CN201572214U - Device transplanted into pulmonary artery biological valve through right ventricular outflow tract without cardiopulmonary bypass - Google Patents

Abstract

The utility model relates to a device transplanted into a pulmonary artery biological valve through a right ventricular outflow tract without cardiopulmonary bypass (CPB). The device comprises a biological valve and a valve conveyor. The biological valve is provided with a hollow fixing base; the valve conveyor comprises a balloon, a handle, a valve assembling-disassembling component and a hollow tube, wherein the exterior of the hollow tube is wrapped with the balloon, the valve assembling-disassembling component is communicated with the balloon and runs through the hollow tube, and a part of the valve assembling-disassembling component is arranged in the handle; and when the biological valve is implanted, the balloon is arranged in the hollow part of the hollow fixing base. The device has the following advantages and benefits: the valve is implanted through the right ventricular outflow tract handily, the operation time is short and the blocking time is extremely short, so that patients suffer less pain with less blood loss and small wound, and recover rapidly. The valve can be implanted without the cardiopulmonary bypass, thus reducing injury to the patients. The adopted valve has abundant models, thus being applicable to patients under different states of illness. The valve is easy to be fixed after being implanted, thus avoiding postoperation displacement, having no perivalvular leakage, and further improving the long-term treatment effect. The valve which is implanted is not folded, thus having good durability.

Description

The device of non-extracorporeal circulation implanting pulmonary artery biological valve (BV) by outflow tract of right ventricle under

Technical field

This utility model relates to the device of operation, and is especially a kind of under the condition of non-extracorporeal circulation heart beating, with the device of bioprosthesis valve via outflow tract of right ventricle implanting pulmonary artery lobe position.

Background technology

In the Cardiac Surgery field, the CMH of lung insufficiency of blood classes such as sufferer execution tetralogy of Fallot is rescued the art postoperative, and whether improving of valve of pulmonary trunk 26S Proteasome Structure and Function is an important problem, and it directly influences patient's late result.Yet chronic pulmonary insufficiency is the modal problem of this class patient postoperative often, because the existence of chronic volume load, can cause finally that the sufferer exercise tolerance is poor, problems such as electrocardiogram QRS ripple broadening companion's cardiac arrhythmia and the increase of sudden death incidence rate.Therapeutic intervention as early as possible can prevent effectively that the right ventricle from irreversible fibrosis taking place, and is significant for the development of the state of an illness.For this situation, conventional therapeutic intervention method is to finish valve of pulmonary trunk to replace art under extracorporeal circulation.Because this operation is a second operation, and need carry out extracorporeal circulation,, add that operation just has more danger so the damage of sufferer is big if the patient has right heart insufficiency.Along with development of science and technology, new diagnosis and treatment apparatus and method constantly occur.The people such as Bonhoeffer of Germany once used the zoopery that percutaneous valve implanted prosthetics has been finished the valve of pulmonary trunk implantation in 2000, in recent years along with the continuous progress of New-support valve and induction system development, be applied this class patient based on the percutaneous valve of pulmonary trunk implantation of conduit.This method wound is little, need not extracorporeal circulation, and determined curative effect obtains extensive approval in the industry, is promoted clinical gradually.Thus, the method for Bonhoeffer has been started the New Times that Wicresoft's stent valve is implanted, and the treatment of backflowing for valve of pulmonary trunk provides new approach.

Yet, this new method also has a born defective: because employing is micro-wound percutaneous implantation, therefore the maximum model of the valve of this method implantation is 22mm, and minimum puncture sheath pipe diameter is 16Fr (about 5.28mm), therefore, enlarge and pulmonary artery increases thick patient (it is much in 22mm that valve of pulmonary trunk is implanted the position) or body weight less than 30kg infant (can not use the puncture sheath pipe of diameter 16Fr) for outflow tract of right ventricle, at present because the defective of technology itself, the valve of suitable types and induction system and reliable valve anchorage method can't be provided and can't use this kind technology.According to the clinical practice experience, the main pulmonary artery diameter of such sufferer is often all greater than 30mm, and therefore, the new technique that this percutaneous is implanted valve is inapplicable for many patients.

For unsolved problem in the method that solves percutaneous implanting pulmonary artery valve, the someone inquires into out to implant on pulmonary artery earlier under the breast and encircles the ring that contracts to dwindle pulmonary artery size, adopts the new method percutaneous to implant the stent valve of suitable types again; Or under non-extracorporeal circulation, implant relatively large number stent valve through outflow tract of right ventricle, though these methods in various degree in zoopery, reached preliminary effect, but also still limited (26mm) of valve model that uses still has many patients better to be treated.In addition, it needs to be noted, the new method of Bonhoeffer and modification method on its basis subsequently, that uses is stent valve, and this valve self also has some other defective that is difficult to overcome: not firm, the easy displacement of stent valve grappling, easily send out perivalvular leakage, support easy fracture and its durability is reduced etc. greatly because valve need be out of shape when implanting.

From the above mentioned, there is following deficiency in existing valve of pulmonary trunk implanted prosthetics: the traditional surgery risk is relatively large; Get involved down percutaneous valve implanted prosthetics scope of application stent valve defective very limited, that implant more (not firm, the easy displacement of grappling, easily send out perivalvular leakage, support easy fracture, poor durability), need expensive special induction system and X-ray equipment.

The utility model content

Purpose of this utility model is relatively large at the traditional surgery risk that occurs in the valve of pulmonary trunk implanted prosthetics; Get involved percutaneous valve implanted prosthetics scope of application stent valve defective very limited, that implant problem design more, that need expensive special induction system and X-ray equipment down a kind of under non-extracorporeal circulation, simple to operation, be easy to implant fixing, valve is superior in quality, the requirement of cheap, no particular procedure equipment, no x-ray radiation danger, special-purpose valve of pulmonary trunk implanting device that the utilization scope is wide.

Another purpose of this utility model is relatively large at the traditional surgery risk that occurs in the valve of pulmonary trunk implanted prosthetics; Get involved percutaneous valve implanted prosthetics scope of application stent valve defective very limited, that implant problem design more, that need expensive special induction system and X-ray equipment down a kind of under non-extracorporeal circulation, simple to operation, be easy to implant fixing, valve is superior in quality, the method for cheap, no x-ray radiation danger, the requirement of no particular procedure equipment, special-purpose valve of pulmonary trunk implantation that the utilization scope is wide.

For achieving the above object, the technical solution of the utility model is to adopt a kind of device of non-extracorporeal circulation implanting pulmonary artery biological valve (BV) by outflow tract of right ventricle under, and this device comprises: biovalve has hollow holders; The valve carrier comprises sacculus, handle, valve loading and unloading assembly, hollow pipe, and described sacculus is wrapped in outward on the hollow pipe, and described valve loading and unloading assembly connection sacculus runs through a hollow pipe part and is built in the handle; During the implantable bioartificial valve, described sacculus is inserted the hollow space of described holder.

Wherein, described biovalve also comprises lobe ring, some lobe leaves, and each lobe leaf base closely is fixed on the lobe ring continuously, and lobe ring and described holder are closely sewed up, described lobe leaf can be in plane, lobe ring place tight connecting.

Wherein, described lobe leaf has three.

Wherein, described lobe leaf is the bioprosthetic valve leaf.

Wherein, described bioprosthetic valve leaf is that homologue lobe leaf or xenogenesis are through chemically treated band lobe bovine jugular vein lobe leaf.

Wherein, described valve loading and unloading assembly comprises syringe, communicating pipe, described communicating pipe one end and syringe interconnect to communicate and be built in the handle, the other end is opened on sacculus and is built in the hollow pipe.

Wherein, described holder material is a rigidity, and the groove of being convenient to the pulmonary artery external fixation is arranged on it.

Wherein, described sacculus is for making with the soft plastic material of content gas increase breathing.

Wherein, also comprise the valve transfer passage, during implantation, insert the valve carrier of biovalve and implant the right ventricle by this transfer passage.

Advantage of the present utility model and beneficial effect be, valve is via the ingenious implantation of outflow tract of right ventricle, and operating time is short, and compole is short during blocking-up, and the patient suffering is little, loses blood less, wound is little, recovery is fast.Need not extracorporeal circulation and can finish the valve implantation, reduce patient's damage.The valve model of using is abundant, is applicable to the patient of the various different state of an illness.Valve is easy to fix after implanting, and avoids the postoperative displacement, and no perivalvular leakage improves therapeutic effect at a specified future date.The valve of implanting is without folding good endurance.

Description of drawings

Fig. 1 is the axonometric chart of the valve carrier of this utility model preferred embodiment;

Fig. 2 is the axonometric chart of the biovalve of this utility model preferred embodiment;

Fig. 3 is the axonometric chart of the valve transfer passage of this utility model preferred embodiment.

The specific embodiment

Following examples are used to illustrate this utility model, but are not used for limiting scope of the present utility model.

Constitute by the biovalve 1 of band holder and valve carrier 2 and valve transfer passage 3 through the device of outflow tract of right ventricle implanting pulmonary artery lobe under the non-extracorporeal circulation of the present utility model.

As shown in Figure 1, valve carrier 2 is by sacculus 7, handle 8, valve loading and unloading assembly 9, hollow pipe 10 constitutes, sacculus 7 is for making with the soft plastic material of content gas increase and decrease breathing, sacculus 7 outer being wrapped on the hollow pipe 10, handle 8 is made the cylindrical, massive device by hard plastics, valve loading and unloading assembly 9 is by syringe 13, communicating pipe 14 constitutes, valve loading and unloading assembly 9 connection sacculus 7 run through hollow pipe 10 parts and are built in the handle 8, syringe 13 is made of stack shell 15 and push rod 16, communicating pipes 14 1 end and syringe 13 interconnect to communicate and be built in the handle 8, the other end is opened on sacculus 7, be built in hollow pipe 10, hollow pipe 10 is fixed in the one end by handle 8 outsourcings, and by communicating pipe 14 holding built-in running through thus, the push rod 16 of pushing syringe 13, gas passes through to flow with the promotion of push rod 16 communicating pipe 14 in the sacculus 7, thereby makes sacculus 7 breathing.The lobe leaf 4 of biovalve 1 is the bioprosthetic valve leaf, preferred bioprosthetic valve leaf be of the same race or xenogenesis through chemically treated lobe leaf, preferred xenogenesis is made for band lobe bovine jugular vein through chemical treatment tissue flap leaf, each lobe leaf base 11 closely is fixed on the lobe ring 5 continuously, three lobe leaves 4 can be smooth identical in plane, lobe ring 5 place, lobe leaf preferable shape, big or small identical, preferred lobe leaf 4 planar diameter are 19～31mm.

As shown in Figure 2, biovalve 1 is made of three lobe leaves 4, lobe ring 5, holder 6, each lobe leaf 4 base portion 11 closely is fixed on the lobe ring 5 continuously, lobe ring 5 is closely sewed up with holder 6, holder 6 preferred lengths are 15～35mm, be preferably made from a rigid material, lateral surface has two parallel fixed grooves 12, and valve can be tied up secure valve after implanting thus.Holder 6 on the biovalve 1 has two parallel fixed grooves 12, after biovalve 1 is implanted, can adopt bounding wire by fixed groove 12 valve to be fixed in the pulmonary artery outside.

During use, valve carrier 2 promotes push rods 16 and regulates sacculus 7 after be slightly less than valve diameter, be inserted into the hollow part of biovalve 1 holder 6, promote push rod 16, increase the sacculus internal gas pressure, sacculus 7 expands, generation is along the radial tension force of sacculus tangent plane, biovalve 1 just is fixed on the sacculus 7, and the push rod 16 of pulling back reduces sacculus 7 internal gas pressures, can discharge biovalve 1.

Mounted pulmonary artery biological lobe implanting device enters pulmonary artery via valve transfer passage 3.

During operation, patient and assistant closely cooperate, treat incision and the stitching of valve transfer passage 3 one ends at outflow tract of right ventricle earlier, valve transfer passage 3 other ends seam pocket, cut outflow tract of right ventricle rapidly through valve transfer passage 3 then, the whole induction system that will install valve is again delivered to valve of pulmonary trunk lobe position through valve transfer passage 3 insertion outflows tract of right ventricle, tighten the purse wire of before having sewed it up on the valve transfer passage 3, prevent hemorrhage, after ligation is reserved in the fixing band of pulmonary artery outside, the pull back push rod 16 of syringe 13 discharges biovalve 1, the careful valve carrier 2 of extracting out fast, aerofluxus, clamp valve transfer passage 3 is sewed up the outflow tract of right ventricle otch fast, finishes the implant procedure of valve of pulmonary trunk.

More than be preferred forms of the present utility model, according to the disclosed content of this utility model, those of ordinary skill in the art can expect some identical, replacement schemes apparently, but these schemes all should fall into protection domain of the present utility model.

Claims (9)

1. the device of a non-extracorporeal circulation implanting pulmonary artery biological valve (BV) by outflow tract of right ventricle under is characterized in that, this device comprises:

Biovalve (1) has hollow holders (6);

Valve carrier (2), comprise sacculus (7), handle (8), valve loading and unloading assembly (9), hollow pipe (10), described sacculus (7) is outer to be wrapped on the hollow pipe (10), and described valve loading and unloading assemblies (9) connection sacculus (7) run through hollow pipe (a 10) part and are built in the handle (8);

During implantable bioartificial valve (1), the hollow space that described sacculus (7) is inserted described holder (6).

2. the device of non-extracorporeal circulation implanting pulmonary artery biological valve (BV) by outflow tract of right ventricle under as claimed in claim 1 is characterized in that,

Described biovalve (1) also comprises lobe ring (5), some lobe leaves (4), each lobe leaf (4) base portion (11) closely is fixed on the lobe ring (5) continuously, lobe ring (5) and described holder (6) are closely sewed up, described lobe leaf (4) can be in lobe ring (5) plane, place tight connecting.

3. the device of non-extracorporeal circulation implanting pulmonary artery biological valve (BV) by outflow tract of right ventricle under as claimed in claim 2 is characterized in that, described lobe leaf has three.

4. the device of non-extracorporeal circulation implanting pulmonary artery biological valve (BV) by outflow tract of right ventricle under as claimed in claim 2 is characterized in that, described lobe leaf is the bioprosthetic valve leaf.

5. the device of non-extracorporeal circulation implanting pulmonary artery biological valve (BV) by outflow tract of right ventricle under as claimed in claim 2 is characterized in that, described bioprosthetic valve leaf is that homologue lobe leaf or xenogenesis are through chemically treated band lobe bovine jugular vein lobe leaf.

6. the device of non-extracorporeal circulation implanting pulmonary artery biological valve (BV) by outflow tract of right ventricle under as claimed in claim 1 is characterized in that,

Described valve loading and unloading assemblies (9) comprise syringe (13), communicating pipe (14), described communicating pipes (14) one end and syringe (13) interconnect to communicate and be built in the handle (8), the other end is opened on sacculus (7) and is built in the hollow pipe (10).

7. the device of non-extracorporeal circulation implanting pulmonary artery biological valve (BV) by outflow tract of right ventricle under as claimed in claim 1 is characterized in that,

Described holder (6) material is a rigidity, and the groove (12) of being convenient to the pulmonary artery external fixation is arranged on it.

8. the device of non-extracorporeal circulation implanting pulmonary artery biological valve (BV) by outflow tract of right ventricle under as claimed in claim 1 is characterized in that, described sacculus (7) is for making with the soft plastic material of content gas increase breathing.

9. as the device of the described non-extracorporeal circulation implanting pulmonary artery biological valve (BV) by outflow tract of right ventricle under of claim 1～8, it is characterized in that, also comprise valve transfer passage (3), during implantation, insert the valve carrier (2) of biovalve (1) and implant the right ventricle by this transfer passage (3).

Images