CN218922887U

CN218922887U - Valve forming device

Info

Publication number: CN218922887U
Application number: CN202123430423.1U
Authority: CN
Inventors: 周小彪
Original assignee: Individual
Current assignee: Individual
Priority date: 2021-12-30
Filing date: 2021-12-30
Publication date: 2023-04-28
Anticipated expiration: 2031-12-30

Abstract

The utility model discloses a valve forming device, which comprises a mounting sleeve, a lead, a clamping piece and a driving piece, wherein the mounting sleeve is arranged on the mounting sleeve; the clamping piece comprises a fixed end and a movable end, wherein the movable end is hinged to the mounting sleeve and is driven by the driving piece to be attached to or away from the fixed end; the driving gear of the driving piece is fixedly connected with the hinged position of the movable end, and the driving rack is slidably connected in the mounting sleeve and meshed with the driving gear; the guide channel in the movable end is communicated with the mounting sleeve, the side opening is communicated with the outside, the fixed end is provided with a clamping groove for aligning the side opening, and a fixing device is arranged in the clamping groove; the lead sequentially passes through the mounting sleeve, the guide channel and the clamping groove and is fixed by the fixing device. The valve forming device clamps the target tissue, threads and holds the suture, so that the problem that the rapid and accurate operation is difficult under the conditions of small operation field, large chordae tendineae intervention and difficult target tissue capture is solved, the success rate of the valve forming operation is improved, and the valve, valve and chordae tendineae forming can be realized.

Description

Valve forming device

Technical Field

The utility model relates to the field of medical instruments, in particular to a device applied to an annuloplasty operation.

Background

With the development of cardiac surgical techniques, annuloplasty has become one of the primary means of treating heart valve disease. Annuloplasty is the administration of a repair to a diseased valve for therapeutic purposes, and is generally applicable to cases of valve insufficiency, and can also be performed on patients with a small number of valve stenoses. Annuloplasty may accomplish mitral valve, aortic valve, tricuspid valve formation. The method specifically comprises reconstruction and annular contraction of an annulus, shortening and reconstructing papillary muscles and chordae tendineae, transferring, implanting an artificial annulus and artificial chordae tendineae, and repairing abnormal valve tissues.

At present, the annuloplasty operation has relatively high requirements, including open chest operation and interventional operation, and the traditional surgical open chest operation has high risk and larger wound, so the interventional operation has larger advantages; the interventional operation mainly comprises making a tiny incision on femoral artery, vein or apex, entering the heart by using a guide wire, positioning at the position of a valve, implanting an artificial valve ring and an artificial chordae, performing annular contraction of the valve ring, performing a two-hole technique, performing border suturing and the like.

In the existing common interventional operation, due to small operation field and difficult clamping of the valve annulus tissue, when the target position of the valve is positioned and the annulus is contracted, the valve is difficult to operate in place once, repeated operation is needed, and the operation efficiency and success rate are affected.

Disclosure of Invention

The utility model aims to provide a valve forming device which has the advantages of simple structure, convenient operation, reliability and practicality and can improve the success rate and efficiency of operation.

In order to achieve the above object, the solution of the present utility model is:

a valve forming device comprises a mounting sleeve, a wire, two groups of clamping pieces arranged in the mounting sleeve and a driving piece for driving the clamping pieces to move; the clamping piece comprises a fixed end and a movable end, the movable end is hinged to the mounting sleeve and driven by the driving piece to be attached to or away from the fixed end, and the fixed end is fixed to the mounting sleeve; the driving piece comprises a driving gear and a driving rack, the driving gear is fixedly connected with the hinged position of the movable end in a shaft joint manner, and the driving rack is slidably connected in the mounting sleeve and meshed with the driving gear; the movable end is internally provided with a guide channel which is communicated with the mounting sleeve through the top opening, the guide channel is also provided with a side opening which is communicated with the outside, the fixed end is provided with a clamping groove for aligning the side opening, and a fixing device is arranged in the clamping groove; the lead sequentially passes through the mounting sleeve, the guide channel and the clamping groove and is fixed in the clamping groove by the fixing device.

Further, the clamping piece is arranged at the installation end of the installation sleeve, and the other end of the installation sleeve is an operation end; the two groups of clamping pieces are respectively arranged front and back, the driving piece is one group and is arranged between the two groups of clamping pieces, and the driving rack extends out of the operating end from the mounting end.

Further, a wire channel is arranged in the mounting sleeve, and the wire channel is communicated with the guide channel and the outside for wires to pass through.

Further, the fixing device is arranged in a through groove of the fixing end, and the through groove is communicated with the clamping groove; the fixing device comprises a sliding part, a limiting part, an elastic part and a pull rope, wherein the sliding part is movably sleeved in the through groove of the fixed end, the limiting part is fixed at one end, far away from the clamping groove, in the through groove, two ends of the elastic part respectively prop against the sliding part and the limiting part, so that the clamping groove is blocked by the sliding part, one end of the pull rope is connected with the sliding part, and the other end of the pull rope penetrates out of the limiting part and the mounting sleeve.

Further, the elastic piece is a spring.

Further, the lead includes a needle portion.

Further, the fixing device is arranged in a through groove of the fixing end, and the through groove is communicated with the clamping groove; the fixing device is a push rod, the push rod movably penetrates through the through groove of the fixing end and the inside of the mounting sleeve, one end of the push rod is used for blocking the clamping groove, and the other end of the push rod extends out of the mounting sleeve.

By adopting the technical scheme, two groups of clamping pieces are arranged, so that the fixation of two sutures can be realized by once putting on and withdrawing in the operation process, the annuloplasty operation of the valve ring is realized, and the valve forming device is prevented from being put on and withdrawing for many times, so that the operation efficiency is improved; and the valve forming device clamps and threads the target tissue, so that the problem that the rapid and accurate operation is difficult under the conditions that the surgical field is small, the intervention of chordae tendineae is large and the capture of the target tissue is difficult under the condition of heart beating is solved, the success rate of the valve forming operation is improved, the operation time is shortened, and the valve, valve and chordae tendineae can be formed.

Drawings

FIG. 1 is a schematic perspective view of an embodiment of the present utility model;

FIG. 2 is a schematic illustration of an embodiment of the present utility model with one set of clamping members removed;

FIG. 3 is a schematic cross-sectional view of an embodiment of the present utility model;

FIGS. 4-6 are schematic diagrams illustrating operations performed by embodiments of the present utility model;

fig. 7 is a schematic cross-sectional view of another embodiment of the present utility model.

Symbol description:

guide wire channel 13 of installation end 11 operation end 12 of installation sleeve 1

Needle portion 21 of lead 2

Clamping groove 311 through groove 312 of fixed end 31 of clamping piece 3

Movable end 32 guides opening 322 in top of channel 321 and side openings 323

The driving member 4 drives the gear 41 to drive the rack 42

Elastic piece 53 of limiting part 52 of sliding piece 51 of fixing device 5

Push rod 55 of pull rope 54

The annulus or valve tissue 20.

Detailed Description

In order to further explain the technical scheme of the utility model, the utility model is explained in detail by specific examples.

In the description of the present utility model, it should be understood that the terms "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", "clockwise", "counterclockwise", etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, are merely for convenience in describing the present utility model and simplifying the description, and do not indicate or imply that the apparatus or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present utility model.

As shown in fig. 1 to 3, an annuloplasty device 10 of the present utility model comprises a mounting sleeve 1, a guide wire 2, two groups of clamping members 3 mounted in the mounting sleeve 1, and a driving member 4 for driving the clamping members 3 to move; the clamping piece 3 comprises a fixed end 31 and a movable end 32, the movable end 32 is hinged to the mounting sleeve 1 and is driven by the driving piece 4 to be attached to or away from the fixed end 31, and the fixed end 31 is fixed to the mounting sleeve 1; the driving piece 4 comprises a driving gear 41 and a driving rack 42, the driving gear 41 is fixedly connected with the hinge position of the movable end 32 in a shaft way, and the driving rack 42 is connected in the mounting sleeve 1 in a sliding way and meshed with the driving gear 41; a guiding channel 321 is arranged in the movable end 32, the guiding channel 321 is communicated with the mounting sleeve 1 through a top opening 322, the guiding channel 321 is also provided with a side opening 323 communicated with the outside, the fixed end 31 is provided with a clamping groove 311 for aligning the side opening 323, and a fixing device 5 is arranged in the clamping groove 311; the wire 2 sequentially passes through the mounting sleeve 1, the guide channel 321 and the clamping groove 311 and is fixed by the fixing device 5 in the clamping groove 311.

As shown in fig. 1 and 2, the clamping member 3 is mounted at a mounting end 11 of the mounting sleeve 1, and the other end of the mounting sleeve 1 is an operating end 12; the two clamping members 3 are respectively arranged front and back, the driving member 4 can be one group and arranged between the clamping members 3, and the driving rack 42 extends out of the operating end 12 from the mounting end 11 so as to drive the movable ends 32 of the two groups of clamping members 3 to be movably attached to or away from the fixed end 31 so as to clamp the valve annulus or the valve tissue 20. The installation sleeve 1 is internally provided with a wire channel 13, and the wire channel 13 is communicated with the guide channel 321 and the outside for the wire 2 to pass through.

As shown in fig. 3, the fixing device 5 is disposed in a through slot 312 of the fixing end 31, the through slot 312 is communicated with the clamping slot 311, the fixing device 5 includes a sliding member 51, a limiting portion 52, an elastic member 53 and a pull cord 54, the sliding member 51 is movably sleeved in the through slot 312 of the fixing end 31, the limiting portion 52 is fixed at one end of the through slot 312 far away from the clamping slot 311, two ends of the elastic member 53 respectively support against the sliding member 51 and the limiting portion 52, so that the sliding member 51 seals the clamping slot 311, one end of the pull cord 54 is connected with the sliding member 51, the other end of the pull cord 54 passes through the limiting portion 52 and the mounting sleeve 1, so that the sliding member 51 is pulled by the operating end 12 to open the clamping slot 311, and the wire 2 entering the clamping slot 311 is clamped and fixed by matching with the elastic member 53, and the elastic member 53 may be a spring.

As shown in fig. 3, the lead 2 includes a needle portion 21 that facilitates passage of the lead 2 through the annulus or valve tissue 20.

When the annuloplasty device 10 of the present utility model is actually used in the procedure of the shaping operation, the incision can be selected to be performed through a small incision on the right side chest wall or under a cavity mirror, the pericardium is incised, the atrium is pre-arranged with a purse string, the operation sheath is passed through the right side chest wall and enters the right atrium, the operation sheath is used for puncturing the left atrium at the foramen ovale by the operation sheath, the operation sheath is placed above the mitral valve of the left atrium, the annuloplasty device 10 is placed at the position where the anterior and posterior valve leaflets of the mitral valve of the left atrium need to be shaped through the operation sheath, under the guidance of esophagus ultrasound, the annuloplasty device 20 is clamped by using one group of clamping members 3, then the guide channel 321 of the movable end 32 is controlled to pass through the annuloplasty ring 20 from the side opening 323 and enter into the clamping groove 311 of the fixed end 31 of the annuloplasty device 10, the suture is placed above the annuloplasty ring 20 by using the fixing device 5, the suture is placed at the position of the other group of clamping members 3, the suture is then retracted by using a clip, and the suture is placed back through the annulus by a clip, and the suture is observed. By arranging the two groups of clamping pieces 3, the fixation of two sutures can be realized by once putting on and withdrawing in the operation process, the annular contraction of the valve is realized, and the valve forming device 10 is prevented from being put on and withdrawing for many times, so that the operation efficiency is improved; and the valve forming device 10 clamps and threads the target tissue, so that the problem that the suture is difficult to keep under the condition of small operation field of view is solved, the operation difficulty is reduced, and the operation success rate is improved.

Of course, a plurality of sutures can be placed at the position of the valve annulus, then the sutures are sutured on the valve annuloplasty ring, the annuloplasty ring is sent into the valve root through the operation sheath tube, and the annuloplasty ring is sequentially knotted and fixed, so that the annuloplasty or annuloplasty technology is realized. The annuloplasty device 10 may also be used to sequentially clip the positions of the valve edges to be treated and knot, if there is a fear of tearing, the above operations may be repeated to reinforce the valve edges, and the annuloplasty techniques such as valve two-hole, juncture suture, edge-to-edge suture, valve folding, etc. may be implemented. In addition, one suture can be fixed on papillary muscles of one valve leaflet, the other suture is fixed on the edge of a diseased valve, and finally a certain length of suture is reserved for knotting, so that the artificial chordae tendineae valvuloplasty technology is realized. The surgical access can also consider the sheath tube which is put into operation through the jugular vein on the right side to the right atrium level, the space between the puncture needle rooms is adopted to establish a channel above the mitral valve of the left atrium, and the valve forming is realized through a mitral valve forming device; in addition, the valve can directly enter the left ventricle through the small incision at the apex of the heart, and forming technologies such as valve two-hole formation, juncture suture, edge-to-edge suture, valve folding and the like are realized.

Similarly, the valve forming device can be used for forming the tricuspid valve, an operation sheath tube is placed above the right atrial tricuspid valve through the right chest wall, and various forming technologies are realized through the same operation; annuloplasty may also be achieved by accessing the right ventricle directly through the left apex.

As shown in fig. 7, another embodiment of the present utility model is different from the above embodiment in that the fixing device 5 is a push rod 55, the push rod 55 movably penetrates through the through groove 312 of the fixing end 31 and the mounting sleeve 1, one end is used for blocking the clamping groove 311, and the other end extends out of the mounting sleeve 1 to pull or push the push rod 55, so as to clamp and fix the wire 2 and the needle head 21 entering the clamping groove 311 after opening the clamping groove 311.

The above description is only a preferred embodiment of the present utility model, and the protection scope of the present utility model is not limited to the above examples, and all technical solutions belonging to the concept of the present utility model belong to the protection scope of the present utility model. It should be noted that equivalent changes and modifications can be made by those skilled in the art without departing from the principles of the present utility model, which still falls within the scope of the present utility model.

Claims

1. An annuloplasty device, characterized by: comprises a mounting sleeve, a wire, two groups of clamping pieces arranged in the mounting sleeve and a driving piece for driving the clamping pieces to move; the clamping piece comprises a fixed end and a movable end, the movable end is hinged to the mounting sleeve and driven by the driving piece to be attached to or away from the fixed end, and the fixed end is fixed to the mounting sleeve; the driving piece comprises a driving gear and a driving rack, the driving gear is fixedly connected with the hinged position of the movable end in a shaft joint manner, and the driving rack is slidably connected in the mounting sleeve and meshed with the driving gear; the movable end is internally provided with a guide channel which is communicated with the mounting sleeve through the top opening, the guide channel is also provided with a side opening which is communicated with the outside, the fixed end is provided with a clamping groove for aligning the side opening, and a fixing device is arranged in the clamping groove; the lead sequentially passes through the mounting sleeve, the guide channel and the clamping groove and is fixed in the clamping groove by the fixing device.

2. The annuloplasty device of claim 1, wherein: the clamping piece is arranged at the mounting end of the mounting sleeve, and the other end of the mounting sleeve is an operating end; the two groups of clamping pieces are respectively arranged front and back, the driving piece is one group and is arranged between the two groups of clamping pieces, and the driving rack extends out of the operating end from the mounting end.

3. The annuloplasty device of claim 1, wherein: and a wire channel is arranged in the mounting sleeve, and is communicated with the guide channel and the outside for wires to pass through.

4. The annuloplasty device of claim 1, wherein: the fixing device is arranged in a through groove of the fixing end, and the through groove is communicated with the clamping groove; the fixing device comprises a sliding part, a limiting part, an elastic part and a pull rope, wherein the sliding part is movably sleeved in the through groove of the fixed end, the limiting part is fixed at one end, far away from the clamping groove, in the through groove, two ends of the elastic part respectively prop against the sliding part and the limiting part, so that the clamping groove is blocked by the sliding part, one end of the pull rope is connected with the sliding part, and the other end of the pull rope penetrates out of the limiting part and the mounting sleeve.

5. The annuloplasty device of claim 4, wherein: the elastic piece is a spring.

6. The annuloplasty device of claim 1, wherein: the lead includes a needle portion.

7. The annuloplasty device of claim 1, wherein: the fixing device is arranged in a through groove of the fixing end, and the through groove is communicated with the clamping groove; the fixing device is a push rod, the push rod movably penetrates through the through groove of the fixing end and the inside of the mounting sleeve, one end of the push rod is used for blocking the clamping groove, and the other end of the push rod extends out of the mounting sleeve.