CN108852559B - Novel guiding catheter for aortic valve transvalve - Google Patents
Novel guiding catheter for aortic valve transvalve Download PDFInfo
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- CN108852559B CN108852559B CN201810787501.7A CN201810787501A CN108852559B CN 108852559 B CN108852559 B CN 108852559B CN 201810787501 A CN201810787501 A CN 201810787501A CN 108852559 B CN108852559 B CN 108852559B
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- 210000001765 aortic valve Anatomy 0.000 title claims abstract description 40
- 238000000926 separation method Methods 0.000 claims abstract description 7
- 229910001220 stainless steel Inorganic materials 0.000 claims description 6
- 239000010935 stainless steel Substances 0.000 claims description 6
- -1 polytetrafluoroethylene Polymers 0.000 claims description 3
- 229920001343 polytetrafluoroethylene Polymers 0.000 claims description 3
- 239000004810 polytetrafluoroethylene Substances 0.000 claims description 3
- 239000000463 material Substances 0.000 claims description 2
- 238000011065 in-situ storage Methods 0.000 abstract description 7
- 230000002349 favourable effect Effects 0.000 abstract description 2
- 241000446313 Lamella Species 0.000 abstract 4
- 206010002906 aortic stenosis Diseases 0.000 description 10
- 230000004083 survival effect Effects 0.000 description 8
- 208000024891 symptom Diseases 0.000 description 6
- 206010002383 Angina Pectoris Diseases 0.000 description 3
- 210000000709 aorta Anatomy 0.000 description 3
- 230000009286 beneficial effect Effects 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 206010042772 syncope Diseases 0.000 description 3
- 206010019280 Heart failures Diseases 0.000 description 2
- PXHVJJICTQNCMI-UHFFFAOYSA-N Nickel Chemical compound [Ni] PXHVJJICTQNCMI-UHFFFAOYSA-N 0.000 description 2
- TZCXTZWJZNENPQ-UHFFFAOYSA-L barium sulfate Chemical compound [Ba+2].[O-]S([O-])(=O)=O TZCXTZWJZNENPQ-UHFFFAOYSA-L 0.000 description 2
- 239000002872 contrast media Substances 0.000 description 2
- 238000002601 radiography Methods 0.000 description 2
- 208000004434 Calcinosis Diseases 0.000 description 1
- VYZAMTAEIAYCRO-UHFFFAOYSA-N Chromium Chemical compound [Cr] VYZAMTAEIAYCRO-UHFFFAOYSA-N 0.000 description 1
- 206010010356 Congenital anomaly Diseases 0.000 description 1
- 208000000059 Dyspnea Diseases 0.000 description 1
- 206010013975 Dyspnoeas Diseases 0.000 description 1
- 241000792859 Enema Species 0.000 description 1
- HTTJABKRGRZYRN-UHFFFAOYSA-N Heparin Chemical compound OC1C(NC(=O)C)C(O)OC(COS(O)(=O)=O)C1OC1C(OS(O)(=O)=O)C(O)C(OC2C(C(OS(O)(=O)=O)C(OC3C(C(O)C(O)C(O3)C(O)=O)OS(O)(=O)=O)C(CO)O2)NS(O)(=O)=O)C(C(O)=O)O1 HTTJABKRGRZYRN-UHFFFAOYSA-N 0.000 description 1
- 208000006083 Hypokinesia Diseases 0.000 description 1
- 206010021718 Induced labour Diseases 0.000 description 1
- 208000002193 Pain Diseases 0.000 description 1
- 206010033557 Palpitations Diseases 0.000 description 1
- 206010064911 Pulmonary arterial hypertension Diseases 0.000 description 1
- 206010067171 Regurgitation Diseases 0.000 description 1
- 208000025747 Rheumatic disease Diseases 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 230000002308 calcification Effects 0.000 description 1
- 210000005242 cardiac chamber Anatomy 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 229910052804 chromium Inorganic materials 0.000 description 1
- 239000011651 chromium Substances 0.000 description 1
- 238000005345 coagulation Methods 0.000 description 1
- 230000015271 coagulation Effects 0.000 description 1
- 230000007797 corrosion Effects 0.000 description 1
- 238000005260 corrosion Methods 0.000 description 1
- 208000002173 dizziness Diseases 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000002565 electrocardiography Methods 0.000 description 1
- 239000007920 enema Substances 0.000 description 1
- 229940095399 enema Drugs 0.000 description 1
- 238000011156 evaluation Methods 0.000 description 1
- 210000001035 gastrointestinal tract Anatomy 0.000 description 1
- 230000036541 health Effects 0.000 description 1
- 210000003709 heart valve Anatomy 0.000 description 1
- 229960002897 heparin Drugs 0.000 description 1
- 229920000669 heparin Polymers 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 230000036244 malformation Effects 0.000 description 1
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- 230000000750 progressive effect Effects 0.000 description 1
- 239000002994 raw material Substances 0.000 description 1
- 230000000552 rheumatic effect Effects 0.000 description 1
- 230000002966 stenotic effect Effects 0.000 description 1
- 238000011477 surgical intervention Methods 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 239000000725 suspension Substances 0.000 description 1
- 230000009747 swallowing Effects 0.000 description 1
- 238000002604 ultrasonography Methods 0.000 description 1
- 230000002861 ventricular Effects 0.000 description 1
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
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2466—Delivery devices therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00778—Operations on blood vessels
- A61B2017/00783—Valvuloplasty
Landscapes
- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Surgery (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Vascular Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Transplantation (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Prostheses (AREA)
Abstract
The invention relates to a novel guiding catheter for aortic valve transvalve, which comprises an outer catheter, an intra-fixed layer catheter and an intra-transvalve layer catheter, wherein the intra-fixed layer catheter and the intra-transvalve layer catheter are arranged in the outer catheter; one end of the fixed-layer inner catheter is separated from the transvalve inner catheter to form an angle, and an elastic device is arranged at the separation position of the fixed-layer inner catheter and the transvalve inner catheter. This a novel guide pipe for aortic valve strides lamella, simple structure is ingenious, is the angle setting through the separation of fixed in situ pipe and striding the in situ pipe one end of lamella to set up resilient means between fixed in situ pipe and striding the in situ pipe of lamella of separation, make this novel guide pipe adaptability excellent, the range of application is wide, the operation of being convenient for can reduce the complexity of art person's operation, reduces the degree of difficulty of striding the lamella through guide pipe seal wire, is favorable to this guide pipe to promote and use on market.
Description
Technical Field
The invention relates to the technical field of medical appliances, in particular to a novel guiding catheter for aortic valve transvalve.
Background
The aortic valve is a semilunar valve, and is positioned between the left ventricular outflow tract and the aorta, blood flow can flow forward through the aortic valve unimpeded, regurgitation can be prevented when the aortic valve is closed, and the aortic valve is positioned at the center and is closely related to each heart chamber and valve.
Aortic stenosis refers to a small area of the aortic orifice due to rheumatic, congenital malformations, senile calcifications, and the like. Aortic stenosis can experience a fairly long asymptomatic period, but progresses rapidly once it occurs, with a 2-year survival rate of only 20-50% without timely surgical intervention. Typical symptoms of a typical aortic valve pathology are labored dyspnea, angina and syncope. Ultrasound electrocardiography is the preferred evaluation means for diagnosing aortic stenosis.
Patients with aortic stenosis are mostly in a latent state in early stages, mostly asymptomatic, or have symptoms of nonspecific manifestations such as palpitation, dizziness and hypodynamia, and as the aortic stenosis progresses, the effective orifice area of the patient becomes smaller and smaller, and progressive exercise tolerance can be reduced. Patients with aortic stenosis can be hidden until the age of approximately 60 years before significant clinical symptoms (angina pectoris, syncope and heart failure) appear, and once symptoms appear, the survival rate is suddenly changed, if no active treatment is carried out, the survival time of patients with aortic stenosis with labor-induced angina symptoms is 5 years on average, the survival time of patients with syncope symptoms with aortic stenosis is 3 years on average, and the survival time of patients with severe heart failure is only 1.5-2 years, and the median survival time of patients with severe aortic stenosis and pulmonary arterial hypertension is only 436 days. Statistics from National Institutes of Health (NIH) indicate that patients with severe aortic stenosis, such as those without surgery or percutaneous aortic valve replacement (transcatheter aortic valve replacement, TAVR), have less than half (48%) 5-year survival and less than 10% 10-year survival with clinical symptoms.
Transcatheter aortic valve implantation (TAVR) refers to the placement of an assembled aortic valve into the aortic root through a catheter, replacing the original aortic valve, and functionally completing the replacement of the aortic valve. The technology has been paid attention from birth and has become a bright star for interventional cardiology in recent years.
During a transcatheter aortic valve replacement procedure, a guidewire is conventionally guided over a stenotic aortic valve by a guide catheter to construct a passageway that lays a foundation for a subsequent series of procedures. The guidewires currently employed are catheters designed for coronary intervention. Because the aortic valve root and the ascending aorta morphological structures are different, and the operation difficulty is high in the operation process with a small application range of the existing guiding catheter, the technical requirement on an operator is high, the guiding wire is difficult to smoothly cross the aortic valve in place through the guiding catheter at one time, the operation is usually carried out for multiple times, and the possible complications are increased while the related operation risks are increased.
Disclosure of Invention
In order to solve the problems in the prior art, the invention provides a novel guiding catheter for aortic valve crossing, which has the advantages of simple and ingenious structure, convenient operation and good adaptability, can effectively relieve pain of patients, and is beneficial to popularization and application of the guiding catheter in the technical field of medical appliances.
In order to achieve the aim, the novel guiding catheter for aortic valve transvalve comprises an outer catheter, a fixed-layer inner catheter and a transvalve inner catheter, wherein the fixed-layer inner catheter and the transvalve inner catheter are arranged in the outer catheter; one end of the fixed-layer inner catheter is separated from the transvalve inner catheter to form an angle, and an elastic device is arranged at the separation position of the fixed-layer inner catheter and the transvalve inner catheter.
As a preferable scheme of the invention, a line is arranged on one side of the transvalve intralayer catheter, which is far away from the fixed intralayer catheter.
As a preferable mode of the invention, one end of the intra-fixed layer catheter separated from the inter-valve layer catheter is a proximal end, the other end is a distal end, and the distal end of the intra-fixed layer catheter is connected to the fixed layer catheter connector.
As a preferred embodiment of the present invention, the distal end of the catheter in the transvalve layer is connected to a catheter hub.
As a preferred embodiment of the present invention, the outer catheter is connected to a catheter hub.
As a preferred embodiment of the present invention, the catheter holder is provided with a connector, and the wire is connected to the connector at one end.
As a preferred embodiment of the present invention, the connector is a rotary connector.
As a preferred embodiment of the present invention, the line is made of stainless steel material.
As a preferable scheme of the invention, the outer surface of the line is covered with a polytetrafluoroethylene film layer.
As a preferred embodiment of the present invention, the elastic means is a spring.
Compared with the prior art, the invention has the beneficial effects that: the novel guiding catheter for aortic valve crossing has a simple and ingenious structure, the fixed-layer inner catheter and one end of the valve-crossing inner catheter are separated to be arranged at an angle, and the elastic device is arranged between the separated fixed-layer inner catheter and the valve-crossing inner catheter, so that the novel guiding catheter has excellent adaptability, wide application range and convenient operation, can reduce the complexity of operation of operators, reduces the difficulty of valve crossing through the guiding catheter guide wire, and is beneficial to popularization and application of the guiding catheter in the market.
Drawings
FIG. 1 is a schematic structural view of a novel guide catheter for aortic valve transvalve in an embodiment;
FIG. 2 is an enlarged schematic view of the structure at A in FIG. 1;
FIG. 3 is an enlarged schematic view of the structure at B in FIG. 1;
FIG. 4 is a schematic structural view of a novel guide catheter for aortic valve transvalve in an embodiment;
FIG. 5 is a structural cross-sectional view at a catheter hub in a novel guide catheter for aortic valve transvalve in an embodiment;
fig. 6 is a schematic view of the use of the novel guide catheter for aortic valve transvalve in an embodiment.
Reference numerals: 1. an outer conduit; 2. fixing the inner conduit; 3. a transvalve intralaminar catheter; 4. an elastic device; 5. a line; 6. a catheter holder; 7. a fixed layer catheter connector; 8. a connector.
Detailed Description
Embodiments of the present invention will be described in detail below with reference to the accompanying drawings.
Examples: as shown in fig. 1 to 6, the novel guiding catheter for aortic valve crossing comprises an outer catheter 1, a fixed-layer inner catheter 2 and a valve-crossing inner catheter 3, wherein the fixed-layer inner catheter 2 and the valve-crossing inner catheter 3 are arranged in the outer catheter 1 and are arranged along the edge of the outer catheter 1, and the direction of the outer catheter 1 can be changed to change the convenience of the fixed-layer inner catheter 2 and the valve-crossing inner catheter 3, so that the operation of medical staff is facilitated.
One end of the fixed-layer inner catheter 2 is separated from the valve-crossing inner catheter 3 to form an angle, and an elastic device 4 is arranged at the separation position of the fixed-layer inner catheter 2 and the valve-crossing inner catheter 3, so that the separation distance between the fixed-layer inner catheter 2 and the valve-crossing inner catheter 3 can be adjusted, the main valve-crossing under different conditions can be dealt with, and the application range of the guide catheter is wider.
The outer catheter 1 is made of full contrast TPU raw materials (X-ray irradiation is used in hospitals, the catheter is white on an X-ray image sheet and used for determining the position of the catheter under the X-ray), the contrast agent adding proportion is 20% -50% (weight ratio is used here, contrast agent such as barium sulfate is prepared into suspension for swallowing or enema for digestive tract radiography), the contrast effect is good, the inner diameter and outer diameter ratio value of the outer catheter 1 is 0.58-0.68, good supporting performance can be ensured, and the catheter is convenient to put in a tube.
The elastic device 4 can be a spring, has a simple structure and low use cost, and can effectively reduce the manufacturing cost of the guiding catheter, thereby reducing the use cost of a patient.
The line 5 is arranged on one side of the transvalve inner catheter 3 far away from the fixed inner catheter 2, the line 5 can be a guide wire with a simple structure, the line 5 is made of stainless steel, preferably medical stainless steel (the main component is 18% chromium+10% nickel), in order to facilitate medical staff to align the proximal end of the transvalve guiding catheter with a narrow aortic valve opening, the line 5 is made of stainless steel, the medical stainless steel is durable and corrosion-resistant, the elastic device 4 is in a zero-stretching state when the catheter is sent forwards, the outer catheter 1, the fixed inner catheter 2 and the transvalve inner catheter 3 are in a straight line, the outer catheter 1, the fixed inner catheter 2 and the transvalve inner catheter 3 are pushed gently, the trend is guided reasonably, and the trend can be observed under perspective and can be confirmed by matching with a radiography technology if necessary.
The outer surface of the line 5 can be further coated with a polytetrafluoroethylene film layer, so that the guide wire is smoother, the friction coefficient between the guide wire and a catheter is reduced, the guide wire with better quality can be subjected to heparin treatment, and the guide wire has the capability of preventing coagulation besides small friction force.
The one end that separates of fixed in-situ catheter 2 and striding in-valve catheter 3 is the proximal end, and the other end that separates one end of fixed in-situ catheter 2 and striding in-valve catheter 3 is the distal end, and fixed in-situ catheter 2 distal end is connected at fixed layer catheter connector 7, and fixed layer catheter connector 7 plays the supporting role, and fixed layer catheter connector 7 exposes outside the patient, is convenient for the operating personnel handheld. The guide wire in the fixed layer 2 is provided with a harder guide wire, so that the fixed layer guide wire 2 can be fixed relatively conveniently, and the position of the fixed layer guide wire 2 is not displaced obviously relatively in the subsequent adjustment of the transvalve layer guide wire 3.
The distal end of the transvalve inner catheter 3 is connected to the catheter seat 6, and the catheter seat 6 is arranged to facilitate the fixation of one end of the transvalve inner catheter 3, so that the inner and outer catheters 1 of the transvalve inner catheter 3 are prevented from being shifted to influence the operation.
The outer catheter 1 is connected to the catheter holder 6, so that one end of the outer catheter 1 is conveniently fixed, and the catheter holder 6 is exposed outside the patient body, so that the outer catheter is convenient for an operator to hold.
The catheter seat 6 is provided with a connector 8, one end of the line 5 is connected to the connector 8, the connector 8 is a rotary connector, external threads can be arranged on the line 5, and internal threads are arranged on the connector 8, so that the line 5 is in threaded connection with the connector 8.
The area through which the narrow aortic valve orifice can pass is relatively small, the included angles between the aortic valve orifice and the ascending aorta are different from person to person, the anatomical structure is complex and various, through the arrangement of the rotary connector, the transvalve intraformational catheter 3 can be pulled through the line 5, and under the balance with the elastic device 4, the different angles are adjusted based on the fixed intraformational catheter 2, so that the proximal end of the transvalve guiding catheter is aligned with the narrow aortic valve orifice
The novel guiding catheter for aortic valve crossing in the embodiment has a simple and ingenious structure, is arranged by separating the fixed inner catheter 2 from one end of the valve crossing inner catheter 3, and is provided with the elastic device 4 between the separated fixed inner catheter 2 and the valve crossing inner catheter 3, so that the novel guiding catheter has excellent adaptability, wide application range and convenient operation, can reduce the complexity of operation of operators, reduces the difficulty of valve crossing through guiding catheter guide wires, and is favorable for popularization and application of the guiding catheter on the market.
The previous description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the spirit or scope of the invention; thus, the present invention is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.
Although the reference numerals in the figures are used more herein: 1. an outer conduit; 2. fixing the inner conduit; 3. a transvalve intralaminar catheter; 4. an elastic device; 5. a line; 6. a catheter holder; 7. a fixed layer catheter connector; 8. connectors, etc., but does not exclude the possibility of using other terms. These terms are used merely for convenience in describing and explaining the nature of the invention; they are to be interpreted as any additional limitation that is not inconsistent with the spirit of the present invention.
Claims (7)
1. A guide catheter for aortic valve transvalve, characterized in that: the valve-crossing catheter comprises an outer catheter (1), a fixed-layer inner catheter (2) and a valve-crossing inner catheter (3), wherein the fixed-layer inner catheter (2) and the valve-crossing inner catheter (3) are arranged in the outer catheter (1); one end of the fixed-layer inner catheter (2) is separated from the transvalve inner catheter (3) to form an angle, an elastic device (4) which enables the distance between the fixed-layer inner catheter (2) and the transvalve inner catheter (3) to be adjustable is arranged at the separation position of the fixed-layer inner catheter (2) and the transvalve inner catheter (3), the elastic device (4) is a spring, and the spring is in a zero-stretching state when the guide catheter is sent forwards; a line (5) is arranged on one side, far away from the fixed-layer inner catheter (2), of the transvalve inner catheter (3); the inner fixed layer catheter (2) is separated from the inner transvalve catheter (3) by a proximal end and a distal end, and the distal end of the inner fixed layer catheter (2) is connected with the inner fixed layer catheter connector (7).
2. The guide catheter for aortic valve transvalve according to claim 1, wherein: the far end of the transvalve inner catheter (3) is connected with a catheter seat (6).
3. The guide catheter for aortic valve transvalve according to claim 2, wherein: the outer catheter (1) is connected to the catheter holder (6).
4. The guide catheter for aortic valve transvalve according to claim 2, wherein: the catheter seat (6) is provided with a connector (8), and one end of the line (5) is connected with the connector (8).
5. The guide catheter for aortic valve transvalve as set forth in claim 4, wherein: the connector (8) is a rotary connector.
6. The guide catheter for aortic valve transvalve according to claim 1, wherein: the line (5) is made of stainless steel material.
7. The guide catheter for aortic valve transvalve according to claim 6, wherein: the outer surface of the line (5) is covered with a polytetrafluoroethylene film layer.
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CN201810787501.7A CN108852559B (en) | 2018-07-18 | 2018-07-18 | Novel guiding catheter for aortic valve transvalve |
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CN201810787501.7A CN108852559B (en) | 2018-07-18 | 2018-07-18 | Novel guiding catheter for aortic valve transvalve |
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CN108852559B true CN108852559B (en) | 2024-02-20 |
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CN110123392B (en) * | 2019-03-26 | 2022-09-02 | 江苏省人民医院(南京医科大学第一附属医院) | Accurate location aortic valve passes through device |
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CN108852559A (en) | 2018-11-23 |
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