Valve clamping device
Technical Field
The present invention relates to the field of medical devices, and in particular to a valve binder for treating mitral regurgitation and tricuspid regurgitation.
Background
The mitral valve is a two-piece valve attached to the periphery of the ostium of the left ventricle (as shown in fig. 1), attached to the papillary muscles by chordae tendineae, and functions to prevent blood from the left ventricle from flowing back into the left atrium.
Mitral Regurgitation (MR) is a series of pathophysiological changes caused by the organic or functional changes in the mitral leaflets and their associated structures that cause poor coaptation of the anterior and posterior leaflets of the mitral valve, with blood flowing back from the left ventricle to the left atrium. Severe MR causes enlargement of the left ventricle, ultimately leading to left systolic dysfunction and heart failure, while left atrial pressure also increases due to regurgitation, easily leading to enlargement of the left atrium, atrial fibrillation and pulmonary hypertension. The MR prognosis is poor, the annual death rate of patients with symptoms but without operation is about 5 percent, and the annual death rate of 5 patients with severe heart failure reaches 60 percent. Meanwhile, MR is also one of the most common cardiac diseases. The incidence rates of people over 65 and 75 years of age were statistically 6.4% and 9.3%, respectively. With the development of economic society and the aging of population, the incidence rate of mitral regurgitation is in a state of obviously rising.
Surgical valve repair or replacement is considered the standard treatment for this disease. However, the surgical operation has the disadvantages of large trauma, obvious postoperative pain, slow recovery, high risk, etc., and in addition, some patients who are elderly, have a history of chest-open disease, have poor cardiac function and have complicated multi-organ dysfunction are often rejected for surgical operation because of the high surgical risk. Therefore, there is a great social and market need to develop minimally invasive, low-risk interventional therapeutic devices for MR treatment. In recent years, with the breakthrough development of valve interventional therapy technology, MR interventional devices have become one of the key directions for the development of cardiovascular devices at home and abroad.
Among them, the valve forceps developed according to the technical principle of surgical valve edge-to-edge suturing is the most certain at present because of high safety, simple technical principle and great feasibility. The principle of the surgical valve edge-to-edge sewing technology is shown in fig. 2: when the mitral valve is in regurgitation, the edges of two valve leaflets cannot be closed together to form a gap in the systole, so that the blood flow of the left ventricle returns to the left atrium from the gap; surgical edge-to-edge suturing sutures the mitral valve at a point intermediate the two leaflet edges such that the inter-leaflet space disappears or becomes smaller during systole, thereby reducing mitral regurgitation (fig. 2a), while during diastole the mitral valve opens into a bi-porous shape and blood flow into the left ventricle remains unaffected (fig. 2 b). The only minimally invasive interventional instrument internationally approved for treatment of MR on the market is MitraClip, a valve-clamping device, by Evalve.
CN201610594219 discloses a valve clamp for performing a trapping clamping operation from the ventricular side of a valve. However, the device still has the defects that the operation space required for capturing the valve is too large, the wound entering from the apex of the heart is still too large, the device can only be operated on the ventricular side, the chordae tendineae are easy to wind, the atrial roof is easy to damage, and only two sides of the valve can be captured simultaneously.
Accordingly, those skilled in the art have endeavored to develop a novel valve clip locking mechanism and a valve clip provided with the same to further shorten the axial operating space of the clip.
Disclosure of Invention
The invention aims to provide a valve clamping device, which shortens the axial operating space of the clamping device, changes the operating direction, performs capturing and clamping operation from the atrial surface of a valve, reduces the risk of damage to the atrium and chordae tendineae during the operation, shortens the length of the clamping device, makes the implanted clamping device shorter, reduces the risk of thrombus formation and reduces the possibility of damage to heart tissues exposed on the ventricular side part of the clamping device.
In order to achieve the purpose, the invention adopts the following technical scheme:
a valve clamping device comprises a clamping component, a coupling mechanism, a base and a locking mechanism, wherein the clamping component comprises a first clamping component and a second clamping component, the first clamping component is provided with at least two first clamping arms, the second clamping component is provided with a corresponding number of second clamping arms, each first clamping arm and the corresponding second clamping arm form a group of clamps, the first clamping arm and the second clamping arm are arranged at the far end of the coupling mechanism, the coupling mechanism is of a hollow structure, the coupling mechanism is provided with a first connecting structure and a second connecting structure which are respectively used for being connected with a conveying sheath and the locking mechanism, the locking mechanism is arranged on the base, and the locking mechanism is provided with a third connecting structure corresponding to the second connecting structure and a fourth connecting structure used for being connected with a pushing rod, the base is movably connected with the second clamping arm through a connecting rod, and the base can be in locking connection through the third connecting structure on the locking mechanism and the second connecting structure on the coupling mechanism;
correspondingly, the first clamping arms and the second clamping arms are made of elastic materials, a shaping included angle is formed between the first clamping arms, and an included angle of 0-300 degrees can be formed between the second clamping arms;
correspondingly, the end part of the free end of the first clamping arm is provided with a threading hole, pull wires are respectively penetrated in the threading holes, the first clamping arm can be controlled to be closed independently through the pull wires, and when the first clamping arm needs to recover the setting included angle so as to capture target tissues, the pull force of the pull wires on the first clamping arm is relieved;
correspondingly, one side of the first clamping arm, which is opposite to the second clamping arm, is provided with a rough structure, the rough structure comprises a tooth-shaped structure, a barb structure or a raised structure, one side of the second clamping arm, which is opposite to the first clamping arm, is provided with a groove structure, and the first clamping arm can capture and clamp the target tissue in the groove structure of the second clamping arm better through the rough structure, so that the clamping force of the clamping part on the target tissue is improved;
correspondingly, the length of the dentate structure, the barb structure or the bulge structure is gradually shortened from the near free end to the far free end;
correspondingly, the end part of the free end of the second clamping arm is provided with a flanging fillet, so that the damage of the end part of the second clamping arm to tissues is reduced;
correspondingly, the first connecting structure comprises a first wave curve wall axially arranged at the proximal end of the coupling mechanism and a second wave curve wall arranged at the distal end of the delivery sheath, and the first wave curve wall and the second wave curve wall are correspondingly arranged; the coupling mechanism is used for limiting the axial displacement of the connection between the coupling mechanism and the conveying sheath, when the pushing rod penetrates through the conveying sheath and the coupling mechanism, the radial displacement of the coupling mechanism and the conveying sheath is limited through the pushing rod, so that the stability of the connection between the coupling mechanism and the conveying sheath is ensured, after the pushing rod is withdrawn, radial dislocation can be firstly carried out between the walls of the wave-shaped curve, and then the axial displacement is carried out, so that the dissociation between the coupling mechanism and the conveying sheath can be realized;
correspondingly, the first connecting structure comprises a first lug and a connector which are arranged on the outer side wall of the coupling mechanism, the connector comprises a hollow connecting seat and an arc-shaped groove wall arranged on the connecting seat, the connecting seat is arranged at the far end of the conveying sheath, the arc-shaped groove wall is made of elastic materials and is shaped into an expanding opening shape, a first notch is arranged on the arc-shaped groove wall, a relative connecting piece is arranged on the inner side of the arc-shaped groove wall, and a hole channel which is convenient for a push rod to pass through is arranged on the connecting piece; when the pushing rod penetrates through the hole channel, the distance between the arc-shaped groove walls is shortened, so that the arc-shaped groove walls are wrapped on the outer side walls of the coupling mechanism, the first convex blocks are clamped into the first notches, stable connection between the coupling mechanism and the conveying sheath is realized, after the pushing rod is withdrawn, the arc-shaped groove walls recover the flaring shapes of the arc-shaped groove walls, the first notches are driven to be outwards far away, the first convex blocks are separated from the first notches, dissociation between the coupling mechanism and the conveying sheath is realized, and the connector is arranged on the conveying sheath, so that the pushing rod is withdrawn from the body along with the conveying sheath after clamping is finished and is not left in the body;
correspondingly, the first connecting structure comprises a second notch arranged on the outer side wall of the coupling mechanism and at least two elastic arms which are made of elastic materials and shaped to be close to the center, the elastic arms are arranged at the far end of the conveying sheath, and second convex blocks are arranged on the elastic arms; when the pushing rod passes through the conveying sheath and the coupling mechanism, the elastic arm is externally supported so as to drive the second bump on the elastic arm to be clamped into the second notch, so that the stable connection between the coupling mechanism and the conveying sheath is realized, after the pushing rod is withdrawn, the elastic arm restores to a close state, and then the second bump is driven to be separated from the second notch, so that the dissociation between the coupling mechanism and the conveying sheath is realized, and the elastic arm is arranged on the conveying sheath, so that the elastic arm is withdrawn from the body along with the conveying sheath after the clamping is finished and is not left in the body;
correspondingly, the second connecting structure comprises a first bayonet arranged on the side wall of the coupling mechanism, the third connecting structure comprises a first base, a first elastic sheet, a clamping piece and a first clamping block, the first base is of a hollow structure, the far end of the first base is arranged on the base, the inner side wall of the first base is provided with the fourth connecting structure, the fourth connecting structure comprises an internal thread, the first elastic sheet is made of elastic materials and is shaped into an outward inclined shape and is arranged on the near end of the first base, the inner side wall and the outer side wall of the first elastic sheet are respectively provided with the clamping piece and the first clamping block, and the clamping piece is provided with a through hole for the push rod to pass through; when the pushing rod passes through the through hole, the first elastic sheet is pulled into the hollow structure of the coupling mechanism through the clamping piece, the capturing state of the second clamping arm on the target tissue is adjusted through the pushing and pulling of the pushing rod, when an ideal capturing position is found, the pushing rod and the first base are spirally dissociated and are withdrawn from the through hole, after the limiting force of the pushing rod on the first elastic sheet is removed, the first elastic sheet expands outwards to restore the shape, the first clamping block on the first elastic sheet is driven to be clamped into the first clamping hole, the locking between the locking mechanism and the coupling mechanism is realized, and then the clamping state of the current clamping part on the target tissue is locked;
correspondingly, the second connecting structure comprises a second bayonet arranged on the side wall of the coupling mechanism, the second bayonet comprises a vertical bayonet and a horizontal bayonet, the third connecting structure comprises a hollow lower clamping table and a hollow upper clamping table, the far end of the lower clamping table is arranged on the base, the near end of the lower clamping table is provided with a groove, the far end of the upper clamping table is correspondingly provided with an inverted buckle with the groove, the outer side wall of the upper clamping table is provided with a second clamping block, in addition, the inner side walls of the lower clamping table and the upper clamping table are provided with the fourth connecting structure, and the fourth connecting structure comprises an internal thread; the back-off card is in the draw-in groove, realize going up the joint between ka tai and lower ka tai, when the push rod not dissociates with locking mechanical system, can freely push and pull the push rod in order to adjust the second clamping arm to the capture state of target tissue, when finding the ideal and catch the position, push rod and lower fixture block, go up the fixture block spiral and dissociate, the second fixture block moves along vertical bayonet socket along with the outer drawing of push rod, after that along with the spiral of push rod dissociates action card income horizontal bayonet socket, realize the locking between locking mechanical system and coupling mechanism, then lock current clamping part to the clamping state of target tissue.
Correspondingly, the second connecting structure comprises a clamping window and a limiting protrusion arranged on the side wall of the coupling mechanism, the clamping window comprises a first clamping window and a second clamping window which are respectively positioned at two sides of the limiting protrusion, the third connecting structure comprises a torsion spring, a hollow upper end block and a hollow lower end block, the near end of the torsion spring is arranged on the side wall of the coupling mechanism, the far end of the torsion spring is connected with the near end of the upper end block, the far end of the upper end block is axially provided with a third wave curve wall, the near end of the lower end block and the third wave curve wall are correspondingly provided with a fourth wave curve wall, the far end of the lower end block is arranged on the base, the outer side wall of the upper end block is provided with a limiting block, the limiting block can move in the first clamping window along the height direction of the first clamping window and can not move in the first clamping window along the width direction of the first clamping window, the upper end block and the lower end block are provided with a fourth connecting structure, and the fourth connecting structure comprises internal threads; when the pushing rod is not separated from the locking mechanism, the limiting block is limited in the first clamping window by the limiting bulge, so that the third wave-shaped curve wall and the fourth wave-shaped curve wall are in a non-clamping state, the pushing rod can be freely pushed and pulled to adjust the capture state of the second clamping arm to the target tissue, when an ideal capture position is found, the pushing rod is spirally dissociated from the lower end block and the upper end block, during the process of dissociation and withdrawal of the push rod, the spiral dissociation of the push rod drives the upper end block to move radially, and then drives the limit block to move along the height direction of the first clamping window so as to cross the limit height of the limit protrusion, under the action of torsional spring torsion, the limiting block is clamped into the second clamping window, and meanwhile, the third wave-shaped curve wall and the fourth wave-shaped curve wall are clamped, so that locking between the locking mechanism and the coupling mechanism is realized, and then the clamping state of the current clamping component on the target tissue is locked;
correspondingly, the second connecting structure comprises a second elastic sheet arranged on the coupling mechanism, the second elastic sheet is made of elastic materials and is shaped into a shape inclined towards the inside of the coupling mechanism, a pull rope is arranged on the second elastic sheet in a penetrating mode, the third connecting structure comprises a hollow second base, the second base is provided with a rough outer side wall, the far end of the second base is arranged on the base, a fourth connecting structure is arranged on the inner side wall of the second base, and the fourth connecting structure comprises internal threads; the pull rope is pulled up, the capture state of the second clamping arm to the target tissue is adjusted through the push-pull of the push rod, when an ideal capture position is found, the push rod and the second base are spirally dissociated and exit, the pull rope is put down, the second elastic sheet recovers the shape of the inner oblique shape of the second elastic sheet and is in friction locking with the rough outer side wall of the second base, the locking between the locking mechanism and the coupling mechanism is realized, and then the clamping state of the current clamping part to the target tissue is locked.
In the present invention, the terms "proximal end" and "distal end" refer to the relative positions of the valve and the operator during normal use. Wherein, the proximal end refers to the end close to the operator, and the distal end refers to the end far away from the operator. The "setting" refers to the shape or included angle of the structure under the natural structure without external force after the previous process, for example, the "setting included angle" is the angle naturally presented between the first clamping arms without external force. The elastic material is a material which is deformed by the stress of an object and the object restores the original shape after the acting force is removed.
The invention has the beneficial effects that:
1) the clamping angle of the first clamping arm adopts a setting angle, the closing angle in the operation process of the first clamping arm can be independently adjusted through a pull wire, the clamping angle of the second clamping arm is pushed and pulled through a push rod and is adjusted, the final clamping angle is locked by means of the connection between the locking mechanism and the coupling mechanism, the first clamping arm and the second clamping arm can be independently adjusted respectively, and compared with clamping arms which adopt the setting angle or can only be synchronously adjusted, the clamping arm can capture target tissues with different thicknesses and shapes at a more proper clamping angle, so that the clamping effect is better;
2) the coupling mechanism is arranged, so that the connection and the disconnection between the clamping device and the conveying sheath are simpler and more convenient, the locking mechanism is arranged, so that the connection and the disconnection between the clamping device and the pushing rod are simpler and more convenient, the locking mechanism and the coupling mechanism are used for locking and connecting, so that the clamping state of the second clamping arm is locked, the locking is simple and easy to operate, and the clamping and locking efficiency is improved;
3) through the arrangement of the coupling mechanism and the locking mechanism, on one hand, the axial operation space of the clamping device is shortened, the operation direction is changed, the capturing and clamping operation is carried out from the other side of the valve, namely the atrium face, and the risk of damage to the atrium and chordae tendineae in the operation process is reduced, on the other hand, the length of the clamping device is shortened, the implanted clamping device is made to be shorter, the risk of forming thrombus is reduced, the possible damage to heart tissues exposed on the ventricular side component of the clamping device is reduced, in addition, the valve clamping system adopts a path for conveying the clamping device out of the atrium after the atrium is punctured through the femoral vein, the intercostals and the puncture apex are not required to be cut, and the operation wound is smaller.
Drawings
FIG. 1 is a schematic view of a heart anatomy;
in the figure: 1 is superior vena cava, 2 is inferior vena cava, 3 is right atrium, 4 is tricuspid valve, 5 is right ventricle, 6 is pulmonary valve, 7 is pulmonary artery, 8 is pulmonary vein, 9 is left atrium, 10 is mitral valve, 11 is left ventricle, 12 is aortic valve, 13 is aorta, 14 is descending aorta, 15 is oxygenated blood flow direction, 16 is anoxic blood flow direction;
FIG. 2 is a schematic diagram of a surgical mitral valve edge-to-edge suturing technique, wherein 2a is mitral valve closing and 2b is mitral valve opening;
FIGS. 3a-3d are schematic perspective views of a valve holder according to a first embodiment of the present invention;
FIG. 4a is a schematic side view of a valve holder according to a first embodiment of the present invention;
fig. 4b is a schematic structural diagram of a coupling mechanism according to the first embodiment, the second embodiment or the third embodiment of the present invention;
FIG. 4c is a schematic structural diagram of the coupling mechanism and the delivery sheath being clamped according to the first embodiment, the second embodiment or the third embodiment of the present invention;
FIG. 4d is a schematic view of the locking mechanism and the coupling mechanism in accordance with the first embodiment of the present invention;
FIG. 5a is a schematic side view of a valve clip according to the second embodiment of the present invention;
FIG. 5b is a schematic structural diagram of a card loading platform according to a second embodiment of the present invention;
FIG. 5c is a schematic view of the mating structure of the locking mechanism and the coupling mechanism according to the second embodiment of the present invention;
FIG. 6a is a schematic side view of a valve holder according to the third embodiment of the present invention;
FIGS. 6b and 6c are schematic structural views of a locking mechanism according to a third embodiment of the present invention;
FIGS. 6d and 6e are schematic views showing the matching structures of the locking mechanism and the coupling mechanism according to the third embodiment of the present invention;
FIG. 7a is a schematic side view of a valve holder according to the fourth embodiment of the present invention;
fig. 7b is a schematic structural diagram of a connecting head according to a fourth embodiment of the present invention;
FIG. 8a is a schematic side view of a valve holder according to the fifth embodiment of the present invention;
FIG. 8b is a schematic structural diagram of a fifth embodiment of the elastic arm according to the present invention;
in the figure:
110. a first clamping arm; 111. a barb structure; 112. threading holes; 113. a pull wire;
120. a second clamping arm; 121. a groove structure; 122. flanging and rounding;
200. a coupling mechanism;
211. a first wave curve wall; 212. a second wave curve wall;
221. a connecting seat; 222. an arc-shaped groove wall; 223. a first notch; 224. a connecting member;
231. a second notch; 232. a resilient arm; 233. a second bump;
240. a first bayonet;
251. a vertical bayonet; 252. a transverse bayonet;
261. a first card window; 262. a second card window; 263. a limiting bulge;
271. a second elastic sheet; 272. pulling a rope;
300. a base;
400. a locking mechanism;
411. a first base; 412. a first spring plate; 413. a clamping piece; 414. a first clamping block;
421. a clamping table is arranged; 422. a clamping table is arranged; 423. a groove; 424. reversing; 425. an internal thread; 426. a second fixture block;
431. a torsion spring; 432. an upper end block; 433. a lower end block; 434. a third curvilinear wall; 435. a fourth curvilinear wall; 436. a limiting block;
441. a second base;
500. a connecting rod;
600. a delivery sheath;
700. a push rod.
Detailed Description
In the description of the present invention, it is to be understood that the terms "center", "longitudinal", "lateral", "length", "width", "thickness", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", "clockwise", "counterclockwise", and the like, indicate orientations and positional relationships based on those shown in the drawings, and are used only for convenience of description and simplicity of description, and do not indicate or imply that the device or element being referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus, should not be considered as limiting the present invention.
Furthermore, the terms "first", "second" and "first" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include one or more of that feature. In the description of the present invention, "a plurality" means two or more unless specifically defined otherwise.
In the present invention, unless otherwise expressly specified or limited, the terms "mounted," "connected," "secured," and the like are to be construed broadly and can, for example, be fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood by those skilled in the art according to specific situations.
In one embodiment of the invention, the valve clip comprises a clip member, a coupling mechanism 200, a base 300, and a locking mechanism 400;
as shown in fig. 3a-3d, the clamping member comprises a first clamping member having two first clamping arms 110 and a second clamping member having a corresponding number of second clamping arms 120, each first clamping arm 110 forming a set of clamps with its corresponding second clamping arm 120. The first clamping arm 110 and the second clamping arm 120 are made of elastic material, such as nitinol, wherein the first clamping arm 110 is fixedly disposed on the coupling mechanism 200 by welding or the like, and the second clamping arm 120 is rotatably disposed on the coupling mechanism 200 by hinging, for example. Be provided with the design contained angle between first clamping arm 110, this design contained angle is the contained angle when catching the clamping target tissue, be provided with through wires hole 112 on the tip of first clamping arm 110 free end, wear to establish acting as go-between 113 in through wires hole 112 respectively, carry or catch the in-process to the target tissue to the clamp, but the contained angle between first clamping arm 110 of independent control through acting as go-between 113, for example, in order to carry first clamping arm 110 to shrink, can tighten acting as go-between 113 for first clamping arm 110 sets up perpendicularly on coupling mechanism 200, with required transport pipe diameter size of furthest reduction. The pushing rod 700 is pushed and pulled to drive the locking mechanism 400 and the base 300 fixedly arranged with the locking mechanism 400 to move, and the movement of the base 300 drives the second clamping arms 120 to open or close by the connecting rod 500, so that an included angle of 0-300 degrees can be formed between the second clamping arms 120. In addition, a rough structure is arranged on one side of the first clamping arm 110 relative to the second clamping arm 120, the rough structure comprises a tooth-shaped structure, a barb structure 111 or a protrusion structure, the length of the tooth-shaped structure, the barb structure 11 or the protrusion structure is gradually shortened from the free end close to the first clamping arm 110 to the free end far away from the first clamping arm 110, a groove structure 121 is arranged on one side of the second clamping arm 120 relative to the first clamping arm 110, the first clamping arm 110 captures and clamps a target tissue in the groove structure 121 of the second clamping arm 120 better through the rough structure, the clamping force of a clamping part on the target tissue is improved, and the end part of the free end of the second clamping arm 120 is provided with a flanging fillet 122, so that the damage of the end part of the second clamping arm 120 to the tissue is reduced;
the coupling mechanism 200 is a hollow structure, a first connecting structure and a second connecting structure which are respectively used for connecting with the conveying sheath 600 and the locking mechanism 400 are arranged on the coupling mechanism 200, the locking mechanism 400 is arranged on the base 300, and a third connecting structure corresponding to the second connecting structure and a fourth connecting structure used for connecting with the pushing rod 700 are arranged on the locking mechanism 400;
in one embodiment of the present invention, as shown in fig. 4a to 4d, the first connecting structure includes a first wave-shaped curved wall 211 axially disposed at the proximal end of the coupling mechanism 200 and a second wave-shaped curved wall 212 axially disposed at the distal end of the delivery sheath 600, the first wave-shaped curved wall 211 and the second wave-shaped curved wall 212 are correspondingly disposed, and the connection between the coupling mechanism 200 and the delivery sheath 600 is realized by the snap-fit engagement of the first wave-shaped curved wall 211 and the second wave-shaped curved wall 212, however, for the convenience of operation, the distal end of the delivery sheath 600 is usually directly disposed as the wave-shaped curved wall, and at this time, the second wave-shaped curved wall 212 can be regarded as a butt-joint structure disposed on the delivery sheath 600; in another embodiment of the present invention, as shown in fig. 7a and 7b, the first connecting structure includes a first protrusion and a connecting head disposed on an outer sidewall of the coupling mechanism 200, the connecting head includes a hollow connecting seat 221 and an arc-shaped groove wall 222 disposed on the connecting seat 221, the connecting seat 221 is disposed at a distal end of the conveying sheath 600, for example, the connecting seat 221 may be directly fixed on the conveying sheath 600 by welding or the like, and similarly, for convenience of operation, the connecting head may be integrally or separately disposed on the conveying sheath 600, and at this time, the connecting head 221 may be regarded as a butt-joint structure disposed on the conveying sheath 600. The arc-shaped groove wall 222 is made of an elastic material and is shaped into a flaring shape, a first notch 223 is formed in the arc-shaped groove wall 222, a connecting piece 224 is arranged on the inner side of the arc-shaped groove wall 222, and a hole for the push rod 700 to pass through is formed in the connecting piece 224; in yet another embodiment of the present invention, as shown in fig. 8a and 8b, the first connecting structure includes a second notch 231 disposed on an outer sidewall of the coupling mechanism 200 and at least two elastic arms 232 made of an elastic material and shaped to be close to the center, the elastic arms 232 are disposed at a distal end of the delivery sheath 600, for example, the elastic arms 232 may be fixedly disposed on the delivery sheath 600 by welding or the like, similarly, for convenience of operation, the elastic arms 232 may be integrally or separately disposed on the delivery sheath 600, at this time, the elastic arms 232 may be regarded as a butt structure disposed on the delivery sheath 600, and the elastic arms 232 are disposed with second protrusions 233;
in an embodiment of the present invention, as shown in fig. 4a and 4d, the second connection structure includes a first bayonet 240 disposed on a side wall of the coupling mechanism 200, the third connection structure includes a first base 411, a first elastic sheet 412, a clamping member 413 and a first fixture block 414, the first base 411 is a hollow structure, a distal end of the first base 411 is disposed on the base 300, a fourth connection structure is disposed on an inner side wall of the first base 411, in this embodiment, the fourth connection structure is an internal thread, the first elastic sheet 412 is made of an elastic material and is shaped into an outward-inclined shape, the first elastic sheet is disposed on a proximal end of the first base 411, the clamping member 413 and the first fixture block 414 are disposed on an inner side wall and an outer side wall of the first elastic sheet 412, respectively, and the clamping member 413 is provided with a through hole for the push rod 700 to; in another embodiment of the present invention, as shown in fig. 5a, 5b and 5c, the second connection structure includes a second bayonet disposed on the sidewall of the coupling mechanism 200, the second bayonet includes a vertical bayonet 251 and a horizontal bayonet 252, the third connection structure includes a hollow lower clamping platform 421 and a hollow upper clamping platform 422, the distal end of the lower clamping platform 422 is disposed on the base 300, the proximal end of the lower clamping platform 422 is disposed with a groove 423, the distal end of the upper clamping platform 421 is disposed with an inverse buckle 424 corresponding to the groove 423, and a second clamping block 426 is disposed on the outer sidewall of the upper clamping platform 422, and further, the inner sidewalls of the lower clamping platform 421 and the upper clamping platform 422 are disposed with a fourth connection structure, in this embodiment, the fourth connection structure is disposed with an internal thread 425; in still another embodiment of the present invention, as shown in fig. 6a to 6e, the second connecting structure includes a card window and a limit protrusion 263 disposed on a side wall of the coupling mechanism, the card window includes a first card window 261 and a second card window 262 disposed at both sides of the limit protrusion 263, the third connecting structure includes a torsion spring 431, a hollow upper block 432, and a hollow lower block 433, a proximal end of the torsion spring 431 is disposed on the side wall of the coupling mechanism 200, a distal end of the torsion spring 431 is connected to a proximal end of the upper block 432, a distal end of the upper block 432 is axially provided with a third wave-shaped curved wall 434, a proximal end of the lower block 433 and the third wave-shaped curved wall 434 are correspondingly provided with a fourth wave-shaped curved wall 435, a distal end of the lower block 433 is disposed on the base 300, a limit block 436 is disposed on an outer side wall of the upper block 432, and the limit block 436 is movable in a height direction of the first card window 261, and is not movable in a width direction of the first card window 261, the upper end block 432 and the lower end block 433 are provided with a fourth connecting structure, in the embodiment, the fourth connecting structure is provided with an internal thread; in still another embodiment of the present invention, as shown in fig. 8a and 8b, the second connecting structure includes a second elastic sheet 271 disposed on the coupling mechanism, the second elastic sheet 271 is made of an elastic material and is shaped to be inclined toward the interior of the coupling mechanism 200, a pulling rope 272 is disposed on the second elastic sheet 271, the third connecting structure includes a hollow second base 441, the second base 441 has a rough outer sidewall, a distal end of the second base 441 is disposed on the base 300, and a fourth connecting structure is disposed on the inner sidewall of the second base 441, in this embodiment, the fourth connecting structure is disposed as an internal thread;
the base 300 is movably connected to the second clamping arm 120 through a connecting rod 500, for example, one end of the connecting rod 500 is hinged to the base 300, and the other end of the connecting rod 500 is hinged to the second clamping arm 120.
According to the valve clamping device, the following embodiments can be obtained:
example one
As shown in fig. 4a-4d, the coupling mechanism 200 is clamped with the delivery sheath 600 by the wave-shaped curved wall, and meanwhile, the locking mechanism 400 is locked by the first base 411, the first elastic sheet 412, the clamping piece 413, the first clamping block 414 and the coupling mechanism 200 by the first clamping opening 240;
the coupling mechanism 200 and the conveying sheath 600 are clamped in an inosculating manner by utilizing the first wave-shaped curve wall 211 and the second wave-shaped curve wall 212, axial displacement cannot directly occur between the coupling mechanism 200 and the conveying sheath 600, then the push rod 700 sequentially passes through the conveying sheath 600, the coupling mechanism 200 and the through hole and is in threaded connection with the first base 411, the push rod 700 limits radial displacement between the coupling mechanism 200 and the conveying sheath 600, the connection stability between the coupling mechanism 200 and the conveying sheath 600 is ensured, meanwhile, the push rod 700 inclines the first elastic sheet 412 which is inclined outwards into the hollow structure of the coupling mechanism 200 through the clamping piece 413, and in such a state, the push rod 700 can be freely pushed and pulled, so that the locking mechanism 400 moves in the coupling mechanism 200. The pushing and pulling of the pushing rod 700 drives the locking mechanism 400 and the base 300 fixedly disposed on the first base 411 to move, and the movement of the base 300 drives the second clamping arm 120 to open or close through the connecting rod 500, and similarly, the pushing rod 700 can also be rotated to drive the second clamping arm 120 to rotate. When the second clamping arm 120 finds a proper capturing clamping position, the pushing rod 700 is used for pulling the locking mechanism 400 to a position convenient for locking with the coupling mechanism 200, the pushing rod 700 is rotated reversely to release the threaded connection between the pushing rod 700 and the first base 411 and withdraw from the pushing rod 700, after the limiting force of the pushing rod 700 on the first elastic sheet 412 is removed, the first elastic sheet 412 is outwards inclined to restore to the shape, the first clamping block 414 on the first elastic sheet is driven to be clamped into the first clamping opening 240, the locking between the locking mechanism 400 and the coupling mechanism 200 is realized, and then the clamping state of the current clamping component on the target tissue is locked. Meanwhile, the withdrawing of the push rod 700 causes the first wave-shaped curved wall 211 and the second wave-shaped curved wall 212 to lack radial limitation, so that radial dislocation can be performed between the first wave-shaped curved wall 211 and the second wave-shaped curved wall 212, the dissociation between the coupling mechanism 200 and the delivery sheath 600 can be realized through the radial dislocation and the axial displacement, and the delivery sheath 600 can be withdrawn, so that the clamp can be implanted in the patient body independently.
Example two
As shown in fig. 5a-5c, the coupling mechanism 200 is clamped with the delivery sheath 600 by the wave-shaped curved wall, and the locking mechanism 400 is locked by the lower clamping table 421, the upper clamping table 422 and the coupling mechanism 200 by the second bayonet;
the upper clamping table 422 and the lower clamping table 421 are clamped in the clamping groove 423 in a clamping manner through the reverse buckle 424, the coupling mechanism 200 and the conveying sheath 600 are clamped in an inosculating manner through the first wave-shaped curve wall 211 and the second wave-shaped curve wall 212, axial displacement cannot directly occur between the coupling mechanism 200 and the conveying sheath 600, then the push rod 700 sequentially passes through the conveying sheath 600 and the coupling mechanism 200 and is in threaded connection with the upper clamping table 422 and the lower clamping table 421, the push rod 700 limits radial displacement between the coupling mechanism 200 and the conveying sheath 600, and connection stability between the coupling mechanism 200 and the conveying sheath 600 is ensured. The pushing and pulling of the pushing rod 700 drives the locking mechanism 400 and the base 300 fixedly disposed with the lower chuck 421 to move, and the movement of the base 300 drives the second clamping arm 120 to open or close through the connecting rod 500, and similarly, the pushing rod 700 can also drive the second clamping arm 120 to rotate through rotating. When the second clamping arm 120 finds a proper capturing clamping position, the second clamping block 426 is ensured to be located at a position where the second clamping block 426 can move along the vertical bayonet 251, the push rod 700 is rotated reversely to sequentially release the threaded connection between the push rod 700 and the lower clamping table 421 and the upper clamping table 422 and exit the push rod 700, more specifically, the push rod 700 is firstly screwed to release the connection with the lower clamping table 421, in the screwing process, the upper clamping table 422 is driven to move for a certain distance until the second clamping block 426 is clamped at the limit position of the vertical bayonet 251, and along with the rotating and detaching direction of the push rod 700 and the upper clamping table 422, the second clamping block 426 is clamped into the horizontal bayonet 252, so that the locking between the locking mechanism 400 and the coupling mechanism 200 is realized, and the clamping state of the current clamping component on the target tissue is locked. Meanwhile, the withdrawing of the push rod 700 causes the first wave-shaped curved wall 211 and the second wave-shaped curved wall 212 to lack radial limitation, so that radial dislocation can be performed between the first wave-shaped curved wall 211 and the second wave-shaped curved wall 212, the dissociation between the coupling mechanism 200 and the delivery sheath 600 can be realized through the radial dislocation and the axial displacement, and the delivery sheath 600 can be withdrawn, so that the clamp can be implanted in the patient body independently.
EXAMPLE III
As shown in fig. 6a-6e, the coupling mechanism 200 is clamped with the delivery sheath 600 by the wave-shaped curved wall, and the locking mechanism 200 is locked by the torsion spring 431, the upper end block 432, the lower end block 433 and the coupling mechanism 200 with the clamping window and the limiting protrusion 263;
the coupling mechanism 200 and the delivery sheath 600 are engaged and clamped by the first wavy curved wall 211 and the second wavy curved wall 212, the coupling mechanism 200 and the delivery sheath 600 cannot be directly axially displaced, then the push rod 700 sequentially passes through the delivery sheath 600, the coupling mechanism 200 and is in threaded connection with the upper end table 432 and the lower end table 433, and the limit protrusion 263 is positioned in the first clamping window 261, so that the third wavy curved wall 434 and the fourth wavy curved wall 435 are in an unclamped state, and in view of the fact that the outer diameters of the upper end table 432 and the lower end table 433 and the axial outer diameter of the torsion spring 431 are smaller than the inner diameter of the delivery sheath 600, the push rod 700 can be freely pushed and pulled in this state, so that the locking mechanism 400 moves in the coupling mechanism 200 within the height limit of the first clamping window 261. The pushing and pulling of the pushing rod 700 drives the locking mechanism 400 and the base 300 fixedly arranged with the lower end platform 433 to move, the movement of the base 300 drives the second clamping arm 120 to open or close through the connecting rod 500, and similarly, the pushing rod 700 can also be rotated within the width limit of the first clamping window 261 to drive the second clamping arm 120 to rotate. When the second clamping arm 120 finds a proper capturing clamping position, the pushing rod 700 is rotated reversely to sequentially release the threaded connection between the pushing rod 700 and the lower end table 433 and the upper end table 432 and exit the pushing rod 700, more specifically, the pushing rod 700 is firstly spirally released and connected with the lower end table 433, and in the spiral process, the upper end table 432 is driven to move for a certain distance, and then the limiting block 436 is driven to move along the height direction of the first clamping window 261, so as to cross the limiting height of the limiting protrusion 263, under the action of the torsion force of the torsion spring 431, the limiting block 436 is clamped into the second clamping window 262, and meanwhile, the third wave-shaped curve wall 434 and the fourth wave-shaped curve wall 435 realize clamping, so that the locking between the locking mechanism 400 and the coupling mechanism 200 is realized, and then the clamping state of the current clamping component on the target tissue is locked. Meanwhile, the withdrawing of the push rod 700 causes the first wave-shaped curved wall 211 and the second wave-shaped curved wall 212 to lack radial limitation, so that radial dislocation can be performed between the first wave-shaped curved wall 211 and the second wave-shaped curved wall 212, the dissociation between the coupling mechanism 200 and the delivery sheath 600 can be realized through the radial dislocation and the axial displacement, and the delivery sheath 600 can be withdrawn, so that the clamp can be implanted in the patient body independently.
Example four
As shown in fig. 7a and 7b, the coupling mechanism 200 is engaged with the delivery sheath 600 by the first protrusion, the connector, and the locking mechanism 400, the coupling mechanism 200, and the pushing rod 700 are engaged with each other by any one of the three embodiments;
the connecting seat 221 of the connecting head is arranged at the far end of the conveying sheath 600 in a welding, sleeving or integrated mold closing mode and the like, the push rod 700 sequentially passes through the conveying sheath 600, the coupling mechanism 200 and the pore channel, the distance between the arc-shaped groove walls 222 is shortened, the arc-shaped groove walls 222 are wrapped on the outer side wall of the coupling mechanism 200, the first protruding block is clamped into the first notch 223 from this, and therefore stable connection between the coupling mechanism 200 and the conveying sheath 600 is achieved. After withdrawing the pushing rod 700, the arc-shaped groove wall 222 recovers the flaring shape thereof, and then drives the first notch 223 to be away from the outside, so that the first bump is separated from the first notch 223, and the separation between the coupling mechanism 200 and the conveying sheath 600 is realized, and the connector is arranged on the conveying sheath 600, so that the connector is withdrawn from the body along with the conveying sheath 600 after the clamping is completed, and is not left in the body. Since the connection and disconnection between the locking mechanism 400, the coupling mechanism 200, and the pushing lever 700 have been described in the first three embodiments, respectively, the description thereof will not be repeated.
EXAMPLE five
As shown in fig. 8a and 8b, the coupling mechanism 200 is formed by engaging the second notch 231, the elastic arm 232, the second protrusion 233 with the delivery sheath 600, and the locking mechanism 400 is formed by locking the second base 441 with the coupling mechanism 200 formed by the second elastic piece 271 and the pull rope 272;
the elastic arm 232 is arranged at the far end of the conveying sheath 600 in a welding, sleeving or integrated die assembly mode and the like, the push rod 700 sequentially passes through the conveying sheath 600 and the coupling mechanism 200 and is in threaded connection with the second base 441, when the push rod 700 passes through the conveying sheath 600 and the coupling mechanism 200, the elastic arm 232 is externally supported, so that the second bump 233 on the elastic arm is driven to be clamped into the second notch 231, stable connection between the coupling mechanism 200 and the conveying sheath 600 is achieved, the pull rope 272 is pulled up, in this state, the second elastic sheet 271 does not have the friction clamping condition on the second base 441, the push rod 700 can be freely pushed and pulled, and the locking mechanism 400 moves in the coupling mechanism 200. The pushing and pulling of the pushing rod 700 drives the locking mechanism 400 and the base 300 fixedly disposed on the second base 441 to move, and the movement of the base 300 drives the second clamping arm 120 to open or close through the connecting rod 500, and similarly, the pushing rod 700 can also be rotated to drive the second clamping arm 120 to rotate. When the second clamping arm 120 finds a proper capturing clamping position, the pushing rod 700 is rotated reversely to sequentially release the threaded connection between the pushing rod 700 and the second base 441 and withdraw from the pushing rod 700, the pulling rope 272 is loosened, so that the second elastic piece 271 recovers the shape of the second base 441 and is clamped by friction, the locking between the locking mechanism 400 and the coupling mechanism 200 is realized, and then the clamping state of the current clamping component on the target tissue is locked. Meanwhile, after the pushing rod 700 is withdrawn, the elastic arm 232 restores to a close state, and then drives the second bump 233 to be pulled out from the second notch 231, so that dissociation of the coupling mechanism 200 and the conveying sheath 600 is realized, and the elastic arm 232 is arranged on the conveying sheath 600, so that the elastic arm is withdrawn from the body along with the conveying sheath 600 after clamping is completed, and is not remained in the body, and other clamping devices are implanted into the body of the patient independently.
In addition, it should be specifically noted that the delivery sheath 600 and the push rod 700 are well known in the art as delivery devices for delivering a valve clip, and of course, the delivery device may include other common structures besides the two delivery structures of the delivery sheath 600 and the push rod 700, such as a catheter sheath and a loader, etc., and therefore, the description is omitted since the rest of the delivery devices and the clip involved in the present invention are not directly connected.
The foregoing detailed description of the preferred embodiments of the invention has been presented. It should be understood that numerous modifications and variations could be devised by those skilled in the art in light of the present teachings without departing from the inventive concepts. Therefore, the technical solutions available to those skilled in the art through logic analysis, reasoning and limited experiments based on the prior art according to the concept of the present invention should be within the scope of protection defined by the claims.