CN109907860A - Artificial Valved allograft - Google Patents
Artificial Valved allograft Download PDFInfo
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- CN109907860A CN109907860A CN201910299015.5A CN201910299015A CN109907860A CN 109907860 A CN109907860 A CN 109907860A CN 201910299015 A CN201910299015 A CN 201910299015A CN 109907860 A CN109907860 A CN 109907860A
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- 210000004204 blood vessel Anatomy 0.000 claims abstract description 130
- 239000002473 artificial blood Substances 0.000 claims abstract description 111
- 238000002360 preparation method Methods 0.000 claims abstract description 10
- 210000001519 tissue Anatomy 0.000 claims description 153
- 241000283690 Bos taurus Species 0.000 claims description 65
- 210000003516 pericardium Anatomy 0.000 claims description 55
- 238000009958 sewing Methods 0.000 claims description 23
- 230000002792 vascular Effects 0.000 claims description 21
- 239000008280 blood Substances 0.000 claims description 14
- 210000004369 blood Anatomy 0.000 claims description 14
- 239000000463 material Substances 0.000 claims description 14
- 238000000034 method Methods 0.000 claims description 13
- 210000004731 jugular vein Anatomy 0.000 claims description 10
- 230000017531 blood circulation Effects 0.000 claims description 9
- 239000007769 metal material Substances 0.000 claims description 4
- 239000000203 mixture Substances 0.000 claims 1
- 210000003462 vein Anatomy 0.000 claims 1
- 230000000694 effects Effects 0.000 abstract description 4
- 238000002513 implantation Methods 0.000 abstract description 4
- 238000012153 long-term therapy Methods 0.000 abstract description 3
- 238000010586 diagram Methods 0.000 description 15
- 210000001147 pulmonary artery Anatomy 0.000 description 11
- 230000000740 bleeding effect Effects 0.000 description 10
- 210000000709 aorta Anatomy 0.000 description 9
- 210000005241 right ventricle Anatomy 0.000 description 9
- 238000005516 engineering process Methods 0.000 description 6
- 210000005240 left ventricle Anatomy 0.000 description 6
- 230000000452 restraining effect Effects 0.000 description 6
- 230000002308 calcification Effects 0.000 description 4
- 230000000735 allogeneic effect Effects 0.000 description 3
- 230000003872 anastomosis Effects 0.000 description 3
- 230000002861 ventricular Effects 0.000 description 3
- OYPRJOBELJOOCE-UHFFFAOYSA-N Calcium Chemical compound [Ca] OYPRJOBELJOOCE-UHFFFAOYSA-N 0.000 description 2
- 241001061076 Melanonus zugmayeri Species 0.000 description 2
- 229910052791 calcium Inorganic materials 0.000 description 2
- 239000011575 calcium Substances 0.000 description 2
- 230000000747 cardiac effect Effects 0.000 description 2
- 230000008859 change Effects 0.000 description 2
- 238000007912 intraperitoneal administration Methods 0.000 description 2
- SXRSQZLOMIGNAQ-UHFFFAOYSA-N Glutaraldehyde Chemical compound O=CCCCC=O SXRSQZLOMIGNAQ-UHFFFAOYSA-N 0.000 description 1
- 206010028980 Neoplasm Diseases 0.000 description 1
- 208000031816 Pathologic Dilatation Diseases 0.000 description 1
- 208000008640 Pulmonary Atresia Diseases 0.000 description 1
- 210000000683 abdominal cavity Anatomy 0.000 description 1
- 210000000702 aorta abdominal Anatomy 0.000 description 1
- 210000002376 aorta thoracic Anatomy 0.000 description 1
- 230000008901 benefit Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000002526 effect on cardiovascular system Effects 0.000 description 1
- 230000008030 elimination Effects 0.000 description 1
- 238000003379 elimination reaction Methods 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 230000005847 immunogenicity Effects 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 210000000664 rectum Anatomy 0.000 description 1
- 230000008439 repair process Effects 0.000 description 1
- 230000002966 stenotic effect Effects 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
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- 230000001225 therapeutic effect Effects 0.000 description 1
- 210000005166 vasculature Anatomy 0.000 description 1
Abstract
The invention discloses a kind of artificial Valved allografts.The artificial Valved allograft is made of tissue valve prosthesis, the artificial blood vessel of the sinus containing valve and artificial valve support ring；Tissue valve prosthesis is located in the valve sinus of the artificial blood vessel of the sinus containing valve, and artificial valve support ring is located at outside the valve sinus of the artificial blood vessel of the sinus containing valve, and the annulus of tissue valve prosthesis is Chong Die with artificial valve support ring position；Tissue valve prosthesis, the sinus containing valve artificial blood vessel connected with artificial valve support ring by silk sutures.The invention also discloses the preparation methods of the artificial Valved allograft.The artificial Valved allograft is that a kind of function is more perfect, durability is more preferable, be easier acquisition, specification is more complete, is easier the artificial prosthesis of implantation, is able to achieve better Long term therapy effect.
Description
Technical field
The invention belongs to biomedical engineering fields, are related to artificial prosthesis, more specifically a kind of by outside heart
Section's operation implantation, for rebuild or repair human body right ventricle to pulmonary artery blood vessel or Human left ventricle to aorta blood vessel
Artificial prosthesis.
Background technique
There are many technologies to be applied to artificial Valved allograft prosthese at present, but these technologies all have certain problems.
In the 1980s, allogeneic Valved allograft is subsequently found blood for rebuilding the right ventricular outflow with valve
The problems such as tube wall and valvular calcification, angiomatoid expansion.Meanwhile allogeneic Valved allograft is difficult to obtain there is also material, ruler
Very little the problem of being difficult matching, supply inconvenience etc..The bioprosthesis valve occurred later or artificial mechanical valve prosthesis and artificial volume
Knit blood vessel combination artificial Valved allograft, because in its structure include complete bioprosthesis valve or artificial mechanical valve prosthesis, manually
Valve is taken up too much space in artificial blood vessel, causes resistance of blood flow larger, especially the blood vessel of small diameter, this problem is more
It is prominent.In last decade, bovine jugular vein Valved allograft is applied to cardiovascular substitute, and commercially produced product occurs.But it exists
The calcification of serious vascular wall, distal anastomosis mouth fiber form and the problems such as narrow, Ectasias.
Currently, percutaneous interventional technology is fast-developing and is received by patient and doctor.It is above-mentioned several common artificial
Valved allograft prosthese after there is stenotic lesion, such as using percutaneous interventional technology carry out balloon expandable, endovascular stent or
It replants into intervention valve, can all encounter very big difficulty.For example, to allogeneic Valved allograft and bovine jugular vein Valved allograft calcium
Change, narrow part progress balloon expandable, vascular wall is easily caused to rupture；Artificial blood vessel with artificial valve artificial valve lose function after,
Since its structure limits, it is difficult to replant by intervention means into intervention valve.
Therefore, it is necessary to a kind of functions, and more perfect, durability more preferably, more easily obtains, specification is more complete, is easier to be implanted into,
It is able to achieve the artificial Valved allograft of better Long term therapy effect.
Summary of the invention
It is an object of the invention to solve the problems, such as existing well-known technique, a kind of perfect in shape and function, durability are provided
It is good, it is easy to get, complete in specifications, supply is convenient, the artificial Valved allograft being easily implanted into, and more satisfied long term can be obtained after implantation
Therapeutic effect.
To achieve the above object, above-mentioned key technical problem is solved, the invention adopts the following technical scheme:
A kind of artificial Valved allograft is made of tissue valve prosthesis, the artificial blood vessel of the sinus containing valve and artificial valve support ring；Tissue
Valve is located in the valve sinus of the artificial blood vessel of the sinus containing valve, and artificial valve support ring is located at outside the valve sinus of the artificial blood vessel of the sinus containing valve,
The annulus of tissue valve prosthesis is Chong Die with artificial valve support ring position；Tissue valve prosthesis, the artificial blood vessel of the sinus containing valve and artificial valve branch
Pushing out ring is connected by silk sutures.
Tissue valve prosthesis is complete natural three leaflets structure valve, or by three pieces tissue leaflet or bovine pericardium splicing system
At three leaflet structure valves.The artificial blood vessel of the sinus containing valve includes first pipe, valve sinus and second pipe.Artificial valve support ring
For resilient sheet-like ring similar with the annulus shape of natural three leaflets structure valve, there is sewing hole thereon.
The tissue valve prosthesis is complete natural three leaflets structure valve, or by three pieces tissue leaflet or bovine pericardium
Three leaflet structure valves made of splicing.
The tissue valve prosthesis is by structure in treated bovine jugular vein blood vessel, form and intact three leaflets of function
Structure valve, under the certain distance sanction of its annulus lower edges vascular wall.Preferably, crop position is away from following on valve annulus tissue
The distance on edge is 3-5mm.The annulus for cutting out lower tissue valve prosthesis is still annular, leaflet and annulus still retain complete valve structure and
Function.
The tissue valve prosthesis is also possible to the group that structure, form in the treated native blood vessels with valve is intact
Leaflet is knitted, under the certain distance sanction of its annulus lower edges vascular wall, chooses size, thickness, the consistent three pieces tissue of form
Leaflet splices manufactured valve.Preferably, the distance of annulus lower edges of the crop position away from tissue leaflet is 3-5mm.Tissue
Leaflet is the leaflet of the tissue valve prosthesis, and the annulus of three pieces tissue leaflet surrounds the valve of one with natural three leaflets structure valve
The consistent annular of ring-shaped, the annulus of the as described tissue valve prosthesis.
The tissue leaflet can be the leaflet in bovine jugular vein blood vessel, three leaflet structure valves, two leaflet structure valves,
The leaflet of single-lobe impeller structure valve can also be the no coronal sinus leaflet in porcine aorta blood vessel.
The tissue valve prosthesis can also be and treated bovine pericardium is cut into substantially fan-shaped piece, choose ruler
Very little, consistency of thickness three pieces bovine pericardium splices manufactured valve.Preferably, the width of the bovine pericardium after cutting out is 16-
38mm is highly 7-28mm.The main part of the fan-shaped surface of bovine pericardium is the leaflet of the tissue valve prosthesis, three pieces bovine pericardium
The bottom edge of piece surrounds the consistent annular of annulus shape of one with natural three leaflets structure valve, the valve of the as described tissue valve prosthesis
Ring.
The tissue valve prosthesis has the structure and function of three leaflet structure valves.Preferably, the annulus of the tissue valve prosthesis
Internal diameter is 8-26mm, and the height of the tissue valve prosthesis is 4-18mm.
It is described to pass through processing, including being not limited under the conditions of the pressure of 25-45mmHg, 4-37 DEG C of temperature, in
Physics and chemical method processing in 12-48 hours are impregnated in 0.256%-0.625% glutaraldehyde solution.
The artificial blood vessel of the sinus containing valve, including first pipe, valve sinus and second pipe, valve sinus are located at first pipe distal end
Between second pipe proximal end.The first pipe of the artificial blood vessel of the same sinus containing valve is identical with the internal diameter of second pipe, and with position
The annulus internal diameter of tissue valve prosthesis in valve sinus is identical.The internal diameter of the valve sinus of the artificial blood vessel of the same sinus containing valve is greater than the first pipe
The internal diameter in road, second pipe, and it is identical as the annulus outer diameter of tissue valve prosthesis being located in valve sinus.Valve sinus relative to first pipe and
Second pipe is generally in convex.The first pipe, valve sinus and second pipe constitute a continuous and complete sinus containing valve
Artificial blood vessel.Preferably, the first pipe, second pipe internal diameter be 8-26mm, the valve sinus internal diameter contains than same respectively
The first pipe of the artificial blood vessel of valve sinus, the big 2-4mm of second pipe internal diameter, the height of the valve sinus are 6-28mm.
The artificial blood vessel of the sinus containing valve is made of medical macromolecular materials.Preferably, artificial blood vessel wall thickness 0.2-
0.8mm.The first pipe and second pipe are flexible, cut out, suture, and can keep tube-like condition during operation and use
With corresponding elasticity.
The artificial valve support ring is resilient sheet-like ring, the annulus shape of shape and natural three leaflets structure valve
Annular similar, that the parabola of substantially three opening upwards surrounds.The internal diameter of artificial valve support ring and the sinus containing valve
The valve sinus outer diameter of artificial blood vessel is identical.There are two rows of sewing holes in artificial valve support ring, is located at and is supported close to artificial valve
The position of ring lower edges；There can also be row's sewing hole in artificial valve support ring, positioned at artificial valve support ring ring wall
Middle part.
The artificial valve support ring is made of medical macromolecular materials or elastic metallic material.Preferably, artificial valve
The height at film support ring bottom to top is 5-26mm, and support ring internal diameter is 10.4-31.6mm, and support ring ring wall is with a thickness of 0.1-
1.1mm, support ring width are 5-24mm.
The artificial Valved allograft, tissue valve prosthesis are located in the valve sinus of the artificial blood vessel of the sinus containing valve, and tissue valve prosthesis enters blood
End and the first pipe distal end of the artificial blood vessel of the sinus containing valve are close, and the of the artificial blood vessel at the bleeding end and sinus containing valve of tissue valve prosthesis
Two proximal tube ends are close；Artificial valve support ring is located at outside the valve sinus of the artificial blood vessel of the sinus containing valve, the annulus position with tissue valve prosthesis
Overlapping is set, the first pipe distal end of the artificial blood vessel of the bottom and sinus containing valve of artificial valve support ring is close, artificial valve support
The second pipe proximal end of the artificial blood vessel at the top and sinus containing valve of ring is close.Suture is walked along the annulus of tissue valve prosthesis
To across the related lower edges vascular wall of the annulus of the tissue valve prosthesis, the valve sinus of the artificial blood vessel of the sinus containing valve, artificial valve
Above-mentioned three-decker is stitched together by the sewing hole in support ring simultaneously.
The artificial Valved allograft, artificial valve support ring can also be Chong Die with the tissue annulus position of leaflet；It is medical
Suture along the annulus of tissue leaflet trend, across the annulus of tissue leaflet related lower edges vascular wall, the sinus containing valve
Sewing hole on the valve sinus of artificial blood vessel, artificial valve support ring, above-mentioned three-decker is stitched together simultaneously.The tissue
The end where entering the annulus that blood end is tissue leaflet of valve, the bleeding end of the tissue valve prosthesis are tissue leaflet free edge place
End.
The artificial Valved allograft, artificial valve support ring can also be Chong Die with the bottom edge position of bovine pericardium；It is medical
Suture along the bottom edge of bovine pericardium trend, in the position of the bottom edge certain distance away from bovine pericardium, it is preferable that the distance is
1-3mm, the sewing hole in the bovine pericardium, the valve sinus of the artificial blood vessel of the sinus containing valve, artificial valve support ring, will be above-mentioned
Three-decker is stitched together simultaneously.The end where entering the bottom edge that blood end is bovine pericardium of the tissue valve prosthesis, the tissue flap
The bleeding end of film is end where the top margin of bovine pericardium.
The artificial blood vessel of the artificial Valved allograft, the sinus containing valve cuts out restraining line with two, for prompting operator
The position that the artificial Valved allograft can at most be dismissed.It cuts out restraining line for two articles and is located at first pipe distal end and the
Position of two proximal tube ends away from valve sinus certain distance.Preferably, which is 6mm.
The artificial blood vessel of the artificial Valved allograft, the sinus containing valve is identified with blood flow direction, for prompting operator institute
The tissue valve prosthesis opening direction for stating artificial Valved allograft, that is, be sewn to direction when tissue.Blood flow direction mark is located at institute
It states on valve sinus, the arrow direction of mark is the bleeding end of tissue valve prosthesis, and arrow tail direction enters blood end for tissue valve prosthesis.
" proximal end " as described herein, "lower", " bottom " refer both to the structure close to one end of human heart, as described herein
" distal end ", "upper", " top " refer both to the one end of the structure far from human heart.
The preparation method of above-mentioned artificial Valved allograft, comprising the following steps:
(1) by three leaflet structure valves in treated bovine jugular vein blood vessel, along its annulus lower edges vascular wall
Certain distance cut out under, the annulus of tissue valve prosthesis sanction under is still annular, leaflet and annulus still retain complete valve structure and
Function；
(2) tissue valve prosthesis is placed in the valve sinus of artificial blood vessel of the sinus containing valve, the artificial valve is supported
Ring is placed in outside the valve sinus of the artificial blood vessel of the sinus containing valve, keeps artificial valve support ring Chong Die with the annulus position of tissue valve prosthesis；
With suture along the trend of the annulus of tissue valve prosthesis, suture is made to pass through related upper following of annulus of tissue valve prosthesis
Sewing hole in vascular wall, the valve sinus of the artificial blood vessel of the sinus containing valve, artificial valve support ring, above-mentioned three-decker is stitched simultaneously
It is combined.
The preparation method of above-mentioned artificial Valved allograft, also may comprise steps of:
(1) by the tissue leaflet in the treated native blood vessels with valve, along its annulus lower edges vascular wall
Under certain distance is cut out；
(2) size, thickness, the consistent three pieces tissue leaflet of form are chosen, wherein sheet of tissue leaflet will be placed in described contain
In the valve sinus of the artificial blood vessel of valve sinus, the artificial valve support ring is placed in outside the valve sinus of the artificial blood vessel of the sinus containing valve,
Keep artificial valve support ring Chong Die with the tissue annulus position of leaflet；The trend of the annulus of leaflet is organized with suture edge,
Make suture across the related lower edges vascular wall of the annulus of tissue leaflet, the valve sinus of the artificial blood vessel of the sinus containing valve, people
The sewing hole on valve support ring is made, above-mentioned three-decker is stitched together simultaneously；
(3) with same method successively by second, the valve sinus of the artificial blood vessel of third piece tissue leaflet and the sinus containing valve, people
Make the conjunction of valve support circumferential weld.
The preparation method of above-mentioned artificial Valved allograft, can with the following steps are included:
(1) treated bovine pericardium is cut into substantially fan-shaped piece；
(2) wherein a piece of bovine pericardium is placed in the sinus containing valve by the three pieces bovine pericardium for choosing size, consistency of thickness
In the valve sinus of artificial blood vessel, the artificial valve support ring is placed in outside the valve sinus of the artificial blood vessel of the sinus containing valve, is made artificial
Valve support ring is Chong Die with the bottom edge position of bovine pericardium；With suture in the position of the bottom edge certain distance away from bovine pericardium
It sets, the trend along the bottom edge of bovine pericardium, suture is made to pass through bovine pericardium, the valve sinus of the artificial blood vessel of the sinus containing valve, people
The sewing hole on valve support ring is made, above-mentioned three-decker is stitched together simultaneously；
(3) with same method successively by second, the valve sinus of the artificial blood vessel of third piece bovine pericardium and the sinus containing valve, people
Make the conjunction of valve support circumferential weld.
Artificial Valved allograft of the present invention, is implanted by cardiac operation, for rebuilding or repairing human body right ventricle
To pulmonary artery blood vessel or Human left ventricle to aorta blood vessel.
The present invention has following advantageous effects:
1. the intensity of blood vessel is increased instead of the vasculature part of the native blood vessels with valve with artificial blood vessel, so that this
It invents the artificial Valved allograft and is not only suitable for human body right ventricle to the pressure environment of pulmonary artery system, be also suitable for Human left ventricle
To the pressure environment of aorta system.Therefore, both may be used as human body right ventricle to pulmonary artery blood vessel substitute, can also be with
The substitute of blood vessel as Human left ventricle to aorta.
2. the structure and function of tissue valve prosthesis had not only been utilized, but also natural biological tissue is eliminated as much as possible, use doctor instead
It is substituted with high molecular material, thus the drawbacks of reducing the immunogenicity of material, avoid the easy calcification of biological tissue, easily decay,
The durability for significantly improving artificial Valved allograft inhibits the generation of calcification, obtains satisfied Long term therapy effect.
3. the design of artificial blood vessel mesopetalum sinus can keep the latus rectum of artificial Valved allograft, pressure gradient is minimized.
4. artificial valve support ring can effectively keep the form of tissue valve prosthesis, prevent tissue valve prosthesis from deforming, guarantees valve function
Energy.
5. the pipe section of artificial blood vessel has good tailorability and plasticity, easily sutured with tissue, so as to
The position at place matches.
6. artificial blood vessel has good intensity and elasticity, convenient for carrying out balloon expandable, blood using percutaneous interventional technology
The implantation of pipe inner support and intervention valve.
7. tissue valve prosthesis, the artificial blood vessel of the sinus containing valve, artificial valve support ring, three-decker are stitched together simultaneously.This
Structure maintains movement and the force modes of tissue valve prosthesis, and valve is made to have better durability.
8. cutting out restraining line clearly denotes the region for forbidding cutting out, for prompting the artificial Valved allograft of operator most
The position that can be dismissed, will not be because cutting out damage valve structure.
9. blood flow direction identifies the blood flow direction for clearly denoting valve working condition, for prompting the artificial band of operator
The tissue valve prosthesis opening direction of valve blood vessel quickly and accurately recognizes artificial Valved allograft suture direction convenient for operator.
10. tissue valve prosthesis can be complete natural three leaflets structure valve, it is also possible to by three pieces tissue leaflet or ox
Pericardium piece splices manufactured three leaflet structure valves, and tissue leaflet is selected from leaflet or porcine aorta in bovine jugular vein blood vessel
No coronal sinus leaflet in blood vessel.Material is easy to get, and can make full use of material, significantly improves elimination factor.Moreover, tissue leaflet
Or tissue valve prosthesis made of bovine pericardium splicing can expand the specification limit of made artificial Valved allograft, be suitable for difference
The patient of disease, different weight.
11. artificial Valved allograft is all easy to be many in terms of storage and transport compared with allogenic material, have in supply side
Very big advantage.
Detailed description of the invention
Fig. 1 is structural schematic diagram of the invention.
Fig. 2 is overlooking structure diagram of the invention.
Fig. 3 is the structural schematic diagram of tissue valve prosthesis in the embodiment of the present invention one.
Fig. 4 is the structural schematic diagram that leaflet is organized in the embodiment of the present invention two.
Fig. 5 is the structural schematic diagram of bovine pericardium in the embodiment of the present invention three.
Fig. 6 is the structural schematic diagram of the artificial blood vessel of the sinus containing valve in the embodiment of the present invention one.
Fig. 7 is the structural schematic diagram of artificial valve support ring in the embodiment of the present invention one.
Fig. 8 is the vertical section schematic diagram of the embodiment of the present invention one.
Fig. 9 is the appearance diagram of the embodiment of the present invention one.
Figure 10 is the vertical section schematic diagram of the embodiment of the present invention two.
Figure 11 is the structural schematic diagram of artificial valve support ring in the embodiment of the present invention three.
Figure 12 is the vertical section schematic diagram of the embodiment of the present invention three.
Figure 13 is the appearance diagram of the embodiment of the present invention three.
Specific embodiment
Below in conjunction with attached drawing with specific embodiment the present invention will be further explained explanation, and embodiment is not constituted
Limitation of the invention.
Referring to Figures 1 and 2, the artificial Valved allograft is by tissue valve prosthesis 1, the artificial blood vessel 2 of the sinus containing valve and artificial valve branch
Pushing out ring 3 forms.Tissue valve prosthesis 1 is located in the valve sinus of artificial blood vessel 2 of the sinus containing valve, and artificial valve support ring 3 is located at the sinus containing valve
Outside the valve sinus of artificial blood vessel 2, the annulus of tissue valve prosthesis 1 is Chong Die with 3 position of artificial valve support ring；Tissue valve prosthesis 1, the sinus containing valve
Artificial blood vessel 2 is connected with artificial valve support ring 3 by silk sutures.
Embodiment one
The embodiment of the present invention one, the tissue valve prosthesis 1 are complete natural three leaflets structure valves.
As shown in figure 3, the tissue valve prosthesis 1, is that structure, form and function in treated bovine jugular vein blood vessel is complete
Three good leaflet structure valves 1, under the certain distance sanction of its 112 lower edges vascular wall 113 of annulus.Preferably, position is cut out
Setting the distance away from 112 lower edges of annulus is 3-5mm.The annulus 112 of tissue valve prosthesis 1 under cutting out is still annular, leaflet 111 and valve
Ring 112 still retains complete valve structure and function.
As shown in fig. 6, the artificial blood vessel 2 of the sinus containing valve includes first pipe 201, valve sinus 203 and second pipe 202, valve sinus
203 are located between 201 distal end of first pipe and 202 proximal end of second pipe.The internal diameter phase of first pipe 201 and second pipe 202
Together, and it is identical as the internal diameter of annulus 112 of tissue valve prosthesis 1 being located in valve sinus 203.The internal diameter of valve sinus 203 is greater than first pipe
201, the internal diameter of second pipe 202, and it is identical as the outer diameter of annulus 112 of tissue valve prosthesis 1 being located in valve sinus 203.Valve sinus 203
Relative to first pipe 201 and second pipe 202 generally in convex.202 structure of first pipe 201, valve sinus 203 and second pipe
At the artificial blood vessel 2 of a continuous and complete sinus containing valve.
The artificial blood vessel 2 of the sinus containing valve cuts out restraining line 204 with two, for prompting artificial Valved allograft described in operator
The position that can at most dismiss.It cuts out restraining line 204 for two and is located at 202 proximal end of 201 distal end of first pipe and second pipe
Position away from 203 certain distance of valve sinus.
The artificial blood vessel 2 of the sinus containing valve is with blood flow direction mark 205, for prompting artificial Valved allograft described in operator
The opening direction of tissue valve prosthesis 1 is sewn to direction when tissue.Blood flow direction mark 205 is located on valve sinus 203, mark
The arrow direction of knowledge is the bleeding end of tissue valve prosthesis 1, and arrow tail direction enters blood end for tissue valve prosthesis 1.
The artificial blood vessel 2 of the sinus containing valve is made of medical macromolecular materials.First pipe 201 and second pipe 202 it is flexible,
It cuts out, suture, and tube-like condition and corresponding elasticity can be kept during operation and use.
As shown in fig. 7, artificial valve support ring 3 is resilient sheet-like ring, the valve of shape and natural three leaflets structure valve
Ring-shaped is similar, the annular that the parabola of substantially three opening upwards surrounds.The internal diameter of artificial valve support ring 3 and sinus containing valve
Artificial blood vessel 2 valve sinus 203 outer diameter it is identical.There are two rows of sewing holes 301 in artificial valve support ring 3, is located at close
The position of 3 lower edges of artificial valve support ring.Artificial valve support ring 3 is made of elastic metallic material.
Referring to Fig. 1 and Fig. 8, tissue valve prosthesis 1 is located in the valve sinus 203 of artificial blood vessel 2 of the sinus containing valve, and tissue valve prosthesis 1 enters
201 distal end of first pipe of the artificial blood vessel 2 of blood end and the sinus containing valve is close, and the bleeding end of tissue valve prosthesis 1 is artificial with the sinus containing valve
202 proximal end of second pipe of blood vessel 2 is close；Artificial valve support ring 3 is located at outside the valve sinus 203 of artificial blood vessel 2 of the sinus containing valve, with
112 position of annulus of tissue valve prosthesis 1 is overlapped, the first pipe of the artificial blood vessel 2 of the bottom and sinus containing valve of artificial valve support ring 3
201 distal ends are close, and 202 proximal end of second pipe of the artificial blood vessel 2 at the top and sinus containing valve of artificial valve support ring 3 is close.Doctor
With suture along the trend of the annulus 112 of tissue valve prosthesis 1, the lower edges vascular wall related across the annulus 112 of tissue valve prosthesis 1
113, the valve sinus 203 of the artificial blood vessel 2 of the sinus containing valve, the sewing hole 301 in artificial valve support ring 3, above-mentioned three-decker is same
When be stitched together.
Fig. 9 is the appearance diagram of embodiment one.Externally, the artificial blood vessel 2 of the sinus containing valve wraps artificial Valved allograft
It includes first pipe 201, second pipe 202, valve sinus 203, cut out restraining line 204 and blood flow direction mark 205；Artificial valve support
Ring 3 is sewn to outside the valve sinus 203 of artificial blood vessel 2 of the sinus containing valve, the bottom of artificial valve support ring 3 and the artificial blood vessel of the sinus containing valve
2 201 distal end of first pipe is close, the second pipe 202 of the artificial blood vessel 2 at the top and sinus containing valve of artificial valve support ring 3
Proximal end is close.There are two rows of sewing holes 301 in artificial valve support ring 3, is located at close to 3 lower edges of artificial valve support ring
Position.
Above-mentioned artificial Valved allograft the preparation method is as follows:
(1) by the tissue valve prosthesis 1 of three leaflet structures in treated bovine jugular vein blood vessel, along its about 112 annulus
Under the certain distance of edge vascular wall 113 is cut out, the annulus 112 of the tissue valve prosthesis 1 under cutting out is still annular, leaflet 111 and annulus 112
Still retain complete valve structure and function；
(2) tissue valve prosthesis 1 is placed in the valve sinus 203 of artificial blood vessel 2 of the sinus containing valve, by the artificial valve
Support ring 3 is placed in outside the valve sinus 203 of the artificial blood vessel 2 of the sinus containing valve, makes the valve of artificial valve support ring 3 and tissue valve prosthesis 1
The overlapping of 112 position of ring；With suture along the trend of the annulus 112 of tissue valve prosthesis 1, suture is made to pass through tissue valve prosthesis
The related lower edges vascular wall 113 of 1 annulus 112, the valve sinus 203 of the artificial blood vessel 2 of the sinus containing valve, artificial valve support ring 3
On sewing hole 301, above-mentioned three-decker is stitched together simultaneously.
Embodiment two
The embodiment of the present invention two, the tissue valve prosthesis 1 are the three leaflet structure valves made of the splicing of three pieces tissue leaflet.
As shown in figure 4, the tissue leaflet 121 that structure, form in treated bovine jugular vein blood vessel is intact, along its valve
Under the certain distance of 122 lower edges vascular wall 123 of ring is cut out.Preferably, distance of the crop position away from 122 lower edges of annulus is
3-5mm。
The tissue valve prosthesis 1 is the valve made of size, thickness, form consistent three pieces tissue leaflet 121.Tissue
Leaflet 121 is the leaflet of the tissue valve prosthesis 1, and the annulus 122 of three pieces tissue leaflet 121 surrounds one and natural three leaflets knot
The consistent annular of annulus shape of structure valve, the annulus of the as described tissue valve prosthesis 1.
The structure and material of the artificial blood vessel 2 of the sinus containing valve described in the present embodiment and artificial valve support ring 3 are and embodiment
One is identical.
Referring to Fig. 1 and Figure 10, tissue valve prosthesis 1 is located in the valve sinus 203 of artificial blood vessel 2 of the sinus containing valve, and tissue valve prosthesis 1 enters
201 distal end of first pipe of the artificial blood vessel 2 of blood end and the sinus containing valve is close, and the bleeding end of tissue valve prosthesis 1 is artificial with the sinus containing valve
202 proximal end of second pipe of blood vessel 2 is close；Artificial valve support ring 3 is located at outside the valve sinus 203 of artificial blood vessel 2 of the sinus containing valve, with
Organize 122 position of the annulus overlapping of leaflet 121, the first pipe of the artificial blood vessel 2 of the bottom and sinus containing valve of artificial valve support ring 3
201 distal end of road is close, and 202 proximal end of second pipe of the artificial blood vessel 2 at the top and sinus containing valve of artificial valve support ring 3 is close；
Trend of the suture along the annulus 122 of tissue leaflet 121, the lower edges related across the annulus 122 of tissue leaflet 121
Vascular wall 123, the valve sinus 203 of the artificial blood vessel 2 of the sinus containing valve, the sewing hole 301 in artificial valve support ring 3, by above-mentioned three layers
Structure is stitched together simultaneously.The tissue valve prosthesis 1 enters the 122 place end of annulus that blood end is tissue leaflet 121, the tissue
The bleeding end of valve 1 is 121 free edge of tissue leaflet, 124 place end.
The appearance of the present embodiment is the same as example 1.
Above-mentioned artificial Valved allograft the preparation method is as follows:
(1) the tissue leaflet 121 that structure, form in the treated native blood vessels with valve is intact, along its annulus
Under the certain distance of 122 lower edges vascular walls 123 is cut out；
(2) size, thickness, the consistent three pieces tissue leaflet 121 of form are chosen, will wherein sheet of tissue leaflet 121 be placed in
In the valve sinus 203 of the artificial blood vessel 2 of the sinus containing valve, the artificial valve support ring 3 is placed in the artificial blood of the sinus containing valve
Outside the valve sinus 203 of pipe 2, keep artificial valve support ring 3 Chong Die with tissue 122 position of annulus of leaflet 121；With suture edge
The trend for organizing the annulus 122 of leaflet 121 makes the lower edges that suture is related across the annulus 122 of tissue leaflet 121
Vascular wall 123, the valve sinus 203 of the artificial blood vessel 2 of the sinus containing valve, the sewing hole 301 in artificial valve support ring 3, by above-mentioned three layers
Structure is stitched together simultaneously；
(3) with same method successively by second, the valve of third piece tissue leaflet 121 and the artificial blood vessel 2 of the sinus containing valve
Sinus 203, artificial valve support ring 3 suture.
Embodiment three
The embodiment of the present invention three, the tissue valve prosthesis 1 are the three leaflet structure valves made of the splicing of three pieces bovine pericardium.
As shown in figure 5, bovine pericardium 131 is piece substantially fan-shaped made of being cut out as treated bovine pericardium,
The bottom edge of bovine pericardium 131 is 132, top margin 133.Preferably, the width of bovine pericardium 131 is 16-38mm, is highly 7-
28mm。
The tissue valve prosthesis 1, be size, consistency of thickness three pieces bovine pericardium 131 made of valve.Bovine pericardium
The main part of 131 fan-shaped surface is the leaflet of the tissue valve prosthesis 1, and the bottom edge 132 of three pieces bovine pericardium 131 surrounds one
With the consistent annular of annulus shape of natural three leaflets structure valve, the annulus of the as described tissue valve prosthesis 1.
The structure and material of the artificial blood vessel 2 of the sinus containing valve described in the present embodiment are the same as example 1.
As shown in figure 11, artificial valve support ring 3 described in the present embodiment, other are the same as example 1, and difference is it
On have row's sewing hole 302, positioned at the middle part of artificial valve support ring ring wall.Artificial valve support ring 3 uses elastic metallic material
Material is made.
Referring to Fig. 1 and Figure 12, tissue valve prosthesis 1 is located in the valve sinus 203 of artificial blood vessel 2 of the sinus containing valve, and tissue valve prosthesis 1 enters
201 distal end of first pipe of the artificial blood vessel 2 of blood end and the sinus containing valve is close, and the bleeding end of tissue valve prosthesis 1 is artificial with the sinus containing valve
202 proximal end of second pipe of blood vessel 2 is close；Artificial valve support ring 3 is located at outside the valve sinus 203 of artificial blood vessel 2 of the sinus containing valve, with
132 position of bottom edge of bovine pericardium 131 is overlapped, the first pipe of the artificial blood vessel 2 of the bottom and sinus containing valve of artificial valve support ring 3
201 distal end of road is close, and 202 proximal end of second pipe of the artificial blood vessel 2 at the top and sinus containing valve of artificial valve support ring 3 is close；
Suture along the bottom edge of bovine pericardium 131 132 trend, in the position of 132 certain distance of bottom edge away from bovine pericardium 131
It sets, it is preferable that the distance is 1-3mm, across bovine pericardium 131, the valve sinus 203 of the artificial blood vessel 2 of the sinus containing valve, artificial valve branch
Sewing hole 302 on pushing out ring 3, above-mentioned three-decker is stitched together simultaneously.The blood end that enters of the tissue valve prosthesis 1 is bovine pericardium
The place end on the bottom edge 132 of piece 131, the bleeding end of the tissue valve prosthesis 1 are the place end of the top margin 133 of bovine pericardium 131.
Figure 13 is the appearance diagram of embodiment three.Artificial Valved allograft described in the present embodiment externally, other with
Embodiment one is identical, and difference is there is row's sewing hole 302 in artificial valve support ring 3, is located at artificial valve support ring ring wall
Middle part.
Above-mentioned artificial Valved allograft the preparation method is as follows:
(1) treated bovine pericardium is cut into substantially fan-shaped bovine pericardium 131；
(2) the three pieces bovine pericardium 131 of size, consistency of thickness is chosen, wherein will be placed in described contain by a piece of bovine pericardium 131
In the valve sinus 203 of the artificial blood vessel 2 of valve sinus, the artificial valve support ring 3 is placed in the valve of the artificial blood vessel 2 of the sinus containing valve
Outside sinus 203, keep artificial valve support ring 3 Chong Die with 132 position of bottom edge of bovine pericardium 131；With suture away from cattle heart
The position of 132 certain distance of bottom edge of package piece 131, the trend along the bottom edge of bovine pericardium 131 132 pass through suture
Bovine pericardium 131, the valve sinus 203 of the artificial blood vessel 2 of the sinus containing valve, in artificial valve support ring 3 sewing hole 302, by above-mentioned three
Layer structure is stitched together simultaneously；
(3) with same method successively by second, the valve of third piece bovine pericardium 131 and the artificial blood vessel 2 of the sinus containing valve
Sinus 203, artificial valve support ring 3 suture.
Artificial Valved allograft of the present invention, is implanted by cardiac operation, for rebuilding or repairing human body right ventricle
To pulmonary artery blood vessel or Human left ventricle to aorta blood vessel.Application method is as follows:
1, the substitute of the blood vessel as human body right ventricle to pulmonary artery is than more typical application method:
In the operation for the treatment of pulmonary atresia, right ventricle is rebuild to pulmonary artery using artificial Valved allograft of the present invention
Blood vessel.First pipe proximal end of the invention is directly coincide onto right ventricle notch, second pipe distal end and pulmonary artery bifurcated
It matches.
In the operation for the treatment of absent pulmonary artery syndrome, tumor is replaced using artificial Valved allograft of the present invention completely
Sample expands pulmonary artery.By second pipe distal end suture completely of the invention, one is each side determined in second pipe later
Opening, the opening for determining left and right pulmonary artery with second pipe respectively make end-to-side anastomosis.First pipe proximal end is cut out and is done
Blast cap shape expands, and coincide with right ventricle.
2, the substitute of the blood vessel as Human left ventricle to aorta is than more typical application method:
Treatment aorta ascendens severe developmental is complete, narrow on valve should not make forming patient or the serious calcium of aortic root
Change etc. can not be made in the left ventricular outflow tract obstruction operation of general valve replacement surgery, using artificial Valved allograft of the present invention
The left apex of the heart is done to descending aorta shunt.Cut left ventricular wall in apex of the heart avascular area, by first pipe proximal end of the invention with
Apex of the heart notch coincide, and then makees a kerf on the diaphram face near the apex of the heart, the artificial band valve blood of the present invention that will have been coincide
Pipe is sent to intraperitoneal by notch, and second pipe of the present invention is distally made end-to-side anastomosis with abdominal aorta.It is of the present invention artificial
Tissue valve prosthesis in Valved allograft be located at it is intraperitoneal under diaphragm, when as needed to perform the operation again in the future, only need to cut abdominal cavity without opening
Chest.
Artificial Valved allograft according to the present invention is described in detail above, specific case pair used herein
The principle of the present invention and embodiment are expounded, method of the invention that the above embodiments are only used to help understand
And its core concept.It should be pointed out that the present invention is not limited to exemplary embodiments mentioned above, those skilled in the art can without departing from
A variety of changes and modification are made in the case where the principle of the present invention, range or spirit.Meanwhile for the general technology of this field
Personnel, technical idea according to the present invention, there will be changes in the specific implementation manner and application range.Thus, to sum up
Described, the contents of this specification are not to be construed as limiting the invention.
Claims (13)
1. a kind of artificial Valved allograft, which is characterized in that by tissue valve prosthesis, the artificial blood vessel of the sinus containing valve and artificial valve support ring
Composition；Tissue valve prosthesis is located in the valve sinus of the artificial blood vessel of the sinus containing valve, and artificial valve support ring is located at the artificial blood vessel of the sinus containing valve
Valve sinus outside, the annulus of tissue valve prosthesis is Chong Die with artificial valve support ring position；Tissue valve prosthesis, the artificial blood vessel of the sinus containing valve and people
Valve support ring is made to be connected by silk sutures.
2. artificial Valved allograft according to claim 1, which is characterized in that the tissue valve prosthesis is from treated ox neck
Complete three leaflets structure valve under cutting out in vein blood vessel, the annulus of the tissue valve prosthesis under cutting out still are annular.
3. artificial Valved allograft according to claim 1, which is characterized in that the tissue valve prosthesis is by three pieces from by handling
The native blood vessels with valve in cut out lower tissue leaflet or manufactured three leaflets of the splicing of the bovine pericardium by handling and cutting out
Structure valve.
4. artificial Valved allograft according to claim 1, which is characterized in that the artificial blood vessel of the sinus containing valve includes the first pipe
Road, valve sinus and second pipe, valve sinus are located between first pipe distal end and second pipe proximal end.
5. artificial Valved allograft according to claim 4, which is characterized in that the first pipe of the artificial blood vessel of the same sinus containing valve
It is identical with the internal diameter of second pipe and identical as the annulus internal diameter of tissue valve prosthesis being located in valve sinus；The same sinus containing valve it is artificial
The internal diameter of the valve sinus of blood vessel be greater than first pipe, second pipe internal diameter, and be located at valve sinus in tissue valve prosthesis annulus outside
Diameter is identical；Valve sinus is relative to first pipe and second pipe generally in convex；The first pipe, valve sinus and second pipe structure
At the artificial blood vessel of a continuous and complete sinus containing valve.
6. artificial Valved allograft according to claim 4, which is characterized in that the artificial blood vessel of the sinus containing valve uses medical height
Molecular material is made；The first pipe and second pipe are flexible, cut out, suture, and can keep during operation and use
Tube-like condition and corresponding elasticity.
7. artificial Valved allograft according to claim 1, which is characterized in that the artificial valve support ring is resilient sheet-like
Ring, shape is similar to the annulus shape of natural three leaflets structure valve, is the annular that the parabola of three opening upwards surrounds,
There is sewing hole thereon.
8. artificial Valved allograft according to claim 7, which is characterized in that the internal diameter of the artificial valve support ring with it is described
The valve sinus outer diameter of the artificial blood vessel of the sinus containing valve is identical.
9. artificial Valved allograft according to claim 7, which is characterized in that the artificial valve support ring uses medical high score
Sub- material or elastic metallic material are made.
10. artificial Valved allograft according to claim 1, which is characterized in that the artificial Valved allograft has and cuts out limitation
Line and blood flow direction mark.
11. the preparation method of artificial Valved allograft described in a kind of claim 1, which comprises the following steps:
(1) by three leaflet structure valves in treated bovine jugular vein blood vessel along the certain of its annulus lower edges vascular wall
Under distance is cut out, the annulus of the tissue valve prosthesis under cutting out still is annular, and leaflet and annulus still retain complete valve structure and function；
(2) tissue valve prosthesis is placed in the valve sinus of artificial blood vessel of the sinus containing valve, the artificial valve support ring is set
In outside the valve sinus of the artificial blood vessel of the sinus containing valve, making artificial valve support ring Chong Die with the annulus position of tissue valve prosthesis；With doctor
With suture along the trend of the annulus of tissue valve prosthesis, make the lower edges blood that suture is related across the annulus of tissue valve prosthesis
Tube wall, the valve sinus of the artificial blood vessel of the sinus containing valve, the sewing hole in artificial valve support ring, above-mentioned three-decker is sewn to simultaneously
Together.
12. the preparation method of artificial Valved allograft described in a kind of claim 1, which comprises the following steps:
(1) by the tissue leaflet in the treated native blood vessels with valve along a spacing of its annulus lower edges vascular wall
From under sanction；
(2) size, thickness, the consistent three pieces tissue leaflet of form are chosen, wherein sheet of tissue leaflet will be placed in the sinus containing valve
Artificial blood vessel valve sinus in, the artificial valve support ring is placed in outside the valve sinus of the artificial blood vessel of the sinus containing valve, is made one
It is Chong Die with the tissue annulus position of leaflet to make valve support ring；With suture along the trend of the annulus of tissue leaflet, make to cure
With the related lower edges vascular wall of the annulus of suture through tissue leaflet, the valve sinus of the artificial blood vessel of the sinus containing valve, artificial valve
Above-mentioned three-decker is stitched together by the sewing hole in film support ring simultaneously；
(3) with same method successively by second, the valve sinus of the artificial blood vessel of third piece tissue leaflet and the sinus containing valve, artificial valve
The suture of film support ring.
13. the preparation method of artificial Valved allograft described in a kind of claim 1, which comprises the following steps:
(1) treated bovine pericardium is cut into substantially fan-shaped piece；
(2) wherein a piece of bovine pericardium is placed in the artificial of the sinus containing valve by the three pieces bovine pericardium for choosing size, consistency of thickness
In the valve sinus of blood vessel, the artificial valve support ring is placed in outside the valve sinus of the artificial blood vessel of the sinus containing valve, makes artificial valve
Support ring is Chong Die with the bottom edge position of bovine pericardium；With suture in the position of the bottom edge certain distance away from bovine pericardium,
Trend along the bottom edge of bovine pericardium makes suture pass through bovine pericardium, the valve sinus of the artificial blood vessel of the sinus containing valve, artificial valve
Above-mentioned three-decker is stitched together by the sewing hole in film support ring simultaneously；
(3) with same method successively by second, the valve sinus of the artificial blood vessel of third piece bovine pericardium and the sinus containing valve, artificial valve
The suture of film support ring.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
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| CN201910299015.5A CN109907860A (en) | 2019-04-15 | 2019-04-15 | Artificial Valved allograft |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910299015.5A CN109907860A (en) | 2019-04-15 | 2019-04-15 | Artificial Valved allograft |
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| CN109907860A true CN109907860A (en) | 2019-06-21 |
Family
ID=66969807
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| CN110236733A (en) * | 2019-07-18 | 2019-09-17 | 南京市儿童医院 | A kind of novel valved conduit and preparation method thereof |
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