CN111588516A

CN111588516A - Inner clamping arm control mechanism, mitral valve repair equipment and control handle thereof

Info

Publication number: CN111588516A
Application number: CN202010581915.1A
Authority: CN
Inventors: 周剑杰; 王海山; 虞奇峰; 秦涛
Original assignee: Shanghai Newmed Medical Co Ltd
Current assignee: Shanghai Newmed Medical Co Ltd
Priority date: 2020-06-23
Filing date: 2020-06-23
Publication date: 2020-08-28

Abstract

The application discloses inner clamp arm control mechanism, mitral valve repair equipment and control handle thereof. The inner clamping arm control mechanism comprises a shell, a second control part and a connecting rod; the shell is provided with a second sliding groove, and the second control part penetrates through the second sliding groove and is fixedly connected with the outer wall of the connecting rod; the second control part can move along the second sliding groove to drive the connecting rod to move, and the movement of the connecting rod can control the movement of the inner clamping arm of the tissue clamping device.

Description

Inner clamping arm control mechanism, mitral valve repair equipment and control handle thereof

Technical Field

The application relates to the field of medical equipment, in particular to an inner clamping arm control mechanism, mitral valve repair equipment and a control handle thereof.

Background

Valves are membranous structures that can be opened and closed inside the organs of humans or some animals. For example, each individual has four valves in the heart, namely the aortic, pulmonary, mitral and tricuspid valves. Taking the mitral valve as an example, the mitral valve is located between the left atrium and the left ventricle, and when the left ventricle contracts, the mitral valve functions as a check valve to tightly close the atrioventricular orifice and prevent blood from flowing backward from the left ventricle into the left atrium. However, when the mitral valve is diseased, it may happen that the left ventricle is difficult to close completely when contracting, resulting in the left atrium receiving a large amount of blood backflow, which may result in a sharp rise in left atrium and pulmonary venous pressure, an increase in left ventricle diastolic volume load, and further a series of pathological changes such as left ventricle enlargement and pulmonary hypertension, and finally clinical manifestations such as heart failure, arrhythmia, etc., which may endanger life in severe cases. When the diseased mitral valve is repaired, the opposite sides of the mitral valve can be clamped by the mitral valve repairing equipment, so that one large hole is changed into two small holes between the valves of the mitral valve, the backflow area is reduced, and the mitral valve backflow is effectively prevented. Similarly, the mitral valve repair device can also be suitable for repairing other valves such as the tricuspid valve of the heart, and the effect of reducing the backflow area is achieved by clamping the valve leaflets on two sides. The mitral valve repair device includes a control handle that can be used to manipulate the tissue gripping device to effect repair of the valve. Mitral valve repair devices include tissue gripping devices in which control of an inner clamp arm is required during valve repair.

Disclosure of Invention

One of the embodiments of the present application provides an inner clamping arm control mechanism, which is characterized by comprising a housing, a second control portion and a connecting rod; the shell is provided with a second sliding groove, and the second control part penetrates through the second sliding groove and is fixedly connected with the outer wall of the connecting rod; the second control part can move along the second sliding groove to drive the connecting rod to move, and the movement of the connecting rod can control the movement of the inner clamping arm of the tissue clamping device.

In some embodiments, the connecting rod controls the movement of the inner clamp arm by a pull cable; the connecting rod includes the hole, the haulage cable is followed pass in the hole of connecting rod, the both ends of haulage cable with the rear end of connecting rod can be dismantled and be connected.

In some embodiments, the second control portion comprises a first sub-control portion for controlling the first inner clamp arm and a second sub-control portion for controlling the second inner clamp arm; the second sliding groove includes a first sub-sliding groove and a second sub-sliding groove corresponding to the first sub-control portion and the second sub-control portion, respectively.

In some embodiments, the second control portion includes a control button and a connecting body, the control button passes through the second sliding groove and is connected with the connecting body, and the connecting body is fixedly connected with an outer wall of the connecting rod.

In some embodiments, the control button is movably connected with the connecting body through a spring; the shell is provided with a groove, the button is provided with a convex block, and the convex block can be clamped with the groove under the action of the spring to limit the second control part to move relative to the second sliding groove.

In some embodiments, the housing is provided with at least two grooves, and when the protruding block is respectively clamped with the two grooves, the second control portion is located at two ends of the second sliding groove.

Embodiments of the present application provide a mitral valve repair control handle including an inner clamp arm control mechanism according to any of the embodiments of the present application.

In some embodiments, the mitral valve repair control handle further comprises an outer clamp arm control mechanism for controlling movement of an outer clamp arm of the tissue clamping device; the outer clamping arm control mechanism comprises a sleeve, a first control part, a sliding part and a driving rod, wherein the sliding part is arranged in the sleeve and is connected with the driving rod; the first control part can drive the sliding part to move in the sleeve along the length direction of the sleeve through rotation, and further drive the driving rod to move so as to control the outer clamping arm to open and close; wherein, the inner peripheral surface of the first control part is provided with an internal thread; the sliding part is provided with an external thread; the sleeve is provided with a first sliding chute along the length direction; the sliding part penetrates through the first sliding groove, and the external threads on the sliding part are matched with the internal threads of the first control part.

In some embodiments, the mitral valve repair control handle further comprises an introducer block; the guide block comprises three through holes A, B and C which are arranged at intervals, the central axes of the three through holes are positioned on a first plane, wherein the through holes A and C at two sides are used for guiding a connecting rod for controlling the movement of the inner clamping arm, and the through hole B at the middle is used for guiding a driving rod for controlling the movement of the outer clamping arm; on one side of the first plane, the through hole A and the through hole B are communicated with each other through a hose, and on the other side of the first plane, the through hole B and the through hole C are communicated with each other through a hose.

Embodiments of the present application provide a mitral valve repair device comprising a mitral valve repair control handle as described in any of the embodiments of the present application.

Drawings

The present application will be further explained by way of exemplary embodiments, which will be described in detail by way of the accompanying drawings. These embodiments are not intended to be limiting, and in these embodiments like numerals are used to indicate like structures, wherein:

FIG. 1 is a schematic structural view of a mitral valve repair device according to some embodiments of the present application;

FIG. 2 is a schematic structural view of a tissue gripping device and a delivery connector according to some embodiments of the present application;

FIG. 3 is a schematic diagram illustrating the open configuration of the outer clamping arms of the tissue gripping device according to some embodiments of the present application;

FIG. 4 is a schematic illustration of a structure of a delivery connector according to some embodiments of the present application;

FIG. 5 is a schematic structural view of a tissue gripping device shown in a closed state according to another embodiment of the present application;

FIG. 6 is a schematic structural view of a tissue gripping device according to another embodiment of the present application in an open state;

FIG. 7 is a schematic structural view of an inner clamp arm control mechanism according to some embodiments of the present application;

FIG. 8 is a schematic illustration of a partial structure of an inner clamp arm control mechanism according to some embodiments of the present application;

FIG. 9 is a schematic structural diagram of a second control portion according to some embodiments of the present application;

FIG. 10 is a schematic illustration in partial cross-sectional view of an inner clamp arm control mechanism according to some embodiments of the present application;

FIG. 11 is a schematic structural view of an outer clamp arm control mechanism according to some embodiments of the present application;

FIG. 12 is a partial schematic structural view of an outer clamp arm control mechanism according to some embodiments of the present application;

FIG. 13 is a schematic structural view of a sliding section according to some embodiments of the present application;

FIG. 14 is an exploded view of a control handle according to some embodiments of the present application;

FIG. 15 is a schematic diagram of a boot block according to some embodiments of the present application.

In the figure: 100-mitral valve repair devices; 200-a tissue gripping device; 210-an inner clamping arm; 211-a first inner clip arm; 213-a second inner clip arm; 215-barbs; 220-outer clamping arm; 221-a first outer clamp arm; 223-a second outer clamp arm; 230-a fixing member; 240-a support; 250-a connector; 260-outer splints; 261-a first external splint; 263-second outer splint; 270-connecting pipe; 280-an elastic locking member; 300-a control handle; 400-outer clamp arm control mechanism; 410-a cannula; 412-a first runner; 420-a first control section; 430-a sliding portion; 440-a drive rod; 460-fixing block; 470-a protective sheath; 500-inner clamp arm control mechanism; 510-a housing; 511-a second chute; 511-1-a first sub-chute; 511-2-a second sub-chute; 520-a second control section; 520-1-a first sub-control section; 520-2-second sub-control section; 521-a connecting rod; 521-1-a first sub-connecting rod; 521-2-a second sub-connecting rod; 523-end cover; 523-1-first sub-end cap; 523-2-second sub-end cap; 533-control button; 535-bump; 537-linker; 539-grooves; 540-a boot block; 541-a first through hole; 542-a second through-hole; 600-a delivery pipe; 700-a delivery connection; 710-a body; 720-a first connection tab; 730-a second connecting piece; 740-fixing the strut.

Detailed Description

In order to make the objects, technical solutions and advantages of the present application more apparent, the present application is described in further detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the present application and are not intended to limit the present application.

On the contrary, this application is intended to cover any alternatives, modifications, equivalents, and alternatives that may be included within the spirit and scope of the application as defined by the appended claims. Furthermore, in the following detailed description of the present application, certain specific details are set forth in order to provide a better understanding of the present application. It will be apparent to one skilled in the art that the present application may be practiced without these specific details.

The embodiment of the application relates to a mitral valve repair device and a control handle thereof. The mitral valve repair device can be used to repair a mitral valve or other valve (e.g., a tricuspid valve). The mitral valve repair device can include a tissue gripping apparatus and a control handle. The tissue gripping device may be used to grip the valve to effect repair of the valve. The control handle may be used to deliver and manipulate the tissue gripping device. In some embodiments, the tissue gripping device can reach the predetermined position through multiple paths. For example, a tissue gripping device may be delivered to the mitral valve via the femoral vein, inferior vena cava, right atrium, and left atrium to repair the mitral valve. For another example, a tissue gripping device may be delivered to the mitral valve via the left atrial appendage and the left atrium to repair the mitral valve.

FIG. 1 is a schematic structural view of a mitral valve repair device according to some embodiments of the present application; FIG. 2 is a schematic structural view of a tissue gripping device and a delivery connector according to some embodiments of the present application; FIG. 3 is a schematic diagram illustrating the open configuration of the outer clamping arms of the tissue gripping device according to some embodiments of the present application; FIG. 4 is a schematic diagram of a delivery connector according to some embodiments of the present application. As shown in fig. 1-4, mitral valve repair device 100 can include a tissue gripping apparatus 200 and a control handle 300. Tissue gripping device 200 may include outer clamp arm 220 and inner clamp arm 210; control handle 300 may correspondingly include an outer clamp arm control mechanism 400 and an inner clamp arm control mechanism 500. Outer clamp arm control mechanism 400 can be used to control the opening and closing of outer clamp arm 220 of tissue clamping device 200, and inner clamp arm control mechanism 500 can be used to control the opening and closing of inner clamp arm 210 relative to outer clamp arm 220, so that control handle 300 can enable a valve (e.g., a mitral valve) to be clamped between outer clamp arm 220 and inner clamp arm 210 by controlling the opening and closing of outer clamp arm 220 and inner clamp arm 210.

In some embodiments, mitral valve repair device 100 may include delivery tube 600; the tissue gripping device 200 is connected to the control handle 300 by a delivery tube 600. In some embodiments, the delivery tube 600 may be curved (e.g., the delivery tube 600 is made of an elastic material); the control handle 300 is capable of delivering the tissue gripping device 200 to the mitral valve via the femoral vein, inferior vena cava, right atrium, or left atrium via the flexible delivery tube 600. In some embodiments, the delivery tube 600 is inflexible (e.g., the delivery tube 600 is made of a rigid material), in which case the control handle 300 can deliver the tissue gripping device 200 through the inflexible delivery tube 600 to the mitral valve via the left atrial appendage or the left atrium. By delivering the tissue gripping device 200 to the mitral valve via the left atrial appendage and the left atrium, mitral valve repair can be performed more easily, with greater efficiency and success. In addition, the mitral valve repair device 100 can be used for other purposes when the delivery tube 600 is not bendable. For example, the mitral valve repair device 100 can be used to perform valve repair experiments on animals (e.g., pigs).

In some embodiments, as shown in fig. 2-4, tissue gripping device 200 may include inner clamp arm 210, outer clamp arm 220, fastener 230, support 240, connector 250, and outer clamp plate 260. Wherein inner clamp arm 210 may include a first inner clamp arm 211 and a second inner clamp arm 213; outer clip arms 220 may include first outer clip arm 221 and second outer clip arm 223; the outer clamping plate 260 may include a first outer clamping plate 261 and a second outer clamping plate 263. One side of the supporting portion 240 is sequentially connected with the first outer clamping arm 221 and the first outer clamping plate 261 in a bendable manner, and the other side of the supporting portion 240 is sequentially connected with the second outer clamping arm 223 and the second outer clamping plate 263 in a bendable manner. The first outer clip arm 221 and the second outer clip arm 223 can be bent relative to the support 240 to be relatively folded, and the first outer clip arm 221 and the second outer clip arm 223 can also be bent away from the support 240 to be relatively opened. Tissue gripping device 200 as shown in FIG. 2 is in a state in which first outer clip arm 221 and second outer clip arm 223 are relatively closed; tissue gripping device 200, shown in FIG. 3, has first outer clip arm 221 and second outer clip arm 223 spread apart 180 degrees relative to one another. The relative opening angle of the first outer clamping arm 221 and the second outer clamping arm 223 can be any angle, such as 10 °, 40 °, 90 °, 120 °, 180 °, 270 °, 350 °, 360 °, and the like. In some embodiments, the outer clamp arm 220, the support portion 240, and the outer clamp plate 260 may be a unitary structure. For example, the outer clamping arms 220, the supporting portion 240 and the outer clamping plate 260 may be integrally formed by cutting and heat-treating a shape memory alloy tube. In some embodiments, as shown in fig. 2, one end (shown upper end) of the supporting portion 240 is connected (e.g., fixedly connected) to the connecting member 250, and one end (shown lower end) of the first outer clamping plate 261 and one end (shown lower end) of the second outer clamping plate 263 are respectively connected (e.g., fixedly connected) to the fixing member 230. With this arrangement, the fixing member 230 can move relative to the supporting portion 240 when the fixing member 230 moves relative to the connection member 250. When the fixing member 230 is far away from the supporting portion 240, the first outer clamping plate 261 and the second outer clamping plate 263 can respectively pull the first outer clamping arm 221 and the second outer clamping arm 223 to be opened relatively under the driving of the fixing member 230. In the embodiment shown in fig. 2-4, the outer clamp arm control mechanism 400 is capable of controlling the opening and closing of the outer clamp arm 220 of the tissue gripping device 200 via the drive rod 440. Specifically, one end (lower end as shown in fig. 2) of the driving rod 440 may have a screw structure by which the driving rod 440 can be detachably coupled to the fixing member 230. The outer clamp arm control mechanism 400 can control the fixing member 230 to move relative to the connecting member 250 by pushing and pulling the driving rod 440 (e.g., the driving rod 440 is driven by the sliding portion 430) so as to control the outer clamp arm 220 of the tissue clamping device 200 to open and close.

In some embodiments, first inner clamp arm 211 may be disposed on first outer clamp arm 221, second inner clamp arm 213 may be disposed on second outer clamp arm 223, first inner clamp arm 211 and second inner clamp arm 213 being openable and closable relative to first outer clamp arm 221 and second outer clamp arm 223, respectively, and enabling tissue to be clamped between first inner clamp arm 211 and first outer clamp arm 221 and between second inner clamp arm 213 and second outer clamp arm 223. In some embodiments, the inner clip arms 210 may be barbed clips. For example, barbs 215 may be mounted at the free ends of inner clip arms 210. In some embodiments, the inner and

outer clamp arms

210 and 220 may be connected by a bend (e.g., an S-bar bend) that may have a pre-formed spring-back force, such that the inner clamp arm 210 can be pressed against the outer clamp arm 220 in a natural state. In some embodiments, inner clamp arm control mechanism 500 may control opening and closing of inner clamp arm 210 relative to outer clamp arm 220 via a pull cable (not shown). For example, a pull cable may be coupled to the free end of the inner clamp arm 210. When the inner clamping arm control mechanism 500 pulls the traction cable, the inner clamping arm 210 can be opened relative to the outer clamping arm 220 under the pulling force of the traction cable; when the pull cord is released, the inner clamp arm 210 may be folded with the outer clamp arm 220 under the pre-formed spring back force of the bend. In some embodiments, the pulling cable may include steel wires, nano-wires, glass strands, or the like, which is not limited in this application.

In some embodiments, the delivery tube 600 may be removably coupled to the tissue gripping device 200 via a delivery connector 700. The conveying connector 700 is provided with through holes for the driving rod 440 and the traction cable to pass through respectively. In the embodiment shown in fig. 2 and 4, the delivery connector 700 may include a main body 710, a first connector piece 720, and a second connector piece 730. Wherein, the connection part of the first connection piece 720 and the second connection piece 730 with the main body 710 can have a pre-made resilience force, and the pre-made resilience force can enable the first connection piece 720 and the second connection piece 730 to automatically open in a natural state. The middle parts of the first connecting piece 720 and the second connecting piece 730 can be further provided with a fixing support rod 740, the fixing support rod 740 is respectively perpendicular to the first connecting piece 720 and the second connecting piece 730, and the suspended end of the fixing support rod 740 is provided with a through hole for the driving rod 440 to pass through. When the delivery connector 700 is connected to the connector 250 of the tissue gripping device, the first connecting piece 720 and the second connecting piece 730 are folded toward each other and engaged with the protrusions on the connector 250, respectively. The driving rod 440 may pass through the through hole of the fixing bar 740 connected to the first connecting piece 720 and the second connecting piece 730, and the driving rod 440 may restrict the first connecting piece 720 and the second connecting piece 730 from being opened. When it is desired to disengage the delivery connector 700 from the tissue holding device 200, the drive rod 440 can be first disconnected from the tissue holding device 200 (e.g., the fastener 230) and the drive rod 440 can be withdrawn such that the drive rod 440 is disengaged from the through-holes in the fixation struts 740 that are connected to the first connector piece 720 and the second connector piece 730, such that the first connector piece 720 and the second connector piece 730 automatically open and disengage from the tabs on the connector 250. In some embodiments, the delivery connector 700 may be a one-piece structure made of shape memory alloy tubing that is cut and heat set.

In some embodiments, the tissue gripping device 200 may be in alternative configurations. For example, FIG. 5 is a schematic structural view of a closed state of a tissue gripping device according to another embodiment of the present application; FIG. 6 is a schematic structural view of a tissue gripping device according to another embodiment of the present application in an open state. In the embodiment shown in fig. 5-6, tissue gripping device 200 may include a fastener 230, an inner clamp arm 210, and an outer clamp arm 220. The inner clip arm 210 may include a first inner clip arm 211 and a second inner clip arm 213, the inner clip arm 210 is disposed on the fixing member 230, and the first inner clip arm 211 and the second inner clip arm 213 can be folded or unfolded with each other. The outer clamp arms 220 may include a first outer clamp arm 221 and a second outer clamp arm 223, the first outer clamp arm 221 and the second outer clamp arm 223 are disposed on the fixing member 230, and the first outer clamp arm 221 and the second outer clamp arm 223 can be relatively folded or unfolded, and enable a valve (such as a mitral valve) to be clamped between the first inner clamp arm 211 and the first outer clamp arm 221 and between the second inner clamp arm 213 and the second outer clamp arm 223.

In the embodiment shown in fig. 5-6, the tissue gripping device 200 can further include a connecting tube 270 and a resilient latch 280. Delivery tube 600 may be removably coupled (e.g., threadably coupled) to coupling tube 270. The drive rod 440 can be directly or indirectly connected to the fixed member 230. The outer clamping arm 220 is rotatably connected with the fixing member 230 and the connecting pipe 270 through a link structure, respectively. The outer clamping arm control mechanism 400 can control the fixing member 230 to move relative to the connecting tube 270 by pushing and pulling the driving rod 440, so as to control the outer clamping arm 220 of the tissue clamping device 200 to open and close. When the outer clip arm 220 is opened and closed to a certain angle (e.g., 10 °, 90 °, 150 °, 180 °) or closed, the elastic locking member disposed on the fixing member 230 may be matched with the bayonet on the connection pipe 270, so as to form a certain resistance to the opening and closing of the outer clip arm 220. In some embodiments, the inner clamp arm 210 may be an integrally formed U-shaped structure with a pre-formed resilient force that flares outward. Inner clamp arm control mechanism 500 may control the opening and closing of inner clamp arm 210 relative to outer clamp arm 220 via a pull cable (not shown). For example, a pull cable may be coupled to the free end of the inner clamp arm 210. When the inner clamp arm control mechanism 500 pulls the traction cable, the inner clamp arm 210 can be opened relative to the outer clamp arm 220 (i.e. the first inner clamp arm 211 and the second inner clamp arm 213 are closed together) under the pulling force of the traction cable; when the pull cable is released, inner clip arms 210 may open outwardly under their pre-formed spring back force to close relative to outer clip arms 220. Specifically, the first inner clamp arm 211 and the first outer clamp arm 221 may be individually controlled to open or close with respect to the first outer clamp arm 221 and the second outer clamp arm 223, respectively.

The control handle 300 will now be described with reference to the tissue gripping device 200 shown in FIGS. 2-4. It should be noted that the control handle described in the following embodiments is for illustrative purposes only and is not limited thereto. Some or all of the structure of the control handle 300 can be adapted to other types of tissue gripping devices (e.g., the tissue gripping devices shown in fig. 5-6) as well as the tissue gripping device 200 shown in fig. 2-4.

In some embodiments, control handle 300 includes an outer clamp arm control mechanism 400 and an inner clamp arm control mechanism 500. The outer clamp arm control mechanism 400 is used to control the movement of the outer clamp arm 220 of the tissue clamping device 200; the inner clamp arm control mechanism 500 is used to control the movement of the inner clamp arm 210 of the tissue gripping device 200.

FIG. 7 is a schematic structural view of an inner clamp arm control mechanism according to some embodiments of the present application; FIG. 8 is a schematic illustration of a partial structure of an inner clamp arm control mechanism according to some embodiments of the present application; FIG. 9 is a schematic structural diagram of a second control portion according to some embodiments of the present application; FIG. 10 is a schematic illustration in partial cross-sectional view of an inner clamp arm control mechanism according to some embodiments of the present application. In some embodiments, as shown in fig. 7-10, the inner clamp arm control mechanism 500 can include a housing 510, a second control 520, and a connecting rod 521; wherein, the housing 510 is provided with a second sliding slot 511, and the second control portion 520 can pass through the second sliding slot 511 to be fixedly connected with the outer wall of the connecting rod 521. The second control portion 520 can move along the second sliding slot 511 to move the connecting rod 521, and the movement of the connecting rod 521 can control the movement of the inner clamping arm 210 of the tissue clamping device 200.

In some embodiments, the tie bar 521 can control the movement of the inner clamp arm 210 via a pull cable. In a particular embodiment, the connecting rod 521 may include an internal bore through which a pull cable may be passed through the connecting rod 521. The pull cable may pass through the through-hole at the free end of the inner clamp arm 210, and both ends of the pull cable may be detachably connected to the rear end (the end away from the tissue holding device 200) of the connecting rod 521. Specifically, the rear end of the connecting rod 521 may be provided with an end cover 523, and both ends of the traction cable may be fixed at the end cover 523. For example, the end cap 523 may be screwed to the connecting rod 521, and both ends of the traction cable may be clamped at the screwed connection between the end cap 523 and the connecting rod 521. When the tissue clamping device 200 is required to be separated from the control handle 300, the end cap 523 can be separated from the connecting rod 521, then the fixation of the two ends of the traction cable can be released, and the traction cable can be pulled out, so that the control handle 300 can be separated from the inner clamping arm 210. In some embodiments, releasing the securing of the two ends of the pull cable may include: releasing the clamping connection between the two ends of the traction rope and the end covers, releasing knots formed at the two ends of the traction rope, cutting off the traction rope and the like. In some embodiments, the pull cable may not be completely withdrawn from the control handle 300, but rather, the pull cable may be disengaged from the inner clamp arm 210. Through the arrangement of the connecting rod 521 and the end cover 523, the pulling-out of the traction cable can be facilitated, and meanwhile, the inner clamping arm control mechanism 500 can be made to be convenient to produce and manufacture.

In some embodiments, second control portion 520 may include a first sub-control portion 520-1 for controlling first inner clamp arm 211 and a second sub-control portion 520-2 for controlling second inner clamp arm 213. The second chute 511 may include a first sub-chute 511-1 and a second sub-chute 511-2 corresponding to the first sub-control part 520-1 and the second sub-control part 520-2, respectively. The connecting rod 521 may include a first sub-connecting rod 521-1 and a second sub-connecting rod 521-2 fixedly connected to the first sub-controlling part 520-1 and the second sub-controlling part 520-2, respectively, and the rear ends of the first sub-connecting rod 521-1 and the second sub-connecting rod 521-2 may be provided with a first sub-cap 523-1 and a second sub-cap 523-2, respectively. In some embodiments, as shown in FIG. 8, the first sub-chute 511-1 and the second sub-chute 511-2 may open on the same side of the housing 510. The first sub sliding slot 511-1 and the second sub sliding slot 511-2 may be both disposed in a strip shape. In alternative embodiments, the first and second sub-chutes 511-1 and 511-2 may be otherwise disposed on the housing 510. For example, the first sub chute 511-1 and the second sub chute 511-2 may be disposed at opposite sides of the housing 510. The first sub-control part 520-1 and the second sub-control part 520-2 can move in the first sub-sliding slot 511-1 and the second sub-sliding slot 511-2 respectively, so as to drive the first sub-connecting rod 521-1 and the second sub-connecting rod 521-2 to move respectively, and the first sub-connecting rod 521-1 and the second sub-connecting rod 521-2 can control separate pulling cables (such as a first pulling cable and a second pulling cable) respectively, so that the first inner clamping arm 211 and the second inner clamping arm 213 of the inner clamping arm 210 can be controlled respectively. Taking the first traction cable as an example, the first traction cable can pass through the through hole of the movable end of the first inner clamp arm 211, the first traction cable passes through the inner hole of the first sub-connecting rod 521-1, and both ends of the first traction cable can be fixed at the first sub-end cap 523-1.

In some embodiments, the second control 520 (e.g., the first sub-control 520-1 or the second sub-control 520-2) may include a control button 533 and a connection 537. The control button 533 can be connected (fixedly or movably connected) to the connection body 537 through the second sliding slot 511. The connector 537 can be fixedly connected with the outer wall of the connecting rod 521 by gluing, welding or clamping and the like.

In some embodiments, the control button 533 may be movably coupled to the connection member 537 via a spring (not shown). For example, the connection body 537 may have a blind hole, one end of the control button 533 is provided with a connection shaft capable of extending and retracting in the blind hole, and the end of the connection shaft is connected to the blind hole through a spring. The other end of the control button 533 may be exposed from the case 510 through the second sliding slot 511. In some embodiments, as shown in fig. 9-10, the control button 533 has a protrusion 535, the housing 510 has a groove 539, and the protrusion 535 can be engaged with the groove 539 under the action of a spring to limit the movement of the second control portion 520 relative to the second chute 511. In controlling inner clamp arm 210, an operator may press control button 533 to disengage tab 535 from recess 539 against the spring force of the spring, and then the operator may push and pull control button 533 to control second control portion 520 to move relative to second runner 511. When the second control portion 520 is completely moved and located at the corresponding position of the groove 539, the operator releases the control button 533, and the protrusion 535 is snapped into the groove 539 by the elastic force of the spring, thereby restricting the movement of the second control portion 520 relative to the second chute 511. Through the matching arrangement of the groove 539 and the bump 535, misoperation of an operator in an operation can be effectively avoided.

In some embodiments, one or more grooves 539 may be provided on the housing 510. Preferably, the housing 510 may include two grooves 539 respectively disposed at two ends of the second sliding slot 511, and the second control portions 520 are respectively located at two ends of the second sliding slot 511 when the protrusions 535 are respectively engaged with the two grooves 539. When the second control part 520 is located at the rear end of the second sliding slot 511, the inner clip arm 210 may be in a folded state. When the second control portion 520 is located at the front end of the second sliding slot 511, the inner clip arm 210 may be in the maximum expandable state (the specific expansion condition also depends on the state of the outer clip arm 220). By arranging the two grooves 539 only at the two ends of the second chute 511, the operator can use the surgical instrument more conveniently on the basis of meeting the surgical requirements, and misoperation of the operator in the surgery can be further avoided. In some alternative embodiments, the housing 510 may be provided with a plurality of grooves 539, so that the second control portion 520 can be limited at a plurality of positions, which is beneficial for an operator to perform manipulation more precisely.

In some embodiments, first sub-control portion 520-1 and second sub-control portion 520-2 may be configured to be linked or separated according to actual needs, so as to accurately control inner clamping arm 210 according to experimental or surgical needs. For example, in the mitral valve repair process, the first inner clamping arm 211 can be controlled to clamp one side of the mitral valve, and then the second inner clamping arm 213 can be controlled to clamp the other side of the mitral valve. For another example, the second control portion 520 may control the first inner clamp arm 211 and the second inner clamp arm 213 to clamp the mitral valve at the same time. In some embodiments, to facilitate the operator to identify the first sub-control 520-1 and the second sub-control 520-2, a mark may be added on the control button 533. The indicia may be "left", "right", "L", "R", or an arrow, etc.

FIG. 11 is a schematic structural view of an outer clamp arm control mechanism according to some embodiments of the present application; FIG. 12 is a partial schematic structural view of an outer clamp arm control mechanism according to some embodiments of the present application; FIG. 13 is a schematic view of a slide according to some embodiments of the present application. In some embodiments, as shown in fig. 11-13, the outer clamp arm control mechanism 400 can include a sleeve 410, a first control portion 420, and a slide portion 430. Wherein, the sliding part 430 is arranged in the sleeve 410; the first control portion 420 can rotate to drive the sliding portion 430 to move in the sleeve 410 along the length direction of the sleeve 410 so as to control the opening and closing of the outer clamping arm 220. If one end of control handle 300 adjacent to tissue gripping device 200 is defined as a front end and the opposite end of control handle 300 is defined as a rear end, then movement of slide 430 within sleeve 410 toward the front end can be used to control the opening of outer clamping arms 220 (e.g., relative opening of first outer clamping arm 221 and second outer clamping arm 223), and movement of slide 430 toward the rear end can be used to control the closing of outer clamping arms 220.

In some embodiments, the inner circumferential surface of the first control portion 420 is provided with an internal thread, the sliding portion 430 is provided with an external thread, and the sleeve 410 is provided with a first sliding groove 412 along the length direction. The sliding portion 430 can pass through the first sliding groove 412 and the external thread on the sliding portion 430 can match with the internal thread of the first control portion 420, so that the sliding portion 430 can be driven to move along the first sliding groove 412 when the first control portion 420 rotates. In this embodiment, the sleeve 410 may be provided with two first sliding grooves 412 respectively located at two opposite sides of the sleeve 410, and the sliding portion 430 is correspondingly provided with two external threads, which can respectively penetrate through the two first sliding grooves 412 to extend outwards and match with the internal threads of the first control portion 420. By providing two first sliding grooves 412 and two external threads, the stability of the first control part 420 driving the sliding part 430 to move can be ensured. In some alternative embodiments, the number of the first sliding grooves 412 may also be one, three, five, or the like.

In some embodiments, as shown in fig. 11-13, the outer clamp arm control mechanism 400 can include a drive rod 440, a securing block 460, and a protective sleeve 470; the sliding portion 430 may be connected to the driving rod 440 and control the opening and closing of the outer clamping arm 220 through the driving rod 440, and the rear end of the driving rod 440 is fixedly connected to the fixing block 460. Specifically, the fixing block 460 may be cylindrical, the cross-sectional diameter of the fixing block may be greater than that of the driving rod 440, and the driving rod 440 may be inserted into the fixing block 460 and fixedly connected to the fixing block 460 by means of glue joint, welding, interference connection, or the like. The protective sleeve 470 may be detachably coupled with the sliding part 430 by a screw; when the protective sleeve 470 is coupled to the sliding part 430, the protective sleeve 470 can limit the relative movement between the fixing block 460 and the sliding part 430. In some embodiments, the drive rod 440 may be made of a memory alloy (e.g., nitinol), thereby allowing the drive rod 440 to have superior tensile and compressive properties as well as superior bending properties; further, when the transfer tube 600 is bent, the outer clip arm control mechanism 400 can effectively control the opening and closing of the outer clip arm 220 by the driving lever 440.

In some embodiments, the sleeve 410 may be connected to (or integrally formed with) one end of the housing 510, and the central axes of the housing 510 and the sleeve 410 coincide, making the control handle 300 more compact and easier to manipulate. For example, the housing 510 may be provided at an end of the cannula 410 proximal to the tissue gripping device 200. In some alternative embodiments, the housing 510 may also be provided at the end of the cannula 410 distal to the tissue gripping device 200.

In some embodiments, the first control part 420 may have a circular ring-shaped outer contour, and a rubber layer may be disposed on a surface of the outer contour. When the operator controls the outer arm clamp 220 by rotating the first control part 420, the rubber layer can increase the friction between the first control part 420 and the palm or the finger, so that the operator can realize accurate control. In other embodiments, the outer contour surface of the first control portion 420 may be made of a hard material such as plastic, metal, etc. without a rubber layer, and the surface thereof is provided with anti-slip patterns to increase the surface friction.

In some embodiments, after tissue holding device 200 has been clamped, drive rod 440 needs to be separated from tissue holding device 200 and withdrawn from control handle 300 (e.g., fully or some distance). As shown in fig. 13, the protective sleeve 470 is detachably coupled to the sliding part 430 by a screw. When it is desired to disengage the drive rod 440, the operator may rotate the sheath 470 away from the slide 430, then the operator may rotate the retention block 460 (i.e., rotate the drive rod 440) to disengage the drive rod 440 from the tissue gripping device, and then the operator may pull the retention block 460 to withdraw the drive rod 440 from the control handle 300.

FIG. 14 is an exploded view of a control handle according to some embodiments of the present application; FIG. 15 is a schematic diagram of a boot block according to some embodiments of the present application. As shown in fig. 14-15, the control handle 300 of the present embodiment may further include a guide block 540. The guide block 540 may include three through holes A, B and C spaced apart with the central axes of the through holes A, B and C lying in a first plane. The first plane is the plane of the central axes of the through holes A, B and C. In some embodiments, through holes A, C are located on both sides of the guide block 540 for guiding the tie bar 521 for controlling the movement of the inner clamp arm 210 (e.g., through hole A for guiding the first sub-tie bar 521-1 and through hole C for guiding the second sub-tie bar 521-2), and through hole B is located in the middle of the through hole A, C for guiding the drive rod 440 for controlling the movement of the outer clamp arm 220. On one side of the first plane (the upper side as viewed in fig. 15), the through-hole a and the through-hole B may communicate with each other through a hose (not shown in the drawings), and on the other side of the first plane (the lower side as viewed in fig. 15), the through-hole B and the through-hole C may communicate with each other through a hose to ensure good sealing of the guide block 540. Specifically, taking the through hole a and the through hole B communicated with each other through a hose as an example, a first through hole 541 may be provided in the middle of the through hole a to penetrate from the inside of the through hole a to the top surface of the guide block 540 shown in fig. 15; a second penetration hole 542 may be provided at the middle of the through-hole B to penetrate from the inside of the through-hole B to the top surface of the guide block 540. The first and second through

holes

541 and 542 may communicate with each other through a hose at the outlet of the top surface of the guide block 540. In some embodiments, a sealing member (e.g., a sealing ring, etc.) may be disposed between the rear end of the guide block 540 (e.g., the rear ends of the through holes A, B and C) and the housing 510 (e.g., an internal baffle disposed on the housing 510), so as to further ensure the sealing performance of the control handle 300, and thus ensure the smooth operation.

The beneficial effects that may be brought by the embodiments of the present application include, but are not limited to: (1) the outer clamping arm and/or the inner clamping arm of the tissue clamping device can be accurately controlled; (2) the control handle is convenient to produce and manufacture; (3) the control handle can be conveniently separated from the tissue clamping device; (4) the mitral valve repair operation can be more convenient, and the repair efficiency and success rate are higher; (5) it is possible to prevent the occurrence of erroneous operation in a plurality of links. It is to be noted that different embodiments may produce different advantages, and in different embodiments, any one or combination of the above advantages may be produced, or any other advantages may be obtained.

The present invention is not intended to be limited to the particular embodiments shown and described, but is to be accorded the widest scope consistent with the principles and novel features herein disclosed.

Claims

1. An inner clamping arm control mechanism is characterized by comprising a shell, a second control part and a connecting rod;

the shell is provided with a second sliding groove, and the second control part penetrates through the second sliding groove and is fixedly connected with the outer wall of the connecting rod;

the second control part can move along the second sliding groove to drive the connecting rod to move, and the movement of the connecting rod can control the movement of the inner clamping arm of the tissue clamping device.

2. The inner clamp arm control mechanism of claim 1, wherein the connecting rod controls the inner clamp arm movement via a pull cable;

the connecting rod includes the hole, the haulage cable is followed pass in the hole of connecting rod, the both ends of haulage cable with the rear end of connecting rod can be dismantled and be connected.

3. The inner clamp arm control mechanism of claim 1, wherein the second control portion comprises a first sub-control portion for controlling a first inner clamp arm and a second sub-control portion for controlling a second inner clamp arm;

the second sliding groove includes a first sub-sliding groove and a second sub-sliding groove corresponding to the first sub-control portion and the second sub-control portion, respectively.

4. The inner clamp arm control mechanism according to claim 1, wherein the second control portion comprises a control button and a connecting body, the control button passes through the second sliding groove and is connected with the connecting body, and the connecting body is fixedly connected with an outer wall of the connecting rod.

5. The inner clamp arm control mechanism of claim 4,

the control button is movably connected with the connecting body through a spring;

the shell is provided with a groove, the button is provided with a convex block, and the convex block can be clamped with the groove under the action of the spring to limit the second control part to move relative to the second sliding groove.

6. The inner clamp arm control mechanism of claim 5,

the shell is at least provided with two grooves, and when the protruding blocks are respectively clamped with the two grooves, the second control parts are located at two ends of the second sliding groove.

7. A mitral valve repair control handle comprising an inner clamp arm control mechanism according to any one of claims 1 to 6.

8. The mitral valve repair control handle of claim 7, wherein: the mitral valve repair control handle further comprises an outer clamping arm control mechanism for controlling the movement of an outer clamping arm of the tissue clamping device;

the outer clamping arm control mechanism comprises a sleeve, a first control part, a sliding part and a driving rod, wherein the sliding part is arranged in the sleeve and is connected with the driving rod; the first control part can drive the sliding part to move in the sleeve along the length direction of the sleeve through rotation, and further drive the driving rod to move so as to control the outer clamping arm to open and close; wherein,

the inner circumferential surface of the first control part is provided with an internal thread; the sliding part is provided with an external thread; the sleeve is provided with a first sliding chute along the length direction; the sliding part penetrates through the first sliding groove, and the external threads on the sliding part are matched with the internal threads of the first control part.

9. The mitral valve repair control handle of claim 7, wherein: the mitral valve repair control handle further comprises an introducer block;

the guide block comprises three through holes A, B and C which are arranged at intervals, the central axes of the three through holes are positioned on a first plane, wherein the through holes A and C at two sides are used for guiding a connecting rod for controlling the movement of the inner clamping arm, and the through hole B at the middle is used for guiding a driving rod for controlling the movement of the outer clamping arm;

on one side of the first plane, the through hole A and the through hole B are communicated with each other through a hose, and on the other side of the first plane, the through hole B and the through hole C are communicated with each other through a hose.

10. A mitral valve repair device, characterized by: comprising a mitral valve repair control handle according to any of claims 7-9.