CN109549756A - Heart valve - Google Patents

Heart valve Download PDF

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Publication number
CN109549756A
CN109549756A CN201710872489.5A CN201710872489A CN109549756A CN 109549756 A CN109549756 A CN 109549756A CN 201710872489 A CN201710872489 A CN 201710872489A CN 109549756 A CN109549756 A CN 109549756A
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CN
China
Prior art keywords
choked flow
leaflet bracket
leaflet
bracket
heart valve
Prior art date
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.)
Granted
Application number
CN201710872489.5A
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Chinese (zh)
Other versions
CN109549756B (en
Inventor
蒋坤
刘香东
姚斌
周涵
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Shenzhen Jianxin Medical Technology Co ltd
Original Assignee
Lifetech Scientific Shenzhen Co Ltd
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Priority to CN201710872489.5A priority Critical patent/CN109549756B/en
Publication of CN109549756A publication Critical patent/CN109549756A/en
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Publication of CN109549756B publication Critical patent/CN109549756B/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart 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
    • A61F2/2469Heart 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 with resilient valve members, e.g. conical spiral

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  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

The present invention relates to a kind of heart valves.A kind of heart valve, including leaflet bracket and the choked flow piece being wrapped on the leaflet bracket, the leaflet bracket has first end and the second end opposite with the first end, the leaflet bracket includes the wave circle that multiple axially spaced-aparts along the leaflet bracket are arranged, the choked flow piece covers the outer surface of the leaflet bracket, and the choked flow piece is pressed into the wave circle of the leaflet bracket close to the second end in one end of the second end close to the leaflet bracket, so that the leaflet bracket is located at the outer surface of the choked flow piece close to the wave circle of the second end.Above-mentioned heart valve, choked flow piece are not easy to be stuck in outside sheath, avoid the heart valve destruction of caused sheath to outer layer choked flow piece when entering sheath, choked flow piece can be protected not to be destroyed in one end of second end indentation leaflet bracket to enter choked flow piece when sheath.

Description

Heart valve
Technical field
The present invention relates to medical instruments fields, more particularly to a kind of heart valve.
Background technique
Heart valve disease is a kind of very universal cardiac disorder, and wherein the damage of valve caused by rheumatic fever is the most often See one of reason.As aging of population aggravates, caused valve lesion after senile valvular heart disease and coronary heart disease myocardial infarction Also increasingly common.These valve lesions not only life threatening safety, influence quality of life, while bring to family and society it is heavy The burden and pressure of weight.The heart of human body is divided into four atrium sinistrum, left ventricle and atrium dextrum, right ventricle chambers of the heart, two atrium point It is not connected with two ventricles, two ventricles and two main arteries are connected.Heart valve is just grown between atrium and ventricle, ventricle Between main artery, play the role of one-way cock, helps blood flow unidirectional motion.Four valves of human body are referred to as two points Valve, tricuspid valve, aorta petal and pulmonary valve.These valves just will affect the movement of blood flow in the event of lesion, to make At heart dysfunction, heart failure is eventually led to.
In recent years, the patient of mitral stenosis and reflux can also be replaced with percutaneous through the mitral valve of sheath Art is implanted into heart valve by intervention, minimally invasive method and carries out this operation, patient is allowed to avoid the hardship of open chest surgery.It is existing When the heart valves such as some brackets usually pass through sheath and are implanted into, the free end of choked flow piece is easy to be stuck in outside sheath when into sheath Face is easily destroyed choked flow piece and causes perivalvular leakage.
Summary of the invention
Based on this, it is necessary to provide a kind of heart valve that choked flow piece when being avoided that sheath is stuck in outside sheath.
A kind of heart valve, including leaflet bracket and the choked flow piece being wrapped on the leaflet bracket, the leaflet bracket With first end and the second end opposite with the first end, the leaflet bracket includes multiple axial directions along the leaflet bracket Spaced wave circle, the choked flow piece covers the outer surface of the leaflet bracket, and the choked flow piece is close to the leaflet One end of the second end of bracket is pressed into the wave circle of the leaflet bracket close to the second end, so that the leaflet branch Frame is located at the outer surface of the choked flow piece close to the wave circle of the second end.
Above-mentioned heart valve, choked flow piece is in one end of second end indentation leaflet bracket, to enter when sheath choked flow piece not It is easily stuck in outside sheath, avoids the heart valve destruction of caused sheath to outer layer choked flow piece when entering sheath, choked flow can be protected Part is not destroyed.
Detailed description of the invention
Fig. 1 is the valvular structural schematic diagram of an embodiment;
Fig. 2 is the status diagram that heart valve shown in FIG. 1 is implanted into heart;
Fig. 3 is the valvular partial structure diagram of Fig. 1;
Fig. 4 is the structural schematic diagram of the valvular bracket of Fig. 1;
Fig. 5 is the partial cutaway view of the valvular bracket of Fig. 1;
Fig. 6 is the outline drawing of the valvular skirt hanger of Fig. 1;
Fig. 7 is the structural schematic diagram of another angle of bracket of Fig. 4;
Fig. 8 is the flat deployable structure schematic diagram of the bracket of Fig. 4;
Fig. 9 is the partial sectional view after the heart valve of Fig. 1 is connect with hollow wirerope;
Figure 10 is the structural schematic diagram of an angle of the valvular connector of Fig. 1;
Figure 11 is the structural schematic diagram of another angle of heart valve of Fig. 1;
Figure 12 is the valvular structural schematic diagram of another embodiment;
Figure 13 is the partial sectional view after the heart valve of another embodiment is connect with hollow wirerope;
Figure 14 is the structural schematic diagram of an angle of valvular connector shown in Figure 13;
Figure 15 is the partial sectional view that the heart valve of another embodiment cooperates with hollow wirerope and sheath;
Figure 16 is the stereogram exploded view of the valvular connector in Figure 15;
Figure 17 is the partial cutaway view of the valvular bracket of another embodiment;
Figure 18 is the structural schematic diagram of the valvular bracket of another embodiment;
Figure 19 is the outline drawing of the valvular skirt hanger of Figure 18;
Outline drawing after valvular leaflet and skirt hanger assembling that Figure 20 is Figure 18;
Figure 21 is the flat deployable structure schematic diagram of the valvular bracket of another embodiment;
Figure 22 is the valvular structural schematic diagram of another embodiment;
Figure 23 is the valvular structural schematic diagram of another embodiment;
Figure 24 is the valvular structural schematic diagram of another embodiment.
Specific embodiment
To facilitate the understanding of the present invention, a more comprehensive description of the invention is given in the following sections with reference to the relevant attached drawings.In attached drawing Give preferred embodiment of the invention.But the invention can be realized in many different forms, however it is not limited to herein Described embodiment.On the contrary, purpose of providing these embodiments is keeps the understanding to the disclosure more saturating It is thorough comprehensive.
It should be noted that it can directly on the other element when element is referred to as " being fixed on " another element Or there may also be elements placed in the middle.When an element is considered as " connection " another element, it, which can be, is directly connected to To another element or it may be simultaneously present centering elements.Term as used herein " vertical ", " horizontal ", " left side ", " right side ", "upper", "lower", " remote ", " close " and similar statement are for illustrative purposes only.
Unless otherwise defined, all technical and scientific terms used herein and belong to technical field of the invention The normally understood meaning of technical staff is identical.Term as used herein in the specification of the present invention is intended merely to description tool The purpose of the embodiment of body, it is not intended that in the limitation present invention.Term " and or " used herein includes one or more phases Any and all combinations of the listed item of pass.
Please refer to Fig. 1 and Fig. 2, in the present embodiment, to heart valve 100 by taking mitral valve bracket as an example Structure is illustrated, and certainly, in other embodiments, heart valve 100 is not limited to mitral valve branch shown in Fig. 1 Frame can also be other kinds of artificial valve bracket, such as pulmonary valve valve bracket, aortic valve stent.
Please refer to Fig. 2 and Fig. 3, heart valve 100 includes bracket 110, connector 130, tether 150, choked flow piece 170 And leaflet 190.
Referring to Fig. 4, bracket 110 includes leaflet bracket 112, skirt hanger 114 and connecting rod 116.
In the illustrated embodiment, leaflet bracket 112 is substantially cylindrical, has first end and opposite with first end Second end.It should be noted that in the illustrated embodiment, first end is distal end, and second end is proximal end.Heart valve distal end Indicate that one end in surgical procedure far from operator, proximal end indicate one end that proximal operator is depended in surgical procedure.Leaflet bracket 112 Including wave circle 1121 and connecting rod 1123.Leaflet bracket 112 includes the wave that multiple axially spaced-aparts along leaflet bracket 112 are arranged Circle 1121 and the connecting rod 1123 for connecting two adjacent wave circles.Wave circle 1121 provides the radial support power of leaflet bracket 112, is scheming In the embodiment shown, leaflet bracket 112 includes three wave circles 1121.
Three wave circles 1121 are connected and fixed by multiple connecting rods 1123.In the illustrated embodiment, connecting rod 1123 Quantity it is identical as the quantity of the trough of wave circle 1121, connecting rod 1123 simultaneously with the trough of three wave circles 1121 is fixed connects It connects.Certainly, in other embodiments, connecting rod 1123 can also be with the fixed company of other positions such as wave crest of wave circle 1121 It connects.
Please refer to Fig. 4 and Fig. 5, skirt hanger 114 includes support portion 1141 and warping part 1143.Support portion 1141 is certainly Leaflet bracket 112 extends radially outwardly along leaflet bracket 112, and 1143 self-supporting portion 1141 of warping part is far from leaflet bracket 112 One end to the first end of leaflet bracket 112 bend extend.Support portion 1141 is used for heart valve 100 in the human body of heart 20 The fixation of mitral annulus, warping part 1143 is for preventing the edge of skirt hanger 114 to the abrasion of left atrial tissue.If not yet Have warping part 1143 then radial support portion 1141 remote edge directly and atrial tissue contact, under long-term heartbeat Cutting effect can be then formed to atrial tissue, cause atrial tissue impaired.And have the presence of warping part 1143, skirt hanger 114 Face contact has been reformed into atrial tissue contact, contact area has been increased, reduces footprint pressure, avoid skirt hanger 114 To the cutting effect of heart tissue, and caused by denude.
In embodiment shown in Fig. 4, the first of the support portion 1141 of skirt hanger 114 and close leaflet bracket 112 The trough of the wave circle 1121 at end is affixed.In this way, 112 nearly three points of leaflet bracket can be allowed when heart valve 100 is implanted into heart 20 One of axial dimension be located at atrium sinistrum, so that it be avoided excessively to be implanted into left ventricle and cause left ventricular outflow tract narrow or even obstruct Resistance.
It should be noted that leaflet bracket 112 is also not necessarily limited to centainly include wave circle 1121 and connecting rod 1123, can also be Other structures, skirt hanger are also not necessarily connect with the trough of wave circle 1121.As long as can guarantee skirt hanger 114 close to leaflet branch One end of frame 112 substantially 1/4~1/2 of the axial length of leaflet bracket 112, preferably three points at a distance from first end One of.Certainly, as needed, skirt hanger 114 can also be adjusted close to the difference in one end of leaflet bracket 112 circumferentially face Position is not exactly the same at a distance from first end at a distance from first end, that is, skirt hanger 114 close to leaflet bracket 112 one Hold the different location on different circumferencial directions.
The width of the support portion 1141 of skirt hanger 114 is 2mm~6mm in one of the embodiments,.Herein, it supports The width in portion 1141 refers to support portion 1141 close to the distance between one end of warping part 1143 and leaflet bracket 112.Support The width in portion 1141 is 2mm~6mm, this width is approximately equal to the width on the inside of 20 mitral annulus of human heart to atrial wall That is the radial width of annulus can fully ensure that heart valve 100 in the fixation of human heart mitral annulus.
The height of warping part 1143 is 2mm~6mm in one of the embodiments,.Herein, the height of warping part 1143 Refer to the one end of warping part 1143 far from support portion 1141 and the distance between one end close to support portion 1141.Warping part The too low edge that cannot prevent skirt hanger 114 well of 1143 height is too high to the abrasion of heart tissue, may hurt To its hetero-organization of atrium sinistrum.
Referring to Fig. 6, the profile of the support portion 1141 of skirt hanger 114 in terms of valve blood flow inflow side, is circular ring shape, outside Profile is circle, and the outer profile of certain support portion 1141 can also be other shapes.
Referring to Fig. 7, in the illustrated embodiment, skirt hanger 114 includes multiple skirt subelements, skirt subelement Substantially petal, multiple skirt subelements are uniformly distributed along the circumferential direction of leaflet bracket 112.Each skirt subelement includes branch Support part 1141 and warping part 1143.
Referring to Fig. 4, connecting rod 116 includes proximal link 1162, leaflet rack rod 1164 and connector 1166.Closely End link 1162 is generally rod-shaped.The substantially V-type of leaflet rack rod 1164, one end including two proximally connecting rods 1162 are prolonged The strut stretched, two one end of strut far from proximal link 1162 are adjacent close to the wave circle of second end with leaflet bracket 112 respectively Two troughs it is affixed.Each trough is connect with a strut, so that multiple connecting rods 116 are uniformly distributed along second end, thus Guiding role is played when heart valve 100 takes in sheath, trough is prevented to be stuck in outside sheath.If leaflet rack rod 1164 connects Leaflet bracket 112 is connected at the wave crest of the wave circle of second end, when heart valve 100 is when entering sheath, trough can be stuck in sheath Outside.In other embodiments, leaflet rack rod 1164 further includes affixed bar, middle part and the proximal link 1162 of affixed bar One end is affixed and substantially vertical proximal link 1162, and two struts are respectively from the middle part of affixed bar to far from proximal link 1162 One end inclination extends, and affixed close to two adjacent troughs of the wave circle of second end with leaflet bracket 112 respectively.
Connector 1166 is formed in the one end of proximal link 1162 far from leaflet rack rod 1164.In embodiment illustrated In, connector 1166 is generally rod-shaped, extends perpendicular to proximal link 1162, and certainly, in other embodiments, connector 1166 is also It can be wafer type, or spherical.
In the illustrated embodiment, it is leaflet bracket 112, skirt hanger 114 and connecting rod 116 by same that bracket 110 is whole One tubing is cut, and is integrally formed structures.One cutting obtains flat deployable structure schematic diagram such as Fig. 8 of bracket 100 It is shown.Certainly, it is pointed out that it is shown in Fig. 8 be expanded view, bracket 110 by tubing one cut after still substantially Tubulose is shaped into shape as shown in Figure 4 by heat treatment process.The relatively seperated cutting of one cutting is then assembled, has pressure The advantages of radial dimension is small after contracting, is easy into sheath, while each section of bracket 100 cancels welding or splicing construction, also improves The anti-fatigue performance of bracket 100.In the present embodiment, bracket 110 is 6~10mm by diameter, and wall thickness is 0.3~0.5mm's It is cut with superelastic nickel titanium tubing.
Please refer to Fig. 1, Fig. 4, Fig. 9 and Figure 10, the connector 1166 and connector 130 of the connecting rod 116 of bracket 110 connect It connects.Connector 130 include plug socket 132 and connection cover 134, the connector 1166 of connecting rod 116 be contained in plug socket 132 with connect In the cavity that lid 134 is formed.In the illustrated embodiment, plug socket 132 is substantially cylindrical, and one end is recessed to form container 1322, the other end offers screw hole 1324.In the illustrated embodiment, screw hole 1324 is connected to container 1322.Specifically, One end that plug socket 132 offers screw hole 1324 gradually tapers up as taper type.Heart valve 100 in one of the embodiments, It further include hollow wirerope 30, the conveying for accessory heart valve 100.Screw hole 1324 can with for conveying heart valve 100 Hollow wirerope 30 connect, one end of hollow wirerope 30 is equipped with screw thread, so as to screw togather with screw hole 1324, thus by hollow steel One end of cable 30 and connector 130 are fixed, and connection can be released by way of rotation.When heart valve 100 is in conveying sheath When conveying in pipe, hollow wirerope 30 can play the role of pushing and pulling heart valve 100, allow heart valve 100 in delivery sheath It is moved in chamber, and after heart valve 100 is discharged from delivery sheath, it can also be by heart valve 100 by hollow wirerope 30 Delivery sheath is retracted again.In the illustrated embodiment, the length of the screw thread of the depth of screw hole 1324 and hollow 30 one end of wirerope Spend roughly the same, certainly, in other embodiments, the depth of screw hole 1324 is greater than the length of the screw thread of hollow 30 one end of wirerope Degree.
The lid of connection cover 134 sets and is fixed on container 1322.In the illustrated embodiment, connection cover 134 is contained in Tank 1322 and with the cell wall of container 1322 by being welded and fixed.Connection cover 134 offers multiple limit holes 1342, each limit Position hole 1342 extends from the end of connection cover 134 to center.Each connecting rod 116 is arranged in a limit hole 1342, connector 1166 It is contained in container 1322.Connector 1166 supports a side surface of the connection cover 134 close to screw hole 1324.In embodiment illustrated In, the aperture that at least one-dimensional size of connector 1166 is greater than limit hole 1342 falls off to avoid connector 1166 from limit hole 1342.
One end of tether 150 is formed with blocking portion 152.Tether 150 is inserted in screw hole 1324 and blocking portion 152 is contained in Container 1322.The one-dimensional size of blocking portion 152 is greater than the internal diameter of screw hole 1324, to avoid blocking portion 152 from screw hole 1324 It falls off.The material of tether 150 in terylene, nylon, ultra-high molecular weight polyethylene, NiTi and stainless steel braided wires at least one Kind.In the illustrated embodiment, the tieing that blocking portion 152 is formed by knots tied for one end of tether 150.Certainly, in other implementations In mode, or be formed in the other structures of 150 one end of tether, fall off as long as being avoided that from from screw hole 1324.Make Used time, tether 150 extend outwardly and pass through the inner hole of hollow wirerope 30 from container 1322, prevent the directly exposure of blocking portion 152 In ventricle, and cause thrombus;It is also prevented from blocking portion 152 simultaneously in the unconfined movement in distal end.
In the illustrated embodiment, connection cover 134 is plate in homogeneous thickness.In other embodiments, connection cover 134 are formed with boss in the middle part of the side of screw hole 1324, and boss supports the cell wall of container 1322, and connector 1166 is housed in In container 1322 and multiple connectors 1166 are set around boss, and connection cover 134 opens up the through-hole worn for tether 150 i.e. at this time Can, tether 150 is arranged in through-hole and blocking portion 152 supports a side surface of 134 connector 1166 of connection cover.Certainly, in order to Guarantee uniform force, through-hole is opened in the middle part of connection cover 134 and through boss.
In the illustrated embodiment, screw hole 1324 extends to container 1322 to the two connection.Certainly, in other realities It applies in mode, screw hole 1324 is connected to and opening up the through-hole worn for tether 150 with container 1322.Certainly, in other realities It applies in mode, hollow wirerope 30 can also open up screw hole, and external screw thread is arranged in corresponding plug socket 132 and screw hole is spirally connected, this When in plug socket 132 open up the through-hole worn for tether 150.
Referring to Fig. 5, Fig. 5 is the partial cutaway view of heart valve 100, under heart valve 100 is in the open state, The angle [alpha] of connecting rod 116 is 40 °~60 °.The angle [alpha] of connecting rod 116 refers to tie point and the company of connecting rod 116 and leaflet bracket 112 The angle of the axis of the determined straight line of tie point and leaflet bracket 112 of bar 116 and connector 130.It should be noted that scheming In the embodiment shown, connecting rod 116 is linear type, and the angle of connecting rod 116 is the folder of the axis of α connecting rod 116 and leaflet bracket 112 Angle.The leaflet bracket 112 of the angle [alpha] of the connecting rod 116 of different angle is tested in the sheath that internal diameter is 11mm, test is different The leaflet bracket 112 of the angle [alpha] of the connecting rod 116 of angle enters sheath power and the support of leaflet bracket 112 the sheath that internal diameter is 11mm Relationship between intensity, the angle [alpha] of discovery connecting rod 116 is 40 °~60 ° and can control sheath power in lower range, and leaflet The intensity of bracket 112 can reach maximum range.Certainly, the leaflet bracket of the angle [alpha] of each different connecting rods 116 used is tested 112 in addition to 116 angle [alpha] of connecting rod other all parameters it is all the same.Preferably, the angle α of connecting rod 116 is 45 °~60 °.
Referring to Fig. 2, heart valve 100 further includes gasket 160.The material of gasket 160 is selected from terylene, nylon, surpasses At least one of High molecular weight polyethylene, NiTi and stainless steel braided wires.Gasket 160 can be disk, the titanium nickel of felt shape Plate-like, the disk like of high molecular material injection molding of silk braiding.After heart valve 100 is implanted into human heart 20, tether 150 is separate One end of connecting rod 116 is formed by knots tied anchor portion 154 after passing through heart 20 and gasket 160 and gasket 160 is fixed.
Choked flow piece 170 is excessive by bracket 110 for blocking blood flow, cooperates with leaflet 190 and guarantees blood in heart valve One-way flow in 100.Please refer to Fig. 5 and Figure 11, the outer surface of leaflet bracket 112 and skirt hanger 114 is all covered with Choked flow piece 170, and it is located at the choked flow piece 170 of 112 outer surface of leaflet bracket in the side pressure close to 112 second end of leaflet bracket Enter leaflet bracket 112 in the wave circle 1121 of second end, so that leaflet bracket 112 is located at resistance close to the wave circle 1121 of second end The outside for flowing part 170, so that the free end of choked flow piece 170 be avoided to be easy to be stuck in outside sheath, protect choked flow piece 170 when entering sheath not It is destroyed.In the illustrated embodiment, two surfaces of leaflet bracket 112 and skirt hanger 114 are all covered with choked flow piece 170. Specifically, one end of choked flow piece 170 is covered along the inner surface of leaflet bracket 112 to first from the second end of leaflet bracket 112 Along the inner surface of the outer surface of leaflet bracket 112 to skirt hanger 114 behind end, finally along skirt hanger 114 and leaflet branch The outer surface of frame covers, and when to wave circle 1121 close to 112 second end of leaflet bracket, is pressed into the wave circle of leaflet bracket 112 In 1121.In the illustrated embodiment, leaflet bracket 112 is close to the wave height of the wave circle 1121 of second end (between peaks and troughs Vertical range) it is 4~8mm, the quantity of wave crest or trough is 8~16.
In the illustrated embodiment, choked flow piece 170 is fiber cloth (i.e. knitted polyester cloth), can increase skirt hanger and valve The choked flow of leaf bracket reduces the risk that heart valve 100 is implanted into generation perivalvular leakage after human heart.Meanwhile the table of fiber cloth Surface roughness is larger, and the circumferential frictional force of heart valve 100 is big, convenient for fixing.Certainly, in other embodiments, as long as covering skirt The part of outer surface of second end of the junction of side rack outer surface and skirt hanger and leaflet bracket to leaflet bracket is to wash Synthetic fibre looped fabric, other parts can be traditional covering materials such as PET, PU, casing or animal packet.
In the illustrated embodiment, choked flow piece 170 is fixed close to one end of connecting rod 116 by suture.Choked flow piece 170 passes through Suture is sewn in connecting rod.
Fiber cloth has radially variable as choked flow piece 170, so different radial dimension of brackets can be by same resistance It flows part 170 to wrap up, for example skirt hanger and leaflet bracket can be wrapped up by same choked flow piece 170, be fixed by radial pressure Choked flow piece 170.
The surface covering choked flow piece 170 of skirt hanger 114 can increase the contact surface of skirt hanger 114 Yu heart tissue Product reduces footprint pressure, cardiac endothelial group can also be accelerated to be woven in climbing for 100 surface of heart valve and covered, to reduce heart valve The thrombus source of film 100.In one of the embodiments, in order to accelerate 100 climbing for surface endothelial tissue of heart valve to cover, heart The abiotic tissue surface of valve 100 is formed with Parylene layer.170 surface of choked flow piece is formed in one of the embodiments, Parylene layer.Parylene layer with a thickness of 1 micron~5 microns.Preferably, the material of Parylene layer is c-type Parylene.
It is appreciated that fiber cloth can increase skirt hanger and leaflet bracket choked flow, there is no need to use other Choked flow material.In other embodiments, choked flow piece 170 or bilayer or multilayer structure, such as in other embodiments, In traditional covering materials such as the inside of fiber cloth covering PET, PU, casing or animal packets.
Referring to Fig. 3, leaflet 190 is located at the inside of leaflet bracket 112 and the choked flow with 112 inner surface of leaflet bracket Part 170 is fixed.Certainly, in other embodiments, when 112 inner surface of leaflet bracket is not provided with choked flow piece 170, directly by valve Leaf 190 and leaflet bracket 112 are affixed.Leaflet 190 is cut by animal pericardium.In the illustrated embodiment, leaflet 190 is substantially fan-shaped, shares three pieces, and the circumferential direction along leaflet bracket 112 is successively arranged.The close valve of adjacent two panels leaflet 190 One end of the inner surface of leaf bracket 112 is combined together to form valve angle 192, and the periphery of leaflet 190 is fixed on leaflet by suture Bracket 112 and choked flow piece 170.Valve angle 192 is fixed to the company of connecting rod 116 Yu leaflet bracket 112 in one of the embodiments, Place is met, so as to increase the intensity of connection and guarantee the normal switch of leaflet 190.
Hydrogel layer (not shown) is additionally provided between choked flow piece 170 and bracket 110 in one of the embodiments,.Water The material of gel layer is selected from least one of polyvinyl alcohol and polyurethane.Hydrogel layer passes through in one of the embodiments, The mode of coating is layered in a side surface of the choked flow piece 170 close to bracket 110.Certainly, in other embodiments, hydrogel layer It can also be fixed on by way of suture between choked flow piece 170 and bracket 110.When heart valve 100 is implanted into human heart 20 Afterwards, hydrogel water-swellable, by the corresponding position bulging of choked flow piece 170.If heart valve 100 is implanted into after human heart with two There are gap between cusp tissue, then the hydrogel layer expanded makes the outside bulging of choked flow piece 170, so that gap be blocked, drops The risk of low perivalvular leakage.
After heart valve 100 is implanted into human heart 20, the skirt hanger 114 of heart valve 100 consolidates heart valve 100 It is scheduled on mitral annulus, tether 150 is passed through to knot after heart 20 and gasket 160 and be fixed far from one end of connecting rod 116, can be to prevent Only heart valve 100 shifts.114 warping part 1143 of skirt hanger avoids skirt 114 for the cutting effect of heart tissue and makes At corrosion.
Above-mentioned heart valve 100 has the advantage that
1), 110 integral cutting of bracket forms, and can reduce into sheath power and Fracture Failure Risk, can be to avoid without welding Structural strength caused by rosin joint etc. reduces;
2), the trough of the support portion 1141 of skirt hanger 114 and wave circle 1121 of the leaflet bracket 112 far from connecting rod 116 is solid It connects, in this way, the axial dimension of the nearly one third of leaflet bracket 112 can be allowed to be located at a left side when heart valve 100 is implanted into heart 20 Atrium, to avoid causing left ventricular outflow tract narrow because of the excessive implantation ventricle of leaflet bracket 112 or even block;
3), connector 130 opens up screw hole 1324 far from one end of connecting rod 116, so as to by rotation mode with it is hollow Wirerope 30 is fixed or releases fixation, and by being spirally connected, the two is not easily disconnected from, and the stability of connection is high, is implanted into heart valve 100 Cheng Zhong, hollow wirerope 30 can play the role of pushing and pulling heart valve 100, and heart valve 100 is allowed to transport in delivery sheath inner cavity It is dynamic, and after heart valve 100 is discharged from delivery sheath, heart valve 100 can also be drawn again by hollow wirerope 30 Return delivery sheath;
4), the angle [alpha] of connecting rod 116, which is 40 °~60 °, can control sheath power in lower range, and leaflet bracket 112 Intensity can reach maximum range;
5) choked flow piece is not easy to be stuck in outside sheath in one end of second end indentation leaflet bracket to enter choked flow piece when sheath Face avoids the heart valve destruction of caused sheath to outer layer choked flow piece when entering sheath, choked flow piece can be protected not to be destroyed.
Please refer to Figure 12, the structure and the structure substantially phase of heart valve 100 of the heart valve 300 of another embodiment Together, difference is: tether 350 includes the monofilament that multiply is fixed together, and tether 350 is formed far from one end of connector 330 In petal-like anchor portion 354.Anchor portion 354 can be unfolded and fix in apex of the heart position, play and pull the work of heart valve 300 With preventing heart valve 300 from falling off in atrium sinistrum side.
It presses, be fastened, pyrocondensation it should be noted that the multiply monofilament of tether 350 can be fixed by gluing, steel bushing The modes such as pipe fixation are fixed.
Certainly, in some embodiments, petal-like anchor portion 354 can cut to be formed by NiTi pipe, pass through later Heat treatment shaping is at petal-shaped.Size is less than the internal diameter of hollow wirerope 30 after the compression of anchor portion 354, so that anchor portion 354 can To be contracted in hollow wirerope 30 and can relatively move.
Please refer to 13 and Figure 14, the structure of the structure of the heart valve 400 of another embodiment and heart valve 100 is substantially Identical, difference is: connecting rod 416 is not provided with connector far from one end of leaflet bracket, and the end of all connecting rods 416 passes through weldering It connects to form bulb 4166, bulb 4166 is housed in container 4322 and supports connection cover 434.
Corresponding, the quantity of limit hole 4342 is one.
Connection cover 434 is two-piece type structure in one of the embodiments, and two chip architectures cooperatively form limit hole 4342, So as to facilitate installation.
Please refer to Figure 15 and Figure 16, the structure of the heart valve 500 of another embodiment and the structure of heart valve 100 Roughly the same, difference is: the connection cover 534 of connector 530 includes connecting sleeve 5343 and being formed in connect sleeve 5343 One end spherical crown 5344, connection sleeve 5343 is sleeved and fixed with plug socket 532, and limit hole 5342 is along the connection sleeve 5343 axially extending strip-shaped hole.
In the illustrated embodiment, plug socket 532 includes main part 5325 and plug division 5326.Main part 5325 is big Cause is hemispherical and one end is plane, and the diameter of main part 5325 is substantially identical as the diameter of spherical crown 5344.Plug division 5326 is convex Set on the plane of main part 5235, and diameter is less than the diameter of main part 5325.Plug division 5362 is contained in connection sleeve 5343 And the two is by being welded and fixed.Screw hole 5324 runs through plug division 5326 and main part 5325.Limit hole 5342 connects sleeve certainly 5343 one end far from spherical crown 5344 extend to the middle part of spherical crown 5344.To, when connecting rod is connected to connection cover 534, connecting rod Angle the deflection of low-angle can be carried out in limit hole 5342, when heart valve 500 is in compressive state and uncompressed shape When state, connecting rod can adapt to the different conditions of heart valve 500 by angle change.
In the illustrated embodiment, connector 530 further includes baffle 536.Baffle 536 is contained in connection sleeve 5343 It is interior, and it is located at plug division 5326 close to one end of spherical crown 5344.The middle part of baffle 536 offers the through-hole corresponding to screw hole 5324 5362.The blocking portion 552 of one end of tether 550 is spherical shape, and diameter is greater than the diameter of through-hole 5362.Blocking portion 552 is located at gear Side of the piece 536 far from plug division 5326 and support baffle 536.Certainly, baffle 536 can be omitted, at this time the ruler of blocking portion 553 The very little size greater than screw hole 5324 and support plug division 5326.
The both ends of connector 530 are hemispherical, it is possible to reduce the stroke of thrombus and reduction are to fluid dynamics Influence.
Please refer to Figure 17, the structure and the structure substantially phase of heart valve 100 of the heart valve 600 of another embodiment Together, difference is: positioned at skirt hanger 614 close to the choked flow piece 670 and skirt branch on the surface of the first end of leaflet bracket 612 Gap is formed between frame 614.
In the illustrated embodiment, choked flow piece 670 is fiber cloth, and choked flow piece 670 wraps up and is sewn to skirt hanger 614 And the surface of leaflet bracket 612, choked flow piece 670 and the support portion 6141 of skirt hanger 614 are formed far from the surface of connecting rod 616 There is gap.Specifically, one end of choked flow piece 670 is fitted in the inner surface of leaflet bracket 612 from the second end of leaflet bracket 612 Covering pulls to the warping part of skirt hanger 614 to first end and from first end along radial, and it is close to be bonded skirt hanger 614 The surface of connecting rod 616 is covered to the outer surface of 612 second end of leaflet bracket, and the both ends of choked flow piece 670 are the of leaflet bracket 612 Two ends are fixed together by suture.Preferably, choked flow piece 670 correspond to support portion 6141 part height substantially with valve The end face of the first end of leaf bracket 612 is concordant.
The choked flow piece 670 of a side surface of the skirt hanger 614 far from connecting rod 616 is not bonded with the surface of skirt hanger 614 Can one end to avoid leaflet bracket 612 far from connecting rod it is prominent with respect to the support portion 6141 of skirt hanger 614 and cause blood flow disorderly Disorderly.Preferably, fiber cloth is less than thrombosed size far from the pore-size of 616 side of connecting rod in support portion, guarantees in fibre The thrombus that Wei Bu is formed in the cavity that skirt hanger 614 is formed will not be run out of from cavity, caused by preventing due to thrombus Various complication.
Please refer to Figure 18 and Figure 19, the structure of the structure of another embodiment heart valve 700 and heart valve 600 is substantially Identical, difference is: the outer profile of support portion 7141 is class D-shaped.
Herein, it is also assumed that being orthographic projection of the support portion 7141 in the plane of the axis perpendicular to leaflet bracket 712 Outer profile is class D-shaped.Certainly it should be noted that in some embodiments, support portion 7141 is perpendicular to leaflet bracket 712 The orthographic projection of the plane of axis is also possible to discontinuous, and outer profile refers to obtaining after being fitted orthographic projection curve at this time Smooth curve.In some embodiments, 7141 surface of support portion is covered with choked flow piece, then outer profile refers to surface The support portion 7141 of the skirt hanger 714 of choked flow piece is covered in the orthographic projection of the plane of the axis perpendicular to leaflet bracket 712 Outer profile.
Because the profile of mitral annulus accompanying by human heart mitral valve is exactly class D-shaped, and skirt hanger 714 Support portion 7141 effect be exactly heart valve 700 is fixed on mitral annulus, therefore outer profile be class D-shaped support Portion 7141 can more preferably be bonded the shape of mitral annulus, to prevent perivalvular leakage.
The outer profile of support portion 7141 and two point accompanying by human heart mitral valve in one of the embodiments, The profile of valve annulus is identical.
Orthographic projection of the support portion 7141 in the plane of the axis perpendicular to leaflet bracket 712 in one of the embodiments, Outer profile include circumferentially distributed first area 7144 and the second area 7145 that is connect with first area 7144.It is illustrating Embodiment in, angle beta that the vertical line of the axis at the both ends and leaflet bracket 712 of first area 7144 limits as 100 °~ 140°.The one end (i.e. the width of support portion 7141) of support portion 7141 far from leaflet bracket 712 in first area 7144 The distance between leaflet bracket 712 be less than one end far from leaflet bracket 712 of support portion 7141 for being located in second area with The distance between leaflet bracket 712.Preferably, the width of the support portion 7141 in first area 7144 is 2~4mm.Position It is minimum when the width of the support portion 7141 in first area 7144 is in the midline position of first area 7144, and gradually to both ends Increase.The one end of support portion 7141 far from leaflet bracket 714 in second area 7145 and between leaflet bracket 712 away from It is 2mm~6mm from being equal, that is, the width for being located at the support portion 7141 in second area 7145 is 2mm~6mm.Second area The angle that the vertical line of 7145 both ends and the axis of leaflet bracket 712 limits is 220 °~260 °.Specific in the present embodiment, position In width of the support portion 7141 at the midline position of first area 7144 in first area 7144 for positioned at second area The 50% of the width of support portion 7141 in 7145.
Figure 20 is please referred to, in a wherein embodiment, leaflet 790 shares three pieces, and valve is arrived at one of valve angle 792 It is pressed from both sides defined by the vertical line of the vertical line of the axis of leaf bracket 712 and the center of first area 7144 to the axis of leaflet bracket 712 Angle γ is 0 °~30 °.It is furthermore preferred that one of valve angle 792 corresponds to the center of first area 7144, i.e., one of valve angle 792 and first area 7144 center defined by straight line it is vertical with the axis of leaflet bracket 712, at this time γ be 0 °.When When the radial pressure that one region 7144 generates it by the heart tissue of mitral annulus aortic root side, leaflet bracket 712 respective side can occur to deform accordingly, and this deformation will lead to the distance between valve angle 792 and change, and cause valve 790 opening and closing function of leaf is limited, ultimately forms 790 incompetence center reflux of leaflet or opening is narrow.One of valve angle 792 It is limited with the vertical line at the vertical line of the axis of leaflet bracket 712 and the center of first area 7144 and the axis of leaflet bracket 712 Angle γ be 0 °~30 °, can will leaflet 790 deform caused by influence to be preferably minimized.
Figure 21 is please referred to, the structure of another embodiment heart valve 800 is roughly the same with the structure of heart valve 700, Its difference is: skirt hanger is provided with locating piece 8147.
The center that locating piece 8147 corresponds to first area in one of the embodiments, will wherein when installing leaflet Defined by the vertical line of the axis at the center and leaflet bracket of the vertical line and first area of the axis of one valve angle and leaflet bracket Angle γ is 0 °~30 °, when discharging heart valve, can adjust valvular position by locating piece 8147, so that should Valve angle is located at the center of mitral anterior lobe.
Skirt hanger is additionally provided with auxiliary member 8148 in one of the embodiments, to facilitate in release to locating piece 8147 are positioned.There are two auxiliary member 8148 is total, it is located at the two sides of locating piece 8147, and locating piece 8147 and auxiliary member 8148 shape is different.In the illustrated embodiment, locating piece 8147 is " 8 " shape, and auxiliary member 8148 is circle.
Preferably, each auxiliary member 8148 arrives the vertical line of the axis of leaflet bracket 712 and the center of first area 7144 Angle defined by vertical line to the axis of leaflet bracket 712 is 30 °.
Leaflet bracket 712 is additionally provided with valve angle mounting hole 8189 in one of the embodiments,.Preferably, valve angle mounting hole 8189 altogether there are three, one of valve angle mounting hole 8189 correspond to locating piece 8147.Correspond to herein and means that valve angle is pacified The vertical line for filling the axis that leaflet bracket 712 is arrived in hole 8189 arrives the vertical line of leaflet bracket perpendicular to leaflet branch with locating piece 8147 Projection in the plane of frame axis overlaps.
In the present embodiment, locating piece 8147 and auxiliary positioning part 8148 be on skirt hanger by forming mounting hole, then By in mounting hole the developing materials such as mosaic gold, platinum or tantalum formed.The shape of locating piece 8147 is not limited to " 8 " shape, may be used also Thinking round, rectangular or polygon etc., other are easy the shape observed under X-ray, as long as locating piece 8147 and auxiliary can be distinguished Assistant piece 8148.
It will also be appreciated that locating piece 8147 and auxiliary positioning part 8148 may be arranged as other development structures.Example Such as, locating piece 8147 and auxiliary positioning part 8148 can also be the development coating coated in choked flow piece corresponding position.
Please refer to Figure 22, the structure and the structure substantially phase of heart valve 100 of the heart valve 900 of another embodiment Together, difference is: wheel of the choked flow piece 970 close to the profile of one end of the second end of leaflet bracket and the second end of leaflet bracket It is wide identical.
In the illustrated embodiment, wave circle 9121 is located at leaflet bracket close to one end of connecting rod 916, and with connecting rod 916 Affixed, profile, that is, wave circle 9121 profile of the second end of leaflet bracket is zigzag, and choked flow piece 970 is close to leaflet bracket The profile of one end of second end is zigzag and identical as the profile of the second end of leaflet bracket, and choked flow piece 970 is close to leaflet branch One end of the second end of frame is fixed by suture and the suture of wave circle 9121.
Certainly, in other embodiments, the second end of leaflet bracket is not zigzag, corresponding at this time to change choked flow piece 970 close to one end of the second end of leaflet bracket shape, as long as both making profile identical, so that it may prevent choked flow piece 970 is prominent when taking in sheath.
Please refer to Figure 23, the structure and the structure substantially phase of heart valve 1000 of the heart valve 1000 of another embodiment Together, difference is: choked flow piece 1070 includes the first choked flow film 1071 and the second choked flow film 1072, the covering of the first choked flow film 1071 The inner surface of leaflet bracket 1010, the second choked flow film 1072 cover outer surface and the skirt hanger 1014 of leaflet bracket 1012 Surface.
In the illustrated embodiment, the one end of the first choked flow film 1071 from leaflet bracket 1012 far from connecting rod 1016 is along valve The inner surface of leaf bracket 1012 extends to leaflet bracket 1012 close to one end of connecting rod 1016.Second choked flow film 1072 is from leaflet branch The outer surface package leaflet bracket 1012 and skirt hanger 1014 of the one end of frame 1012 far from connecting rod 1016, extend to leaflet branch Frame 1012 is close to one end of connecting rod 1016.
In the illustrated embodiment, the one end of the second choked flow film 1072 far from connecting rod 1016 is remote with the first choked flow film 1071 One end from connecting rod 1016 is sutured by suture, the one end and the first choked flow film of the second choked flow film 1072 close to connecting rod 1016 1071 are sutured close to one end of connecting rod 1016 by suture.
In the illustrated embodiment, the second choked flow film 1072 of a side surface of the skirt hanger 1014 far from connecting rod 1016 Gap is formed between skirt hanger 1014.Preferably, the second choked flow film 1072 corresponds to the height of the part of support portion 10141 The one end spent substantially with leaflet bracket 1012 far from connecting rod 1016 is concordant.
In the illustrated embodiment, the first choked flow film 1071 and the second choked flow film 1072 are fiber cloth, such as fiber Cloth or plain weave woven fabric, and the fiber line count of the first choked flow film 1071 is greater than the fiber line braiding of the second choked flow film 1072 Density.The number of the fiber line of first choked flow film 1071 is greater than the number of the fiber line of the second choked flow film 1072, so that the first resistance Coefficient of friction of the coefficient of friction less than the second choked flow film 1072 of film 1071 is flowed, to improve valvular circumferential frictional resistance, Convenient for valvular fixation.Certainly, in other embodiments, the first choked flow film 1071 can also for PET, PU, casing or Traditional covering material such as animal packet.
Please refer to Figure 24, the structure and the structure substantially phase of heart valve 100 of the heart valve 1100 of another embodiment Together, difference is: choked flow piece 1170 includes the first choked flow film 1171 and the second choked flow film 1172, the covering of the first choked flow film 1171 The surface of the one end of inner surface and skirt hanger 1114 far from connecting rod 1116 of leaflet bracket 1112, the covering of the second choked flow film 1172 The surface of the outer surface of leaflet bracket 1112 and skirt hanger 1114 close to one end of connecting rod 1116.
In the illustrated embodiment, one end of the first choked flow film 1171 is located at leaflet bracket 1112 and skirt hanger 1114 Junction, one end of the second choked flow film 1172 also is located at the junction of leaflet bracket 1112 Yu skirt hanger 1114.Second resistance The other end indentation leaflet bracket 1112 of film 1172 is flowed in the wave circle of connecting rod 1116.
In the illustrated embodiment, the first choked flow film 1171 and the second choked flow film 1172 are fiber cloth, such as fiber Cloth or plain weave woven fabric, and the fiber line count of the first choked flow film 1171 is greater than the fiber line braiding of the second choked flow film 1172 Density, the number of the fiber line of the first choked flow film 1171 are greater than the number of the fiber line of the second choked flow film 1172.Certainly, at it In his embodiment, the first choked flow film 1171 can also be traditional covering materials such as PET, PU, casing or animal packet.
It should be strongly noted that the technical solution of above-mentioned 10 embodiments can carry out without conflicting with each other Combined application, such as D type support portion can be combined with the relevant programme of fiber cloth, and D type support portion can be with different shape Connecting rod be combined or the scheme of connecting rod of different shapes and fiber cloth is combined, be possible and be understood.
Each technical characteristic of embodiment described above can be combined arbitrarily, for simplicity of description, not to above-mentioned reality It applies all possible combination of each technical characteristic in example to be all described, as long as however, the combination of these technical characteristics is not deposited In contradiction, all should be considered as described in this specification.
The embodiments described above only express several embodiments of the present invention, and the description thereof is more specific and detailed, but simultaneously It cannot therefore be construed as limiting the scope of the patent.It should be pointed out that coming for those of ordinary skill in the art It says, without departing from the inventive concept of the premise, various modifications and improvements can be made, these belong to protection of the invention Range.Therefore, the scope of protection of the patent of the invention shall be subject to the appended claims.

Claims (10)

1. a kind of heart valve, including leaflet bracket and the choked flow piece being wrapped on the leaflet bracket, which is characterized in that described Leaflet bracket has first end and the second end opposite with the first end, and the leaflet bracket includes multiple along the leaflet branch The wave circle of the axially spaced-apart setting of frame, the choked flow piece covers the outer surface of the leaflet bracket, and the choked flow piece is close One end of the second end of the leaflet bracket is pressed into the wave circle of the leaflet bracket close to the second end, so that institute State the outer surface that leaflet bracket is located at the choked flow piece close to the wave circle of the second end.
2. heart valve according to claim 1, which is characterized in that the leaflet bracket further includes connecting two neighboring institute The connecting rod of wave circle is stated, the choked flow piece is sewn in the connecting rod by suture.
3. heart valve according to claim 1, which is characterized in that the choked flow piece includes the first choked flow film and the second resistance Film is flowed, the first choked flow film covers the inner surface of the leaflet bracket, and the second choked flow film covers the leaflet bracket Outer surface.
4. heart valve according to claim 3, which is characterized in that the first choked flow film and the second choked flow film are equal For fiber cloth, and the fiber line count of the first choked flow film is greater than the fiber line count of the second choked flow film.
5. heart valve according to claim 4, which is characterized in that the number of the fiber line of the first choked flow film is greater than The number of the fiber line of the second choked flow film.
6. heart valve according to claim 3, which is characterized in that the first choked flow film and the second choked flow film Both ends are sutured by suture.
7. heart valve according to claim 1, which is characterized in that the heart valve further includes skirt hanger, described Skirt hanger is connect with the leaflet bracket, the skirt hanger from the leaflet bracket along the leaflet bracket radially outward Extend, the choked flow piece covers at least one surface of the skirt hanger.
8. heart valve according to claim 7, which is characterized in that the choked flow piece covers the skirt hanger close to institute The surface for stating the first end of leaflet bracket, positioned at the skirt hanger close to the table of the first end of the leaflet bracket Gap is formed between the choked flow piece and the skirt hanger in face.
9. heart valve according to claim 1, which is characterized in that the leaflet bracket is close to described in the second end The wave height of wave circle is 4~8mm, and the number of wave crest or trough is 8~16.
10. heart valve according to claim 1, which is characterized in that between the choked flow piece and the leaflet bracket also It is provided with hydrogel layer.
CN201710872489.5A 2017-09-25 2017-09-25 Heart valve Active CN109549756B (en)

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