CN208573789U - Total aortic arch replacement and bracket elephant trunk technique aorta clamping device - Google Patents
Total aortic arch replacement and bracket elephant trunk technique aorta clamping device Download PDFInfo
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- CN208573789U CN208573789U CN201721370853.XU CN201721370853U CN208573789U CN 208573789 U CN208573789 U CN 208573789U CN 201721370853 U CN201721370853 U CN 201721370853U CN 208573789 U CN208573789 U CN 208573789U
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Abstract
This application provides a kind of total aortic arch replacements and bracket elephant trunk technique aorta clamping device, comprising: support type artificial blood vessel；Occluding device, the occluding device include conduit, and the sacculus of the tube at one end is arranged in and can make the plus-minus pressure device of the balloon inflation and contraction；It can be fixed on after the sacculus pressurized expansion in the support type artificial blood vessel, and block the support type artificial blood vessel in support zone.The application creatively will include the occluding device of sacculus applied in total aortic arch replacement and bracket elephant trunk technique, it is used in combination to the blood flow for blocking aorta with the support type artificial blood vessel being placed in descending aorta, to avoid profound hypothermia, it is significant to shorten descending aorta and far to stop circulation time, greatly reduce postoperative complications, improves surgical effect.
Description
Technical field
The application belongs to occluding device technical field more particularly to a kind of total aortic arch replacement and bracket elephant trunk technique master
Artery occlusion device.
Background technique
Total aortic arch replacement adds the operation of bracket trunk to be widely used in aneurysm of thoracic aorta and acute and chronic A type aorta
In the treatment of the diseases such as interlayer, nearly medium-long term operative effect has obtained the approval of domestic and international more and more experts.This hand
The implementation of art must use deep hypothermic circulatory arrest, i.e., need total body hypothermia in art, when nasopharyngeal temperature is down to 18~20 DEG C, warp
Axillary artery or the unilateral selective cerebral perfusion of innominate artery intubation row, the lower part of the body stops recycling at this time, i.e. the device that is perfused of descending aorta
Official, including spinal cord, liver, kidney, alimentary canal etc. are without hemoperfusion, after the very intracavitary implantation stented vessel of descending aorta, use
" open anastomosis " completes descending aorta proximal end and bow portion distal anastomosis, then restores lower part of the body perfusion, and stopping circulation terminates,
Time, general control was in 20~30min or so.However, Deep Hypothermia Circulatory Arrest can cause interior environment disturbance, coagulation function damage and
Acute hepatic and kidney function obstacle, functional disturbances of gastrointestinal tract, spinal cord injury etc. are a series of to be difficult to the problem of evading, after leading to patients surgery
Restore bad, severe complication even death.Therefore, how to shorten the Deep Hypothermia Circulatory Arrest time with important clinical application valence
Value.
Summary of the invention
In view of this, the application be designed to provide a kind of total aortic arch replacement and bracket elephant trunk technique is hindered with aorta
Disconnected device avoids profound hypothermia when the occluding device for bending in displacement and bracket elephant trunk technique entirely, it is significant shorten descending aorta and with
Far stop circulation time, to reduce postoperative complications, improves surgical effect.
This application provides a kind of total aortic arch replacements and bracket elephant trunk technique aorta clamping device, comprising:
Support type artificial blood vessel；
Occluding device, the occluding device include conduit, and the sacculus of the tube at one end is arranged in and can make the sacculus
Expansion and the plus-minus pressure device shunk；
It can be fixed on after the sacculus pressurized expansion in the support type artificial blood vessel, and block the branch in support zone
Support type artificial blood vessel.
In this application, the support type artificial blood vessel is common blood vessel in total aortic arch replacement and bracket elephant trunk technique
Bracket, the application have no this specifically limited.
The occluding device includes conduit, and the sacculus of the tube at one end is arranged in and can make the balloon inflation and contraction
Plus-minus pressure device.In use, sacculus enters support type artificial blood vessel under the guidance of conduit, plus-minus pressure device carries out sacculus
Pressurization makes its expansion, is fixed in support type artificial blood vessel, and block the artificial blood vessel in support zone；At this point, body can be opened
Outer circulation terminates the lower part of the body and stops recycling.Surgical procedure is completed, and when without blocking, is depressurized using plus-minus pressure device to sacculus
Make its contraction, support type artificial blood vessel is withdrawn under the action of conduit.
The application has no particular/special requirement to the material of the conduit, can be sent into sacculus and enter the artificial blood of support type in vivo
Pipe；Situations such as it is soft, pressure-resistant, anti-stab that this application claims the sacculus, is not in rupture in closure vascular process, material
Matter can be polyethylene, polyester, nylon, polyurethane or silica gel, meet requirement.
In one embodiment, the occluding device further includes the pressing device that can push the sacculus of pressurized expansion.Sacculus
In support type artificial blood vessel after pressurized expansion, pressing device gives sacculus pushing force to fix sacculus, avoids sacculus from shifting, shadow
Ring plugging effect.
Aorta clamping device provided by the present application in total aortic arch replacement and bracket elephant trunk technique in accordance with the following methods
It uses:
In total aortic arch replacement and bracket elephant trunk technique, 28 DEG C are down to nasopharyngeal temperature, blocks lower part of the body circulation, row choosing
The perfusion of selecting property brain, the cross-section arch of aorta, after quickly trimming and preparing bow portion distal anastomosis mouth, by support type artificial blood vessel through actively
Arcus haemalis notch is put very intracavitary to descending aorta, and then occluding device is quickly put into support type artificial blood vessel, opens plus-minus pressure
Device be fixed on balloon inflation extremely can in support type artificial blood vessel, and block the support type artificial blood vessel in support zone,
Hereafter, open femoral artery infusion pipe improves extracorporal circulatory system flow to 1/2 full flow, restores internal organ and lower limb are perfused, stop circulation knot
Beam.Four branches aortic graft distal end is completed with behind support type artificial blood vessel proximal end and arch of aorta end-to-end anastomosis, is pressed using plus-minus
Device, which depressurizes sacculus, to be shunk, and taking-up can carry out subsequent operation.
Occluding device including sacculus is creatively applied in total aortic arch replacement and bracket elephant trunk technique by the application,
It is used in combination to the blood flow for blocking aorta with the support type artificial blood vessel being placed in descending aorta, so that profound hypothermia is avoided,
It is significant to shorten descending aorta and far to stop circulation time, greatly reduce postoperative complications, improve surgical effect.
Detailed description of the invention
In order to illustrate the technical solutions in the embodiments of the present application or in the prior art more clearly, to embodiment or will show below
There is attached drawing needed in technical description to be briefly described, it should be apparent that, the accompanying drawings in the following description is only this
The embodiment of application for those of ordinary skill in the art without creative efforts, can also basis
The attached drawing of offer obtains other attached drawings.
Fig. 1 is the structural schematic diagram for the occluding device that the embodiment of the present application one provides；
Fig. 2 is the structural schematic diagram for the occluding device that the embodiment of the present application two provides.
Specific embodiment
Below by the technical scheme in the embodiment of the application is clearly and completely described, it is clear that described implementation
Example is merely a part but not all of the embodiments of the present application.Based on the embodiment in the application, this field is common
Technical staff's every other embodiment obtained without making creative work belongs to the model of the application protection
It encloses.
This application provides a kind of total aortic arch replacements and bracket elephant trunk technique aorta clamping device, comprising:
Support type artificial blood vessel；
Occluding device, the occluding device include conduit, and the sacculus of the tube at one end is arranged in and can make the sacculus
Expansion and the plus-minus pressure device shunk；
It can be fixed on after the sacculus pressurized expansion in the support type artificial blood vessel, and block the branch in support zone
Support type artificial blood vessel.
In one embodiment, the occluding device includes:
Hollow conduit closed at one end；
The double-layered balloon of the closed one end of the hollow conduit is set；
The plus-minus pressure device being connected with the hollow conduit other end；
The part of the hollow conduit cladding sacculus, which is provided with through-hole, communicates hollow conduit with sacculus.
Referring to Fig. 1, Fig. 1 is the structural schematic diagram for the occluding device that the embodiment of the present application one provides, wherein 11 be conduit,
12 be sacculus, and 13 be syringe, and 14 be sheath, and 15 be handle, and 16 be triple valve.
The occluding device includes hollow conduit 11 closed at one end, and hollow conduit 11 is made of flexible material, bent,
Resiliently.
Hollow conduit 11 it is closed at one end, and the end is provided with sacculus 12；Sacculus 12 can by polyethylene, polyester, nylon,
Polyurethane or silica gel etc. are made, and soft, pressure resistance can be prevented puncturing.Sacculus 12 can be double-layer structure, and more conducively raising sacculus is resistance to
Pressure prevents puncturing performance, while not influencing its shrinkage.The voltage endurance capability of sacculus 12 is 450mmhHg~600mmHg.
The other end of hollow conduit 11 is connected with syringe 13；The part that hollow conduit 11 coats sacculus 12 is provided with logical
Hole communicates hollow conduit 11 with sacculus 12.
Syringe 13 is plus-minus pressure device, physiological saline or gas injection can be entered hollow conduit 11, and pass through
Through-hole thereon, which enters sacculus 12, makes the expansion of sacculus 12 realize plugging action；Physiological saline or gas can also be led by hollow
Through-hole on pipe 11 is taken away out of sacculus 12 shrinks sacculus 12, so that occluding device be withdrawn from vitro.
It is provided with triple valve 16 on the pipeline that syringe 13 is connected with hollow conduit 11, is easy to implement adding to sacculus 12
Pressure and decompression.
The occluding device further includes sheath 14, and sheath 14 is removably set in outside the conduit 11, and can be to adding
Sacculus 12 after compression swelling applies pushing force.Sheath 14 is bent, does not spring back, and has axial support force, can guiding catheter into
Enter in support type artificial blood vessel.
It is provided with handle 15 in sheath 14, convenient for applying pushing force to the sacculus 12 after pressurized expansion, prevents sacculus 12 from existing
The lower displacement of blood flow impact.
In another embodiment, the occluding device includes:
Hollow conduit closed at one end；
The double-layered balloon of the closed one end of the hollow conduit is set；
It is attached on the hollow conduit inner wall plus reduced pressure conduit, described plus reduced pressure conduit one end and plus-minus pressure device
It communicates, the other end is communicated with sacculus.
Referring to fig. 2, Fig. 2 is the structural schematic diagram for the occluding device that the embodiment of the present application two provides, wherein 21 lead to be hollow
It manages, 22 be sacculus, and 23 be syringe, and 24 be setting core, and 25 be handle, and 26 is add reduced pressure conduit, and 27 be three-way valve, and 28 be to add
Strong net.
The occluding device includes hollow conduit 21 closed at one end, and hollow conduit 21 is made of flexible material, bent,
Resiliently.
Hollow conduit 21 it is closed at one end, and the end is provided with sacculus 22；Sacculus 22 can by polyethylene, polyester, nylon,
Polyurethane or silica gel etc. are made, and soft, pressure resistance can be prevented puncturing.Sacculus 22 can be double-layer structure, and more conducively raising sacculus is resistance to
Pressure prevents puncturing performance, while not influencing its shrinkage.The voltage endurance capability of sacculus 22 is 450mmhHg~600mmHg.
It is pasted on 21 inner wall of hollow conduit and adds reduced pressure conduit 26, one end of reduced pressure conduit 26 is added to be connected with sacculus 22,
The other end is connected with syringe 23.
Syringe 13 is plus-minus pressure device, physiological saline can be made by adding reduced pressure conduit 26 to be injected into sacculus 12
Plugging action is realized in the expansion of sacculus 12；Physiological saline can also be made into sacculus 12 by adding reduced pressure conduit 26 to take away out of sacculus 12
It shrinks, so that occluding device be withdrawn from vitro.It is provided with triple valve 27 on adding reduced pressure conduit 26, is easy to implement to sacculus 12
Pressurization and decompression.
The occluding device further includes reinforcing mat 28 and setting core 24, and the tube wall of hollow conduit 21 is arranged in reinforcing mat 28
Interior, setting core 24 is arranged in the hollow cavity of hollow conduit 21, and reinforcing mat 28 and setting core 24 make that conduit is bent, does not spring back,
And have axial support force, easily enter support type artificial blood vessel etc..The setting core can be steel core, and reinforcing mat can be steel wire
Net.
The occluding device is additionally provided with handle 25, and the one end of hollow conduit 21 far from sacculus 22 is arranged in handle 25, and
It is connected with setting core 24, convenient for applying pushing force to the sacculus 22 after pressurized expansion, prevents sacculus 22 from shifting under blood flow impact.
Total aortic arch replacement and bracket elephant trunk technique aorta clamping device provided by the present application makes in accordance with the following methods
With:
In total aortic arch replacement and bracket elephant trunk technique, 28 DEG C are down to nasopharyngeal temperature, blocks lower part of the body circulation, row choosing
The perfusion of selecting property brain, the cross-section arch of aorta, after quickly trimming and preparing bow portion distal anastomosis mouth, by support type artificial blood vessel through actively
Arcus haemalis notch put it is very intracavitary to descending aorta, then by sheath or directly sacculus being quickly put into support type artificial blood vessel,
Injecting 40~45mL physiological saline into sacculus by syringe makes balloon inflation, and it is artificial to guarantee that sacculus is blocked in support zone
Blood vessel, hereafter, open femoral artery infusion pipe improves extracorporal circulatory system flow to 1/2 full flow, restores internal organ and lower limb are perfused, stop
Circulation terminates, meanwhile, by handle to sacculus apply pushing force in case sacculus shift.Complete Four branches aortic graft distal end and branch
Behind support type artificial blood vessel proximal end and arch of aorta end-to-end anastomosis, being taken away the physiological saline in sacculus using syringe receives sacculus
Contracting can carry out subsequent operation after taking out sacculus.
Specifically, using aorta clamping device provided by the present application implement aorta A type interlayer entirely bend displacement with
Bracket elephant trunk technique operating procedure is as follows:
1, dissociate right axillary artery and femoral artery, and standby single pump is two-tube, aortic cannulation is perfused.
2, using mid-sternal incision, sufficiently free innominate vein, innominate artery, left common carotid artery, left subclavian artery.
3, right axillary artery, femoral arteriography, atrium dextrum insert two ladder drainage tubes, establish extracorporal circulatory system.Right upper pulmonary vein is set
Left heart drainage-tube.Clamping of aorta, after longitudinal incision aorta ascendens, coronary ostium direct-view in left and right is perfused cold crystal and contains blood
Stop jumping liquid.
4, it in extracorporal circulatory system temperature-fall period, is trimmed according to interlayer proximal end lesion situation and prepares proximal aorta previous anastomotic.
5, it closely, is distally blocked in left subclavian artery respectively, after cross-section, proximal end seam is closed.
6, the sufficiently free arch of aorta when nasopharyngeal temperature is down to 28 DEG C, blocks innominate artery, and left common carotid artery blocks stock
Arterial perfusion pipe reduces flow to 5~8ml/ (minkg), through axillary artery row selective cerebral perfusion.
7, the cross-section arch of aorta between left subclavian artery and left common carotid artery is quickly trimmed and prepares bow portion distal end and kisses
It heals up.
8, support type artificial blood vessel is put through arch of aorta notch very intracavitary to descending aorta.It will pass through what trimming finished
The sacculus of the main blood vessel of Four branches aortic graft is quickly put into support type artificial blood vessel by conduit, saline injection in sacculus
40~45ml, it is ensured that balloon occluder presses sacculus in support zone, using handle, in case it is shifted.
9, open femoral artery infusion pipe improves extracorporal circulatory system flow to 1/2 full flow, restores internal organ and lower limb are perfused, stop
Circulation terminates, and stops circulation time at this time within 5min.
10, Four branches aortic graft distal end and support type artificial blood vessel proximal end and arch of aorta end-to-end anastomosis are completed.By ball
Intracapsular water is released, and sacculus, conduit are taken out, and blocks the main blood vessel of Four branches aortic graft.
11, by the 8mm branch vessel of Four branches aortic graft and left common carotid artery end to end anastomosis, extracorporal circulatory system restores to complete
Flow starts rewarming.Four branches aortic graft proximal end and aorta ascendens end to end anastomosis, after exhaust, open state block is clamped, and heart is multiple
Soviet Union.It is respectively completed 8mm, 10mm branch and left subclavian artery, innominate artery end to end anastomosis.
12, for nasopharynx temperature to 37.5 DEG C, anus temperature withdraws extracorporal circulatory system to 35 DEG C.
Using occluding device described herein, 3 acute type A aortic dissection patients are risen according to above-mentioned steps
Aorta and full bow displacement and bracket elephant trunk technique, clinical data are shown in Table 1.
The data of 13 acute type A aortic dissection patients of table
As can be seen that the application creatively will include the occluding device of sacculus applied to total aortic arch replacement and bracket
In elephant trunk technique, it is used in combination to the blood flow for blocking aorta with the support type artificial blood vessel being placed in descending aorta, to keep away
Exempt from profound hypothermia, it is significant to shorten descending aorta and far to stop circulation time, greatly reduce postoperative complications, improve surgical effect.
The above is only the preferred embodiment of the application, it is noted that for the ordinary skill people of the art
For member, under the premise of not departing from the application principle, several improvements and modifications can also be made, these improvements and modifications are also answered
It is considered as the protection scope of the application.
Claims (9)
1. a kind of total aortic arch replacement and bracket elephant trunk technique aorta clamping device characterized by comprising
Support type artificial blood vessel；
Occluding device, the occluding device include conduit, and the sacculus of the tube at one end is arranged in and can make the balloon inflation
With the plus-minus pressure device of contraction；
It can be fixed on after the sacculus pressurized expansion in the support type artificial blood vessel, and block the support type in support zone
Artificial blood vessel.
2. aorta clamping device according to claim 1, which is characterized in that the occluding device further include:
The pressing device of the sacculus of pressurized expansion can be pushed.
3. aorta clamping device according to claim 2, which is characterized in that the occluding device includes:
Hollow conduit closed at one end；
The double-layered balloon of the closed one end of the hollow conduit is set；
The plus-minus pressure device being connected with the hollow conduit other end；
The part of the hollow conduit cladding sacculus, which is provided with through-hole, communicates hollow conduit with sacculus.
4. aorta clamping device according to claim 3, which is characterized in that the plus-minus press fitting is set to syringe.
5. aorta clamping device according to claim 4, which is characterized in that the pressing device is removably to be arranged
Sheath outside the conduit.
6. aorta clamping device according to claim 2, which is characterized in that the occluding device includes:
Hollow conduit closed at one end；
The double-layered balloon that the hollow conduit closes one end is set；
It is attached on the hollow conduit inner wall plus reduced pressure conduit, described plus reduced pressure conduit one end and plus-minus pressure device phase
Logical, the other end is communicated with sacculus.
7. aorta clamping device according to claim 6, which is characterized in that be provided with and add on the hollow conduit inner wall
Strong net is internally provided with setting core.
8. aorta clamping device according to claim 7, which is characterized in that the pressing device is that setting is led hollow
The handle of one end far from sacculus is managed, the handle is connected with setting core.
9. aorta clamping device according to claim 8, which is characterized in that the plus-minus press fitting is set to syringe.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201721370853.XU CN208573789U (en) | 2017-10-19 | 2017-10-19 | Total aortic arch replacement and bracket elephant trunk technique aorta clamping device |
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| CN201721370853.XU CN208573789U (en) | 2017-10-19 | 2017-10-19 | Total aortic arch replacement and bracket elephant trunk technique aorta clamping device |
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Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107595348A (en) * | 2017-10-19 | 2018-01-19 | 孙晓刚 | Total aortic arch replacement and support elephant trunk technique aorta clamping device |
| CN110192904A (en) * | 2019-06-24 | 2019-09-03 | 中南大学湘雅二医院 | A kind of intercostal arteries temporary closure |
| CN110639117A (en) * | 2019-09-26 | 2020-01-03 | 中国人民解放军北部战区总医院 | Air bag arterial cannula with suction function |
| CN111281463A (en) * | 2020-02-24 | 2020-06-16 | 河北医科大学第二医院 | Perfusion flow guiding device for avoiding deep low temperature stop circulation in aortic total-arch replacement |
| WO2021258772A1 (en) * | 2020-06-22 | 2021-12-30 | 上海微创心脉医疗科技(集团)股份有限公司 | Medical device |
-
2017
- 2017-10-19 CN CN201721370853.XU patent/CN208573789U/en active Active
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107595348A (en) * | 2017-10-19 | 2018-01-19 | 孙晓刚 | Total aortic arch replacement and support elephant trunk technique aorta clamping device |
| CN110192904A (en) * | 2019-06-24 | 2019-09-03 | 中南大学湘雅二医院 | A kind of intercostal arteries temporary closure |
| CN110192904B (en) * | 2019-06-24 | 2024-05-07 | 中南大学湘雅二医院 | Intercostal artery temporary closing device |
| CN110639117A (en) * | 2019-09-26 | 2020-01-03 | 中国人民解放军北部战区总医院 | Air bag arterial cannula with suction function |
| CN111281463A (en) * | 2020-02-24 | 2020-06-16 | 河北医科大学第二医院 | Perfusion flow guiding device for avoiding deep low temperature stop circulation in aortic total-arch replacement |
| WO2021258772A1 (en) * | 2020-06-22 | 2021-12-30 | 上海微创心脉医疗科技(集团)股份有限公司 | Medical device |
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