CN113940791B - Mitral valve forceps holder and mitral valve forceps holder conveying device - Google Patents
Mitral valve forceps holder and mitral valve forceps holder conveying device Download PDFInfo
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- CN113940791B CN113940791B CN202111576028.6A CN202111576028A CN113940791B CN 113940791 B CN113940791 B CN 113940791B CN 202111576028 A CN202111576028 A CN 202111576028A CN 113940791 B CN113940791 B CN 113940791B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—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
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Abstract
The invention provides a mitral valve forceps holder and a mitral valve forceps holder conveying device, and relates to the technical field of surgical instruments in biomedicine, wherein the mitral valve forceps holder comprises a fixed seat, a slide block, a driving rod, a lower valve clamp, an upper valve clamp and a slide block locking assembly, wherein the slide block locking assembly is used for locking the slide block to the fixed seat so as to lock the opening or closing state of two lower clamp arms; the mitral valve clamp delivery device comprises the mitral valve clamp. The invention solves the technical problem that the closed upper and lower valve clamps are easy to open under the impact of blood after the mitral valve clamp in the prior art is delivered to the lesion position and is closed.
Description
Technical Field
The invention relates to the technical field of surgical instruments in biomedicine, in particular to a mitral valve forceps holder and a mitral valve forceps holder conveying device.
Background
The mitral valve is an important valve of the heart. The heart blood flows from the left atrium through the mitral valve into the left ventricle, from where it is pumped into the aorta and into the body. The mitral valve opens and blood flows from the left atrium into the left ventricle; the mitral valve is then closed to ensure that blood does not flow back into the left atrium as the left ventricle contracts to pump blood into the aorta. If the mitral valve becomes diseased and fails to close sufficiently, it can lead to regurgitation of blood into the left atrium upon contraction of the left ventricle, which is mitral regurgitation.
Mitral regurgitation is the most common heart valve disease worldwide. The reflux reduces the amount of blood flow to various parts of the body, and the heart attempts to pump blood more forcefully to compensate for this, increasing the heart's burden. Patients with severe mitral regurgitation can develop a variety of debilitating symptoms such as shortness of breath, palpitations, dizziness, and fatigue. These patients are at risk of poor quality of life, significantly limited mobility, repeated hospitalization for heart failure and increased mortality. Chronic severe mitral regurgitation is often accompanied by heart failure, which can lead to death if left untreated.
Transcatheter mitral valve clamping (MitraClip) is a minimally invasive catheter intervention for patients with severe mitral regurgitation and high surgical risk, and is the first intervention for treating part of severe mitral regurgitation at present. Specifically, transcatheter mitral valve clamping (MitraClip) is inspired by surgical edge repair and limbal mitral valve repair technology, and adopts similar technical principles, and a special mitral valve clamp (Clip) is used to reach the heart through a human blood vessel, and under the three-dimensional ultrasonic guidance, the middle parts of two leaflets of the mitral valve are clamped, so that the mitral valve is changed from a large single orifice into a small double orifice during the contraction period, and the mitral valve regurgitation is reduced. In brief, the following steps: the instrument is sent into the heart through the blood vessel of the human body by the catheter mitral valve repair technology, the wound is extremely small, the heart is not damaged, the heart normally beats in the operation process, the cardiopulmonary circulation support in vitro is not needed, the recovery of the patient is quicker, the patient can be discharged from the hospital within 2 to 3 days after the operation, and the patient can participate in daily activities within 1 week after the operation.
In the prior art, after the mitral valve clamp is delivered to a diseased position and closed, the closed upper valve clamp and the closed lower valve clamp are easy to open under the impact of blood along with the normal pulsation of the heart.
Disclosure of Invention
The invention aims to provide a mitral valve clamp device and a mitral valve clamp conveying device, which are used for relieving the technical problem that closed upper and lower valve clamps are easy to open under the impact of blood after the mitral valve clamp device in the prior art is delivered to a diseased position and is closed.
In order to achieve the above purpose, the embodiment of the invention adopts the following technical scheme:
in a first aspect, an embodiment of the present invention provides a mitral valve forceps, including a fixing base, a slider, a driving rod, a lower valve clip, and an upper valve clip;
the sliding block is connected to the fixed seat in a sliding mode, and the far end of the driving rod is connected to the near end of the sliding block; the lower valve clamp comprises two lower clamping arms, one ends of the two lower clamping arms are symmetrically hinged to two sides of the sliding block, and the parts, close to the parts hinged to the sliding block, of the two lower clamping arms are hinged to the far end of the fixed seat through hinge rods respectively; the driving rod can drive the sliding block to slide towards the far end relative to the fixed seat so as to pull the two lower clamping arms to be closed, or drive the sliding block to slide towards the near end relative to the fixed seat so as to open the two lower clamping arms; the upper valve clamp comprises two upper clamp arms, one ends of the two upper clamp arms are symmetrically connected to two sides of the sliding block, the two upper clamp arms are positioned at the proximal ends of the two lower clamp arms, and traction wire through holes for penetrating and arranging the folded upper clamp arm traction wires are formed in the two upper clamp arms; the two upper clamping arms are respectively made of elastic materials and are configured to be opened towards a direction far away from the sliding block all the time so as to be attached to the movement trends of the two lower clamping arms;
wherein: the mitral valve clamp also comprises a slide block locking assembly, and the slide block locking assembly is used for locking the slide block in the fixed seat so as to lock the opening or closing state of the two lower clamp arms.
The embodiment of the invention can effectively solve the problem that the closed upper valve clamp and the closed lower valve clamp are easy to open under the impact of blood along with the normal pulsation of the heart after the mitral valve clamp is delivered to a diseased position to be closed.
In an optional implementation manner of this embodiment, the slider locking assembly includes an elastic snap strip and a snap strip limiting member;
the far end of the elastic buckle strip is suspended in the air, and the near end of the elastic buckle strip is connected to the fixed seat; the near end of the buckle strip limiting piece is connected with a limiting piece traction wire; the elastic buckle strip is provided with a limiting hole, and the buckle strip limiting part penetrates through the limiting hole;
in the direction extending from the near end to the far end, a plurality of slots or jacks are arranged on the side surface of the sliding block at intervals; under the circumstances of elasticity buckle strip, the distal end of elasticity buckle strip is in under the effect of elasticity buckle strip self the middle part of slider moves to inserting in a slot or the jack of slider side, and then with the slider locks in the fixing base.
Further optionally, the buckle strip limiting part and the limiting part traction wire connected to the near end of the buckle strip limiting part are of an integrated traction wire structure, or the buckle strip limiting part is a hard limiting part.
Optionally, the elastic buckle strip with buckle strip locating part includes two respectively, and from the near-end to the direction that the distal end extends, two the symmetry of elastic buckle strip is located the both sides of fixing base, be equipped with respectively on the relative both sides face of slider with two a plurality of slots or jacks that the elastic buckle strip corresponds.
Further optionally, in the slots or insertion holes on opposite sides of the slider: and the slot or the jack on one side surface of the sliding block and the slot or the jack on the other side surface of the sliding block are arranged in a staggered mode.
Optionally, a cavity extending in a proximal-to-distal direction is disposed in the fixing seat, the proximal end of the cavity extends to the proximal end face of the fixing seat, and the slider is slidably disposed in the cavity;
the side of the fixed seat is provided with a buckle strip through hole extending from the near end to the far end, and the near end of the elastic buckle strip is correspondingly connected with the near end side wall of the buckle strip through hole.
Further optionally, a side surface of the fixed seat is provided with a slotted track extending along a proximal direction to a distal direction, a side surface of the slider is fixedly or integrally connected with a guide protrusion, and the guide protrusion extends out and is slidably connected to the slotted track so as to guide a sliding motion of the slider relative to the fixed seat.
Optionally, a widening part is mounted at the edge part of each of the two lower clamping arms;
in any said lower arm lock: the two sides of the lower clamping arm in the length direction are respectively provided with a slide way, the widening part comprises an elastic wire, and the elastic wire is connected with the lower clamping arm in a semi-surrounding way in a way that the middle part of the elastic wire bypasses one end of the lower clamping arm, which is far away from the slide block, one end of the elastic wire is connected with the inside of the slide way on one side of the lower clamping arm in the length direction in a sliding way, and the other end of the elastic wire is connected with the inside of the slide way on the other side of the lower clamping arm in the length direction in a sliding way; in a free state, the elastic wires are positioned on two sides of the lower clamping arm in the length direction, and the parts of the elastic wires, which are exposed out of the slide way, are arched towards one side, which is far away from the lower clamping arm, in the width direction of the lower clamping arm to form a curved shape;
the elastic wire receives the edge the width direction of lower arm lock court under the circumstances of lower arm lock extruded extrusion force, the both ends of elastic wire are followed the slide slides, so that the elastic wire is located both sides on the lower arm lock length direction just expose the position of slide laminate in both sides face on the lower arm lock length direction.
Further optionally, the elastic wire is wound around the lower clamping arm, one end of the elastic wire, far away from the sliding block, is fixedly connected to the lower clamping arm, and/or the slide is set to be of a structure capable of limiting the end of the elastic wire so as to prevent the elastic wire from slipping off the slide.
In a second aspect, embodiments of the present invention provide a mitral valve clamping delivery device, comprising an operating handle, an outer tube, a connecting rod, and a mitral valve clamp according to any one of the preceding embodiments; wherein:
the operating handle comprises a handle shell, a first upper clamping arm traction wire handle and a second upper clamping arm traction wire handle;
the near end of the outer tube is connected to the handle shell and communicated with the inner space of the handle shell, the outer tube comprises an outer sleeve and a middle sleeve, the near end of the middle sleeve is connected to the inside of the far end of the outer sleeve, and the far end of the middle sleeve extends out of the outer sleeve and is in threaded connection or clamped connection with the near end of the fixed seat; the connecting rod penetrates through the middle sleeve, the outer sleeve and the handle shell, and the far end of the connecting rod is in threaded connection with the near end of the driving rod;
the far end of the first upper clamping arm traction wire handle and the far end of the second upper clamping arm traction wire handle are connected to the handle shell and communicated with the inner space of the handle shell, one upper clamping arm traction wire penetrating through the upper clamping arm penetrates through the outer tube and the first upper clamping arm traction wire handle and then is pressed on the first upper clamping arm traction wire handle by a first handle rear cover, and the other upper clamping arm traction wire penetrating through the upper clamping arm penetrates through the outer tube and the second upper clamping arm traction wire handle and then is pressed on the second upper clamping arm traction wire handle by a second handle rear cover.
Because the mitral valve clamping and conveying device provided by the embodiment of the invention comprises the mitral valve clamp provided by the first aspect, the mitral valve clamping and conveying device provided by the embodiment of the invention can achieve all the beneficial effects which can be achieved by the mitral valve clamp provided by the first aspect.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and other drawings can be obtained by those skilled in the art without creative efforts.
Fig. 1 is a schematic view of the overall structure of a mitral valve holder according to an embodiment of the present invention;
FIG. 2 is a partial cross-sectional structural view of the mitral valve holder shown in FIG. 1;
FIG. 3 is an enlarged view of a portion A of FIG. 2;
FIG. 4 is an exploded view of a portion of the mitral valve holder shown in FIG. 1;
FIG. 5 is an enlarged view of a portion B of FIG. 4;
FIG. 6 is a schematic view of the distal end face configuration of the mitral valve holder shown in FIG. 1;
FIG. 7 is an exploded view of FIG. 6;
fig. 8 is a schematic structural diagram of a mitral valve forceps delivery device according to an embodiment of the present invention;
FIG. 9 is an enlarged view of a portion C of FIG. 8;
FIG. 10 is an enlarged view of a portion D of FIG. 8;
fig. 11 is a partial structure enlarged view of a portion E in fig. 8.
Icon: 1-a fixed seat; 11-punching the buckle strip; 12-slotted track; 2-a slide block; 21-slot; 22-guide bumps; 3-a drive rod; 4-upper clamping arm; 41-barbs; 5-lower clamping arm; 51-a hinged lever; 61-elastic snap strips; 610-a limiting hole; 62-snap strip limit; 7-elastic yarns; 81-a handle housing; 82-a first upper clamp arm pull wire handle; 83-a second upper clamp arm pull wire handle; 84-a limiter pull wire handle; 85-connecting the rod handle; 9-an outer tube; 91-connecting rod.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all embodiments of the present invention. The components of embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.
Thus, the following detailed description of the embodiments of the present invention, presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, it need not be further defined and explained in subsequent figures.
In the description of the present invention, it should be noted that the terms "upper", "lower", "vertical", "horizontal", "inner", "outer", etc. indicate orientations or positional relationships based on orientations or positional relationships shown in the drawings or orientations or positional relationships conventionally placed when the products of the present invention are used, and are only for convenience of description and simplification of the description, but do not indicate or imply that the devices or elements referred to must have specific orientations, be constructed and operated in specific orientations, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and the like are used solely to distinguish one from another, and are not to be construed as indicating or implying relative importance.
Furthermore, the terms "horizontal", "vertical" and the like do not imply that the components are required to be absolutely horizontal or pendant, but rather may be slightly inclined. For example, "horizontal" merely means that the direction is more horizontal than "vertical" and does not mean that the structure must be perfectly horizontal, but may be slightly inclined.
In particular, in this embodiment, during the operation, the end of the medical instrument close to the operator is the proximal end of the medical instrument, and the end of the medical instrument entering the blood vessel of the patient is the distal end of the medical instrument (the front end of the surgical instrument is the distal end, and the rear end of the surgical instrument is the proximal end).
In the description of the present invention, it should also be noted that, unless otherwise explicitly specified or limited, the terms "disposed," "mounted," and "connected" are to be construed broadly, e.g., as meaning fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.
Some embodiments of the invention are described in detail below with reference to the accompanying drawings. The embodiments and features of the embodiments described below can be combined with each other without conflict.
Example one
The present embodiment provides a mitral valve forceps, referring to fig. 1 to 7, the mitral valve forceps includes a fixing base 1, a slider 2, a driving rod 3, a lower valve clip, and an upper valve clip; the slide block 2 is connected with the fixed seat 1 in a sliding way, and the far end of the driving rod 3 is connected with the near end of the slide block 2; the lower valve clamp comprises two lower clamping arms 5, one ends of the two lower clamping arms 5 are symmetrically hinged to two sides of the sliding block 2, the parts, close to the parts hinged to the sliding block 2, of the two lower clamping arms 5 are hinged to the far end of the fixed seat 1 through hinge rods 51 respectively, preferably, but not limited to, a connector is fixedly connected or integrally connected to the head of the far end of the fixed seat 1, and one end of each hinge rod 51 is hinged to the connector; the driving rod 3 can drive the sliding block 2 to slide towards the far end direction relative to the fixed seat 1 so as to pull the two lower clamping arms 5 to be closed, or drive the sliding block 2 to slide towards the near end direction relative to the fixed seat 1 so as to open the two lower clamping arms 5; the upper valve clamp comprises two upper clamp arms 4, one ends of the two upper clamp arms 4 are symmetrically connected to two sides of the sliding block 2, the two upper clamp arms 4 are positioned at the proximal ends of the two lower clamp arms 5, and traction wire through holes for penetrating and arranging traction wires of the folded upper clamp arms 4 are formed in the two upper clamp arms 4; the two upper clamping arms 4 are made of nitinol or other memory alloy or other kinds of elastic materials, specifically, the two upper clamping arms 4 are made of nitinol or other memory metal or other kinds of elastic materials, respectively, or the two upper clamping arms 4 are connected to the slider 2 through springs or other elastic structures, respectively, so that the two upper clamping arms 4 are configured to be always opened in a direction away from the slider 2 to be attached to the movement tendency of the two lower clamping arms 5.
During operation, the two lower clamping arms 5 and the two upper clamping arms 4 of the mitral valve forceps holder are loaded and closed by using the mitral valve forceps holder conveying device, specifically, the mitral valve forceps holder is detachably connected to the distal end of the mitral valve forceps holder conveying device, the traction wire of the upper clamping arms is tensioned towards the proximal direction so that the two upper clamping arms 4 are in a folded state, and the drive rod 3 is pushed towards the distal direction relative to the fixed seat 1 by using the mitral valve forceps holder conveying device so that the two lower clamping arms 5 are closed and the mitral valve forceps holder is in a completely folded state; then, the mitral valve clamp is sent to the heart in a puncture mode, under the guidance of three-dimensional ultrasound, the two lower clamp arms 5 penetrate through the middle parts of the two leaflets of the mitral valve, the mitral valve clamp conveying device is operated to pull the driving rod 3 towards the proximal direction relative to the fixed seat 1 so as to open the two lower clamp arms 5, then the whole mitral valve clamp conveying device is pulled towards the proximal direction so that one lower clamp arm drags one leaflet of the mitral valve, and the other lower clamp arm drags the other leaflet of the mitral valve; then, releasing the traction wire of the upper clamping arm, so that one leaflet of the mitral valve is clamped between one lower clamping arm 5 and one upper clamping arm 4, and the other leaflet of the mitral valve is clamped between the other lower clamping arm 5 and the other upper clamping arm 4; then, the whole mitral valve forceps holder conveying device is pulled towards the proximal direction, and meanwhile, the mitral valve forceps holder conveying device is operated to continuously push the driving rod 3 towards the distal direction relative to the fixed seat 1, so that the two lower clamping arms 5 drive the two upper clamping arms 4 to be completely folded, and finally the middle parts of two leaflets of the mitral valve are clamped, so that the mitral valve is changed from a large single hole into a small double hole in the contraction period, and the mitral valve regurgitation is reduced; and finally, withdrawing the conveying part of the mitral valve forceps holder conveying device and each traction wire out of the patient body, and leaving the mitral valve forceps holder in the patient body.
In order to solve the problem that the closed upper and lower valve clips are easy to open under the impact of blood when the heart normally beats after the mitral valve clip device is delivered to the diseased position to be closed, in the embodiment, particularly, with continuing reference to fig. 1 to 7, and particularly, with reference to fig. 1 to 5, the mitral valve clip device further comprises a slider locking assembly for locking the slider 2 to the fixing base 1 so as to lock the open or closed state of the two lower clip arms 5.
More specifically, the slider locking assembly described above has a variety of alternative configurations, and in some alternative embodiments, as shown in fig. 1-5, the slider locking assembly includes a resilient snap strip 61 and a snap strip stop 62; the far end of the elastic buckle strip 61 is suspended, and the near end of the elastic buckle strip 61 is connected to the fixed seat 1; a limit piece traction wire is connected to the near end of the buckle strip limit piece 62; the elastic buckle strip 61 is provided with a limiting hole 610, and the buckle strip limiting part 62 penetrates through the limiting hole 610. A plurality of slots 21 or jacks are arranged on the side surface of the sliding block 2 at intervals in the direction extending from the near end to the far end; when drawing the silk to distal end direction tractive locating part, buckle strip locating part 62 can break away from elasticity buckle strip 61, break away from under the condition of elasticity buckle strip 61 at buckle strip locating part 62, the distal end of elasticity buckle strip 61 moves to inserting in a slot 21 or the jack of 2 sides of slider to the middle part of slider 2 under the effect of elasticity buckle strip 61 self elasticity, and then locks slider 2 in fixing base 1, lock in when fixing base 1 when slider 2, can lock two opening or the closure state of arm lock 5 this moment down. The buckle strip limiting member 62 and the limiting member traction wire connected to the proximal end of the buckle strip limiting member 62 are of an integrated traction wire structure, or the buckle strip limiting member 62 is a hard limiting member.
In these embodiments, as shown in fig. 1 to fig. 5, preferably, the two elastic buckling strips 61 and the buckling strip limiting members 62 respectively include two elastic buckling strips 61 and two buckling strip limiting members 62, the two elastic buckling strips 61 are symmetrically disposed on two sides of the fixing base 1, and a plurality of slots 21 or insertion holes corresponding to the two elastic buckling strips 61 are respectively disposed on two opposite side surfaces of the sliding block 2.
Furthermore, in these embodiments, if the slider 2 is inserted into the slot 21 or the insertion hole on the opposite sides: the slot 21 or the jack on one side of the slider 2 is symmetrically arranged with the slot 21 or the jack on the other side of the slider 2, so that when the slider 2 is driven by the driving rod 3 to move to some positions to be locked relative to the fixing base 1, actually, the distal ends of the elastic buckle strips 61 on both sides of the fixing base 1 correspond to the positions between the adjacent slots 21 or jacks on the slider 2, so that the slider 2 can only be inserted into the adjacent slot 21 or jack after continuously sliding relative to the fixing base 1, thereby causing the problem of dislocation locking, and in these embodiments, it is further preferable that the slider 2 is inserted into the slots 21 or jacks on both sides of the slider 2: slot 21 or jack on 2 sides of slider and slot 21 or jack on 2 another sides of slider set up in a staggered way, through such structure, can make slider 2 under the drive of actuating lever 3, when relative fixing base 1 moves to arbitrary position, the distal end of the elasticity buckle strip 61 of 1 at least one side of fixing base can be inserted in the slider 2 and correspond a slot 21 or jack of side in order to lock slider 2 in fixing base 1, lock in the degree of accuracy of slider latched position when fixing base 1 with slider 2 in order to improve.
In addition, in the present embodiment, there are various specific sliding connection manners for the sliding block 2 to be slidably connected to the fixing base 1, for example, but not limited to, as shown in fig. 1 to 5, a cavity is provided inside the fixing base 1 and extends along the proximal end to the distal end, the proximal end of the cavity extends to the proximal end surface of the fixing base 1, and the sliding block 2 is slidably provided inside the cavity; the side of the fixing base 1 is provided with a snap strip through hole 11 extending from the proximal end to the distal end, the proximal end of the elastic snap strip 61 is correspondingly connected to the proximal end side wall of the snap strip through hole 11, and the elastic snap strip 61 can be in a curved shape with the middle portion arched towards one side departing from the fixing base 1 as shown in fig. 1 to 5.
Further preferably, but not limited to, as shown in fig. 4 and 5, a side of the above-mentioned fixed seat 1 is provided with a slotted track 12 extending in a proximal to distal direction, and a side of the sliding block 2 is fixed or integrally connected with a guide projection 22, the guide projection 22 extends out and is slidably connected with the slotted track 12, and the function of the guide projection 22 is: the sliding motion of the sliding block 2 relative to the fixed seat 1 is guided, so that the sliding block 2 slides smoothly relative to the fixed seat 1.
With continuing reference to fig. 1-7, and in particular to fig. 6 and 7, in order to further avoid that the closed upper and lower valve clips are opened by blood impact after the mitral valve clip device is delivered to the lesion site and closed, in an alternative embodiment of the present embodiment, it is preferable that a widening part is installed at an edge portion of both lower clip arms 5, specifically, in any one of the lower clip arms 5: the two sides of the lower clamping arm 5 in the length direction are both provided with slideways, the widening part comprises an elastic wire 7, and the elastic wire 7 is connected with the lower clamping arm 5 in a semi-surrounding manner in a way that the middle part of the elastic wire bypasses one end of the lower clamping arm 5 far away from the slide block 2, one end of the elastic wire is connected with the inside of the slideway on one side of the lower clamping arm 5 in the length direction in a sliding manner, and the other end of the elastic wire is connected with the inside of the slideway on the other side of the lower clamping arm 5 in the length direction in a sliding manner; in a free state, the elastic wires 7 are positioned on two sides of the lower clamping arm 5 in the length direction, and the parts of the elastic wires 7, which are exposed out of the slideways on the two sides of the lower clamping arm 5 in the length direction, are arched towards one side away from the lower clamping arm 5 in the width direction of the lower clamping arm 5 to form a curved shape; under the condition that the elastic wire 7 is subjected to the extrusion force which is extruded towards the lower clamping arm 5 along the width direction of the lower clamping arm 5, two ends of the elastic wire 7 slide along the slideways on two sides in the length direction of the lower clamping arm 5, so that the elastic wire 7 is positioned on two sides in the length direction of the lower clamping arm 5 and the parts which are exposed out of the slideways on the two sides in the length direction of the lower clamping arm 5 are attached to two side surfaces in the length direction of the lower clamping arm 5.
In these optional embodiments, by providing the widening component, the area of the mitral valve leaflet clamped by the upper and lower clamping arms can be widened and enlarged, so that the clamping force for clamping the mitral valve leaflet is improved, and the problem that the closed upper and lower valve clamps are easy to open under the impact of blood after the mitral valve clamp in the prior art is delivered to a diseased position and is closed is effectively solved. It is worth mentioning in particular: although the clamping area can be enlarged by directly widening the wide edge of the lower clamping arm 5, the conveying pipe of the mitral valve clamp conveying device is required to have a larger diameter by the structure, and the conveying pipe with the enlarged diameter cannot meet the requirement of safely entering the heart of a patient to perform interventional operation treatment, in contrast, the embodiment is characterized in that the elastic wire 7 is made in the structure, in the conveying process, the mitral valve clamp is positioned in the conveying pipe, the elastic wire 7 is extruded towards the lower clamping arm 5 along the width direction of the lower clamping arm 5, the parts, which are positioned on two sides in the length direction of the lower clamping arm 5 and exposed out of the slide way, of the elastic wire 7 are attached to two side faces in the length direction of the lower clamping arm 5, so that the diameter of the conveying pipe does not need to be increased, the mitral valve clamp is pushed out after the elastic wire 7 is conveyed to the right position, and the parts, which are positioned on two sides in the length direction of the lower clamping arm 5 and exposed out of the slide way, are arched towards one side away from the lower clamping arm 5 along the width direction of the lower clamping arm 5 to form a curve, so as to widen the function of the lower clamping arm 5, and the structure has a good application prospect in the medical procedure for treating the mitral valve regurgitation.
In an alternative structure of this embodiment, it is preferable that the elastic wire 7 is fixedly connected to the lower arm 5 by bypassing one end of the lower arm 5 away from the slider 2, and/or the slide ways on both sides of the length direction of the lower arm are configured to limit the end of the elastic wire 7 to prevent the elastic wire 7 from slipping off the slide ways, such as but not limited to a blind hole structure or a slot structure, where "and/or" means that the aforementioned "and/or" front structure and the "and/or" rear structure are provided at the same time or alternatively.
In addition, in some optional embodiments of this embodiment, the two upper clipping arms 4 are provided with barbs 41 on the sides facing the lower clipping arm 5, so that the clamping force of the upper clipping arm 4 and the lower clipping arm 5 in the fitting state can be further increased by the barbs 41, and the closed upper and lower valve clips are prevented from being easily opened under the impact of blood.
Example two
The present embodiment provides a mitral valve clamping and delivering device, referring to fig. 8 to 11, and in combination with fig. 1 to 7, which includes an operating handle, an outer tube 9, a connecting rod 91, and a mitral valve clamp provided in any one of the alternative embodiments.
Specifically, the operating handle includes a handle housing 81, a first upper clamp arm pull wire handle 82 and a second upper clamp arm pull wire handle 83; the proximal end of the outer tube 9 is connected to the handle housing 81 and is communicated with the inner space of the handle housing 81, the outer tube 9 comprises an outer sleeve and a middle sleeve, wherein the proximal end of the middle sleeve is connected to the inside of the distal end of the outer sleeve, and the distal end of the middle sleeve extends out of the outer sleeve and is in threaded connection or clamped connection with the proximal end of the fixing seat 1; the connecting rod 91 passes through the middle sleeve, the outer sleeve and the handle housing 81, and the distal end of the connecting rod 91 is in threaded connection with the proximal end of the drive rod 3; the driving rod 3 is pushed and pulled in a manner of pushing and pulling the connecting rod 91 relative to the middle sleeve to drive the sliding block 2 to slide relative to the fixed seat 1 so as to open and close the lower clamping arm, the connecting rod 91 can be separated from the driving rod 3 in a manner of rotating the connecting rod 91 relative to the middle sleeve after the operation is finished, and then the far end of the middle sleeve is separated from the fixed seat 1; the far end of the first upper clamping arm traction wire handle 82 and the far end of the second upper clamping arm traction wire handle 83 are both connected to the handle shell 81 and communicated with the inner space of the handle shell 81, an upper clamping arm traction wire penetrating through one upper clamping arm 4 penetrates through the outer tube 9 and the first upper clamping arm traction wire handle 82 and then is pressed on the first upper clamping arm traction wire handle 82 by the first handle rear cover, and an upper clamping arm traction wire penetrating through the other upper clamping arm 4 penetrates through the outer tube 9 and the second upper clamping arm traction wire handle 83 and then is pressed on the second upper clamping arm traction wire handle 83 by the second handle rear cover; when the upper clamping arm 4 is released to enable the upper clamping arm 4 to recover the free state, the corresponding upper clamping arm traction wire can be loosened by opening the first handle rear cover and the second handle rear cover, after the mitral valve clamp is implanted, the first handle rear cover and the second handle rear cover are opened to extract one end of the corresponding upper clamping arm traction wire, and the upper clamping arm traction wire which penetrates through the corresponding upper clamping arm 4 in a folded manner can be extracted from the corresponding upper clamping arm traction wire handle. In this embodiment, it is preferable, but not limited to, that a connecting rod handle 85 is connected to the proximal end of the connecting rod 91, and in this embodiment, the first upper clamping arm pull wire handle 82 and the second upper clamping arm pull wire handle 83 can be connected by a handle connector (not shown) to control the actions of the two upper clamping arms 4 simultaneously, or alternatively, the first upper clamping arm pull wire handle 82 and the second upper clamping arm pull wire handle 83 can be disconnected from each other to control the actions of the two upper clamping arms 4 independently.
Since the mitral valve clamping and delivering device provided by this embodiment includes the mitral valve clamp described in the first embodiment, the mitral valve clamping and delivering device provided by this embodiment can achieve all the advantages that the mitral valve clamp can achieve in the first embodiment, and the specific structure and the achievable effects can be obtained with reference to the optional or preferred embodiments in the first embodiment.
Further, in each optional embodiment of the mitral valve forceps holder delivery device, in which the slider locking component adopts the above-mentioned structure of the elastic fastener strip 61 and the fastener strip stopper 62, and the slider 2 having the slot 21 or the insertion hole, the operating handle of the mitral valve forceps holder delivery device according to this embodiment is further shown in the figure, and includes a stopper pulling wire handle 84; the distal end of the retainer pull wire handle 84 is attached to the handle housing and communicates with the interior space of the handle housing, and the retainer pull wire passes through the outer tube 9 and the retainer pull wire handle 84.
Furthermore, in order to avoid interference between the traction wires, in various alternative embodiments of this embodiment, a plurality of traction wire cavities may be provided inside the outer tube 9 to separate the traction wires, the plurality of traction wire cavities may be provided inside the outer tube 9 directly on the wall of the outer tube 9, or may be provided by inserting a multi-lumen tube or a multi-lumen connector inside the outer tube 9, so that the connection rod 91 passes through the multi-lumen tube or the multi-lumen connector, and the proximal end of the middle sleeve may be fixedly connected to the inside of the multi-lumen tube or the distal end interface of the multi-lumen connector.
Finally, it should be noted that: all the embodiments in the specification are described in a progressive mode, the emphasis of each embodiment is on the difference from other embodiments, and the same and similar parts among the embodiments can be referred to each other; the above embodiments in the present specification are only used for illustrating the technical solution of the present invention, and not for limiting the same; while the invention has been described in detail and with reference to the foregoing embodiments, it will be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; and these modifications or substitutions do not depart from the spirit of the corresponding technical solutions of the embodiments of the present invention.
Claims (7)
1. A mitral valve holder, comprising: comprises a fixed seat (1), a slide block (2), a driving rod (3), a lower petal clamp and an upper petal clamp;
the sliding block (2) is connected to the fixed seat (1) in a sliding mode, and the far end of the driving rod (3) is connected to the near end of the sliding block (2); the lower valve clamp comprises two lower clamping arms (5), one ends of the two lower clamping arms (5) are symmetrically hinged to two sides of the sliding block (2), and parts, close to the parts hinged to the sliding block (2), of the two lower clamping arms (5) are hinged to the far end of the fixed seat (1) through hinge rods (51) respectively; the driving rod (3) can drive the sliding block (2) to slide towards the far end direction relative to the fixed seat (1) so as to pull the two lower clamping arms (5) to be closed, or drive the sliding block (2) to slide towards the near end direction relative to the fixed seat (1) so as to open the two lower clamping arms (5); the upper valve clamp comprises two upper clamp arms (4), one ends of the two upper clamp arms (4) are symmetrically connected to two sides of the sliding block (2), the two upper clamp arms (4) are located on the proximal end sides of the two lower clamp arms (5), and traction wire through holes for penetrating through the folded upper clamp arm traction wires are formed in the two upper clamp arms (4); the two upper clamping arms (4) are respectively made of elastic materials, and the two upper clamping arms (4) are configured to be always opened towards the direction far away from the sliding block (2) so as to be attached to the movement trends of the two lower clamping arms (5);
wherein:
the mitral valve clamping device also comprises a slide block locking component, wherein the slide block locking component is used for locking the slide block (2) to the fixed seat (1) so as to lock the open or closed state of the two lower clamping arms (5);
the sliding block locking assembly comprises an elastic buckle strip (61) and a buckle strip limiting piece (62); the far end of the elastic buckle strip (61) is suspended, and the near end of the elastic buckle strip (61) is connected to the fixed seat (1); the near end of the buckle strip limiting piece (62) is connected with a limiting piece traction wire; a limiting hole (610) is formed in the elastic buckling strip (61), and the buckling strip limiting piece (62) penetrates through the limiting hole (610); a plurality of slots (21) or jacks are arranged on the side surface of the sliding block (2) at intervals in the direction extending from the near end to the far end; under the condition that the buckle strip limiting piece (62) is separated from the elastic buckle strip (61), the far end of the elastic buckle strip (61) moves towards the middle of the sliding block (2) under the action of the elasticity of the elastic buckle strip (61) to be inserted into one slot (21) or an insertion hole on the side surface of the sliding block (2), and then the sliding block (2) is locked on the fixed seat (1);
the elastic buckling strips (61) and the buckling strip limiting parts (62) respectively comprise two elastic buckling strips (61), the two elastic buckling strips (61) are symmetrically arranged on two sides of the fixed seat (1) from the near end to the far end, and a plurality of slots (21) or jacks corresponding to the two elastic buckling strips (61) are respectively arranged on two opposite side surfaces of the sliding block (2); in slot (21) or the jack on the relative both sides face of slider (2): and the slot (21) or the jack on one side surface of the sliding block (2) and the slot (21) or the jack on the other side surface of the sliding block (2) are arranged in a staggered manner.
2. The mitral valve holder of claim 1, wherein: the buckle strip limiting part (62) and a limiting part traction wire connected to the near end of the buckle strip limiting part (62) are of an integrated traction wire structure, or the buckle strip limiting part (62) is a hard limiting part.
3. The mitral valve holder of claim 1, wherein: a cavity extending from the near end to the far end is formed in the fixed seat (1), the near end of the cavity extends to the near end face of the fixed seat (1), and the sliding block (2) is arranged in the cavity in a sliding mode;
the side of the fixed seat (1) is provided with a buckle strip through hole (11) extending from the near end to the far end, and the near end of the elastic buckle strip (61) is correspondingly connected with the near end side wall of the buckle strip through hole (11).
4. The mitral valve holder of claim 3, wherein: the side surface of the fixed seat (1) is provided with a long hole type track (12) extending along the direction from the near end to the far end, the side surface of the sliding block (2) is fixedly or integrally connected with a guide protruding block (22), and the guide protruding block (22) extends out and is connected with the long hole type track (12) in a sliding mode so as to guide the sliding motion of the sliding block (2) relative to the fixed seat (1).
5. The mitral valve holder according to any one of claims 1-4, wherein: the edge parts of the two lower clamping arms (5) are respectively provided with a widening part;
any one of the lower clamping arms (5) is: the two sides of the lower clamping arm (5) in the length direction are respectively provided with a slide way, the widening part comprises an elastic wire (7), and the elastic wire (7) is connected with the lower clamping arm (5) in a semi-surrounding manner in a mode that the middle part of the elastic wire bypasses one end of the lower clamping arm (5) far away from the slide block (2), one end of the elastic wire is connected with the inside of the slide way on one side of the lower clamping arm (5) in the length direction in a sliding manner, and the other end of the elastic wire is connected with the inside of the slide way on the other side of the lower clamping arm (5) in the length direction in a sliding manner; in a free state, the elastic wires (7) are positioned on two sides of the length direction of the lower clamping arm (5) and the parts of the elastic wires exposed out of the slide way arch towards one side departing from the lower clamping arm (5) along the width direction of the lower clamping arm (5) to form a curved shape;
elastic wire (7) receive the edge the width direction of arm lock (5) court down under the condition of arm lock (5) extruded extrusion force, the both ends of elastic wire (7) are followed the slide slides, so that elastic wire (7) are located down arm lock (5) ascending both sides in length direction and expose the position of slide laminate in arm lock (5) ascending both sides face in length direction down.
6. The mitral valve holder of claim 5, wherein: elastic wire (7) are walked around lower arm lock (5) are kept away from the one end fixed connection of slider (2) in arm lock (5) down, and/or, the slide is established to be can right the tip of elastic wire (7) is carried on spacingly in order to prevent elastic wire (7) slippage the structure of slide.
7. A mitral valve forceps holder delivery device, characterized by: comprising an operating handle, an outer tube (9), a connecting rod (91) and a mitral valve holder according to any one of claims 1 to 6;
the operating handle comprises a handle shell (81), a first upper clamping arm traction wire handle (82) and a second upper clamping arm traction wire handle (83);
the near end of the outer tube (9) is connected to the handle shell (81) and communicated with the inner space of the handle shell (81), the outer tube (9) comprises an outer sleeve and a middle sleeve, the near end of the middle sleeve is connected to the inside of the far end of the outer sleeve, and the far end of the middle sleeve extends out of the outer sleeve and is in threaded connection or clamped connection with the near end of the fixing seat (1); the connecting rod (91) penetrates through the middle sleeve, the outer sleeve and the handle shell (81), and the far end of the connecting rod (91) is in threaded connection with the near end of the driving rod (3);
the distal end of arm lock haulage silk handle (82) on the first with the distal end of arm lock haulage silk handle (83) all connect in on the second handle casing (81) and with the inner space intercommunication of handle casing (81), one go up wear to establish on arm lock (4) go up the arm lock haulage silk pass outer tube (9) with after first arm lock haulage silk handle (82) on the first lid compress tightly in first arm lock haulage silk handle (82) is gone up, another go up arm lock (4) wear to establish go up the arm lock haulage silk pass outer tube (9) with after arm lock haulage silk handle (83) on the second by behind the second handle lid compress tightly in arm lock haulage silk handle (83) is gone up to the second.
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| Application Number | Priority Date | Filing Date | Title |
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| CN202111576028.6A CN113940791B (en) | 2021-12-22 | 2021-12-22 | Mitral valve forceps holder and mitral valve forceps holder conveying device |
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| CN202111576028.6A CN113940791B (en) | 2021-12-22 | 2021-12-22 | Mitral valve forceps holder and mitral valve forceps holder conveying device |
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| CN113940791A (en) | 2022-01-18 |
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