CN209474866U - The aorta ascendens overlay film frame discharged through apical approach - Google Patents
The aorta ascendens overlay film frame discharged through apical approach Download PDFInfo
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- CN209474866U CN209474866U CN201822134301.XU CN201822134301U CN209474866U CN 209474866 U CN209474866 U CN 209474866U CN 201822134301 U CN201822134301 U CN 201822134301U CN 209474866 U CN209474866 U CN 209474866U
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- corolla
- overlay film
- film frame
- support rod
- area
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- 210000000709 aorta Anatomy 0.000 title claims abstract description 57
- 241001573881 Corolla Species 0.000 claims abstract description 88
- 241000463219 Epitheca Species 0.000 claims abstract description 16
- 239000003550 marker Substances 0.000 claims abstract description 16
- 229910052751 metal Inorganic materials 0.000 claims abstract description 16
- 239000002184 metal Substances 0.000 claims abstract description 16
- 230000017531 blood circulation Effects 0.000 claims abstract description 5
- 229910001000 nickel titanium Inorganic materials 0.000 claims abstract description 5
- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 claims abstract description 4
- 239000000463 material Substances 0.000 claims description 8
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- 210000003291 sinus of valsalva Anatomy 0.000 description 7
- 230000001174 ascending effect Effects 0.000 description 6
- 238000004873 anchoring Methods 0.000 description 5
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- 206010002329 Aneurysm Diseases 0.000 description 2
- 210000001765 aortic valve Anatomy 0.000 description 2
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- 201000010099 disease Diseases 0.000 description 2
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 2
- 238000009413 insulation Methods 0.000 description 2
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Landscapes
- Prostheses (AREA)
Abstract
The aorta ascendens overlay film frame through apical approach release of the utility model includes: self-expansion type overlay film frame and conveyer；Self-expansion type overlay film frame includes corolla area and stem portion；Corolla area includes corolla and multiple metal marker points for being arranged at the top of corolla, corolla is made of the leaflet that 6 Nitinol wires are compiled into, corolla is anchored to patient sustainer sinus portion, adjusts backing positions by metal marker point when positioning, guarantees that coronary opening is unobstructed；Corolla area is to flow into area, plays support and blood flow guiding role；Stem portion connect perforation with corolla area, and stem portion includes bracket overlay film and support skeleton；Conveyer include hollow support rod, across support rod hollow seal wire, support rod starting point is set epitheca, be arranged on support rod corolla locking device, the conical tip that can develop under X-ray at support rod end end is set.The embodiment of the utility model, for bracket through apex of the heart approach, release way is straight and short, reduces the intracavitary risk for repairing aorta ascendens.
Description
Technical field
The utility model relates to recovery technique field in aorta lumen more particularly to a kind of liter masters discharged through apical approach
Arteria covering membrane supporter.
Background technique
In the therapy field of arotic disease (interlayer or aneurysm), minimally invasive intracavitary recovery technique just gradually replaces biography
The open surgery for huge wound of uniting.Consensus is reached that, involve the interlayer of descending aorta, preferred intracavitary reparation at present.For involving master
The interlayer lesion in arch of aorta portion, " parallel bracket technology ", " overlay film frame windowing technology ", even with " the overlay film branch with branch
The treatment concept of aortic arch lesion is just being altered in steps although all cases cannot still be solved perfectly in the strategies such as frame ",
Complete intracavitary aortic arch lesion of repairing is the trend that Aortic surgery develops.However, interlayer for involving aorta ascendens or
Aneurysm opens chest and carries out lesion artery prosthetic vessel replacement under circulatory support in vitro, is still the main of such lesion
Treatment means.
Currently, clinical rarely have the intracavitary report for repairing Study on Ascending Aortic Lesions, also lack the branch dedicated for ascending aortic segment
Frame graft.Reason mainly has two o'clock: one, anatomy limits: root of ascending aorta is related to aortic valve, coronary opening, sinus
The complicated anatomical conditions such as pipe boundary；When aorta ascendens migrates as the arch of aorta, the head arm to brain and right upper extremity blood supply is issued
It is dry.This requires stent grafts on the one hand to adapt to " expanding " of aortic sinus, on the one hand cannot cover coronary artery and head arm is dynamic
Arteries and veins opening.Morphologic feature limits existing intracavity implant in the application in aorta ascendens area.It there is no a " reason at present
Think bracket " these problems can be solved perfectly, so that Study on Ascending Aortic Lesions is always the forbidden zone of " intracavitary reparation ".Two, hemodynamic
Limitation: left ventricle pumps blood pressure power height, and existing stent graft is femoral artery approach, and path is too long, need to be passed through curved
The arch of aorta.In the release of aorta ascendens area Endovascular, it is difficult to it is accurately positioned and firm anchoring, once in displacement will occur
Leakage, fall through of performing the operation.Minority report selects relatively simple and direct " through arteria carotis communis approach ", but will in advance distal end arteria carotis communis with
The provisional turn of tidal stream of opposite side arteria carotis communis influences the blood supply of head and neurological complication occurs in order to avoid Xining is too long.
Also there is the case for being placed in aorta ascendens bracket " through right subclavian artery approach ", but equally exist into curved way, angulation, it is fixed to influence
The problem of position.
Utility model content
In view of the above drawbacks of the prior art, the utility model provides a kind of aorta ascendens overlay film discharged through apical approach
Bracket.
The aorta ascendens overlay film frame provided by the utility model discharged through apical approach, comprising: self-expansion type overlay film branch
Frame and conveyer；
The self-expansion type overlay film frame includes corolla area and stem portion；Corolla area includes corolla and is arranged at the top of corolla
Metal marker point, corolla is made of the leaflet that 6 Nitinol wires are compiled into, the quantity of metal marker point be it is multiple,
Corolla is anchored to patient sustainer sinus portion, and the diameter of corolla is greater than the 10%-20% of patient sustainer sinus portion diameter, and when positioning is logical
Metal marker point adjustment backing positions are crossed, guarantee that coronary opening is unobstructed；Corolla area is to flow into area, plays support and blood flow guiding is made
With；Stem portion connect perforation with corolla area, and the diameter of corolla is 6-10mm bigger than the diameter of stem portion, and stem portion includes bracket overlay film
And support skeleton, the material of bracket overlay film are expanded PTFE, the material of support skeleton is wire；Support skeleton is located at
The outside of bracket overlay film perhaps support skeleton be located at the inside of bracket overlay film or support skeleton be sandwiched in two layers of bracket overlay film it
Between；
The conveyer includes hollow support rod, the hollow seal wire across support rod, setting in support rod starting point
Epitheca, be arranged on support rod corolla locking device, the circular cone that can develop under X-ray at support rod end end is set
Shape tip；Seal wire is hard silk, and the conveyer for being loaded with overlay film frame is sent into aorta ascendens along seal wire；Corolla locking device is for controlling
Corolla processed is shunk and release, and when release first removes epitheca, and stem portion discharges 1-2 section, is tentatively anchored, graft is attached to support
Bar adjusts transplanting object location, and ensureing Coronary Artery in patients and brachiocephalic artery opening not is covering, after accurate positioning, opens corolla, carries out
Secondary anchoring ensures that graft no longer shifts；After overlay film frame use, corolla locking device is withdrawn into epitheca, recycling
Conical tip, conveyer are integrally withdrawn from.
The aorta ascendens overlay film frame discharged as described above through apical approach, it is preferable that bracket overlay film passes through medical seam
Line is fixed on support skeleton.
The aorta ascendens overlay film frame discharged as described above through apical approach, further, the length in the corolla area
For 10-20mm, the length of the stem portion is 40-80mm.
The aorta ascendens overlay film frame discharged as described above through apical approach, wherein support rod is pre-installed on conveyer
In epitheca, corolla prelock is stuck in corolla locking device.
The aorta ascendens overlay film frame provided by the utility model discharged through apical approach, has the advantage that
1, it is not necessarily to extracorporal circulatory system, so that it may complete aorta ascendens inner cavity insulation, break intracavitary reparation " forbidden zone ".
2, have a common boundary from sinus pipe to brachiocephalic artery and be open, Wheat straw mulching Study on Ascending Aortic Lesions, closer to clinical truth.
3, self-expansion type bracket does not have to sacculus when release, avoids the interruption of aortic flow.
4, " corolla " section does not have overlay film, it is effectively guaranteed that blood supply coronarius.
5, overlay film frame is imported by aorta ascendens using transcatheter method, reduces operation pain and risk, and can be disease
People reduces medical expense.
6, when discharging bracket, overlay film section is first discharged, Primary Location is in brachiocephalic artery open proximal.At this point, bracket is not yet complete
It is complete fixed, bilateral coronary opening position can be determined again according to radiography, had a common boundary under perspective according to overlay film section and bare bracket section
Marker point (metal marker point) adjusts bracket integral position, finally discharges " corolla " bare bracket, is accurately anchored to sinus portion, can
Transfemoral approach is avoided, crosses after bending and positions inaccurately.
7, when lesion involves aortic valve, (TAVI+TEVAR) can be used simultaneously with the aorta petal discharged through conduit,
Two kinds of graft " corolla " sections can be overlapped.
Detailed description of the invention
It, below will be to required in embodiment description in order to illustrate more clearly of the technical scheme in the embodiment of the utility model
Attached drawing to be used is briefly described, it should be apparent that, the accompanying drawings in the following description is only some realities of the utility model
Example is applied, it for those of ordinary skill in the art, without creative efforts, can also be according to these attached drawings
Obtain other attached drawings.
Fig. 1 is the structural schematic diagram of the aorta ascendens overlay film frame through apical approach release of the utility model；
Fig. 2 is the top view of Fig. 1；
Fig. 3 is that the structure after the whole release of the aorta ascendens overlay film frame of apical approach release of the utility model is shown
It is intended to；
Fig. 4 is the structure of the Application Example one of the aorta ascendens overlay film frame through apical approach release of the utility model
Schematic diagram；
Fig. 5 is the structure of the Application Example two of the aorta ascendens overlay film frame through apical approach release of the utility model
Schematic diagram；
Fig. 6 is the structure of the Application Example three of the aorta ascendens overlay film frame through apical approach release of the utility model
Schematic diagram；
Fig. 7 is the structure of the Application Example four of the aorta ascendens overlay film frame through apical approach release of the utility model
Schematic diagram.
In figure: 1, corolla；2, metal marker point；3, bracket overlay film；4, support skeleton；5, conical tip；6, support rod；
7, corolla locking device；8, epitheca；9, aorta petal；10, coronary opening；11, seal wire.
Specific embodiment
The following will be combined with the drawings in the embodiments of the present invention, carries out the technical scheme in the embodiment of the utility model
Clearly and completely describe, it is clear that the described embodiments are only a part of the embodiments of the utility model, rather than whole
Embodiment.Based on the embodiments of the present invention, those of ordinary skill in the art are without creative efforts
Every other embodiment obtained, fall within the protection scope of the utility model.
Fig. 1 is the structural schematic diagram of the aorta ascendens overlay film frame through apical approach release of the utility model, and Fig. 2 is figure
1 top view, Fig. 3 are the structure after the whole release of the aorta ascendens overlay film frame of apical approach release of the utility model
Schematic diagram.With reference to shown in Fig. 1-Fig. 3, the aorta ascendens overlay film frame provided by the utility model discharged through apical approach, comprising:
Self-expansion type overlay film frame and conveyer；Self-expansion type overlay film frame includes corolla area and stem portion；Corolla area includes 1 He of corolla
The metal marker point 2 at 1 top of corolla is set, and corolla 1 is made of the leaflet that 6 Nitinol wires are compiled into, metal mark
The quantity of note point 2 be it is multiple, corolla 1 is anchored to patient sustainer sinus portion, and the diameter of corolla 1 is greater than patient sustainer sinus portion diameter
10%-20%, backing positions are adjusted by metal marker point 2 when positioning, guarantee that coronary opening is unobstructed；Corolla area is to flow into
Support and blood flow guiding role play in area；Stem portion connect perforation with corolla area, and the length in corolla area is 10-20mm, stem portion
Length is 40-80mm.The diameter of corolla 1 is 6-10mm bigger than the diameter of stem portion, and stem portion includes bracket overlay film 3 and support skeleton
4, the material of bracket overlay film 3 is expanded PTFE, and the material of support skeleton 4 is wire；Support skeleton 4 is covered positioned at bracket
The outside of film 3 perhaps support skeleton 4 be located at the inside of bracket overlay film 3 or support skeleton 4 be sandwiched in two layers of bracket overlay film 3 it
Between；Preferably, bracket overlay film 3 is fixed on support skeleton 4 by medical suture, and support rod 6 is pre-installed on the epitheca 8 of conveyer
In, 1 prelock of corolla is stuck in corolla locking device 7.
Conveyer includes hollow support rod 6, the hollow seal wire 11 across support rod 6, setting in 6 starting point of support rod
Epitheca 8, be arranged on support rod corolla locking device 7, can developing under X-ray for support rod 6 end end is set
Conical tip 5；Seal wire 11 is hard silk, and the conveyer for being loaded with overlay film frame is sent into aorta ascendens along seal wire 11；Corolla locking
Device 7 is shunk for controlling corolla 1 and release, when release first remove epitheca 8, and stem portion discharges 1-2 section, is tentatively anchored, shifting
Plant attaching adjusts transplanting object location in support rod 6, and ensureing Coronary Artery in patients and brachiocephalic artery opening not is covering, accurate positioning
Afterwards, corolla 1 is opened, secondary anchoring is carried out, ensures that graft no longer shifts；After overlay film frame use, corolla is locked and is filled
7 withdrawal epithecas 8 are set, recycling cone tip 5, conveyer is integrally withdrawn from.
The aorta ascendens overlay film frame through apical approach release in the present embodiment consists of two parts: self-expansion type overlay film
Bracket and conveyer.
Self-expansion type overlay film frame: metallic support is woven by Nitinol wire or stainless steel, form such as Fig. 1
It is shown.Corolla area is " apterium ", is made of 6 leaflets, outer diameter 30-50mm, length 10-20mm.Corolla is to flow into area, plays support
And blood flow guiding role, secure anchorage guarantee that coronary opening is unobstructed in aortic sinus portion.Stem portion and corolla area interconnecting piece, flower
Crown portion is provided with multiple metal marker points, for being identified during having an X-rayed.Stem portion outer diameter 30-45mm, length 40-
80mm connect perforation with corolla area, and the material of whole overlay film, coating layer is expanded PTFE, is covered in metallic support master
When cadre, wire and coating layer combine, wire is located at the outside of coating layer, inside or is sandwiched in any between two layers
It is a kind of.It is fixed on metallic support by medical suture.Corolla diameter is greater than patient sustainer sinus portion diameter 10-20%.Corolla
Diameter differs 6-10mm with overlay film section diameter.
Conveyer: being made of medical material, and polyphosphazene polymer and the development of material acoustic contrast agent can be added, auxiliary convenient for ultrasound
Help positioning.Conveyer includes: hollow support rod 6, and interior is silk guide passage.Head end is the cone to develop under conical x-ray
Tip 5 (tip).Graft is attached to support rod 6.Corolla closes at the insurance lock of the corolla on support rod, extraction corolla insurance
Corolla side can discharge after silk.Epitheca can be 18-22F, when release, first remove epitheca, overlay film section discharges 1-2 section, preliminary to be anchored.This
When can be according to radiography, a little to recycle overlay film section, fine tuning transplanting object location, ensureing coronary artery and brachiocephalic artery opening not is covering.It is fixed
After level is true, corolla fuse being extracted out, opening corolla, secondary anchoring ensures that graft no longer shifts.
Fig. 4 is the structure of the Application Example one of the aorta ascendens overlay film frame through apical approach release of the utility model
Schematic diagram.Refering to what is shown in Fig. 4, being after overlay film section discharges in the present embodiment, corolla locking device not yet discharges signal when corolla
Figure.At this point it is possible to which under fluoroscopy, according to metal marker point (mark point), integrally-regulated backing positions guarantee that coronary opening is not
Covering.
Fig. 5 is the structure of the Application Example two of the aorta ascendens overlay film frame through apical approach release of the utility model
Schematic diagram.As shown in figure 5, through the 4th intercostal, small notch appears apical region of heart, Proset pouch suture in the present embodiment.Puncture the apex of the heart
Portion.
Fig. 6 is the structure of the Application Example three of the aorta ascendens overlay film frame through apical approach release of the utility model
Schematic diagram.As shown in fig. 6, in the present embodiment, seal wire is by the apex of the heart, through left ventricle, aorta petal, and through aorta ascendens, the arch of aorta,
Into descending aorta, operation access is established.
Fig. 7 is the structure of the Application Example four of the aorta ascendens overlay film frame through apical approach release of the utility model
Schematic diagram.As shown in fig. 7, the transportation system for being loaded with overlay film frame is sent into aorta ascendens along seal wire in the present embodiment.
Referring again to epitheca 8 shown in Fig. 4, is removed, the overlay film section of bracket is opened at this time.And corolla section bare bracket (corolla 1) is still
" lock " is in corolla locking device 7.At this point it is possible to confirm two, aortic sinus portion coronary opening by radiography.According to corolla with
The intersection metal marker point (mark point) of overlay film section adjusts backing positions, guarantees that coronary opening is unaffected.Determine position
Afterwards, corolla is opened.
Situation can be with reference to shown in Fig. 3 after integral support release.At this point, corolla 1 is anchored to aortic sinus portion, coronary opening
10 is unobstructed, and 9 leaflet activity condition of aorta petal is visible.Corolla locking device 7 is withdrawn into epitheca 8, then careful recycling cone point
First 5 (tip), conveyer is integrally withdrawn from.The tightening of apex of the heart pocket.Bracket overlay film 3 still has distance apart from truncus brachiocephalicus opening.At this point,
Can Transfemoral approach by seal wire 11 be sent into overlay film section, establish rise a master-arch of aorta-descending aorta approach.After this path setting,
It using the prior art, rebuilds and bends upper three branch, and be further processed bow portion and drop principal piece lesion.As it can be seen that when lesion involves master
When the arch of aorta, technical solution provided by the utility model can make simultaneously with the existing complete intracavitary technology for repairing aortic arch lesion
With.In clinical practice situation, few lesions for involving aorta ascendens merely.Often by rising main starting, involve aorta always
Bow and descending aorta.Currently, the complete intracavitary reparation arch of aorta and descending aorta lesion are very mature.Existing intracavitary reparation skill
The overlay film frame that art uses is constituted in addition to " corolla " design that aortic sinus portion is anchored, overlay film part and such bracket
It is similar, it can accomplish ascending aortic segment and bow portion bracket " seamless connection ".
In conclusion the utility model is for existing aortic stents existing location difficulty and aortic sinus portion after crossing bow
It is inconvenient that coronary opening retains, so that intracavitary reparation Study on Ascending Aortic Lesions has that operation risk is high, discloses a kind of knot
Structure is reasonable, easy to use, the small Novel warp apical approach aorta ascendens inner cavity insulation bracket of operation risk.It is a kind of self-expanding
Formula bracket forms overlay film frame by nickel-titanium alloy framework and eptfe membrane, and mount proximal end is bare bracket corolla, anchoring
In aortic sinus portion, and the wave bracket with corolla perforation connection, polytetrafluoroethylene film is covered thereon, and bracket is to enter through the apex of the heart
Road, release way is straight and short, reduces the intracavitary risk for repairing aorta ascendens, has a good application prospect.
Finally, it should be noted that above embodiments are only to illustrate the technical solution of the utility model, rather than its limitations；
Although the utility model is described in detail with reference to the foregoing embodiments, those skilled in the art should understand that:
It is still possible to modify the technical solutions described in the foregoing embodiments, or part of technical characteristic is carried out etc.
With replacement；And these are modified or replaceed, various embodiments of the utility model technology that it does not separate the essence of the corresponding technical solution
The spirit and scope of scheme.
Claims (4)
1. it is a kind of through apical approach discharge aorta ascendens overlay film frame characterized by comprising self-expansion type overlay film frame and
Conveyer；
The self-expansion type overlay film frame includes corolla area and stem portion；Corolla area includes that corolla (1) and setting are pushed up in corolla (1)
The metal marker point (2) in portion, corolla (1) are made of the leaflet that 6 Nitinol wires are compiled into, metal marker point (2)
Quantity be it is multiple, corolla (1) is anchored to patient sustainer sinus portion, and the diameter of corolla (1) is greater than patient sustainer sinus portion diameter
10%-20% adjusts backing positions by metal marker point (2) when positioning, guarantees that coronary opening is unobstructed；Corolla area is to flow into
Support and blood flow guiding role play in area；Stem portion connect perforation with corolla area, and the diameter of corolla (1) is bigger than the diameter of stem portion
6-10mm, stem portion include bracket overlay film (3) and support skeleton (4), and the material of bracket overlay film (3) is expanded PTFE,
The material of support skeleton (4) is wire；Support skeleton (4) is located at the outside or support skeleton (4) position of bracket overlay film (3)
It is sandwiched between two layers of bracket overlay film (3) in the inside of bracket overlay film (3) or support skeleton (4)；
The conveyer includes hollow support rod (6), the hollow seal wire (11) for passing through support rod (6), is arranged in support rod
(6) epitheca (8) of starting point, be arranged on support rod corolla locking device (7), be arranged at support rod (6) end end can
The conical tip (5) to develop under X-ray；Seal wire (11) is hard silk, is loaded with the conveyer of overlay film frame along seal wire (11)
It is sent into aorta ascendens.
2. the aorta ascendens overlay film frame according to claim 1 discharged through apical approach, which is characterized in that bracket overlay film
(3) it is fixed on support skeleton (4) by medical suture.
3. the aorta ascendens overlay film frame according to claim 2 discharged through apical approach, which is characterized in that the corolla
The length in area is 10-20mm, and the length of the stem portion is 40-80mm.
4. the aorta ascendens overlay film frame according to claim 1-3 discharged through apical approach, which is characterized in that
Support rod (6) is pre-installed in the epitheca (8) of conveyer, and corolla (1) prelock is stuck in corolla locking device (7).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201822134301.XU CN209474866U (en) | 2018-12-19 | 2018-12-19 | The aorta ascendens overlay film frame discharged through apical approach |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201822134301.XU CN209474866U (en) | 2018-12-19 | 2018-12-19 | The aorta ascendens overlay film frame discharged through apical approach |
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| Publication Number | Publication Date |
|---|---|
| CN209474866U true CN209474866U (en) | 2019-10-11 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201822134301.XU Withdrawn - After Issue CN209474866U (en) | 2018-12-19 | 2018-12-19 | The aorta ascendens overlay film frame discharged through apical approach |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109481082A (en) * | 2018-12-19 | 2019-03-19 | 云南省阜外心血管病医院 | The aorta ascendens overlay film frame discharged through apical approach |
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2018
- 2018-12-19 CN CN201822134301.XU patent/CN209474866U/en not_active Withdrawn - After Issue
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109481082A (en) * | 2018-12-19 | 2019-03-19 | 云南省阜外心血管病医院 | The aorta ascendens overlay film frame discharged through apical approach |
| CN109481082B (en) * | 2018-12-19 | 2023-12-19 | 云南省阜外心血管病医院 | Ascending aorta covered stent released by apex of heart way |
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