and push rod is taken in delivery conduit, withdraws from ventricle guarantor
Device is protected, puncture sheath is exited, rotation punctures the curvature of the crooked knob adjustment cutting tip of sheath.
Using above-mentioned technical proposal, the present invention has the advantages that：
1, the present invention provides a kind of puncturing the new method for repairing chordae tendineae of mitral valve and its special equipment positioning through interventricular septum
Sheath, sheath middle section have 30 degree to 60 degree of bending, enable sheath from jugular vein enter atrium dextrum after it is very well
Enter right ventricle through tricuspid valve, and heart is not caused to pull or be oppressed.The superior vena cava of the mankind and plane where tricuspid valve
And out of plumb, we are on the basis of analyzing a large amount of human heart image datas, the specific position design one in the middle part of positioning sheath
Fixed camber enables positioning sheath is tension-free to enter in tricuspid valve from superior vena cava.
2, the push club head of ventricle protector of the invention is to form cone reticular structure by nitinol alloy wire braiding, is closed
Spun gold surface is coated with insulating materials, and nitinol alloy wire has memory function, can be contracted in casing or stretch out in casing shape
At cone structure, cone shape is consistent with the structure of ventricular apex, can cram at ventricular apex well, and do not influence the heart
Room is shunk and blood flow movement, and when puncturing seal wire across atrial septum, the reticular structure on surface can be such that puncture seal wire penetrates, but
Due to the insulating materials blocking in push club head, ventricular posterior wall will not further be pierced through by puncturing seal wire, but stop at push
In club head, the damage of ventricular posterior wall is efficiently avoided.Since B alloy wire surface is coated with insulating materials, seal wire contact protector
When will not Guiding high frequency Energy Damage heart.
3, interventricular septum puncture instrument component of the present invention is used cooperatively, and can ensure that puncture position is accurate, while preventing from puncturing
When pierce through ventricle cause heart rear wall damage.
4, the puncture sheath of interventricular septum puncture instrument component of the present invention is further bent after can entering ventricle, subsequently to exist
The intervention that intraventricular operation provides multiple angles is convenient.
Description of the drawings
Fig. 1 is the structural schematic diagram of present invention positioning sheath；
Fig. 2 is the structural schematic diagram that the present invention punctures sheath；
Fig. 3 is the structural schematic diagram that the present invention punctures that sheath interpolation enters expander；
Fig. 4 is the structural schematic diagram of ventricle protector of the present invention；
Fig. 5 is the intervention flow chart of interventricular septum puncture instrument component of the present invention.
Wherein, 1- positions sheath, 11- positioning sheaths crooked knob, 12- and positions sheath discharge pipe
2- punctures sheath, 21- punctures sheath crooked knob, 22- punctures sheath discharge pipe, 3- ventricles protector, 31- cones
Shape head, 32- push rod, 4- expanders
Specific implementation mode
In order to make the purpose , technical scheme and advantage of the present invention be clearer, with reference to the accompanying drawings and embodiments, right
The present invention is further elaborated.It should be appreciated that structure chart described herein and specific embodiment are only explaining this
Invention, is not intended to limit the present invention.
Embodiment 1
As shown in Figs. 1-2, the present invention provides a kind of interventricular septum puncture instrument components, including positioning sheath 1, puncture sheath
2, seal wire is punctured, the both ends for positioning sheath are respectively positioning end and handheld terminal, and sheath middle section is bending sheath, positioning end
Inner tubal wall is equipped with screw thread spring, can cause positioning end sheath Bending Deformation, and the connecting rod of spring is connected to be arranged on handheld terminal
Crooked knob 11, rotoflector knob control positioning end Bending Deformation.
Positioning sheath AC length is 40-80cm, and a diameter of 10-28F, sheath bent intermediate angle is 30-60 °, preferably
45 °, the distance of vertex to positioning end apex end at bending section is 3-15cm.Enable sheath from jugular vein enter atrium dextrum after it is non-
Often smoothly enter right ventricle through tricuspid valve, and heart is not caused to pull or be oppressed.The superior vena cava and tricuspid valve of the mankind
Place plane and out of plumb, we are on the basis of analyzing a large amount of human heart image datas, the certain bits in the middle part of positioning sheath
It installs and counts certain camber, enable positioning sheath is tension-free to enter in tricuspid valve from superior vena cava.
Positioning end BC length is 1-5cm, and positioning end can be with bending angle for 0-120 °.It is additionally provided with discharge pipe in handheld terminal
12, for gas or liquid to be discharged in the course of surgery.The positioning end that sheath is positioned when use reaches interventricular septum and by curved
Bent knob 11 adjusts the bending angle of positioning end, and withstands on the position that interventricular septum target punctures by port is positioned, and is worn to be subsequent
It pierces component and puncture site and path is provided.
As shown in figure 3, puncturing 2 diameter of sheath is less than positioning sheath, it is inserted among positioning sheath, is puncturing in sheath
Expander can be inserted, expander hardness is larger, can help to puncture sheath across interventricular septum by the tip of expander front.
It is respectively cutting tip and handheld terminal to puncture sheath both ends, and the inner tubal wall of cutting tip is equipped with screw thread spring, can cause cutting tip sheath
Pipe Bending Deformation, the connecting rod of spring are connected to the crooked knob 21 being arranged on handheld terminal, and rotoflector knob controls the puncture
Hold Bending Deformation；It is additionally provided with discharge pipe 22 in handheld terminal, is used for for discharge gas or liquid, puncture sheath pipe in the course of surgery
Across interventricular septum.
Preferably, a diameter of 0.035 inch of the puncture seal wire that the present invention uses, head are that straight soft head or bending are in disk
Shape, bending section can stress stretch, after removing external force, restore bending on head, and seal wire outer surface is except parts 5~20mm of both ends end to end
It is coated with insulating coating outside.
The sheath a length of 50-100cm of DF are punctured, cutting tip EF length is 2-8cm, and cutting tip bending angle is 0-180 °.Make
Used time punctures seal wire and is reached at target puncture along positioning sheath, punctures the external high-frequency energy of seal wire and pierces through interventricular septum, puncture sheath
Pipe reaches the puncture orifice in interventricular septum via positioning sheath again, and the cutting tip for puncturing sheath enters purpose ventricle across interventricular septum,
Further the bending angle of adjustment cutting tip provides the operating space of multi-angle for next step operation, and puncturing end opening can direction
Bicuspid valve or ventricle wall, help guide various instruments further to be treated.
Embodiment 2
As shown in figure 3, interventricular septum puncture instrument component can also include ventricle protector 3, ventricle protector is by the heart
Room protector is formed by connecting by cone-shaped head 31 and push rod 32, and cone-shaped head is netted cone made of Nitinol braiding
Body structure, cone inside are filled with insulant；Ventricle protector, which can be taken in, to be loaded intrathecal and is sent into conduit, by pushing away
After sending bar that cone-shaped head external extension in conduit, the cone-shaped head is made to be pushed out conduit, centrum shape is reverted to.
It is woven by nitinol alloy wire by cone-shaped head 31, there are many latticed gaps on surface, punctures seal wire and passes through
It can enter inside centrum through these gaps after interventricular septum, cotton-shaped insulating materials is equipped with inside centrum, high-frequency energy can be prevented
Conduction, and prevent from puncturing seal wire contact ventricular posterior wall impair cardiac.
Push pole length is ML100-180cm, a diameter of 6-7F, and cone-shaped head maximum gauge IJ is 4-10cm, preferably
It is 4-10cm, preferably 5cm for 6cm, cone-shaped head length LK.
Embodiment 3
Fig. 4 is the intervention flow chart of interventricular septum puncture instrument component of the present invention, as shown in figure 4, interventricular septum puncture instrument group
The interventional method of part, includes the following steps：
Step is inserted into atrial septal puncture sheath once femoral vein, punctures atrial septum and enters atrium sinistrum indwelling seal wire, along seal wire
It is sent into delivery conduit and enters left ventricle arrival apex, ventricle protector income loading is intrathecal, sheath and delivery conduit will be loaded
Tail portion is connected, and is inserted into the ventricle protector, pushes the push rod forward, and cone-shaped head is made to stretch out delivery conduit,
The head of cone is expanded in left ventricular apex；
Step 2 is sent into pigtail catheter through right external jugular vein and enters right ventricle by tricuspid valve, and indwelling seal wire withdraws from pigtail
Conduit is sent into the positioning sheath along seal wire and enters right ventricle, the curvature of positioning end is adjusted by rotating the crooked knob,
Positioning port is withstood at the target puncture of interventricular septum；
Step 3 is inserted into expander in positioning sheath pipe, and expander is sent to the positioning port of positioning sheath, along expansion
Device, which is inserted into, punctures seal wire, in puncturing the external high-frequency energy in seal wire tail portion, so that seal wire head is penetrated interventricular septum and enters in left ventricle, lead
Silk is inserted into after penetrating interventricular septum in the cone-shaped head；Along seal wire push expander is punctured by interventricular septum, expand puncture orifice；
Step 4 exits expander, retains seal wire, is packed into expander punctures in sheath in vitro, will puncture sheath edge and lead
Silk is inserted into positioning sheath, and cutting tip is passed through to the puncture orifice of interventricular septum, and push rod is taken in delivery conduit, withdraws from ventricle guarantor
Device is protected, puncture sheath is exited, rotation punctures the curvature of the crooked knob adjustment cutting tip of sheath, punctures port towards bicuspid valve
Or ventricle wall, it can help that various instruments is guided further to be treated.
Embodiments of the present invention above described embodiment only expresses, the description thereof is more specific and detailed, but can not
Therefore it is interpreted as the limitation to the scope of the claims of the present invention.It should be pointed out that for those of ordinary skill in the art,
Without departing from the inventive concept of the premise, various modifications and improvements can be made, these belong to the protection model of the present invention
It encloses.Therefore, the protection domain of patent of the present invention should be determined by the appended claims.
Claims (8)
1. a kind of interventricular septum puncture instrument component, including positioning sheath, puncture sheath, puncture seal wire, which is characterized in that described fixed
The both ends of position sheath are respectively positioning end and handheld terminal, and sheath middle section has curvature, set in the inner tubal wall of the positioning end
There is screw thread spring, positioning end sheath Bending Deformation, the connecting rod of spring can be caused to be connected to the bending being arranged on the handheld terminal
Knob rotates the crooked knob and controls the positioning end Bending Deformation, and the positioning sheath positions interventricular septum puncture position；
The puncture sheath pipe diameter is less than positioning sheath, and it is respectively cutting tip and handheld terminal, the cutting tip to puncture sheath both ends
Inner tubal wall be equipped with screw thread spring, cutting tip sheath Bending Deformation, the connecting rod of spring can be caused to be connected on the handheld terminal
The crooked knob of setting rotates the crooked knob and controls the cutting tip Bending Deformation, and the puncture sheath pipe is used for across room
Interval；
The puncture seal wire is inserted among puncture sheath when use, is punctured sheath and is inserted into positioning sheath, it is external to puncture seal wire
High-frequency energy punctures sheath and enters purpose ventricle across interventricular septum along seal wire is punctured via tip for piercing through interventricular septum.
2. interventricular septum puncture instrument component according to claim 1, which is characterized in that described to puncture a diameter of of seal wire
0.035 inch, head is that straight soft head or bending are disc-shaped, bending section can stress stretch, after removing external force, head restores curved
Song, seal wire outer surface are coated with insulating coating in addition to the parts 5~20mm of both ends end to end.
3. interventricular septum puncture instrument component according to claim 1, which is characterized in that interventricular septum puncture instrument component also wraps
Ventricle protector is included, the ventricle protector is formed by connecting by cone-shaped head with push rod, and the cone-shaped head is NiTi
Gauze cone structure made of alloy braiding, cone inside are filled with insulant；The ventricle protector can take in loading sheath
It is interior and be sent into delivery conduit, make cone-shaped head external extension in delivery conduit, the cone by pushing and pulling the push rod
After shape head is pushed out conduit, centrum shape is reverted to.
4. interventricular septum puncture instrument component according to any one of claim 1 or 2, which is characterized in that the positioning sheath
Pipe range is 40-80cm, a diameter of 10-28F, and sheath bent intermediate angle is 30-60 °, the vertex to positioning end top in knee
Distance is 3-15cm, and positioning end length is 1-5cm, and head end bending angle is 0-120 °.
5. the interventricular septum puncture instrument component according to any one of claim 1,2 or 3, which is characterized in that the puncture
The a length of 50-100cm of sheath, cutting tip length are 2-8cm, and cutting tip bending angle is 0-180 °, and the puncture seal wire is a diameter of
0.035 inch.
6. interventricular septum puncture instrument component according to claim 3, which is characterized in that the cone-shaped head surface is netted
Structure is coated with insulation coating, and the push pole length is 100-180cm, and a diameter of 6-7F of push rod, cone-shaped head is most
Major diameter is 4-10cm, and cone-shaped head length is 4-10cm.
7. interventricular septum puncture instrument component according to claim 6, which is characterized in that the cone-shaped head maximum gauge
For 6cm, cone-shaped head length is 5cm.
8. the interventional method of interventricular septum puncture instrument component according to claim 3, which is characterized in that including following step
Suddenly：
Step is inserted into atrial septal puncture sheath once femoral vein, punctures atrial septum and enters atrium sinistrum indwelling seal wire, is sent into along seal wire
Delivery conduit enters left ventricle and reaches apex, and ventricle protector income loading is intrathecal, will load sheath and delivery conduit tail portion
It is connected, is inserted into the ventricle protector, pushes the push rod forward, cone-shaped head is made to stretch out delivery conduit, taper
The head of body is expanded in left ventricular apex；
Step 2 is sent into pigtail catheter through right external jugular vein and enters right ventricle by tricuspid valve, and indwelling seal wire withdraws from pigtail catheter,
It is sent into the positioning sheath along seal wire and enters right ventricle, the curvature of positioning end is adjusted by rotating the crooked knob, will be determined
Bit port is withstood at the target puncture of interventricular septum；
Step 3 is inserted into expander in positioning sheath pipe, and expander is sent to the positioning port of positioning sheath, is inserted along expander
Enter to puncture seal wire, in puncturing the external high-frequency energy in seal wire tail portion, so that seal wire head is penetrated interventricular septum and enter in left ventricle, seal wire is worn
It is inserted into the cone-shaped head after saturating interventricular septum；Along seal wire push expander is punctured by interventricular septum, expand puncture orifice；
Step 4 exits expander, retains seal wire, is packed into expander punctures in sheath in vitro, will puncture sheath and is inserted along seal wire
Enter to position in sheath, cutting tip is passed through to the puncture orifice of interventricular septum, push rod is taken in delivery conduit, withdraws from ventricle protection
Device, exits puncture sheath, and rotation punctures the curvature of the crooked knob adjustment cutting tip of sheath.
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| CN109700508A (en) * | 2018-12-29 | 2019-05-03 | 先健科技(深圳)有限公司 | Piercing assembly and lancing system with it |
| CN109820576A (en) * | 2019-03-27 | 2019-05-31 | 武汉唯柯医疗科技有限公司 | Transportation system is intervened through atrial septum with puncture function |
| CN110448360A (en) * | 2019-08-19 | 2019-11-15 | 中国石油大学(北京) | A kind of multifunctional heart interval tubulose sting device and preparation method thereof and application |
| WO2020207118A1 (en) * | 2019-04-08 | 2020-10-15 | 中国石油大学(北京) | Puncture needle device for entering left ventricle through peripheral artery to puncture interventricular septum and preparation method |
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| CN113812998A (en) * | 2021-09-18 | 2021-12-21 | 王建 | Puncture reconstruction system for ventricular aneurysm |
| CN114727804A (en) * | 2019-09-20 | 2022-07-08 | 东端医疗有限公司 | Directional balloon transseptal insertion device for medical procedures and improved transseptal puncture system with puncture member balloon seal |
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