CN113558814B - Aortic root valve-containing vessel endovascular graft - Google Patents
Aortic root valve-containing vessel endovascular graft Download PDFInfo
- Publication number
- CN113558814B CN113558814B CN202110859381.9A CN202110859381A CN113558814B CN 113558814 B CN113558814 B CN 113558814B CN 202110859381 A CN202110859381 A CN 202110859381A CN 113558814 B CN113558814 B CN 113558814B
- Authority
- CN
- China
- Prior art keywords
- sinus
- ring
- shaped
- aortic
- support
- 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.)
- Active
Links
- 229910001000 nickel titanium Inorganic materials 0.000 claims abstract description 62
- 210000001765 aortic valve Anatomy 0.000 claims abstract description 27
- 238000004873 anchoring Methods 0.000 claims abstract description 20
- 229910052751 metal Inorganic materials 0.000 claims abstract description 8
- 239000002184 metal Substances 0.000 claims abstract description 8
- 230000002792 vascular Effects 0.000 claims abstract description 4
- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical group [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 claims description 30
- 239000012528 membrane Substances 0.000 claims description 10
- 229920000295 expanded polytetrafluoroethylene Polymers 0.000 claims description 8
- 210000004351 coronary vessel Anatomy 0.000 abstract description 19
- 210000003291 sinus of valsalva Anatomy 0.000 description 16
- 239000007943 implant Substances 0.000 description 10
- 239000011248 coating agent Substances 0.000 description 4
- 238000000576 coating method Methods 0.000 description 4
- 238000002513 implantation Methods 0.000 description 4
- 238000002955 isolation Methods 0.000 description 4
- 238000002601 radiography Methods 0.000 description 4
- 208000002251 Dissecting Aneurysm Diseases 0.000 description 3
- 210000000709 aorta Anatomy 0.000 description 3
- 206010002895 aortic dissection Diseases 0.000 description 3
- 230000002146 bilateral effect Effects 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 208000007474 aortic aneurysm Diseases 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 2
- 230000017531 blood circulation Effects 0.000 description 2
- 210000001105 femoral artery Anatomy 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 230000002035 prolonged effect Effects 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 241000283690 Bos taurus Species 0.000 description 1
- 210000002376 aorta thoracic Anatomy 0.000 description 1
- 206010002906 aortic stenosis Diseases 0.000 description 1
- 201000002064 aortic valve insufficiency Diseases 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 238000007731 hot pressing Methods 0.000 description 1
- 239000011229 interlayer Substances 0.000 description 1
- 210000004731 jugular vein Anatomy 0.000 description 1
- 210000005240 left ventricle Anatomy 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 230000037361 pathway Effects 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 238000003825 pressing Methods 0.000 description 1
- 210000002321 radial artery Anatomy 0.000 description 1
- 238000009958 sewing Methods 0.000 description 1
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
- A61F2/07—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
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2427—Devices for manipulating or deploying heart valves during implantation
- A61F2/243—Deployment by mechanical expansion
- A61F2/2433—Deployment by mechanical expansion using balloon catheter
-
- 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
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2445—Annuloplasty rings in direct contact with the valve annulus
-
- 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
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2466—Delivery devices therefor
-
- 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
Abstract
The invention discloses an aortic root vascular endovascular graft, which comprises a sinus region support and a straight cylinder support which are sequentially arranged from bottom to top, wherein the sinus region support and the outer wall of the straight cylinder support are covered with films, the sinus region support comprises an aortic valve ring, a sinus W-shaped filament nickel-titanium alloy support and a sinus tube boundary ring which are sequentially arranged from bottom to top, the inner wall of the aortic valve ring is sewed with an aortic three-leaf valve leaflet, the outer wall of the sinus W-shaped filament nickel-titanium alloy support is provided with a plurality of W-shaped metal wires which are connected end to end, and a plurality of U-shaped valves are arranged on the films on the outer wall of the sinus W-shaped filament nickel-titanium alloy support; the straight barrel support comprises a straight barrel region nickel-titanium alloy support with the bottom connected with the sinus canal junction ring and a distal end anchoring ring arranged at the top of the straight barrel region nickel-titanium alloy support. The invention is a transplant which is convenient for the whole accurate positioning of the transplant, the accurate positioning between the transplant and the double-sided coronary artery openings and the operation in operation.
Description
Technical Field
The invention mainly relates to the technical field of medical instruments, in particular to an aortic root valve-bearing endovascular graft.
Background
In the field of aortic dissection treatment, minimally invasive endoluminal repair techniques are gradually replacing traditional giant invasive open surgery. At present, the consensus is achieved at home and abroad that the interlayer of descending aorta is simply involved, and the intra-luminal repair is preferred.
According to an aortic root stent system provided in patent document CN202011504274.6, the product comprises an aortic stent and a sinus anchoring stent, the aortic stent is correspondingly arranged on the inner wall of the ascending aorta, the sinus anchoring stent is attached to the inner wall of the aortic sinus and extends downwards from the sinus tube junction, the bottom of the sinus anchoring stent extends inwards to form a plurality of coronary valve stents attached to the aortic sinus, the outer peripheral surfaces of the coronary valve stents form a garlic-shaped structure, the inner top ends of the coronary valve stents correspondingly extend to the outer side of the valve annulus, and the tail ends of all the coronary valve stents form an opening for free movement of valve leaflets. The coronary valve support of the product can enlarge the anchoring area of the whole sinus anchoring support in the aortic valve, is firm in positioning, is not easy to shift under the impact of blood flow, and improves the stability of the aortic root anchoring system in the aortic valve.
The coronary valve stent in the patent can enlarge the anchoring area of the whole sinus anchoring stent in the aortic valve, is more stable in fixation, but is inconvenient for the accurate positioning of the whole plant, is inconvenient for the accurate positioning between the plant and the openings of the double coronary arteries, and is inconvenient in operation.
Disclosure of Invention
The invention mainly provides an aortic root valved vascular endovascular graft which is used for solving the technical problems in the background technology.
The technical scheme adopted for solving the technical problems is as follows:
the aortic root vascular endovascular graft comprises a sinus region support and a straight cylinder support which are sequentially arranged from bottom to top, wherein the sinus region support and the outer wall of the straight cylinder support are covered with films, the sinus region support comprises an aortic valve ring, a sinus W-shaped filament nickel-titanium alloy support and a sinus tube juncture ring which are sequentially arranged from bottom to top, the inner wall of the aortic valve ring is sewed with aortic three-leaf valve leaflets, the outer wall of the sinus W-shaped filament nickel-titanium alloy support is provided with a plurality of W-shaped metal wires which are connected end to end, and a plurality of U-shaped valves are arranged on the films on the outer wall of the sinus W-shaped filament nickel-titanium alloy support;
the straight barrel support comprises a straight barrel region nickel-titanium alloy support with the bottom connected with the sinus canal junction ring and a distal end anchoring ring arranged at the top of the straight barrel region nickel-titanium alloy support.
Preferably, the film is formed on the sinus region bracket and the outer wall of the straight cylinder bracket in a hot pressing mode, and the film is an ePTFE (ePTFE) film. In the preferred embodiment, the plant life is increased by coating with ePTFE.
Preferably, the diameter of the aortic valve ring is 16-30mm, and the aortic valve ring is a nickel-titanium alloy ring. In the preferred embodiment, positioning fixation of the plant base is facilitated by the aortic annulus.
Preferably, the sinus W-shaped filament nickel-titanium alloy bracket is drum-shaped, the wave crest and the wave trough of the W-shaped metal wire are respectively connected with an aortic valve ring and a sinus tube boundary ring, the height of the sinus W-shaped filament nickel-titanium alloy bracket is 10-30mm, and the maximum diameter of the sinus W-shaped filament nickel-titanium alloy bracket is 35-45mm. In the preferred embodiment, the sinus portion of the graft is conveniently attached to the aortic sinus portion by the sinus W-shaped filarium nitinol stent, and the effectiveness of the graft in isolating the breach in the aortic sinus is improved.
Preferably, the diameter of the sinus tube interface ring is 20-35mm, and the sinus tube interface ring is a nickel-titanium alloy ring. In the preferred embodiment, the positioning and fixation of the plant middle part is facilitated by the sinus canal interface ring.
Preferably, 10-15U-shaped flaps are arranged in each V-shaped area of the W-shaped metal wire. In the preferred embodiment, the U-shaped valve facilitates the rapid passage of the 0.014 guidewire through any one of the microholes under the guidance of the guide catheter after the intraoperative graft release to establish a bilateral coronary passageway.
Preferably, the length of the U-shaped valve is 1mm, and the short diameter is 0.5mm. In the preferred embodiment, the passage of a 0.014 guidewire is facilitated by a U-shaped flap of 1mm long diameter and 0.5mm short diameter.
Preferably, the straight cylinder zone nickel-titanium alloy bracket is composed of a plurality of circles of straight cylinder zone W-shaped filament nickel-titanium alloy brackets. In the preferred embodiment, the expansion of the straight barrel zone nitinol stent is facilitated by a plurality of turns of straight barrel zone W-filament nitinol.
Preferably, the height of the straight cylinder area W-shaped filament nickel-titanium alloy bracket is 15mm, and the length of the straight cylinder area nickel-titanium alloy bracket is 50-70mm. In the preferred embodiment, the implantation of plants is facilitated by a straight barrel zone nitinol stent.
Preferably, the diameter of the distal anchoring ring is 25-45mm, and the distal anchoring ring is a nickel-titanium alloy ring. In the preferred embodiment, the top fixation of the plant is facilitated by a distal anchor ring.
Compared with the prior art, the invention has the beneficial effects that:
the implant in the invention is convenient for prolonging the service life of plants through the ePTFE coating film, is convenient for positioning and fixing the bottom of the plants through the aortic valve ring, is convenient for the sinus part of the implant to be attached to the aortic sinus part through the sinus part W-shaped filament nickel-titanium alloy stent, improves the isolation efficiency of the implant to the rupture port in the aortic sinus, is convenient for positioning and fixing the middle part of the plants through the sinus tube interface ring, is convenient for the release of the implant in operation through the U-shaped valve, and can quickly pass through any one micropore under the guidance of the guiding catheter by the 0.014 guide wire so as to establish a bilateral coronary artery passage, and is convenient for the passing of the 0.014 guide wire through the U-shaped valve with the length of 1mm and the short diameter of 0.5mm, and the extension of the straight tube area nickel-titanium alloy stent is convenient for the W-shaped filament nickel-titanium alloy stent through the multi-tube area, the straight tube area nickel-titanium alloy stent is convenient for the implantation operation of the plants, and the distal end ring is convenient for the top fixing of the plants;
the graft in the invention can be loaded on a thinner conveyor without branches, is delivered in place through a femoral artery path and then released, does not need to be released through a large sheath by a cardiac apex approach like Jing Shi valve, is relatively safe, has a bovine pericardial valve, needs to be soaked and stored according to requirements, is similar to a TAVI valve, is loaded on a table, is loaded on the table, and is compressed by a valve pressing device to retract a delivery sheath, the femoral artery access is used for radiography positioning the aortic sinus, the jugular vein is rapidly paced, the conveyor is used for delivering the graft in place along an ultra-hard guide wire after the self-valve is expanded, three anchoring rings are respectively aligned, the sheath is released, the right radial artery path is respectively used for carrying out U-shaped valve through sinus part, the ultra-selected double coronary artery is adopted, the small balloon is expanded after the guide wire enters the coronary artery, and the inlet diameter is equivalent to that of a covered stent or a bare stent of the coronary artery, so that the purpose of remodelling the aortic root in a cavity is achieved;
the graft of the present invention can be used for endoluminal minimally invasive treatment of aortic root lesions such as aortic sinuses, coronary ostia, aortic dissection and aortic aneurysm involving aortic valves, aortic stenosis or insufficiency with aortic aneurysm, aortic dissection and the like
The invention will be explained in detail below with reference to the drawings and specific embodiments.
Drawings
FIG. 1 is an isometric view of the primary structure of the present invention;
FIG. 2 is an isometric view of the overall structure of the present invention;
FIG. 3 is an exploded view of the overall structure of the present invention;
FIG. 4 is a top view of the overall structure of the present invention;
FIG. 5 is a cross-sectional view of the overall structure of the present invention;
FIG. 6 is a side view of the overall structure of the present invention;
fig. 7 is a schematic diagram of the sewing shrinkage of the implant of the present invention.
Description of the drawings: 10. dou Ou support; 11. an aortic valve annulus; 12. sinus W-type filament nitinol stent; 121. a W-shaped wire; 13. sinus canal interface ring; 14. aortic three leaflet valve leaflets; 15. u-shaped valve; 20. a straight cylinder bracket; 21. nickel-titanium alloy bracket in straight cylinder area; 211. a straight cylinder area W-shaped filament nickel-titanium alloy bracket; 22. a distal anchor ring; 30. a film; 40. a first suture; 41. a second suture; 42. the guide wire is locked.
Detailed Description
In order that the invention may be more fully understood, a more particular description of the invention will be rendered by reference to the appended drawings, in which several embodiments of the invention are illustrated, but which may be embodied in different forms and are not limited to the embodiments described herein, which are, on the contrary, provided to provide a more thorough and complete disclosure of the invention.
It will be understood that when an element is referred to as being "mounted" on another element, it can be directly on the other element or intervening elements may be present, and when an element is referred to as being "connected" to the other element, it may be directly connected to the other element or intervening elements may also be present, the terms "vertical", "horizontal", "left", "right" and the like are used herein for the purpose of illustration only.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly connected to one of ordinary skill in the art to which this invention belongs, and the knowledge of terms used in the description of this invention herein for the purpose of describing particular embodiments is not intended to limit the invention, and the term "and/or" as used herein includes any and all combinations of one or more of the associated listed items.
Referring to fig. 1-5, in a preferred embodiment of the present invention, the aortic root endovascular graft includes a sinus region stent 10 and a straight stent 20 sequentially disposed from bottom to top, wherein the sinus region stent 10 and the straight stent 20 both cover a membrane 30, the sinus region stent 10 includes an aortic annulus 11, a sinus W-shaped wire nitinol stent 12 and a sinus tube junction ring 13 sequentially disposed from bottom to top, the aortic three-leaflet valve leaflet 14 is sewn on the inner wall of the aortic annulus 11, the membrane 30 is hot-formed on the sinus region stent 10 and the straight stent 20 outer wall, the membrane 30 is an ePTFE coating, the aortic annulus 11 has a diameter of 16-30mm, the aortic annulus 11 is a nickel-titanium alloy ring, the sinus W-shaped wire nitinol stent 12 is in a drum shape, the peaks of the W-shaped wire 121 are respectively connected with the aortic annulus 11 and the sinus tube junction ring 13, the sinus W-shaped wire nitinol stent 12 has a height of 10-30mm, and the sinus tube junction ring diameter of 35-35 mm, and the sinus tube junction ring diameter of the sinus tube junction ring 13 mm.
It should be noted that, in this embodiment, the service life of the plant is conveniently prolonged by the ePTFE membrane, the positioning and fixing of the bottom of the plant are facilitated by the aortic valve ring 11, the sinus of the graft is conveniently attached to the aortic sinus by the sinus W-shaped filament nitinol stent 12, the isolation efficiency of the graft to the rupture port in the aortic sinus is improved, and the positioning and fixing of the middle of the plant are facilitated by the sinus tube interface ring 13.
Referring to fig. 3, 4, 5 and 6, in another preferred embodiment of the present invention, the outer wall of the sinus W-shaped filament nitinol stent 12 is provided with a plurality of W-shaped wires 121 connected end to end, and a membrane 30 on the outer wall of the sinus W-shaped filament nitinol stent 12 is provided with a plurality of U-shaped flaps 15; and 10-15U-shaped flaps 15 are arranged in each V-shaped area of the W-shaped metal wire 121, and the long diameter of each U-shaped flap 15 is 1mm, and the short diameter is 0.5mm.
In this embodiment, after the release of the implant during surgery is facilitated by the U-shaped valve 15, the 0.014 guidewire can rapidly pass through any one of the micropores under the guidance of the guiding catheter, so as to establish a double-sided coronary artery passage, and the passage of the 0.014 guidewire is facilitated by the U-shaped valve 15 with a length of 1mm and a short diameter of 0.5mm.
Referring to fig. 3, 5 and 7, in another preferred embodiment of the present invention, the straight tube bracket 20 includes a straight tube region nitinol bracket 21 with a bottom connected to the sinus tube boundary ring 13, and a distal end anchoring ring 22 disposed on top of the straight tube region nitinol bracket 21, the straight tube region nitinol bracket 21 is composed of a plurality of loops of straight tube region W-shaped filament nitinol brackets 211, the height of the straight tube region W-shaped filament nitinol brackets 211 is 15mm, the length of the straight tube region nitinol bracket 21 is 50-70mm, the diameter of the distal end anchoring ring 22 is 25-45mm, and the distal end anchoring ring 22 is a nitinol ring.
It should be noted that, in this embodiment, the extension of the straight tube region nitinol stent 21 is facilitated by the multi-turn straight tube region W-shaped filament nitinol stent 211, the implantation operation of the plant is facilitated by the straight tube region nitinol stent 21, and the top fixation of the plant is facilitated by the distal end anchoring ring 22;
further, when the graft is loaded back into the delivery device: the graft "tie" is first sewn with 6-0Prolene stitches, and in each section of "two arms" of the W-shaped metal stent, stitch one 40 and stitch two 41 are intermittently sewn, using 1 guide wire or stitch as the locking guide wire 42, the locking guide wire 42 is threaded through all the knots while tightening all the stitches, reducing the overall graft "shrink seam" by about 30-40% in overall diameter. The graft is then passed through the "push rod" of the delivery device, and is retracted, using a "valve presser", into the delivery device sheath, together with a "lock catch" guidewire, in a coordinated manner. The tail part of the lock catch guide wire passes through an opening at the tail end of the outer sheath of the conveyor; after the locking guidewire 42 is withdrawn, the suture is opened and the implant is fully opened.
The specific flow of the invention is as follows:
the service life of the plant is prolonged conveniently through the ePTFE coating, the bottom of the plant is positioned and fixed conveniently through the aortic valve ring 11, the sinus part of the implant is attached to the aortic sinus part conveniently through the sinus part W-shaped filament nickel-titanium alloy bracket 12, the isolation efficiency of the implant to the rupture port in the aortic sinus is improved, and the middle part of the plant is positioned and fixed conveniently through the sinus canal juncture ring 13;
after the intraoperative graft is released conveniently through the U-shaped valve 15, the 0.014 guide wire can rapidly pass through any one micropore under the guidance of the guide catheter so as to establish a double-sided coronary artery passage, and the 0.014 guide wire can pass through the U-shaped valve 15 with the long diameter of 1mm and the short diameter of 0.5mm conveniently;
the extension of the straight barrel area nickel-titanium alloy bracket 21 is facilitated through the multi-circle straight barrel area W-shaped filament nickel-titanium alloy bracket 211, the implantation operation of plants is facilitated through the straight barrel area nickel-titanium alloy bracket 21, and the top fixation of the plants is facilitated through the distal end anchoring ring 22;
the graft sinus region stent 10 is drum-shaped to adapt to the shape of an aortic sinus part, in a state that the radial expansion of a graft is completely opened, the distance H between the proximal edge of the sinus part and the graft straight tube stent 20 is 10-50mm, the widest point of the sinus part protrudes 3-15mm relative to an aortic valve ring 11, specific values of H and H can be set according to actual needs, an active space is provided for aortic valve opening and closing, shielding of an aortic valve leaf on an opening window of a coronary artery is avoided, space is provided for reserving a coronary artery opening when the aortic valve is placed in a secondary cavity, the design is also beneficial to the bonding of the sinus part of the graft with the aortic sinus part, the isolation efficiency of the graft on a rupture opening in the aortic sinus part is improved, a plurality of dense U-shaped flaps 15 are arranged at the sinus part, a coronary artery path is utilized, a left/right coronary artery can be super-selected by utilizing any U-shaped flap 15 under the cooperation of a left/right coronary artery catheter, a coronary artery pathway is established, a small sinus membrane stent can be placed after the expansion of the small balloon is ensured, the diameter of the coronary artery is ensured, the coronary artery is opened, the diameter is not required to be opened, and the patent is not has a small-side coronary artery diameter is required, and the patent has a small-open cycle is set, and the technical problem is solved, and the technical problem is that the patent is solved;
when the graft is loaded back into the delivery device: the graft "tie" is first sewn with 6-0Prolene stitches, and in each section of "two arms" of the W-shaped metal stent, stitch one 40 and stitch two 41 are intermittently sewn, using 1 guide wire or stitch as the locking guide wire 42, the locking guide wire 42 is threaded through all the knots while tightening all the stitches, reducing the overall graft "shrink seam" by about 30-40% in overall diameter. The graft is then passed through the "push rod" of the delivery device, and is retracted, using a "valve presser", into the delivery device sheath, together with a "lock catch" guidewire, in a coordinated manner. The tail part of the lock catch guide wire passes through an opening at the tail end of the outer sheath of the conveyor; after the lock catch guide wire 42 is withdrawn, the suture is opened, and the implant is completely opened;
graft release is performed: the three paths of a left brachial-ascending aorta path and a right brachial-ascending aorta path are established under the guidance of rays, the left brachial path is led into a pigtail catheter to the aortic sinus for intraoperative radiography positioning, and the right brachial path is used for establishing coronary artery blood circulation. After the balloon is expanded to the original aortic valve (the method is the same as TAVI), a conveyer enters along the super-hard guide wire, a tip of the conveyer enters the left ventricle, the aortic valve ring 11, the sinus canal juncture ring 13 and the distal end anchoring ring 22 of the graft are used as references, and after successful positioning, the sheath is removed, at the moment, the graft is opened by about 50-60 percent and is not fully opened, and the position can be adjusted by using a conveying rod;
the left/right coronary artery is selected by the way of 'brachial artery-graft distal end-graft cavity-U-shaped valve' under the cooperation of the left/right coronary catheter and the guide wire, the passageway is established, the radiography positioning is performed again, the successful establishment of the bilateral coronary passageway is determined, the aortic valve is in place, at the moment, the locking guide wire 42 is pulled, the graft is completely opened, the release is completed, and the position and the shape of the graft are determined again by radiography.
While the invention has been described above with reference to the accompanying drawings, it will be apparent that the invention is not limited to the embodiments described above, but is intended to be within the scope of the invention, as long as such insubstantial modifications are made by the method concepts and technical solutions of the invention, or the concepts and technical solutions of the invention are applied directly to other occasions without any modifications.
Claims (10)
1. The aortic root vascular endovascular graft comprises a sinus region support (10) and a straight cylinder support (20) which are sequentially arranged from bottom to top, and is characterized in that the sinus region support (10) and the outer wall of the straight cylinder support (20) are covered with films (30), the sinus region support (10) comprises an aortic valve ring (11), a sinus W-shaped filament nickel-titanium alloy support (12) and a sinus tube boundary ring (13) which are sequentially arranged from bottom to top, an aortic three-leaflet valve (14) is sewn on the inner wall of the aortic valve ring (11), a plurality of W-shaped metal wires (121) which are connected end to end are arranged on the outer wall of the sinus W-shaped filament nickel-titanium alloy support (12), and a plurality of U-shaped valves (15) are arranged on the films (30) on the outer wall of the sinus W-shaped filament nickel-titanium alloy support (12);
the straight barrel support (20) comprises a straight barrel region nickel-titanium alloy support (21) with the bottom connected with the sinus membrane boundary ring (13), and a distal end anchoring ring (22) arranged on the top of the straight barrel region nickel-titanium alloy support (21).
2. The aortic root valved endovascular graft according to claim 1, wherein the membrane (30) is thermoformed to the sinus region stent (10) and the outer wall of the straight tubular stent (20), the membrane (30) being an ePTFE membrane.
3. The aortic root valved endovascular graft according to claim 1, wherein the aortic valve ring (11) is 16-30mm in diameter, and the aortic valve ring (11) is a nitinol ring.
4. The aortic root valved endovascular graft according to claim 1, wherein the sinus W-shaped wire nitinol stent (12) is drum-shaped, the peaks and valleys of the W-shaped wire (121) are respectively connected with an aortic valve annulus (11) and a sinus tube interface ring (13), and the sinus W-shaped wire nitinol stent (12) has a height of 10-30mm and a diameter ranging from 35-45mm.
5. The aortic root valved endovascular graft of claim 1, wherein the sinus ostium ring (13) is 20-35mm in diameter, the sinus ostium ring (13) being a nitinol ring.
6. The aortic root valved endovascular graft according to claim 1, wherein there are 10-15U-shaped flaps (15) in each V-shaped region of the W-shaped wire (121).
7. The aortic root valved endovascular graft according to claim 1, wherein the U-shaped flap (15) is 1mm long and 0.5mm wide.
8. The aortic root valved endovascular graft according to claim 1, wherein the straight barrel zone nitinol stent (21) consists of a multi-turn straight barrel zone W-shaped filament nitinol stent (211).
9. The aortic root valved endovascular graft according to claim 8, wherein the straight barrel zone W-shaped filament nitinol stent (211) is 15mm in height and the straight barrel zone nitinol stent (21) is 50-70mm in length.
10. The aortic root valved endovascular graft according to claim 1, wherein the distal anchor ring (22) is 25-45mm in diameter, and the distal anchor ring (22) is a nitinol ring.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110859381.9A CN113558814B (en) | 2021-07-28 | 2021-07-28 | Aortic root valve-containing vessel endovascular graft |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110859381.9A CN113558814B (en) | 2021-07-28 | 2021-07-28 | Aortic root valve-containing vessel endovascular graft |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN113558814A CN113558814A (en) | 2021-10-29 |
| CN113558814B true CN113558814B (en) | 2024-03-15 |
Family
ID=78168657
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202110859381.9A Active CN113558814B (en) | 2021-07-28 | 2021-07-28 | Aortic root valve-containing vessel endovascular graft |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN113558814B (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2023235620A1 (en) * | 2022-06-04 | 2023-12-07 | The Board Of Trustees Of The Leland Stanford Junior University | Adjustable aortic annuloplasty rings for symmetric annulus reduction and methods for use |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107320219A (en) * | 2017-07-03 | 2017-11-07 | 中国人民解放军第二军医大学第二附属医院 | Aortic root valved conduit device |
| CN109481082A (en) * | 2018-12-19 | 2019-03-19 | 云南省阜外心血管病医院 | The aorta ascendens overlay film frame discharged through apical approach |
| CN112336497A (en) * | 2020-12-18 | 2021-02-09 | 陈宏伟 | Aortic root stent system |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP2821030B1 (en) * | 2012-02-27 | 2017-12-06 | Hiroshima University | Stent graft |
-
2021
- 2021-07-28 CN CN202110859381.9A patent/CN113558814B/en active Active
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107320219A (en) * | 2017-07-03 | 2017-11-07 | 中国人民解放军第二军医大学第二附属医院 | Aortic root valved conduit device |
| CN109481082A (en) * | 2018-12-19 | 2019-03-19 | 云南省阜外心血管病医院 | The aorta ascendens overlay film frame discharged through apical approach |
| CN112336497A (en) * | 2020-12-18 | 2021-02-09 | 陈宏伟 | Aortic root stent system |
Also Published As
| Publication number | Publication date |
|---|---|
| CN113558814A (en) | 2021-10-29 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| JP6738392B2 (en) | Intravascular aortic repair device and method of using the same | |
| CA2593587C (en) | Aaa repair device with aneurysm sac access port | |
| JP4394125B2 (en) | Multi-lumen prosthesis system and method | |
| EP1401357B1 (en) | Implant having means for fixation to a body lumen | |
| CN105208969B (en) | Multicompartment stent graft system for dissection of aorta | |
| CN102458309B (en) | Monoblock type quick-connect prosthetic heart valve and development system and method | |
| CN105792780B (en) | Aortic insuffciency prosthetic appliance and method | |
| US7491231B2 (en) | One-branch stent-graft for bifurcated lumens | |
| US6210422B1 (en) | Bifurcated vascular graft deployment device | |
| JP4350383B2 (en) | Upper kidney fixation prosthesis | |
| US6951572B1 (en) | Bifurcated vascular graft and method and apparatus for deploying same | |
| EP2606852B1 (en) | Endoluminal prosthesis comprising a valve replacement and at least one fenestration | |
| US20160193029A1 (en) | Ascending aorta stent-graft system | |
| US8771336B2 (en) | Endoluminal prosthesis comprising a valve replacement and at least one fenestration | |
| Jakob et al. | Development of an integrated stent graft-dacron prosthesis for intended one-stage repair in complex thoracic aortic disease | |
| JP2004130100A (en) | Abrasion resistant vascular graft | |
| JP2003502080A (en) | Self-expanding bifurcated luminal prosthesis | |
| JP2003230577A (en) | Supra-renal prosthesis and renal artery bypass | |
| JP2003230632A (en) | Prosthesis | |
| CN101172058B (en) | Bracket valve with bracket and biovalve knitted integrally and preparation method thereof | |
| EP2095793B1 (en) | Device for attaching a stent structure to aaa graft material | |
| CN113558814B (en) | Aortic root valve-containing vessel endovascular graft | |
| CN109481082B (en) | Ascending aorta covered stent released by apex of heart way | |
| CN101036602B (en) | Self-extending type bracket flexible connection ring compressing mechanism | |
| CN209474866U (en) | The aorta ascendens overlay film frame discharged through apical approach |
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 | ||
| GR01 | Patent grant | ||
| GR01 | Patent grant |