CN203043288U

CN203043288U - Aorta cannula used for puncturing through chest and applicable for heart minimally invasive surgery

Info

Publication number: CN203043288U
Application number: CN 201320056777
Authority: CN
Inventors: 赁可; 宋海波; 王润词; 安琪; 刘进; 石应康
Original assignee: West China Hospital of Sichuan University
Current assignee: West China Hospital of Sichuan University
Priority date: 2013-01-31
Filing date: 2013-01-31
Publication date: 2013-07-10
Anticipated expiration: 2023-01-31

Abstract

Disclosed is an aorta cannula used for puncturing through a chest and applicable for a heart minimally invasive surgery. The aorta cannula used for puncturing through the chest and applicable for the heart minimally invasive surgery comprises a cannula body, a saccule, a connection sleeve, a puncturing inner core and a guiding steel wire, wherein the length of the puncturing inner core and the length of the guiding steel wire are larger than the length of the cannula body. The saccule is arranged at the front end of a segment, punctured into an aorta, of the saccule. The connection sleeve is installed at the tail end of the cannula body. The end surface of the front end of the cannula body is an oblique section with a puncturing function. An outer wall of the cannula body is provided with a scale. An inner hole of the cannula body is a blood transfusion channel. A spring ring is embedded in a cannula wall of the cannula body, and the cannula wall of the cannula body is provided with an air-conveying channel and a transfusion channel with a central line of the cannula body as the symmetry axis, wherein the air-conveying channel and the transfusion channel are in parallel to the central line of the cannula body. An air outlet of the air-conveying channel is located in the saccule, an air-conveying pipe is connected on an air inlet of the air-conveying channel, the air inlet of the air-conveying channel is provided with an indicating bladder, a liquid outlet of the transfusion channel is located behind the saccule, and a liquid inlet pipe is connected on a liquid inlet of the transfusion channel. The puncturing inner core and the guiding steel wire are used for being matched with the cannula body so as to conduct puncturing.

Description

Be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation

Technical field

This utility model belongs to medical apparatus and instruments, and is particularly a kind of be used to the aortic cannulation of setting up extracorporeal circulation.

Background technology

Mostly be through breast ascending aorta intubation in the mid-mode of going into aortic cannulation of operation on heart at present, the aortic cannulation that uses is single lumen catheter, the capsule of not dribbling, do not have blocking blood flow and isolate action of the heart, the function that does not have perfused hearts paralysis liquid, head end is not suitable for directly puncturing, need do than skin skin otch when therefore performing the operation, vertical bone is right against the chest opened breast, expose behind the ascending aorta it clamp, on ascending aorta, make about 1cm left and right sides longitudinal incision, aortic cannulation is inserted, and do end-to-side anastomosis with aorta, again aortic cannulation is inserted foley's tube, not only the patient is caused big wound, and complicated operation, waste time and energy, need to cooperate in many ways just can finish the perfusion arterial blood, processes such as aorta clamping and paralysis heart.

Chinese patent ZL200520085173.4 provides a kind of puncture to fix exhaust integrated aortic cannulation, its architectural feature is: puncture needle is installed in the body, can directly insert aorta, the excessive phenomenon of bleeding profusely that causes of otch takes place when preventing because of the incision aorta; The body afterbody is equipped with exhaustor, is used for bubble in the discharge pipe; The body front end is provided with is convenient to sew up fixing convex edge; The body front end side wall is provided with through hole, can increase blood flow.Though this intubate has the function of puncture, need not make otch at aorta than the formula of incision intubate, reduced the massive hemorrhage risk, but use this intubate still need open clamp aorta row puncture again behind the breast, damage greatlyyer, and this intubate does not still have the function that blocking blood flow is isolated action of the heart and perfused hearts paralysis liquid.

Chinese patent ZL200620135951.0 provides a kind of multi-functional aortic cannulation of Wicresoft that integrates blocking-up, cold-penetration, blood supply, and its architectural feature is: the body front end is furnished with air bag, and air bag is communicated with the gas tube inflation by the gas transmission road on the tube wall; The body top offers the outlet of cold-penetration liquid, is communicated with cold-penetration pipe perfused hearts paralysis liquid by the tube for transfusion on the tube wall; Air bag rear side body is provided with the side opening that is communicated with the blood transfusion chamber; Tube wall disposes turn; Body disposes the scale that is increased by the tip forward end.This intubate does not have the puncture structure, femoral artery otch from abdominal part during use inserts, the straight aorta place that upwards delivers to the heart top, thereby not only there is a risk of the narrower hypoperfusion of tube chamber, and intubate walks distance in vivo, and controllability reduces relatively, and the hemoperfusion direction is for driving in the wrong direction, there is lower limb ischemia, the problem that complication is more; Moreover intubate sacculus on it in walking aortal process may cause the aorta damage.

Summary of the invention

The purpose of this utility model is to overcome the deficiencies in the prior art, provide a kind of be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, to reduce operation risk, set up easy and simple to handle, effectively and the extracorporeal circulation system of Wicresoft.

Described in the utility model be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, comprise that body, sacculus, adapter sleeve and length is longer than puncture inner core and the guiding steel wire of body; Described sacculus is arranged on the front end that body inserts the aorta section section, described adapter sleeve is installed in the end of body, the front end end face of described body is the oblique section with puncture function, the outer wall of described body is provided with scale, the endoporus of described body is the blood transfusion passage, the tube wall of described body is embedded with turn and is provided with and is parallel to the body centrage and is gas distribution channel and the infusion channel of axis of symmetry with the body centrage, the gas outlet of gas distribution channel is positioned at sacculus, the air inlet of gas distribution channel is connected with appendix and is provided with the indication capsule, the liquid outlet of described infusion channel is positioned at after the sacculus, the inlet of infusion channel is connected with feed tube, described puncture inner core and guiding steel wire are used for cooperating the body puncture, the puncture inner core is provided with centre bore, its rear end is provided with the core medicated cap, described core medicated cap is provided with the centre bore with the inner core coaxial line that punctures, puncture inner core front end passes the front end that adapter sleeve inserts the endoporus of body and stretches out body when puncturing, the core medicated cap that is connected with the puncture inner core is installed on the adapter sleeve, guiding steel wire inserts puncture inner core centre bore and stretches out from the front end of puncture inner core from core medicated cap centre bore, after finishing puncture, take out guiding steel wire and puncture inner core.

In order to protect the damage of the sacculus that aorta vessel do not risen and fallen, and make things convenient for thoracoscope to operate, this utility model has adopted the technical scheme that aorta protection assembly is set in body aorta insertion section section, described aorta protection assembly is made up of positioning sleeve and balloon sheath, positioning sleeve is rubber sleeve, can insert this section that the aorta section section moved and be positioned body along body, balloon sheath is cylindrical shell, the one end is connected with positioning sleeve, its other end is free end, described free end end is taper, and boring the gap that sharp hole and body insert between the aorta section section can be by being limited with the sacculus of unaerated; Before body inserts aorta; described sacculus is in the unaerated state; and be positioned at balloon sheath; after body inserts aorta and puts in place, after move aorta protection assembly, the liquid outlet of infusion channel and sacculus are exposed to outside the balloon sheath; so that full sacculus; after operation was finished, the aorta that can move forward protection assembly made the sacculus that exhausts gas be positioned at the protection sheath.

In order in blocking blood flow, to reduce sacculus to the damage of aorta vessel, the preferred following two kinds of schemes of shape and size after described sacculus is full:

1, sacculus is shaped as elliposoidal after full, and its major axis a is 4～5 ︰ 1 with the ratio of minor axis b.

2, sacculus is shaped as cydariform after full, and its maximum diameter d is 4～5 ︰ 1 with the ratio of height h.

In order to increase blood flow, this utility model has adopted the body tube wall before sacculus that the technical scheme of blood outlet hole is set.

Described in the utility model be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, described scale is starting point with the front end end that body inserts the aorta section section, count from front to back, and be arranged on the tube wall of gas distribution channel one side, insert the aortal degree of depth so that directly know body, and the orientation of indication infusion channel liquid outlet, assist finishing smoothly of paralysis perfusion.

The utlity model has following beneficial effect:

1, described in the utility model be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation integrate puncture, blocking blood flow, lure asystole into, function such as oxygenated blood supply, use this intubate, not only can simplify operation technique, shorten operating time, and can reduce operation risk, avoid the patient is caused big wound.

2, protect assembly owing to be provided with aorta in body aorta insertion section section, thereby in the process of the interspersed aorta vessel of body, can avoid aorta vessel by balloon injured, improve patient's prognosis.

3, owing to the shape and size after full to sacculus have been carried out preferably, thereby sacculus can reduce the damage to aorta vessel in blocking blood flow.

4, the liquid outlet of infusion channel arranges finishing that the set-up mode of position, scale is conducive to perform the operation.

Description of drawings

Fig. 1 is the structural representation through breast puncture aortic cannulation that is applicable to the heart Minimally Invasive Surgery described in the utility model, and sacculus is in the unaerated state;

Fig. 2 is the partial enlarged drawing through breast puncture aortic cannulation that is applicable to the heart Minimally Invasive Surgery described in the utility model;

Fig. 3 is the structural representation through breast puncture aortic cannulation that is applicable to the heart Minimally Invasive Surgery, and the liquid outlet of infusion channel and sacculus are exposed to outside the balloon sheath, and sacculus is in full state;

Fig. 4 is the sketch map after guiding steel wire is removed with the puncture inner core among Fig. 3;

Fig. 5 is the sketch map of elliposoidal sacculus;

Fig. 6 is the sketch map of cydariform sacculus.

Among the figure, 1-body, 2-sacculus, 3-blood transfusion passage (body endoporus), 4-blood transfusion passage blood outlet (oblique section with puncture function), 5-blood outlet hole, 6-gas distribution channel, 7-gas distribution channel gas outlet, 8-indication capsule, 9-appendix, 10-infusion channel, 11-infusion channel liquid outlet, 12-feed tube, 13-turn, 14-scale, 15-adapter sleeve, 16-balloon sheath, 17-positioning sleeve, 18-puncture inner core, 19-core medicated cap, 20-guiding steel wire.

The specific embodiment

Below by embodiment structure and the using method through breast puncture aortic cannulation of heart Minimally Invasive Surgery of being applicable to described in the utility model is described further.

In the present embodiment, be applicable to the heart Minimally Invasive Surgery through the structure of breast puncture aortic cannulation as shown in Figure 1 and Figure 2, comprise that body 1, sacculus 2, aorta protection assembly, adapter sleeve 15 and length is longer than puncture inner core 18 and the guiding steel wire 20 of body.Body 1 is reducer pipe, formed by the less pipe of the bigger pipe of caliber, caliber and the tapering transition pipe between the less pipe of the bigger pipe of caliber and caliber, the less pipe of caliber is insertion aorta section section, the pipe that caliber is bigger is the rear section of body, and it is external to be positioned at the patient during operation; Described sacculus 2 is arranged on the front end that body 1 inserts the aorta section section, and full back is elliposoidal, and its major axis is 5 ︰ 1 with the ratio of minor axis, as shown in Figure 5; The front end end face of described body is the oblique section with puncture function, and described adapter sleeve 15 is installed in the end of body 1; The endoporus of described body 1 is the blood transfusion passage, and the blood outlet of blood transfusion passage is positioned on the oblique section with puncture function, also is provided with blood outlet hole 5 on the body tube wall before the sacculus 2; The tube wall of described body 1 is embedded with turn 13 and is provided with and is parallel to the body centrage and is gas distribution channel 6 and the infusion channel 10 of axis of symmetry with the body centrage, the gas outlet of gas distribution channel 6 is positioned at sacculus 2, the air inlet of gas distribution channel 6 is connected with appendix 9 and is provided with indication capsule 8, the liquid outlet 11 of infusion channel is positioned at after the sacculus, and the inlet of infusion channel 10 is connected with feed tube 12; The outer wall of described body 1 is provided with scale 14, and described scale 14 is starting point with the front end end that body inserts the aorta section section, counts from front to back, and is arranged on the tube wall of gas distribution channel 6 one sides; Aorta protection assembly is made up of positioning sleeve 17 and balloon sheath 16, positioning sleeve 17 is rubber sleeve, can insert this section that the aorta section section moved and be positioned body along body, balloon sheath is cylindrical shell, the one end is connected with positioning sleeve, its other end is free end, described free end end is taper, boring the gap that sharp hole and body insert between the aorta section section can be by being limited with the sacculus of unaerated, tremulous pulse protection assembly is installed in body and inserts the aorta section section, before body 1 inserted aorta, sacculus 2 was in the unaerated state, and is positioned at balloon sheath 16, after body inserts aorta and puts in place, after move aorta protection assembly, the liquid outlet 11 of infusion channel and sacculus 2 are exposed to outside the balloon sheath 16, so that full sacculus, after operation is finished, reach aorta protection assembly makes the sacculus that exhausts gas be positioned at protection sheath 16, as Fig. 1, shown in Figure 3; Described puncture inner core 18 and guiding steel wire 20 are used for cooperating the body puncture, puncture inner core 18 is provided with centre bore, its external diameter is less than the internal diameter of body, its front end is ＂ writing brush head ＂ shape, thereafter termination core medicated cap 19, described core medicated cap is integrated with the puncture inner core, be provided with the centre bore with the inner core coaxial line that punctures, when puncturing, puncture inner core 18 front ends pass the front end that adapter sleeve inserts the endoporus of body and stretches out body, and core medicated cap 19 is installed on the adapter sleeve, guiding steel wire 20 inserts puncture inner core 18 centre bores and stretches out from the front end of puncture inner core from the centre bore of core medicated cap 19, after finishing puncture, take out guiding steel wire 20 and puncture inner core 18, as shown in Figure 4.

In the present embodiment, body 1, puncture inner core 18, balloon sheath 16 usefulness medical plastics are made, and adapter sleeve 15, positioning sleeve 17 usefulness rubber are made.

The using method through breast puncture aortic cannulation that is applicable to the heart Minimally Invasive Surgery is as follows: do a little otch through right border of sternum three or four intercostals, under the help of transesophageal ultrasonography guide and thoracoscope, in patient's ascending aorta, imbed guiding steel wire 20, puncturing in the oblique section that has the puncture function with puncture inner core 18 and body front end, makes body shown in Figure 1 enter ascending aorta.Prompting by the body scale, determine sacculus 2, infusion channel liquid outlet 11 enters aortal length and orientation, locate in conjunction with transesophageal ultrasonography, guarantee that sacculus 2 does not block coronary artery, the tube wall at infusion channel liquid outlet 11 places and ascending aorta sidewall, hemi-closure space of the common formation of rear wall, when the location of determining sacculus 2 and after making infusion channel liquid outlet 11 be positioned at ideal position, balloon sheath 16 is moved a certain distance backward, make sacculus 2, infusion channel liquid outlet 11 is exposed to (as shown in Figure 3) outside the balloon sheath 16, and balloon sheath 16 still some is positioned at aorta; Charge into gas from appendix 9, gas enters sacculus 2 through gas distribution channel 6 from its gas outlet 7, by the filling degree of indication capsule 8, judges whether sacculus 2 reaches full fully, and full sacculus 2 has been blocked the blood flow in the ascending aorta; Push cardioplegic solution from feed tube 12, cardioplegic solution is discharged the perfusion coronary artery through infusion channel 10 from its liquid outlet 11, can lure asystole into; After finishing blocking blood flow, perfused hearts paralysis liquid, take out guiding steel wire 20 and puncture inner core 18, adapter sleeve 15 is connect shunt tube, the outer oxygenate device of connected component by feeding back in the body, can be set up extracorporeal circulation with oxygenated blood.After operation is finished, the gas in the sacculus is extracted out, reach aorta protection assembly makes the sacculus that exhausts gas be positioned at protection sheath 16, takes out body then.

This utility model is not limited to above-described embodiment, can be according to clinical needs, design and make multiple structure that claim limits through breast puncture aortic cannulation.

Claims

One kind be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, comprise body (1), sacculus (2), described sacculus (2) is arranged on the front end that body (1) inserts the aorta section section, the endoporus of described body (1) is the blood transfusion passage, the tube wall of described body (1) is embedded with turn (13) and is provided with and is parallel to the body centrage and is gas distribution channel (6) and the infusion channel (10) of axis of symmetry with the body centrage, the gas outlet of gas distribution channel (6) is positioned at sacculus (2), the air inlet of gas distribution channel (6) is connected with appendix (9) and is provided with indication capsule (8), the outer wall of described body (1) is provided with scale (14), it is characterized in that also comprising that adapter sleeve (15) and length is longer than puncture inner core (18) and the guiding steel wire (20) of body, the front end end face of described body (1) is the oblique section with puncture function, described adapter sleeve (15) is installed in the end of body (1), the liquid outlet of described infusion channel (11) is positioned at after the sacculus, the inlet of infusion channel (10) is connected with feed tube (12), described puncture inner core (18) and guiding steel wire (20) are used for cooperating the body puncture, puncture inner core (18) is provided with centre bore, its rear end is provided with core medicated cap (19), described core medicated cap is provided with the centre bore with the inner core coaxial line that punctures, puncture inner core (18) front end passes the front end that adapter sleeve inserts the endoporus of body and stretches out body when puncturing, the core medicated cap (19) that is connected with the puncture inner core is installed on the adapter sleeve, guiding steel wire (20) inserts puncture inner core (18) centre bore and stretches out from the front end of puncture inner core from core medicated cap (19) centre bore, after finishing puncture, take out guiding steel wire (20) and puncture inner core (18).
According to claim 1 described be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, it is characterized in that also comprising the aorta protection assembly that is installed in body insertion aorta section section, described aorta protection assembly is made up of positioning sleeve (17) and balloon sheath (16), positioning sleeve (17) is rubber sleeve, can insert this section that the aorta section section moved and be positioned body along body, balloon sheath is cylindrical shell, the one end is connected with positioning sleeve, its other end is free end, described free end end is taper, and boring the gap that sharp hole and body (1) insert between the aorta section section can be by being limited with the sacculus of unaerated;

Before body (1) inserts aorta; described sacculus (2) is in the unaerated state; and be positioned at balloon sheath (16); after body inserts aorta and puts in place, after move aorta protection assembly, the liquid outlet (11) of infusion channel and sacculus (2) are exposed to outside the balloon sheath (16); so that full sacculus; after operation was finished, reach aorta protection assembly made the sacculus that exhausts gas be positioned at protection sheath (16).
According to claim 1 or 2 described be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, it is characterized in that the full back of described sacculus (2) is elliposoidal, its major axis is 4～5 ︰ 1 with the ratio of minor axis.
According to claim 1 or 2 described be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, it is characterized in that the full back of described sacculus (2) is cydariform, its maximum gauge is 4～5 ︰ 1 with the ratio of height.
According to claim 1 or 2 described be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, it is characterized in that sacculus (2) body tube wall before is provided with blood outlet hole (5).
According to claim 3 described be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, it is characterized in that sacculus (2) body tube wall before is provided with blood outlet hole (5).
According to claim 4 described be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, it is characterized in that sacculus (2) body tube wall before is provided with blood outlet hole (5).
According to claim 1 or 2 described be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, it is characterized in that described scale (14) is starting point with the front end end that body inserts the aorta section section, count from front to back, and be arranged on the tube wall of gas distribution channel (6) one sides.
According to claim 3 described be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, it is characterized in that described scale (14) is starting point with the front end end that body inserts the aorta section section, count from front to back, and be arranged on the tube wall of gas distribution channel (6) one sides.
According to claim 7 described be applicable to the heart Minimally Invasive Surgery through breast puncture aortic cannulation, it is characterized in that described scale (14) is starting point with the front end end that body inserts the aorta section section, count from front to back, and be arranged on the tube wall of gas distribution channel (6) one sides.