CN210903510U - Artificial ring-on-mechanical valve for replacing mitral valve - Google Patents
Artificial ring-on-mechanical valve for replacing mitral valve Download PDFInfo
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- CN210903510U CN210903510U CN201920310126.7U CN201920310126U CN210903510U CN 210903510 U CN210903510 U CN 210903510U CN 201920310126 U CN201920310126 U CN 201920310126U CN 210903510 U CN210903510 U CN 210903510U
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Abstract
A mitral valve replacement prosthetic on-ring mechanical valve for implantation in the heart to replace a diseased mitral valve of the heart at the junction of the left atrium and left ventricle, comprising: a valve frame, which contains a tubular part matched with the mitral valve ring of the left ventricle inflow channel in the left ventricle, a pair of valve blades which can be opened and closed, and is arranged on the valve frame for controlling the unidirectional circulation of blood; and a suturing ring fixed on the tubular part and used for suturing and connecting with the mitral valve annulus, wherein, the tubular part is also provided with an inflow port part and an outflow port part for blood flowing into the left ventricle from the left atrium, the suturing ring is tubular, one end of the suturing ring is connected with the outflow port part, the other end of the suturing ring extends to be an extending end, and the pair of valve leaves are completely contained in the tubular part.
Description
Technical Field
The utility model relates to an artificial mechanical valve, in particular to an on-ring mechanical valve for replacing a mitral valve.
Background
The heart valve includes mitral valve, tricuspid valve, aortic valve and pulmonary valve, wherein the mitral valve is located between the left atrium and the left ventricle for ensuring unidirectional blood flow from the left atrium to the left ventricle. Mitral valve disease is one of common heart valve diseases, the etiology of which comprises rheumatic, degenerative and infectious endocarditis, and the like, and mitral valve mechanical valve replacement is a common treatment means for treating the heart mitral valve disease.
The mitral valve includes leaflets, an annulus, chordae tendineae, papillary muscles and the left ventricular wall to which the papillary muscles are attached, and how to treat a diseased valve when performing valve replacement directly affects the patient's prognosis. To implant a prosthetic valve of the desired size, the mitral valve tissue (including leaflets and chordae tendineae) needs to be removed too much, but this can cause excessive post-operative left ventricular relaxation, leading to the occurrence of low-row syndrome, and thus the sub-valvular device of the mitral valve is preserved as much as possible during the operation to maintain the post-operative relatively desired left ventricular morphology and function. At present, in the process of placing, opening and closing various traditional mitral valve mechanical valves, the metal structure and the valve leaflets of a part of valve devices are positioned in the left ventricular outflow tract, and the structural design may result in that:
1. because the original mitral valve of a human body is an elastic tissue and has certain deformation, and the valve frame of the mechanical valve is of a metal structure and has a fixed shape, the original function of deformation along with the movement of the human body is lost after the mechanical valve replaces the mitral valve.
2. When the mitral valve leaflets or an subvalvular device is excessively reserved, the chordae tendineae, papillary muscles and the like can block the movement of the mechanical valve, and the opening and closing functions of the mechanical valve are further influenced.
In order to solve the above problems, the remaining mitral valve structure must be folded and sutured during the operation, but this may make the mechanical valve difficult to implant, or the chordae tendineae may be displaced and lose their original function of maintaining the morphology of the left ventricle, or even the diastolic function of the left ventricle may be affected after the operation due to the excessive traction of the contracture chordae tendineae.
SUMMERY OF THE UTILITY MODEL
The utility model relates to a solve above-mentioned traditional mitral valve mechanical valve structure and have the problem that lacks deformation function and leaflet motion and receive device hindrance under the lamella, aim at provides a mitral valve replacement is with artifical mechanical valve on ring.
The utility model provides a mitral valve replacement is with artifical mechanical valve on ring for implant heart in the replacement be located the heart mitral valve of left atrium and left ventricle juncture pathological change, a serial communication port, include: a valve frame having a tubular portion matching the mitral annulus in the left ventricle, a pair of openable and closable leaflets mounted on the valve frame and accommodated in the tubular portion for controlling the one-way circulation of blood; and the suturing ring is fixed on the tubular part and is used for being connected with the mitral valve annulus in a suturing way, wherein the tubular part is also provided with an inflow port part and an outflow port part for allowing blood to flow into the left ventricle from the left atrium, the suturing ring is tubular, one end of the suturing ring is connected with the outflow port part, the other end of the suturing ring extends out to form an extending end, the suturing ring can deform under the condition of external force, the valve leaflets are flaky, and when a pair of valve leaflets are vertical to the end surface of the outflow port part, the bottommost ends of the valve leaflets close to the extending ends do not exceed the end surface of the extending.
The utility model provides a mitral valve replacement is with artifical mechanical valve on ring can also have such characteristic, its characterized in that: when the pair of valve leaflets are both vertical to the end surface of the outflow port part, the bottommost end of the valve leaflet close to the extension end and the end surface of the extension end are in the same plane.
The utility model provides a mitral valve replacement is with artifical mechanical valve on ring can also have such characteristic, its characterized in that: when the pair of valve leaflets are both vertical to the end surface of the outflow port part, the bottommost ends of the valve leaflets close to the extending ends are positioned at the positions which are retracted into the tubular part by 1-2mm from the end surface of the extending ends along the axial direction of the tubular part.
The utility model provides a mitral valve replacement is with artifical mechanical valve on ring can also have such characteristic, its characterized in that: the suture ring comprises a ring body and an elastic ring arranged in the ring body, the elastic ring has a shape matched with the shape of the ring body, and a port at one end of the ring body is directly contacted with a port at the outflow port part and is fixed on the port at the outflow port part.
The utility model provides a mitral valve replacement is with artifical mechanical valve on ring can also have such characteristic, its characterized in that: wherein the elastic ring is made of medical silicon rubber.
The utility model provides a mitral valve replacement is with artifical mechanical valve on ring can also have such characteristic, its characterized in that: wherein, one end of the elastic tube is fixed on the outflow port part, the other end of the elastic tube extends out and can deform under the action of external force, and the sewing ring is fixed on the circumferential wall of the deformable end of the elastic tube.
The utility model provides a mitral valve replacement is with artifical mechanical valve on ring can also have such characteristic, its characterized in that: wherein the elastic tube is made of medical silicon rubber.
The utility model provides a mitral valve replacement is with artifical mechanical valve on ring can also have such characteristic, its characterized in that: wherein, the valve frame is also provided with a pair of convex parts which are symmetrically arranged and used for installing a pair of valve leaflets.
The utility model provides a mitral valve replacement is with artifical mechanical valve on ring can also have such characteristic, its characterized in that: the inner cross section of the tubular part is circular, two limiting groove groups which are arranged along the diameter of the tubular part in a bilateral symmetry mode are arranged on the inner wall of the protruding part, and each limiting groove group comprises two limiting grooves for mounting one valve leaflet.
The utility model provides a mitral valve replacement is with artifical mechanical valve on ring can also have such characteristic, its characterized in that: each valve leaf is provided with a straight edge and an arc edge, the straight edge is connected with the arc edge, two ends of the straight edge are respectively provided with a convex block, the two convex blocks of each valve leaf are respectively arranged in the two limiting grooves in the limiting groove group, so that the valve leaf can rotate along the straight edge of the valve leaf, and the maximum distance from the straight edge of each valve leaf to the arc edge of the valve leaf is larger than the inner radius of the tubular part.
Action and effect of the utility model
The utility model provides a mitral valve replacement is with artifical ring on mechanical valve has one end to be connected with the outflow port portion of valve frame, the other end stretches out and sews up the circle for stretching out the end, should sew up the circle and can take place deformation under the condition that receives external force, such setting makes on the artificial ring that lie in mitral valve ring department behind the mechanical valve replacement mitral valve be sew up the circle, and the shape of sewing up the circle is deformable, do not receive valve frame shape fixed, so the replacement postoperative mitral valve ring position still has the ability that can take place deformation along with the organism motion. And because the suture ring is arranged at the outflow port part and is positioned at the bottommost end of the whole valve frame, after the suture ring is sutured with the mitral valve annulus, the mechanical valve on the whole artificial ring after replacement can be positioned in the left atrium, and further the mechanical valve on the whole artificial ring is positioned above the device under the valve, thereby ensuring that the mechanical valve on the whole artificial ring is not influenced by the device under the valve and being greatly improved by the limitation influence of the size factor of the valve annulus.
And simultaneously, the utility model relates to a mitral valve replacement is with artifical ring on mechanical valve has a pair of slice leaflet of setting on the valve frame, when a pair of leaflet all with the terminal surface of outflow port portion perpendicular, the leaflet is close to the terminal surface that sews up that the end is stretched out to the circle bottommost no longer than stretching out the end, this makes the leaflet be in the inside of mechanical valve on the artifical ring completely, the leaflet also is in inside the mechanical valve on the artifical ring completely when the operation is complete, do not receive the interference of outer structure, consequently no matter how many valves under the operation process remain the device can not cause the interference to the motion of leaflet, so can furthest remain normal position mitral valve lower structure, and need not too much folding or tractive leaflet and valve lower structure device, it is better to maintaining postoperative left ventricle form and function.
Drawings
Figures 1 and 7 are schematic structural views of a mechanical valve on a ring prosthesis for mitral valve replacement;
fig. 2 is a schematic structural view of a leaflet;
FIGS. 4 and 8 are schematic structural views showing the mechanical valve conduction state on the ring prosthesis for mitral valve replacement;
FIGS. 3 and 9 are schematic views showing the closed state of the mechanical valve on the ring prosthesis for mitral valve replacement;
FIG. 5 is a schematic view of the position of a mechanical valve on a prosthetic ring for mitral valve replacement in the heart;
FIGS. 6 and 12 are schematic views of the structure of a second mechanical valve on a ring prosthesis for mitral valve replacement;
FIG. 10 is a schematic view showing the arrangement of the position-limiting grooves; and
fig. 11 is a schematic view of the installation structure of the valve leaflet in the limiting groove.
Detailed Description
In order to make the technical means, creation features, achievement purposes and effects of the present invention easy to understand, the following embodiments are combined with the accompanying drawings to specifically explain the composition, operation principle and beneficial effects of the mechanical valve on the artificial ring for replacing mitral valve provided by the present invention.
< example >
Fig. 1 and 7 are schematic views showing the structure of a mechanical valve on a prosthetic ring for mitral valve replacement.
As shown in fig. 1 and 7, the mitral valve replacement artificial on-ring mechanical valve 100 in the present embodiment has a valve frame 10, a pair of valve leaflets 20, and a sewing ring 30.
The petal holder 10 has a tubular portion in the shape of a circular tube and a pair of convex portions.
The tubular portion has an inflow port portion 11 and an outflow port portion 12 through which blood enters and exits. The end surfaces of the outflow end 12 are all planes, and the port parts are smooth circular arcs. The outer peripheral wall of the outlet port portion 12 has an annular groove thereon.
The pair of protruding portions includes two symmetrical protrusions provided on one side of the inflow port portion 11, and is formed integrally with the tubular portion using pyrolytic carbon for medical use.
Two groups of limiting groove groups are arranged on the inner walls of the pair of convex parts, the two groups of limiting groove groups are symmetrical along the diameter of the tubular part, each group of limiting groove groups comprises two limiting grooves 13 used for installing one valve leaflet 20, and the two limiting grooves 13 are respectively positioned on the two bulges.
Fig. 10 is a schematic distribution diagram of the limiting grooves.
As shown in fig. 7 and 10, each of the limiting grooves 13 includes two fan-shaped grooves that are centrosymmetric and have the same shape, the two fan-shaped grooves are disposed up and down along the axial direction of the tubular portion, and one radius of each fan-shaped groove is parallel to the axial direction of the tubular portion.
Fig. 2 is a schematic view of a leaflet structure.
As shown in fig. 3 to 4 and 7 to 9, the pair of openable and closable leaflets 20 of the present invention include two leaflets 20 symmetrically disposed in the radial direction of the tubular portion, and are used to control the circulation of blood through the mechanical valve 100 on the artificial ring.
As shown in fig. 2, the valve leaflet 20 is sheet-shaped, and has a straight side and an arc side matching with the shape of the inner wall of the tubular portion, and the two ends of the straight side are respectively provided with a convex block 21 matching with the limiting groove 13. The projection has a projecting edge and a straight edge, both ends of which are connected to one end of the straight edge and a corresponding end of the arc edge of the leaflet 20, respectively.
Fig. 11 is a schematic view of the installation structure of the valve leaflet in the limiting groove.
As shown in fig. 7, 10 and 11, the two protrusions 21 of each leaflet 20 are respectively snap-fitted into the two limiting grooves 13 of one limiting groove set, so that the leaflet 20 can rotate along a straight edge in the valve frame 10.
Specifically, one of the limiting grooves 13 includes two fan-shaped grooves, and the projection 21 of one end of one leaflet 20 is engaged in the fan-shaped groove on the upper side while a part of the arc side of the leaflet 20 is inserted in the fan-shaped groove on the lower side, whereby both ends of one leaflet 20 are mounted in the leaflet frame 10, so that the leaflet 20 can rotate about the axis formed by the projection 21 and the straight side portion of the leaflet 20. Meanwhile, a part of the curved edge of the leaflet 20 is embedded into the fan-shaped groove located at the lower side, so that the edge of the curved edge of the leaflet 20 can be tightly contacted with the leaflet frame 10 without affecting the rotation of the leaflet 20 (if such a structure is not adopted, the leaflet 20 rotates as shown in the figure).
Because one radius of each fan-shaped groove is parallel to the axial direction of the tubular part of the valve frame 10, when the valve leaflet 20 rotates to the vertical position (the position parallel to the axial direction of the tubular part of the valve frame 10), the convex block 21 and one part of the arc edge of the valve leaflet 20 are respectively contacted with the groove edges corresponding to the radii of the two fan-shaped grooves, so that the limiting is realized; on the other hand, the other radius of each sector groove has a certain angle with the axial direction of the tubular part of the valve frame 10, and when the valve leaflet 20 rotates to a position having a certain angle with the axial direction of the tubular part of the valve frame 10, the convex block 21 and a part of the arc edge of the valve leaflet 20 respectively contact with the groove edge corresponding to the other radius of the two sector grooves, so that the limiting is realized. That is, the structure of the limiting groove 13 as in the present embodiment enables the rotatable mounting of the leaflet 20 and the limitation of the rotation thereof.
The sewing ring 30 includes a ring body and an elastic ring 31 disposed within the ring body.
The ring body comprises a skirt edge which is integrally formed and woven by terylene and used for sewing and a circular fixing ring.
The fixing ring has the same inner diameter as the tubular portion, and a port at one end is fixed by adhesion to a port of the outlet port portion 12.
The skirt is annular and has a plurality of strip-like projections on its outer surface, which are axially parallel to the tubular portion.
The plurality of strip-shaped bulges are uniformly distributed along the circumferential direction of the skirt edge.
The elastic ring 31 is a circular ring matched with the shape of the skirt, is made of medical silicon rubber, and is completely covered in the skirt.
Fig. 4 and 8 are schematic structural views showing the conduction state of the mechanical valve on the artificial ring for mitral valve replacement.
As shown in fig. 4 and 8, when the two leaflets 20 are parallel to each other and are perpendicular to the end surface of the outflow port 12, the two leaflets 20 are in the maximum open/close state, the lowermost end of the leaflet 20 close to the protruding end of the suturing ring 30 and the end surface of the protruding end are in the same plane, and at this time, two radii parallel to the axial direction of the tubular portion in the limiting groove group limit the leaflets 20, and blood can flow from the left atrium into the left ventricle through the mechanical valve 100 on the artificial ring for mitral valve replacement.
If necessary, when the two leaflets 20 are in the maximum open-close state, the lowermost end of the leaflet 20 near the protruding end of the sewing ring 30 can be located at a position retracted from the end face of the protruding end into the tubular portion by 1-2mm, preferably 2mm, in the axial direction of the tubular portion.
Fig. 3 and 9 are schematic structural views showing a mechanical valve closing state on a prosthetic ring for mitral valve replacement.
As shown in fig. 3 and 9, when the two straight sides of the two leaflets 20 completely adhere to each other and the two arc sides of the two leaflets 20 completely adhere to the inner wall of the tubular portion, the two leaflets 20 are in a closed state, and at this time, the other two radii in the limiting groove 13 limit the two leaflets 20, an angle formed between the two leaflets 20 is greater than 90 ° and less than 180 °, and blood cannot pass through the mitral valve to replace the mechanical valve 100 on the artificial ring.
Both leaflets 20 are made of pyrolytic carbon for medical use.
Fig. 5 is a schematic view of a position in the heart.
As shown in fig. 5, in the replacement operation, the suture ring 30 is sutured to the mitral annulus of the lv inflow so that the mechanical valve 100 is fixed in the left atrium over the entire artificial ring, forming an supravalvular state.
< modification example >
This modification is a modification of the embodiment, and the same components as those in the first embodiment are given the same reference numerals, and the same description thereof is omitted.
Fig. 6 is a schematic view of a second mechanical valve on an annulus prosthesis for mitral valve replacement.
As shown in fig. 6, the mechanical valve on the mitral valve replacement ring 200 according to the present modification further includes an elastic tube 40 made of medical silicone rubber. One end of the elastic tube 40 is sleeved on the outflow end 12, and the other end extends out and can deform under the action of external force.
The sewing ring 30' has a fixing ring and a skirt for sewing, the skirt and the fixing ring are integrally formed of polyester by knitting. The fixing ring is adhesively fixed to the outer wall of the deformable end of the elastic tube 40.
The skirt is annular, and the outer surface has a plurality of strip-shaped bulges which are parallel to the axial direction of the tubular part. The plurality of strip-shaped bulges are uniformly distributed along the circumferential direction of the skirt edge.
Effects and effects of the embodiments
The utility model provides a mitral valve replacement is with artifical ring on mechanical valve has one end to be connected with the outflow port portion of valve frame, the other end stretches out and sews up the circle for stretching out the end, should sew up the circle and can take place deformation under the condition that receives external force, such setting makes on the artificial ring that lie in mitral valve ring department behind the mechanical valve replacement mitral valve be sew up the circle, and the shape of sewing up the circle is deformable, do not receive valve frame shape fixed, so the replacement postoperative mitral valve ring position still has the ability that can take place deformation along with the organism motion. And because the suture ring is arranged at the outflow port part and is positioned at the bottommost end of the whole valve frame, after the suture ring is sutured with the mitral valve annulus, the mechanical valve on the whole artificial ring after replacement can be positioned in the left atrium, and further the mechanical valve on the whole artificial ring is positioned above the device under the valve, thereby ensuring that the mechanical valve on the whole artificial ring is not influenced by the device under the valve and being greatly improved by the limitation influence of the size factor of the valve annulus.
And simultaneously, the utility model relates to a mitral valve replacement is with mechanical valve on artificial ring has the setting on the valve frame and the complete a pair of leaflet that holds in the tubulose part for leaflet is in the inside of valve frame completely, and leaflet also is in inside the valve frame completely when the operation is complete, does not receive the interference of exterior structure, consequently no matter how many valvular devices under the operation process remain and can not cause the interference to the motion of leaflet, so can furthest remain under the normal position mitral valve structure, and need not too much folding or tractive leaflet and valvular constructional device, it is better to maintaining postoperative left ventricle form and function.
Furthermore, the elastic ring and the elastic tube are made of medical silicon rubber, have certain deformability, can be deformed by matching with the operation of a human body, and have good resilience to restore the original shape quickly.
Because the maximum distance from the straight edge to the arc edge of the valve leaflet is greater than the inner radius of the tubular part, when the two valve leaflets are in a closed state, an included angle is formed between the two valve leaflets, and the arrangement ensures that the resistance of blood flowing through the valve leaflets is relatively small, so that the closed valve leaflets can be more easily flushed away.
The setting of spacing recess makes two valve leafs only can move in fixed region, and the valve leaf displacement of avoiding causes the influence each other too big.
The above embodiments are preferred examples of the present invention, and are not intended to limit the scope of the present invention.
Claims (10)
1. A mitral valve replacement prosthetic on-ring mechanical valve for implantation in the heart to replace a diseased mitral valve of the heart at the junction of the left atrium and left ventricle, comprising:
a valve frame having a tubular portion that mates with a mitral valve annulus in the left ventricle,
a pair of openable and closable valve leaflets mounted on the valve frame for controlling the unidirectional circulation of blood; and
a suturing ring secured to the tubular portion for suturing connection with the mitral annulus,
wherein the tubular portion further has an inflow port and an outflow port for blood to flow from the left atrium into the left ventricle,
the sewing ring is tubular, one end of the sewing ring is connected with the outflow port part, the other end of the sewing ring extends out to be an extension end,
the suture loop can deform under the condition of external force,
the valve leaflets are in a sheet shape, and when the pair of valve leaflets are perpendicular to the end surface of the outflow port part, the bottommost end of the valve leaflet close to the extending end does not exceed the end surface of the extending end.
2. The mechanical valve on a prosthetic ring for mitral valve replacement of claim 1, wherein:
when the pair of valve leaflets are perpendicular to the end surface of the outflow port part, the bottommost end of the valve leaflet close to the extending end and the end surface of the extending end are in the same plane.
3. The mechanical valve on a prosthetic ring for mitral valve replacement of claim 1, wherein:
when the pair of valve leaflets are perpendicular to the end surface of the outflow port part, the bottommost end of the valve leaflet close to the extending end is positioned at a position retracted from the end surface of the extending end into the tubular part by 1-2mm along the axial direction of the tubular part.
4. The mechanical valve on a prosthetic ring for mitral valve replacement of claim 1, wherein:
wherein the suture ring comprises a ring body and an elastic ring arranged in the ring body,
the elastic ring has a shape matching the shape of the ring body,
the port at one end of the ring body is directly contacted with the port of the outflow port part and is fixed on the port of the outflow port part.
5. The mechanical valve on a prosthetic ring for mitral valve replacement of claim 4, wherein:
wherein, the elastic ring is made of medical silicon rubber.
6. The mechanical valve on a ring prosthesis for mitral valve replacement according to claim 1, further comprising:
one end of the elastic tube is fixed on the outflow port part, the other end of the elastic tube extends out and can deform under the action of external force,
the sewing ring is fixed on the peripheral wall of the deformable end of the elastic tube.
7. The mechanical valve on a prosthetic ring for mitral valve replacement of claim 6, wherein:
wherein, the elastic tube is made of medical silicon rubber.
8. The mechanical valve on a prosthetic ring for mitral valve replacement of claim 1, wherein:
wherein the valve frame is also provided with a pair of symmetrically arranged convex parts for installing a pair of valve leaflets.
9. The mechanical valve on a prosthetic ring for mitral valve replacement of claim 8, wherein:
wherein the tubular portion has a circular inner cross-section,
two groups of limiting groove groups which are arranged along the diameter of the tubular part in a bilateral symmetry way are arranged on the inner wall of the convex part,
each group of limiting groove groups comprises two limiting grooves for mounting one valve leaflet.
10. The mechanical valve on a prosthetic ring for mitral valve replacement of claim 9, wherein:
wherein each valve leaf has a straight edge and an arc edge, the straight edge is connected with the arc edge,
two ends of the straight edge are respectively provided with a convex block,
the two convex blocks of each valve leaf are respectively arranged in the two limit grooves in one group of limit groove groups, so that the valve leaf can rotate along the straight edge of the valve leaf,
the maximum distance from the straight edge of each leaflet to the curved edge of that leaflet is greater than the inner radius of the tubular portion.
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CN2018203399017 | 2018-03-13 | ||
CN201820339901 | 2018-03-13 |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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CN109771099A (en) * | 2018-03-13 | 2019-05-21 | 唐杨烽 | A kind of mitral valve replacement manually mechanical prosthetic valve on ring |
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2019
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Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN109771099A (en) * | 2018-03-13 | 2019-05-21 | 唐杨烽 | A kind of mitral valve replacement manually mechanical prosthetic valve on ring |
CN109771099B (en) * | 2018-03-13 | 2023-09-22 | 中国人民解放军海军军医大学第一附属医院 | Mechanical valve on artificial ring for replacing mitral valve |
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