CN110236606A - Postinfarction ventricular septal defect plugging device - Google Patents
Postinfarction ventricular septal defect plugging device Download PDFInfo
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- CN110236606A CN110236606A CN201910508944.2A CN201910508944A CN110236606A CN 110236606 A CN110236606 A CN 110236606A CN 201910508944 A CN201910508944 A CN 201910508944A CN 110236606 A CN110236606 A CN 110236606A
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- disk
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- septal defect
- ventricular septal
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00606—Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
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- Heart & Thoracic Surgery (AREA)
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Abstract
The present invention relates to a kind of postinfarction ventricular septal defect plugging devices.The postinfarction ventricular septal defect plugging device includes: the first disk, and for being bonded left ventricle and interventricular septum, first disk is in arcuation；Second disk, for being bonded right ventricle and interventricular septum；Waist connects first disk, second disk.First disk is arranged to arcuation, make the first disk carry out arc with left ventricle, interventricular septum respectively to be bonded, reduce the shearing force between the first disk and left ventricle, the first disk and interventricular septum, reduce abrasion, to keep the two sides of postinfarction ventricular septal defect plugging device and the stickiness of left ventricle, interventricular septum more preferable, it is conducive to regeneration endothelialization, prevents patient from residual shunt, haemolysis, lateral thrombus complication occur, then surgical cure rate is improved, the pain of patient is reduced.
Description
Technical field
The present invention relates to medical instruments, more particularly to a kind of postinfarction ventricular septal defect plugging device.
Background technique
Perforation of ventricular septum is one of the severe complication after Acute myocardial infarction, broken in the heart that acute myocardial infarction AMI is led to
It is located at interventricular septum person in splitting and accounts for about 10%.Because in the pathological anatomy data of acute myocardial infarction AMI death, perforation of ventricular septum
Incidence is 1.3%-2%.Perforation of ventricular septum causes hurried hemodynamic responses, seriously threatens patients ' lives, Chang Fa
Caused death in a short time after being ill.After being ill 25% patient is played in dead in 24 hours, 50% is dead in one week, and 70% in two weeks
Interior death, person only has 20% within existence after the onset one month or more.
Therapeutic intervention measure is generally taken in order to treat perforation of ventricular septum, which includes internal medicine treatment, intervention envelope
It is stifled to be intended to improve symptom and heart function preparation with surgical operation therapy internal medicine treatment, and to perform the operation or intervening in next step
Chance is created in treatment.It reports and has successfully repaired after heart infarction since perforation of ventricular septum for the first time from nineteen fifty-seven Cooley, operation has become this
The first choice of class disease treatment, but the most of patients state of an illness is critical, and haemodynamics is unstable or is in shock state, needs IABP
(Intra-aortic balloon pump, intra-aortic balloon pump) auxiliary, there are still disputes when operation.If patient occurs
Acute perforation of ventricular septum, such as through IABP (Intra-aortic balloon pump, intra-aortic balloon pump) and medical treatment
Haemodynamics is still unstable, it is contemplated that emergency operation, but surgical risk is big；If patient's large area heart infarction has occurred cardiogenic
When shock, do not consider generally to perform the operation.
Need to carry out the small percutaneous catheter research of transcatheter closure of ventricular septal defect of wound for certain patients, the plugging device used is first
The cardiopathic ventricular septal defect of nature, this kind of plugging device easily lead to the complication such as residual shunt, haemolysis, lateral thrombus.
Summary of the invention
Based on this, it is necessary to aiming at the problem that plugging device leads to residual shunt, haemolysis, lateral thrombus complication, provide one
Kind postinfarction ventricular septal defect plugging device.
A kind of postinfarction ventricular septal defect plugging device, the postinfarction ventricular septal defect plugging device include:
First disk, for being bonded left ventricle and interventricular septum, first disk is in arcuation；Second disk, for being bonded right ventricle and interventricular septum；
Waist connects first disk, second disk.
Above-mentioned postinfarction ventricular septal defect plugging device when in use, is punched through heart surface, is implanted into human body, by the
One disk fits between left ventricle and interventricular septum, and the second disk fits between right ventricle and interventricular septum, and waist is worn across interventricular septum
Hole, the first disk and the second disk are used to block the both ends of perforation of ventricular septum, avoid extracorporal circulatory system, cardiac arrest to the wound of patient body
Wound.First disk is arranged to arcuation, so that the first disk is carried out arc with left ventricle, interventricular septum respectively and is bonded, reduce the first disk and a left side
Shearing force between ventricle, the first disk and interventricular septum reduces abrasion, to make the of postinfarction ventricular septal defect plugging device
One disk and the stickiness of left ventricle, interventricular septum are more preferable, be conducive to regeneration endothelialization, prevent patient occur residual shunt, haemolysis,
Lateral thrombus complication, then improves surgical cure rate, reduces the pain of patient.
It is the first face that first disk, which is bonded the face of the left ventricle, in one of the embodiments, first face
Middle part is recessed to form the arcuation to the direction of second disk.
The outer wall of the arcuation and left ventricle matches in one of the embodiments,.
The face of the second disk fitting right ventricle is the second face, the diameter in first face in one of the embodiments,
Greater than the diameter in second face.
The diameter in second face is greater than the waist diameter of the waist in one of the embodiments,.
The waist is in structure narrow in the middle and wide at both ends in one of the embodiments, and is slipped over from middle part to two terminal circle
It crosses.
First disk, second disk, the waist are compiled by Ultimum Ti in one of the embodiments,
Knit the elastic network(s) of sizing.
The postinfarction ventricular septal defect plugging device further includes choked flow film in one of the embodiments, described
Choked flow film is set in the elastic network(s).
The choked flow film includes the first choked flow film, the second choked flow film and third choked flow film in one of the embodiments,；Institute
It states the first choked flow film to be located in first disk, and shape and the shape of first disk match；The second choked flow film position
In in the waist, the third choked flow film is located in second disk.
The postinfarction ventricular septal defect plugging device further includes nut head in one of the embodiments, described
Nut head is fixed on second disk, and protrudes second face, and the spiral shell for connecting conveying lever is equipped in the nut head
Line.
Detailed description of the invention
Fig. 1 is the sectional view of perforation of ventricular septum plugging device after an embodiment myocardial infarction；
Fig. 2 is traditional plugging device sectional view.
10, postinfarction ventricular septal defect plugging device；
100, the first disk, the 110, first face；
200, the second disk, the 210, second face；
300, waist；
400, choked flow film, the 410, first choked flow film, the 420, second choked flow film, 430, third choked flow film；
500, nut head, 510, screw thread；
20, traditional plugging device；
21, left disk, 22, right disk, 23, cylinder.
Specific embodiment
If Fig. 1 is postinfarction ventricular septal defect plugging device sectional view.One embodiment of the application provides a kind of cardiac muscle stalk
After death perforation of ventricular septum plugging device, the postinfarction ventricular septal defect plugging device 10 includes: the first disk 100, for pasting
Left ventricle and interventricular septum are closed, first disk 100 is in arcuation；Second disk 200, for being bonded right ventricle and interventricular septum；Waist
300, connect first disk 100, second disk 200.
Above-mentioned postinfarction ventricular septal defect plugging device 10 when in use, is punched through heart surface, is implanted into human body, will
First disk fits between left ventricle and interventricular septum, and the second disk fits between right ventricle and interventricular septum, and waist passes through interventricular septum
Perforation, the first disk and the second disk are used to block the both ends of perforation of ventricular septum, avoid extracorporal circulatory system, cardiac arrest to patient body
Wound.First disk 100 is arranged to arcuation, so that the first disk 100 is carried out arc with left ventricle, interventricular septum respectively and is bonded, reduce the
Shearing force between one disk 100 and left ventricle, the first disk 100 and interventricular septum reduces abrasion, to make interventricular septum after myocardial infarction
Perforation plugging device 10 and the stickiness of left ventricle, interventricular septum are more preferable, are conducive to regeneration endothelialization, prevent patient from occurring remaining point
Stream, haemolysis, lateral thrombus complication, then improve surgical cure rate, reduce the pain of patient.
Such as the sectional view that Fig. 2 is traditional plugging device.The tradition plugging device 20 includes left disk 21, right disk 22 and cylinder 23, a left side
Disk 21 is identical with the structure of right disk 22, and left disk 21 and right disk 22 are axially symmetric structure, passes through 23 center of cylinder and perpendicular to cylinder
The line of axis is middle line, which is symmetry axis, this kind of structure is when playing plugging effect, convenient for manufacture, save the cost.But it passes through
The study found that patient's left ventricle after scheming infarction becomes larger, in traditional plugging device 20 of symmetrical structure when blocking and left ventricle
Shearing force increase, improve abrasion, reduce plugging device and left ventricle compactness, be unfavorable for regeneration endothelialization, easily occur
Residual shunt, haemolysis, lateral thrombus complication, be unfavorable for the healing of patient.
Patient postinfarction ventricular septal defect operation in, residual shunt, haemolysis, lateral thrombus complication be usually
The common complication of transcatheter operation, in transcatheter operation, due to having foreign matter, ductus arteriosus occluder effect bad etc.
Lead to the above complication, patient's left ventricle with myocardial infarction becomes larger, left ventricle and right ventricle based on human anatomy
First disk of postinfarction ventricular septal defect plugging device is arranged to arcuation, the dissection of the arcuation and perforation of ventricular septum by structure
Size has good matching, and the compactness of postinfarction ventricular septal defect plugging device and left ventricle can be improved, and improves envelope
Stifled effect, reduces the appearance of residual shunt, haemolysis, lateral thrombus complication.
It is the first face 110 that first disk 100, which is bonded the face of the left ventricle, in one of the embodiments, described the
110 middle part is recessed to form the arcuation to the direction of second disk 200 on one side.
Since interventricular septum is between left ventricle and right ventricle, obviously it is convex in right ventricle in the middle part of interventricular septum, therefore in hand
When art process is blocked perforation of ventricular septum using postinfarction ventricular septal defect plugging device 10, the first face 110 is arranged to
Portion is recessed to the direction of the second disk 200, in addition to making the shape of the first disk 100 be consistent with the outer wall shape of left ventricle, moreover it is possible to room
The outer wall shape at interval is consistent, and then has the shape of the first disk 100 and the anatomic dimensions of postinfarction ventricular septal defect
Preferable consistency, the more difficult displacement of postinfarction ventricular septal defect plugging device 10 have preferable plugging effect, prevent from causing
Residual shunt, haemolysis, lateral thrombus complication, and can more preferably be bonded perforation of ventricular septum.
Specifically, the outer wall of the arcuation and left ventricle matches in one of the embodiments,.In order to obtain preferably
Plugging effect improves the surgical cure rate of patient, the first disk 100 is shaped to it is identical as the outer wall shape of left ventricle,
Make postinfarction ventricular septal defect plugging device 10 and left ventricle, perforation of ventricular septum that there is good adaptability, improves and block energy
Power.
Specifically, the second disk 200 is in plane in one of the embodiments,.Second disk 200 and the first disk 100 press from both sides jointly
Plugging action is played in the interventricular septum two sides of damage in short supply.
It is the second face 210, first face that second disk 200, which is bonded the face of right ventricle, in one of the embodiments,
110 diameter d1 is greater than the diameter d2 in second face 210.The diameter d1 in the first face 110 is big compared with the diameter d2 in the second face 210
5mm-7mm.Tissue necrosis, acute stage hyperemia, water because patient's left ventricle with myocardial infarction becomes larger, near perforation of ventricular septum
Swollen, as time went on, the diameter meeting further expansion of ventricular septal defect, left ventricle forms aneurysm, better in order to reach
Therapeutic effect, the diameter of the outer rim in the first face 110 is arranged to it is big compared with the diameter of the outer rim in the second face 210, for covering shape
At aneurysm, keep the plugging effect of perforation of ventricular septum plugging device after scheming infarction more preferable.
The diameter d2 in second face 210 is greater than the waist diameter d3 of the waist 300 in one of the embodiments,.Waist
300 are used to block perforation of ventricular septum, and waist diameter is identical as the Defect diameter of perforation of ventricular septum, by the way that the second face 210 is arranged to it
Diameter is greater than the waist diameter d3 of waist 300, and the diameter d2 for being typically provided to the second face 210 is greater than Defect diameter about 3mm, makes the second disk
200 can cover the fistula mouth in interventricular septum, achieve the purpose that closure.
The waist 300 is in structure narrow in the middle and wide at both ends in one of the embodiments, and round and smooth from middle part to both ends
Transition.Waist 300 is arranged to the structure that both ends are wider than middle part, in order to be stuck in postinfarction ventricular septal defect plugging device 10
It in perforation of ventricular septum, prevents plugging device from shifting, reduces the generation of residual shunt, haemolysis, lateral thrombus complication.
Distance between the both ends of waist 300 is 6mm-10mm, and waist diameter range refers to Defect diameter substantially 8mm-32mm, should
Size passes through clinical verification, has preferable surgical effect.
Optionally, first disk 100, second disk 200 and the waist 300 are equal in one of the embodiments,
It is by the elastic network(s) of Ultimum Ti braiding sizing.Postinfarction ventricular septal defect plugging device 10 is by Ultimum Ti
Silk weaves according to certain route, and certain elasticity and memory function are formed after Overheating Treatment.
The postinfarction ventricular septal defect plugging device 10 further includes choked flow film in one of the embodiments,
4000, the choked flow film 400 is set in the elastic network(s).It is worn to make one the entrance such as intracorporal water, blood less than interventricular septum
The inside in hole, choked flow film 400 can be one of polyester film, polytetrafluoroethylene film, polyethylene film or polyester film, poly- four
The composite membrane of fluoride film, polyethylene film.
Specifically, the choked flow film 400 includes the first choked flow film 410, the second choked flow film in one of the embodiments,
420 and third choked flow film 430；The first choked flow film 410 is located in first disk 100, and shape and first disk 100
Shape match；The second choked flow film 420 is located in the waist 300, and the third choked flow film 430 is located at described second
In disk 200.By being respectively provided with choked flow film in the first disk, the second disk and waist, the intracorporal water of people, blood etc. are effectively obstructed, is protected
Card red blood cell can effectively pass through choked flow film, and thrombus cannot shorten Case treatment and observing time by choked flow film.
The postinfarction ventricular septal defect plugging device 10 further includes nut head 500 in one of the embodiments,
The nut head 500 is fixed on second disk 200, and protrudes second face 210, is equipped with and is used in the nut head 500
In the screw thread 510 of connection conveying lever.Screw thread 510 is used for the release and recycling of postinfarction ventricular septal defect plugging device.NiTi
After memory alloy wire is formed according to the braiding of certain route, there is sealing, in nut head 500, nut head 500 uses the sealing plug
Medical stainless steel material is made, and by seal welding in nut head 500, no-welding-spot when welding, firm welding not will cause running,
The appearance for leading to thrombotic phenomena due to solder joint is avoided simultaneously.
Perforation of ventricular septum plugging device has good shape memory function after scheming infarction, is in lines by external force traction
Shape recovers immediately original-shape after external force removal.
Perforation of ventricular septum plugging device is woven by elastic NiTi memory alloy wire after scheming infarction, is sent into through cardiac catheter
The position of heart defect, the shape of automatic restoration designing, is clipped in the interventricular septum two sides of defect, closes defect after releasing out of conduit
It closes, achievees the purpose that healing.
When operation, perforation of ventricular septum plugging device after scheming infarction is connected with conveying lever, pulls in short intrathecal, sent through short sheath
Enter in long sheath, is pushed to plugging device at left ventricle through delivery sheath by push rod, the disc of left ventricle leans on after going out sheath
The elasticity of itself is opened, and is pulled back to interventricular septum aperture, the first face of ultrasound display postinfarction ventricular septal defect plugging device
Positioned at left ventricle side, if any resistance, then conveying lever is fixed, sheath is withdrawn, release the second face, the first face, the second face pass through certainly
The elasticity of body, is clipped in the two sides of ventricular septal defect, and plugging device position is fixed when such as pushing and pulling back, then releasable plugging device, knot
Art in a helpless situation.
In clinical application, according between the ventricular septal defect diameter selection myocardial infarction rear chamber of radiography measurement in ultrasound and book
Every the size of perforation plugging device.Postinfarction ventricular septal defect plugging device is sent into left ventricle through delivery sheath, in left ventricle
It is first turned on the first face and waist, withdraws sheath, releases the second face.Determine that plugging device is planted under ultrasonic wave and the guidance of X-ray line
The position entered and plugging effect.
Each technical characteristic of embodiment described above can be combined arbitrarily, for simplicity of description, not to above-mentioned reality
It applies all possible combination of each technical characteristic in example to be all described, as long as however, the combination of these technical characteristics is not deposited
In contradiction, all should be considered as described in this specification.
The embodiments described above only express several embodiments of the present invention, and the description thereof is more specific and detailed, but simultaneously
It cannot therefore be construed as limiting the scope of the patent.It should be pointed out that coming for those of ordinary skill in the art
It says, without departing from the inventive concept of the premise, various modifications and improvements can be made, these belong to protection of the invention
Range.Therefore, the scope of protection of the patent of the invention shall be subject to the appended claims.
Claims (10)
1. a kind of postinfarction ventricular septal defect plugging device, which is characterized in that the postinfarction ventricular septal defect envelope
Stifled device includes:
First disk, for being bonded left ventricle and interventricular septum, first disk is in arcuation；
Second disk, for being bonded right ventricle and interventricular septum；
Waist connects first disk, second disk.
2. postinfarction ventricular septal defect plugging device according to claim 1, which is characterized in that the first disk fitting
The face of the left ventricle is the first face, and the middle part in first face is recessed to form the arcuation to the direction of second disk.
3. postinfarction ventricular septal defect plugging device according to claim 2, which is characterized in that the arcuation and the left heart
The outer wall of room matches.
4. postinfarction ventricular septal defect plugging device according to claim 2, which is characterized in that the second disk fitting
The face of right ventricle is the second face, and the diameter in first face is greater than the diameter in second face.
5. postinfarction ventricular septal defect plugging device according to claim 4, which is characterized in that second face it is straight
Diameter is greater than the waist diameter of the waist.
6. postinfarction ventricular septal defect plugging device according to claim 4, which is characterized in that the waist is in middle part
The wide structure in narrow both ends, and from middle part to both ends rounding off.
7. postinfarction ventricular septal defect plugging device according to claim 4, which is characterized in that first disk, institute
It states the second disk and the waist is by the elastic network(s) of Ultimum Ti braiding sizing.
8. postinfarction ventricular septal defect plugging device according to claim 7, which is characterized in that the myocardial infarction
Perforation of ventricular septum plugging device further includes choked flow film afterwards, and the choked flow film is set in the elastic network(s).
9. postinfarction ventricular septal defect plugging device according to claim 8, which is characterized in that the choked flow film includes
First choked flow film, the second choked flow film and third choked flow film；The first choked flow film is located in first disk, and shape with it is described
The shape of first disk matches；The second choked flow film is located in the waist, and the third choked flow film is located at second disk
It is interior.
10. postinfarction ventricular septal defect plugging device according to claim 7, which is characterized in that the cardiac muscle stalk
After death perforation of ventricular septum plugging device further includes nut head, and the nut head is fixed on second disk, and protrudes described second
Face, the interior screw thread being equipped with for connecting conveying lever of the nut head.
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| CN201910508944.2A CN110236606A (en) | 2019-06-13 | 2019-06-13 | Postinfarction ventricular septal defect plugging device |
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| CN201910508944.2A CN110236606A (en) | 2019-06-13 | 2019-06-13 | Postinfarction ventricular septal defect plugging device |
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Cited By (6)
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| CN110604600A (en) * | 2019-10-22 | 2019-12-24 | 石家庄帝中医疗器械科技有限公司 | Atrial septal defect occluder and occluder installation suit |
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| CN111728651A (en) * | 2020-07-02 | 2020-10-02 | 南昌大学第二附属医院 | Plugging device for perforation of indoor space and using method thereof |
| WO2022121300A1 (en) * | 2020-12-11 | 2022-06-16 | 上海捍宇医疗科技股份有限公司 | Puncturable interatrial septum occluder |
| CN115462844A (en) * | 2021-06-10 | 2022-12-13 | 微创投资控股有限公司 | Plugging device for perforation of ventricular septum and treatment system |
| CN115462843A (en) * | 2021-06-10 | 2022-12-13 | 微创投资控股有限公司 | Plugging device for perforation of ventricular septum and treatment system |
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| WO2022121300A1 (en) * | 2020-12-11 | 2022-06-16 | 上海捍宇医疗科技股份有限公司 | Puncturable interatrial septum occluder |
| CN115462844A (en) * | 2021-06-10 | 2022-12-13 | 微创投资控股有限公司 | Plugging device for perforation of ventricular septum and treatment system |
| CN115462843A (en) * | 2021-06-10 | 2022-12-13 | 微创投资控股有限公司 | Plugging device for perforation of ventricular septum and treatment system |
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