CN220090206U - Auxiliary sheath for bedside placement of temporary pacing leads - Google Patents
Auxiliary sheath for bedside placement of temporary pacing leads Download PDFInfo
- Publication number
- CN220090206U CN220090206U CN202321219984.3U CN202321219984U CN220090206U CN 220090206 U CN220090206 U CN 220090206U CN 202321219984 U CN202321219984 U CN 202321219984U CN 220090206 U CN220090206 U CN 220090206U
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- China
- Prior art keywords
- sheath
- head end
- temporary pacing
- auxiliary sheath
- pacing leads
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- 239000004372 Polyvinyl alcohol Substances 0.000 claims description 3
- 229920001971 elastomer Polymers 0.000 claims description 3
- 239000000463 material Substances 0.000 claims description 3
- 229920000747 poly(lactic acid) Polymers 0.000 claims description 3
- 239000004626 polylactic acid Substances 0.000 claims description 3
- -1 polytetrafluoroethylene Polymers 0.000 claims description 3
- 229920001343 polytetrafluoroethylene Polymers 0.000 claims description 3
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- 210000005241 right ventricle Anatomy 0.000 abstract description 9
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Abstract
The utility model discloses an auxiliary sheath tube for arranging a temporary pacing lead at a bedside, which comprises a tube body and an arc-shaped head end; the pipe orifice of the head end is provided with a one-way hemostatic valve which can be opened from inside to outside, the pipe wall of the head end is provided with a guide hole for penetrating a loach guide wire, and the guide hole is led to the inner cavity of the sheath pipe; the pipe wall of the head end is also provided with a plurality of flexible fixing wings which are obliquely arranged, and the oblique fixing wings extend from the head end obliquely towards the pipe body direction in a normal state. The utility model can assist the temporary pacing lead to be implanted into the right ventricle rapidly and safely in a minimally invasive bypass way, and ensures that the lead is firm and not easy to dislocation.
Description
Technical Field
The utility model relates to the field of temporary pacing lead auxiliary instruments, in particular to an auxiliary sheath tube for arranging a temporary pacing lead beside a bed.
Background
The bradyarrhythmia is clinically quite common, and is characterized by obviously reduced heart rate, about 30-45 times/minute, and most patients have obvious bradycardia related symptoms such as dizziness and black , and serious patients even have an A-S syndrome, so that the life is endangered. The implantation of temporary pacing lead is an important means for treating slow arrhythmia, and can quickly stabilize patient's condition, avoid serious complications, facilitate further defining patient's condition, and guide subsequent treatment decisions.
Currently, there are three main types of temporary pacing leads that are widely used clinically: (1) A stiff temporary pacing lead such as the Atlantic temporary pacing lead (model: IBI-80214) is secured. The medical composition is delivered into the right ventricle through the lower limb femoral vein, and the head end is provided with a fixed bend design, so that dislocation is not easy to occur. The defect is that the implantation of the lead wire is completed under the direct vision of interventional X-rays, and the lead wire has ray damage to patients and operators and is even forbidden for pregnant women. In addition, the lead head end is hard, and myocardial perforation is easy to occur. Secondly, the lead is fed through the puncture of the lower limb, so that the lower limb is required to be absolutely bedridden after operation, and complications such as thrombus are easy to occur. (2) A balloon-borne floating temporary pacing lead, such as the balloon temporary pacing lead of the bard company (model number 008556P). After the air bag is sent into a right atrium through an internal jugular vein or subclavian vein, the air bag is inflated by utilizing a head end air bag, and the thrust of the air bag is automatically sent into the right ventricle by virtue of blood flow. The advantages are that the device can be directly completed beside a bed without X-ray direct vision, and the head end is softer and is not easy to cause myocardial perforation. The defects are also obvious, and due to the lack of a fixing device at the head end, dislocation occurs at a high rate, so that patients are required to be absolutely bedridden and can not move in order to reduce dislocation risks, and thrombus is easy to be complicated. (3) epicardial temporary pacing lead: unlike the first two minimally invasive implants, it directly sews temporary pacing leads on the heart surface by surgical chest opening. Although stable and reliable, the utility range is limited, and the utility model is only used in cardiac surgery.
Disclosure of Invention
The utility model aims to provide an auxiliary sheath tube for arranging a temporary pacing lead at a bedside, which can assist the temporary pacing lead to be quickly and safely implanted into a right ventricle in a minimally invasive way by-pass of the bedside and ensure that the lead is firm and not easy to dislocation.
In order to achieve the above purpose, the present utility model adopts the following technical scheme:
an auxiliary sheath for bedside placement of temporary pacing leads, the sheath comprising a tube body and an arcuate head end; the pipe orifice of the head end is provided with a one-way hemostatic valve which can be opened from inside to outside, the pipe wall of the head end is provided with a guide hole for penetrating a loach guide wire, and the guide hole is led to the inner cavity of the sheath pipe; the pipe wall of the head end is also provided with a plurality of flexible fixing wings which are obliquely arranged, and the oblique arrangement is that the head end obliquely extends towards the pipe body direction in a normal state.
Preferably, the head end is 30 ° arc-shaped.
Preferably, the one-way hemostatic valve comprises 3 flexible valves, and the inner surface of each flexible valve is provided with a plurality of protruding particles.
Preferably, the number of the fixing wings is 3, the length is 5mm to 8mm, the width is 3mm to 6mm, the thickness is 0.2mm to 0.4mm, and the tail ends of the fixing wings are rounded.
Preferably, the tail end of the pipe body is provided with an operating handle, and the operating handle is connected with the fixed wing through a guide piece, so that the tail end of the fixed wing can be folded by pulling the operating handle.
Preferably, the inner diameter of the loach guide wire guide hole is 0.1mm to 0.2mm.
Preferably, the sheath has a length of 100cm and an outer diameter of 2.5mm to 3.0mm.
Preferably, the sheath has a length of 100cm and an inner diameter of 2.2mm to 2.5mm.
Preferably, the sheath tube is prepared from polylactic acid or polyvinyl alcohol or polytetrafluoroethylene or rubber materials, and the tube body is soft and has a smooth outer surface.
Preferably, the head end and the pipe body are integrally formed.
The utility model has the advantages that:
the auxiliary sheath tube for arranging the temporary pacing lead beside the bed can be minimally invasively implanted through the internal jugular vein or subclavian vein, and the external end only needs to be stuck on the skin by the dressing paste, so that the damage to a patient is small, the patient does not need to lie in bed absolutely, and the comfort level is high.
Further, the head end is 30 arc designs, embeds loach seal wire guiding hole, guides into the right ventricle through loach seal wire, directly can send into right ventricle heart point portion together sheath pipe and interim pacing lead at the bedside, need not to arrange the patient to send into X line pipe room, wins the rescue time, and practices thrift economic cost to avoid X line exposure to patient and operator's radiation damage.
Further, the part of the unidirectional hemostatic valve, which contacts the temporary pacing lead, is a convex particle, so that friction force can be increased, and the temporary pacing lead can be clamped.
Further, the head end is provided with 3 flexible fixing wings which can firmly hang rich muscular trabecular structures at the apex of the right ventricle, so that the stability of the sheath tube and the temporary pacing lead in the right ventricle is ensured; and the flexible material does not damage normal myocardial tissue.
Further, the sheath may be sized to accommodate a variety of existing temporary pacing leads available on the market.
Drawings
FIG. 1 is a schematic perspective view of an auxiliary sheath for bedside placement of temporary pacing leads according to the present utility model;
FIG. 2 is a schematic view of a partial cross-sectional structure of an auxiliary sheath for bedside placement of temporary pacing leads of the present utility model, showing the structure of a one-way hemostatic valve from the inside-out view of the sheath;
FIG. 3 is a schematic cross-sectional view of another auxiliary sheath for bedside placement of temporary pacing leads of the present utility model;
FIG. 4 is an enlarged view of a part of the structure of FIG. 3;
fig. 5 is a schematic view of the use of an auxiliary sheath for bedside placement of temporary pacing leads according to the present utility model.
Detailed Description
The utility model is described in further detail below with reference to the drawings and examples.
Referring to fig. 1-4, the main structure of an auxiliary sheath for bedside placement of temporary pacing leads is schematically illustrated. As shown in the figure, the auxiliary sheath for bedside placement of temporary pacing leads provided in this embodiment includes a tube body 1 and an arcuate head end 2. The whole length of the sheath tube is 100cm, the inner diameter is 2.5mm to 3.0mm, and the inner diameter can be plugged into a fixed bent hard temporary pacing lead (inner diameter is 2.0 mm) and a floating temporary pacing lead (inner diameter is 1.67 mm) which are commonly used in the market. The sheath has an outer diameter of 2.5mm to 3.0mm. The dimensions of the outer and inner diameters may be selected for practical use. The sheath tube is made of polylactic acid, polyvinyl alcohol, polytetrafluoroethylene, rubber or other insulating materials, and the whole tube body is soft, has good biocompatibility and good blood compatibility, and has a smooth outer surface.
A guide hole 3 for penetrating the loach guide wire is arranged on the pipe wall of the head end 2, the guide hole 3 is led to the inner cavity of the sheath pipe, and the inner diameter of the guide hole 3 is 0.1mm to 0.2mm. The head end 2 is in a 30-degree arc shape and is used for providing an angle for feeding the loach guide wire into the right ventricle.
The orifice of the head end 2 is provided with a one-way hemostatic valve 4 which can be opened from inside to outside, the one-way hemostatic valve 4 comprises 3 flexible valves 5, and the inner surface of the flexible valve 5 is provided with a plurality of raised particles 6. The unidirectional hemostatic valve 4 is formed by laminating 3 flexible biocompatible materials together and has a thickness of about 0.5mm, and the structural design ensures that the mechanical direction can be opened only from inside to outside, so that the blood in the heart of the device can not flow back into the sheath tube. The inner surface of the flexible valve 5 is provided with an elliptic particle 6, which is designed to be biocompatible polymer material, when the inserted temporary pacing lead is pushed out of the sheath head end 2, the elliptic particle 6 can clamp the pacing lead, increase the friction force of the backward movement, and prevent the pacing lead from being automatically pushed back into the sheath device due to the self-beating of the heart.
The pipe wall of the head end 2 is also provided with a plurality of flexible fixing wings 7, and the fixing wings 7 are obliquely arranged, and the inclination is that the head end 2 obliquely extends towards the pipe body 1 in a normal state. Preferably, the number of the fixing wings 7 is 3, the length is 5mm to 8mm, the width is 3mm to 6mm, the thickness is 0.2mm to 0.4mm, and the tail ends of the fixing wings 7 are rounded and not damaging cardiac muscle. Referring to fig. 3, the rear end of the pipe body 1 may be provided with an operating handle 8, and the operating handle 8 is connected to the fixing wing 7 through a guide 9, so that the end of the fixing wing 7 can be folded by pulling the operating handle 8. In this embodiment, the guide member 9 is a guide wire, and the guide wire is threaded through the wall of the sheath.
Referring to fig. 5, an auxiliary sheath for installing a temporary pacing lead at a bedside is provided in this embodiment, and a head end 2 and a tube body 1 are integrally formed, and can be delivered through a jugular vein or subclavian vein by minimally invasive, and the sheath is firmly fixed at a right ventricular apex muscle trabecula by fixing a tail fin, and the specific operation steps are as follows:
a. a temporary pacing lead is inserted into the sheath and reaches the head end of the sheath.
b. The deep vein is punctured to establish a venous access.
c. Inserting a loach guiding wire, and sending the sheath tube into a deep vein.
d. And (3) properly rotating the sheath tube and pushing the loach guide wire until the right room source room touched by the guide wire is early in electrocardiographic monitoring.
e. After slowly pushing the sheath until a resistance sensation appears, the auxiliary device is prompted to reach the right ventricular trabecula.
f. The temporary pacing lead is connected with a pulse box, is set to be in a VVI mode, has a voltage of 2.0V and a current of 1.0mA, and has a pacing frequency set to be less than 10 times/min of the self ventricular rate.
g. Pushing the head end of the sheath tube for about 1-2cm until resistance feeling appears, and prompting stable pacing state by electrocardiograph monitoring
h. The sheath tube is pushed out of the vein passage to open the fixing wings, the pull-back has obvious resistance, and the pacing electrocardio is still stable, so that the fixation is indicated to be good.
i. The dressing is stuck and fixed on the skin at the puncture point.
In summary, the auxiliary sheath for arranging the temporary pacing lead at the bedside according to the embodiment is provided, one end of the sheath can be delivered through the jugular vein or subclavian vein in a minimally invasive manner, and the sheath is firmly fixed at the trabecula of the right ventricular apex muscle through the pushed out fixing tail wing piece. The other end of the sheath tube is arranged under the puncture point of the internal jugular vein or subclavian vein, and can be wrapped by a common dressing patch, so that a patient can move downwards at will without being influenced. After the patient evaluates the illness state, the temporary pacing lead and the sheath tube are required to be pulled out, and the fixed tail wing is retracted and slowly pulled out only by pulling back the operating handle.
The foregoing is a description of the preferred embodiments of the present utility model and the technical principles applied thereto, and it will be apparent to those skilled in the art that any equivalent transformation, simple substitution, etc. based on the technical scheme of the present utility model can be made without departing from the spirit and scope of the present utility model.
Claims (10)
1. An auxiliary sheath for bedside placement of temporary pacing leads, the sheath comprising a shaft and an arcuate head end; the pipe orifice of the head end is provided with a one-way hemostatic valve which can be opened from inside to outside, the pipe wall of the head end is provided with a guide hole for penetrating a loach guide wire, and the guide hole is led to the inner cavity of the sheath pipe; the pipe wall of the head end is also provided with a plurality of flexible fixing wings which are obliquely arranged, and the oblique arrangement is that the head end obliquely extends towards the pipe body direction in a normal state.
2. The auxiliary sheath for bedside placement of temporary pacing leads of claim 1, wherein the head end is 30 ° arc.
3. The auxiliary sheath for bedside placement of temporary pacing leads of claim 1, wherein the unidirectional hemostatic valve comprises 3 flexible membranous structures, the inner surface of the flexible valve being provided with a plurality of raised particles.
4. The auxiliary sheath for bedside placement of temporary pacing leads of claim 1, wherein the number of fixation wings is 3, the length is 5mm to 8mm, the width is 3mm to 6mm, the thickness is 0.2mm to 0.4mm, and the ends of the fixation wings are rounded.
5. The auxiliary sheath for bedside placement of temporary pacing lead of claim 4, wherein the tail end of the tube body is provided with an operating handle that is connected to the stationary wing by a guide such that the distal end of the stationary wing can be retracted by pulling the operating handle.
6. The auxiliary sheath for bedside placement of temporary pacing leads of claim 1, wherein the loach guide wire guide hole has an inner diameter of 0.1mm to 0.2mm.
7. The auxiliary sheath for bedside placement of temporary pacing leads of claim 1, wherein the sheath has a length of 100cm and an outer diameter of 2.5mm to 3.0mm.
8. The auxiliary sheath for bedside placement of temporary pacing leads of claim 1, wherein the sheath has a length of 100cm and an inner diameter of 2.2mm to 2.5mm.
9. The auxiliary sheath for bedside placement of temporary pacing lead according to any one of claims 1-8, wherein the sheath is made of polylactic acid or polyvinyl alcohol or polytetrafluoroethylene or rubber material, and the tube is soft and smooth in outer surface.
10. The auxiliary sheath for bedside placement of temporary pacing leads of claim 9, wherein the head end and the shaft are integrally formed.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202321219984.3U CN220090206U (en) | 2023-05-19 | 2023-05-19 | Auxiliary sheath for bedside placement of temporary pacing leads |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202321219984.3U CN220090206U (en) | 2023-05-19 | 2023-05-19 | Auxiliary sheath for bedside placement of temporary pacing leads |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN220090206U true CN220090206U (en) | 2023-11-28 |
Family
ID=88865558
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202321219984.3U Active CN220090206U (en) | 2023-05-19 | 2023-05-19 | Auxiliary sheath for bedside placement of temporary pacing leads |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN220090206U (en) |
-
2023
- 2023-05-19 CN CN202321219984.3U patent/CN220090206U/en active Active
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