CN110290818A - 具有用于引入动脉血管系统的泵头的导管泵 - Google Patents

具有用于引入动脉血管系统的泵头的导管泵 Download PDF

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CN110290818A
CN110290818A CN201880011290.6A CN201880011290A CN110290818A CN 110290818 A CN110290818 A CN 110290818A CN 201880011290 A CN201880011290 A CN 201880011290A CN 110290818 A CN110290818 A CN 110290818A
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catheter
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pump
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克劳斯·埃普勒
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Cardiobridge GmbH
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    • A61M60/00Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/10Location thereof with respect to the patient's body
    • A61M60/122Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
    • A61M60/126Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
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    • A61M60/148Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
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    • A61M60/216Non-positive displacement blood pumps including a rotating member acting on the blood, e.g. impeller
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    • A61M60/30Medical purposes thereof other than the enhancement of the cardiac output
    • A61M60/36Medical purposes thereof other than the enhancement of the cardiac output for specific blood treatment; for specific therapy
    • A61M60/38Blood oxygenation
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    • A61M60/403Details relating to driving for non-positive displacement blood pumps
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    • A61M60/80Constructional details other than related to driving
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    • A61M60/804Impellers
    • A61M60/806Vanes or blades
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    • AHUMAN NECESSITIES
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    • FMECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
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Abstract

本发明涉及一种导管泵(10),其具有用于引入动脉血管的泵头(12)、外导管(14)、安置在外导管(14)中的内导管(16)和可旋转地安置在内导管(16)中的用于驱动设置在泵头(12)处的可展开输送元件(20)的转子轴(18),其中,输送元件(20)可旋转地安装在远侧轴承点(24)和近侧轴承点(26)之间,并且其中,外导管(14)在其远端上具有围绕近侧轴承点的套管部件(50),并且其中,近侧轴承点可以相对于套管部件(50)沿轴向移动以展开输送元件(20),其中,近侧轴承点(26)包括轴承容纳器(32),该轴承容纳器(32)具有用于将旋转头(40)旋转固定到转子轴(18)的远端(38)的旋转轴承点(34),并且具有力施加点(36),其与旋转轴承点(34)轴向间隔开,用于在内导管(16)的远端(44)处设置的力施加部件(46)以使近侧支承点轴承点(26)相对于套管部件(50)沿轴向移动。

Description

具有用于引入动脉血管系统的泵头的导管泵
本发明涉及一种导管泵,该导管泵具有用于引入例如主动脉或心脏的动脉血管的泵头、外导管、安置在外导管中的内导管、以及可旋转地安置在内导管中用于驱动设置在泵头处可展开的输送元件的转子轴,输送元件可旋转地安装在远端轴承点和近端轴承点之间,外导管在其远端上具有围绕近端轴承点的套管部件,并且可以使近端轴承点相对于套管部件沿轴向移动以展开输送元件。
这种导管泵是已知的,例如由EP 2 308 422 B1。例如,如EP 768 900 B1中所述的包括折叠式螺旋桨的转子可用作旋转输送元件。还可以想到可以使用不同形状的输送元件,例如螺旋形成的螺旋物。
导管泵作为临时循环支持系统插入患者的主动脉中,特别是当天然心脏不能为身体提供足够的含氧血液时。输送元件和转子轴以7000至15000转/分钟范围内相对高的速度工作。导管泵的泵头可以在主动脉中保留数天,特别是在手术后。
本发明所解决的问题是有利地设计先前所述的导管泵的近端轴承点。
该问题通过具有权利要求1的特征的导管泵解决。本发明因此提供了近端轴承点,即位于导管和轴向上的另一个远端轴承点之间的轴承点,该近端轴承点包括轴承容纳器,其具有用于将旋转头旋转固定到转子轴远端的旋转轴承点,并且具有力施加点,该力施加点与旋转轴承点轴向间隔开,用于在内导管的远端处设置的力施加部件以使近侧轴承点相对于套管部件沿轴向移动。通过提供具有旋转轴承点和力施加点的这种轴承容纳器,可以在单个组件中在最小空间内实现多个功能。一方面,输送元件特别是输送元件的转子可以旋转固定地安装在旋转轴承点中。另一方面,由于轴承容纳器上提供了力施加点,因此可以功能可靠地实现外导管的套管部件和轴承容纳器之间的相对运动以展开输送元件。
套管部件可以整体地安置在外导管上或由此形成。还可以想到的是,套管部件可以形成与外导管刚性连接的单独部件。
为了在输送元件中收缩或折叠,套管部件在轴向方向上相对于近侧轴承点远离远侧轴承点移动。
有利地,轴承容纳器是套管形的。旋转轴承点由第一内槽形成,并且力施加点由第二内槽形成。总的来说,这允许通过旋转轴承点和力施加点形成相对简单的轴承容纳器。第一内槽可以具有相对平坦的倒角,从而可以适当方便地存储旋转头。在这种情况下,形成环形套环的力施加部件能够功能可靠的由第二内槽接收这样特别的方式形成第二内槽。
在特别优选的实施例中,轴承容纳器包括至少两个轴承壳。两个半壳可以用于提供两个轴承壳。使用两个或更多个轴承壳具有可以简单地安装近侧轴承点的优点。
为此,为了安装近侧轴承点,套管部件被有利地设计使得首先沿径向将轴承壳安置在旋转头和力施加部件上,然后将套管部件沿轴向推过轴承壳。这具有可以省略进一步安装或紧固装置的优点。轴承壳牢固地安置在套管部件中。
轴承容纳器特别是轴承壳可以优选地在面向套管部件的径向外侧上具有凹槽,使得在内导管和外导管之间流动的冲洗流体可以在轴承容纳器或轴承壳与套管部件内壁之间流动。凹槽优选地在轴承容纳器或轴承壳中形成为沿轴向延伸的通道。因而可以确保在外导管和内导管之间朝向泵头输送的冲洗流体可以穿过近侧轴承点,而不必使流体通过旋转轴承点。
此外,根据本发明可以意识到,储存腔室邻接轴承容纳器的远端,在操作期间,在储存腔室内收集冲洗流体,并且冲洗流体从储存腔室进一步引到远侧轴承点,进入主动脉和/或通过内导管返回。因此,一方面,远侧轴承点也可以提供适当的冲洗流体。另一方面,在引入的冲洗流体的三分之一范围内的冲洗流体的一部分可以通过旋转轴承点移过旋转头并且通过内导管返回。由此可以通过适当的冲洗流体充分地冲洗和润滑旋转轴承点。因此,穿过旋转轴承点的冲洗流体通过内导管或通过内导管和转子轴之间的内腔被输送回来,使得潜在的支承磨损在可能的情况下不会到达患者的血流。
力施加部件有利地安置在衬管上,衬管固定安置在内导管的远端上。衬管可以沿径向围绕内导管。力施加部件可以特别设计为环形套环,该环形套环在径向方向上突出并且接合在轴承容纳器的第二内部槽中。以这种方式,可以提供在内导管或衬管与轴承容纳器或轴承壳之间沿轴向作用地牢固移动的连接。
衬管转而可以具有与在背离旋转轴承点的一侧上的力施加部件相距一定距离的套环部件。该套环部件可以用作抵靠在外导管或抵靠在设置在衬管和外导管之间的间隔套管上的轴向止挡。
有利地,间隔套管具有沿径向延伸的用于冲洗流体的通过的开口。由此可以确保,当间隔套管与套环部件完全接触时,在内导管和外导管之间朝向近侧轴承点输送的冲洗流体也可以在较低部件和间隔套管之间传输。
在以下描述中可以找到本发明的进一步细节和有利设计,在此基础上更详细地解释和描述本发明的一个实施例。
在附图中:
图1是根据本发明的具有部分切除的近侧轴承点的导管泵的泵头的透视图;
图2是穿过图1所示的近侧轴承点的纵剖视图;以及
图3示出了在安装之前图2中所示的轴承点。
图1中所示的导管泵10包括用于引入患者主动脉或心脏的泵头12。泵10包括外导管14、内导管16和可旋转地安置在内导管16中的转子轴18。在图1中示出为展开的输送元件20可以通过转子轴18,以具有螺旋桨22的转子42的形式被驱动。螺旋桨22在远侧轴承点24和近侧轴承点26之间安置在转子42上。输送元件20或螺旋桨22被笼架28围绕,笼架2提供各种细丝30。在如图1所示的展开状态下,笼架28形成如球茎状,使得螺旋桨22能够在笼架28内自由旋转。为了将泵头12引入主动脉,泵头12不会展开,而是处于收缩或折叠状态。在该收缩状态下,螺旋桨22靠近转子42的旋转轴,并且笼架28的细丝30位于与转子42的旋转轴平行的位置。
从根据图2的截面可以清楚地看到,近侧轴承点26具有轴承容纳器32,其包括旋转轴承点34和力施加点36。旋转轴承点34和力施加点36均在套管状轴承容纳器32内形成为环形内槽。
旋转固定到转子轴18的远端38的旋转头40,优选为球状头,旋转地安装在旋转轴承点34中。包括螺旋桨22的转子42通过旋转头40驱动。转子轴18转而在操作时在其近端(未显示)通过驱动装置驱动。
力施加部件46设置在力施加点36中。力施加部件46由设置在衬管52上的环形套环形成,衬管52刚性连接到内导管16。环形套环在力施加点36中正向接合,力施加点36由轴承容纳器32形成并且被设计为环形内槽。
轴承容纳器32转而容纳在套管部件50内,套管部件50安置在外导管14的远端48处并且能够相对于轴承容纳器32在轴向方向上移动,并因此相对于内导管16移动。
通过所描述的布置,通过外导管14相对于内导管16并从而相对于与内导管16运动耦合的轴承容纳器32轴向移动,套管部件50能够从如图2所示的远侧位置移位,其中,输送元件20向右展开到近侧位置,由此螺旋桨22折叠并且笼架28收缩。
在图2所示的套管部件50的远侧位置,存在与轴承容纳器32的远端邻接的储存腔室54。该储存腔室54是因当输送元件20展开时套管部件50沿远侧方向轴向移动而产生的。在套管部件50的近侧位置,换言之在收缩的输送元件20的情况下,轴承容纳器32位于储存腔室54中。
从图3中可以清楚地看到,轴承容纳器32由两个轴承壳56组成。为了安装近侧轴承点26,首先将两个轴承壳56沿径向安置在旋转头40和力施加部件46上。随后,将套管部件50沿轴向推过轴承壳56。这具有的优点是,安装或固定轴承壳56可以在没有其他组件或固定装置的情况下进行。通过这种布置,可以在最小的空间内实现对该安装的要求。
在背离旋转轴承点34的一侧,衬管52具有套环部件68,套环部件68与力施加部件46相距一定距离。套环部件68与间隔套管62一起能够用作轴向止挡,并因此限制套管部件50的轴向位移路径。
从图3中还可以清楚地看到,轴承壳56在其径向外侧上具有以沿轴向延伸的通道形式的凹槽58。在导管泵10的操作期间,在内导管16和外导管14之间流动的冲洗流体可以在轴承壳56和套管部件50的内壁之间流入储存腔室54,该冲洗流体由图2中的箭头60指示并且穿过间隔套管62。在内导管16和外导管14之间在压力下泵送的冲洗流体由此收集在储存腔室54中,使得入口中的大部分冲洗流体不与旋转头40或旋转轴承点34接触。如箭头64所示,然后冲洗流体能够从储存腔室54通过相应的开口(图中未示出)输送到远侧轴承点24以便供给轴承点24轴承点。另一部分冲洗流体可以通过旋转解耦(在图中未进一步标识)从储存腔室54中逸出到主动脉中。第三部分,约为冲洗流体的三分之一,可以从储存腔室54流出,如箭头66所示,通过旋转轴承点34以便对其进行冲洗和润滑,并且在内导管16和转子轴18之间朝向外导管14的近端移除。以这种方式,旋转头40和整个转子轴18都可以被提供足够的冲洗和润滑,流过轴承容纳器32的冲洗流体的部分不会到达患者的主动脉。
在背离旋转轴承点34的一侧,衬管52具有与力施加部件46相距一段距离的套环部件68。套环部件68与间隔套管62一起可以用作轴向止挡。因此,冲洗流体可以在衬管52和间隔套管62之间不受阻碍地行进,如图1所示,间隔套管62包括轴向开口70,即使当间隔套管62抵靠衬管52的套环部件68时,轴向开口70也保持打开。
由于近侧轴承点26的所述设计,可以实现轴承点26与两个轴承壳56的简单但可靠的安装,同时确保近侧轴承点26相对于套管部件50的轴向运动以便使输送元件20展开。

Claims (9)

1.一种导管泵(10),其具有用于引入动脉血管的泵头(12),
外导管(14),
内导管(16),其安置在外导管(14)中,以及
转子轴(18),其可旋转地安置在内导管(16)中用于驱动设置在泵头(12)处的可展开输送元件(20),
所述输送元件(20)可旋转地安装在远侧轴承点(24)和近侧轴承点(26)之间,
其中,外导管(14)在其远端上具有围绕近侧轴承点(26)的套管部件(50),并且其中,近侧轴承点(26)可相对于套管部件(50)沿轴向移动以用于展开输送元件(20)
其特征在于,近侧轴承点(26)包括轴承容纳器(32),
轴承容纳器(32)具有用于将旋转头(40)旋转固定到转子轴(18)的远端(38)上的旋转轴承点(34),并且具有力施加点(36),其与旋转轴承点(34)轴向间隔开,用于在内导管(16)的远端(44)处设置的力施加部件(46)以使近侧轴承点(26)相对于套管部件(50)沿轴向移动。
2.根据权利要求1所述的导管泵(10),其特征在于,所述轴承容纳器(32)是套管形的,并且所述旋转轴承点(34)由第一内槽形成并且所述力施加点(36)由第二内槽形成。
3.根据权利要求1或2所述的导管泵(10),其特征在于,所述轴承容纳器(32)包括至少两个轴承壳(56)。
4.根据权利要求3所述的导管泵(10),其特征在于,为了安装所述近侧轴承点(26),所述套管部件(50)的形成使得首先将所述轴承壳(56)沿径向安置在所述旋转头(40)和力施加部件(46)上,然后将套管部件(50)沿轴向推过轴承壳(56)。
5.根据前述权利要求中任一项所述的导管泵(10),其特征在于,所述轴承容纳器(32)在面向所述套管部件(50)的外侧具有凹槽(58),使得在所述内导管(16)和外导管(14)之间流动的冲洗流体能够在轴承容纳器(32)和套管部件(50)的内壁之间流动。
6.根据前述权利要求中任一项所述的导管泵(10),其特征在于,储存腔室(54)邻接所述轴承容纳器(32)的远端,在操作期间,在所述储存腔室中收集冲洗流体并且所述冲洗流体从所述储存腔室被进一步导入远侧轴承点(24),进入动脉血管系统和/或通过内导管(16)返回。
7.根据前述权利要求中任一项所述的导管泵(10),其特征在于,所述力施加部件(46)安置在衬管(52)上,所述衬管(52)固定安置在所述内导管(16)的远端(44)上。
8.根据权利要求7所述的导管泵(10),其特征在于,所述衬管(52)具有套环部件(68),所述套环部件(68)在远离所述旋转轴承点(34)的一侧上与所述力施加部件(46)相距一定距离,该套环部件与间隔套管(62)一起形成轴向止挡。
9.根据权利要求8所述的导管泵(10),其特征在于,所述间隔套管(62)具有沿径向延伸的开口(70)用于冲洗流体的通过。
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