CN110897758A - Intracardiac tunnel patch module with curved surface of turning - Google Patents
Intracardiac tunnel patch module with curved surface of turning Download PDFInfo
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- CN110897758A CN110897758A CN201911327621.XA CN201911327621A CN110897758A CN 110897758 A CN110897758 A CN 110897758A CN 201911327621 A CN201911327621 A CN 201911327621A CN 110897758 A CN110897758 A CN 110897758A
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- intracardiac
- tunnel
- turning
- ventricular septal
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
Abstract
The invention discloses an intracardiac tunnel patch module with a turning curved surface, which comprises an intracardiac tunnel flow cavity, wherein the intracardiac tunnel flow cavity is formed by wrapping and sewing a ventricular septal defect sewing body, an isosceles triangle connecting patch, a turning part and an aortic valve orifice sewing body; the turning part is a turning curved surface formed by sewing and splicing a plurality of rhombic patches end to end, and the top end and the bottom end of the turning curved surface are respectively connected with the aortic valve orifice sewing body and the ventricular septal defect sewing body through isosceles triangle connecting patches. The patches can be designed into different sizes according to statistical data, and a modularized intracardiac tunnel patch form is formed by selecting the patches according to needs, so that the physiological requirements of most patients can be met, the subjective factors of doctors during treatment are reduced, and particularly, the tunnel is established in vitro, so that the operation time and the operation difficulty can be reduced, the treatment effect can be effectively ensured, and the generation of postoperative intervention factors is reduced.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to an intracardiac tunnel patch module with a turning curved surface.
Background
Double ventricular outlet (DORV) is a less common complex cyanotic congenital heart disease. The international association of thoracic surgeons and the european association of thoracic surgery in 2000 adopted a new naming convention for DORV, namely the "50%" rule: all of one aorta and more than 50% of the other aorta are derived from the morphological right ventricle and are called DORV. Classical DORV should meet the following 3 basic conditions: (1) the aorta and the pulmonary artery are completely or mainly opened in the right ventricle, and the semilunar valves of the two groups are basically at the same level; (2) there is no fibrous link between semilunar valve and atrioventricular valve and muscle connection is used instead; (3) ventricular Septal Defect (VSD) is the only exit from the left ventricle. Congenital ventricular septal defects may exist as individual malformations, or may be part of other complex cardiac malformations, such as Fallofours, complete atrioventricular malformations, aortic transposition, tricuspid valve occlusion, and right ventricular double-outlet. Determination of the location, size and shape of the aortic valve orifice and ventricular septal defect in a patient is critical to the preparation prior to surgery.
The primary treatment for DORV is right ventricular double-outlet correction, which creates an intracardiac tunnel from the ventricular septal defect to the aortic orifice to restore normal cardiac function. The 10-year survival rate after operation of the patient is 87%, the re-intervention rate is 24%, and the most significant re-intervention factors are related to an intracardiac tunnel (IVT), such as postoperative residual fistula, left ventricular outflow obstruction, extracardiac right ventricular-pulmonary artery catheterization and the like. In DORV biventricular correction with a ventricular septal defect away from the two major aortas, an IVT needs to be established to connect the ventricular septal defect with the aortic orifice. The form and material property of the IVT are main factors influencing hemodynamics and suture edge stress distribution, the improper form of the IVT can cause obstruction of left and right ventricular outflow tracts, and the insufficient inner diameter of the IVT can cause obstruction of left ventricular outflow. Meanwhile, if the IVT with the overlarge sewing volume is used for ensuring the smoothness of the tunnel, the IVT occupies the volume of the right chamber excessively, the pressure in the right chamber is increased, the blood flow is obstructed, even an external tube operation is additionally performed, and the latter is an independent risk factor for long-term re-operation intervention.
Recent studies have found that the pressure difference in an IVT with a turning radius is much lower than that of an IVT established in an operation, and the volume is relatively small, but the IVT with the turning radius is difficult to suture by only depending on a doctor, so that a patch cutting method is urgently needed to simplify the operation difficulty of the doctor and meet the physiological requirements of most patients.
Disclosure of Invention
The invention aims to provide an intracardiac tunnel patch module with a turning curved surface, which can be built in vitro, not only can reduce the operation time and the operation difficulty, but also can effectively ensure the treatment effect and reduce the generation of postoperative re-intervention factors.
In order to achieve the purpose, the invention provides the following scheme:
the invention provides an intracardiac tunnel patch module with a turning curved surface, which comprises an intracardiac tunnel flow cavity, wherein the intracardiac tunnel flow cavity is formed by encirclement sewing of a ventricular septal defect sewing body, an isosceles triangle connecting patch, a turning part and an aortic valve orifice sewing body; the turning part is a turning curved surface formed by sewing and splicing a plurality of rhombic patches end to end, the top end and the bottom end of the turning curved surface are respectively connected with the aortic valve orifice sewing body and the ventricular septal defect sewing body through isosceles triangles, the aortic valve orifice sewing body and the ventricular septal defect sewing body are respectively connected with the bottom edge of the isosceles triangle connecting patch, and two waists of the isosceles triangle connecting patch are respectively connected with one side of the rhombic patch.
Optionally, the ventricular septal defect suture body is in a rectangular patch structure in a fully deployed state, and is used for covering the ventricular septal defect.
Optionally, the aortic valve orifice suture body comprises a fan-shaped patch and two right-angle trapezoid patches symmetrically distributed on two sides of the fan-shaped patch; the two right-angle trapezoidal patches are respectively connected with the straight sides of the two sides of the fan-shaped patch by the bevel edges and connected with the two sides of the ventricular septal defect suture body by the height; the upper bottom edges of the two right-angle trapezoidal patches and the inner circular arc of the fan-shaped patch are connected with the bottom edge of the isosceles triangle connection patch, and the lower bottom edges and the outer circular arc of the fan-shaped patch encircle the aortic orifice to form the downstream part of the intracardiac tunnel flow cavity.
Optionally, the central line of the intracardiac tunnel flow cavity is formed by connecting a central arc and a central straight line, the starting point of the central arc is the ventricular septal defect midpoint, and the tangent line of the central arc at the ventricular septal defect midpoint is perpendicular to the ventricular septal plane, the central straight line starts from the aortic valve orifice central point, the ending point is tangent and connected with the terminal point of the central arc, the turning angle of the central arc is equal to the turning angle of the turning curved surface, and the turning angle β formula of the turning curved surface is as follows:
sinγ＝(dAO/2+d1)/l (1)
γ＝arcsin[(dAO/2+d1)/l](2)
cosθ＝r/l (3)
θ＝arcos(r/l) (4)
β＝π-γ-θ (5)
wherein d isAOAortic orifice diameter; dVSDIs the ventricular septal defect diameter; r is the turning radius of the central line of the intracardiac tunnel; d1The distance from the center of the aortic orifice to the inflection point of the ventricular septum and the ventricular septum; d2The distance from the ventricular septal defect center to the inflection point of the ventricular septal and the ventricular atrial septal defects, α the included angle between the aortic valve orifice plane and the ventricular septal defect plane, theta the turning angle of the intracardiac tunnel, gamma the angle of auxiliary calculation, l the auxiliary line of the auxiliary calculation, and t the contour line of the intracardiac tunnel.
Optionally, the required turning angle β is calculated according to formulas (1) to (6) according to the relative position and size of the ventricular septal defect and the aortic valve orifice of the patient, the turning angle of one diamond-shaped patch is Φ, and the turning surface includes the number n of diamond-shaped patches which is β/Φ.
Optionally, D of the rectangular patch structure1The length is 3-5mm and the length is L8The calculation formula of (a) is as follows:
L8＝π(dVSD+4)/2+2r (7)。
optionally, the base length of the isosceles triangle connecting patch is equal to the length L of the long side of the ventricular septal defect suture body8The waist length of the isosceles triangle connecting patch and the side length of each rhombic patch are both L6The length of the long diagonal of the rhombic patch is L7The length of the short diagonal of the rhombic patch is D2；L6And L7The length calculation formula of (c) is as follows:
L7＝2r+π(dVSD+4)/2 (8)
2L6＝π(dAO/2+2)*sinβ+2[dAO+4-(dAO/2+2)*sinβ]+2r (9)。
optionally, the sum of the arc length of the outer arc of the sector patch and the length of the lower bottom edge of the two right trapezoid patches is equal to the length of the aortic suture edge, and the height of the right trapezoid patch is L4The length L of the inner arc of the sector patch1And the upper bottom edges L of the two right-angle trapezoidal patches2The sum of the lengths is L5The formula is as follows:
L1＝π(dAO/2+2)*sinβ+2[dAO+4-(dAO/2+2)*sinβ](10)
L2＝r(11)
L3＝d1+dAO/2 (12)
L4＝dVSD/2+d2-r (13)
L5＝π(dAO+4)/2 (14)。
optionally, the edge of each patch structure is provided with a plurality of connecting serrations to form a serrated edge, and each serrated edge extends outward by 3-5 mm.
Compared with the prior art, the invention has the following technical effects:
in the intracardiac tunnel patch module with the turning curved surface, the intracardiac tunnel is divided into four patch parts, namely a ventricular septal defect suture body, an isosceles triangle connection patch, a turning part and an aortic valve orifice suture body, the patch parts are mutually independent and have a certain relation, the patch parts can be designed into different sizes according to statistical data, and a modular intracardiac tunnel patch form is formed by selecting according to needs. The modularized intracardiac tunnel patch not only can adapt to the physiological requirements of most patients, but also reduces the subjective factors of doctors during treatment, and particularly, the tunnel is established in vitro, so that the operation time can be reduced, the operation difficulty is reduced, the treatment effect can be effectively ensured, and the generation of postoperative intervention factors is reduced.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings needed to be used in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings without inventive exercise.
FIG. 1 is a schematic diagram of the calculation of the centerline of an ideal intracardiac tunnel according to the present invention;
FIG. 2 is a left side view of FIG. 1;
FIG. 3 is a cross-sectional view A-A of FIG. 1;
figure 4 is an isometric view of an intracardiac tunnel flow lumen and an established intracardiac tunnel of the present invention;
figure 5 is a front view of the intracardiac tunnel flow lumen and the established intracardiac tunnel of the present invention;
FIG. 6 is a left side view of FIG. 5
FIG. 7 is a schematic plan view of the ventricular septal defect suture of the present invention;
FIG. 8 is a schematic view of an isosceles triangle patch of the present invention in a flat expanded configuration;
FIG. 9 is a schematic plan view of a diamond patch of the present invention;
FIG. 10 is a schematic plan view of the aortic valve orifice suturing body of the present invention deployed;
wherein the reference numerals are: 1-chamber intervalA defect suture body; 2-connecting patches in an isosceles triangle shape; 3-diamond patch; 4-aortic valve orifice suture body; 4-1, sector patch; 4-2, right-angled trapezoidal patches; 5-connecting the saw teeth; 6-intracardiac tunnel flow chamber; 7-ventricular septal defect; 8-aortic valve orifice; dAO-aortic valve orifice diameter; dVSD-ventricular septal defect diameter; r-turning radius of central line of the tunnel in the center; d1-distance of aortic orifice center to ventricular septum and ventricular atrial septum inflection point; d2Distance from ventricular septal defect center to inflection point of ventricular septal and atrial septal defects, α -included angle between aortic orifice plane and ventricular septal defect plane, theta-intracardiac tunnel turning angle, gamma-angle of auxiliary calculation, l-auxiliary line of auxiliary calculation, and t-outline of intracardiac tunnel.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
The invention aims to provide an intracardiac tunnel patch module with a turning curved surface, which can be built in vitro, not only can reduce the operation time and the operation difficulty, but also can effectively ensure the treatment effect and reduce the generation of postoperative re-intervention factors.
Based on the above, the invention provides an intracardiac tunnel patch module with a curved surface, which comprises an intracardiac tunnel flow cavity, wherein the intracardiac tunnel flow cavity is formed by enclosedly sewing a ventricular septal defect sewing body, an isosceles triangle connecting patch, a curved part and an aortic valve orifice sewing body; the turning part is a turning curved surface formed by sewing and splicing a plurality of rhombic patches end to end, the top end and the bottom end of the turning curved surface are respectively connected with the aortic valve orifice sewing body and the ventricular septal defect sewing body through isosceles triangle connecting patches, the aortic valve orifice sewing body and the ventricular septal defect sewing body are both connected with the bottom edges of the isosceles triangle connecting patches, and two waists of the isosceles triangle connecting patches are respectively connected with one edge of the corresponding rhombic patches.
In the intracardiac tunnel patch module with the turning curved surface, the intracardiac tunnel is divided into four patch parts, namely a ventricular septal defect suture body, an isosceles triangle connection patch, a turning part and an aortic valve orifice suture body, the patch parts are mutually independent and have a certain relation, the patch parts can be designed into different sizes according to statistical data, and a modular intracardiac tunnel patch form is formed by selecting according to needs. The modularized intracardiac tunnel patch not only can adapt to the physiological requirements of most patients, but also reduces the subjective factors of doctors during treatment, and particularly, the tunnel is established in vitro, so that the operation time can be reduced, the operation difficulty is reduced, the treatment effect can be effectively ensured, and the generation of postoperative intervention factors is reduced.
In order to make the aforementioned objects, features and advantages of the present invention comprehensible, embodiments accompanied with figures are described in further detail below.
The first embodiment is as follows:
as shown in fig. 1-10, the present embodiment provides an intracardiac tunneling patch module with a curved surface, comprising an intracardiac tunneling flow lumen 6, wherein the intracardiac tunneling flow lumen 6 is formed by suturing a ventricular septal defect suturing body 1, an isosceles triangle connecting patch 2, a curved portion and an aortic valve orifice suturing body 4; the turning part is a turning curved surface formed by sewing and splicing a plurality of rhombic patches 3 end to end, and the edges of two rhombic patches 3 which are connected are repeatedly sewn for a plurality of times to obtain a curved surface; the top end and the bottom end of the curved surface are respectively connected with the aortic valve orifice suture body 4 and the ventricular septal defect suture body 1 through the isosceles triangle connection patch 2, the aortic valve orifice suture body 4 and the ventricular septal defect suture body 1 are both connected with the bottom edge of the isosceles triangle connection patch 2, and two waists of the isosceles triangle connection patch 2 are respectively connected with one side of the corresponding rhombic patch 3. In consideration of the geometrical configuration of the IVT and achieving the ideal treatment effect, the 4 large patch parts are arranged, and planar materials can be sequentially connected according to the requirements of a patient to form a three-dimensional intracardiac tunnel flow cavity 6 with a right turning radius, so that the treatment effect of relatively small pressure difference and volume at two ends of the intracardiac tunnel is achieved.
In this embodiment, as shown in fig. 7, the ventricular septal defect suturing body 1 is a rectangular patch structure in the fully deployed state, and is used for covering the ventricular septal defect.
In this embodiment, as shown in fig. 10, the aortic valve orifice suture body 4 includes a fan-shaped patch 4-1 and two right-angle trapezoid patches 4-2 symmetrically distributed on two sides of the fan-shaped patch 4-1; the two right-angle trapezoidal patches 4-2 are respectively connected with the straight edges at the two sides of the fan-shaped patch 4-1 by the bevel edges and connected with the two sides of the ventricular septal defect suture body 1 by the height; the upper bottom edges of the two right-angle trapezoidal patches 4-2 and the inner circular arc of the fan-shaped patch 4-1 are connected with the bottom edge of the isosceles triangle connection patch 2, and the lower bottom edges and the outer circular arc of the fan-shaped patch 4-1 encircle the aortic valve orifice 8 to form the downstream part of the intracardiac tunnel flow cavity. The aortic valve orifice suturing body 4 has the advantages that a space structure with a small upstream cross section and a large downstream cross section is formed, the design requirement of low flow resistance is met, and the occupied right ventricle volume is relatively small.
In this embodiment, as shown in fig. 1, the central line of the intracardiac tunnel flow cavity 6 is formed by connecting a central circular arc and a central straight line, the starting point of the central circular arc is the midpoint of the ventricular septal defect 7, the tangent of the central circular arc at the midpoint of the ventricular septal defect 7 is perpendicular to the ventricular septal plane, the central straight line starts from the central point of the aortic orifice 8, the end point is tangent and connected with the end point of the central circular arc, the geometric configuration of the central line not only can reduce the pressure difference at the two ends of the intracardiac tunnel, but also the central line of the latter half-stroke flow cavity is a straight line to reduce the invasion to the volume of the right ventricle, the turning angle of the central circular arc is equal to the turning angle of the turning curved:
sinγ＝(dAO/2+d1)/l (1)
γ＝arcsin[(dAO/2+d1)/l](2)
cosθ＝r/l (3)
θ＝arcos(r/l) (4)
β＝π-γ-θ (5)
wherein d isAOAortic orifice diameter; dVSDIs the ventricular septal defect diameter; r is the turning radius of the central line of the intracardiac tunnel; d1The distance from the center of the aortic orifice to the inflection point of the ventricular septum and the ventricular septum; d2The distance from the ventricular septal defect center to the inflection point of the ventricular septal and the ventricular atrial septal defects, α the included angle between the aortic valve orifice plane and the ventricular septal defect plane, theta the turning angle of the intracardiac tunnel, gamma the angle of auxiliary calculation, l the auxiliary line of the auxiliary calculation, and t the contour line of the intracardiac tunnel.
In this embodiment, as shown in fig. 5 and 9, the required turning angle β is calculated according to the above equations (1) to (6) according to the relative positions and sizes of the ventricular septal defect 7 and the aortic orifice 8 of the patient, wherein the turning angle of one diamond patch 3 is determined as Φ, so the number n of the diamond patches 3 included in the turning surface can be determined according to the turning angle Φ, that is, n is β/Φ, thereby achieving the purpose of adapting to a large number of patients.
In this embodiment, as shown in fig. 7 to 10, the length of the rectangular patch structure is L8Width of D1. The base length of the isosceles triangle connecting patch 2 is equal to the length L of the long side of the ventricular septal defect suture body 18The waist length of the isosceles triangle connecting patch 2 and the side length of each diamond patch 3 are both L6The long diagonal length of the diamond patch 3 is L7. Meanwhile, the sum L of the arc length of the outer circular arc of the fan-shaped patch 4-1 and the lower bottom edges of the two right-angle trapezoidal patches 4-25And L3The height of the right-angle trapezoidal patch 4-2 is L4The sum of the arc length of the inner circular arc of the sector patch 4-1 and the upper bottom edges of the two right-angle trapezoidal patches 4-2 is L1And L2。
In this embodiment, L is1～L8The calculation formula of (a) is as follows:
L8＝π(dVSD+4)/2+2r (7)
L7＝2r+π(dVSD+4)/2 (8)
2L6＝π(dAO/2+2)*sinβ+2[dAO+4-(dAO/2+2)*sinβ]+2r (9)
L1＝π(dAO/2+2)*sinβ+2[dAO+4-(dAO/2+2)*sinβ](10)
L2＝r (11)
L3＝d1+dAO/2 (12)
L4＝dVSD/2+d2-r (13)
L5＝π(dAO+4)/2 (14)。
wherein d isAO+4 denotes a value dAOOn the basis of the structure and the size of the sewing machine, sewing allowance with the width of 2mm is arranged at each outward extension of two ends, essentially dAO+4 and dAOThe same numerical dimensions are indicated. The sewing margin is not limited to 2mm, corresponding to dAO+4 may be equivalent to dAO+2 ∈ (epsilon is the one-sided stitching margin value actually set).
In the embodiment, as shown in fig. 7 to 10, each patch structure comprises a rectangular patch structure, an isosceles triangle connection patch 2, a sector patch 4-1, a right trapezoid patch 4-2 and a diamond patch 3, the edges are all provided with a plurality of connection sawteeth 5 to form a sawtoothed edge, and each sawtoothed edge extends outwards for 3-5mm, so that the sewing connection is facilitated, the allowance is reserved, the flow cavity is ensured to be smooth, and the generation of residual fistula is avoided; meanwhile, the zigzag edge is arranged to ensure that the shape of the bending part of the planar patch is zigzag, because the sewing part is basically vertical to the part forming the tunnel, a ring-shaped structure can be generated during bending, the inner diameter and the outer diameter are not equal, the forming is difficult, the operation difficulty is high, the design of the zigzag patch is simple in operation, and the wrinkles generated by sewing can be reduced. The stitching manner between the patch parts in this embodiment is the existing stitching manner in the field, and is not described herein again.
The present embodiment will be described in detail below.
According to research, the average pressure difference at two ends of the tunnel is greatly reduced when the turning curved surface exists in the intracardiac tunnel, the average pressure difference at two ends of the tunnel is gradually reduced along with the increase of the radius of the central line of the turning curved surface, but the average pressure difference is basically kept unchanged along with the increase of the radius after the radius is increased to 6 mm. In order to reduce the volume of the intracardiac tunnel, the central line is designed into a form that the straight line is tangent to the circular arc, the turning curved surface not only reduces the average pressure difference at two ends of the tunnel, but also ensures the advantage of smaller volume when the downstream part of the central line which is the straight line meets the design requirement of no obstruction. As shown in fig. 2 and 3, the present invention is based on this study to perform a modular design of an intracardiac tunnel patch for the assembly of an intracardiac tunnel constructed by the present invention with an ideal intracardiac tunnel flow lumen.
As shown in fig. 1, for the calculation of the central line of an ideal intracardiac tunnel, the turning radius is fixed to 6mm, the geometrical size and the relative position of an included angle α between the plane of an aortic valve orifice 8 and the plane of a ventricular septal defect 7 are different from person to person, the size and the relative position are determined through a CT or an ultrasound image before operation, the turning angle β is calculated, and the type and the number of the diamond patches 3 of the turning part are selected according to the size and the relative position.
In order to conform as much as possible to the fluid domains of the ideal intracardiac tunnel shown in fig. 4, the present invention divides its structure into 4 parts: ventricular septal defect suturing body 1, isosceles triangle connection patch 2, turning part and aortic valve orifice suturing body 4, link to each other various patches in proper order: long side L of ventricular septal defect suture body 18The bottom edge L of the patch 2 is connected with the isosceles triangle8Sewing; two sides L of the isosceles triangle connecting patch 26Obtuse-angle sides L of diamond patch 3 with turning part6Sewing; repeatedly sewing the diamond-shaped patch 3 of the turning part for a plurality of times; connecting the other isosceles triangle on the curved surface formed by the diamond patch 3 with the patch 2 and the upper bottom edge L of the aortic valve orifice suture body 41And L2And (4) performing connecting suture to finally form the complete intracardiac tunnel flow cavity 6 which has a curved surface and conforms to the individual characteristics of the patient. In the right ventricular double-outlet correction operation, the built intracardiac tunnel is sutured according to a preset suture edge.
FIG. 7 is a schematic plan view of the ventricular septal defect suture body 1, wherein the dotted line is internally the part participating in the construction of the intracardiac tunnel and externally the margin left for convenient suture and has a zigzag shape. Long side L of ventricular septal defect suture body 18The length is about half of the circumference of the ventricular septal defect 7, and the distance between the connecting sawteeth 5 is equal to the distance between the two needles during suturing, which is about 3-5 mm; short edge D of ventricular septal defect suture body 11The outward extending part has the main function of making up possible leaks formed by the turning part, and the final sewing point of the turning part due to the structure of the diamond patch 3 is in one area, so that the end point of the sewing edge of each patch can be intensively sewn in the area, the sewing difficulty is reduced, and the occurrence of residual fistula is reduced.
As shown in fig. 8, the isosceles triangle patch 2 is shown in a schematic plane development, and the length of the bottom edge of the isosceles triangle patch 2 and the long edge of the rectangular patch ventricular septal defect suture body 1 are both L8The number and the spacing of the connecting sawteeth 5 are equal to those on the long edge of the ventricular septal defect suturing body 1; and the isosceles triangle connects the two waists of the patch 2 with the side length L of the rhombic patch 36The number of the connecting saw teeth 5 and the distance between the saw teeth are equal.
As shown in fig. 5, 6 and 9, the plane development schematic diagram of the diamond patch 3 of the turning part is shown, the diamond patch 3 is a centrosymmetric graph, the size parameters of all sides are completely equal, the connection of the turning part mainly comprises that two obtuse-angle sides of one diamond patch 3 are connected with two obtuse-angle sides of another diamond patch 3, and the turning part is repeatedly formed into a turning curved surface.
As shown in fig. 10, which is a schematic plan view of the aortic valve orifice suture body 4, the lengths of the upper base edges of the aortic valve orifice suture body 4 are all L1With twice L2And the length L of the lower base edge5With twice L3The sum is equal to the length of the suture edge of the aortic valve orifice 8; the two hypotenuses are sutured to the ventricular septum and the length depends on the relative position of the ventricular septal defect 7 and the aortic orifice 8.
In the intracardiac tunnel patch module with the turning curved surface, the intracardiac tunnel is divided into four patch parts, namely a ventricular septal defect suture body, an isosceles triangle connection patch, a turning part and an aortic valve orifice suture body, the patch parts are mutually independent and have a certain relation, the patch parts can be designed into different sizes according to statistical data, and a modular intracardiac tunnel patch form is formed by selecting according to needs. The modularized intracardiac tunnel patch not only can adapt to the physiological requirements of most patients, but also reduces the subjective factors of doctors during treatment, and particularly, the tunnel is established in vitro, so that the operation time can be reduced, the operation difficulty is reduced, the treatment effect can be effectively ensured, and the generation of postoperative intervention factors is reduced.
It will be evident to those skilled in the art that the invention is not limited to the details of the foregoing illustrative embodiments, and that the present invention may be embodied in other specific forms without departing from the spirit or essential attributes thereof. The present embodiments are therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein, and any reference signs in the claims are not intended to be construed as limiting the claim concerned.
The principle and the implementation mode of the invention are explained by applying a specific example, and the description of the embodiment is only used for helping to understand the method and the core idea of the invention; meanwhile, for a person skilled in the art, according to the idea of the present invention, the specific embodiments and the application range may be changed. In view of the above, the present disclosure should not be construed as limiting the invention.
Claims (9)
1. An intracardiac tunnel patch module with a curved turn surface, characterized by: comprises an intracardiac tunnel flow cavity, wherein the intracardiac tunnel flow cavity is formed by suturing a ventricular septal defect suturing body, an isosceles triangle connecting patch, a turning part and an aortic valve orifice suturing body in an enveloping way; the turning part is a turning curved surface formed by sewing and splicing a plurality of rhombic patches end to end, the top end and the bottom end of the turning curved surface are respectively connected with the aortic valve orifice sewing body and the ventricular septal defect sewing body through isosceles triangles, the aortic valve orifice sewing body and the ventricular septal defect sewing body are respectively connected with the bottom edge of the isosceles triangle connecting patch, and two waists of the isosceles triangle connecting patch are respectively connected with one side of the rhombic patch.
2. The intracardiac tunnel patch module with a curved turn surface according to claim 1, characterized in that: the ventricular septal defect suture body is of a rectangular patch structure in a completely unfolded state and is used for covering ventricular septal defects.
3. The intracardiac tunnel patch module with a curved turn surface according to claim 1, characterized in that: the aortic valve orifice suture body comprises a fan-shaped patch and two right-angle trapezoidal patches which are symmetrically distributed on two sides of the fan-shaped patch; the two right-angle trapezoidal patches are respectively connected with the straight sides of the two sides of the fan-shaped patch by the bevel edges and connected with the two sides of the ventricular septal defect suture body by the height; the upper bottom edges of the two right-angle trapezoidal patches and the inner circular arc of the fan-shaped patch are connected with the bottom edge of the isosceles triangle connection patch, and the lower bottom edges and the outer circular arc of the fan-shaped patch encircle the aortic orifice to form the downstream part of the intracardiac tunnel flow cavity.
4. The intracardiac tunnel patch module with the curved turning surface according to claim 1, wherein the centerline of the intracardiac tunnel flow lumen is formed by connecting a central arc and a central straight line, the starting point of the central arc is the ventricular septal defect midpoint, and the tangent of the central arc at the ventricular septal defect midpoint is perpendicular to the ventricular septal plane, the central straight line starts from the aortic orifice central point, the ending point is tangent and connected with the terminal point of the central arc, the turning angle of the central arc is equal to the turning angle of the curved turning surface, and the turning angle β of the curved turning surface is calculated as follows:
sinγ＝(dAO/2+d1)/l (1)
γ＝arcsin[(dAO/2+d1)/l](2)
cosθ＝r/l (3)
θ＝arcos(r/l) (4)
β＝π-γ-θ (5)
wherein d isAOAortic orifice diameter; dVSDIs the ventricular septal defect diameter; r is the turning radius of the central line of the intracardiac tunnel; d1The distance from the center of the aortic orifice to the inflection point of the ventricular septum and the ventricular septum; d2The distance from the ventricular septal defect center to the inflection point of the ventricular septal and the ventricular atrial septal defects, α the included angle between the aortic valve orifice plane and the ventricular septal defect plane, theta the turning angle of the intracardiac tunnel, gamma the angle of auxiliary calculation, l the auxiliary line of the auxiliary calculation, and t the contour line of the intracardiac tunnel.
5. The intracardiac tunneling patch module with a curved surface according to claim 4, wherein the required turning angle β is calculated according to the formulas (1) to (6) according to the relative position and size of the ventricular septal defect and the aortic orifice of the patient, the turning angle of one diamond-shaped patch is phi, and the curved surface contains the number n of the diamond-shaped patches which is β/phi.
6. The intracardiac tunnel patch module with a curved turn surface according to claim 2, characterized in that: the rectangular patch structure has a length L8Width of D1。
7. The intracardiac tunnel patch module with a curved turn surface according to claim 6, characterized in that: the base length of the isosceles triangle connecting patch is equal to the length L of the long side of the ventricular septal defect suture body8The waist length of the isosceles triangle connecting patch and the side length of each rhombic patch are both L6The length of the long diagonal of the rhombic patch is L7The length of the short diagonal of the rhombic patch is D2。
8. The intracardiac tunnel patch module with a curved turn surface according to claim 3, characterized in that: the sum of the arc length of the outer arc of the fan-shaped patch and the length of the lower bottom edge of the two right-angle trapezoidal patches is equal to the length of the aortic suture edge, and the height of the right-angle trapezoidal patch is L4The length L of the inner arc of the sector patch1And the upper bottom edges L of the two right-angle trapezoidal patches2Sum of L5。
9. The intracardiac tunnel patch module with a curved turn surface according to claim 1, characterized in that: the edge of each patch structure is provided with a plurality of connecting sawteeth to form a saw-toothed edge, and each saw-toothed edge extends outwards for 3-5 mm.
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| CN2765585Y (en) * | 2004-08-31 | 2006-03-22 | 解启莲 | Heart septal defect stopper with unilateral valve |
| CN2932527Y (en) * | 2006-06-15 | 2007-08-08 | 熊兆文 | A direct-inserted letter mosaic toy |
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| CN2765585Y (en) * | 2004-08-31 | 2006-03-22 | 解启莲 | Heart septal defect stopper with unilateral valve |
| CN2932527Y (en) * | 2006-06-15 | 2007-08-08 | 熊兆文 | A direct-inserted letter mosaic toy |
| US20090281614A1 (en) * | 2007-06-27 | 2009-11-12 | Aesculap Ag, A Corporation Of Germany | Sinus patches for replacing defective sinuses at the aortic root |
| CN203291359U (en) * | 2013-06-19 | 2013-11-20 | 孙伟 | Catheter easy to pass intracardiac defect |
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