CN112155813A - Ventricular volume reduction device - Google Patents
Ventricular volume reduction device Download PDFInfo
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- CN112155813A CN112155813A CN202011050052.1A CN202011050052A CN112155813A CN 112155813 A CN112155813 A CN 112155813A CN 202011050052 A CN202011050052 A CN 202011050052A CN 112155813 A CN112155813 A CN 112155813A
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- support
- connecting piece
- volume reduction
- hole body
- reduction device
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- 238000011038 discontinuous diafiltration by volume reduction Methods 0.000 title claims abstract description 53
- 230000002861 ventricular Effects 0.000 title claims abstract description 32
- 238000007789 sealing Methods 0.000 claims description 24
- 230000009471 action Effects 0.000 claims description 12
- 230000000149 penetrating effect Effects 0.000 claims description 10
- 230000006978 adaptation Effects 0.000 claims 1
- 230000009286 beneficial effect Effects 0.000 abstract 1
- 210000003205 muscle Anatomy 0.000 description 13
- 230000003014 reinforcing effect Effects 0.000 description 11
- 210000005240 left ventricle Anatomy 0.000 description 8
- 238000004873 anchoring Methods 0.000 description 6
- 230000006378 damage Effects 0.000 description 5
- 238000000034 method Methods 0.000 description 5
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- 239000007788 liquid Substances 0.000 description 4
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- 230000002349 favourable effect Effects 0.000 description 2
- 230000004217 heart function Effects 0.000 description 2
- 238000002513 implantation Methods 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 206010007513 Cardiac aneurysm Diseases 0.000 description 1
- 206010019280 Heart failures Diseases 0.000 description 1
- 206010061218 Inflammation Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 210000000709 aorta Anatomy 0.000 description 1
- 210000001765 aortic valve Anatomy 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
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- YHHSONZFOIEMCP-UHFFFAOYSA-O phosphocholine Chemical compound C[N+](C)(C)CCOP(O)(O)=O YHHSONZFOIEMCP-UHFFFAOYSA-O 0.000 description 1
- 229950004354 phosphorylcholine Drugs 0.000 description 1
- 239000011148 porous material Substances 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
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Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/97—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve the outer sleeve being splittable
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
The invention relates to a ventricular volume reduction device, which comprises a volume reduction support, wherein the volume reduction support comprises a first support and a second support which are coaxially arranged, the first support comprises a first connecting piece and a plurality of first supporting ribs which are uniformly distributed around the circumference of the first support, and the first ends of the first supporting ribs are connected with the first connecting piece; the second support comprises a second connecting piece and a plurality of second supporting ribs which are uniformly distributed around the circumference of the second connecting piece, and the first ends of the second supporting ribs are connected with the second connecting piece; the second end of the first support rib and the second end of the second support rib are connected with each other, and an anchor thorn is arranged at the connection part of the first support rib and the second support rib in an outward extending mode; the part of the first support rib close to the first connecting piece and the part of the second support rib close to the second connecting piece are in a sine shape; at least one surface of the first support and the second support is covered with a flow-blocking film. The invention can improve the strength of the volume-reducing bracket, prevent the volume-reducing bracket from being damaged by fatigue and is beneficial to prolonging the service life of the volume-reducing bracket.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a ventricular volume reduction device.
Background
Percutaneous Ventricular Reconstruction (PVR) is a new technology for minimally invasive intervention treatment of ventricular aneurysms and heart failure, and the technology is mainly characterized in that a ventricular isolation device is implanted into the left ventricle of a patient through reverse catheter movement so as to isolate a nonfunctional ventricular region, reduce contraction and relaxation volumes of the left ventricle, reduce tension of the left ventricle and improve reconstruction and cardiac function of the left ventricle; compared with the traditional surgery left ventricle reconstruction, the Percutaneous Ventricular Reconstruction (PVR) has the advantages of small trauma and low safety risk, so the application prospect is wide.
The chinese patent application publication No. CN109009589A discloses a ventricular volume reduction device and a delivery system thereof, which can realize accurate and controllable release of the ventricular volume reduction device by using the delivery system, and the required release and recovery space is small, and the ventricular volume reduction device can be recovered and repeatedly positioned for many times after being unfolded, thereby reducing the difficulty of implantation of the ventricular volume reduction device. After the ventricular volume reduction device is released, the anchoring thorn penetrates into the muscle of the wall of the chamber to fix the ventricular volume reduction device, but the anchoring thorn gradually penetrates into the muscle of the wall of the chamber when the ventricular volume reduction device is gradually unfolded, the penetration depth is not controllable, and the situation that the ventricular volume reduction device is displaced or falls off due to the fact that the anchoring thorn is not firmly anchored is easy to happen in the actual operation process, so that the treatment effect is affected. In addition, the first support and the second support are both in a linear shape, so that the strength is low, fatigue damage is easy to occur, and the service life is influenced.
Disclosure of Invention
Aiming at the defects in the prior art, the technical problem to be solved by the invention is to provide the ventricular volume reduction device, wherein the part of the volume reduction support connected with the first connecting piece and the second connecting piece is designed into a sine shape, so that the strength of the volume reduction support can be improved, the fatigue damage of the volume reduction support is prevented, and the service life of the volume reduction support is prolonged.
In order to solve the technical problem, the invention provides a ventricular volume reduction device, which comprises a volume reduction support, wherein the volume reduction support can be switched from a stretching state to a releasing state under the action of external force, the volume reduction support comprises a first support and a second support which are coaxially arranged, when the volume reduction support is in the stretching state, the first support and the second support are far away from each other to form a strip shape, when the volume reduction support is in the releasing state, the first support and the second support are close to each other to form an umbrella shape, the first support comprises a first connecting piece and a plurality of first supporting ribs which are uniformly distributed around the circumference of the first connecting piece, and the first ends of the first supporting ribs are connected with the first connecting piece; the second support comprises a second connecting piece and a plurality of second supporting ribs which are uniformly distributed around the circumference of the second connecting piece, and the first ends of the second supporting ribs are connected with the second connecting piece; the second end of the first support rib and the second end of the second support rib are connected with each other, and an anchor thorn is arranged at the connection part of the first support rib and the second support rib in an outward extending mode; the part of the first support rib close to the first connecting piece and the part of the second support rib close to the second connecting piece are in a sine shape; at least one surface of the first support and the second support is covered with a flow-blocking film.
In the invention, the volume-reducing support maintains a strip shape in the conveying process, and after the volume-reducing support is conveyed into the left ventricle, the volume-reducing support is unfolded to form an umbrella shape under the action of the conveying device, and the volume-reducing support is penetrated into the muscle of the ventricle wall by virtue of an anchor to realize the fixation of the volume-reducing support, isolate the non-functional ventricle area, and reduce the contraction and relaxation volume of the ventricle, thereby increasing the positive blood flow and the cardiac output, improving the ejection fraction and improving the cardiac function. And the part that first support muscle is close to first connecting piece to and the part that the second support muscle is close to the second connecting piece all designs for sinusoidal shape, can improve the intensity of reducing the volume support, prevents its fatigue damage under the impact of blood, is favorable to improving the life of reducing the volume support.
Preferably, the inner peripheries of the first connecting piece and the second connecting piece are provided with internal threads so as to be connected with a conveying device.
Preferably, one side of the first connecting piece, which is close to the second connecting piece, is provided with a plurality of hooks along the axis direction, one side of the second connecting piece, which is close to the first connecting piece, is provided with an annular hanging rod matched with the hooks, and the hanging rod is connected with the second connecting piece through a plurality of support rods. By adopting the design, when the volume-reducing support is released, the hook can be hung on the hanging rod under the action of external force, so that the axial position of the first connecting piece relative to the second connecting piece is fixed, namely the relative positions of the first support and the second support are fixed, the stability of the volume-reducing support is improved, and the volume-reducing support is prevented from falling off.
Preferably, the ventricular volume reduction device of the present invention further comprises a delivery device for delivering the volume reduction stent; the conveying device comprises a mandrel, an outer sleeve and an operating handle, wherein one ends of the mandrel and the outer sleeve, which are far away from the operating handle, are respectively used for being connected with the second connecting piece and the first connecting piece; the outer sleeve is provided with a cavity communicated with the inside of the inflatable bag body, the cavity is not communicated with the shaft hole, and the outer sleeve is provided with an operation port communicated with the cavity. The inflatable bag body is additionally arranged, in the process of releasing the volume-reducing support, gas or liquid can be filled into the cavity through the operation port to enable the inflatable bag body to be inflated and apply pressure to the volume-reducing support, so that the anchor thorn of the volume-reducing support can smoothly penetrate into muscle of the wall of the chamber, the volume-reducing support and the muscle of the wall of the chamber can be anchored reliably, and the volume-reducing support is prevented from shifting or falling off.
Preferably, the operating handle comprises a housing comprising a rotationally connected disengaging section and a rotating section; the sliding part is arranged in the shell, a guide hole is formed in the sliding part in a penetrating mode, a guide part penetrates through the guide hole, the guide part is fixed relative to the circumferential position of the sliding part, and the sliding part can do linear reciprocating motion along the length direction of the guide part under the action of external force; the sliding part is fixedly connected with one end, close to the operating handle, of the outer sleeve, the mandrel is fixedly connected with one end, close to the operating handle, of the guide part, and the disengagement section is connected with the guide part in a non-rotatable mode. The sliding part is linearly reciprocated under the action of external force, and can drive the outer sleeve to synchronously move, so that the outer sleeve can slide in a reciprocating manner relative to the mandrel, and corresponding releasing and withdrawing actions of the volume-reducing support are realized; and because the disengagement section is non-rotatably connected with the guide piece, when the disengagement section is rotated, the guide piece can drive the sliding piece and the disengagement section to synchronously rotate together, so that the mandrel and the outer sleeve synchronously rotate together, and the mandrel and the outer sleeve can be separated from the volume-reducing support.
Preferably, the outer circumference of the sliding part is provided with an external thread, and the inner circumference of the rotating section is provided with an internal thread matched with the external thread. By adopting the structure, the sliding part can be driven to slide relative to the guide part by screwing the rotating section.
Preferably, a first hole body, a second hole body and a third hole body are sequentially arranged in the sliding part along the direction far away from the releasing section, and the first hole body, the second hole body and the third hole body are mutually communicated and are coaxially arranged with the sliding part; the outer sleeve is fixedly arranged in the first hole body in a penetrating mode, the mandrel is arranged in the second hole body and the third hole body in a penetrating mode, and a sealing piece is arranged in the third hole body, so that a sealing space is formed inside the second hole body; and a first operation channel communicated with the second hole body and a second operation channel communicated with the first hole body are further arranged on the sliding piece, and the second operation channel is aligned with the operation port, so that the second operation channel is communicated with the cavity through the operation port. Through the first operation channel, air in the blood vessel can be exhausted by using the outer sleeve; by means of the second operating channel, a gas or liquid can be injected into the inflatable balloon to inflate it, penetrating the anchors of the volume-reducing stent into the wall muscles of the chamber.
Preferably, the sealing member includes a sealing gasket and a set screw, the sealing gasket and the set screw are sleeved on the periphery of the mandrel, the set screw is in threaded connection with the inner periphery of the third hole body, the sealing gasket is tightly abutted to the bottom wall of the third hole body, and the inner periphery of the sealing gasket is in sealing abutment with the outer periphery of the mandrel. The sealing gasket can play a sealing role and prevent blood from leaking from the third hole body to enter the interior of the operating handle.
Preferably, the guide member comprises a first support, a second support and a guide rod connected between the first support and the second support, and the guide rod is arranged in the guide hole in a penetrating manner; the first support is rotationally connected with the rotating section, the second support is non-rotationally connected with the releasing section, and the axial positions of the first support and the second support relative to the shell are fixed; one end of the mandrel, which is close to the operating handle, is fixedly connected with the first support.
Preferably, a first operating pipe and a second operating pipe are fixedly connected in the first operating channel and the second operating channel respectively, and the other ends of the first operating pipe and the second operating pipe penetrate through the first support and then extend out of the operating handle. The operator can perform the auxiliary operation through the portions of the first and second operating pipes located outside the operating handle.
Preferably, a reinforcing tube is sleeved on the outer periphery of a part of the mandrel inside the operating handle, the mandrel is connected with the sealing gasket in a sealing mode through the reinforcing tube, and the outer periphery of the reinforcing tube is connected with the inner periphery of the sealing gasket in a sealing mode. The arrangement of the reinforcing pipe can play a role in protecting the mandrel.
Preferably, a locker is arranged at one end of the releasing section, which is far away from the rotating section, the locker comprises a locking sleeve sleeved on the periphery of the outer sleeve, a locking hole is arranged on the locking sleeve along the radial direction of the locking sleeve, and a locking screw is connected in the locking hole in a threaded manner; a passage is formed between the inner periphery of the locking sleeve and the outer periphery of the outer sleeve for passage of a loader. The locker is arranged to define the position of the loader relative to the operating handle after the volume reducing bracket is delivered in place, so as to prevent the loader from affecting the action of the outer sleeve and the mandrel.
Drawings
In order to more clearly illustrate the detailed description of the invention or the technical solutions in the prior art, the drawings that are needed in the detailed description of the invention or the prior art will be briefly described below. Throughout the drawings, like elements or portions are generally identified by like reference numerals. In the drawings, elements or portions are not necessarily drawn to scale.
FIG. 1 is a schematic three-dimensional view of a volume-reducing stent according to an embodiment of the present invention;
FIG. 2 is a schematic structural view of a first bracket and a second bracket according to an embodiment of the present invention;
FIG. 3 is a top view of a first bracket and a second bracket of an embodiment of the present invention;
FIG. 4 is a schematic view of a connection structure of a first connection member and a second connection member according to an embodiment of the present invention;
FIG. 5 is a schematic structural diagram of a conveying apparatus according to an embodiment of the present invention;
FIG. 6 is a schematic view showing the internal structure of the operating handle according to the embodiment of the present invention;
FIG. 7 is an exploded view of the operating handle of the embodiment of the present invention;
FIG. 8 is a schematic structural diagram of a slider according to an embodiment of the present invention;
FIG. 9 is a schematic view showing a connection structure of a slider, an outer sleeve and a mandrel according to an embodiment of the present invention;
fig. 10 is a schematic view of the connection structure of the outer sleeve and the inflatable balloon according to the embodiment of the present invention.
Description of the drawings:
1-a volume-reducing support; 11-a first support; 111-a first connector; 112-first support ribs; 113-hanging hooks; 12-a second scaffold; 121 a second connecting member; 122-second support ribs; 123-hanging rod; 124-strut; 13-anchoring; 14-a base; 15-development mark; 2-mandrel; 21-a reinforced pipe; 3-outer sleeve; 31-an inflatable balloon; 32-a cavity; 33-shaft hole; 4-operating a handle; 41-disengagement section; 411-a limiting block; 42-a rotation section; 43-a slide; 431-a pilot hole; 432-a first aperture body; 433-a second porous body; 434-third pore body; 435-a first operating channel; 436-a second operating channel; 44-a first seat; 45-a second support; 451-a limit groove; 46-a guide rod; 47-a gasket; 48-set screws; 49-a locker; 5-a delivery sheath; 6-a loader; 7-a first handling tube; 8-second operation tube.
Detailed Description
Embodiments of the present invention will be described in detail below with reference to the accompanying drawings. The following examples are only for illustrating the technical solutions of the present invention more clearly, and therefore are only examples, and the protection scope of the present invention is not limited thereby.
As shown in fig. 1, fig. 2, fig. 3, fig. 4, fig. 5, fig. 6, fig. 7, fig. 8, fig. 9, and fig. 10, the present embodiment provides a ventricular volume reduction device including a volume reduction stent 1 and a delivery device for placing the volume reduction stent 1 into the left ventricle. Referring to fig. 1, 2, 3 and 4, the volume-reducing stent 1 includes a first stent 11 and a second stent 12 coaxially disposed, and at least one surface of the first stent 11 and the second stent 12 is covered with a flow-blocking film, and in addition, in the present embodiment, the surfaces of the first stent 11 and the second stent 12 are coated with a PC film (phosphorylcholine) to reduce inflammatory reaction after implantation and reduce platelet adsorption. The volume-reducing bracket 1 can be switched from a stretching state to a releasing state under the action of external force, when the volume-reducing bracket 1 is in the stretching state, the first bracket 11 and the second bracket 12 are away from each other to form a long strip shape, and when the volume-reducing bracket 1 is in the releasing state, the first bracket 11 and the second bracket 12 are close to each other to form an umbrella shape (refer to fig. 2).
Specifically, the first bracket 11 includes a first connecting member 111, and a plurality of first support ribs 112 uniformly distributed around the circumference of the first connecting member 111, and a first end of the first support rib 112 is connected to the first connecting member 111; the second bracket 12 comprises a second connecting piece 121 and a plurality of second supporting ribs 122 uniformly distributed around the circumference of the second connecting piece 121, wherein the first ends of the second supporting ribs 122 are connected with the second connecting piece 121; the second end of the first support rib 112 and the second end of the second support rib 122 are connected with each other, and an anchor 13 extends outwards from the connection position of the first support rib 112 and the second support rib 122; the part of first support muscle 112 near first connecting piece 111 and the part of second support muscle 122 near second connecting piece 121 become sinusoidal shape, and the design of sinusoidal shape can improve the intensity of first support muscle 112 and second support muscle 122 to prevent the fatigue damage of volume reduction support 1, be favorable to improving the life of volume reduction support 1.
Specifically, the base 14 is connected to one end of the second connecting member 121 far away from the first support 11, so as to stabilize the whole volume reduction support 1, and prevent the volume reduction support 1 from puncturing the ventricular wall and causing injury to the patient. And at least one visualization mark 15 is arranged on the side of the volume-reducing support 1 close to the anchor thorn 13 to increase the visibility of the volume-reducing support provided by the present application in X-ray examination or the like. The development mark 15 can indicate the position of the volume-reducing support 1 during the insertion of the volume-reducing support 1.
Internal threads are provided on the inner circumference of each of the first and second connectors 111 and 121 to facilitate connection with a transfer device. In this embodiment, the volume-reducing stent 1 is stretched into a long strip shape during the delivery process, and can be unfolded into an umbrella shape under the action of an external force after reaching the target position, and the form change of the volume-reducing stent 1 during the release process can refer to the related description in CN 109009589A.
Furthermore, a plurality of hooks 113 are arranged on one side of the first connecting piece 111 close to the second connecting piece 121 along the axial direction of the first connecting piece, an annular hanging rod 123 matched with the hooks 113 is arranged on one side of the second connecting piece 121 close to the first connecting piece 111, and the hanging rod 123 is connected with the second connecting piece 121 through a plurality of support rods 124, so that when the volume-reducing support 1 is released, the first support 11 is pushed towards the direction close to the second support 12, the hooks 113 move towards the direction of the hanging rod 123 and are hung on the hanging rod 123, and further the relative positions of the first support 11 and the second support 12 are fixed, so that the stability of the volume-reducing support 1 is improved, and the volume-reducing support is prevented from shifting or falling off.
Referring to fig. 5, 6, 7, 8, 9 and 10, the above-mentioned conveying device includes a mandrel 2, an outer sleeve 3 and an operating handle 4, a shaft hole is provided inside the outer sleeve 3 along the axial direction thereof, the mandrel 2 is inserted into the shaft hole, and one ends of the mandrel 2 and the outer sleeve 3 far away from the operating handle 4 are respectively in threaded connection with the second connecting piece 121 and the first connecting piece 111, a conveying sheath 5 and a loader 6 are further sleeved on the periphery of the outer sleeve 3, and one end of the conveying sheath 5 and one end of the conveying sheath close to the operating handle 4 are connected with the loader 6. In this embodiment, the delivery sheath 5 is used as a channel for the delivery mandrel 2, the outer cannula 3 and the elongated strip-shaped volume-reducing stent 1 connected with the two, when in use, the delivery sheath 5 is sent to the apex of the left ventricle through the femoral artery, the aorta and the aortic valve along the arterial blood channel, then the mandrel 2 provided with the volume-reducing stent 1 and the outer cannula 3 are loaded into the loader 6 together, and then one end of the loader 6 far away from the operating handle 4 is connected with the delivery sheath 5 through screw threads, at this time, the operator can deliver the volume-reducing stent 1 to a target position along the delivery sheath 5 through the operating handle 4. In practice, in order to facilitate the delivery sheath 5 to reach the target position smoothly, the distal end of the delivery sheath 5 may be designed to have an adjustable bending structure, and such an adjustable bending delivery sheath is prior art in the field and will not be described herein.
Further, an expandable balloon 31 is sleeved on the outer periphery of one end of the outer sleeve 3, which is far away from the operating handle 4, the expandable balloon 31 is specifically a balloon, the expanded size of the expandable balloon 31 is matched with the maximum inner peripheral size of the volume-reducing stent 1 after being expanded, a cavity 32 communicated with the inside of the expandable balloon 31 is arranged on the outer sleeve 3, the cavity 32 is not communicated with a shaft hole 33 for accommodating the mandrel 2, and an operating port communicated with the cavity 32 is arranged on the outer sleeve 3, so that liquid or gas for expanding the expandable balloon 31 can be injected into the outer sleeve through the operating port. Compared with the traditional conveying device, after the volume-reducing stent is conveyed to the position and released, the conveying device of the embodiment can apply pressure to the volume-reducing stent 1 through the expanded expandable balloon 31, so that the anchoring thorn 13 of the volume-reducing stent can smoothly penetrate into the muscle of the wall of the chamber, and the volume-reducing stent 1 can be effectively prevented from shifting or falling off due to the fact that the anchoring thorn 13 is not firmly anchored.
Specifically, the operating handle 4 includes a housing including a release section 41 and a rotation section 42 which are rotatably connected, an inner periphery of the rotation section 42 is provided with an internal thread, a sliding member 43 is provided inside the housing, an outer periphery of the sliding member 43 is provided with an external thread adapted to the inner periphery of the rotation section 42, and screwing the rotation section 42 causes the sliding member 43 to make a reciprocating linear motion along a guide.
The above-mentioned guide member includes the first seat 44 and the second seat 45, the first seat 44 and the second seat 45 are fixed relative to the axial position of the casing of the operating handle 4, and the first seat 44 is connected with the rotating section 42 rotatably, the second seat 45 is connected with the disengaging section 41 non-rotatably; specifically, a limiting groove 451 is disposed on the periphery of the second support 45, a limiting block 411 adapted to the limiting groove is disposed on the inner wall of the disengagement section 41, and the limiting groove 451 cooperates with the limiting block 411 to limit the circumferential position of the second support 45 relative to the disengagement section 41. Two guide rods 46 are connected between the first support 44 and the second support 45, two guide holes 431 are provided in the slider 43, and the two guide rods 46 are slidably inserted into the two guide holes 431, respectively. The sliding member 43 can move in a reciprocating linear motion along the length direction of the guide rod 46 by the rotation section 42.
Specifically, a first hole 432, a second hole 433, and a third hole 434 are sequentially disposed inside the sliding member 43 along a direction away from the disengagement section 41, and the first hole 432, the second hole 433, and the third hole 434 are communicated with each other and are all disposed coaxially with the sliding member 43; one end of the outer sleeve 3 close to the operating handle 4 is fixedly inserted into (e.g., glued) the first hole 432, and one end of the core shaft 2 close to the operating handle 4 extends out of the second hole 433 and the third hole 434 and is fixedly connected (e.g., glued) with the first support 44; a first operating channel 435 communicating with the second aperture 433 and a second operating channel 436 communicating with the first aperture 432 are also provided on the slider 43, and the second operating channel 436 is aligned with the operating port on the outer sleeve 3. In this embodiment, a first operation tube 7 and a second operation tube 8 are respectively fixedly connected (e.g., glued) in the first operation channel 435 and the second operation channel 436, the other ends of the first operation tube 7 and the second operation tube 8 extend out of the operation handle 4 after penetrating through the first support 44, and two-way valves are respectively disposed at the ends of the first operation tube 7 and the second operation tube 8 for facilitating operation.
In practice, an operator can rotate the rotating section 42 to reciprocate the sliding member 43, so as to drive the outer sleeve 3 to extend or retract relative to the mandrel 2, so that the volume-reducing support 1 is unfolded into an umbrella shape or stretched into a long strip shape; when the release of the volume-reducing bracket 1 is completed, the releasing section 41 can be rotated, so that the rotating section 42, the sliding member 43, the guide member, the outer sleeve 3 and the mandrel 2 rotate together synchronously, thereby separating the mandrel 2 from the second connecting member 121 and the outer sleeve 3 from the first connecting member 111, so as to facilitate the removal of the mandrel 2 and the outer sleeve 3. Further, during the installation, the air exhaust operation may be performed through the first operation tube 7, and the inflation gas or liquid may be injected into the inflatable bladder 31 through the second operation tube 8.
In addition, a reinforcing tube 21 is sleeved on the outer periphery of a part of the mandrel 2 positioned inside the operating handle 4, one end of the reinforcing tube 21 is fixedly connected with the first support 44, and the other end of the reinforcing tube 21 extends into the outer sleeve 3 so as to protect the mandrel 2. And a sealing member is provided in the third bore body 434 such that a sealed space is formed inside the second bore body 433 to facilitate an exhaust operation through the first operating pipe 7.
The sealing member specifically comprises a sealing gasket 47 and a set screw 48 which are sleeved on the outer periphery of the reinforcing tube 21, the set screw 48 is in threaded connection with the inner periphery of the third hole body 434, the sealing gasket 47 is tightly abutted on the bottom wall of the third hole body 434, and the inner periphery of the sealing gasket 47 is tightly abutted on the outer periphery of the reinforcing tube 21, so that the sealing gasket 47 and the second hole body 433 as well as the sealing gasket 47 and the reinforcing tube 21 are sealed, and blood is prevented from leaking and entering the inside of the operating handle. In practice, instead of the set screw 48, other parts can be used, such as a fastener around the periphery of the reinforcing tube, which is glued to the third body, so that the gasket abuts tightly against the bottom wall of the third body.
Furthermore, a locker 49 is arranged at one end of the releasing section 41 far away from the rotating section 42, the locker 49 comprises a locking sleeve sleeved on the periphery of the outer sleeve 3, a locking hole is arranged on the locking sleeve along the radial direction of the locking sleeve, and a locking screw is connected with the locking hole in an internal thread manner; a passage for the loader 6 to pass through is formed between the inner periphery of the locking sleeve and the outer periphery of the outer sleeve 3, the loader 6 gradually approaches the operating handle 4 along with the gradual approach of the volume-reducing support 1 to the target position, one end of the loader 6 close to the operating handle 4 is positioned between the inner periphery of the locking sleeve and the outer periphery of the outer sleeve 3 after the volume-reducing support 1 reaches the target position, and at the moment, the position of the loader 6 relative to the operating handle 4 can be limited by tightening a locking screw so as to prevent the loader 6 from influencing the action of the outer sleeve and the mandrel.
Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; these modifications and substitutions do not cause the essence of the corresponding technical solution to depart from the scope of the technical solution of the embodiments of the present invention, and are intended to be covered by the claims and the specification of the present invention.
Claims (10)
1. A ventricular volume reduction device comprises a volume reduction support, the volume reduction support can be switched to a release state from a stretching state under the action of external force, the volume reduction support comprises a first support and a second support which are coaxially arranged, when the volume reduction support is located in the stretching state of the volume reduction support, the first support and the second support are mutually far away to form a long strip shape, and when the volume reduction support is located in the release state of the volume reduction support, the first support and the second support are mutually close to form an umbrella shape, and the ventricular volume reduction device is characterized in that:
the first support comprises a first connecting piece and a plurality of first supporting ribs which are uniformly distributed around the circumference of the first connecting piece, and the first ends of the first supporting ribs are connected with the first connecting piece;
the second support comprises a second connecting piece and a plurality of second supporting ribs which are uniformly distributed around the circumference of the second connecting piece, and the first ends of the second supporting ribs are connected with the second connecting piece;
the second end of the first support rib and the second end of the second support rib are connected with each other, and an anchor thorn is arranged at the connection part of the first support rib and the second support rib in an outward extending mode;
the part of the first support rib close to the first connecting piece and the part of the second support rib close to the second connecting piece are in a sine shape;
at least one surface of the first support and the second support is covered with a flow-blocking film.
2. A ventricular volume reduction device as claimed in claim 1, wherein:
the inner peripheries of the first connecting piece and the second connecting piece are both provided with internal threads.
3. A ventricular volume reduction device as claimed in claim 1, wherein:
one side of the first connecting piece, which is close to the second connecting piece, is provided with a plurality of hooks along the axis direction of the first connecting piece, one side of the second connecting piece, which is close to the first connecting piece, is provided with an annular hanging rod matched with the hooks, and the hanging rod is connected with the second connecting piece through a plurality of supporting rods.
4. A ventricular volume reduction device as claimed in claim 1, wherein:
the conveying device is used for conveying the volume reduction support;
the conveying device comprises a mandrel, an outer sleeve and an operating handle, wherein one ends of the mandrel and the outer sleeve, which are far away from the operating handle, are respectively used for being connected with the second connecting piece and the first connecting piece;
the outer sleeve is provided with a cavity communicated with the inside of the inflatable bag body, the cavity is not communicated with the shaft hole, and the outer sleeve is provided with an operation port communicated with the cavity.
5. A ventricular volume reduction device as claimed in claim 4, wherein:
the operating handle comprises a shell, and the shell comprises a release section and a rotating section which are rotatably connected;
the sliding part is arranged in the shell, a guide hole is formed in the sliding part in a penetrating mode, a guide part penetrates through the guide hole, the guide part is fixed relative to the circumferential position of the sliding part, and the sliding part can do linear reciprocating motion along the length direction of the guide part under the action of external force;
the sliding part is fixedly connected with one end, close to the operating handle, of the outer sleeve, the mandrel is fixedly connected with one end, close to the operating handle, of the guide part, and the disengagement section is connected with the guide part in a non-rotatable mode.
6. A ventricular volume reduction device as claimed in claim 5, wherein:
the periphery of slider is provided with the external screw thread, the internal periphery of rotatory section be provided with the internal thread of external screw thread adaptation.
7. A ventricular volume reduction device as claimed in claim 5, wherein:
a first hole body, a second hole body and a third hole body are sequentially arranged in the sliding part along the direction far away from the disengagement section, and the first hole body, the second hole body and the third hole body are mutually communicated and are coaxially arranged with the sliding part;
the outer sleeve is fixedly arranged in the first hole body in a penetrating mode, the mandrel is arranged in the second hole body and the third hole body in a penetrating mode, and a sealing piece is arranged in the third hole body, so that a sealing space is formed inside the second hole body;
and a first operation channel communicated with the second hole body and a second operation channel communicated with the first hole body are further arranged on the sliding piece, and the second operation channel is aligned with the operation port, so that the second operation channel is communicated with the cavity through the operation port.
8. A ventricular volume reduction device as claimed in claim 7, wherein:
the sealing member is established including the cover sealed pad and holding screw in dabber periphery, this holding screw threaded connection be in the internal periphery of the third hole body, sealed the inseparable butt of pad is in on the diapire of the third hole body, just sealed the internal periphery of pad with the sealed butt in periphery of dabber.
9. A ventricular volume reduction device as claimed in claim 7, wherein:
the guide piece comprises a first support, a second support and a guide rod connected between the first support and the second support, and the guide rod is arranged in the guide hole in a penetrating manner; the first support is rotationally connected with the rotating section, the second support is non-rotationally connected with the releasing section, and the axial positions of the first support and the second support relative to the shell are fixed;
one end of the mandrel, which is close to the operating handle, is fixedly connected with the first support.
10. A ventricular volume reduction device as claimed in claim 9, wherein:
and a first operating pipe and a second operating pipe are fixedly connected in the first operating channel and the second operating channel respectively, and the other ends of the first operating pipe and the second operating pipe penetrate through the first support and then extend out of the operating handle.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011050052.1A CN112155813B (en) | 2020-09-29 | 2020-09-29 | Ventricular volume-reducing device |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011050052.1A CN112155813B (en) | 2020-09-29 | 2020-09-29 | Ventricular volume-reducing device |
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| CN112155813B CN112155813B (en) | 2024-04-23 |
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| CN112155813B (en) | 2024-04-23 |
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