CN216455492U - Universal heart valvulopathy interventional instrument stabilizer - Google Patents
Universal heart valvulopathy interventional instrument stabilizer Download PDFInfo
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- CN216455492U CN216455492U CN202120344378.9U CN202120344378U CN216455492U CN 216455492 U CN216455492 U CN 216455492U CN 202120344378 U CN202120344378 U CN 202120344378U CN 216455492 U CN216455492 U CN 216455492U
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Abstract
The utility model provides a universal stabilizer for heart valve intervention instruments, which comprises a base, a plane rotation device, a mechanical arm, a sliding rail, a supporting platform, a clamping jaw and a joint capable of universally rotating. The universal heart Valve intervention instrument stabilizer can assist a surgeon in stabilizing an intervention instrument in an intervention operation, and particularly can ensure that the motion direction of the instrument is consistent with the bending direction of the front end of a catheter in a Lux-Valve transcatheter tricuspid Valve replacement operation, so that the surgeon is helped to operate the intervention instrument, the delivery and the release of a prosthetic Valve are completed, and the operation efficiency is improved.
Description
Technical Field
The utility model belongs to the technical field of medical instruments, and particularly relates to a universal heart valvular disease interventional instrument stabilizer.
Background
The heart valve is a one-way valve structure between an atrium and a ventricle, and ensures that blood flows from the atrium to the ventricle. The normal valve structure includes two portions, a leaflet and an annulus. Valvular disease, typically of the type of valve stenosis/insufficiency, occurs when the anatomy and/or function of the annulus or leaflets is disrupted due to aging, disease, etc. Once a stenosis and/or insufficiency of the valve occurs, normal blood flow is affected and abnormal hemodynamic changes burden the heart, ultimately leading to heart failure. Valvular heart disease seriously affects patient health and quality of life, and therefore, sufficient attention needs to be paid.
With the aging population getting worse, valvular heart disease has become a non-negligible disease burden in our country. Although traditional surgical open valve repair or replacement procedures are the standard treatment for valvular heart disease, patients of advanced age and at high risk as evaluated by surgery often cannot tolerate surgical procedures due to the complexity of the disease spectrum in our country. In recent years, the rapid development of domestic and foreign transcatheter interventional therapy becomes an important treatment method for high risk groups of surgical operations. Currently, transcatheter interventions on mitral, aortic, and pulmonary valves are common, but treatment for tricuspid disease is still in its early stages. Due to the large diameter of the tricuspid valve, the anatomical location is adjacent to the right coronary artery, and the lack of calcification of the valve, annulus, greatly limits the progression of transcatheter interventions to treat tricuspid valve disease. The current tricuspid valve registration research shows that the cardiac output of patients at high risk after selected surgical operation receives NovelGate technical treatment is obviously increased within 3-6 months in a short period. In our country, the primary clinical practice of applying Lux-Valve transcatheter artificial tricuspid Valve replacement proves that the technology is safe and effective, and postoperative ultrasound prompts that the Valve position is good and the Valve orifice has no regurgitation. Because the Lux-Valve artificial Valve is fixed at the anterior Valve of the tricuspid Valve and the interventricular position through the hook and the anchoring device, compared with the radial supporting force of the traditional artificial Valve, the risk of atrioventricular block after operation is greatly reduced. Therefore, Lux-Valve is expected to become an important treatment means for tricuspid insufficiency in the future.
The existing transcatheter interventional instruments are all operated by hands, and operators need to adjust the operation of the instruments according to different operation approaches, patient positions and disease severity. The handheld instrument influences the accuracy of operating instruments of an operator to a certain extent and increases the operation risk. Especially in transcatheter interventional manual tricuspid Valve replacement, the pericardium, heart and right atrium are exposed through the axillary midline horizontal intercostal incision, and the right atrium approach and tricuspid Valve annulus level are not in a straight line, so the front end of the catheter of the Lux-Valve delivery device is designed to be an angle-bending adjustable structure. Because the front end of the delivery catheter forms a certain angle with the delivery system, the moving direction of the hand-held instrument end of the operator and the moving direction of the front end of the catheter in the atrium are not on the same axis. Although this design is anatomically correct, when the operator needs to advance or retract the catheter tip horizontally at the valve annulus to determine the optimal valve release position, the hand-held operation is often difficult to grasp and 1-2 assistant is needed to assist the operation. If the operator directly conveys the front end of the catheter blindly along the end direction of the handheld instrument, the valve is likely to be not firmly fixed, serious complications such as displacement after release, paravalvular leakage, heart rupture and perforation and the like occur, and even the operation is directly failed. This disadvantage causes inconvenience to the surgeon and limits the widespread use of this technique.
SUMMERY OF THE UTILITY MODEL
In order to solve the problems, the utility model provides a universal stabilizer for an interventional instrument for heart valvulopathy, which is a stabilizer for an interventional instrument with an angled front end of a delivery catheter and a delivery system.
The technical scheme is as follows:
the utility model provides a general type heart valve disease intervenes apparatus stabilizer, includes base, plane rotary device, arm, slide rail, supporting platform, clamping jaw and can universal pivoted joint, connect plane rotary device on the base, plane rotary device connects the arm, and the arm extends and leaves plane rotary device can buckle and keep this shape, and the arm top is through one the joint slide rail slides in the slide rail and is provided with supporting platform, supporting platform is through another the joint clamping jaw.
The interventional therapy is a therapeutic method for delivering a artificial stent/valve to a human body lesion position through an interventional instrument delivery device and then withdrawing the delivery device so that the artificial stent/valve stays at the human body lesion position to replace the lesion human body tissue organ. The stabilizer is an interventional instrument conveying device for assisting in treating various heart valvular diseases, and the specific using steps are as follows: firstly, a stabilizer is placed at a proper position of an operating table; secondly, detaching the supporting platform with the clamping jaws from the slide rail, adjusting the angles of the clamping jaws, and placing the conveying device of the interventional instrument into the clamping jaws; thirdly, adjusting the azimuth height of the rest part of the stabilizer, and adjusting the height of the slide rail to a position suitable for loading the supporting platform; and fourthly, loading the supporting platform on the sliding rail and continuing the operation. The position of the clamping jaw moving on the sliding rail is adjusted in the operation process, and the artificial support/valve is slowly released after the position is satisfied. The stabilizer can assist an operator in stabilizing an interventional instrument in an interventional operation, and avoids errors caused by handheld operation of the operator. Particularly in the artificial tricuspid Valve replacement by applying the Lux-Valve through a duct, the front end of the duct of the Lux-Valve conveying device is a structure which can be bent by adjusting the angle, and the front end of the conveying duct and the end of the clamping jaw clamping conveying duct form a certain angle. The stabilizer can lead the motion direction of the clamping jaw for clamping the catheter end to be consistent with the bending direction of the front end of the catheter, thereby helping a surgeon to control an interventional instrument, completing the conveying and releasing of the artificial tricuspid valve and improving the efficiency and the accuracy of the operation.
Further, the slide rail includes that the guide rail puts up and the screw thread guide rail on the guide rail frame, and the arm top is through one articulate in the below of the one end of guide rail frame, guide rail frame one end is the blind end, and the other end is the end of can opening, and the screw thread guide rail erects between blind end and the end of can opening, supporting platform offers the screw thread guide slot that is used for passing the screw thread guide rail, and screw thread guide slot matches each other and is used for realizing that the one end of screw thread guide rail is close to on the screw thread guide rail and keep away from this one end when rotating. The utility model provides a specific slide rail structure, wherein the slide rail is integrally designed to be hollow, one end of the slide rail is connected to a joint, the other end of the slide rail is a far end, the slide rail is designed to be open, a threaded guide rail is matched with a threaded guide groove of a supporting platform in shape, and the supporting platform can move back and forth on the threaded guide rail by rotating the threaded guide rail. The purpose of the open design of the other end of the guide rail frame is as follows: in the operation, the supporting platform is taken down from the slide rail, and the angle of the clamping jaw is adjusted according to the bending angle of the conveying device of the interventional instrument; and loading the clamping jaw and the supporting platform connected with the interventional instrument conveying device onto the sliding rail, and then carrying out subsequent operation. The openable design is convenient for taking down and installing.
Furthermore, two cylindrical guide rails are erected between the closed end and the openable end, the cylindrical guide rails are separately arranged on two sides of the threaded guide rails, and a circular groove used for penetrating through the cylindrical guide rails and matched with the cylindrical guide rails is formed in the supporting platform. The supporting platform performs back-and-forth motion on the threaded guide rail and the two cylindrical guide rails, the cylindrical guide rails on the two sides are mainly used for avoiding the supporting platform from shifting in the movement of the threaded guide rail and limiting the moving direction of the supporting platform, so that the moving route is more accurate, and errors are reduced.
Further, one end of the threaded guide rail is connected with a manual knob. The supporting platform can move back and forth on the threaded guide rail and the cylindrical guide rail by rotating the manual knob, and the stabilizer is more convenient to use due to the arrangement of the manual knob.
Further, the guide rail frame realizes the opening and closing of one side of the openable end through a rotating device. The clamping jaw and the supporting platform are used for unloading or loading in the opening state, and the supporting platform moves back and forth on the threaded guide rail and the two cylindrical guide rails in the closing state.
Further, the clamping jaw includes clamping jaw mount pad and left clamping jaw and the right clamping jaw that sets up in opposite directions, sets up the spring in the clamping jaw mount pad, left side clamping jaw, right clamping jaw are fixed in clamping jaw mount pad both sides through the spring respectively, supporting platform passes through joint connection clamping jaw mount pad. The two ends of the clamping jaw are of pop-up structures so as to adapt to instruments with different diameters, and springs are arranged in the clamping jaw so as to adjust tension when the clamping jaw is opened.
Further, but universal pivoted joint includes spherical joint, lock sleeve, screw locking device and go-between, spherical joint includes spheroid and the connecting axle of connection on the spheroid, the lock sleeve forms left locking portion and right locking portion, the outside surface of left side locking portion and right locking portion is equipped with screw locking device, and when locking the spheroid, through operating screw locking device, make left locking portion and right locking portion draw close each other and tighten up inwards, hold tightly, paste on the surface of spheroid level great circle top or below, the connecting axle is with the go-between block at the spherical other end of lock sleeve holding tightly, and the arm top is connected one the lock sleeve of joint, the slide rail is connected to the go-between of joint, and supporting platform connects another the go-between of joint, the clamping jaw mount pad is connected to the locking sleeve of joint. The utility model provides a specific joint structure, which realizes universal rotation through a ball body, and locks the ball body through a screw locking device and a locking sleeve. One joint is arranged between the mechanical arm and the sliding rail and used for adjusting the inclination angle of the sliding rail, the other joint is arranged between the supporting platform and the clamping jaw and used for adjusting the angle of the clamping jaw, and after the angles are adjusted, the screw locking device is operated to lock the spherical state at the angle.
Further, the mechanical arm comprises a first joint shaft, a main mechanical arm, a second joint shaft, an auxiliary mechanical arm and a third joint shaft which are sequentially connected, the first joint shaft is connected to the plane rotating device, and the third joint shaft is connected to the locking sleeve. The first joint shaft realizes shoulder rotation motion, so that the overall height of the stabilizer can be adjusted preliminarily. The second joint axis realizes the elbow turning motion, and the height of the stabilizer can be further adjusted. The third joint axis enables "pitch" motion to fine tune the height and orientation of the stabilizer.
Further, be connected with basement fixing device on the base, basement fixing device includes two outer splint and two inlayer splint, and two outer splint set up in base one side in opposite directions, are equipped with fastening screw on the outer splint respectively, fastening screw connects inlayer splint for adjust the centre gripping elasticity of inlayer splint. A hollow part is formed between the inner layer clamping plates and used for penetrating through a railing of the operating bed, and the depth of the hollow part is adjusted through the fastening screws so as to adapt to different diameters and sizes of operating beds with different models and specifications.
Furthermore, angle scale marks are arranged on the plane rotating shaft device, the first joint shaft, the second joint shaft, the third joint shaft and the connecting ring connected with the supporting platform. The angle scale mark is arranged, so that the proper angle can be conveniently selected for fixation, and the accuracy of the operation is enhanced.
Compared with the prior art, the universal heart valvulopathy intervention instrument stabilizer has the advantages that an operator can be assisted in an intervention operation to stabilize an intervention instrument, especially the motion direction of the instrument is consistent with the bending direction of the front end of the catheter in the Lux-Valve transcatheter tricuspid Valve replacement operation, so that the operator is helped to control the intervention instrument, the delivery and the release of a prosthetic Valve are completed, and the operation efficiency and the accuracy are improved.
Drawings
Fig. 1 is a first structural schematic diagram of the universal heart valvulopathy interventional device stabilizer of the utility model.
Fig. 2 is a second structural schematic diagram of the universal heart valvulopathy interventional device stabilizer of the utility model.
Fig. 3 is a third schematic structural diagram of the universal stabilizer for an interventional instrument for valvular diseases of the utility model.
Fig. 4 is an exploded view of the slide rail and the jaw platform moving thereon.
Fig. 5 is an exploded view of the joint between the robot arm and the slide rail.
Fig. 6 is an exploded view of the movable device on the slide rail.
FIG. 7 is an exploded view of the substrate holder.
Fig. 8 is a Lux valve release flow.
The robot comprises a base 1, a plane rotation device 2, a robot arm 3, a first joint shaft 31, a main robot arm 32, a second joint shaft 33, an auxiliary robot arm 34, a third joint shaft 35, a robot arm mounting seat 36, a slide rail 4, a guide rail frame 41, a threaded guide rail 42, a cylindrical guide rail 43, a manual knob 44, a rotating device 45, a supporting platform 5, a threaded guide groove 51, a circular groove 52, a clamping jaw 6, a left clamping jaw 61, a right clamping jaw 62, a clamping jaw mounting seat 63, a spring 64, a joint 7, a spherical joint 71, a sphere 711, a connecting shaft 712, a locking sleeve 72, a left locking part 721, a right locking part 722, a screw locking device 73, a connecting ring 74, a transition connecting piece 8, a substrate fixing device 9, an outer clamping plate 91, an inner clamping plate 92 and a fastening screw 93.
Detailed Description
The following are specific embodiments of the present invention and are further described with reference to the drawings, but the present invention is not limited to these embodiments.
As shown in fig. 1 to 3, a universal stabilizer for an interventional instrument for valvular heart disease comprises a base 1, a planar rotation device 2, mechanical arms 3, a sliding rail 4, a support platform 5, a clamping jaw 6 and a joint 7 capable of universally rotating, wherein the planar rotation device 2 is connected to the base 1, the planar rotation device 2 is connected to the mechanical arms 3, the mechanical arms 3 extend away from the planar rotation device 2 and can be bent to maintain the shape, the top ends of the mechanical arms 3 are connected to the sliding rail 4 through one joint 7, the support platform 5 is slidably arranged in the sliding rail 4, and the support platform 5 is connected to the clamping jaw 6 through the other joint 7.
The interventional therapy is a therapeutic method for delivering a artificial stent/valve to a human body lesion position through an interventional instrument delivery device and then withdrawing the delivery device so that the artificial stent/valve stays at the human body lesion position to replace the lesion human body tissue organ. The stabilizer is an interventional instrument conveying device for assisting in treating various heart valvular diseases, and the specific using steps are as follows: firstly, a stabilizer is placed at a proper position of an operating table; secondly, detaching the supporting platform 5 with the clamping jaw 6 from the slide rail 4, adjusting the angle of the clamping jaw 6, and placing the interventional instrument conveying device into the clamping jaw 6; thirdly, adjusting the azimuth height of the rest part of the stabilizer, and adjusting the height of the slide rail 4 to a position suitable for loading the supporting platform 5; the fourth step loads the support platform 5 onto the slide 4 and continues the surgical operation. The position of the clamping jaw 6 moving on the sliding rail 4 is adjusted during the operation, and the artificial stent/valve is slowly released after the position is satisfied. The stabilizer can assist an operator in stabilizing an interventional instrument in an interventional operation, and avoids errors caused by handheld operation of the operator. Particularly in the artificial tricuspid Valve replacement by applying the Lux-Valve transcatheter, the front end of the catheter of the Lux-Valve delivery device is a structure which can be bent by adjusting the angle, and the front end of the delivery catheter and the end of the clamping jaw clamping delivery catheter form a certain angle. The stabilizer can lead the motion direction of the clamping jaw 6 for clamping the catheter end to be consistent with the bending direction of the front end of the catheter, thereby helping a surgeon to control an interventional instrument, completing the conveying and releasing of the artificial tricuspid valve and improving the efficiency and the accuracy of the operation.
Referring to fig. 4, the slide rail 4 includes a rail bracket 41, and a threaded rail 42 and two cylindrical rails 43 on the rail bracket 41. One end of the guide rail frame 41 is a closed end, the other end 42 is an openable end, the threaded guide rail 42 and the two cylindrical guide rails 43 are erected between the closed end and the openable end, and the cylindrical guide rails 43 are arranged on two sides of the threaded guide rail 42 in a separated mode. The support platform 5 is provided with a threaded guide slot 51 for passing through the threaded guide rail 42 and a circular groove 52 for passing through the cylindrical guide rail 43. The threaded guide 42 and the threaded guide slot 51 are matched with each other for enabling the support platform 5 to approach and depart from one end of the threaded guide 42 when the one end of the threaded guide 42 is rotated. The cylindrical guide rail 43 and the circular groove 52 are matched with each other, so that the support platform 5 is prevented from moving on the threaded guide rail 42 to generate deviation, the moving direction of the support platform 5 is limited, the moving route is more accurate, and errors are reduced. The purpose of the openable design of the other end of the rail holder 42 is: in the operation, the supporting platform 5 is taken down from the slide rail 4, the angle of the clamping jaw 6 is adjusted according to the bending angle of the interventional device conveying device, the clamping jaw 6 and the supporting platform 5 which are connected with the interventional device conveying device are loaded on the slide rail 4, and then follow-up operation is carried out. The openable design is convenient for taking down and installing. Specifically, the rail bracket 41 realizes opening and closing of the openable end side by the rotating device 45.
Preferably, one end of the threaded rail 42 is connected to a manual knob 44. The support platform 5 can move back and forth on the threaded guide 42 and the cylindrical guide 43 by rotating the manual knob 44, and the stabilizer is more convenient to use due to the arrangement of the manual knob 44.
Fig. 1 to 3 show a schematic structural view of the assembled slide rail 4 and the support platform 5 shown in fig. 4, wherein the slide rail 4 is integrally hollow, one end of the slide rail is connected to the joint 7, and the other end of the slide rail is a far end and is open. This has the effect that the back and forth movement of the support platform 5 on the threaded rail 42 and the cylindrical rail 43 can be achieved by rotating the manual knob 44.
As shown in fig. 1 to 3, the top end of the robot arm 3 is connected below one end of the rail frame 41 through one of the joints 7. Fig. 5 is a schematic structural view of the joint 7. The universal rotating joint 7 comprises a spherical joint 71, a locking sleeve 72, a screw locking device 73 and a connecting ring 74, wherein the spherical joint 71 comprises a sphere 711 and a connecting shaft 712 connected to the sphere 711, the locking sleeve 72 forms a left locking portion 721 and a right locking portion 722, the screw locking device 73 is arranged on the outer side surfaces of the left locking portion 721 and the right locking portion 722, when the sphere 711 is locked, the screw locking device 73 is operated to enable the left locking portion 721 and the right locking portion 722 to be drawn close to each other and tightened inwards to be clasped and attached to the surface below the horizontal great circle of the sphere 711, and the connecting shaft 712 and the connecting ring 74 are clamped on the surface above the horizontal great circle of the sphere 711, namely the locking sleeve 72 clasps the other end of the sphere 711. In the operation process of the stabilizer of the utility model, universal free rotation is realized through the ball 711, and the screw locking device 73 is operated to lock the state of the ball 711 at the angle after the angle is adjusted.
As shown in fig. 6, the clamping jaw 6 includes a clamping jaw mounting base 63, and a left clamping jaw 61 and a right clamping jaw 62 which are oppositely disposed, a spring 64 is disposed in the clamping jaw mounting base 63, and the left clamping jaw 61 and the right clamping jaw 62 are respectively fixed at two sides of the clamping jaw mounting base 63 through the spring 64. The two ends of the clamping jaw 6 are in pop-up structures to adapt to instruments with different diameter sizes, and the clamping jaw 6 is internally provided with a spring to adjust the tension when the clamping jaw is opened.
As shown in fig. 7, a transition piece 8 is disposed on the support platform 5, and the transition piece 8 is connected to the jaw mounting base 63 through the joint 7. The left and right locking portions 721, 722 draw together and tighten inward, clasping, and adhering to the surface of the sphere 711 above the horizontal great circle. The connecting shaft 712 and the connecting ring 74 are engaged with the surface of the ball 711 below the horizontal great circle. The connecting ring 74 at the position is provided with angle scale marks, so that the proper angle of the clamping jaw 6 can be conveniently selected, and the accuracy of the operation is enhanced.
As shown in fig. 1 to 3, the robot arm 3 includes a first joint shaft 31, a main robot arm 32, a second joint shaft 33, an auxiliary robot arm 34, and a third joint shaft 35, which are connected in sequence, the first joint shaft 31 is connected to the planar rotation device 2 through a robot arm mounting base 36, and the third joint shaft 35 is connected to a locking sleeve 72. The first joint shaft 31 can realize shoulder turning motion to primarily adjust the overall height of the stabilizer. The second articulation axis 33 enables a "toggle" motion, which further allows for adjustment of the stabilizer height. The third joint axis 35 enables a "pitch" movement which allows fine adjustment of the height and orientation of the stabilizer. The plane rotating shaft device 2, the first joint shaft 31, the second joint shaft 33 and the third joint shaft 34 are provided with angle scale marks, so that the fixing at a proper angle is convenient to select, and the accuracy of the operation is enhanced.
As shown in fig. 7, the base 1 is connected with a base fixing device 9, the base fixing device 9 includes two outer layer clamping plates 91 and two inner layer clamping plates 92, the two outer layer clamping plates 91 are oppositely disposed on one side of the base, the outer layer clamping plates 91 are respectively provided with a fastening screw 93, and the fastening screw 93 is connected with the inner layer clamping plates 92 for adjusting clamping tightness of the inner layer clamping plates 92. A hollow part is formed between the inner layer clamping plates 92 and is used for penetrating through a railing of the operating bed, and the depth of the hollow part is adjusted through the fastening screws 93 so as to adapt to different diameters and sizes of operating beds with different models and specifications. Preferably, the inner layer clamp plate 92 is C-shaped in cross-section. Since the cross-section of the rails of the operating bed is mostly circular, the inner clamping plates 92 of the C-shaped cross-section help to clamp and fix.
For convenience of description, a position close to the operator is hereinafter defined as a proximal end, and a position far from the operator is hereinafter defined as a distal end. The present design will now be described in detail with reference to the use of a Lux-Valve artificial tricuspid Valve replacement. In the design implementation, firstly, with the assistance of CT radiography and a 3D printing model of the heart of a patient, an operator confirms the angle between the right atrium approach and the tricuspid valve annulus. Adjusting the operating rod of the interventional device before or during the operation bends the front end of the delivery sheath by a corresponding angle, which is shown as an angle a in fig. 8. In the present exemplary embodiment, 30 ° is taken as an example, and the following is the same.
In a first step, the "fixed stabilizer" fixes the stabilizer in place on the operating table by means of the base fixture 9.
In the second step, the "angle adjustment, clamping instrument" removes the support platform 5 and the devices above it from the stabilizer, and the rotary joint 7 performs the angle adjustment to align the angular groove of the connection ring 74 with 30 °. The screw locking means 73 of the joint 7 is adjusted and tightened. The two sides of the clamping jaw 6 are pulled apart to be adjusted to the position for clamping the instrument, so that the instrument can be clamped without loosening.
In a third step, the "height adjusted, ready to load" adjustment of the stabilizer's respective joint axes to bring the stabilizer into proper orientation. And adjusting the third joint shaft 35 of the mechanical arm 3 and the joint 7 at the top of the mechanical arm to enable the inclination of the sliding rail 4 to accord with the positions of the instrument and the clamping jaw, and screwing a screw locking device 73 of the joint 7. Preferably, the main mechanical arm 32 and the auxiliary mechanical arm 34 of the stabilizer far end opposite to the operating table or the mechanical arm 3 are positioned at one side of the body of the operator so as to reserve an operating space for the operator.
And step four, loading the supporting platform 5 and the devices above the supporting platform on the slide rail 4 for debugging.
And fifthly, confirming that the long axis direction of the slide rail 4 is consistent with the front end direction of the catheter bent by 30 degrees under the condition of completing debugging and continuing surgery by the screw locking device 73 of the joint 7 at the lower part of the slide rail 4 under the assistance of ultrasound or radiography. As indicated by arrow B shown in fig. 8. If the directions are consistent, the operation can be continued; if the directions are not consistent, the joints 7 and the rest joint shafts of the mechanical arm 3 are readjusted until the directions and angles are satisfied. At this point the stabilizer of the present invention is fully secured and the surgical and delivery catheter is ready for use.
Sixth step, the general operation process: the patient is anesthetized by tracheal intubation, placed with esophageal ultrasound, and placed in position by extracorporeal circulation. The surgical incision was intended to be a fourth intercostal incision, antero-lateral (incision about 5-8 cm). And (4) sewing the double pouches of the right atrium. The delivery device is implanted through the right atrial incision. Under the guidance of X rays and ultrasound, an operator moves the tip end of the delivery catheter through the sliding rail 4 of the stabilizer of the utility model to pass through the tricuspid orifice, and positions the posterior valve annulus of the tricuspid valve according to a positioning method. Under X-ray fluoroscopy, the manual knob 44 on the rotary slide rail 4 adjusts the position of the catheter. Slowly releasing the artificial tricuspid valve after the position is satisfied, hooking the anterior valve ring by the anterior valve leaf holder, enabling the anchoring device to be parallel to the ventricular septum, enabling the anchoring needle to be vertical to the ventricular septum, and pushing the anchoring needle to fix the anchor. The transporter is withdrawn, hemostasis is taken in the right atrium, and tricuspid valve function is evaluated ultrasonically. Close the chest, return to the ward.
In conclusion, the universal heart valvulopathy interventional instrument stabilizer can assist a surgeon in stabilizing interventional instruments in interventional operations, and particularly can ensure that the motion direction of the instrument is consistent with the bending direction of the front end of a catheter in the Lux-Valve transcatheter tricuspid Valve replacement operation, so that the surgeon is helped to control the interventional instruments, the delivery and the release of artificial valves are completed, and the operation efficiency is improved.
The specific embodiments described herein are merely illustrative of the spirit of the utility model. Various modifications or additions may be made to the described embodiments or alternatives may be employed by those skilled in the art without departing from the spirit or ambit of the utility model as defined in the appended claims.
Claims (10)
1. The utility model provides a general type heart valvular disease intervenes apparatus stabilizer, its characterized in that, includes base (1), plane rotary device (2), arm (3), slide rail (4), supporting platform (5), clamping jaw (6) and can universal pivoted joint (7), connecting plane rotary device (2) on base (1), arm (3) are connected in plane rotary device (2), and arm (3) extend to leave plane rotary device (2) can buckle and keep this shape, and arm (3) top is through one slide rail (4) are connected in joint (7), slide in slide rail (4) and be provided with supporting platform (5), supporting platform (5) are through another clamping jaw (6) are connected in joint (7).
2. The stabilizer of the universal heart valve intervention instrument according to claim 1, wherein the slide rail (4) comprises a guide rail frame (41) and a threaded guide rail (42) on the guide rail frame (41), the top end of the mechanical arm (3) is connected below one end of the guide rail frame (41) through one joint (7), one end of the guide rail frame (41) is a closed end, the other end of the guide rail frame is an openable end, the threaded guide rail (42) is erected between the closed end and the openable end, the support platform (5) is provided with a threaded guide groove (51) for passing through the threaded guide rail (42), and the threaded guide rail (42) and the threaded guide groove (51) are matched with each other to enable one end of the threaded guide rail (42) to approach and be away from the one end of the support platform (5) on the threaded guide rail (42) when the one end of the threaded guide rail (42) rotates.
3. The stabilizer for a universal valvular heart disease interventional instrument according to claim 2, characterized in that two cylindrical guide rails (43) are further erected between the closed end and the openable end, the cylindrical guide rails (43) are separately arranged at two sides of the threaded guide rail (42), and a circular groove (52) matched with the cylindrical guide rails (43) is arranged on the supporting platform (5) and used for penetrating through the cylindrical guide rails (43).
4. The universal valvular heart disease interventional instrument stabilizer according to claim 2, wherein one end of the threaded guide (42) is connected to a manual knob (44).
5. The universal valvular heart disease interventional instrument stabilizer according to claim 3, wherein the rail holder (41) is opened and closed on the openable end side by a rotating device (45).
6. The stabilizer of the universal heart valve intervention instrument of claim 1, wherein the clamping jaw (6) comprises a clamping jaw mounting seat (63) and a left clamping jaw (61) and a right clamping jaw (62) which are oppositely arranged, a spring (64) is arranged in the clamping jaw mounting seat (63), the left clamping jaw (61) and the right clamping jaw (62) are respectively fixed on two sides of the clamping jaw mounting seat (63) through the spring (64), and the supporting platform (5) is connected with the clamping jaw mounting seat (63) through the joint (7).
7. The stabilizer of the universal heart valve intervention instrument as claimed in any one of claims 1 to 6, wherein the universal rotatable joint (7) comprises a spherical joint (71), a locking sleeve (72), a screw locking device (73) and a connecting ring (74), the spherical joint (71) comprises a sphere (711) and a connecting shaft (712) connected to the sphere (711), the locking sleeve (72) forms a left locking portion (721) and a right locking portion (722), the screw locking device (73) is arranged on the outer side surfaces of the left locking portion (721) and the right locking portion (722), when the sphere (711) is locked, the left locking portion (721) and the right locking portion (722) are held close to each other and tightened inward and tightly pressed on the surface above or below the horizontal great circle of the sphere (711) by operating the screw locking device (73), connecting axle (712) and go-between (74) block are at the other end that lock sleeve (72) held ball (711) tightly, and one is connected on arm (3) top lock sleeve (72) of joint (7), slide rail (4) are connected in go-between (74) of joint (7), and support platform (5) are connected another joint's go-between (74), clamping jaw mount pad (63) is connected in lock sleeve (72) of joint (7).
8. The universal heart valvulopathy interventional instrument stabilizer according to claim 7, wherein the mechanical arm (3) comprises a first joint shaft (31), a main mechanical arm (32), a second joint shaft (33), an auxiliary mechanical arm (34) and a third joint shaft (35) which are connected in sequence, the first joint shaft (31) is connected to the planar rotation device (2), and the third joint shaft (35) is connected to the locking sleeve (72).
9. The stabilizer of the universal heart valve intervention instrument of claim 1, wherein a base fixing device (9) is connected to the base (1), the base fixing device (9) comprises two outer layer clamping plates (91) and two inner layer clamping plates (92), the two outer layer clamping plates (91) are oppositely arranged on one side of the base (1), fastening screws (93) are respectively arranged on the outer layer clamping plates (91), and the fastening screws (93) are connected with the inner layer clamping plates (92) and used for adjusting the clamping tightness of the inner layer clamping plates (92).
10. The universal valvular heart disease interventional instrument stabilizer according to claim 8, wherein angle scale marks are arranged on the plane rotation device (2), the first joint shaft (31), the second joint shaft (33), the third joint shaft (35) and the connecting ring (74) connected with the support platform (5).
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