CN211325408U

CN211325408U - Electric heart muscle cutter in heart cavity

Info

Publication number: CN211325408U
Application number: CN201921492514.8U
Authority: CN
Inventors: 魏翔; 王锐; 方静; 刘红云
Original assignee: Wuhan Weixintan Medical Technology Co ltd
Current assignee: Wuhan Weixintan Medical Technology Co ltd
Priority date: 2019-09-09
Filing date: 2019-09-09
Publication date: 2020-08-25
Anticipated expiration: 2029-09-09

Abstract

The utility model relates to an electric heart intracavitary myocardium cutter, which comprises a shell, a puncture needle component, a cutting knife component and an outer tube component which are coaxially arranged from inside to outside, wherein one end of the outer tube component is fixedly connected with the shell, the other end of the outer tube component is sealed, the sealing end part is provided with a cutting window and a negative pressure suction window, and the needle head of the puncture needle component and the cutting edge of the cutting knife component are matched with the cutting window; the cutting knife driving component and the puncture needle driving component in the shell are respectively electrically connected with the controller; the cutting knife component is connected with the cutting knife driving component, and the puncture needle component is connected with the puncture needle driving component; the negative pressure suction assembly comprises a negative pressure pipe, one end of the negative pressure pipe is connected with the negative pressure suction window in a sealing mode, and the other end of the negative pressure pipe is connected with the negative pressure machine and the injector. The utility model has simple operation, can accurately cut the myocardium, has small wound and is beneficial to postoperative rehabilitation; integrates the functions of tissue cutting and recovery, and prevents the cut myocardial tissue from falling off to cause peripheral arterial embolism.

Description

Electric heart muscle cutter in heart cavity

Technical Field

The utility model relates to a minimally invasive cardiac surgery surgical instrument technical field, concretely relates to electrodynamic type heart intracavity myocardium cutterbar.

Background

The current treatment methods for hypertrophic obstructive cardiomyopathy mainly comprise drug treatment, double-cavity pacing treatment, alcohol ablation through coronary ventricular septum and myocardial excision through open ventricular septum (Morrow and modified Morrow). The medicine and the double-cavity pacing therapy only can reduce the myocardial oxygen consumption to a certain extent, relieve heart failure symptoms, enhance exercise tolerance of patients and cannot fundamentally remove causes. The alcohol ablation procedure causes partial myocardial infarction by injecting anhydrous alcohol into the first septal branch of the left anterior descending branch of the coronary artery, so that the basal segment of the septal thickening chamber becomes thinner, and the obstruction of the left ventricular outflow tract is reduced. However, this method is still very limited at present: firstly, abnormal myocardial motion caused by non-target myocardial infarction can be caused, and the condition is aggravated; secondly, complications such as atrioventricular block, ventricular arrhythmia and the like are high due to myocardial scar formation; thirdly, about 5 to 8 percent of patients are not suitable for alcohol ablation due to the variation of the first spacing branch; the short-term and long-term curative effects are inferior to those of the myocardial resection of the ventricular septum; fifthly, mitral papillary muscle deformity and complicated valve structural abnormality cannot be treated. In addition, few heart centers have attempted compartmental radio frequency ablation via percutaneous catheters, but have not been deployed on a large scale due to the number of complications. Therefore, compartmental cardiomyopathy remains the best treatment for hypertrophic obstructive cardiomyopathy at present.

Nevertheless, conventional compartmental cardiomyopathy still faces a number of problems: firstly, because the heart is subjected to resection operation in a state of stopping jumping, the thickness and the texture of the heart are different from those of the heart in a state of jumping, the resection range is difficult to evaluate before an operation and completely depends on the experience of an operator, so that only few heart centers with rich experience can well complete the operation, and the heart resection operation is difficult to popularize; secondly, the resection effect cannot be evaluated in real time after resection, if the resection range is too wide, the ventricular septum perforation and the conduction bundle damage can be caused, and if the resection is not complete, the operation curative effect is poor; and operation trauma, myocardial damage and systemic inflammatory reaction caused by open heart operation and extracorporeal circulation. Therefore, the surgical mode of ventricular septal cardiomyopathy still needs to be improved urgently, a matched surgical instrument needs to be improved urgently, a surgical instrument which is simple in operation, small in wound, beneficial to recovery of a patient and capable of accurately cutting cardiac muscles is urgently needed at present, and the problem that the cut cardiac muscles are prevented from entering blood vessels to form embolism after being cut is needed to be solved is solved urgently.

SUMMERY OF THE UTILITY MODEL

The utility model discloses to the technical problem who exists among the prior art, provide an electrodynamic type heart intracavity myocardium cutterbar, its easy and simple to handle, only need can accomplish the operation of cardiac muscle excision through small wound, and fix a position accurately, can not miscut non-excision target area, the fixed absorption of cardiac muscle tissue that will drop through the mode that the negative pressure attracts after the excision is accomplished is in the intracavity of outer tube subassembly, prevents that it from getting into the blood vessel, and the cardiac muscle that prevents to drop arouses the vascular embolism.

The utility model provides an above-mentioned technical problem's technical scheme as follows: an electric myocardial cutter in a cardiac chamber comprises a shell, and further comprises a puncture needle assembly, a cutting knife assembly and an outer tube assembly which are coaxially arranged from inside to outside, wherein any two adjacent puncture needle assemblies are in sliding fit, one end of the outer tube assembly is fixedly connected with the shell, the other end of the outer tube assembly is arranged to be a sealing end part, the sealing end part is provided with a cutting window and a negative pressure suction window, the puncture needle assembly comprises a needle head and a needle rod which are fixedly connected in sequence, and the needle head of the puncture needle assembly and the cutting edge of the cutting knife assembly are matched at the cutting window; a cutting knife driving assembly, a puncture needle driving assembly and a controller are arranged in the shell, and the cutting knife driving assembly and the puncture needle driving assembly are respectively and electrically connected with the controller; one end of the cutter component, which is far away from the cutting edge, is connected with the cutter driving component, and one end of the puncture needle component, which is far away from the needle head, is connected with the puncture needle driving component; still include the negative pressure suction subassembly, the negative pressure suction subassembly includes the negative pressure pipe, negative pressure pipe one end with negative pressure suction window sealing connection, outside negative pressure machine is connected to the negative pressure pipe other end.

The utility model has simple operation and reliable use, can accurately cut the target area of the myocardium under the guidance of the ultrasonic wave of the esophagus, can determine the amount of the myocardium to be cut by monitoring the pressure difference of the outflow tract of the left ventricle in real time through the ultrasonic wave while cutting, can not hurt the myocardium of the non-target area by mistake, does not need an operator to judge the amount of the myocardium to be cut by depending on the experience, and increases the safety of the operation; the volume of the part of the utility model which needs to be inserted into the thoracic cavity is small, and the operation can be completed only by a small wound, which is beneficial to the postoperative rehabilitation of the patient; integrates the functions of tissue cutting and recovery, and prevents the cut myocardial tissue from falling off to cause peripheral arterial embolism.

On the basis of the technical scheme, the utility model discloses can also do following improvement.

Preferably, the cutting knife assembly comprises a knife cylinder and a hollow screw rod which are coaxially arranged, one end of the knife cylinder is provided with an annular knife edge, the other end of the knife cylinder is hermetically connected with the end part of the hollow screw rod, and one end of the hollow screw rod, which is far away from the knife cylinder, is slidably and hermetically connected with the outer wall of the puncture needle assembly. The cutting knife component and the outer tube component are also in closed connection through a second sealing plug, and the end part of the hollow screw rod and the needle rod of the puncture needle component are in closed connection through a first sealing plug. Preventing high pressure blood from gushing out through the gaps among the outer tube assembly, the cutter assembly and the puncture needle assembly during operation.

Preferably, the cutting knife driving assembly comprises a first micro motor, a driving gear and a driven gear, the first micro motor is fixedly mounted on the shell, an output shaft of the first micro motor is coaxially arranged and fixedly connected with the driving gear, the driving gear is meshed with the driven gear, and the hollow screw rod is coaxially arranged with the driven gear; a straight groove and a thread groove are sequentially arranged on the hollow screw, the straight groove is arranged in parallel with the central shaft of the hollow screw, a first pin is arranged on the driven gear, and the first pin is in sliding fit with the straight groove; and a second pin is fixedly installed on the shell and matched with the thread groove of the hollow screw. The cutting knife driving assembly drives the first micro motor to rotate forward and backward under the control of the controller, and the hollow screw rod rotates forward or backward under the action of gear transmission, so that the cutting edge of the cutting knife assembly is driven to rotate for cutting or backward.

Preferably, the puncture needle driving assembly comprises a second micro motor, a lead screw and a sliding block, the second micro motor is fixedly mounted on the shell, an output shaft of the second micro motor is coaxially arranged with and fixedly connected with the lead screw, a through hole is formed in the sliding block, an internal thread is formed in the through hole and matched with the lead screw, and the sliding block is fixedly connected with the outer wall of the puncture needle assembly. The puncture needle driving assembly can rotate forwards and backwards under the control action of the controller, so that the technical effect of driving the puncture needle assembly to advance or retreat through the lead screw is achieved, and the target area is positioned.

Preferably, the negative pressure suction mechanism further comprises a three-way connector, the puncture needle assembly is of a hollow structure, a first end of the three-way connector is hermetically connected with an end part, far away from the needle head, of the puncture needle assembly, a second end of the three-way connector is hermetically connected with the negative pressure suction window, and a third end of the three-way connector is hermetically connected with an external negative pressure machine. When cutting, the negative pressure machine generates negative pressure, so that the myocardium is effectively fixed under the negative pressure suction action of the puncture needle assembly and the negative pressure tube, displacement is prevented, and more accurate cutting is facilitated; after cutting, the cut cardiac muscle is taken out of the wound by the cutter under the action of negative pressure suction, so as to prevent vascular embolism.

Preferably, the third end of the three-way connector is further connected with an injector, and the injector, the negative pressure machine and the third end of the three-way connector are connected through a three-way valve. When the cutter of the utility model is sealed by liquid, the negative pressure machine is closed, the injector is opened, the heparin saline is pre-filled to remove the gas in the cutter, and then the cutter component is controlled to rotate and advance until the requirement of liquid sealing is met; meanwhile, the heparin saline is discharged from the negative pressure pipe through the negative pressure pipe.

Preferably, the cutting edge of the cutter assembly is an annular cutting edge. The annular cutting edge can accurately cut off the cardiac muscle of the target area when rotationally advancing under the driving action of the cutting knife driving component.

Preferably, the sealed end of the outer tube assembly is provided in the form of a tapered bullet nose. The head end of the outer tube assembly is sealed, is in a bullet head shape, is convenient to insert into the heart cavity, and simultaneously avoids causing damage to other tissues in the heart cavity.

Preferably, the inner side of the sealing end part of the outer pipe assembly is further provided with a silica gel pad, the silica gel pad is fixedly connected with the cutting window, and when the annular cutting edge extends out, the silica gel pad is matched with the annular cutting edge. The silica gel pad is located the last edge of cutting window, and the silica gel pad is convenient for provide reverse shear force for annular cutting edge as the chopping block when cutting the tissue, changes in the muscle tissue that cuts off, can provide the liquid seal for the cutting knife subassembly simultaneously.

Preferably, the negative pressure pipe is disposed along an outer wall of the outer pipe assembly. When performing the operation, the negative pressure pipe is along the outer wall of outer tube, and resistance when this device stretches into the wound when having reduced the operation can further reduce the dimensional requirement of wound simultaneously, does benefit to the patient and recovers.

Preferably, the shell is provided with a control panel, the control panel is provided with a control button, and the control button is connected with the controller. The operator can conveniently control the puncture needle assembly to advance or retreat and the cutting knife to rotate to advance or retreat through the control button on the operation panel so as to complete the actions of positioning, cutting and the like on the target area.

Preferably, the shell is further provided with a power interface, and the controller is connected with a power supply through the power interface. In order to ensure the stability of the operation of the cutter, an external power supply is used for supplying power to the cutter.

The utility model has the advantages that: the utility model has simple operation and reliable use, can accurately cut the target area of the myocardium under the guidance of the ultrasonic wave of the esophagus, can determine the amount of the myocardium to be cut by monitoring the pressure difference of the outflow tract of the left ventricle in real time through the ultrasonic wave while cutting, can not hurt the myocardium of the non-target area by mistake, does not need an operator to judge the amount of the myocardium to be cut by depending on the experience, and increases the safety of the operation; the volume of the part of the utility model which needs to be inserted into the thoracic cavity is small, and the operation can be completed only by a small wound, which is beneficial to the postoperative rehabilitation of the patient; integrates the functions of tissue cutting and recovery, and prevents the cut myocardial tissue from falling off to cause peripheral arterial embolism.

Drawings

FIG. 1 is a schematic view of the external structure of the present invention;

FIG. 2 is a schematic view of the movement mechanism of the present invention;

fig. 3 is a schematic view of the oblique view angle of the moving mechanism of the present invention;

FIG. 4 is an enlarged view of the portion A of FIG. 3 according to the present invention;

fig. 5 is a schematic structural view of the driven gear of the present invention;

FIG. 6 is a schematic view of the cutting window structure of the present invention;

FIG. 7 is a schematic view of the structure of the vacuum suction assembly of the present invention;

FIG. 8 is a schematic view of the structure of the cutting blade assembly of the present invention;

fig. 9 is a block diagram of the system structure of the present invention.

In the drawings, the components represented by the respective reference numerals are listed below:

1. a housing, 101, a control panel, 102, a control button, 2, an outer tube assembly, 201, a sealed end, 202, a cutting window, 203, a negative pressure suction window, 204, a silicone pad, 3, a cutting knife assembly, 301, a circular blade, 302, a knife cylinder, 4, a puncture needle assembly, 401, a needle head, 402, a needle rod, 5, a cutting knife driving assembly, 501, a first micro motor, 502, a driving gear, 503, a driven gear, 504, a hollow screw, 505, a first sealing plug, 506, a first coupling, 507, a second sealing plug, 508, a first pin, 509, a second pin, 6, a puncture needle driving assembly, 601, a second micro motor, 602, a lead screw, 603, a slider, 604, a second coupling, 7, a negative pressure suction assembly, 701, a negative pressure tube, 702, a three-way connector, 703, a negative pressure machine, 704, an injector, 705, a three-way valve, 8, a controller, 9. a power source.

Detailed Description

The principles and features of the present invention are described below in conjunction with the following drawings, the examples given are only intended to illustrate the present invention and are not intended to limit the scope of the present invention.

The electric heart intracavity myocardium cutter shown in fig. 1 to 8 comprises a housing 1, a puncture needle assembly 4, a cutting knife assembly 3 and an outer tube assembly 2 which are coaxially arranged from inside to outside, any two adjacent two are in sliding fit, one end of the outer tube assembly 2 is fixedly connected with the housing 1, the other end of the outer tube assembly 2 is arranged to be a sealed end portion 201, a cutting window 202 and a negative pressure suction window 203 are arranged on the side surface of the sealed end portion 201, the puncture needle assembly 4 comprises a needle head 401 and a needle rod 402 which are fixedly connected in sequence, and the needle head 401 of the puncture needle assembly 4 and a blade of the cutting knife assembly 3 are matched with each other in the cutting window 202; a cutting knife driving assembly 5, a puncture needle driving assembly 6 and a controller 8 are arranged in the shell 1, the cutting knife driving assembly 5 and the puncture needle driving assembly 6 are respectively and electrically connected with the controller 8, and the controller 8 only needs to adopt a common ARM9 single chip microcomputer because the function of the cutter is relatively simple; one end of the cutting knife component 3, which is far away from the cutting edge, is connected with the cutting knife driving component 5, and one end of the puncture needle component 4, which is far away from the needle head 401, is connected with the puncture needle driving component 6; still include negative pressure suction subassembly 7, negative pressure suction subassembly 7 includes negative pressure pipe 701, negative pressure pipe 701 one end with negative pressure suction window 203 sealing connection, the outside negative pressure machine is connected to the negative pressure pipe 701 other end. The negative pressure suction window 203 is a plurality of small through holes distributed dispersedly and arranged on the side surface of the sealing end part 201 of the outer tube assembly 2, and the plurality of small through holes are positioned in the pipe orifice range of the negative pressure pipe 701.

In this embodiment, the cutting knife assembly 3 includes a knife cylinder 302 and a hollow screw rod 504 which are coaxially disposed, one end of the knife cylinder 302 is set as an annular knife edge 301, the other end of the knife cylinder is hermetically connected with the end of the hollow screw rod 504, and one end of the hollow screw rod 504, which is far away from the knife cylinder 302, is slidably and hermetically connected with the outer wall of the puncture needle assembly 4. The cutting knife component 3 and the outer tube component 2 are hermetically connected through a second sealing plug 507, and the end part of the hollow screw rod 504 and the needle rod 402 of the puncture needle component 4 are hermetically connected through a first sealing plug 505. Preventing high pressure blood from gushing out through the gaps among the outer tube component 2, the cutting knife component 3 and the puncture needle component 4 during operation.

In this embodiment, the cutting knife driving assembly 5 includes a first micro motor 501, a driving gear 502, and a driven gear 503, the first micro motor 501 is fixedly mounted on the housing 1, an output shaft of the first micro motor 501 is coaxially disposed with the driving gear 502 and fixedly connected through a first coupling 506, the driving gear 502 is engaged with the driven gear 503, and the hollow screw 504 is coaxially disposed with the driven gear 503; a straight groove and a thread groove are sequentially arranged on the hollow screw rod 504, the straight groove is arranged in parallel with the central shaft of the hollow screw rod 504, a first pin 508 is arranged on the driven gear 503, and the first pin 508 is in sliding fit with the straight groove; a second pin 509 is fixedly mounted on the housing 1, and the second pin 509 is matched with the thread groove of the hollow screw 504. The cutting knife driving component 5 drives the first micro motor 501 to rotate forward and backward under the control of the controller 8, and under the action of gear transmission, the screw rod rotates forward or backward, so that the cutting edge of the cutting knife component 3 is driven to rotate for cutting or backward.

In this embodiment, the puncture needle driving assembly 6 includes a second micro motor 601, a lead screw 602, and a slider 603, the second micro motor 601 is fixedly mounted on the housing 1, an output shaft of the second micro motor 601 is coaxially disposed with the lead screw 602 and is fixedly connected through a second coupling 604, a through hole is disposed on the slider 603, an internal thread is disposed on the through hole, the internal thread is matched with the lead screw 602, and the slider 603 is fixedly connected with an outer wall of the puncture needle assembly 4. The puncture needle driving assembly 6 can rotate forwards and backwards under the control of the controller 8, so that the technical effect of driving the puncture needle assembly 4 to advance or retreat through the lead screw 602 is achieved, and the target area is positioned.

In this embodiment, the negative pressure suction mechanism further includes a three-way connector 702, the puncture needle assembly 4 is a hollow structure, a first end of the three-way connector 702 is hermetically connected to an end portion of the puncture needle assembly 4, which is far away from the needle head 401, a second end of the three-way connector 702 is hermetically connected to the negative pressure suction window 203, and a third end of the three-way connector 702 is hermetically connected to an external negative pressure machine. When cutting, the negative pressure machine generates negative pressure, so that the myocardium is effectively fixed under the negative pressure suction action of the puncture needle assembly 4 and the negative pressure tube 701, displacement is prevented, and more accurate cutting is facilitated; after cutting, the cut cardiac muscle is taken out of the wound by the cutter under the action of negative pressure suction, so as to prevent vascular embolism.

In this embodiment, the third end of the three-way connector 702 is further connected to an injector 704, and the injector 704, the negative pressure machine, and the third end of the three-way connector 702 are connected by a three-way valve 705. When the cutter of the utility model is sealed by liquid, the negative pressure machine is closed, the injector 704 is opened, the heparin saline is pre-filled to remove the gas in the cutter, and then the cutting knife component 3 is controlled to rotate and advance until the requirement of liquid sealing is reached; meanwhile, the heparin saline exhausts the gas in the negative pressure pipe 701 through the negative pressure pipe 701. The negative pressure tube 701 is connected with the puncture needle assembly 4 by a three-way valve 705, and is connected with the injector 704 and the negative pressure machine 703 by the three-way valve 705, so that the cutter can be conveniently subjected to liquid sealing, air exhaust, pressure measurement and flushing.

In this embodiment, the cutting edge of the cutting knife assembly 3 is an annular cutting edge 301. The annular blade 301 can accurately cut off the myocardium in the target region when rotationally advancing under the driving action of the cutting knife driving assembly 5.

In this embodiment, the sealing end 201 of the outer tube assembly 2 is provided with a tapered bullet nose type. The head end of the outer tube component 2 is sealed, is in a bullet head shape, is convenient to insert into the heart cavity, and simultaneously avoids causing damage to other tissues in the heart cavity.

In this embodiment, a silicone rubber pad 204 is further disposed on the inner side of the sealing end portion 201 of the outer tube assembly 2, the silicone rubber pad 204 is fixedly connected to the cutting window 202, and when the annular blade 301 extends out, the silicone rubber pad 204 is matched with the annular blade 301. The silicone pad is located at the upper edge of the cutting window 202, and the silicone pad is convenient to be used as a chopping board to provide reverse shearing force for the annular blade 301 when cutting tissue, so that the muscle tissue can be cut off more easily, and meanwhile, a liquid seal can be provided for the cutting knife assembly 3.

In this embodiment, the negative pressure pipe 701 is disposed along the outer wall of the outer pipe assembly 2. When performing the operation, negative pressure pipe 701 is along the outer wall of outer tube, and resistance when this device stretches into the wound when having reduced the operation can further reduce the dimensional requirement of wound simultaneously, does benefit to the patient and recovers.

In this embodiment, a control panel 101 is disposed on the housing 1, a control button 102 is disposed on the control panel 101, the control button 102 includes five operation buttons, i.e., a safety locking button, "1", "2", "3", and "4", and the control button 102 is connected to the controller 8. Wherein, the safety locking button provides the switch function of the power supply 9, and the four buttons of '1', '2', '3' and '4' respectively provide the functions of controlling the puncture needle assembly 4 to advance or retreat and the cutting knife to rotate to advance or retreat according to the requirements of the operation process. The operator can conveniently control the puncture needle assembly 4 to advance or retreat and the cutting knife to rotate to advance or retreat through the control button 102 on the operation panel so as to complete the actions of positioning, cutting and the like of the target area.

In this embodiment, the housing 1 is further provided with a power interface, and the controller 8 is connected to the power supply 9 through the power interface. To ensure the stability of the operation of the cutter, an external power supply 9 is used to supply power to the cutter.

In order to avoid the cutter made of metal from influencing the ultrasonic image, the outer surface of the outer tube assembly 2 is coated with a coating for preventing the metal from generating sound shadow under the ultrasonic condition.

The working principle is as follows:

the head end of the outer tube component 2 is sealed and is in a bullet shape, so that the outer tube component is convenient to insert into the heart cavity, and simultaneously, other tissues in the heart cavity are prevented from being damaged; the side wall of the sealing end part 201 of the outer tube component 2 is provided with a cutting window 202, protruding hypertrophic myocardial tissues can be embedded, and meanwhile, the wall of the rear side of the cutting window 202 can protect the intracardiac tissues behind the cutter, so that the cutting edge of the cut component is prevented from being accidentally injured; the negative pressure suction assembly 7 is arranged on the outer side of the outer tube assembly 2, and adsorbs and fixes the embedded myocardial tissue through an externally connected negative pressure machine 703 to prevent the fallen myocardial tissue from falling off and blocking peripheral arterial blood vessels; the cutter assembly 3 is sleeved in the outer tube assembly 2 and consists of a cutter cylinder 302 and a hollow screw 504, a second sealing plug 507 is arranged between the hollow screw 504 and the outer tube assembly 2, high-pressure blood in the back heart can be prevented from leaking out along the gap between the inner sleeve and the outer sleeve after the cutter enters, and the top end of the cutter cylinder 302 is provided with an annular cutting edge 301 for cutting cardiac muscle when the cutter assembly 3 rotates and pushes; the cutting knife driving component 5 for driving the cutting knife component 3 to rotate forwards consists of a gear set and a first micro motor 501, and the cutting knife component 3 is driven to rotate forwards and backwards through the connection of the gear set and the hollow screw rod 504; the puncture needle assembly 4 is sleeved in the screw rod and consists of a needle rod 402 and a needle head 401, the needle rod 402 is in sliding fit with the hollow screw rod 504, a first sealing ring is arranged between the needle rod 402 and the hollow screw rod 504, high-pressure blood in the heart can be prevented from leaking out along a gap between the needle rod 402 and the hollow screw rod 504 after a cutter enters a heart cavity, the needle head 401 of the puncture needle assembly 4 is arranged at the head end of the needle rod 402, and can puncture and fix the hypertrophic myocardial tissue embedded in the cutting window; the cutter driving assembly 5 for driving the puncture needle assembly 4 to move forward and backward consists of a lead screw 602, a slide block 603 and a second micro motor 601, and is connected with the slide block 603 between the lead screw 602 and the needle bar 402 so as to drive the puncture needle assembly 4 to move forward or backward along the axial direction; cutting knife drive assembly 5 and pjncture needle drive assembly 6 are integrated in shell 1, and the shape design of shell 1 becomes the shape that is fit for the staff to hold, and its rear end is equipped with control panel 101, and control panel 101 includes safe locking button and four step operation button "1", "2", "3", "4", can realize pjncture needle subassembly 4 and a sword section of thick bamboo 302 and retreat (open cutting window 202) after pressing down in proper order, and pjncture needle subassembly 4 advances to puncture fixedly, and a sword section of thick bamboo 302 precession cutting flow.

The working process is as follows:

in the process of implementing the removal of hypertrophic myocardium, the pericardium is entered through the small incisions of the 4 th and 5 th intercostal spaces of the left front chest wall of a patient, the apex of the heart is exposed, a purse-string is made at the apex of the heart, the sheath tube is used for puncturing the center of the purse-string to the left ventricle, the sheath tube is withdrawn, the entrance of the apex of the heart is enlarged by using a dilator, and the purse-string is tightened while the dilator is withdrawn. Connecting an injector 704 through a three-way valve 705 interface of a negative pressure suction assembly 7 to perform heparin saline pre-filling liquid sealing, removing air in an outer tube assembly 2 and a cutting knife assembly 3, sending the head end of a sealing end part 201 of the cutting knife of the embodiment into a left ventricle cavity, positioning to a hypertrophy compartment basal segment to be cut under the guidance of esophagus ultrasound and esophagus three-dimensional ultrasound, aligning a cutting window 202 to a cutting target area, pressing a safety locking button to unlock, sequentially pressing '1' and '2' to enable the cutting knife assembly 3 and a puncture needle assembly 4 to retreat back and open the cutting window 202, confirming that tendon and papillary muscles cannot be injured under the three-dimensional ultrasound again and determining the cutting thickness at the same time, opening an external negative pressure machine connected to the negative pressure suction assembly 7, sucking target myocardial tissues into the cutting window 202 to be fixed, pressing the button '3', and advancing the puncture needle assembly 4 to puncture the target myocardial tissues for further fixing, then, a button '4' is pressed, the cutter assembly 3 is screwed in, the target cardiac muscle is cut off and is accommodated in the cutter barrel 302 to finish cutting; after confirming that the cut tissue is cut off, slowly withdrawing the cutter from the heart cavity; pressing the knobs "1" and "2" again opens the cutting window 202 and takes out the cut myocardial tissue, and flushing the outer tube assembly 2 and the cutting knife assembly 3 with heparin saline through the syringe 704; the resection effect was examined under esophageal ultrasound and the left ventricular outflow tract differential pressure was measured by doppler ultrasound. If the cutting range is not satisfactory, the cutting process is repeated again to enlarge the cutting range until the operation effect is satisfactory. The apical incision is closed by surgical closure and the chest wall incision is closed layer by layer.

The above description is only for the preferred embodiment of the present invention, and is not intended to limit the present invention, and any modifications, equivalent replacements, improvements, etc. made within the spirit and principle of the present invention should be included within the protection scope of the present invention.

Claims

1. An electric myocardial cutter in a cardiac chamber comprises a shell (1) and is characterized by further comprising a puncture needle assembly (4), a cutting knife assembly (3) and an outer tube assembly (2) which are coaxially arranged from inside to outside, wherein one end of the outer tube assembly (2) is fixedly connected with the shell (1), the other end of the outer tube assembly (2) is arranged to be a sealed end part (201), a cutting window (202) and a negative pressure suction window (203) are arranged on the side surface of the sealed end part (201), the puncture needle assembly (4) comprises a needle head (401) and a needle rod (402) which are fixedly connected, and the needle head (401) of the puncture needle assembly (4) and a blade of the cutting knife assembly (3) are matched with each other at the cutting window (202); a cutting knife driving assembly (5), a puncture needle driving assembly (6) and a controller (8) are arranged in the shell (1), and the cutting knife driving assembly (5) and the puncture needle driving assembly (6) are respectively and electrically connected with the controller (8); one end of the cutter component (3) far away from the cutting edge is connected with the cutter driving component (5), and one end of the puncture needle component (4) far away from the needle head (401) is connected with the puncture needle driving component (6); still include negative pressure suction subassembly (7), negative pressure suction subassembly (7) include negative pressure pipe (701), negative pressure pipe (701) one end with negative pressure suction window (203) sealing connection, outside negative pressure machine (703) are connected to negative pressure pipe (701) other end.

2. The electrodynamic type endocardial myocardial cutter of claim 1, wherein the cutting knife assembly (3) comprises a knife cylinder (302) and a hollow screw (504) which are coaxially arranged, one end of the knife cylinder (302) is provided with an annular knife edge (301), the other end of the knife cylinder is hermetically connected with the end of the hollow screw (504), and one end of the hollow screw (504) far away from the knife cylinder (302) is slidably and hermetically connected with the outer wall of the puncture needle assembly (4).

3. The electrodynamic endocardial myocardial cutter of claim 2, characterized in that the cutting knife driving assembly (5) comprises a first micro motor (501), a driving gear (502) and a driven gear (503), the first micro motor (501) is fixedly mounted on the housing (1), the output shaft of the first micro motor (501) is coaxially arranged and fixedly connected with the driving gear (502), the driving gear (502) is engaged with the driven gear (503), and the hollow screw (504) is coaxially arranged with the driven gear (503); a straight groove and a thread groove are sequentially arranged on the hollow screw rod (504), the straight groove is arranged in parallel with the central shaft of the hollow screw rod (504), a first pin (508) is arranged on the driven gear (503), and the first pin (508) is in sliding fit with the straight groove; and a second pin (509) is fixedly installed on the shell (1), and the second pin (509) is matched with a thread groove of the hollow screw (504).

4. The electric type endocardial myocardium cutter according to claim 2 or 3, wherein the puncture needle driving assembly (6) comprises a second micro motor (601), a lead screw (602), and a sliding block (603), the second micro motor (601) is fixedly mounted on the housing (1), an output shaft of the second micro motor (601) is coaxially disposed and fixedly connected with the lead screw (602), a through hole is disposed on the sliding block (603), an internal thread is disposed on the through hole, the internal thread is matched with the lead screw (602), and the sliding block (603) is fixedly connected with an outer wall of the puncture needle assembly (4).

5. The electric intracardiac myocardium cutter according to claim 1, wherein said vacuum suction mechanism further comprises a three-way connector (702), said needle assembly (4) is a hollow structure, a first end of said three-way connector (702) is hermetically connected to an end portion of said needle assembly (4) far from said needle (401), a second end of said three-way connector (702) is hermetically connected to said vacuum suction window (203), and a third end of said three-way connector (702) is hermetically connected to an external vacuum machine (703).

6. The electrodynamic endocardial myocardial cutter of claim 1, characterized in that the sealed end (201) of the outer tube assembly (2) is of tapered bullet nose type.

7. The electric intracardiac myocardium cutter according to claim 2, characterized in that a silicone pad (204) is further disposed inside the sealing end (201) of the outer tube assembly (2), the silicone pad (204) is fixedly connected to the cutting window (202), and when the annular blade (301) is extended, the silicone pad (204) is engaged with the annular blade (301).

8. The electrodynamic intracardiac myocardial cutter according to claim 1, characterized in that the negative pressure tube (701) is arranged along the outer wall of the outer tube assembly (2).

9. The electrodynamic cardiotomy cutter in heart chamber according to claim 1, characterized in that the housing (1) is provided with a control panel (101), the control panel (101) is provided with a control button (102), and the control button (102) is connected to the controller (8).

10. The electrodynamic cardiotomy cutter in cardiac chamber according to claim 1, characterized in that the housing (1) is further provided with a power interface, and the controller (8) is connected to a power supply (9) through the power interface.