CN109771099B - Mechanical valve on artificial ring for replacing mitral valve - Google Patents
Mechanical valve on artificial ring for replacing mitral valve Download PDFInfo
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- CN109771099B CN109771099B CN201910186170.6A CN201910186170A CN109771099B CN 109771099 B CN109771099 B CN 109771099B CN 201910186170 A CN201910186170 A CN 201910186170A CN 109771099 B CN109771099 B CN 109771099B
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- 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
- A61F2/2412—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 with soft flexible valve members, e.g. tissue valves shaped like natural valves
-
- 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
- A61F2/2412—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 with soft flexible valve members, e.g. tissue valves shaped like natural valves
- A61F2/2418—Scaffolds therefor, e.g. support stents
-
- 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
-
- 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
- A61F2/2463—Implants forming part of the valve leaflets
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
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- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial 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
A mitral valve replacement for replacing a heart mitral valve located at a lesion at a junction of a left atrium and a left ventricle with an artificial supraannular mechanical valve for implantation in a heart, comprising: a valve frame having a tubular portion for mating with a mitral valve annulus in a left ventricle, a pair of openable and closable leaflets mounted on the valve frame and received within the tubular portion for controlling unidirectional flow of blood; and a sewing ring fixed on the tubular part for sewing connection with the mitral valve annulus, wherein the tubular part is also provided with an inflow port part and an outflow port part for blood to flow into the left ventricle from the left atrium, the sewing ring is tubular, one end of the sewing ring is connected with the outflow port part, the other end of the sewing ring extends to an extending end, and the sewing ring can deform under the condition of external force.
Description
Technical Field
The present invention relates to a prosthetic mechanical valve, and in particular to an over-the-annulus mechanical valve for replacing a mitral valve.
Background
The heart valves include a mitral valve, a tricuspid valve, an aortic valve, and a pulmonary valve, wherein the mitral valve is positioned between the left atrium and the left ventricle for ensuring unidirectional flow of blood from the left atrium to the left ventricle. Mitral valve pathology is one of the common heart valve diseases, and its etiology includes rheumatic, degenerative and infectious endocarditis, etc., and mitral valve mechanical valve replacement is a common treatment for heart mitral valve pathology.
The mitral valve includes the left ventricle wall to which the leaflets, annulus, chordae tendineae, papillary muscles and papillary muscles attach, and how to treat a diseased valve directly affects the patient's prognosis recovery when performing valve replacement. Too much removal of mitral valve tissue (including leaflets and chordae tendineae) is required to implant a prosthetic valve of the desired size, but this can cause excessive diastole of the left ventricle after surgery leading to the onset of hypo-ventricular drainage syndrome, so that the subvalvular device of the mitral valve is retained as much as possible during surgery in order to maintain the morphology and function of the left ventricle after surgery that is relatively desirable. At present, in the process of placing and opening and closing various traditional mitral valve mechanical valves, the metal structures and valve leaflets of part of valve devices are all positioned in the left ventricular outflow tract, and the structural design possibly causes:
1. because the original mitral valve of the human body is elastic tissue and has certain deformation, and the valve frame of the mechanical valve is of a metal structure and is fixed in shape, the mechanical valve loses the function of deformation originally along with the movement of the human body after replacing the mitral valve.
2. Part of mechanical structures of the artificial valve are implanted into the left ventricle inflow channel, and when too many mitral valve leaflets or subvalvular devices are reserved, chordae tendineae, papillary muscles and the like can obstruct the movement of the mechanical valve, so that the opening and closing functions of the mechanical valve are affected.
In order to solve the above-mentioned problems, the mitral valve structure which is remained in the operation must be folded and sutured, but this may cause difficulty in implanting the mechanical valve, or the chordae may be shifted to lose the original function of maintaining the morphology of the left ventricle, and even the function of dilating the left ventricle after the operation may be affected due to excessive traction of contracture chordae.
Disclosure of Invention
The invention aims to solve the problems that the traditional mitral valve mechanical valve structure has a lack of deformation function and the movement of valve leaves is blocked by an subvalvular device, and aims to provide an artificial annular upper mechanical valve for replacing a mitral valve.
The invention provides a mitral valve replacement artificial mechanical valve on a ring, which is used for being implanted into a heart to replace a heart mitral valve positioned at a lesion at the juncture of a left atrium and a left ventricle, and is characterized by comprising the following components: a valve frame having a tubular portion for mating with a mitral valve annulus in a left ventricle, a pair of openable and closable leaflets mounted on the valve frame and received within the tubular portion for controlling unidirectional flow of blood; and a sewing ring fixed on the tubular part for sewing connection with the mitral valve annulus, wherein the tubular part is also provided with an inflow port part and an outflow port part for blood to flow into the left ventricle from the left atrium, the sewing ring is tubular, one end of the sewing ring is connected with the outflow port part, the other end of the sewing ring extends out to form an extending end, the sewing ring can deform under the condition of external force, the valve leaves are sheet-shaped, and when the valve leaves are perpendicular to the end surfaces of the outflow port part, the bottommost end of the valve leaves, which is close to the extending end, does not exceed the end surfaces of the extending end.
The mitral valve replacement provided by the invention is an artificial mechanical valve on the ring, and can be characterized in that: when the pair of valve blades are perpendicular to the end face of the outflow port part, the bottommost end of the valve blades, which is close to the extending end, and the end face of the extending end are in the same plane.
The mitral valve replacement provided by the invention is an artificial mechanical valve on the ring, and can be characterized in that: when the pair of valve blades are perpendicular to the end face of the outflow port part, the bottommost end of the valve blades, which is close to the extension end, is located at a position of retracting 1-2mm from the end face of the extension end into the tubular part along the axial direction of the tubular part.
The mitral valve replacement provided by the invention is an artificial mechanical valve on the ring, and can be characterized in that: the suture ring comprises a ring body and an elastic ring arranged in the ring body, wherein the elastic ring is in a shape matched with the shape of the ring body, and a port at one end of the ring body is directly contacted with a port of the outflow port part and is fixed on the port of the outflow port part.
The mitral valve replacement provided by the invention is an artificial mechanical valve on the ring, and can be characterized in that: wherein the elastic ring is made of medical silicon rubber.
The mitral valve replacement provided by the invention is an artificial mechanical valve on the ring, and can be characterized in that: one end of the elastic tube is fixed on the outflow port part, the other end of the elastic tube stretches out and can deform under the action of external force, and the sewing ring is fixed on the peripheral wall of the deformable end of the elastic tube.
The mitral valve replacement provided by the invention is an artificial mechanical valve on the ring, and can be characterized in that: wherein the elastic tube is made of medical silicone rubber.
The mitral valve replacement provided by the invention is an artificial mechanical valve on the ring, and can be characterized in that: wherein the valve frame further has a pair of symmetrically disposed bosses for mounting a pair of valve leaflets.
The mitral valve replacement provided by the invention is an artificial mechanical valve on the ring, and can be characterized in that: the inner cross section of the tubular part is circular, two groups of limiting groove groups which are symmetrically arranged along the diameter of the tubular part are arranged on the inner wall of the protruding part, and each group of limiting groove groups comprises two limiting grooves for installing a flap.
The mitral valve replacement provided by the invention is an artificial mechanical valve on the ring, and can be characterized in that: each valve blade is provided with a straight edge and an arc edge, the straight edge is connected with the arc edge, two ends of the straight edge are respectively provided with a convex block, and the two convex blocks of each valve blade are respectively arranged in the two limiting grooves in the group of limiting grooves, so that the valve blade can rotate along the straight edge of the valve blade, and the maximum distance from the straight edge of each valve blade to the arc edge of the valve blade is larger than the inner radius of the tubular part.
Effects and effects of the invention
The mechanical valve on the artificial ring is provided with a sewing ring, one end of the sewing ring is connected with the outflow port part of the valve frame, the other end of the sewing ring extends to form an extending end, the sewing ring can deform under the condition of external force, the mechanical valve on the artificial ring is positioned at the mitral valve annulus after replacing the mitral valve, the shape of the sewing ring is deformable and is not fixed by the shape of the valve frame, and the position of the mitral valve annulus after the replacement operation still has the capability of deforming along with the movement of a body. And because the suture ring is arranged at the outflow port part and is positioned at the bottommost end of the whole valve frame, after suture with the mitral valve annulus, the whole replaced artificial ring upper mechanical valve is positioned in the left atrium, and then the whole artificial ring upper mechanical valve is positioned above the subvalvular device, the condition that the whole artificial ring upper mechanical valve is not influenced by the subvalvular device is ensured, and the influence of the limitation of the size factor of the valve ring is greatly improved.
Meanwhile, the artificial ring upper mechanical valve is provided with a pair of sheet-shaped valve leaves arranged on the valve frame, when the pair of valve leaves are perpendicular to the end face of the outflow port part, the bottommost end of the valve leaves, which is close to the extending end of the suture ring, does not exceed the end face of the extending end, so that the valve leaves are completely positioned in the artificial ring upper mechanical valve, and are completely positioned in the artificial ring upper mechanical valve when the operation is complete, and are not interfered by external structures, so that no matter how many valve lower devices are reserved in the operation process, the movement of the valve leaves is not interfered, the original position of the valve lower structure can be reserved to the greatest extent, and excessive folding or pulling of the valve leaves and the valve lower structure devices are not needed, so that the shape and the function of the left ventricle after the operation are better maintained.
Drawings
FIGS. 1 and 7 are schematic illustrations of the structure of mechanical petals on an artificial annulus for mitral valve replacement;
FIG. 2 is a schematic structural view of a leaflet;
FIGS. 4 and 8 are schematic structural views of a mechanical valve on an artificial annulus for mitral valve replacement;
FIGS. 3 and 9 are schematic structural views showing the closed state of mechanical petals on an artificial ring for mitral valve replacement;
FIG. 5 is a schematic illustration of the position of a mechanical valve in the heart on an artificial annulus for mitral valve replacement;
FIGS. 6 and 12 are schematic illustrations of the structure of a mechanical flap on an artificial ring for a second mitral valve replacement;
FIG. 10 is a schematic diagram of the distribution of the limiting grooves; and
fig. 11 is a schematic view of the mounting structure of the leaflet in the limiting groove.
Detailed Description
In order to make the technical means, creation characteristics, achievement purposes and effects achieved by the present invention easy to understand, the following embodiments specifically describe the composition, working principle and beneficial effects of the mechanical valve on the artificial ring for replacing the mitral valve provided by the present invention in combination with the accompanying drawings.
< example >
Fig. 1 and 7 are schematic structural views of mechanical petals on an artificial annulus for mitral valve replacement.
As shown in fig. 1 and 7, the mitral valve replacement artificial on-ring mechanical valve 100 in the present embodiment has a frame 10, a pair of leaflets 20, and a sewing ring 30.
The valve frame 10 has a tubular portion having a circular tube shape and a pair of convex portions.
The tubular portion has an inflow port portion 11 and an outflow port portion 12 for blood to enter and exit. The end surfaces of the outflow ends 12 are all plane, and the ports are smooth circular arcs. The outflow port portion 12 has an annular groove in its outer peripheral wall.
The pair of protruding parts comprises two symmetrical protruding parts arranged at one side of the inflow port part 11, and the protruding parts and the tubular part are integrally formed by medical pyrolytic carbon.
The inner walls of the pair of protruding portions are provided with two sets of limiting grooves, the two sets of limiting grooves are symmetrical along the diameter of the tubular portion, each set of limiting grooves comprises two limiting grooves 13 for mounting a flap 20, and the two limiting grooves 13 are respectively positioned on the two protrusions.
Fig. 10 is a schematic diagram showing the distribution of the limiting grooves.
As shown in fig. 7 and 10, each of the limiting grooves 13 includes two fan-shaped grooves 13A which are symmetrical in center and identical in shape, the two fan-shaped grooves 13A are disposed up and down along the axial direction of the tubular portion, and one radius of each of the fan-shaped grooves 13A is parallel to the axial direction of the tubular portion.
Fig. 2 is a schematic structural view of a leaflet.
A pair of openable and closable leaflets 20 having two leaflets 20 symmetrically disposed about the diameter of the tubular portion for controlling blood flow through the mechanical valve 100 on the artificial ring.
As shown in fig. 2, the valve leaflet 20 is sheet-shaped and has a straight edge and an arc edge matched with the shape of the inner wall of the tubular part, and two ends of the straight edge are respectively provided with a convex block 21 matched with the limit groove 13. The bump has a convex edge and a straight edge, both ends of which are respectively connected with one end of the straight edge of the leaflet 20 and the corresponding end of the curved edge.
Fig. 11 is a schematic view of the mounting structure of the leaflet in the limiting groove.
As shown in fig. 7, 10 and 11, the two protrusions 21 of each leaflet 20 are respectively engaged and mounted in the two limiting grooves 13 in the set of limiting grooves, so that the leaflet 20 can rotate in the valve frame 10 along a straight edge.
Specifically, one limit groove 13 includes two fan-shaped grooves 13A, a projection 21 of one end of one leaflet 20 is engaged in the fan-shaped groove 13A located at the upper side, and a part of the arc edge of the leaflet 20 is embedded in the fan-shaped groove 13A located at the lower side, whereby both ends of one leaflet 20 are mounted in the valve frame 10 so that the leaflet 20 can rotate about an axis formed by the projection 21 and the straight edge portion of the leaflet 20. Meanwhile, a part of the arc edge of the leaflet 20 is embedded in the fan-shaped groove 13A located at the lower side, and thus, the arc edge portion of the leaflet 20 can be in close contact with the valve frame 10 without affecting the rotation of the leaflet 20 (when the leaflet 20 is rotated as shown in the figure if such a structure is not adopted).
Since one radius of each sector-shaped groove 13A is parallel to the axial direction of the tubular portion of the valve frame 10, when the valve leaflet 20 is rotated to the vertical position (the position parallel to the axial direction of the tubular portion of the valve frame 10), the convex block 21 and a part of the arc edge of the valve leaflet 20 are respectively contacted with the groove edges corresponding to the radii of the two sector-shaped grooves 13A, thereby realizing the limit; on the other hand, the other radius of each fan-shaped groove 13A forms a certain angle with the axial direction of the tubular part of the valve frame 10, when the valve leaflet 20 rotates to a position with a certain included angle with the axial direction of the tubular part of the valve frame 10, the convex block 21 and a part of the arc edge of the valve leaflet 20 are respectively contacted with the groove edges corresponding to the other radius of the two fan-shaped grooves 13A, so that limit is realized. That is, the structure of the limiting groove 13 as in the present embodiment enables rotatable mounting of the leaflet 20 and limits rotation thereof.
In addition, since the two fan grooves 13A are centrally symmetrical, have the same shape, and each have a radius parallel to the axial direction of the tubular portion of the valve frame 10, and the leaflet 20 has a certain thickness, the leaflet 20 is not actually in an absolutely vertical state (i.e., the leaflet 20 is completely parallel to the axial direction of the tubular portion of the valve frame 10 and perpendicular to the end face of the outflow port portion 12) when the projection 21 and a portion of the arcuate edge of the leaflet 20 are respectively in contact with the two vertical radii of the fan grooves 13A. However, in the present embodiment, for convenience of description, the state is described as a vertical state (i.e., a state in which the leaflet 20 is parallel to the axial direction of the tubular portion of the valve frame 10 and perpendicular to the end face of the outflow port portion 12).
The sewing ring 30 includes a ring body and an elastic ring 31 provided in the ring body.
The ring body comprises a skirt edge and a circular fixing ring which are integrally woven and made of terylene and used for stitching.
The retaining ring has the same inner diameter as the tubular portion and the port at one end is adhesively secured to the port of the outflow port portion 12.
The skirt is annular, and the outer surface is provided with a plurality of strip-shaped bulges axially parallel to the tubular part.
The plurality of strip-shaped bulges are uniformly distributed along the circumferential direction of the skirt edge.
The elastic ring 31 is a circular ring shape matching the shape of the skirt, is made of medical silicone rubber, and is completely covered in the skirt.
Fig. 4 and 8 are schematic structural views of the mechanical valve on the artificial annulus in a conducting state for mitral valve replacement.
As shown in fig. 4 and 8, when the two valve leaflets 20 are parallel to each other and perpendicular to the end face of the outflow port portion 12, the two valve leaflets 20 are in the maximum open/close state, the bottommost end of the valve leaflet 20 near the protruding end of the sewing ring 30 is in the same plane with the end face of the protruding end, at this time, the two radii parallel to the axial direction of the tubular portion in the limiting groove group limit the valve leaflet 20, and blood can flow from the left atrium into the left ventricle through the mitral valve replacement with the above-ring mechanical valve 100.
Alternatively, the bottommost end of the leaflet 20 adjacent to the extended end of the sewing ring 30 may be located at a position of 1-2mm, preferably 2mm, from the end face of the extended end toward the inside of the tubular portion in the axial direction of the tubular portion when the two leaflets 20 are in the maximally opened and closed state, as required. That is, the length of the leaflet 20 in the vertical direction (in the axial direction of the tubular portion) is set as required so that, when the leaflet 20 is in the maximum open-close state, the bottommost end thereof near the outflow port portion 12 is located at a distance of 1 to 2mm from the end face of the outflow port portion 12 to retract into the tubular portion in the axial direction of the tubular portion.
Fig. 3 and 9 are schematic structural views showing a state in which a mechanical valve is closed on an artificial ring for mitral valve replacement.
As shown in fig. 3 and 9, when the two straight edges of the two leaflets 20 are completely attached to each other, and the two curved edges of the two leaflets 20 are completely attached to the inner wall of the tubular portion, respectively, the two leaflets 20 are in a closed state, and at this time, the other two radii in the limiting groove 13 limit the leaflets 20, and an angle formed between the two leaflets 20 is greater than 90 ° and less than 180 °, so that blood cannot pass through the mitral valve to replace the mechanical valve 100 on the artificial ring.
Both leaflets 20 are leaflets made of medical pyrolytic carbon.
Fig. 5 is a schematic view of a location in the heart.
As shown in FIG. 5, in the case of performing the replacement operation, the sewing ring 30 is sewn to the mitral valve annulus of the left ventricular inlet passage, so that the entire prosthetic supraannular mechanical valve 100 is fixed in the left atrium, resulting in the supraannular state.
< modification >
The present modification is a modification of the embodiment, and the same configuration as in the first embodiment is given the same reference numerals, and the same description is omitted.
Fig. 6 and 12 are schematic views of the structure of a mechanical flap on an artificial ring for a second mitral valve replacement.
As shown in fig. 6 and 12, the artificial above-ring mechanical valve 200 for replacing a mitral valve in the present modification further has an elastic tube 40 made of medical silicone rubber. One end of the elastic tube 40 is sleeved on the outflow end 12, and the other end extends out and can deform under the action of external force.
The sewing ring 30' has a fixing ring and a skirt for sewing, and the skirt and the fixing ring are integrally formed by knitting terylene. The fixing ring is adhesively fixed to the outer wall of the deformable end of the elastic tube 40.
The skirt is annular, and the outer surface is provided with a plurality of strip-shaped bulges axially parallel to the tubular part. The plurality of strip-shaped bulges are uniformly distributed along the circumferential direction of the skirt edge.
Effects and effects of the examples
The mechanical valve on the artificial ring is provided with a sewing ring, one end of the sewing ring is connected with the outflow port part of the valve frame, the other end of the sewing ring extends to form an extending end, the sewing ring can deform under the condition of external force, the mechanical valve on the artificial ring is positioned at the mitral valve annulus after replacing the mitral valve, the shape of the sewing ring is deformable and is not fixed by the shape of the valve frame, and the position of the mitral valve annulus after the replacement operation still has the capability of deforming along with the movement of a body. And because the suture ring is arranged at the outflow port part and is positioned at the bottommost end of the whole valve frame, after suture with the mitral valve annulus, the whole replaced artificial ring upper mechanical valve is positioned in the left atrium, and then the whole artificial ring upper mechanical valve is positioned above the subvalvular device, the condition that the whole artificial ring upper mechanical valve is not influenced by the subvalvular device is ensured, and the influence of the limitation of the size factor of the valve ring is greatly improved.
Meanwhile, the artificial ring-mounted mechanical valve for replacing the mitral valve is provided with a pair of valve leaves which are arranged on the valve frame and are completely accommodated in the tubular part, so that the valve leaves are completely positioned in the valve frame when the operation is complete, and the valve leaves are also completely positioned in the valve frame and are not interfered by external structures, so that no matter how many valve lower devices remain in the operation process, the movement of the valve leaves is not interfered, the in-situ mitral valve lower structure can be furthest reserved, and the valve leaves and the valve lower structure devices do not need to be excessively folded or pulled, so that the shape and the function of the left ventricle after the operation are better maintained.
Further, the elastic ring and the elastic tube are made of medical silicon rubber, have certain deformability, can be matched with the operation of a human body to deform, and have good rebound resilience to quickly restore the original shape.
Because the maximum distance from the straight edge to the curved edge of the leaflet is greater than the inner radius of the tubular portion, the two leaflets have an included angle therebetween when in a closed condition, and the arrangement provides relatively less resistance to blood flow through the leaflets, allowing the closed leaflets She Chong to be opened more easily.
The arrangement of the limiting grooves enables the two valve leaflets to move only in a fixed area, and the influence caused by overlarge displacement of the valve leaflets is avoided.
The above embodiments are preferred examples of the present invention, and are not intended to limit the scope of the present invention.
Claims (5)
1. A mitral valve replacement artificial mechanical valve on the annulus for implantation in the heart to replace a mitral valve of the heart that is positioned at the intersection of the left atrium and left ventricle, comprising:
a valve frame comprising a tubular portion for matching the mitral valve annulus in the left ventricle,
a pair of openable and closable petals mounted on the petal frame for controlling unidirectional blood flow; and
a sewing ring fixed on the tubular part for sewing connection with the mitral valve annulus,
wherein the tubular portion further has an inflow port portion and an outflow port portion for inflow of blood from the left atrium into the left ventricle,
the sewing ring can deform under the condition of external force,
the sewing ring is tubular, one end of the sewing ring is connected with the outflow port part, the other end extends to form an extending end,
the valve blades are sheet-shaped, when a pair of the valve blades are perpendicular to the end face of the outflow port part, the bottommost end of the valve blades close to the protruding end does not exceed the end face of the protruding end,
when a pair of the petals are perpendicular to the end face of the outflow port portion, the bottommost end of the petals close to the protruding end is in the same plane as the end face of the protruding end, or when a pair of the petals are perpendicular to the end face of the outflow port portion, the bottommost end of the petals close to the protruding end is located at a position of retracting 1-2mm inward from the end face of the protruding end toward the tubular portion in the axial direction of the tubular portion,
one end of the elastic tube is fixed on the outlet port part, the other end of the elastic tube extends out and can deform under the action of external force,
the sewing ring is provided with a fixing ring and a skirt edge used for sewing, the skirt edge and the fixing ring are made of terylene through braiding in an integrated mode, and the fixing ring is fixed on the peripheral wall of the deformable end of the elastic tube.
2. The artificial over-the-loop mechanical valve for mitral valve replacement of claim 1, wherein:
wherein the elastic tube is made of medical silicone rubber.
3. The artificial over-the-loop mechanical valve for mitral valve replacement of claim 1, wherein:
wherein the valve frame further has a pair of symmetrically disposed bosses for mounting a pair of the valve leaflets.
4. A mitral valve replacement artificial on-annulus mechanical valve as claimed in claim 3, wherein:
wherein the inner cross section of the tubular portion is circular,
the inner wall of the convex part is provided with two groups of limit groove groups which are symmetrically arranged along the diameter of the tubular part,
each limiting groove group comprises two limiting grooves for mounting one flap.
5. The artificial over-the-loop mechanical valve replacement for a mitral valve of claim 4, wherein:
wherein each of the valve leaflets has a straight edge and an arc edge, the straight edge is connected with the arc edge,
two ends of the straight edge are respectively provided with a bump,
the two convex blocks of each valve blade are respectively arranged in the two limit grooves in one limit groove group, so that the valve blade can rotate along the straight edge of the valve blade,
the maximum distance from the straight edge of each of the leaflets to the curved edge of the leaflet is greater than the inner radius of the tubular portion.
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| CN201810205222.5A CN108451670A (en) | 2018-03-13 | 2018-03-13 | A kind of mitral valve replaces mechanical prosthetic valve on manually ring |
| CN2018102052225 | 2018-03-13 |
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| CN201910186170.6A Active CN109771099B (en) | 2018-03-13 | 2019-03-12 | Mechanical valve on artificial ring for replacing mitral valve |
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| CN113967043B (en) * | 2021-10-27 | 2024-01-12 | 邹承伟 | Suture-free auxiliary implantation device for artificial mitral valve |
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Also Published As
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| CN108451670A (en) | 2018-08-28 |
| CN109771099A (en) | 2019-05-21 |
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