CN113081385A - Aortic arch part is provided with side port and is embedded with anastomotic line artificial blood vessel - Google Patents
Aortic arch part is provided with side port and is embedded with anastomotic line artificial blood vessel Download PDFInfo
- Publication number
- CN113081385A CN113081385A CN202110488454.8A CN202110488454A CN113081385A CN 113081385 A CN113081385 A CN 113081385A CN 202110488454 A CN202110488454 A CN 202110488454A CN 113081385 A CN113081385 A CN 113081385A
- Authority
- CN
- China
- Prior art keywords
- blood vessel
- artificial blood
- artificial
- aortic arch
- branch pipe
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
- 210000004204 blood vessel Anatomy 0.000 title claims abstract description 173
- 239000002473 artificial blood Substances 0.000 title claims abstract description 138
- 210000002376 aorta thoracic Anatomy 0.000 title claims abstract description 73
- 230000036770 blood supply Effects 0.000 claims abstract description 109
- 210000002168 brachiocephalic trunk Anatomy 0.000 claims abstract description 78
- 210000001168 carotid artery common Anatomy 0.000 claims abstract description 70
- 210000003270 subclavian artery Anatomy 0.000 claims abstract description 22
- 230000000149 penetrating effect Effects 0.000 claims abstract description 11
- 239000008280 blood Substances 0.000 claims description 38
- 210000004369 blood Anatomy 0.000 claims description 38
- 238000007789 sealing Methods 0.000 claims description 17
- 230000003872 anastomosis Effects 0.000 claims description 15
- 238000009958 sewing Methods 0.000 claims description 15
- 238000000034 method Methods 0.000 claims description 8
- 230000003044 adaptive effect Effects 0.000 claims description 6
- 238000005336 cracking Methods 0.000 claims 1
- 230000007954 hypoxia Effects 0.000 abstract description 7
- 208000002381 Brain Hypoxia Diseases 0.000 abstract description 6
- 201000006474 Brain Ischemia Diseases 0.000 abstract description 5
- 206010008120 Cerebral ischaemia Diseases 0.000 abstract description 5
- 206010008118 cerebral infarction Diseases 0.000 abstract description 5
- 210000001367 artery Anatomy 0.000 description 19
- 206010002329 Aneurysm Diseases 0.000 description 14
- 230000004087 circulation Effects 0.000 description 10
- 230000000694 effects Effects 0.000 description 10
- 230000002490 cerebral effect Effects 0.000 description 6
- 230000002792 vascular Effects 0.000 description 6
- 206010021143 Hypoxia Diseases 0.000 description 5
- 210000000709 aorta Anatomy 0.000 description 5
- 208000028867 ischemia Diseases 0.000 description 5
- 230000003014 reinforcing effect Effects 0.000 description 5
- 208000027418 Wounds and injury Diseases 0.000 description 4
- 210000000702 aorta abdominal Anatomy 0.000 description 4
- 230000000740 bleeding effect Effects 0.000 description 4
- 230000006378 damage Effects 0.000 description 4
- 239000000463 material Substances 0.000 description 4
- 241000976983 Anoxia Species 0.000 description 3
- 230000007953 anoxia Effects 0.000 description 3
- 230000008901 benefit Effects 0.000 description 3
- 239000011230 binding agent Substances 0.000 description 3
- 238000005086 pumping Methods 0.000 description 3
- 238000004804 winding Methods 0.000 description 3
- 206010002660 Anoxia Diseases 0.000 description 2
- 201000008982 Thoracic Aortic Aneurysm Diseases 0.000 description 2
- 206010053648 Vascular occlusion Diseases 0.000 description 2
- 208000007474 aortic aneurysm Diseases 0.000 description 2
- 230000004872 arterial blood pressure Effects 0.000 description 2
- 210000004556 brain Anatomy 0.000 description 2
- 210000005013 brain tissue Anatomy 0.000 description 2
- 238000006073 displacement reaction Methods 0.000 description 2
- 208000003457 familial thoracic 1 aortic aneurysm Diseases 0.000 description 2
- 239000007789 gas Substances 0.000 description 2
- 230000002439 hemostatic effect Effects 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 238000009434 installation Methods 0.000 description 2
- 230000003902 lesion Effects 0.000 description 2
- 210000001364 upper extremity Anatomy 0.000 description 2
- 208000021331 vascular occlusion disease Diseases 0.000 description 2
- 241000251468 Actinopterygii Species 0.000 description 1
- 206010013554 Diverticulum Diseases 0.000 description 1
- 208000010496 Heart Arrest Diseases 0.000 description 1
- 208000034693 Laceration Diseases 0.000 description 1
- 206010028851 Necrosis Diseases 0.000 description 1
- 206010028980 Neoplasm Diseases 0.000 description 1
- 208000006011 Stroke Diseases 0.000 description 1
- 241000692569 Stylephorus chordatus Species 0.000 description 1
- 208000007536 Thrombosis Diseases 0.000 description 1
- 208000006288 Vascular Tissue Neoplasms Diseases 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- 101150097977 arch-1 gene Proteins 0.000 description 1
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 208000029185 blood vessel neoplasm Diseases 0.000 description 1
- 230000036760 body temperature Effects 0.000 description 1
- 210000004958 brain cell Anatomy 0.000 description 1
- 230000005978 brain dysfunction Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 208000035475 disorder Diseases 0.000 description 1
- 238000002224 dissection Methods 0.000 description 1
- 201000011066 hemangioma Diseases 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 210000000936 intestine Anatomy 0.000 description 1
- 230000000302 ischemic effect Effects 0.000 description 1
- 238000010030 laminating Methods 0.000 description 1
- 239000012567 medical material Substances 0.000 description 1
- 230000017074 necrotic cell death Effects 0.000 description 1
- 239000001301 oxygen Substances 0.000 description 1
- 229910052760 oxygen Inorganic materials 0.000 description 1
- 238000006213 oxygenation reaction Methods 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 238000004904 shortening Methods 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 208000024891 symptom Diseases 0.000 description 1
- 210000000115 thoracic cavity Anatomy 0.000 description 1
- 230000009092 tissue dysfunction Effects 0.000 description 1
- 201000011531 vascular cancer Diseases 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
Images
Classifications
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0491—Sewing machines for surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00778—Operations on blood vessels
Abstract
The invention relates to an artificial blood vessel with a side port arranged at an aortic arch part and an embedded anastomotic line. The aortic arch artificial blood vessel branch pipe comprises an aortic arch artificial main pipe and a branch pipe group arranged on the outer side wall of the aortic arch artificial main pipe, wherein the branch pipe group comprises a head-arm trunk artificial blood vessel branch pipe, a common carotid artery artificial blood vessel branch pipe and a subclavian artery artificial blood vessel branch pipe. A side opening is arranged on the artificial main tube of the aortic arch in a penetrating way, a plurality of suture lines are embedded in the side opening, and the side opening can be closed by tightening the suture lines. In the aortic arch artificial blood vessel replacement operation, when the innominate artery and the common carotid artery of the brachiocephalic trunk are anastomosed, the blood supply catheter can be placed into the innominate artery and the common carotid artery of the brachiocephalic trunk through the side port arranged on the aortic arch artificial main tube, so that the blood supply of the head and the neck can be kept sufficient, and various complications caused by cerebral ischemia and hypoxia are avoided; after the blood supply catheter is pulled out, the suture can be quickly tightened, the side opening is closed, the operation time is shortened, and the operation safety is ensured.
Description
Technical Field
The invention relates to an aortic arch artificial blood vessel, in particular to an aortic arch part artificial blood vessel with a side port and an embedded anastomotic line.
Background
Artificial blood vessel replacement is one of the methods for radically treating aortic hemangioma, and in thoracic aortic aneurysm close to heart, the blood vessel bifurcations are more, the operation is more complicated, and the operation time is extremely long. Currently, for thoracic aortic aneurysm surgery near the heart, cardiac arrest is employed and blood circulation support is provided to the operator in coordination with extracorporeal circulation. The operation time is 8-12 hours, the low-temperature heartbeat stops the extracorporeal circulation for 5-8 hours, and a plurality of risks are brought to the patient.
When the distal ends of the aortic arch vessels are anastomosed, the placing tubes can be used for supplying blood for the upper limbs and the head and neck. When the innominate artery of the head and arm trunk of the aortic arch part blood vessel and the common carotid artery are anastomosed, the blood supply of the upper limb and the head and neck part is seriously insufficient in the anastomosis process. Because the brain has very poor ability to tolerate ischemia and hypoxia, various surgical complications are easily caused by ischemic necrosis of brain cells at different positions. Among them, stroke is the main symptom, and is accompanied by various brain dysfunctions, and the operation risk is huge.
To reduce the surgical risk, currently common solutions include: accelerating the anastomosis speed, shortening the operation time, reducing the operation body temperature, prolonging the time of cerebral tolerance ischemia and anoxia, and performing the treatment in a hyperbaric oxygen chamber after the operation so as to recover adverse sequelae of the operation as much as possible.
In conclusion, there is an urgent clinical need for an operation method or consumable material which can maintain sufficient blood supply to the head and neck when the innominate artery of the head and arm trunk and the common carotid artery of the aortic arch artificial blood vessel replacement are anastomosed, avoid various complications caused by cerebral ischemia and hypoxia, and ensure the safety of the operation.
Disclosure of Invention
The invention aims to overcome the defects in the prior art, and provides an aortic arch part provided with a side port and an embedded anastomotic line artificial blood vessel, which can keep blood supply for head and neck when the innominate artery and the common carotid artery of the aortic arch part artificial blood vessel replacement are anastomosed, avoid various complications caused by cerebral ischemia and anoxia, improve the efficiency of the operation and ensure the safety of the operation.
According to the technical scheme provided by the invention, the aortic arch part is provided with a side opening and an anastomotic line artificial blood vessel is pre-embedded, the aortic arch part comprises an arc-shaped aortic arch artificial main pipe and an artificial blood vessel branch pipe group arranged on the aortic arch artificial main pipe, the artificial blood vessel branch pipe group comprises a head-arm trunk innominate artery artificial blood vessel branch pipe, a common carotid artery artificial blood vessel branch pipe and a subclavian artery artificial blood vessel branch pipe, the head-arm trunk innominate artery artificial blood vessel branch pipe, the common carotid artery artificial blood vessel branch pipe and the subclavian artery artificial blood vessel branch pipe are positioned on the arc-shaped outer side wall of the aortic arch artificial main pipe, and the head-arm trunk innominate artery artificial blood vessel branch pipe, the common carotid artery artificial blood vessel branch pipe and the subclavian artery artificial blood vessel branch pipe are communicated.
The artificial main pipe of the arc-shaped aortic arch penetrates through the side wall below the artificial blood vessel branch pipe group to be provided with 1-2 side openings, a plurality of closing sutures are loosely embedded at each side opening, and the side openings can be sealed and closed by tightening the plurality of closing sutures.
The side opening comprises a linear crack, a sewing skirt edge part is arranged on the outer side of the side opening, the perimeter of the sewing skirt edge part is matched with the side opening, and the width of the sewing skirt edge part is larger than 5 mm.
Two supporting blood supply catheters are embedded in the aortic arch artificial main tube, one end of each supporting blood supply catheter forms a blood inlet tube end at the outlet side of the gap of the closed suture line, and the other end of each supporting blood supply catheter respectively forms a brachiocephalic trunk innominate artificial blood vessel branch tube and a common carotid artery artificial blood vessel branch tube to form a brachiocephalic trunk blood supply tube end and a common carotid blood supply tube end.
The closing suture line is one, one end part of the closing suture line is knotted at one side edge of the side opening to form a fixed line point, the other side of the closing suture line repeatedly penetrates through the side walls at two sides of the side opening in an S-shaped mode, a free line tail is formed after the other side edge of the side opening penetrates out of the side walls, and the distance between every two adjacent groups of penetrating holes is smaller than 3 mm.
The closing suture line is one, one end part of the closing suture line is knotted at one side edge of the side opening to form a fixed line point, the other side of the closing suture line spirally and alternately penetrates through the side walls at two sides of the side opening, a free line tail is formed after the other side edge of the side opening is exposed out of the side walls, and the distance between every two adjacent groups of penetrating holes is smaller than 3 mm.
An arc opening rod is arranged between every two adjacent arc rings of the S-shaped closed suture line body or the spiral line body, the arc opening rod comprises an elastic rod in the middle and clamping wire rings arranged at the end parts of the two ends of the elastic rod, and the clamping wire rings cut off the ring body on one side away from the arc opening rod to form an outlet crack. Every two adjacent arc wire rings are respectively clamped in the wire clamping rings at two ends of an arc wire opening rod.
The blood vessel closing device is respectively sleeved on the outer walls of the unknown arterial artificial blood vessel branch pipe of the head-arm trunk and the artificial blood vessel branch pipe of the common carotid artery, and the unknown arterial artificial blood vessel branch pipe of the head-arm trunk and the artificial blood vessel branch pipe of the common carotid artery can be respectively bound and fixed with the blood supply supporting catheter arranged in the cavity of the unknown arterial artificial blood vessel branch pipe of the head-arm trunk and the artificial blood vessel branch pipe of the common carotid artery through the.
The blood vessel ligation device comprises a double-cavity ligation sleeve and a ligation line with a main body embedded in the ligation sleeve. The end parts of the two ends of the tying line penetrating through the tying sleeve are provided with traction handles, and the middle section of the tying line is led out of the tying sleeve to form a tying ring. The diameter of the pulling handle is larger than the inner diameter of the ligation sleeve. The outer sleeve of the binding sleeve is provided with a locking sheet, the locking sheet is internally provided with a locking line hole, and the locking line hole comprises a loosening hole with the aperture larger than that of the binding sleeve and a crack-shaped clamping crack hole with the gap smaller than that of the binding sleeve.
Be equipped with linking mechanism between a plurality of pitch arc struts pole, linking mechanism is including establishing linking dop and the linking draw-in groove in pitch arc struts the relative both sides of pole. The connecting clamping head can be clamped in the connecting clamping groove in an adaptive mode.
The supporting blood supply catheter is communicated with a blood inlet port at a blood inlet end, and a plurality of puncture grooves are respectively annularly arranged on the outer walls of the end parts of the head and arm stem blood supply pipe end and the neck main blood supply pipe end.
The invention has the advantages that: through the arrangement of the supporting blood supply catheter in the side port, blood can be supplied to the double tubes of the head and the neck when the innominate artery and the common carotid artery branch of the head and the arm trunk are anastomosed, and various complications caused by cerebral tissue ischemia and hypoxia are avoided. The side opening can be quickly closed when the operation is finished through the closing suture lines pre-embedded in the side opening, so that the bleeding of the operation is reduced, and the operation time is greatly shortened. Through the setting of pitch arc opening rod, can tighten up each pitch arc ring in order, effectively close the side mouth fast, simultaneously, avoid each pitch arc ring winding to tie a knot. Through the setting of blood vessel ligation device, can avoid supporting the blood supply pipe and drop, simultaneously, when coincide first arm trunk innominate artery and common carotid artery, can prick first arm trunk innominate artery and common carotid artery fast and close at supporting the blood supply pipe outer wall, create sealed environment for neck blood supply. At the end of anastomosis, the brachiocephalic trunk innominate artery and common carotid artery can be quickly loosened.
Drawings
FIG. 1 is a schematic view of an embodiment of the present invention and a partial enlargement;
FIG. 1-A is an enlarged view of a portion of FIG. 1 at I;
FIG. 2 is a schematic view of the buried support donor catheter of the present invention;
FIG. 3 is a schematic view of one embodiment of a side port pre-closing suture of the present invention;
FIG. 4 is a schematic view of another embodiment of a side port pre-closing suture of the present invention;
FIG. 5 is a schematic view of an arc opening bar of the present invention;
FIG. 6 is a schematic view of the present invention showing a vascular occlusion device disposed outside the brachiocephalic trunk innominate arterial artificial vascular branch and the common carotid artery artificial vascular branch;
FIG. 7 is a schematic view of a vascular occlusion device of the present invention;
description of reference numerals: 1. an aortic arch artificial supervisor; 2. a branch pipe of the artificial artery of the brachiocephalic trunk and the innominate artery; 3. a common carotid artery artificial blood vessel branch; 4. subclavian artery artificial vessel branch; 5. a side port; 5-1, sewing the edge part of the skirt; 5-2, through holes; 6. closing the suture; 6-1, fixing a line point; 6-2, free line tail; 6-3, an arc wire ring; 7-supporting a blood supply catheter, 7-1 and a blood inlet tube end; 7-2, a head and arm trunk blood supply pipe end; 7-3, neck main blood supply tube end; 7-4, a blood inlet interface; 7-5, closing the groove; 8-arc opening rod, 8-1, elastic rod; 8-2, clamping a wire ring; 8-3, a line-out crack; 8-4, a connecting mechanism; 8-5, connecting the clamping head; 8-6, connecting the clamping grooves; 9-a vessel closing device; 9-1, closing the sleeve; 9-2, tying a closing wire; 9-3, a pulling handle; 9-4, binding a ring; 9-5, a locking sheet; 9-6, a lockwire hole; 9-7, loosening holes; 9-8, clamping the split holes.
Detailed Description
The invention is further illustrated by the following specific figures and examples.
To the aneurysm patient of aortic arch portion, the tumor body is the intermediate layer aneurysm, forms the breach after the inner wall damage of aortic arch portion in essence, and under stronger arterial pressure, arterial blood struts the artery outer wall of originally tightly laminating in the artery inner wall outside through the breach to latent clearance between the each layer vascular wall of original artery can become a blood vessel tumor chamber that the essence exists. If the treatment is not carried out in time, the lumen of the dissected aneurysm is larger and larger under the pushing of arterial pressure, and finally the dissected aneurysm is difficult to avoid rupture, once the dissection is ruptured, a patient dies directly in minutes and the like, and the rescue opportunity is basically not available.
If aneurysm when in other comparatively simple structures's blood vessels, can adopt arterial stent to put into the blood vessel inner wall intracavity that corresponds the position at aneurysm, utilize arterial stent can block brokenly mouthful isolated with the aneurysm chamber to make aneurysm chamber blood and arterial blood isolated, aneurysm intracavity blood loses the activity, solidifies gradually, finally the machine.
However, the aneurysm located in the aortic arch is due to three important arterial branches above the aortic arch: the innominate artery, common carotid artery and subclavian artery of the brachiocephalic trunk can supply blood for the head and neck through the innominate artery and the common carotid artery of the brachiocephalic trunk. If the treatment is carried out by using the arterial stent implantation method, openings corresponding to the innominate artery and the common carotid artery of the head and arm trunk can be blocked, so that serious complications can be caused; furthermore, the aneurysm at this site often involves branches of the innominate artery of the head and arm trunk, the common carotid artery and the subclavian artery, and the aneurysm cavity communicating the involved branch arteries also needs to be treated. In this case, aortic arch artificial blood vessel replacement becomes the only treatment for this patient.
The replacement of the aortic arch artificial blood vessel needs to be completed under the support of extracorporeal circulation, and during the operation, the heartbeat needs to be stopped, and the aorta needs to be clamped and closed at the normal blood vessel at the far end of the aneurysm behind the heart. After the clamped aorta is internally provided with a tube, blood vessels affected by aneurysm are cut open, blood is sucked into an extracorporeal circulation machine for oxygenation after flowing out through a laceration, and the blood is pumped into the aorta through the tube. In order to avoid serious insufficiency of blood supply to the innominate artery, the common carotid artery and the subclavian artery of the brachiocephalic trunk and complications caused by cerebral ischemia and hypoxia, the aorta indwelling tube is often provided with three branch catheters for supplying blood to the innominate artery, the common carotid artery and the subclavian artery of the brachiocephalic trunk respectively. However, when the innominate artery, the common carotid artery and the subclavian artery of the brachiocephalic trunk are anastomosed, the corresponding internal catheter needs to be pulled out, at the moment, the blood supply of the artery in the anastomosis is completely stopped, the cerebral blood supply of the branch blood supply area of the artery is greatly reduced, and various complications are easily caused by cerebral ischemia and hypoxia.
In order to solve the above problem, as shown in fig. 1: the aortic arch part is provided with a side opening and embedded anastomotic line artificial blood vessel, and comprises an arc-shaped aortic arch artificial main pipe 1 and an artificial blood vessel branch pipe group arranged on the aortic arch artificial main pipe 1. The artificial blood vessel branch pipe group comprises a brachiocephalic trunk innominate artery artificial blood vessel branch pipe 2, a common carotid artery artificial blood vessel branch pipe 3 and a subclavian artery artificial blood vessel branch pipe 4. The brachiocephalic trunk innominate artery artificial blood vessel branch pipe 2, the common carotid artery artificial blood vessel branch pipe 3 and the subclavian artery artificial blood vessel branch pipe 4 are located on the arc-shaped outer side wall of the aortic arch artificial main pipe 1, and the brachiocephalic trunk innominate artery artificial blood vessel branch pipe 2, the common carotid artery artificial blood vessel branch pipe 3 and the subclavian artery artificial blood vessel branch pipe 4 are communicated with the aortic arch artificial main pipe 1.
The arc-shaped aortic arch artificial main pipe 1 is provided with 1-2 side openings 5 penetrating through the side wall below the artificial blood vessel branch pipe group, a plurality of closing suture lines 6 are embedded at each side opening 5 in a loose mode, and the side openings 5 can be closed in a sealing mode by tightening the closing suture lines 6.
Specifically, the aortic arch artificial main pipe 1 is arc-shaped, and the brachiocephalic trunk innominate artery artificial blood vessel branch pipe 2, the common carotid artery artificial blood vessel branch pipe 3 and the subclavian artery artificial blood vessel branch pipe 4 are arranged on the arc-shaped outer side wall of the aortic arch artificial main pipe 1. The specific shape of the aortic arch artificial main tube 1 and the specific matching of the brachiocephalic trunk innominate arterial artificial blood vessel branch tube 2, the common carotid artery artificial blood vessel branch tube 3 and the subclavian artery artificial blood vessel branch tube 4 are consistent with the prior art, are known to those skilled in the art, and are not described herein again. The specific materials of the aortic arch artificial main tube 1, the brachiocephalic trunk innominate artery artificial blood vessel branch tube 2, the common carotid artery artificial blood vessel branch tube 3 and the subclavian artery artificial blood vessel branch tube 4 can all adopt the existing commonly used medical materials, are specifically known to those skilled in the art, and are not described herein again.
The unknown arteries and common carotid arteries of the brachiocephalic trunk are important blood supply vessels for brain tissues, and lack of any blood supply vessel of the unknown arteries and the common carotid arteries can cause cerebral blood supply insufficiency of the brain, brain tissue dysfunction and serious complications.
In the embodiment of the invention, after the diseased aortic arch part blood vessel is cut off in the operation, the two ends of the arc-shaped aortic arch artificial main pipe 1, the brachiocephalic trunk innominate artery artificial blood vessel branch pipe 2, the common carotid artery artificial blood vessel branch pipe 3 and the subclavian artery artificial blood vessel branch pipe 4 are cut in an adaptive way according to the size of the diseased region, so that the artificial blood vessel with proper length is reserved and can be matched with the normal blood vessel in an anastomotic way. The arc end of the arc-shaped aortic arch artificial main pipe 1 is matched with the aortic incision at the root part of the aorta, the brachiocephalic trunk innominate arterial artificial blood vessel branch pipe 2 is matched with the aortic incision, the common carotid arterial artificial blood vessel branch pipe 3 is matched with the common carotid vascular incision, the subclavian arterial artificial blood vessel branch pipe 4 is matched with the subclavian arterial blood vessel incision, and the other end of the aortic arch artificial main pipe 1 is matched with the thoracic aortic incision (the lesion range is short, the abdominal aorta is not affected) or matched with the abdominal aorta incision (the lesion range is long, the abdominal aorta is affected).
During anastomosis, two adaptive support blood supply catheters 7 are selected, the aortic arch artificial main tube 1 is placed in the cavity of the aortic arch artificial main tube 1 through a side port 5 formed in the side wall of the aortic arch artificial main tube 1, one support blood supply catheter 7 penetrates out of the brachiocephalic trunk innominate artery artificial blood vessel branch tube 2, and the other support blood supply catheter 7 penetrates out of the common carotid artery artificial blood vessel branch tube 3. A plurality of closing sutures 6 are loosely embedded at the side openings 5, and a supporting blood supply catheter 7 can pass through the gaps of the closing sutures 6. Thus, the main bodies of the two supporting blood supply catheters 7 are kept in the cavity of the aortic arch artificial main tube 1, one end of each supporting blood supply catheter penetrates out of the side port 5, and the other end of each supporting blood supply catheter penetrates out of the brachiocephalic trunk innominate artery artificial blood vessel branch tube 2 and the common carotid artery artificial blood vessel branch tube 3 respectively. When in anastomosis, one end of the two supporting blood supply catheters 7 which penetrate out of the side port 5 is hermetically connected with an extracorporeal circulation pump blood pipeline; the other end of the support blood supply catheter 7 which penetrates out of the common carotid artery artificial blood vessel branch pipe 3 is placed into the common carotid artery blood vessel cavity, and the common carotid artery blood vessel wall is sleeved and tied outside the support blood supply catheter 7 for sealing and binding, so that oxygenated blood of extracorporeal circulation can supply blood for the common carotid artery blood vessel through the support blood supply catheter 7. Similarly, the other end of the supporting blood supply catheter 7 which penetrates out of the artificial blood vessel branch pipe 2 of the brachiocephalic trunk innominate artery is placed into the blood vessel cavity of the brachiocephalic trunk innominate artery, and the wall of the brachiocephalic trunk innominate artery is sleeved and tied outside the supporting blood supply catheter 7 to be sealed and tied, so that oxygenated blood of extracorporeal circulation can supply blood for the blood vessel of the brachiocephalic trunk innominate artery through the supporting blood supply catheter 7. The two supporting blood supply catheters 7 can simultaneously supply blood for common carotid artery blood vessels and unknown brachiocephalic artery blood vessels by double pipelines, ensure cerebral blood supply and avoid cerebral anoxia complications caused by insufficient blood supply. When in anastomosis, the supporting blood supply catheter 7 does not influence the anastomosis of the vessel incision, but can play a role in supporting the wall of the common carotid artery and the wall of the unknown arterial vessel of the brachiocephalic trunk, so that the incisions of the common carotid artery and the unknown arterial vessel of the brachiocephalic trunk are opened and are in a full state, and the correct alignment is convenient during the suturing.
When the end of the arc-shaped aortic arch artificial main pipe 1 and the aortic root arteriotomy, the brachiocephalic trunk innominate artery artificial blood vessel branch pipe 2 and the aortic incision, the common carotid artery artificial blood vessel branch pipe 3 and the common carotid artery vascular incision, the subclavian artery artificial blood vessel branch pipe 4 and the subclavian artery blood vessel incision and the other end of the aortic arch artificial main pipe 1 are anastomosed with the thoracic aorta or the abdominal aorta incision, the gas in the artificial blood vessel cavity can be discharged, two supporting blood supply catheters 7 are drawn out, a plurality of closing sutures 6 are tightened, and the side ports 5 are sealed and closed, so that the anastomosis of the artificial blood vessels is completed.
It is worth noting that when one side port 5 is arranged on the aortic arch artificial main tube 1 penetrating through the side wall, two supporting blood supply catheters 7 penetrate through the same side port 5; when the number of the side openings 5 arranged by the aortic arch artificial main pipe 1 penetrating through the side wall is two, the two supporting blood supply catheters 7 respectively penetrate through one side opening 5 and respectively penetrate out of the brachiocephalic trunk innominate artery artificial blood vessel branch pipe 2 and the common carotid artery artificial blood vessel branch pipe 3. The side openings 5 of the aortic arch artificial main tube 1 arranged through the side wall are one or two and have no essential difference: if one side opening 5 is arranged, the length of the side opening is longer, the removal of the two supporting blood supply catheters 7 must be completed simultaneously, and the operation of closing the side opening 5 can be completed once. If two side openings 5 are provided, the length of the side opening 5 is shorter, the removal of the two supporting blood supply catheters 7 can be completed in two steps, but the operation of closing the side opening 5 also needs to be completed in two times respectively.
As shown in figure 1, the side opening 5 comprises a linear slit, a sewing skirt part 5-1 is arranged outside the side opening 5, the circumference of the sewing skirt part 5-1 is matched with that of the side opening 5, and the width of the sewing skirt part 5-1 is more than 5 mm. The purpose that side mouth 5 set up the linear crack is after supporting blood supply pipe 7 and pulling out, can the at utmost in the artifical main pipe of aortic arch 1 lateral wall formation comparatively smooth inner chamber lateral wall, be convenient for on the one hand close the suture to side mouth 5, on the other hand avoids forming diverticulum at the artifical main pipe of artificial blood vessel 1 inner wall, avoids blood to form the vortex at side mouth 5 position, avoids leading to from this to form the thrombus at side mouth 5 position inner wall. When supporting blood supply pipe 7 and pulling out the back, need tighten up pre-buried closing suture 6, when tightening up closing suture 6, can preferably press from both sides closed side mouth 5, when avoiding tightening up closing suture 6, blood gushes out from side mouth 5 in a large number, has both influenced the field of vision and has been unfavorable for tightening up the operation of closing suture 6, also causes a large amount of bloodings to be unfavorable to the patient. In order to facilitate clamping and closing the side opening 5, a sewing skirt part 5-1 with matched circumference is arranged outside the side opening 5, and the width is larger than 5mm, so that after the supporting blood supply catheter 7 is pulled out, the side opening 5 is clamped and closed by the hemostatic forceps on the sewing skirt part 5-1 in time, and when the suture line 6 is tightened and closed, blood loss is avoided, the safety is improved, the visual field is clear, and the operation is convenient. When the closing suture 6 is tightened, the side opening 5 is closed, the hemostatic forceps can be loosened, and the redundant sewing skirt part 5-1 can be cut off when necessary.
As shown in figure 2, two supporting blood supply catheters 7 are embedded in an aortic arch artificial main tube 1, one ends of the two supporting blood supply catheters 7 form a blood inlet tube end 7-1 at a gap side outlet 5 of a closing suture 6, and the other ends of the two supporting blood supply catheters respectively extend out of a brachiocephalic trunk innominate artificial blood vessel branch tube 2 and a common carotid artery artificial blood vessel branch tube 3 to form a brachiocephalic trunk blood supply tube end 7-2 and a common carotid blood supply tube end 7-3. Two schemes are provided for embedding two supporting blood supply catheters 7: one proposal is that only one side port 5 is provided, and two supporting blood supply catheters 7 are penetrated from the same side port 5; alternatively, the side ports 5 are provided in two, and two support donor catheters 7 are threaded through each of the side ports 5. The advantages and disadvantages of the two schemes have been elucidated, and are not described herein. The two supporting blood supply catheters 7 are preset to avoid the operation of temporarily penetrating the supporting blood supply catheters 7 in the operation, reduce the operation time and ensure that the positions of the supporting blood supply catheters 7 are more standardized.
During specific implementation, the length of the head-arm trunk blood supply pipe end 7-2 and the neck main blood supply pipe end 7-3 formed by the support blood supply catheter 7 at the end part close to one side of the head-arm trunk innominate arterial artificial blood vessel branch pipe 2 and the neck main arterial artificial blood vessel branch pipe 3 is shorter, and the length is generally set to be 30-50 mm optimal, when the head-arm trunk innominate arterial blood vessel and the neck main arterial blood vessel are anastomosed, the support blood supply catheter 7 with the length can be conveniently placed into the head-arm trunk innominate arterial blood vessel and the neck main arterial blood vessel, and the situation that the head-arm trunk innominate arterial artificial blood vessel branch pipe 2 and the neck main arterial artificial blood vessel branch pipe 3 are too deeply placed due to overlong length can be avoided, and unpredictable damage and complications of the. Meanwhile, after the head-arm trunk blood-supply tube end 7-2 and the neck main blood-supply tube end 7-3 with the length are placed in the head-arm trunk innominate artery blood vessel and the neck main artery blood vessel, the sealing and binding of the head-arm trunk blood-supply tube end 7-2 and the neck main blood-supply tube end 7-3 can be performed on the outer walls of the head-arm trunk innominate artery blood vessel and the neck main artery blood vessel.
Further, the supporting blood supply catheter 7 is communicated with a blood inlet port 7-4 at the blood inlet tube end 7-1, the blood inlet tube end 7-1 is conveniently connected to a blood pumping pipeline of extracorporeal circulation through the arrangement of the blood inlet port 7-4, of course, a plurality of ports are arranged in the blood pumping pipeline of extracorporeal circulation, and the blood inlet port 7-4 needs to be matched with the port with the adaptive inner diameter and can be hermetically connected to the port of the blood pumping pipeline of extracorporeal circulation.
Meanwhile, a plurality of tying grooves 7-5 are respectively arranged on the outer walls of the end parts of the head and arm stem blood supply pipe end 7-2 and the neck main blood supply pipe end 7-3 in a surrounding mode. The plurality of tying grooves 7-5 are orderly arranged along the long axes of the outer walls of the head and arm trunk blood supply pipe ends 7-2 and the neck main blood supply pipe ends 7-3. Therefore, when the unknown artery and the common carotid artery of the head and arm trunk are bound at the blood supply pipe end 7-2 and the common carotid artery end 7-3 of the head and arm trunk, the binding wire can fall into the binding groove 7-5, and the stability and the tightness during binding can be enhanced. The width of the opening part of the tying groove 7-5 is 0.5mm-1mm as the best, and the depth is 1mm as the best. Not only can ensure the fixing effect, but also can be implemented on the thinner tube wall of the supporting blood supply catheter 7.
As shown in fig. 3, one of the preset embodiments of the closing suture 6 is a single closing suture 6, one end of which is knotted at one side edge of the side opening 5 to form a fixed line point 6-1, and the other side of which repeatedly and alternately penetrates through the side walls at two sides of the side opening 5 in an S-shaped manner to form a free line tail 6-2 after exiting the side wall at the other side edge of the side opening 5; the distance between every two adjacent groups of through holes 5-2 is less than 3 mm. The method for embedding the closing suture 6 forms a transverse reinforced sealing line outside the side port 5, and by adopting the embedding mode, when the closing suture 6 is tightened, the wire rings are sequentially tightened from a fixed wire point 6-1 to a free wire tail 6-2 direction, so that the closing suture 6 forms an effective closing and sealing effect on the side port 5. During the concrete implementation, close stylolite 6 and preferably select for use thinner vascular stylolite that toughness is stronger, the stitch interval, namely every two sets of through-hole 5-2 (close stylolite 6 and run through the line eye of side mouth 5 promptly, close the needle eye of sewing needle when stylolite 6 is pre-buried) the interval is less than 3mm, closes stylolite 6 and is more thin, and the stitch is less, and the sewing effect is better. When each loop of the suture 6 is closed and tightened, the free thread tail 6-2 is used to be reversely folded and knotted at the other side of the side opening 5 corresponding to the fixed thread point 6-1 for fixation. The thickness of the closing suture 6 is specific, the distance between every two groups of through holes 5-2 is properly selected according to the material of the aortic arch artificial main tube 1, and after the closing suture 6 is sequentially tightened, the closing suture 6 can effectively seal and close the side opening 5. If some suture closing points are not good in sealing performance and bleeding occurs, a thin blood vessel dividing line is selected to be used for reinforcing suture of the bleeding points.
As shown in fig. 4, the closing suture 6 is a single suture, one end of which is knotted at one side edge of the side opening 5 to form a fixed line point 6-1, and the other side of which repeatedly and alternately penetrates through the side walls at two sides of the side opening 5 in an S-shaped manner to form a free line tail 6-2 after the side wall is formed at the other side edge of the side opening 5; the distance between every two adjacent groups of through holes 5-2 is less than 3 mm. The method for pre-embedding the closing suture line 6 forms a longitudinal reinforcing sealing strip on the outer side of the side opening 5, the distance between the inner through hole 5-2 and the outer through hole 5-2 is the width of the longitudinal reinforcing sealing strip, the width of the reinforcing sealing strip is not too large, and 3mm is preferred. The width of the reinforced sealing tape is too large, when the closing suture 6 is tightened, tissues between the inner and outer through holes 5-2 outside the side port 5 can be curled, and the sealing effect is reduced; the width of the reinforcing sealing strip is too small, the distance between two adjacent through holes 5-2 on the inner side and the outer side is too small, and the sealing effect is reduced. The distance between every two adjacent groups of through holes 5-2 on the inner side is the stitch of the closing suture 6. The optimal stitch spacing of the closing suture 6 is 2mm-3mm, so that the difficulty is greatly increased when the closing suture is too small, and the sealing effect is reduced when the closing suture is too large.
Fig. 3 and 4 show two simple embodiments of pre-embedding the closing suture 6, and in specific implementation, there may be more embodiments, and the effect of sealing and closing the side opening 5 after the closing suture 6 is tightened may be achieved. Regardless of the pre-installation scheme used for the closure sutures 6, the loops of the sutures 6 need to be loosened during pre-installation. When penetrating or pre-burying through side mouth 5 and propping blood supply pipe 7, need to make side mouth 5 open, loose wire loop does benefit to side mouth 5 and opens, can not open because of both sides line body length is too short, causes the restriction to side mouth 5.
In order to avoid that the loops formed by the loose closing suture 6 are mutually wound and even form knots which are difficult to loosen; meanwhile, in order to avoid accidental unordered tightening of loose wire bodies and cause difficulty in tightening of part of wire loops, obstacles are caused for orderly tightening of subsequent closing suture 6 wire bodies, even the closing suture 6 wire bodies cannot be tightened in order and cannot be effectively sealed and closed to the side opening 5, arc opening rods 8 are arranged between adjacent arc rings 6-3 on two sides of the side opening 5, the arc rings 6-3 on two sides are respectively and temporarily fixed at the end parts of two ends of the arc opening rods 8, and the two adjacent arc rings 6-3 formed on two sides of the side opening 5 by the closing suture 6 wire bodies are sequentially opened and temporarily fixed by the arc opening rods 8. If the closing suture line 6 adopts the scheme shown in fig. 3, the closing suture line 6 penetrates through the two sides of the side opening 5 in an S shape, and the line body forms a plurality of arc-shaped rings 6-3 on the two sides of the side opening 5; if the scheme of fig. 4 is adopted, the closing suture line 6 is spirally penetrated at two sides of the side opening 5, and the line body forms a plurality of arc line rings 6-3 at two sides of the side opening 5. An arc opening rod 8 is sequentially arranged between every two adjacent arc rings 6-3; the arc opening rod 8 is utilized to open the left and right adjacent arc rings 6-3, thereby avoiding the accidental tightening, winding and knotting of each arc ring 6-3.
Fig. 5 is a schematic view of an embodiment of the arc opening lever 8. The arc opening rod 8 comprises an elastic rod 8-1 in the middle and clamping wire rings 8-2 arranged at the end parts of two ends of the elastic rod 8-1, and the clamping wire rings 8-2 cut off ring bodies on one side far away from the arc opening rod 8 to form an outlet wire crack 8-3. When the arc opening rod 8 is used for opening the adjacent arc rings 6-3, the arc rings 6-3 corresponding to the two sides of the side opening 5 are clamped into the wire clamping ring 8-2 through the wire outlet cracks 8-3 respectively, and the suture wires 6 are properly tightened and closed, so that the lengths of the arc wire rings 6-3 are matched with the length of the arc opening rod 8, and the arc opening rod 8 is not wound due to overlong length, is not deformed due to overlong short length, and is suitable. At this point, the two adjacent loop wires 6-3 are approximately the same length as the arc opening bar 8.
After the anastomosis of the first arm trunk innominate artery and common carotid artery blood vessel cuts is finished, the side port 5 is clamped, the pair of arc line rings 6-3 which are closest to each other are separated from the line-outgoing crack 8-3 on the side wall of the wire clamping ring 8-2 at the two ends of the arc line opening rod 8 from the fixed line point 6-1 at one end of the side port 5, the arc line rings 6-3 are tightened, and the farthest arc line ring 6-3 is kept tensioned. Then, the arc opening rod 8 is sequentially loosened from the fixed line point 6-1 to the free line tail 6-2 direction, the arc line ring 6-3 is separated from the line outlet crack 8-3 on the side wall of the line clamping ring 8-2, the arc line ring 6-3 is tightened, the farthest arc line ring 6-3 is kept tightened until the last arc line ring 6-3 is tightened and disappears, and at the moment, the free line tail 6-2 is utilized to suture and tie at the side port 5 for fixing.
The arc rings 6-3 are provided with a plurality of pairs, which are determined by the length of the side opening 5, and each pair of arc rings 6-3 is provided with an arc opening rod 8 for opening each pair of arc rings 6-3. The arc opening rods 8 are easy to deflect due to the stress of the wire body, and are arranged disorderly, so that the operation of orderly tightening the arc rings 6-3 is not facilitated, and the arc opening rods 8 are prevented from entering the tightened arc rings 6-3 and being not beneficial to the subsequent tightening operation of the arc rings 6-3 after partial arc rings 6-3 are tightened.
In order to avoid closing 6 tightening operations of stylolite, in pitch arc struts pole 8 got into taut pitch arc ring 6-3, also for a plurality of pitch arc strut pole 8 arrange in order, make things convenient for the operation of tightening up in proper order of pitch arc ring 6-3, a plurality of pitch arc strut poles are equipped with linking mechanism 8-4 between 8, and two adjacent pitch arc strut poles 8 can neatly arrange through linking mechanism 8-4 between, make all pitch arc strut poles 8 connect and fix into a whole.
The connecting mechanism 8-4 comprises connecting chucks 8-5 and connecting clamping grooves 8-6 which are arranged on two opposite sides of the arc line opening rod 8, and the connecting chucks 8-5 can be clamped in the connecting clamping grooves 8-6 in an adaptive mode. If the engaging dopes 8-5 and the engaging notches 8-6 are set to be circular, each arc opening bar 8 is optimally provided with two engaging dopes 8-5 at one side of the bar body and two engaging notches 8-6 at corresponding positions at the other side, so that the minimum number can prevent rotational displacement between two adjacent arc opening bars 8. Of course, if the engaging chucks 8-5 and the engaging grooves 8-6 are configured in a non-circular shape, such as a matching sheet shape and a slit shape, each arc opening bar 8 is preferably configured with one engaging chuck 8-5 at one side of the bar body and one engaging groove 8-6 at the corresponding position at the other side. The connecting clamping heads 8-5 and the connecting clamping grooves 8-6 are fewer, so that the assembly between two adjacent arc line expanding rods 8 is facilitated, and the separation operation between two adjacent arc line expanding rods 8 is facilitated.
Furthermore, as shown in fig. 6, in order to further increase the convenience in use, the outer walls of the first and second brachiocephalic trunk innominate arterial artificial blood vessel branch pipes 2 and the common carotid arterial artificial blood vessel branch pipes 3 are respectively sleeved with a blood vessel closing device 9, and the first and second brachiocephalic trunk innominate arterial artificial blood vessel branch pipes 2 and the common carotid arterial artificial blood vessel branch pipes 3 can be respectively bound and fixed with the supporting blood supply catheter 7 arranged in the cavity of the first and second brachiocephalic trunk innominate arterial artificial blood vessel branch pipes 9. In this embodiment, the vessel closing device 9 is respectively sleeved on the outer walls of the first-arm trunk innominate arterial artificial blood vessel branch pipe 2 and the common carotid arterial artificial blood vessel branch pipe 3, the first-arm trunk innominate arterial artificial blood vessel branch pipe 2 and the common carotid arterial artificial blood vessel branch pipe 3 are respectively bound and fixed with the supporting blood supply catheter 7 embedded in the cavity of the first-arm trunk innominate arterial artificial blood vessel branch pipe 2 and the common carotid arterial artificial blood vessel branch pipe 3, and the supporting blood supply catheter 7 can be prevented from being separated from the cavity of the first-arm trunk innominate arterial artificial blood vessel branch pipe 2 and the common carotid.
Meanwhile, before the head-arm trunk innominate artery blood vessel and the common carotid artery blood vessel are anastomosed, the head-arm trunk blood supply tube end 7-2 and the common carotid artery blood supply tube end 7-3 are placed into the head-arm trunk innominate artery blood vessel and the common carotid artery blood vessel, so that the handheld blood vessel closing device 9 can conveniently position the head-arm trunk innominate artery artificial blood vessel branch tube 2 and the common carotid artery artificial blood vessel branch tube 3, and the head-arm trunk blood supply tube end 7-2 and the common carotid artery blood supply tube end 7-3 are placed into the head-arm trunk innominate artery blood vessel and the common carotid artery blood vessel and are accurately aligned.
When the head and arm trunk blood-supply tube end 7-2 and the neck main blood-supply tube end 7-3 are placed in the head and arm trunk innominate artery blood vessel and the neck main artery blood vessel and are accurately aligned, the binding and fixing of the blood vessel binder 9 to the head and arm trunk innominate artery artificial blood vessel branch tube 2 and the neck main artery artificial blood vessel branch tube 3 can be loosened, the blood vessel binder 9 is moved to the free ends of the head and arm trunk innominate artery artificial blood vessel branch tube 2 and the neck main artery artificial blood vessel branch tube 3 and is sleeved on the head and arm trunk innominate artery blood vessel and the neck main artery blood vessel outer wall outside the head and arm trunk blood-supply tube end 7-2 and the neck main blood-supply tube end 7-3, the blood vessel binder 9 is tightened again, the head and arm trunk innominate artery blood vessel and the neck main artery blood vessel can be sealed and bound and fixed outside the head and arm trunk blood-supply tube end 7-2 and the neck main artery blood-supply tube end 7-3, when, the head and neck are supplied with blood through a double channel by the head and arm stem blood supply pipe end 7-2 and the neck main blood supply pipe end 7-3, so that the functional disorder caused by ischemia and anoxia of the head and neck during anastomosis is avoided.
Fig. 7 shows an embodiment of the vessel occluder 9. The blood vessel ligation device 9 comprises a double-cavity ligation sleeve 9-1 and a ligation line 9-2 with a main body embedded in the ligation sleeve 9-1. The end parts of the two ends of the tying line 9-2 penetrating out of the tying sleeve 9-1 are provided with pulling handles 9-3, and the middle section of the tying line 9-2 is led out of the tying sleeve 9-1 to form a tying ring 9-4.
Specifically, the tying line 9-2 is folded in half to form two free line tails at one side and a line loop at the other end, namely the tying loop 9-4. Two free wire tails respectively penetrate through two inner cavity openings at the same end of the double-cavity ligation sleeve 9-1 and penetrate out from two openings at the other end, and after the two wire tails penetrate out, a traction handle 9-3 is fixedly connected to facilitate traction operation of the ligation wire 9-2. In order to prevent the pulling grip 9-3 from entering the lumen of the ligation sleeve 9-1 when it is pulled, the diameter of the pulling grip 9-3 is greater than the inner diameter of the ligation sleeve 9-1. What needs to be prompted is: for convenience of operation, the closing line 9-2 is made of a small amount of material with strong elasticity and toughness, such as a fish intestine line, the thickness of the closing line is 0.2mm-0.4mm, the closing line can tightly close the brachiocephalic trunk innominate artery blood vessel and the common carotid artery blood vessel, the pressure of the closing line 9-2 on the brachiocephalic trunk innominate artery blood vessel and the common carotid artery blood vessel during closing can be reduced, and the cutting injury of the outer wall of the blood vessel is avoided. Of course, the cross section of the tying line 9-2 can be of an oblate structure, so that the sealing tying effect can be improved, and the injury of the tying line 9-2 to the outer wall of the blood vessel during tying can be reduced to the maximum extent.
The size of the binding ring 9-4 is optimally the size that the binding ring can be sleeved on the outer wall of the pipe body with the outer diameter of 30mm in a loose way, and can not be sleeved on the outer wall of the pipe body with the outer diameter of 50mm in a loose way. The tying ring 9-4 with the size can be sleeved on the outer walls of the first-arm trunk innominate arterial artificial blood vessel branch pipe 2 and the common carotid arterial artificial blood vessel branch pipe 3 in an annular mode, and can be sleeved on the outer walls of the first-arm trunk innominate arterial blood vessel and the common carotid arterial blood vessel in an annular mode, and meanwhile, the tying ring 9-4 cannot be too large to cause inconvenience in moving the tying ring 9-4.
When the tying ring 9-4 is sleeved in a proper position, the tying ring 9-4 needs to be tightened and fixed, namely the tying wire 9-2 in the tying sleeve 9-1 needs to be tightened and fixed. The tightening of the closing thread 9-2 can be accomplished by two pulling handles 9-3 arranged at the tail of the thread. The pulling handle 9-3 is pulled to make the tying line 9-2 in the tying sleeve 9-1 move to one side of the line tail, part of the line body of the tying ring 9-4 is pulled into the tying sleeve 9-1, and the tying ring 9-4 becomes small, so that the tying ring is tightened and sleeved on a proper position.
In order to fix the tying line 9-2 in the tying sleeve 9-1 conveniently, a locking sheet 9-5 is sleeved outside the tying sleeve 9-1, and a locking line hole 9-6 is formed in the locking sheet 9-5. The lock hole 9-6 comprises a loosening hole 9-7 with the aperture larger than that of the binding sleeve 9-1 and a crack-shaped clamping crack hole 9-8 with the gap smaller than that of the binding sleeve 9-1. When the fixing is carried out, the locking sheet 9-5 is pushed, so that the clamping split hole 9-8 is tightly clamped on the outer wall of the binding sleeve 9-1. The outer diameter of the puncture sleeve 9-1 is larger than the crack-shaped clearance of the clamping crack hole 9-8, at the moment, the puncture sleeve 9-1 is deformed into an oblate laminated structure, and the tightened puncture wire 9-2 is tightly clamped. When the position of the loop of the binding ring 9-4 needs to be moved, the binding ring 9-4 needs to be enlarged. At the moment, the locking sheet 9-5 is pushed, so that the pricking sleeve 9-1 is separated from the clamping split hole 9-8 and enters the release hole 9-7. The diameter of the release hole 9-7 is larger than the outer diameter of the ligation sleeve 9-1, the inner cavity of the ligation sleeve 9-1 recovers, and the clamping and fixing effect on the ligation line 9-2 in the inner cavity of the ligation sleeve 9-1 disappears. The tying line 9-2 in the tying sleeve 9-1 moves to one side of the tying ring 9-4, so that the line body of the tying ring 9-4 is lengthened, the tying ring 9-4 is enlarged, the ring sleeve on the outer wall of the blood vessel or the artificial blood vessel is loosened, and the tying sleeve 9-1 can be held by hand to perform displacement operation on the tying ring 9-4.
After the anastomosis of all the artificial blood vessels and the stumps of autologous blood vessels is finished and before the side port 5 is closed and sutured, the exhaust operation can be adopted to exhaust the gas in the artificial blood vessels, and then the side port 5 is closed and sutured. After the side port 5 is closed and sutured, the process of rewarming and heart rebounding can be performed, which is the same as the current treatment and is well known in the art, and will not be described herein again.
In a word, the blood supply catheter is arranged in the side port, so that blood can be supplied to the double tubes of the head and the neck when the innominate artery and the common carotid artery branch of the head and the arm stem are anastomosed, and various complications caused by cerebral tissue ischemia and hypoxia are avoided. The side opening can be quickly closed when the operation is finished through the closing suture lines pre-embedded in the side opening, so that the bleeding of the operation is reduced, and the operation time is greatly shortened. Through the setting of pitch arc opening rod, can tighten up each pitch arc ring in order, effectively close the side mouth fast, simultaneously, avoid each pitch arc ring winding to tie a knot. Through the setting of blood vessel ligation device, can avoid supporting the blood supply pipe and drop, simultaneously, when coincide first arm trunk innominate artery and common carotid artery, can prick first arm trunk innominate artery and common carotid artery fast and close at supporting the blood supply pipe outer wall, create sealed environment for neck blood supply. At the end of anastomosis, the brachiocephalic trunk innominate artery and common carotid artery can be quickly loosened. Can be used in the operation quickly and conveniently, greatly saves the operation time and improves the operation safety.
Claims (10)
1. An aortic arch part is provided with a side port and an anastomotic line artificial blood vessel is pre-embedded, and comprises an arc-shaped aortic arch artificial main pipe (1); the method is characterized in that: the artificial blood vessel branch pipe group is arranged on the aortic arch artificial main pipe (1), and comprises a head-arm trunk innominate artery artificial blood vessel branch pipe (2), a common carotid artery artificial blood vessel branch pipe (3) and a subclavian artery artificial blood vessel branch pipe (4), wherein the head-arm trunk innominate artery artificial blood vessel branch pipe (2), the common carotid artery artificial blood vessel branch pipe (3) and the subclavian artery artificial blood vessel branch pipe (4) are positioned on the arc-shaped outer side wall of the aortic arch artificial main pipe (1), and the head-arm trunk innominate artery artificial blood vessel branch pipe (2), the common carotid artery artificial blood vessel branch pipe (3) and the subclavian artery artificial blood vessel branch pipe (4) are communicated with the aortic arch artificial main pipe (1);
the artificial main pipe (1) of the arc aortic arch penetrates through the side wall below the artificial blood vessel branch pipe group to be provided with 1-2 side openings (5), a plurality of closing suture lines (6) are embedded at each side opening (5) in a loose mode, and the side openings (5) can be closed in a sealing mode by tightening the closing suture lines (6).
2. The aortic arch of claim 1 with side port and anastomotic line pre-embedded artificial blood vessel, wherein: the side opening (5) comprises a linear crack, a sewing skirt part (5-1) is arranged on the outer side of the side opening (5), the perimeter of the sewing skirt part (5-1) is matched with that of the side opening (5), and the width of the sewing skirt part (5-1) is larger than 5 mm.
3. The aortic arch of claim 1 with side port and anastomotic line pre-embedded artificial blood vessel, wherein: two supporting blood supply catheters (7) are buried in the aortic arch artificial main tube (1), one end of each supporting blood supply catheter (7) forms a blood inlet tube end (7-1) at a side outlet (5) of a gap of a closing suture line (6), and the other end of each supporting blood supply catheter respectively extends out of a brachiocephalic trunk innominate artery artificial blood vessel branch tube (2) and a common carotid artery artificial blood vessel branch tube (3) to form a brachiocephalic trunk blood supply tube end (7-2) and a common carotid blood supply tube end (7-3).
4. The aortic arch of claim 1 with side port and anastomotic line pre-embedded artificial blood vessel, wherein: the closing suture line (6) is one, one end part of the closing suture line is knotted at one side edge of the side opening (5) to form a fixed line point (6-1), the other side of the closing suture line repeatedly and alternately penetrates through the side walls at two sides of the side opening (5) in an S shape, and a free line tail (6-2) is formed after the other side edge of the side opening (5) goes out of the side walls; the distance between every two adjacent groups of through holes (5-2) is less than 3 mm.
5. The aortic arch of claim 1 with side port and anastomotic line pre-embedded artificial blood vessel, wherein: the closing suture line (6) is one, one end of the closing suture line is knotted at one side edge of the side opening (5) to form a fixed line point (6-1), the other side of the closing suture line spirally and repeatedly penetrates through the side walls at two sides of the side opening (5) in an alternating mode, and a free line tail (6-2) is formed after the side wall is arranged at the other side edge of the side opening (5); the distance between every two adjacent groups of through holes (5-2) is less than 3 mm.
6. The aortic arch part of claims 4 and 5 with side port and anastomotic line pre-embedded artificial blood vessel, wherein: an arc opening rod (8) is arranged between every two adjacent arc rings (6-3) of the S-shaped wire body or the spiral wire body of the closing suture (6); the arc opening rod (8) comprises an elastic rod (8-1) in the middle and clamping wire rings (8-2) arranged at the two end parts of the elastic rod (8-1), and the clamping wire rings (8-2) cut off ring bodies on one side far away from the arc opening rod (8) to form wire outlet cracks (8-3); every two adjacent arc-shaped wire rings (6-3) are respectively clamped in wire clamping rings (8-2) at two ends of an arc-shaped opening rod (8).
7. The aortic arch portion side-port anastomosis wire embedding artificial blood vessel as claimed in claim 3, wherein: the outer walls of the first-arm trunk innominate artificial blood vessel branch pipe (2) and the common carotid artery artificial blood vessel branch pipe (3) are respectively sleeved with a blood vessel closing device (9), and the first-arm trunk innominate artificial blood vessel branch pipe (2) and the common carotid artery artificial blood vessel branch pipe (3) can be respectively bound and fixed with a supporting blood supply catheter (7) arranged in the cavity of the first-arm trunk innominate artificial blood vessel branch pipe and the common carotid artery artificial blood vessel branch pipe through the blood vessel closing device (9).
8. The aortic arch of claim 7 with side port and anastomotic line pre-embedded artificial blood vessel, wherein: the blood vessel closing device (9) comprises a double-cavity closing sleeve (9-1) and a closing line (9-2) with a main body embedded in the closing sleeve (9-1); the end parts of the two ends of the tying line (9-2) penetrating through the tying sleeve (9-1) are provided with traction handles (9-3), and the middle section of the tying line (9-2) is led out of the tying sleeve (9-1) to form a tying ring (9-4); the diameter of the traction handle (9-3) is larger than the inner diameter of the ligation sleeve (9-1); a locking sheet (9-5) is sleeved outside the tying sleeve (9-1), and a locking line hole (9-6) is formed in the locking sheet (9-5); the lock hole (9-6) comprises a loosening hole (9-7) with the aperture larger than that of the binding sleeve (9-1) and a crack-shaped clamping and cracking hole (9-8) with the gap smaller than that of the binding sleeve (9-1).
9. The aortic arch of claim 6 with side port and anastomotic line prosthesis pre-embedded, wherein: a connecting mechanism (8-4) is arranged among the arc line opening rods (8), and the connecting mechanism (8-4) comprises connecting chucks (8-5) and connecting clamping grooves (8-6) which are arranged at two opposite sides of the arc line opening rods (8); the connecting clamping head (8-5) can be adaptive clamped in the connecting clamping groove (8-6).
10. The aortic arch portion side-port anastomosis wire embedding artificial blood vessel as claimed in claim 3, wherein: the supporting blood supply catheter (7) is communicated with a blood inlet interface (7-4) at a blood inlet tube end (7-1), and a plurality of puncture grooves (7-5) are respectively annularly arranged on the outer walls of the end parts of the head and arm stem blood supply tube end (7-2) and the neck main blood supply tube end (7-3).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110488454.8A CN113081385A (en) | 2021-05-06 | 2021-05-06 | Aortic arch part is provided with side port and is embedded with anastomotic line artificial blood vessel |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110488454.8A CN113081385A (en) | 2021-05-06 | 2021-05-06 | Aortic arch part is provided with side port and is embedded with anastomotic line artificial blood vessel |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN113081385A true CN113081385A (en) | 2021-07-09 |
Family
ID=76681382
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202110488454.8A Withdrawn CN113081385A (en) | 2021-05-06 | 2021-05-06 | Aortic arch part is provided with side port and is embedded with anastomotic line artificial blood vessel |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN113081385A (en) |
-
2021
- 2021-05-06 CN CN202110488454.8A patent/CN113081385A/en not_active Withdrawn
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| US6176864B1 (en) | Anastomosis device and method | |
| US20060241659A1 (en) | Screw-device for anastomosis | |
| CN107789094B (en) | Artificial blood vessel without sewing stent | |
| US7883518B1 (en) | Surgical knot | |
| Gonzalez-Rivas et al. | Technical aspects of uniportal video-assisted thoracoscopic double sleeve bronchovascular resections | |
| EP3429483A1 (en) | Medical connector device | |
| CN110314014A (en) | Intravascular stent and its traction device | |
| JP2017522963A (en) | Apparatus and method for making a knot | |
| CN112022431B (en) | Integrated stent artificial blood vessel with assembled suture-free branches and application thereof | |
| CN114224549A (en) | Improved vein lining stent rat orthotopic liver transplantation model establishment method | |
| KR20220077134A (en) | Vascular and Aortic Grafts and Deployment Tools | |
| KR20150104168A (en) | Connector | |
| CN113081385A (en) | Aortic arch part is provided with side port and is embedded with anastomotic line artificial blood vessel | |
| CN116350390A (en) | Vascular suture-free device, suture-free artificial blood vessel and conveying system | |
| CN214017683U (en) | Branch artificial blood vessel free of suture at far end and device for quickly connecting branch artificial blood vessel with main blood vessel | |
| CN212466259U (en) | Device for rapid liver transplantation of rubber-magnetic combined intravascular stent | |
| CN106821544B (en) | A kind of artificial blood vessel's system | |
| CN208851712U (en) | Intravascular stent and its traction device | |
| CN113229997B (en) | Aortic arch artificial blood vessel with embedded anastomosis line and blood supply realization in anastomosis process | |
| RU2266059C1 (en) | Method for cannulation of thoracic duct (3 variants) | |
| US20130345499A1 (en) | Side to side anastomosis | |
| JP3079465U (en) | Structure of artificial blood vessel connecting sleeve ring | |
| CN117442258B (en) | Conveying device and binding method thereof | |
| CN215080266U (en) | Safety aortic arch artificial blood vessel | |
| CN217310714U (en) | Artificial blood vessel used in full-aortic arch replacement bracket elephantiasis |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| WW01 | Invention patent application withdrawn after publication | ||
| WW01 | Invention patent application withdrawn after publication |
Application publication date: 20210709 |