CN209966663U - Valve ring-contracting system - Google Patents

Abstract

The utility model provides a valve ring contracting system, which comprises a positioning device, a conveying device, an anchoring device and a tightening line, wherein the anchoring device comprises a plurality of anchoring parts; the positioning device is provided with a plurality of windows which are axially arranged, the positioning device is positioned on the targeting part, and the windows face to different positions of the targeting part; the delivery device delivers the plurality of anchors to different positions of the target part through the plurality of windows respectively along the positioning device; the anchoring device fixes the anchoring piece passing through each window on different positions of the targeting part in sequence; the tightening wire is used to connect in series and tighten a plurality of anchors fixed to different positions of the target portion so as to reduce the circumference of the target portion. The utility model provides a valve system of encircleing stretches out anchoring device from different windows to fix the anchoring piece on the different positions of target portion, and then tighten up target portion through tightening up the line, thereby realize reducing the effect of target portion girth.

Description

Valve ring-contracting system

Technical Field

The utility model relates to the field of medical equipment, concretely relates to valve system of encircleing.

Background

As shown in fig. 1, the human heart is composed of a left heart and a right heart, the right heart including a Right Ventricle (RV) and a Right Atrium (RA), and the left heart including a Left Ventricle (LV) and a Left Atrium (LA). The mitral valve is a "one-way valve" between the left atrium and the left ventricle, including the annulus (MVA), anterior leaflet (AML), posterior leaflet (PML), Chordae Tendineae (CT), and Papillary Muscles (PM). The valve ring is arranged between the left atrium and the left ventricle, the front lobe and the rear lobe are connected with the valve ring, a plurality of Chordae Tendineae (CT) are arranged on the two valve lobes, and the other ends of the chordae tendineae are connected with papillary muscles. During the beating of the heart, the anterior and posterior leaflets of the normal mitral valve are in an open and closed circulatory motion, thereby ensuring that blood circulation is directed from the left atrium to the left ventricle and through a certain flow. When the leaflets, annulus, papillary muscles, chordae tendinae and other components of the mitral valve are organically or functionally changed to cause the anterior and posterior leaflets of the mitral valve to be in poor anastomosis, the mitral regurgitation (abbreviated as MR) can be caused. Mitral regurgitation is a common heart valve disease. Mitral regurgitation can be classified into functional and organic (also called degenerative) groups in etiology. For mitral regurgitation, clinical trials have shown that drug treatment can only improve patient symptoms, but not prolong patient survival or surgical time. The traditional standard treatment is surgery, primarily surgical valve repair or replacement. However, the surgery has large trauma, difficult healing, more complications and higher surgery risk. Percutaneous mitral annuloplasty, an interventional method, is one of the most commonly used mitral annuloplasty methods, and has a good long-term treatment effect. However, in the prior art, in the patients with functional mitral regurgitation accompanied with heart failure and left ventricle enlargement, the left ventricle cannot be effectively reduced due to the ring contraction only aiming at the valve ring, and the treatment effect is not ideal.

SUMMERY OF THE UTILITY MODEL

In view of this, the present invention provides a valve-annuloplasty system capable of effectively reducing the volume of the left ventricle, so as to improve the therapeutic effect of functional mitral regurgitation. The specific technical scheme is as follows.

A valve collar system comprising a positioning device, a delivery device, an anchoring device, and a cinch cord, the anchoring device comprising a plurality of anchors;

the positioning device is provided with a plurality of windows which are axially arranged, the positioning device is positioned on the targeting part, and the windows face different positions of the targeting part;

the delivery device delivers a plurality of the anchors along the positioning device to different positions of the target portion via a plurality of the windows, respectively;

the anchoring device sequentially fixes the anchoring element penetrating through each window on different positions of the targeting part;

the tightening line is used for connecting and tightening a plurality of anchoring elements fixed on different positions of the targeting portion in series so as to reduce the circumference of the targeting portion.

Compared with the prior art, the utility model, following beneficial effect has at least:

the utility model provides a valve system of encircleing stretches out anchoring device from different windows to fix the anchoring piece on the different positions of target portion, and then tighten up target portion through tightening up the line, thereby realize reducing the effect of target portion girth. For example, the utility model provides a valve ring system contracts in the myocardial wall circumference department of the left ventricle of 0.5-2cm below the mitral valve annulus, implants a plurality of anchoring members in proper order to concatenate a plurality of anchoring members and strain, fix, not only can reduce the girth of mitral valve annulus, can also reduce left ventricle radial diameter, and then reduce left ventricle volume, thereby improve the palirrhea treatment effect of mitral valve, be particularly useful for treating functional mitral valve regurgitation.

Drawings

Fig. 1 is a schematic diagram of a human heart structure.

Fig. 2 is a schematic structural view of a valve ring-retracting system according to a first embodiment of the present invention.

Fig. 3 is a schematic structural view of a guiding sheath according to the present invention.

Fig. 4a is a schematic structural diagram of a track guide tube according to the present invention.

Fig. 4b is a schematic structural diagram of another track guide tube provided by the present invention.

Fig. 5 is a schematic structural diagram of a catheter positioning device according to the present invention.

Fig. 6 is a schematic perspective view of a positioning tube of the catheter positioning device provided in fig. 5.

Fig. 7 is a partial structural sectional view of a conveying device provided by the present invention.

Fig. 8 is a partial structural sectional view of an anchoring device according to the present invention.

Fig. 9 is a schematic structural view of a bending track catheter in a valve retraction system according to a second embodiment of the present invention.

Fig. 10 is a schematic structural view of an anchoring device in a valve-ring-contracting system according to a third embodiment of the present invention.

Fig. 11 is a schematic structural view of an anchoring device in a valve-ring-contracting system according to a fourth embodiment of the present invention.

Fig. 12 is a schematic structural view of an anchor in a valve-ring-contracting system according to a fifth embodiment of the present invention.

Fig. 13 is a schematic structural view of an anchor in a valve retraction system according to a sixth embodiment of the present invention.

Fig. 14 is a schematic structural view of an anchor in a valve retraction system according to a seventh embodiment of the present invention.

Fig. 15 is a schematic view of the anchor provided in fig. 14 in a contracted state.

Fig. 16 is a schematic view of the anchor provided in fig. 14 in an expanded state.

Fig. 17 is a schematic view of the catheter positioning device of the present invention attached to the ventricular wall.

Fig. 18 is a schematic view of the guiding device of the present invention being delivered to the lower side of the leaflet through the apex of the heart.

Fig. 19 is a schematic view of an anchor according to the present invention implanted in a ventricular wall.

Fig. 20 is a schematic view of a plurality of anchors of the present invention implanted in different locations in a ventricular wall.

Fig. 21 is a schematic view of the tightening line tightening a plurality of anchors according to the present invention.

Fig. 22 is a schematic view of the guiding device of the present invention being delivered into the left ventricle via the aortic approach.

Fig. 23 is a schematic view of the guiding device of the present invention being delivered into the left ventricle via the interatrial septum pathway.

Detailed Description

The following description is of the preferred embodiments of the present invention, and it should be noted that, for those skilled in the art, a number of modifications and decorations can be made without departing from the principle of the present invention, and these modifications and decorations are also considered to be the protection scope of the present invention.

To more clearly describe the structure of the valve retraction system, the terms "proximal" and "distal" are defined herein as terms commonly used in the interventional medical field. Specifically, "distal" refers to the end of the surgical procedure that is distal from the operator, and "proximal" refers to the end of the surgical procedure that is proximal to the operator.

Referring to fig. 2, a first embodiment of the present invention provides a valve-ring-contracting system 10, which includes a positioning device 20, a delivery device 300, an anchoring device 400 and a tightening wire 500, wherein the anchoring device 400 includes a plurality of anchors 440 a. A plurality of windows 231 which are axially arranged are arranged in the positioning device 20, the positioning device 20 is positioned on the target part, and the windows 231 face different positions of the target part; the delivery device 300 delivers the plurality of anchors 440a along the positioning device 20 to different locations of the target portion via the plurality of windows 231, respectively; the anchoring device 400 sequentially fixes the anchors 440a passing through each window 231 at different positions of the target portion; the tightening wire 500 is used to connect in series and tighten a plurality of anchors 440a fixed at different positions of the target portion so as to reduce the circumference of the target portion.

In further embodiments, the target is the mitral valve annulus or the left ventricular myocardial wall below the mitral valve annulus.

In a further embodiment, the target portion is the myocardial wall of the left ventricle under the mitral valve annulus, in particular, the myocardial wall of the left ventricle which is 0.5-2cm under the mitral valve annulus, the plurality of anchoring elements 440a are implanted in sequence, and the plurality of anchoring elements 440a are connected in series, tensioned and fixed, so that the purpose of contracting the mitral valve and reducing the volume of the left ventricle is achieved, the treatment effect of mitral regurgitation is improved, and the mitral regurgitation treatment device is particularly suitable for treating functional mitral regurgitation.

In a further embodiment, the positioning device 20 comprises a guide device 100 and a catheter positioning device 200, the guide device 100 being used to establish a trajectory from outside the patient's body to a target site inside the body, the catheter positioning device 200 having a plurality of windows 231 therein, the catheter positioning device 200 being accessed through a lumen of the guide device 100 and positioned at the target site such that each window 231 faces a different location of the target site. It will be appreciated that the catheter positioning device 200 is threaded into the lumen of the introducer device 100, the delivery device 300 is threaded into the lumen of the catheter positioning device 200, and the anchoring device 400 extends the anchor 440a from the various windows 231 through the lumen of the delivery device 300.

Referring to fig. 3 and 4a, in a further embodiment, the guiding device 100 comprises a guiding sheath 101 (see fig. 3) and a track catheter 102 (see fig. 4a) inserted into the guiding sheath 101, wherein the track catheter 102 extends from the distal end of the guiding sheath 101, fits over the target portion, and establishes a track from the outside of the body to the target portion, and the lumen of the track catheter 102 is used for accommodating and passing through the catheter positioning device 200.

Referring to fig. 3, in a further embodiment, the guiding sheath 101 comprises a sheath 130 having an axial length and a first pulling member 104; the sheath 130 comprises a first supporting section 131 close to the proximal end and a first bending section 132 close to the distal end, the distal end of the first pulling member 104 is connected with the first bending section 132, and the first pulling member 104 moves along the axial direction of the sheath 130 to adjust the first bending section 132 to the shape fitting the target part. The sheath 130 is made of a high polymer material selected from one or more of ABS, PE, PP, PEBAX, PC, PU, Nylon, PVC, PTFE, or PB, a copolymer or a mixture thereof. In this example, PEBAX was selected and used to have a hardness of 40D.

In a further embodiment, the sheath 130 is a hollow multi-layer tube, the first pulling member 104 includes a first pulling wire 110, a first threading tube 120 and a first anchoring ring 160, the first threading tube 120 is axially disposed in the inner wall of the sheath 130, the first pulling wire 110 is disposed in the first threading tube 120, the first anchoring ring 160 is disposed at the distal end of the first threading tube 120, and the first anchoring ring 160 is disposed in the first bend-adjusting section 132. The distal end of the first pull wire 110 is connected to the first anchoring ring 160, and the first bending section 132 is driven to bend to conform to the shape of the target portion by pulling the first pull wire 110. It can be understood that the first traction wire 110 is embedded in the inner wall of the sheath 130, and the first traction wire 110 is received in the first threading tube 120 to prevent the first traction wire 110 from bending, and the distal end of the first traction wire 110 extends to the distal end of the sheath 130 and is rigidly connected to the first anchoring ring 160, so that the first bending adjustment section 132 is driven to bend by pulling the first traction wire 110 to realize the bending adjustment function. The first traction wire 110 is made of 304 stainless steel, copper or other metal capable of bearing certain tensile force; the first threading tube 120 may be made of 304 stainless steel; the sheath 130 is composed of a plurality of layers of polymer films and metal reinforcing layers, for example, the inner film is a PTFE tube, the middle layer is a 304 stainless steel woven mesh tube, and the outer layer is a PEBAX tube; the first anchoring ring 160 is made of a metallic material, such as 304 stainless steel.

In a further embodiment, the guiding sheath 101 further comprises a first bending adjuster 140 disposed at the proximal end of the sheath 130, the proximal end of the first pulling wire 110 is connected to the first bending adjuster 140, and the first bending adjuster 140 is pulled to pull the first pulling wire 110, thereby bending the first bending adjusting section 132. The first bend adjuster 140 is made of PC.

In a further embodiment, the guiding sheath 101 further comprises a first handle 150, the first handle 150 is disposed between the first bend adjuster 140 and the sheath 130, or the first bend adjuster 140 and the proximal end of the sheath 130 are accommodated in the first handle 150, so as to facilitate the gripping and operation of the operator.

In other embodiments, the sheath 130 has a sharp end at its distal end, preferably a conical configuration.

It is understood that in other embodiments, the guiding sheath 101 may also be shaped like a conventional shaping conveying sheath, and will not be described herein again.

Referring to fig. 4a, in a further embodiment, the orbital conduit 102 is a pre-shaped, shaped orbital conduit 102 a. The shaping rail catheter 102a includes a rigidly connected second handle 110a and a shaping tube 103a, the second handle 110a being disposed at a proximal end of the shaping tube 103 a. The shaping tube 103a includes a first tube 120a, a second tube 130a and a third tube 140a connected in sequence from a proximal end to a distal end, an angle between an extending direction of the third tube 140a and an extending direction of the first tube 120a ranges from 0 to 180 degrees, and the third tube 140a and the first tube 120a are in smooth transition through the second tube 130 a.

Referring to fig. 4b, in a further embodiment, a shaping rail catheter 200b with better fit to a target portion is provided, which includes a first tube 201b, a second tube 203b and a third tube 202b connected in sequence from a proximal end to a distal end, wherein an angle between a first plane where the proximal ends of the first tube 201b and the second tube 203b are located and a second plane where the distal ends of the third tube 202b and the second tube 203b are located is 30-150 degrees.

It will be appreciated that the shaped tube body 103a has an internal cavity 150a therein that can receive the catheter positioning device 200.

It is understood that the shaped tubular body 103a is a flexible tube with certain hardness, and may be made of high molecular polymer material, such as one or more of PEEK, ABS, PE, PP, PEBAX, PC, PU, Nylon, PVC, PTFE, or PB, or copolymer or mixture thereof, or made of biocompatible metal, such as nitinol. The shaping tube 103a may be a single layer tube; or a multi-layer tube, such as a multi-layer tube body formed by hot-melting inner-film PTFE, middle-woven mesh tube and outer-layer PEBAX tube into a flexible tube. In this embodiment, a PEBAX tube is used, and the entire tube is shaped by heat setting or the like to fit closely under the valve annulus (i.e., at the junction of the anterior and posterior leaflets and the myocardial wall).

Referring again to fig. 2, the valve-constricting ring system 10 further comprises a guide wire 600, the guide wire 600 being disposed through the rail catheter 102. The guidewire 600 is used to provide directions for the catheter positioning device 200, the delivery device 300, and the anchoring device 400 to enter the target site. The one end of seal wire 600 is flexible seal wire head, has certain distance, can not cause the injury to human tissue when getting into the human body, and the other end is flexible silk, and the material is flexible metal materials such as nickel titanium, and is preferred, and seal wire 600 surface can be plated the PTFE membrane, and holistic smoothness is better after the coating film, promotes the maneuverability in the human body. The guide wire 600 is selected from a guide wire, a straight guide wire, a J-shaped guide wire, a loach guide wire, and the like. The dimensions are 0.014 ", 0.018", 0.035 ", 0.038", 0.046 ", etc.

Referring to fig. 5 and 6, the catheter positioning device 200 includes a fourth handle 210 and a positioning tube 230, the fourth handle 210 is disposed at a proximal end of the positioning tube 230, a distal tube body of the positioning tube 230 is axially disposed with a plurality of windows 231, the plurality of windows 231 all penetrate through a same side tube wall of the positioning tube 230, and the plurality of windows 231 face different positions of the target portion. It will be appreciated that in further embodiments, the differently positioned windows 231 are aligned with different positions of the left ventricular wall (targeting portion) to provide a positioning function for the delivery device 300 and the anchoring device 400. The number of the windows 231 is preferably 3 to 15, and more preferably 10. The shape of the window 231 may be one or more of a circle, an ellipse, a square, a diamond, a triangle, and a polygon, in this embodiment, a rectangle is used, and four corners of the rectangle are preferably arc-shaped to prevent scratching the delivery device 300, the anchoring device 400, or the human tissue. The area of the window 231 is 4-4000 mm²。

In a further embodiment, two adjacent windows 231 are communicated through a notch 233, the notch 233 penetrates through the same side wall of the positioning tube 230, the window 231 located at the farthest end of the positioning tube 230 is closed at the far end, and the window 231 located at the nearest end of the positioning tube 230 is closed at the near end. It will be appreciated that the windows 231 extend through a side wall of the positioning tube 230 such that each window 231 is in communication with the lumen of the positioning tube 230, whereby the delivery device 300, when delivered through the lumen of the positioning tube 230 into the body, may extend through each window 231 to provide a positioning function for the anchoring device 400. The plurality of windows 231 communicating through the notches 233 may increase the flexibility of the proximal body of the positioning tube 230 to smoothly deflect in the rail catheter 102 to conform to the shape of the target portion (e.g., ventricular wall).

In a further embodiment, adjacent windows 231 are axially spaced apart by a projection 232, and a notch 233 is open at the middle of the projection 232.

In a further embodiment, the catheter positioning device 200 further comprises a steering head 220, the steering head 220 being arranged at the distal end of the positioning tube 230, the steering head 220 being made of a flexible material, the distal end of the steering head 220 being provided with an inclined surface 221 facing the target portion. When the catheter positioning device 200 is placed in the left ventricle, the angled surface 221 of the steering head 220 faces the ventricular wall to further conform to the ventricular wall.

It is understood that the body of the positioning tube 230 is made of a high molecular polymer material, such as one or more of ABS, PE, PP, PEBAX, PC, PU, Nylon, PVC, PTFE or PB, a copolymer or a mixture thereof. In this embodiment, a PE pipe is used. The inner diameter of the positioning tube 230 is 0.3-15 mm, preferably 1.5-10 mm. The developing member is embedded in the tube body of the positioning tube 230 to indicate the tube body position. The developing member is made of a metal material which does not transmit X-rays, such as one or more of iron, copper, gold, platinum, titanium, nickel, and iridium.

The delivery device 300 is used to reach the target site along the guidewire 600 and catheter positioning device 200, and in turn protrudes through the plurality of windows 231 of the catheter positioning device 200, providing a delivery channel for each of the plurality of anchors 440a of the anchoring device 400.

Referring to fig. 7, in a further embodiment, the delivery device 300 comprises a delivery tube 330 and a third pulling member 106, the delivery tube 330 comprises a second support section 331 near the proximal end and a second bending section 332 near the distal end, and the third pulling member 106 moves along the axial direction of the delivery tube 330 to adjust the second bending section 332 to the shape matched with the positioning device 20, so that the distal end of the delivery tube 330 reaches the window 231. It is understood that the delivery tube 330 is a hollow tube, and can be a single-layer tube made of high polymer material, such as PEEK, PI, ABS, PE, PP, PEBAX, PC, PU, Nylon, PVC, PTFE, or PB, or a copolymer or mixture thereof, or a multi-layer tube. In this embodiment, a multilayer tube body composed of multiple layers of polymer films and metal is adopted, the inner film is a PTFE tube, the middle layer is a stainless steel 304 woven mesh tube, and the outer layer is a PEBAX tube. It can be understood that the second bending adjusting section 332 can be bent at will in the same plane direction, and the bending adjusting angle is 0-360 degrees.

In a further embodiment, the delivery tube 330 is a hollow, multi-layered tube, and the third pulling member 106 includes a third pulling wire 340, a third threading tube 350, and a third anchoring ring 360. The third threading tube 350 is axially arranged in the inner wall of the conveying tube 330, the third traction wire 340 is arranged in the third threading tube 350, the third anchoring ring 360 is arranged at the far end of the third threading tube 350, and the third anchoring ring 360 is positioned in the second bending adjusting section 332; the distal end of the third pull wire 340 is connected to the third anchor ring 360, and the second bending section 332 is driven to bend to the shape matched with the positioning device 20 by pulling the third pull wire 340, so that the distal end of the delivery tube 330 reaches the window 231.

In a further embodiment, the delivery device 300 further comprises a third bending adjuster 310 disposed at the proximal end of the delivery tube 330, the proximal end of the third pull wire 340 is connected to the third bending adjuster 310, and the second bending adjusting section 332 is driven to bend by pulling the third bending adjuster 310 to pull the third pull wire 340.

In a further embodiment, the delivery device 300 further comprises a fifth handle 320, the fifth handle 320 is disposed between the third bend adjuster 310 and the delivery tube 330, or the third bend adjuster 310 and the proximal end of the delivery tube 330 are accommodated in the fifth handle 320, so as to facilitate the gripping and the operation of the operator.

It is understood that the third bending adjustor 310 is made of polymer material such as ABS or metal material such as 304 stainless steel, 316 stainless steel, etc., and the fifth handle 320 is made of metal or polymer material such as 304 stainless steel, ABS, PC, etc. The traction wire 340 can be 304 stainless steel wire, iron wire, copper wire, nickel titanium wire, or the like, or a polymer traction rope such as nylon rope, polypropylene rope, polyurethane rope, fiber rope, or the like. The third feed-through tube 350 may be a 304 stainless steel tube. The third anchor ring 360 is made of a metallic material, such as 304 stainless steel.

In a further embodiment, a developing member may be embedded in the tube of the delivery tube 330 to indicate the position of the tube, the developing member being made of a metal material that is opaque to X-rays, such as one or more of iron, copper, gold, platinum, titanium, nickel, or iridium.

The anchoring device 400 is passed through the lumen of the delivery device 300 to the annulus and a plurality of anchors 440a are implanted at different locations on the target portion (e.g., myocardial wall).

Referring to fig. 8, in a further embodiment, the anchoring device 400 further includes a release controller 410a and a pushing rod 420a disposed between the release controller 410a and the anchor 440a, the pushing rod 420a is detachably connected to the anchor 440a, and the release controller 410a controls the anchor 440a to be released at the target portion. It will be appreciated that the release controller 410a may be twisted to rotate the anchor 440a until the anchor 440a is implanted in a targeted portion of the patient's tissue, such as the myocardial wall adjacent the annulus.

It is understood that the pushing rod 420a may be a solid thin rod or a hollow thin tube made of metal or polymer material with a certain axial length, and the metal material is selected from one or more of iron, steel, copper, titanium, nickel or chromium. The polymer material is selected from one or more of ABS, PE, PP, PEBAX, PC, PU, Nylon, PVC, PTFE or PB. It can be a single/strand rod or tube, or it can be formed by winding/braiding a plurality/strand rods or tubes or wires. In this embodiment, a wire rope formed by twisting a plurality of wires is used as the push lever 420 a.

In a further embodiment, anchoring device 400 further comprises a coupling mechanism 430a, a proximal end of coupling mechanism 430a rigidly coupled to a distal end of push rod 420a, and push rod 420a removably coupled to anchor 440a via coupling mechanism 430a at its distal end; release controller 410a controls attachment mechanism 430a to open to release anchor 440 a. It is understood that release control 410a also includes controlling the action of anchor 440a, e.g., advancing, retracting, twisting, rotating, sliding, moving, swinging, etc.

In a further embodiment, the means for detachably connecting comprises one of a threaded connection, a snap connection or a snap connection. It will be appreciated that in this embodiment, the distal end of the attachment mechanism 430a is removably attached to the anchor 440a by a threaded connection.

In a further embodiment, when a threaded connection is used, the tube at the distal end of the attachment mechanism 430a is threaded and threadably engages the anchor 440 a. The distal-most end 431a of the attachment mechanism 430a is unthreaded to prevent the threaded engagement with the anchor 440a from locking out, and subsequently being difficult to disengage.

In a further embodiment, anchor 440a includes a connecting portion 441a and an anchor portion 442a, and anchor portion 442a is removably coupled to push rod 420a via connecting portion 441 a. In this embodiment, the anchor 442a is removably coupled to the distal end of the coupling mechanism 430a by a coupling portion 441 a. Wherein the connecting portion 441a and the anchoring portion 442a are rigidly connected or integrally formed. It will be appreciated that in this embodiment, connecting portion 441a is internally threaded to engage distal end body 432a of connecting mechanism 430a, anchoring portion 442a is adapted to be anchored in body tissue, and the distal end of anchoring portion 442a is sharp and needle-like to facilitate penetration of anchoring portion 442a into body tissue.

In a further embodiment, the anchor 442a includes at least one helical structure. Inside back is pierced to the point of the helical structure of anchor portion 442a, but greatly increased anchor portion 442a and the area of target portion tissue contact to firmly fix inside organizing, avoid prior art's flexible anchor portion can't stably keep the extension shape and take place to warp, the easy problem of being pulled off.

It is understood that the anchor 442a has a cross-section that may be continuously the same and/or vary (i.e., helical). The anchoring portion 442a has a length ranging from 4mm to 16mm, a diameter ranging from 0.2mm to 5mm, and a penetration depth ranging from 2mm to 10 mm. In this embodiment, connecting portion 441a is rigidly connected to the proximal end of anchoring portion 442a, and connecting portion 441a has a cross-sectional diameter substantially larger than anchoring portion 442a for limiting anchoring portion 442a to control anchoring portion 442a from penetrating the target tissue to a predetermined depth to prevent damage to the target tissue due to over-penetration.

It is understood that the connecting portion 441a is made of a material having better rigidity, such as stainless steel, POM, PEEK, etc. The spiral structure of the anchor portion 442a is made of a rigid biocompatible metal material or a material having a shape memory function. The rigid biocompatible metal material is selected from one or more of iron, steel, copper, titanium, nickel, and chromium, and stainless steel is used in this embodiment. In the prior art, the implant used in mitral valve annuloplasty is usually made of shape memory metal with high flexibility, and such implant has low rigidity, and is easy to pull off the implant in the process of drawing a rope to contract the valve annulus, so that the heart is seriously damaged.

In a further embodiment, the connection portion 441a is provided with a line connection hole 443a, and the line connection hole 443a is used for the tightening line 500 to pass through.

It will be appreciated that the tightening wire 500 connects a plurality of anchors 440a in series through the holes in the wire holes 443 a. The cinch line 500 is a length of flexible wire, single/multi-strand cable/cord, which may be a conventional medical cinch line or other medical grade flexible cord. The tightening wire 500 is made of a biocompatible metal/polymer material, and the metal material is selected from one or more of iron, steel, copper, titanium, nickel, or chromium. The high molecular material is selected from one or more of ABS, PE, PP, PEBAX, PC, PU, Nylon, PVC, PTFE or PB.

Referring to fig. 9, a second embodiment of the present invention provides a valve-ring-contracting system 10a, which is different from the first embodiment in that in the valve-ring-contracting system 10a, the rail guide 102 is a curved rail guide 102b capable of adjusting the shape in real time. The bend-adjusting track catheter 102b comprises a bend-adjusting tube 103b and a second traction member 105, the bend-adjusting tube 103b comprises a fourth tube 130b near the proximal end and a fifth tube 140b near the distal end, and the second traction member 105 moves along the axial direction of the bend-adjusting tube 103b to adjust the fifth tube 140b to fit the shape of the target portion.

In a further embodiment, the bend adjusting pipe 103b is a hollow multi-layer pipe body, the second traction member 105 includes a second traction wire 133b, a second threading pipe 132b and a second anchoring ring 131b, the second threading pipe 132b is opened in the inner wall of the bend adjusting pipe 103b, the second traction wire 133b is threaded in the second threading pipe 132 b; the second anchoring ring 131b is disposed at the distal end of the second threading tube 132b, and the second anchoring ring 131b is located in the fifth tube body 140 b; the distal end of the second traction wire 133b is connected with the second anchoring ring 131b, and the second traction wire 133b can be pulled, so that the fifth tube body 140b is driven to be bent to the shape fitting the target portion, and the bending adjusting function is realized.

In a further embodiment, the bend-adjusting track guide tube 102b further includes a second bend adjuster 110b disposed at a proximal end of the bend-adjusting tube 103b, a proximal end of the second pull wire 133b is connected to the second bend adjuster 110b, and the second pull wire 133b is pulled by pulling the second bend adjuster 110b to further drive the fifth tube 140b to bend.

In a further embodiment, the bend-adjusting track catheter 102b further comprises a third handle 120b, the third handle 120b is disposed between the second bend adjuster 110b and the bend-adjusting tube 103b, or the second bend adjuster 110b and the bend-adjusting tube 103b are accommodated in the third handle 120b at the proximal end, which is convenient for the operator to grasp and operate.

It is understood that the bend tuning pipe 103b is made of a high molecular polymer material, such as a copolymer or a mixture of one or more of ABS, PE, PP, PEBAX, PC, PU, Nylon, PVC, PTFE, or PB.

Referring to fig. 10, a third embodiment of the present invention provides a valve ring-contracting system 10b, which is different from the first embodiment in that in the valve ring-contracting system 10b, a pushing rod 420b of an anchoring device 400b is detachably connected with an anchoring member 440 b. That is, the push rod 420b is directly connected to the anchor 440b without any other connection mechanism therebetween.

It will be appreciated that the manner in which the distal end of the push rod 420b is removably coupled to the anchor 440b can include one of a threaded connection, a snap-fit connection, or a snap-fit connection. When threaded, the proximal end of pusher rod 420b is threaded and engages the anchoring element 440 b. The distal-most end of the push rod 420b is unthreaded to prevent the threaded engagement with the anchor 440b from locking out, and subsequently becoming difficult to disengage.

Referring to fig. 11, a fourth embodiment of the present invention provides a valve-ring-contracting system 10c, which is different from the first embodiment in that in the valve-ring-contracting system 10c, the anchoring device 400c further comprises a sixth handle 460c and a release tube 450c, the sixth handle 460c is disposed at the proximal end of the release tube 450c, the push rod 420c passes through the sixth handle 460c, and the distal end of the push rod 420c and the connecting mechanism 430c are inserted into the release tube 450 c.

When release controller 410c pulls push rod 420c proximally, coupling mechanism 430c cooperates with release tube 450c to cause coupling mechanism 430c to grip anchor member 440 c; when the release controller 410c pulls the push rod 420c distally, the attachment mechanism 430c cooperates with the release tube 450c to cause the attachment mechanism 430c to release the anchor 440 c.

In a further embodiment, the connecting mechanism 430c includes a plurality of sets of connecting rods 432 and a plurality of pins 431, the plurality of sets of connecting rods 432 are movably connected by the plurality of pins 431, a proximal-most set of connecting rods 432 of the plurality of sets of connecting rods 432 is connected to the pushing rod 420c by the pins 431, and an end of a distal-most set of connecting rods 432 of the plurality of sets of connecting rods 432 is provided with a clamping portion 434c for clamping and releasing the anchor 440 c. The connecting rod 432 and the pin 431 may be made of metal or polymer material with relatively high density, such as stainless steel, POM, etc.,

when the release controller 410c pulls the push rod 420c to move proximally, the coupling mechanism 430c cooperates with the release tube 450c to cause the gripping portion 434c to grip the anchor 440c, and when the release controller 410c pulls the push rod 420c to move distally, the coupling mechanism 430c cooperates with the release tube 450c to cause the gripping portion 434c to release the anchor 440 c.

Specifically, as shown in fig. 11, the pushing rod 420c is movably connected to a first set of connecting rods 432c via a first pin 431c, the first set of connecting rods 432c is movably connected to a second set of connecting rods 433c via two second pins 436c, the second set of connecting rods 433c is connected to the distal end of the releasing tube 450c via a third pin 435c, and the third pin 435c is rigidly connected to the releasing tube 450 c. The distal ends of the second set of connecting rods 433c are bent toward the axial direction of the push rod 420c and extend to form a clamping portion 434 c. The release controller 410c is rigidly connected to a push rod 420c, and the push rod 420c passes through the lumen of the sixth handle 460c and the release tube 450c in sequence. When 420c is tightened by release control 410c, first set of connecting rods 432c are pulled proximally due to first pin 431c, thereby moving the second set of connecting rods 433c proximally via the second pin 436c, but since the second set of connecting rods 433c are connected to the release tube 450c via the third pin 435c, the second set of connecting rods 433c will not move proximally, causing the proximal ends thereof connected to the second pins 436c to move closer to the midline, thereby causing the second set of connecting rods 433c to rotate via the third pins 435c, the distal end portions 434c of the second set of connecting rods 433c are thus brought together medially and grip the connecting portions 441c of the anchor 440c, and vice versa, the disengagement function is achieved by pushing the push rod 420c distally to disengage the connection with the anchor member 440c, thereby achieving both the movement of the anchor 440c with the entire assembly and the remote detachment operation.

Referring to fig. 12, a fifth embodiment of the present invention provides a valve collar system 10d, which differs from the first embodiment in that another anchor 440d is provided in the valve collar system 10d, in the anchor 440d, the anchor 442d includes two helical structures 4421 and 4422. When the anchor 442d is two spirals 4421 and 4422, the sizes of the two spirals are the same or the difference in size is less than the first preset range. Preferably, an included angle between the starting points of the two sets of spiral structures 4421 and 4422 is 180 °, the structure increases the contact area between the anchoring portion 442d and the human tissue, and the anchoring portion 442d can realize larger anchoring force after being implanted into the human tissue, so that the anchoring portion is firmer and prevented from falling off.

Referring to fig. 13, a sixth embodiment of the present invention provides a valve ring-contracting system 10e, which is different from the first embodiment in that a further anchoring member 440e is provided in the valve ring-contracting system 10e, and when the anchoring portion 442e includes two spiral structures 4423 and 4424, the difference between the sizes of the two spiral structures 4423 and 4424 is larger than a second predetermined range. That is, it is comprised of two sets of differently sized internal and external helical structures 4423 and 4424 which, in addition to increasing the anchoring force, also result in a more flexible, lighter weight overall anchor 440e with less trauma to the patient.

Referring to fig. 14-16, a seventh embodiment of the present invention provides a valve-ring-contracting system 10f, which is different from the first embodiment in that another kind of anchoring member 440f is provided in the valve-ring-contracting system 10f, and the anchoring member 440f is connected to the pushing rod 420f through a connecting member 441 f.

The anchoring portion 442f of the anchor 440f includes a connecting ring 4425 near the proximal end, an anchoring needle 4426 near the distal end, and a binding portion 4427 fitted over the connecting ring 4425 and the anchoring needle 4426; anchor needle 4426 has an expanded shape in its natural state (see fig. 16) and a contracted shape (see fig. 15) that is constrained by delivery device 300. The anchoring portion 442f has a length in the range of 4mm to 16mm, a diameter in the range of 0.2mm to 5mm, and a penetration depth in the range of 2mm to 10 mm. In this embodiment, the anchoring portion 442f is made of a material having a shape memory function, and is compressed in the delivery device 300 in a contracted shape, and its tip can penetrate into the deep portion of the target tissue after being released from the delivery device 300 and be fixed inside the tissue to be completely restored to an expanded shape in a natural state. In this embodiment, the anchoring needle 4426 comprises two branches 4426a and 4426b, the proximal portions of the branches 4426a and 4426b are respectively staggered and extended from the distal end of the connection ring 4425, and the distal portions of the branches 4426a and 4426b are oppositely extended, i.e. the branches 4426a and 4426b respectively have two symmetrically arranged openings pointing towards the proximal hook-like configuration. The binding portion 4427 is sleeved on the distal end intersection of the connection ring 4425, so as to limit the relative position between the two branches 4426a and 4426b of the anchoring needle 4426, and prevent the two hook-shaped structures from completely springing open due to the elasticity of the two hook-shaped structures in a natural state.

In use, as shown in figures 14 and 15, pusher-rod 420f is pulled proximally until the entire anchor 440f is received at the distal end of the lumen of delivery device 300, at which time the two branches 4426a and 4426b of anchor needle 4426 are constrained to be parallel to the axial direction of pusher-rod 420 f. When the predetermined position is reached, push rod 420f is pushed distally until anchoring needle 4426 extends from delivery tube 330, anchoring needle 4426 returns to its natural hook configuration, as shown in fig. 16, and the entire anchoring needle 4426 is double-bent, i.e., in the configuration of implanted anchor 440 f. Such an anchor 440f having an expanded shape and a contracted shape, which expands to the expanded shape as the tip penetrates the target tissue to a predetermined depth in the contracted shape, ensures that the anchor 440f stably maintains the expanded shape without any deformation due to the expanded shape having a cross section significantly larger than the contracted shape while the anchor 440f is rigid, thereby firmly securing the anchor 440f within the tissue, thereby avoiding the problem that the prior art flexible anchors are easily pulled out due to deformation caused by failure to stably maintain the expanded shape.

It will be appreciated that in this embodiment, the tightening wire 500 passes through the attachment ring 4425 to tighten the plurality of anchors 440 f. In other embodiments, the anchor portion 442f is releasably coupled to the connecting member 441f, and the release controller controls the connecting member 441f to release the anchor portion 442f after the anchor member 440f is implanted in the target portion, leaving only the anchor portion 442f in the target portion.

The first embodiment is used as an example to describe the method of using the present invention in a surgical procedure for treating mitral regurgitation by using the present invention as a valvular ring system 10.

The procedure can be performed in a variety of ways, e.g., ① transapical, ② transfemoral-abdominal-thoracic-aortic-arch-left ventricle, ③ transfemoral-abdominal-venal-right-atrium-left-atrium-right-ventricle.

The following are described in detail, respectively:

the first surgical path is transapical, and the operation steps are as follows:

the first step is as follows: a surgical operation, wherein an incision is made at the apex of the heart, and a guiding sheath 101 of a guiding device 100 is sent to the position below the valve leaflet PML through the apex of the heart and the position is adjusted;

the second step is that: adjusting the distal end of the sheath 130 of the guiding sheath 101 to orient the first bend-adjusting segment 132 toward the myocardial wall LVPW;

the third step: a rail catheter (a shaping rail catheter or an adjustable bent rail catheter) is fed through the inner cavity of the sheath tube 130, and the shaping rail catheter can automatically and gradually fit with the lower part of the valve annulus in the process of extending out of the distal end of the self-guiding sheath tube 101; the bending adjusting track catheter is firstly pushed out from the far end of the guiding sheath tube 101, and then the bending degree of the bending adjusting track catheter is adjusted to be attached to the lower part of the valve ring;

the fourth step: as shown in fig. 18, a guide wire 600 is fed through the lumen of the rail catheter, and then the rail catheter is withdrawn, at which time a rail is established from the outside to the inside of the body; then, the catheter positioning device 200 is fed along the guide wire 600 until the catheter positioning device 200 smoothly reaches a preset position, and positioning is completed, as shown in fig. 17, the catheter positioning device 200 is completely attached to the ventricular wall after positioning, so that positioning is conveniently provided for subsequent implantation of the anchor 440 a;

the fifth step: as shown in fig. 19, in vitro, one end of the tightening wire 500 is first passed through the wire connecting hole 443a of the first anchor 440a and tied, and then fed into the delivery device 300 and the anchoring device 400 through the guide wire 600 and the catheter positioning device 200, and after the first anchor 440a of the anchoring device 400 reaches the predetermined position, the first anchor 440a is rotated by rotating the release controller 410a of the anchoring device 400 until the first anchor 440a pierces into the ventricular wall; delivery device 300 is then withdrawn from first window 231 of catheter positioning device 200 and delivery device 300 is re-advanced into second window 231 to provide positioning for second anchor 440 a.

And a sixth step: the other end of the cinch cord 500 is passed through the wire-connecting hole 443a of the second anchor 440a, the second anchor 440a is advanced along the guidewire 600 and delivery device 300 into the patient and implanted in the ventricular wall, and the distal end of the cinch cord 500 is then passed sequentially through the subsequent plurality of anchors 440a, and the plurality of anchors 440a are advanced sequentially along the guidewire 600 into the patient and sequentially threaded into different locations of the ventricular wall along the annulus.

The seventh step: after all the anchoring elements 440a are implanted, the catheter positioning device 200, the delivery device 300 and the anchoring device 400 are withdrawn, leaving only the anchoring elements 440a and the tightening wire 500 connecting the anchoring elements 440a in series in the left ventricle as shown in fig. 20. as shown in fig. 21, the tightening wire 500 is tightened to reduce the volume of the entire left ventricle and achieve the purpose of reducing the annulus, and then the tightening wire 500 is knotted and cut to complete the operation.

The second surgical approach, shown in fig. 22, is a transarterial approach, which differs from the transapical approach in that all the instruments in the procedure are routed through the femoral artery, the abdominal artery, the thoracic artery, the aortic arch and the left ventricle, and the rest of the procedure is the same as the transapical approach.

As shown in fig. 23, the third surgical path is a trans-atrial septal path, which is different from the trans-apical path in that all instruments in the operation are paths through femoral artery-abdominal artery-vena cava-right atrium-left ventricle, and the left atrium needs to be penetrated through the foramen ovale by cooperating with the interatrial puncture device when going from the right atrium to the left atrium, and then passes through the mitral valve orifice when going from the left atrium to the left ventricle, and the rest of the operation is the same as the trans-apical path.

The second and third routes use a purely invasive approach, which results in less surgical injury to the patient, faster patient recovery, lower risk of complications, and greater acceptance.

It is understood that the valve repair system 10 of the present invention can also directly position the catheter positioning device 200 on the annulus of the mitral valve, and then sequentially implant the plurality of anchoring elements 440a at different positions of the annulus, and then tighten and fix the plurality of anchoring elements 440a via the tightening wire 500, thereby achieving the purpose of reducing the annulus.

The above-mentioned embodiments only represent some embodiments of the present invention, and the description thereof is specific and detailed, but not to be construed as limiting the scope of the present invention. It should be noted that, for those skilled in the art, without departing from the spirit of the present invention, several variations and modifications can be made, which are within the scope of the present invention. Therefore, the protection scope of the present invention should be subject to the appended claims.

Claims (30)

1. A valve collar system comprising a positioning device, a delivery device, an anchoring device, and a cinch wire, the anchoring device comprising a plurality of anchors;

the positioning device is provided with a plurality of windows which are axially arranged, the positioning device is positioned on the targeting part, and the windows face different positions of the targeting part;

the delivery device delivers a plurality of the anchors along the positioning device to different positions of the target portion via a plurality of the windows, respectively;

the anchoring device sequentially fixes the anchoring element penetrating through each window on different positions of the targeting part;

the tightening line is used for connecting and tightening a plurality of anchoring elements fixed on different positions of the targeting portion in series so as to reduce the circumference of the targeting portion.

2. The valve collar system of claim 1, wherein the positioning device comprises a guide device and a catheter positioning device;

the guiding device is used for establishing a track from the outside of the body to the target part;

the catheter positioning device is provided with a plurality of windows, and the catheter positioning device reaches the targeting part through the inner cavity of the guiding device and is positioned at the targeting part, so that each window faces to different positions of the targeting part.

3. The valve collar system of claim 2, wherein the guide device comprises a guide sheath and a rail catheter threaded into the guide sheath, the rail catheter extending from a distal end of the guide sheath, engaging the target portion, and establishing a rail from outside the body to the target portion;

the lumen of the orbital catheter is adapted to receive and pass through the catheter positioning device.

4. The valve collar system of claim 3, wherein the guide sheath comprises a sheath having an axial length and a first pull member; the sheath pipe is including being close to the first support segment of near-end and the first section of turning that is close to the distal end, the distal end of first piece of pulling is connected first section of turning, first piece of pulling is followed the axial displacement of sheath pipe is in order to incite somebody to action first section of turning is adjusted to the shape of laminating targeting portion.

5. The valve collar system of claim 4, wherein the sheath is a hollow, multi-layered tube, the first pulling member comprises a first pull wire, a first threading tube axially open in an inner wall of the sheath, the first pull wire passing through the first threading tube, and a first anchoring ring disposed at a distal end of the first threading tube, the first anchoring ring being located in the first turning section;

the far end of the first traction wire is connected with the first anchoring ring, and the first bending adjusting section is driven to be bent to the shape of the attaching target portion by pulling the first traction wire.

6. The valve collar system of claim 5, wherein the guiding sheath further comprises a first bend adjuster disposed at a proximal end of the sheath, wherein a proximal end of the first pull wire is coupled to the first bend adjuster, and wherein pulling the first bend adjuster pulls the first pull wire to cause the first bend adjuster to bend.

7. The valve system of claim 3, wherein the rail catheter is a shaped rail catheter comprising a rigidly connected second handle disposed at a proximal end of the shaped tube and a shaped tube;

the shaping pipe body comprises a first pipe body, a second pipe body and a third pipe body which are sequentially connected from a near end to a far end, the angle range between the extending direction of the third pipe body and the extending direction of the first pipe body is 0-180 degrees, and the third pipe body and the first pipe body are in smooth transition through the second pipe body.

8. The valve collar system of claim 7, wherein an angle between a first plane in which the proximal ends of the first and second tubes lie and a second plane in which the distal ends of the third and second tubes lie is in a range of 30-150 degrees.

9. The valve collar system of claim 3, wherein the rail conduit is a bend adjusting rail conduit, the bend adjusting rail conduit including a bend adjusting tube and a second pulling member, the bend adjusting tube including a fourth tube near a proximal end and a fifth tube near a distal end, the second pulling member moving in an axial direction of the bend adjusting tube to adjust the fifth tube to conform to a shape of the target portion.

10. The valve collar system of claim 9, wherein the adjustment tube is a hollow multi-layer tube, the second pulling member comprises a second pull wire, a second threading tube axially open in an inner wall of the adjustment tube, the second pull wire passing through the second threading tube, and a second anchoring ring disposed at a distal end of the second threading tube, the second anchoring ring being located in the fifth tube;

the far end of the second traction wire is connected with the second anchoring ring, and the fifth pipe body is driven to be bent to the shape of the fit target portion by pulling the second traction wire.

11. The valve collar system of claim 10, wherein the bend adjustment rail conduit further comprises a second bend adjuster disposed at a proximal end of the bend adjustment tube, wherein a proximal end of the second pull wire is coupled to the second bend adjuster, and wherein pulling the second bend adjuster pulls the second pull wire, thereby bending the fifth tube.

12. The valve collar system of claim 2, wherein the catheter positioning device comprises a fourth handle and a positioning tube, the fourth handle is disposed at a proximal end of the positioning tube, a distal tube body of the positioning tube is axially provided with a plurality of the windows, the plurality of windows each extend through a same side tube wall of the positioning tube, and the plurality of windows face different positions of the targeting portion.

13. The valve system of claim 12, wherein adjacent windows communicate with each other through a slot that extends through the same sidewall of the positioning tube, wherein the window located at the distal end of the positioning tube is closed at its distal end and the window located at the proximal end of the positioning tube is closed at its proximal end.

14. The valve annuloplasty ring system of claim 12 wherein said catheter positioning device further comprises a steering head disposed at a distal end of said positioning tube, said steering head being made of a flexible material, said steering head having a distal end provided with an inclined surface facing the target portion.

15. The valve collar system of any one of claims 2-14, wherein the delivery device comprises a delivery tube and a third pulling member, the delivery tube comprising a second support section near a proximal end and a second bend section near a distal end, the third pulling member being movable in an axial direction of the delivery tube to adjust the second bend section to a shape that fits the positioning device such that the distal end of the delivery tube reaches the window.

16. The valve collar system of claim 15, wherein the delivery tube is a hollow, multi-layered tube, the third traction element comprises a third traction wire, a third threading tube axially open in an inner wall of the delivery tube, the third traction wire threaded through the third threading tube, and a third anchoring ring disposed at a distal end of the third threading tube, the third anchoring ring located in the second turning section;

the far end of the third traction wire is connected with the third anchoring ring, and the third traction wire is pulled to further drive the second bending adjusting section to be bent to a shape matched with the positioning device, so that the far end of the conveying pipe reaches the window.

17. The valve collar system of claim 16, wherein the delivery device further comprises a third bend adjuster disposed at the proximal end of the delivery tube, wherein the proximal end of the third pull wire is coupled to the third bend adjuster, and wherein pulling the third bend adjuster pulls the third pull wire, thereby bending the second bend adjuster.

18. The valve collar system of claim 1, wherein the anchoring device further comprises a release controller and a push rod disposed between the release controller and the anchor, the push rod being detachably coupled to the anchor, the release controller controlling the anchor to release at the target.

19. The valve collar system of claim 18, wherein the anchoring device further comprises a coupling mechanism having a proximal end rigidly coupled to a distal end of the push rod, the push rod being removably coupled to the anchor via the coupling mechanism distal end; the release controller controls the connecting structure to open to release the anchor.

20. The valve collar system of claim 19, wherein the releasable connection comprises a threaded connection, a snap connection, or a snap connection.

21. The valve collar system of claim 20, wherein when a threaded connection is used, the distal end of the connecting mechanism proximal to the tube is threaded and threadably engages the anchor, and the distal-most end of the connecting mechanism is unthreaded.

22. The valve collar system of claim 19, wherein the anchoring device further comprises a sixth handle disposed at a proximal end of the release tube and a release tube through which the push rod passes, a distal end of the push rod and the attachment mechanism being threaded into the release tube;

when the release controller pulls the push rod to move proximally, the connecting mechanism cooperates with the release tube to cause the connecting mechanism to clamp the anchor; when the release controller pulls the push rod to move distally, the connecting mechanism cooperates with the release tube to cause the connecting mechanism to release the anchor.

23. The valve collar system of claim 22, wherein the connecting mechanism comprises a plurality of sets of connecting rods and a plurality of pins, the plurality of sets of connecting rods are movably connected by the plurality of pins, a proximal-most set of the plurality of sets of connecting rods is connected to the push rod by the pins, and an end of a distal-most set of the plurality of sets of connecting rods is provided with a clamping portion for clamping and releasing the anchor.

24. The valve collar system of any one of claims 18-23, wherein the anchor comprises a connecting portion and an anchoring portion, the anchoring portion being removably connected to the push rod via the connecting portion.

25. The valve collar system of claim 24, wherein the connecting portion has a wire hole for passage of a tightening wire.

26. The valve collar system of claim 24, wherein the anchoring portion comprises at least one helical structure.

27. The valve collar system of claim 26, wherein the anchoring portion comprises two helical structures that are the same size or differ in size by less than a first predetermined range.

28. The valve collar system of claim 26, wherein the anchoring portion comprises two helical structures, the difference in size between the two helical structures being greater than a second predetermined range.

29. The valve collar system of claim 24, wherein the anchoring portion comprises a connecting ring near a proximal end, an anchoring needle near a distal end, and a tether disposed over the connecting ring and the anchoring needle; the anchoring needle has an expanded shape in a natural state and a contracted shape constrained by the delivery device.

30. The valve collar system of claim 1, wherein the target portion is the mitral valve annulus or the left ventricular myocardial wall below the mitral valve annulus.

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