CN218589059U - Left auricle suturing device for transfemoral vein access intervention operation - Google Patents

Abstract

The application discloses intervene operation through femoral vein approach and use left auricle suturing device, sew up left auricle portion, the cerebral infarction that the prevention atrial fibrillation arouses takes place, belong to the wicresoft and intervene technical field, including carrying sheath and operating handle, operating handle even has transport assembly, carry the sheath to pass through the room interval through femoral vein approach and reach left auricle portion, transport assembly reachs left auricle portion through carrying the sheath, transport assembly includes banding transport, the one end and the operating handle of piece are connected to the strip, in order to carry the piece bending and flexible through operating handle independent control, be equipped with the suture silk in the transport, it even has the suture to collude to sew up the silk tip, it colludes the tip that is located the transport that corresponds to sew up. Not only the suture of the left auricle is completed without the thoracotomy, but also no implant is left in the body after the suture material is degraded; the operation is carried out under the ultrasonic real-time monitoring in the heart cavity, so that the accurate operation of the operation can be realized, and the occurrence of complications is reduced.

Description

Left auricle suturing device for transfemoral vein access intervention operation

Technical Field

The utility model belongs to the technical field of intervene the wicresoft and sew up, especially, relate to a intervene operation through femoral vein approach and use left atrial appendage suture device.

Background

Currently, the complication of cerebral infarction caused by atrial fibrillation is widely noticed and regarded by clinicians, and the cause of the complication is left atrial appendage thrombus. The left auricle is a long, narrow and curved blind end structure extending forwards and downwards along the front side wall of the Left Atrium (LA), and due to the blind end structure, when atrial fibrillation occurs, the atrium is out of function and irregular in beating, blood in the atrium easily forms vortex at the mouth of the left auricle, so that the blood flows slowly in the left auricle and easily forms thrombus, and the thrombus falls off to cause complications such as cerebral infarction, acute occlusion of lower limb arteries, mesenteric embolism and the like. In order to prevent complications caused by atrial fibrillation, reduce the hospitalization rate of patients and the like, the prior art means comprises open chest left atrial appendage suture, minimally invasive intervention left atrial appendage occlusion and the like. The thoracotomy of the left auricle needs to be performed, which causes great trauma to the patient. The implementation steps of the existing minimally invasive intervention plugging operation generally comprise that a conveying sheath is inserted into a body from the outside of the body along a blood vessel in a mode of pre-inserting the conveying sheath, the end part of the conveying sheath is positioned outside the entrance of a left auricle, then an alloy plugging umbrella device is fixed at the end part of a strip-shaped conveying piece, the conveying piece is extended into the conveying piece along the conveying sheath, and the alloy plugging umbrella device is conveyed to the opening part of the left auricle to implement plugging; in addition, after the left auricle is blocked, no blood enters or exits and no nutrition exists, the left auricle has the possibility of atrophy, and once the left auricle is shrunken, the blocking umbrella implanted in the body can bring disadvantages to the heart and the human body due to the weak wall of the auricle; moreover, although percutaneous left atrial appendage occlusion is safe and effective, there are complications that occur, such as: pericardial effusion, occluder embolism, occluder-related thrombosis, and the like.

Disclosure of Invention

The application aims to provide a left auricle suturing device for suturing the mouth of a left auricle through femoral vein access, and solves the risk that an implanted umbrella is permanently left on a human body to cause the falling and displacement of the umbrella in the existing left auricle interventional occlusion; and adverse effects of the umbrella on the heart and human body caused by left auricle injury after atrophy; and avoids the complications associated with percutaneous left atrial appendage occlusion.

The embodiment of the application provides a through femoral vein access minimally invasive intervention operation is with left atrial appendage suture device, including carrying sheath and operating handle, operating handle even has transport assembly, and transport assembly can pass and carry the sheath, transport assembly includes banding transport piece, and the one end and the external operating handle of banding transport piece are connected, in order to pass through operating handle independent control transport piece is crooked and flexible, is equipped with the suture silk in the transport piece, and the suture silk tip even has the suture to collude, and the suture is located the tip of corresponding transport piece, coats the medicine that is favorable to endothelial hyperplasia on the suture silk, leave in advance between transport assembly and the transport sheath inner wall and assist the clearance, assist clearance intercommunication left atrial appendage mouth portion and patient external;

the left auricle suturing device further comprises a mouth restraining component and a thread cutting component, wherein the mouth restraining component and the thread cutting component reach the working position of the mouth restraining component and the thread cutting component through the conveying sheath.

Optionally, the tying assembly comprises a tying knot, a boosting member and a rope pulling member, the tying assembly is sent to the outside of the suture thread along the transmission sheath by the transmission rod, and the boosting member is used for pushing the tying knot to move along the length direction of the transmission assembly.

Optionally, the boosting member is a sleeve, and the boosting member is slidably sleeved outside the root suture thread and located at the far end of the collar.

Optionally, the thread trimming structure is arranged at the far end of the boosting member close to the orifice ring.

Optionally, the thread trimming mechanism comprises a fixed knife and a shearing knife, the shearing knife is connected with a power mechanism, the power mechanism is connected with an operating end, and the operating end is located outside the body of the patient.

Optionally, the operating end is arranged on the operating handle.

Optionally, the thread trimming mechanism includes a thread trimming handle, the thread trimming handle is connected with a strip-shaped thread trimming member, a fixed knife and a shearing knife are arranged at the end portion of the thread trimming member, the shearing knife is connected with a power mechanism, the power mechanism is connected with an operating end, and the operating end is arranged on the thread trimming handle.

Optionally, the suture hook comprises a central rod and a barb, one end of the central rod is connected with the corresponding suture thread, and the other end of the central rod is hinged to the barb.

Optionally, the suture hook comprises a central rod and a barb, one end of the central rod is connected with the corresponding suture thread, and the other end of the central rod is hinged to the barb.

Optionally, the suturing device is operated under intracardiac ultrasound monitoring.

One or more technical solutions in the embodiments of the present application have at least the following technical effects or advantages:

according to the left auricle suturing device for the transfemoral vein access interventional minimally invasive surgery, which is provided by the embodiment of the invention, the vessel wall is effectively protected by arranging the conveying sheath, and a safe operation space is formed in the conveying sheath; by arranging an operating handle and a conveying component, arranging the conveying component to comprise a strip-shaped conveying part, arranging a sewing wire in the conveying part, connecting a sewing hook at the end part of the sewing wire, extending the conveying component into a conveying sheath during sewing, controlling the directional bending of the conveying component by the operating handle in the process, preventing the conveying component from damaging blood vessels, respectively controlling the strip-shaped conveying part to extend by the operating handle after the end part of the conveying component extends out of an inner port of the conveying sheath, enabling the conveying part to be positioned at the inner side of a left atrial appendage ostium part, respectively controlling the strip-shaped conveying part to be bent outwards in an umbrella shape by the operating handle, respectively enabling the end part of the strip-shaped conveying part to be tightly attached to the endocardium peripheral wall of the left atrial appendage ostium part until the sewing hook hooks the inside of the myocardium of the left atrial appendage ostium part, then shortening the conveying component by the operating handle, driving the sewing wire to be tensioned, and determining the closing of the left atrial appendage ostium part under the ultrasonic monitoring in a heart cavity; through reserving the auxiliary clearance and setting up the binding assembly and cutting line subassembly, after left auricle portion closure, stretch into the binding assembly through the auxiliary clearance earlier, utilize the binding assembly to tighten many taut sewing wires, then take out the binding assembly, stretch into the cutting line subassembly, cut off unnecessary sewing wires, finally withdraw from the conveyor components and can. The device does not need to be placed into an occlusion device, and the risk that the occlusion device is implanted into a body to cause displacement, falling and the like is overcome from the source.

Drawings

In order to more clearly illustrate the technical solutions in the embodiments of the present application, the drawings needed to be used in the description of the embodiments are briefly introduced below, and it is obvious that the drawings in the following description are some embodiments of the present application, and it is obvious for those skilled in the art to obtain other drawings based on these drawings without creative efforts.

Fig. 1 is a schematic view of a left atrial appendage suturing device provided in example 1 of the present application in a pre-suturing state;

FIG. 2 is a schematic view of the left atrial appendage suture device provided in example 1 of the present application after the suture filaments have been tensioned;

FIG. 3 is a schematic view of a tying knot of a left atrial appendage suture apparatus provided in example 1 of the present application pushed up and tightened;

fig. 4 is a schematic view of a left atrial appendage suture device provided in embodiment 1 of the present application after cutting suture filaments;

fig. 5 is a schematic view of a suture hook of a left atrial appendage suture device provided in example 1 of the present application;

FIG. 6 is a schematic view of the left atrial appendage suture device provided in example 2 of the present application after tensioning of the suture filaments;

fig. 7 is a schematic view of the suturing device for the left atrial appendage shown after the suturing ring is pushed up in example 2;

fig. 8 is a schematic view of a left atrial appendage suture device provided in embodiment 2 of the present application after cutting suture filaments;

fig. 9 is a schematic view of a cutting blade of a left atrial appendage suturing device provided in example 2 of the present application in an initial state;

fig. 10 is a schematic view of the left atrial appendage suture device provided in example 2 of the present application with the cutting blade in proximity to the stationary blade.

Reference numerals:

1-a delivery sheath; 2-operating a handle; 3-auxiliary clearance; 10-a transport; 20-suture thread; 21-sewing hook; 211-a center pole; 212-barbs; 30-a collar; 31-a boosting part; 32-tying knot; 40-fixing the knife; 41-shearing knife.

Detailed Description

The technical solutions in the embodiments of the present application will be described clearly and completely with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only a part of the embodiments of the present application, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application.

Example 1

Referring to fig. 1 to 5, the present embodiment provides a left atrial appendage suture device, the suture device works under real-time monitoring of intracardiac ultrasound, and the suture device includes a delivery sheath 1 and an operating handle 2, the operating handle 2 is connected with a delivery assembly, the delivery assembly can pass through the delivery sheath 1, the delivery assembly includes a plurality of strip-shaped delivery members 10, one end of each delivery member 10 is connected with the operating handle 2, so as to independently control bending and stretching of each delivery member 10 through the operating handle 2, a suture thread 20 is arranged in the delivery member 10, a suture hook 21 is connected to an end of the suture thread 20, and the suture hook 21 is located at an end of the corresponding delivery member 10; an auxiliary gap 3 is reserved between the conveying assembly and the inner wall of the conveying sheath 1, and the auxiliary gap 3 is communicated with the left auricle part and the outside of the patient body; the left auricle suturing device further comprises a mouth binding assembly and a thread cutting assembly, wherein the mouth binding assembly and the thread cutting assembly can penetrate through the operation gap 3, an auxiliary gap 3 is reserved between the conveying assembly and the inner wall of the conveying sheath 1, the auxiliary gap 3 is communicated with the left auricle part and the outside of a patient, when the conveying piece 10 reaches the left auricle part through the conveying sheath, the strip-shaped conveying piece 10 is controlled in direction through an external handle, when the position is determined, the external control handle operates to eject a suturing thread 20 through the strip-shaped conveying piece 10 and prick the myocardial tissue of the auricle part, when the ultrasonic monitoring evaluation position in the auricle is appropriate, an ejecting suturing hook is ejected, and the suturing thread 20 is firmly clamped in the myocardial of the auricle part. Withdrawing the strip-shaped conveying member 10 to the outside of the body, and preparing to release the next sewing thread 20 and the next sewing hook 21. At least four suture threads 20 and suture hooks 21 are released, the position of the suture hooks 21 is evaluated to be proper by ultrasonic in the heart cavity, and the suture threads 20 and the suture hooks 21 are connected between the maximum radial lines of the heart ear calibers. At this time, the strip-like transfer member 10 for releasing the suture thread 20 and the suture hook 21 has already exited from the body. The suture thread 20 is pulled in vitro and the atrial appendage portion is ultrasonically monitored to be reduced to the minimum caliber in the heart cavity. Visualization of the left atrial appendage was not seen by transmission sheath angiography.

The conveying sheath 1 is arranged, so that the blood vessel wall is effectively protected, and a safe operation space is formed in the conveying sheath 1; by arranging the operating handle 2 and the conveying assembly, the conveying assembly comprises a plurality of conveying pieces 10, the conveying pieces 10 are internally provided with the sewing threads 20, the end parts of the sewing threads 20 are connected with the sewing hooks 21, the conveying assembly extends into the conveying sheath 1 during sewing, the directional bending of the conveying assembly is controlled by the operating handle 2 in the process to prevent the conveying assembly from damaging blood vessels, after the end parts of the conveying assembly extend out of the inner port of the conveying sheath 1, the conveying pieces are respectively controlled by the operating handle 2 to extend to be positioned at the inner side of the left atrial appendage, the conveying pieces 10 are respectively controlled by the operating handle 2 to be bent outwards in an umbrella shape, the end parts of the conveying pieces 10 are respectively close to the peripheral wall of the left atrial appendage until the sewing hooks 21 catch the inner wall of the left atrial appendage, then the conveying assembly is pulled back by shortening of the operating handle 2 to drive the sewing threads 20 to be tensioned, and the sewing threads 20 tension the left atrial appendage by the sewing hooks 21 to close the left atrial appendage; through reserving auxiliary gap 3 to set up and restraint mouthful subassembly and trimming subassembly, after left auricle portion is closed, stretch into the subassembly of restrainting mouthful earlier through auxiliary gap 3, utilize and restraint mouthful subassembly and tighten taut many sewing threads 20, then take out and restraint mouthful subassembly, stretch into trimming subassembly, cut unnecessary sewing threads 20, it can to take out the transport subassembly at last.

It should be noted that, the connection mode and the specific structure of the operation handle 2 and the delivery member 10 adopt any similar structure in the prior art, for example, the result of the minimally invasive interventional occlusion operation mentioned in the background art, or the result similar to the adjustable bent large end used in the cardiac electrophysiology, or the operation control device similar to the a, P, L, R bend in the direction of the ultrasonic control head end in the heart chamber, only needs to be able to control the bending and extension of the delivery member 10 through the operation handle 2, for example, the bending of the delivery member 10 can be completed by using a built-in rope, pulling the rope in a certain direction, the delivery member 10 is bent to the corresponding direction, and the extension of the delivery member 10 can be realized by using a telescopic tube structure. Other embodiments may employ other schemes known in the art and are not limited to the schemes mentioned herein.

For further explanation of the binding assembly, the binding assembly comprises a binding knot 32, a boosting member 31 and a pulling rope member, the binding knot 32 is sleeved outside the conveying assembly, and the boosting member 31 is used for pushing the binding knot 32 to move along the length direction of the conveying assembly. Through setting up binding port knot 32, locate the conveying component with its cover outside, make it can slide along conveying component, through setting up boosting piece 31, stretch into supplementary clearance 3 with it, utilize it to promote binding port knot 32 and slide to being close to the department of sewing up along conveying component, through setting up the stay cord spare, realize binding port knot 32's taut.

It should be noted that the tying knot 32 may be any one of the existing knots, and only the sewing thread 20 needs to be tightly bound; the boosting member 31 can adopt any medical strip device capable of bending and stretching in the prior art, such as the operating handle 2 and the conveying member 10 in the application, and the extending end of the conveying member 10 is used for pushing the binding end knot 32; the pull rope part can adopt the same structure as the boosting part 32, and only a clamp is arranged at the extending end, and the tying end knot 32 is tightened by the clamp.

It should be noted that both suture filament 20 and tying knot 32 are degradable materials and have the property of being radiopaque.

For further explanation of the specific structure of the thread trimming mechanism, the thread trimming mechanism comprises a thread trimming handle (not shown), the thread trimming handle is connected with a strip-shaped thread trimming piece (not shown), the end part of the thread trimming piece is provided with a fixed knife 40 and a shearing knife 41, the shearing knife 41 is connected with a power mechanism, the power mechanism is connected with an operating end, and the operating end is arranged on the thread trimming handle. Through setting up thread trimming handle and thread trimming spare, analogize in operating handle 2 and conveying 10, through the crooked and flexible of thread trimming spare of thread trimming handle control to make thread trimming spare stretch into from supplementary clearance 3, bring in stationary knife 40 and shearing sword 41, drive through power unit and cut sword 41 and stationary knife 40 closed, cut unnecessary sewing silk 20.

In order to facilitate the hook 21 to hook the flesh wall of the left atrial appendage, the hook 21 includes a central rod 211 and a barb 212, one end of the central rod 211 is connected with the corresponding suture thread 20, and the other end is hinged to the barb 212. Through setting up well core rod 211, conveniently sew up colluding 21 and stretch into left atrial appendage intraorally, through setting up barb 212, adopt the mode of returning to close barb 212 and meat wall hook, articulated with barb 212 through setting up well core rod 211, the angle of adjustment by oneself of convenient pull-back in-process prevents the unhook that the angle is improper to result in.

In order to effectively monitor the whole operation process and facilitate the smooth operation of all the operations, an intracardiac ultrasonic device (not shown) is also included.

Example 2

Referring to fig. 6 to 10 on the basis of embodiment 1, this embodiment provides a left atrial appendage suture device, which is a further optimization of embodiment 1, and the difference between this embodiment and embodiment 1 is only that:

the mouth tying assembly comprises a mouth tying ring 30 and a boosting part 31, the mouth tying ring 30 is hooped outside the conveying assembly, and the boosting part 31 is used for pushing the mouth tying ring 30 to move along the length direction of the conveying assembly. By providing the cinch ring 30, the cinch ring 30 has elasticity and self-contraction performance, and is pushed to the position close to the left atrial appendage by the boosting member 31, and falls from the outer wall of the conveying member 10 to the outer wall of the suture thread 20, so that the suture thread 20 is hooped by self-contraction, and the steps of the rope pulling member and the rope pulling in the embodiment 1 are omitted.

It should be noted that any degradable material with elasticity can be used for the collar 30.

In order to further optimize the structure of the pushing aid 31, the pushing aid 31 is a sleeve, and the pushing aid 31 is slidably sleeved outside the conveying assembly and is located at the distal end of the cuff ring 30. The position of the constricting ring is determined to be proper by ultrasonic monitoring in the heart cavity, and then the drawstring of the constricting ring is pulled outside the body to tighten the suture. The binding ring is designed to be a dead knot, can not be untied when being bound, and the ultrasonic in the heart cavity can clearly determine the position of the binding ring and determine the binding and locking of the suture thread. And exiting the bundle exit assembly transfer rod. The conveying rod sends the conveying sheath into the trimming structure, the space occupied by the boosting part 31 can be obviously reduced through the arrangement, and the conveying sheath can be self-adapted according to the bending degree of the conveying assembly in the process of pushing the conveying sheath to slide along the conveying assembly, so that the handle for controlling the boosting part 31 in the embodiment 1 is omitted.

In order to further optimize the space occupation of the thread trimming mechanism, the thread trimming mechanism is arranged at one end of the boosting member 31 close to the orifice ring 30.

The thread trimming mechanism comprises a fixed knife 40 and a shearing knife 41, the shearing knife 41 is connected with a power mechanism (not shown), the power mechanism is connected with an operating end (not shown), and the operating end is positioned outside the body of a patient.

Preferably, the operating end is provided on the operating handle 2.

It should be noted that the power mechanism may be any one of a medical hydraulic component and a pneumatic component, and only needs to be able to drive the shearing knife 41 to close to the fixed knife 40 and to shear with it.

Technical solutions between various embodiments may be combined with each other, but must be realized by those skilled in the art, and when the technical solutions are contradictory or cannot be realized, such a combination should not be considered to exist, and is not within the protection scope of the present application.

While embodiments of the present application have been shown and described, it will be understood by those of ordinary skill in the art that: numerous changes, modifications, substitutions and alterations can be made to the embodiments without departing from the principles and spirit of the application, the scope of which is defined by the claims and their equivalents.

Claims (8)

1. A left auricle suturing device for a transfemoral vein access interventional operation comprises a conveying sheath (1) and an operating handle (2), and is characterized in that the operating handle (2) is connected with a conveying assembly, the conveying assembly can penetrate through the conveying sheath (1), the conveying assembly comprises a strip-shaped conveying piece (10), one end of the strip-shaped conveying piece (10) is connected with the external operating handle (2) so as to independently control the bending and stretching of the conveying piece (10) through the operating handle (2), a suturing thread (20) is arranged in the conveying piece (10), a suturing hook (21) is connected to the end of the suturing thread (20), the suturing hook (21) is located at the end of the corresponding conveying piece (10), and the suturing thread is beneficial to coating of medicine for endothelial hyperplasia;

the left auricle suturing device also comprises a mouth restraining component and a thread cutting component, wherein the mouth restraining component and the thread cutting component reach the working position of the mouth restraining component and the thread cutting component through the conveying sheath; the thread trimming assembly is arranged at the far end of the boosting part (31) close to the orifice ring (30).

2. The left atrial appendage closure device of claim 1, wherein the cinch assembly comprises a cinch cord (32), a driver (31), and a pull cord member, wherein the cinch assembly is fed out of the suture filament (20) along the transfer sheath by the drive rod, and wherein the driver (31) is configured to drive the cinch cord (32) along the length of the feed assembly.

3. A left atrial appendage suture assembly as defined in claim 2, wherein said pushing member (31) is a cannula, and wherein said pushing member (31) is slidably disposed over at least 4 of said suture filaments (20) and is located at a distal end of said cinch ring (30).

4. The left atrial appendage suture device of claim 1, wherein the thread cutting assembly comprises a fixed knife (40) and a cutting knife (41), the cutting knife (41) is connected with a power mechanism, the power mechanism is connected with an operating end, and the operating end is located outside the body of a patient.

5. A left atrial appendage suturing device as defined in claim 4, wherein the operating end is provided on an operating handle (2).

6. The left atrial appendage suture device according to claim 1, wherein the thread cutting assembly comprises a thread cutting handle, the thread cutting handle is connected with a strip-shaped thread cutting piece, a fixed knife (40) and a shearing knife (41) are arranged at the end part of the thread cutting piece, the shearing knife (41) is connected with a power mechanism, the power mechanism is connected with an operating end, and the operating end is arranged on the thread cutting handle.

7. A left atrial appendage suturing device as defined in claim 1, wherein the suturing hook (21) comprises a central rod (211) and a barb (212), the central rod (211) being connected at one end to a corresponding suturing thread (20) and at the other end being hinged to the barb (212).

8. A left atrial appendage suturing device as in claim 1, wherein the suturing device operates under intracardiac ultrasound monitoring.

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