CN204562318U - A kind of puncture instrument for operation on heart - Google Patents
A kind of puncture instrument for operation on heart Download PDFInfo
- Publication number
- CN204562318U CN204562318U CN201520154697.8U CN201520154697U CN204562318U CN 204562318 U CN204562318 U CN 204562318U CN 201520154697 U CN201520154697 U CN 201520154697U CN 204562318 U CN204562318 U CN 204562318U
- Authority
- CN
- China
- Prior art keywords
- puncture
- sheath pipe
- instrument
- heart
- tail end
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
Abstract
This utility model belongs to medical instruments field, relates to a kind of puncture instrument for operation on heart, particularly relates to a kind of puncture instrument for endocardium of left ventricle Pacing, and it is made up of puncture needle, puncture sheath pipe and wire introducer; Described wire introducer mediates described puncture needle through in described puncture sheath pipe; The tail end of described puncture needle is fixedly connected with puncturing head; " S " type in the overall spatially conformation of described puncture sheath pipe, tail end is in " hanging basket " shape; Described wire introducer entirety is cylindrical, hollow.Use result shows, the puncture instrument for operation on heart of the present utility model, can realize good location interatrial septum, and safety, simplification operating procedure, this puncture instrument is used for can from superior vena cava Direct perforantes interatrial septum in endocardium of left ventricle Pacing.
Description
Technical field
This utility model belongs to medical instruments field, relate to a kind of puncture instrument for operation on heart, particularly relate to a kind of atrial septal puncture apparatus for endocardium of left ventricle Pacing, particularly a kind of for the puncture needle through superior vena cava Direct perforantes interatrial septum and puncture sheath pipe.This puncture instrument is used for realizing carrying out pace-making left room electrode directly implants left room endocardium from superior vena cava Direct perforantes interatrial septum in heart failure patient cardiac muscle cardiac resynchronization therapy, and replacement, radio-frequency ablation procedure, the transplanting of stem cell subendocardiac muscle etc. in Bicuspid valve conduit.
Background technology
Research practice shows, in the generating process of heart failure, about have the patient of 30% to there is cardiac dilatation, heart lock-out, it show as left heart free wall and interventricular septum systolic dyssynchrony in left and right ventricles systolic dyssynchrony, left ventricle, shrink between atrium and ventricle inharmonious, heart lock-out causes cardiac output to reduce, mitral incompetence, two points are distinguished and are backflowed in a large number, increase the weight of heart failure, clinical practice shows, and Drug therapy is inoperative to described lock-out phenomenon; And following cardiac resynchronization therapy (CRT, cardiac resynchronization therapy) treat and can reduce admission rate and the mortality rate that cardiac insufficiency accompanies the asynchronous patient in left room, improve prognosis, the storing of left ventricular electrode wherein shows important impact to therapeutic effect; Usually, left ventricular electrode is implanted three kinds of approach: (1) is by coronary sinus vein implant electrode (operation method the most frequently used at present); (2) surgical operation or application thoracoscope, deliver to visceral pericardium place, left room pace-making by left room electrode; (3) puncture interatrial septum portion, and left room electrode is implanted to pace-making under the endocardium of left room.
Research also finds, good pacing site can improve hemodynamics, but pacing site is not only invalid improperly, on the contrary possibility exacerbate hemodynamics, even has the patients of 20-40% for CRT nonreply.In current clinical treatment, be modal operation pathway by coronary sinus vein implant electrode, desirable electrode cable position, left room is by the impact of cardiac veins anatomical variations.Normal Coronary vein is divided into 5-6 to prop up, vein on rear side of the main intentionally lateral vein of the target vessel of inserting as left room electrode cable and the heart; When vein on rear side of heart lateral vein and the heart can not be selected, optional middle cardiac vein; Other veins are placed left ventricular electrode wire and CRT postoperative curative effect may be caused not good.According to research reports, the anatomic variation of Coronary vein vein, as Coronary vein and branch out of shape abnormal, narrow or scarce as etc., not only cause left room electrode to implant difficulty, and left room pace-making inefficiency can be caused; Cleland JG etc. report the patient of CRT indication, more than 5% patient because of left ventricular electrode can not be inserted suitable blood vessel or late period loose electrode placement and lose CRT treatment.
In recent years those skilled in the art propose a kind of left room wire newly and implant strategy: through puncture interatrial septum, approach implants left room wire endocardial pacing.Theoretically, endocardium of left ventricle pace-making compares with cardiac veins Epicardial pacing many advantages: the left ventricular pacing threshold value that (1) is lower: compare endocardium of left ventricle pacing threshold with Epicardial pacing and obviously reduce, even if find that in implantation process endocardial pacing threshold value is higher, also more easily lead location can be changed, and endocardium implants application active fixation lead, has good stability and lower wire displacement rate; (2) lower diaphragm nerve stimulation risk: can significantly reduce the danger even avoiding diaphragm nerve stimulation by endocardium of left ventricle pace-making; (3) more left ventricular pacing point selection: it is the topmost advantage of endocardium of left ventricle pace-making; Therefore left ventricular lead pacing sites is the key factor determining the reaction of left ventricle Acute Hemodynamic; (4) more physiology and not easily bring out arrhythmia: have research to confirm to compare with the CRT of traditional left ventricle Epicardial pacing, accept the CRT patients with implantation of endocardium of left ventricle pace-making, can obviously reduce QT dispersion after endocardial pacing; (5) ventricular synchronous efficiency is improved by rapid pace-making left ventricle: about the research of the animal model to left bundle branch block finds, endocardium stimulation is conducted and shorter endocardium girth faster by endocardium, ventricular activation can be shortened further and ask the phase, increase the long-term efficacy that CRT alleviates ventricle lock-out, reduce the unresponsive ratio of CRT.
Usually, in clinical treatment, first endocardium of left ventricle pace-making needs interatrial septum of puncturing, and then left ventricular electrode just can be implanted to certain position, left room through atrial septal puncture portion.The Jais of Dogue de Bordeaux university etc. 1998 first describe and carry out from right lateral thigh vein and internal jugular vein mixing approach first case to implant endocardium of left ventricle wire technology through puncture interatrial septum, operation is all this technology path of continuity mostly at present.
At present, those skilled in the art just carry out various improvement to atrial septal puncture method, but there is not been reported from the technology of superior vena cava Direct perforantes interatrial septum, and reason lacks the suitable apparatus through superior vena cava Direct perforantes interatrial septum and method in essence.
Utility model content
The purpose of this utility model is the defect or the deficiency that overcome prior art, a kind of puncture instrument for operation on heart is provided, particularly relate to a kind of atrial septal puncture apparatus for endocardium of left ventricle Pacing, particularly a kind of for the puncture needle through superior vena cava Direct perforantes interatrial septum and puncture sheath pipe.This puncture instrument is used for realizing carrying out pace-making left room electrode directly implants left room endocardium from superior vena cava Direct perforantes interatrial septum in heart failure patient cardiac muscle cardiac resynchronization therapy, and replacement, radio-frequency ablation procedure, the transplanting of stem cell subendocardiac muscle etc. in Bicuspid valve conduit.
Puncture instrument for operation on heart of the present utility model, is made up of puncture needle, puncture sheath pipe and wire introducer, and described puncture needle is overall soft, ensure the safety of puncture, and its rear is sharp, then ensure that enough strength breaks through interatrial septum portion; Described puncture sheath pipe entirety in a three-dimensional conformation on " S " type, tail end is " hanging basket " shape, and comprises the curved and scalable design of controllable, can realize good location interatrial septum portion.
Specifically, the puncture instrument for operation on heart of the present utility model, is characterized in that, is made up of puncture needle 1, puncture sheath pipe 2 and wire introducer 3; Described wire introducer 3 mediates described puncture needle 1 and wears in described puncture sheath pipe 2;
The tail end 12 of described puncture needle 1 is fixedly connected with puncturing head 13;
Described puncture sheath pipe 2 entirety " S " type spatially in conformation, tail end is in " hanging basket " shape;
Overall cylindrical, the hollow of described wire introducer 3;
In this utility model, described puncture needle 1 adopts soft steel wire or other materials (such as: various alloy, pottery etc.) to make, its surface scribbles hydrophilic coating or not containing hydrophilic coating, length is 200mm ~ 2000mm, diameter is 0.05mm ~ 1.5mm; The puncturing head 13 (length 1mm ~ 5mm) of this puncture steel wire 1 containing coating, is not hard seal wire, and is polished into and possesses certain angle, and this puncturing head 13 can be bias or non-eccentricity design (taper shape), and angle is 10 ° ~ 89 °; Described puncture needle 1 possesses flexibility, can ensure the safety of puncturing, and described puncturing head 13 is sharp, ensure enough strength breaks through interatrial septum portion;
In this utility model, described puncture sheath pipe 2 entirety " S " type spatially in conformation, its tail end is in " hanging basket " shape, the shape of tail end opening 23 is circular annular form, trapezoidal, prismatic, taper shape etc., comprise flexible translation-angle (controllable is curved), scalable design, described puncturing head 13 can be passed by tail end opening 23; In an embodiment of the present utility model, the length of described puncture sheath pipe 2 is 200mm ~ 500mm, and similar solid is snakelike, and which is provided with 3 and bend, lumen diameter is 4F ~ 10F (medically 1F=0.33mm, F are conventional unit); The tail end 22 of described puncture sheath pipe 2 is in " hanging basket " shape, and the shape of tail end opening 23 is circular annular form, trapezoidal, prismatic, taper shape etc.; The most back segment of described puncture sheath pipe 2 is that controllable is curved, can realize three-dimensional 360 ° regulate and control (curved binding site 29 place of controllable can solid 360 ° rotate) around the binding site 29 that described puncture sheath pipe 2 is curved with controllable; And this controllable curved for scalable design (tail end 1-5cm can be withdrawn into 22 parts) and (or) bourdon tube design, play an important role when accurate interatrial septum portion, location; The head end 21 of described puncture sheath pipe 2 also can be fixedly connected with valve 24, this valve 24 connecting tee pipe 25;
In this utility model, described wire introducer 3 is one can mediate described puncture needle 1 to the instrument in described puncture sheath pipe 2; This wire introducer 3 is a cylindrical object, its diameter is than the large 0.25F ~ 0.5F of diameter of described puncture needle 1,0.5F (medically 1F=0.33mm less of the diameter of described puncture sheath pipe 2, F is conventional unit), be used for being inserted in the head end guided puncture draw point 1 of described puncture sheath pipe 2 during operation.
During use, first puncture left side jugular vein or left subclavian vein success, after implantable intravascular sheath, then; Adopt wire introducer 3 that described puncture needle 1 is penetrated described puncture sheath pipe 2, then by described implantations puncture sheath pipe 2, arrive, locate interatrial septum portion (comprise the curved and telescopic tube of controllable or bourdon tube accurately locates interatrial septum); After described puncture needle 1 breaks through interatrial septum portion, re-use described puncture sheath pipe 2 and break through forward expansion atrial septal puncture position, puncture needle 1 described in backed off after random, change a common guide wire and arrive left ventricle; Retain guide wire while left room, exit described atrial septal puncture sheath pipe 2, continue to implant various left heart delivery sheath, then send into the operating theater instruments that the operation of the various left heart needs, carry out various operation (such as: implant under the left endocardium of left room electrode, arrhythmia melts, replacement, the transplanting of stem cell subendocardiac muscle etc. in Bicuspid valve conduit).
Use result shows, the puncture instrument for operation on heart of the present utility model, in endocardium of left ventricle Pacing, can realize good location interatrial septum, and safety, simplification operating procedure, can realize from superior vena cava Direct perforantes interatrial septum.
For the ease of understanding, by by concrete drawings and Examples, the puncture instrument for operation on heart of the present utility model is described in detail below.It needs to be noted, instantiation and accompanying drawing are only to illustrate, obvious those of ordinary skill in the art can according to illustrating herein, in scope of the present utility model, make various correction and change to this utility model, these are revised and change and also include in scope of the present utility model.
Accompanying drawing explanation
Fig. 1 is structural representation of the present utility model,
Wherein, 1 be puncture needle, 2 for puncture sheath pipe, 3 be wire introducer;
Fig. 2 is the structural representation of puncture needle described in this utility model,
Wherein, 11 be head end, 12 be tail end, 13 for puncturing head;
Fig. 3 is the structural representation of the sheath pipe that punctures described in this utility model,
Wherein, 21 for head end, 22 be tail end, 23 be tail end opening, 24 be valve, 25 be tee T, 26 be first bends, 27 be second to bend, 28 be the 3rd to bend, 29 be the curved binding site of controllable, 30 is controllable bight portion (comprising or do not comprise bourdon tube design).
Detailed description of the invention
Embodiment 1
As shown in Figures 1 to 3, this is used for the puncture instrument of operation on heart, is made up of puncture needle 1, puncture sheath pipe 2 and wire introducer 3; Described wire introducer 3 mediates described puncture needle 1 through in described puncture sheath pipe 2; The tail end 12 of described puncture needle 1 is fixedly connected with puncturing head 13; Described puncture sheath pipe 2 entirety " S " type spatially in conformation, tail end is in " hanging basket " shape; Overall cylindrical, the hollow of described wire introducer 3;
Described puncture needle 1 adopts soft steel wire or other alloys and pottery to make, and its surface has hydrophilic coating or not containing hydrophilic coating, length is 200mm ~ 2000mm, diameter is 0.05mm ~ 2.5mm; The puncturing head 13 (1mm ~ 5mm) of this puncture steel wire 1 containing coating, is not hard seal wire, and is polished into and possesses certain angle, and this puncturing head 13 can be bias or non-eccentricity design (taper shape), and angle is 10 ° ~ 89 °; Described puncture needle 1 possesses flexibility, ensures the safety of puncture, and described puncturing head 13 is sharp, ensure that enough strength breaks through interatrial septum portion;
Described puncture sheath pipe 2 entirety " S " type spatially in conformation, its tail end is in " hanging basket " shape, flexible translation-angle (controllable is curved), and the shape of tail end opening is circular annular form, trapezoidal, prismatic, taper shape etc., the length of described puncture sheath pipe 2 is 200mm ~ 1000mm, and similar solid is snakelike, and which is provided with 3 and bend, lumen diameter is 4F ~ 10F (medically 1F=0.33mm, F are conventional unit), the tail end 22 of described puncture sheath pipe 2 is in " hanging basket " shape, the shape of tail end opening 23 is circular annular form, trapezoidal, prismatic, conical, flat etc., 30 is that controllable is curved, three-dimensional 360 ° can be realized around the binding site 29 that described puncture sheath pipe 2 is curved with controllable to regulate and control, and this controllable is curved is scalable design (the scalable part 1-5cm of rear, can be retracted into sheath pipe 22 part), and this controllable bight portion 30 comprises or does not comprise bourdon tube design, this bourdon tube is in detail: all can comprise one section of bourdon tube in controllable bight portion 30 sections of any parts in position, length is between 1-5cm, this bourdon tube is primarily of metal (comprising various alloy) or add plastics by metal and form, bourdon tube component is made up of submissile reed pipe, and the number of turns comprises 2-300, the head end 21 of described puncture sheath pipe 2 also can be fixedly connected with valve 24, this valve 24 connecting tee pipe 25,
Described wire introducer 3 is one can mediate described puncture needle 1 to the instrument in described puncture sheath pipe 2; This wire introducer 3 is a cylindrical object, its diameter is than the large 0.25F ~ 0.5F of diameter of described puncture needle 1,0.5F (medically 1F=0.33mm less of the diameter of described puncture sheath pipe 2, F is conventional unit), be used for being inserted in the head end guided puncture draw point 1 of described puncture sheath pipe 2 during operation.
During use, first puncture left side jugular vein or left subclavian vein success, after implantable intravascular sheath, then; Adopt wire introducer 3 that described puncture needle 1 is penetrated described puncture sheath pipe 2, then by described implantations puncture sheath pipe 2, arrive, interatrial septum portion, location (comprise controllable is curved, extendable temple members locate interatrial septum); After described puncture needle 1 breaks through interatrial septum portion, re-use described puncture sheath pipe 2 and break through forward expansion atrial septal puncture position, puncture needle 1 described in backed off after random, change a common guide wire and arrive left ventricle; Retain guide wire while left room, exit described atrial septal puncture sheath pipe 2, continue to implant various left heart delivery sheath, then send into the operating theater instruments that various left heart operation needs, carry out various operation (such as: transplant in replacement, stem cell subendocardiac muscle in implantation under the left endocardium of left room electrode, left atrial ablation operation, atrial fibrillation ablation operation, Bicuspid valve conduit).
The result of above-described embodiment shows, the operating theater instruments of the puncture instrument for operation on heart of the present utility model, can realize good location interatrial septum, and safety, simplification operating procedure, can realize from superior vena cava Direct perforantes interatrial septum.
Claims (8)
1. for a puncture instrument for operation on heart, it is characterized in that, be made up of puncture needle (1), puncture sheath pipe (2) and wire introducer (3); Described wire introducer (3) mediates described puncture needle (1) through in described puncture sheath pipe (2);
The tail end (12) of described puncture needle (1) is fixedly connected with puncturing head (13);
" S " type in the overall spatially conformation of described puncture sheath pipe (2), tail end is in " hanging basket " shape;
Overall cylindrical, the hollow of described wire introducer (3).
2., by the puncture instrument for operation on heart according to claim 1, it is characterized in that, the length of described puncture needle (1) is 200mm ~ 2000mm, diameter is 0.05mm ~ 1.5mm.
3. by the puncture instrument for operation on heart according to claim 1, it is characterized in that, the length of described puncturing head (13) is 1mm ~ 5mm, and its shape is eccentric or non-eccentricity, and angle is 10 ° ~ 89 °.
4. by the puncture instrument for operation on heart according to claim 1, it is characterized in that, the length of described puncture sheath pipe (2) is 200mm ~ 500mm, which is provided with 3 and bends.
5., by the puncture instrument for operation on heart according to claim 1, it is characterized in that, the lumen diameter of described puncture sheath pipe (2) is 4F ~ 10F.
6. by the puncture instrument for operation on heart according to claim 1, it is characterized in that, the shape of the tail end opening (23) of described puncture sheath pipe (2) is circular annular form, trapezoidal, prismatic or taper shape.
7. by the puncture instrument for operation on heart according to claim 1, it is characterized in that, the decline of described puncture sheath pipe (2) is the curved and/or bourdon tube design of controllable.
8. by the puncture instrument for operation on heart according to claim 1, it is characterized in that, the diameter of described wire introducer (3) is than the large 0.25F ~ 0.5F of diameter of described puncture needle (1), 0.5F less of the diameter of described puncture sheath pipe (2).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201520154697.8U CN204562318U (en) | 2015-02-17 | 2015-03-18 | A kind of puncture instrument for operation on heart |
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201520115980X | 2015-02-17 | ||
| CN201520115980 | 2015-02-17 | ||
| CN201520154697.8U CN204562318U (en) | 2015-02-17 | 2015-03-18 | A kind of puncture instrument for operation on heart |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN204562318U true CN204562318U (en) | 2015-08-19 |
Family
ID=53855019
Family Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201510119488.4A Pending CN106031651A (en) | 2015-02-17 | 2015-03-18 | Puncture instrument for cardiac surgery |
| CN201520154697.8U Expired - Fee Related CN204562318U (en) | 2015-02-17 | 2015-03-18 | A kind of puncture instrument for operation on heart |
Family Applications Before (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201510119488.4A Pending CN106031651A (en) | 2015-02-17 | 2015-03-18 | Puncture instrument for cardiac surgery |
Country Status (1)
| Country | Link |
|---|---|
| CN (2) | CN106031651A (en) |
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106618749A (en) * | 2015-10-30 | 2017-05-10 | 四川锦江电子科技有限公司 | Positioning catheter and puncture guiding assembly adopting same |
| CN106618685A (en) * | 2015-10-30 | 2017-05-10 | 四川锦江电子科技有限公司 | Sheath for atrial septal puncture |
| CN108030539A (en) * | 2018-02-02 | 2018-05-15 | 张巧玲 | The puncture needle that a kind of Pediatric Clinic uses |
| CN110403640A (en) * | 2018-04-26 | 2019-11-05 | 复旦大学附属中山医院 | It is a kind of through subclavian vein having sexual intercourse interval piercing assembly |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108324352B (en) * | 2017-12-14 | 2020-05-08 | 潘湘斌 | Room partition puncture instrument assembly and intervention method thereof |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9072872B2 (en) * | 2010-10-29 | 2015-07-07 | Medtronic, Inc. | Telescoping catheter delivery system for left heart endocardial device placement |
| CN204147098U (en) * | 2014-10-20 | 2015-02-11 | 张素芳 | A kind of atrial septal puncture dispensing sheath of improvement |
-
2015
- 2015-03-18 CN CN201510119488.4A patent/CN106031651A/en active Pending
- 2015-03-18 CN CN201520154697.8U patent/CN204562318U/en not_active Expired - Fee Related
Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106618749A (en) * | 2015-10-30 | 2017-05-10 | 四川锦江电子科技有限公司 | Positioning catheter and puncture guiding assembly adopting same |
| CN106618685A (en) * | 2015-10-30 | 2017-05-10 | 四川锦江电子科技有限公司 | Sheath for atrial septal puncture |
| CN106618749B (en) * | 2015-10-30 | 2019-07-19 | 四川锦江电子科技有限公司 | A kind of positioning conduit and the puncture arrangement for guiding using the positioning conduit |
| CN108030539A (en) * | 2018-02-02 | 2018-05-15 | 张巧玲 | The puncture needle that a kind of Pediatric Clinic uses |
| CN110403640A (en) * | 2018-04-26 | 2019-11-05 | 复旦大学附属中山医院 | It is a kind of through subclavian vein having sexual intercourse interval piercing assembly |
Also Published As
| Publication number | Publication date |
|---|---|
| CN106031651A (en) | 2016-10-19 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| US11786723B2 (en) | Systems and methods for implanting a medical device | |
| JP6902617B2 (en) | Leadless pacing device and its positioning system | |
| JP6888112B2 (en) | Leadless pacing device for treating cardiac arrhythmias | |
| US11383080B2 (en) | Implantable medical devices and methods for making and delivering implantable medical devices | |
| US9597514B2 (en) | Epicardial heart rhythm management devices, systems and methods | |
| CN204562318U (en) | A kind of puncture instrument for operation on heart | |
| EP3727578B1 (en) | Implantable medical device for vascular deployment | |
| US10441777B2 (en) | Implantable medical device having restrained tether device | |
| JP2018520798A (en) | Placement of pacing / defibrillation electrodes under sternum | |
| US9265937B2 (en) | Implantable indifferent reference electrode pole | |
| US9987484B2 (en) | Method and system for lead delivery | |
| CN111556774A (en) | Implantable medical device for vascular deployment | |
| CN204600795U (en) | A kind of conveyer device for insertion type artificial cardiac valve | |
| US20210251553A1 (en) | Multidirectional balloon tipped catheter system for conducting his bundle sensing and pacing | |
| US20240058603A1 (en) | Temporary pacing lead | |
| US20100228330A1 (en) | Lead configured for hisian, para-hisian, rv septum and rv outflow tract pacing | |
| KR102137740B1 (en) | Pacemaker lead for cerclage pacing | |
| US20110218604A1 (en) | Cardiac Lead for Epicardial, Endocardial and Trans-Coronary Sinus Placement |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| CF01 | Termination of patent right due to non-payment of annual fee | ||
| CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20150819 Termination date: 20210318 |