CN213099895U - Aortic arch three-branch arterial perfusion tube - Google Patents

Abstract

An aortic arch three-branch arterial perfusion tube relates to the technical field of medical instruments and comprises a main perfusion tube, wherein the rear end of the main perfusion tube is connected with a perfusion connector, and the front end of the main perfusion tube is forked to form three perfusion branch tubes; all fill and all be equipped with the clip that is used for controlling the pipeline break-make on the branch pipe, press from both sides tight branch pipe that fills with the clip after, the blood flow in this branch pipe pipeline that fills will be blocked, and all the front ends that fill the branch pipe all are provided with the water pocket, the pipeline that the water pocket extends through toward filling the branch pipe rear end is connected with the water injection respectively and connects. By utilizing the aortic arch three-branch arterial perfusion tube, the perfusion of the brachiocephalic trunk artery, the perfusion of the left common carotid artery, the perfusion of the left subclavian artery can be implemented in the operation process, the complications of postoperative nerve dysfunction are reduced, the circulation stopping time of the brain, the upper limbs and the vertebral artery at two sides of a patient can be shortened, the organ damage of the patient caused by circulation stopping is further reduced, and the postoperative recovery is facilitated.

Description

Aortic arch three-branch arterial perfusion tube

Technical Field

The utility model relates to the technical field of medical equipment, in particular to an aortic arch three-branch arterial perfusion tube.

Background

Aortic arch replacement has become the standard surgical mode of present treatment Stanford A type aortic dissection and aortic arch aneurysm, needs to implement low temperature stop cycle in the operation process, and brain, spinal cord and viscera protection are the key of successful operation in the stop cycle process, generally adopt right side axillary artery intubate line selective cerebral perfusion as brain protection means, and the blood of pouring is redistributed and is compensated through the cerebral artery ring to maintain the blood supply of brain. It should be noted that although the cryogenic shutdown technique has a longer safe time frame for shutdown, it is accompanied by problems of internal environment disorders, impaired coagulation function and organ damage. In the process of deep hypothermia stopping circulation, the problems of postoperative nerve dysfunction (such as postoperative waking delay and temporary brain dysfunction) caused by unilateral brain perfusion under the condition that Willis rings of a patient are incomplete cannot be ignored, and in addition, the upper limbs and vertebral arteries on both sides in the process of stopping circulation can be damaged by ischemia and hypoxia, which is very unfavorable for the postoperative recovery of the patient.

Generally, three vessels are present on the side of the aortic arch that is in the greater curvature: brachiocephalic artery, left common carotid artery, and left subclavian artery. The left common carotid artery supplies blood to the left cerebral hemisphere and the left face, and the left subclavian artery supplies blood to the left upper arm, the axillary vertebral artery, the internal thoracic artery and the thyroid. It would be beneficial to improve post-operative neurological dysfunction and post-operative recovery if an instrument were available to help the physician perform perfusion through the aortic arch circumflex side three-branch artery during the procedure, reducing the time to arrest circulation.

SUMMERY OF THE UTILITY MODEL

The utility model aims at providing an aortic arch three-branch artery perfusion tube, at the in-process that stops the circulation, can implement to corresponding organ with the help of this perfusion tube through three blood vessels of the big bent side of patient's aortic arch and pour into, and then improve the problem of postoperative nerve dysfunction and organ ischemia damage to do benefit to the postoperative and resume.

In order to achieve the above purpose, the utility model adopts the following technical scheme: an aortic arch three-branch artery perfusion tube is characterized in that: the device comprises a main filling pipe, wherein the rear end of the main filling pipe is connected with a filling connector, and the front end of the main filling pipe is forked to form three filling branch pipes;

all fill and all be equipped with the clip that is used for controlling the pipeline break-make on the branch pipe, press from both sides tight branch pipe that fills with the clip after, the blood flow in this branch pipe pipeline that fills will be blocked, and all the front ends that fill the branch pipe all are provided with the water pocket, the pipeline that the water pocket extends through toward filling the branch pipe rear end is connected with the water injection respectively and connects.

Preferably, a steel wire mesh reinforcing layer is embedded in the pipe wall of the first half section of the perfusion branch pipe, and the foremost end of the steel wire mesh reinforcing layer has a certain distance from the front end face of the perfusion branch pipe.

Or, it has the steel wire to embed in the pipe wall of the first half section of filling the branch pipe, the steel wire extends along the length direction spiral that fills the branch pipe, there is a distance at the foremost end of steel wire apart from the preceding terminal surface that fills the branch pipe.

The included angle between the front end surface of the perfusion branch pipe and the axis of the perfusion branch pipe is smaller than 90 degrees, so that a tip is formed at the front end of the perfusion branch pipe.

Wherein, the clip is a Robert tube clip made of plastic.

Furthermore, the water bag and the filling branch pipe are welded into a whole, and the axial length of the water bag is 2cm-4 cm.

The utility model discloses an aortic arch three-branch artery perfusion tube, the user mode who relates to in the aortic arch portion operation clinically is: firstly, establishing extracorporeal circulation through right axillary artery (or femoral artery and ascending aorta) and right atrial cannula, then cooling, blocking transverse sinus when nasopharynx temperature is 32 ℃, and directly injecting 1: 4 cold crystalloid blood stopping jumping liquid, incising aorta, cutting off diseased aorta, when the nasopharynx temperature is 28 ℃, respectively inserting three perfusion branch pipes of the three branch artery perfusion pipes of the aortic arch into brachiocephalic artery, left common carotid artery and left subclavian artery, or only inserting left common carotid artery and left subclavian artery (the specific situation is different by different modes of extracorporeal circulation aorta intubation), injecting water into the water sac to expand the water sac and tightly support the blood vessel wall to block the reflux of perfusion blood, performing whole brain antegrade cerebral perfusion by inserting the perfusion branch pipes of the left common carotid artery and the brachiocephalic artery, restoring blood supply of left upper arm and partial vertebral artery by inserting the perfusion branch pipes of the left subclavian artery, then selecting proper four-branch artificial blood vessels in descending aorta implantation, matching the four-branch artificial blood vessels with descending aorta stent skirts, connecting the descending aorta perfusion pipes on the four-branch artificial blood vessels to restore lower half-body perfusion, the left common carotid artery is firstly matched with the perfusion branch pipes in the left common carotid artery after the left common carotid artery is drawn out, the oxygen saturation of the mixed venous blood is checked and analyzed by blood gas after the flow is recovered for 10-15 minutes, the mixed venous blood oxygen can be rewarming, then the proximal end of the four-branch artificial blood vessel and the ascending aorta are matched, the exhaust and the heart rebound, then the remaining two perfusion branch pipes are sequentially drawn out from the left subclavian artery and the brachiocephalic artery one by one, and the artery corresponding to the perfusion branch pipe is matched with the branch corresponding to the artificial blood vessel when one perfusion branch pipe is drawn out. Reducing the flow and stopping extracorporeal circulation after the heart rate, the blood pressure and the temperature are stable, ligating a perfusion branch blood vessel of the four-branch artificial blood vessel, removing an extracorporeal circulation pipeline, neutralizing heparin, stopping bleeding, placing one pericardium mediastinum drainage tube respectively, closing the chest, and sending the pericardium mediastinum drainage tube into a monitoring room after the operation is finished.

According to the operation process, the utility model provides an aortic arch three-branch artery perfusion tube can implement whole brain antegrade brain perfusion in the operation process, compare with unilateral brain perfusion, and whole brain perfusion can alleviate postoperative nerve dysfunction complication. In addition, by using the aortic arch three-branch arterial perfusion tube, partial vertebral artery and left upper arm blood supply can be recovered before the four-branch artificial blood vessel is anastomosed with the left subclavian artery, the head-arm trunk artery and the left common carotid artery, the circulation stopping time of partial vertebral artery and left upper arm of a patient is shortened, the ischemic injury of the patient caused by circulation stopping can be reduced, and postoperative recovery is facilitated.

Drawings

FIG. 1 is a schematic view of the overall structure of the aortic arch three-branch arterial perfusion tube;

fig. 2-7 are schematic views illustrating the manner in which the aortic arch three-branch arterial infusion tube is used during the operation;

in the figure:

1-main filling pipe 2-filling joint 3-filling branch pipe

4-clamp 5-water bag 6-water injection joint

7-steel wire 8-four-forked artificial blood vessel 9-descending aorta

10-bracket 11-descending aorta perfusion tube 8 a-perfusion branch vessel.

Detailed Description

In order to facilitate the understanding of those skilled in the art, the present invention will be further described with reference to 2 embodiments and the accompanying drawings, which are not intended to limit the present invention.

Furthermore, in the present invention, unless otherwise expressly specified or limited, the terms "front", "back", "inner", "outer", and the like, indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are merely for convenience of description and simplicity of description, and do not indicate or imply that the device or element being referred to must have a particular orientation, be constructed in a particular orientation, and be operated, and therefore should not be construed as limiting the present invention.

Fig. 1 shows the overall structure of the aortic arch three-branch arterial perfusion tube, which comprises a main perfusion tube 1, wherein the rear end of the main perfusion tube 1 is connected with a perfusion connector 2, and the front end of the main perfusion tube 1 is forked to form three perfusion branch tubes 3.

All be equipped with the clip 4 that is used for the control circuit break-make on filling the branch pipe 3, press from both sides tightly with the clip and fill behind the branch pipe 3, the blood flow that should fill in the branch pipe 3 pipeline will be blocked, all is provided with water pocket 5 at the front end of all filling the branch pipe 3, and water pocket 5 is connected with water injection joint 6 respectively through the pipeline toward filling the extension of branch pipe 3 rear end.

Optionally, a steel wire mesh reinforcement layer is embedded in the pipe wall of the first half section of the perfusion branch pipe 3, and the foremost end of the steel wire mesh reinforcement layer is a distance away from the front end face of the perfusion branch pipe 3.

Or, a steel wire 7 is embedded in the pipe wall of the first half section of the perfusion branch pipe 3, the steel wire 7 spirally extends along the length direction of the perfusion branch pipe 3, and as shown in fig. 1, the foremost end of the steel wire 7 is a distance away from the front end face of the perfusion branch pipe 3. It should be noted that the steel wire 7 and the steel wire mesh reinforcement layer are not limited to be embedded in the pipe wall of the first half of the perfusion branch pipe 3, but may also extend to the pipe wall of the middle section of the perfusion branch pipe 3, but this does not mean that the steel wire 7 or the steel wire mesh reinforcement layer may be embedded in the pipe wall of the whole perfusion branch pipe 3, and it is understood by those skilled in the art that when the steel wire 7 or the steel wire mesh reinforcement layer is embedded in the position where the clamp 4 is disposed on the perfusion branch pipe 3, it may cause that the clamp 4 cannot block the pipeline when clamping the perfusion branch pipe 3.

Further, the angle between the front end face of the perfusion branch 3 and its axis is less than 90 degrees, similar to most of the perfusion tubes of the prior art, so that a tip is formed at the front end of the perfusion branch 3.

The clamp 4 may be a commercially available plastic robert clamp.

In practical application, the water bag 5 and the perfusion branch pipe 3 can be welded into a whole through ultrasonic welding, and the axial length of the water bag 5 is preferably 2cm-4 cm.

The aortic arch three-branch artery perfusion tube is used in the aortic arch surgery in the clinical mode as follows: firstly, establishing extracorporeal circulation through right axillary artery (or femoral artery and ascending aorta) and right atrial cannula, then cooling, blocking transverse sinus when nasopharynx temperature is 32 ℃, and directly injecting 1: 4 cooling blood circulation stopping and jumping liquid, cutting the aorta, processing the ascending aorta part, when the nasopharynx temperature and the anal temperature are 25 ℃, cutting off the diseased aortic arch as shown in figure 2, then respectively inserting three perfusion branches of the three branch artery perfusion tubes of the aortic arch into the brachiocephalic artery, the left common carotid artery, the left subclavian artery or two perfusion branches of the three perfusion branch tubes into the left common carotid artery and the left subclavian artery as shown in figure 3 (in order to avoid the three branch artery perfusion tubes of the aortic arch and the four-branch artificial blood vessel 8 from shielding each other and influencing the observation, the left common carotid artery, the brachiocephalic artery and the left subclavian artery are moved upwards for a certain distance in figures 3-7), injecting water into the water sac 5 to expand the water sac 5 and tightly abut against the vessel wall to block the backflow of perfusion blood, performing full brain antegrade cerebral perfusion by the perfusion branch tubes 3 inserted into the left common carotid artery and the brachiocephalic artery, restoring blood supply of the upper arm and part of vertebral artery on the left side by inserting the perfusion branch pipe 3 of the subclavian artery on the left side, as shown in figure 4-5, implanting the stent in the descending aorta 9, selecting a proper four-branch artificial blood vessel 8, anastomosing the skirt edges of the four-branch artificial blood vessel 8 and the stent 10 in the descending aorta, inserting the descending aorta perfusion pipe 11 through the perfusion branch blood vessel 8a of the artificial blood vessel to restore blood supply of viscera and lower limbs, then as shown in figure 6, extracting the left carotid perfusion pipe to enable the four-branch artificial blood vessel branch to be anastomotic with the left common carotid artery, anastomosing the proximal end of the four-branch artificial blood vessel with the ascending aorta, heating and exhausting, and heart rebound, sequentially extracting the remaining two perfusion branch pipes from the subclavian artery and the brachiocephalic artery one by one, enabling the artery corresponding to the perfusion branch of the perfusion branch pipe 3 to be anastomosed with the corresponding artificial blood vessel every extraction, reducing the flow and stopping extracorporeal circulation after the heart rate, blood pressure and temperature are stable, ligating a perfusion branch blood vessel 8a (shown in figure 7), removing an extracorporeal circulation pipeline, neutralizing heparin, stopping bleeding, placing one pericardial mediastinum drainage tube respectively, closing the chest, and sending the pericardial mediastinum drainage tube into a monitoring room after the operation is finished.

From the above operation process, it can be seen that the use of the aortic arch three-branch arterial perfusion tube shown in fig. 1 can perform full brain antegrade brain perfusion during the operation process, and compared with unilateral brain perfusion, the full brain perfusion can reduce postoperative neurological dysfunction complications. In addition, the aortic arch three-branch arterial perfusion tube can restore the whole blood supply of the head before the four-branch artificial blood vessel 8 is anastomosed with the brachiocephalic trunk artery, the left subclavian artery and the left common carotid artery, thereby being beneficial to postoperative recovery.

In order to make it easier for those skilled in the art to understand the improvement of the present invention over the prior art, some drawings and descriptions of the present invention have been simplified, and in order to clarify, some other elements have been omitted from this document, those skilled in the art should recognize that these omitted elements may also constitute the content of the present invention.

Claims (6)

1. The aortic arch three-branch artery perfusion tube is characterized in that: the device comprises a main filling pipe (1), wherein the rear end of the main filling pipe (1) is connected with a filling connector (2), and the front end of the main filling pipe (1) is forked to form three filling branch pipes (3);

all be equipped with clip (4) that are used for the control circuit break-make on all filling branch pipe (3), press from both sides tight filling branch pipe (3) back with the clip, the blood flow in this filling branch pipe (3) pipeline will be blocked, and the front end of all filling branch pipe (3) all is provided with water pocket (5), water pocket (5) are connected with water injection joint (6) respectively through the pipeline toward filling branch pipe (3) rear end extension.

2. The aortic arch three-branch arterial infusion tube according to claim 1, wherein a steel wire mesh reinforcement layer is embedded in the tube wall of the first half section of the infusion branch tube (3), and the foremost end of the steel wire mesh reinforcement layer is a distance away from the front end face of the infusion branch tube (3).

3. The aortic arch three-branch arterial infusion tube according to claim 1, wherein a steel wire (7) is embedded in the tube wall of the first half section of the infusion branch tube (3), the steel wire (7) extends spirally along the length direction of the infusion branch tube (3), and the foremost end of the steel wire (7) is at a distance from the front end face of the infusion branch tube (3).

4. The aortic arch three-branch arterial infusion tube according to any one of claims 1 to 3, wherein: the included angle between the front end surface of the perfusion branch pipe (3) and the axis thereof is smaller than 90 degrees, so that a pointed end is formed at the front end of the perfusion branch pipe (3).

5. The aortic arch three-branch arterial infusion tube of claim 4, wherein: the clamp (4) is a Robert tube clamp made of plastic.

6. The aortic arch three-branch arterial infusion tube of claim 1, wherein: the water bag (5) and the perfusion branch pipe (3) are welded into a whole, and the axial length of the water bag (5) is 2cm-4 cm.

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