CN220193786U - Balloon perfusion tube for descending aorta distal perfusion in aortic dissection operation - Google Patents
Balloon perfusion tube for descending aorta distal perfusion in aortic dissection operation Download PDFInfo
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- CN220193786U CN220193786U CN202321644199.2U CN202321644199U CN220193786U CN 220193786 U CN220193786 U CN 220193786U CN 202321644199 U CN202321644199 U CN 202321644199U CN 220193786 U CN220193786 U CN 220193786U
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- aortic dissection
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- 230000010412 perfusion Effects 0.000 title claims abstract description 51
- 208000002251 Dissecting Aneurysm Diseases 0.000 title claims abstract description 24
- 206010002895 aortic dissection Diseases 0.000 title claims abstract description 24
- 210000002376 aorta thoracic Anatomy 0.000 title abstract description 29
- 230000000903 blocking effect Effects 0.000 claims abstract description 24
- 229910000831 Steel Inorganic materials 0.000 claims abstract description 11
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Abstract
The utility model discloses a balloon perfusion tube for aortic dissection operation descending aorta distal perfusion, which is characterized in that: the perfusion intubation body comprises an operation part, a body part, an anterograde outlet end and a rear end part, wherein the front end of the body part is the anterograde outlet end, meanwhile, a blocking balloon is arranged on the side wall of the body part, the rear end part penetrates into an inner core, the medium pipe is arranged at the operation part and extends to the front end of the body part to be communicated with the blocking balloon, the medium passes through the medium pipe to reach the blocking balloon to expand the blocking balloon, and the body part is internally lined with steel wires; the utility model can be operated in a deep low-temperature stop circulation mode basically when the distal operation of the descending aortic stent is carried out in aortic dissection operation, and has great protection effect on brain and spinal cord. Changing the mode that the prior aortic dissection operation needs deep cryogenic stop circulation. Thus protecting the blood supply of the abdominal organs and spinal cord and reducing the paraplegia after aortic dissection.
Description
Technical Field
The utility model belongs to the technical field of aortic distal perfusion, and particularly relates to a balloon perfusion tube for aortic dissection operation descending aortic distal perfusion.
Background
Acute Aortic Dissection (AAD) is a rare and extremely dangerous cardiovascular surgical disease with a morbidity of 3-4 people/10 ten thousand/year. About 2/3 of AAD patients are involved in the ascending aorta, and according to the Stanford typing, the cumulative ascending aorta is type a, the mortality of Stanford type a aortic dissection patients is closely related to dissection extent, time from onset to diagnosis and treatment method, if only conservative treatment is relied on, the 24 hour incidence is 20% and increases with 1% mortality per hour, which can be as high as 80% after 2 weeks. In the recent IRAD published database, early hospital mortality was 59%, and since the main causes of early mortality were aortic rupture, pericardium tamponade, and visceral perfusion failure, surgery became the only and effective treatment for Stanford type a. The total aortic arch replacement and descending aortic trunk stent surgery (Sun's Procedure) proposed by Sun Lizhong and the like is verified and approved by domestic and foreign cardiac surgical specialists, and is currently the standard surgical formula for treating Stanford A aortic dissection in China. However, in order to reduce ischemic injury of spinal cord, abdominal organs, and the like, which are ischemic and anoxic during the lower body stop cycle during the Sunshan operation, the lower body perfusion should be resumed as early as possible. During repair of aortic arch at moderate to low temperature, lower body perfusion techniques have been demonstrated to provide effective protection for the final organs, and this approach has been applied in many aortic arch replacement procedures. There is currently no directly available balloon catheter that provides effective and reliable lower body perfusion.
For the descending aortic balloon occlusion method, in order to solve the problem of protecting the remote organ, some research groups advocate that an inflatable catheter is used to occlude the descending aorta and the lower body is infused through femoral artery intubation, namely, the descending aortic balloon occlusion method is shown in fig. 1. The descending aortic balloon occlusion method is simple to operate, and the lower body perfusion can be completed without additional intubation in aortic arch surgery adopting the axillary artery and femoral artery intubation. However, since femoral artery cannulation often causes reversal of blood flow, debris or thrombus may be pumped back into the brain from the anatomical site, thereby risking embolism, and the learner also indicated that this approach may result in a false luminal perfusion. In addition, retrograde perfusion of the femoral artery may further exacerbate intimal peeling, causing organ hypoperfusion, progressive vascular injury and nerve injury, and previous studies reported a incidence of hypoperfusion syndrome of 2.5% -13% after femoral artery catheterization.
For balloon catheterization, balloon catheterization is a perfusion strategy in which a balloon catheter is placed into the descending aorta, the balloon is used to block back blood, and the catheter is perfused to complete the lower body perfusion. Recently, tarola (Tarola CL, losenno KL, gelinas JJ, et al Whole body Perfusion strategy for aortic arch repair under moderate hypothermia [ J ]. Perfusion,2018, 33 (4): 254-263) and the like have performed lower body Perfusion on 62 patients by the same method, after an endotracheal tube is placed in a descending aorta, an endotracheal tube balloon is inflated until there is no blood reflux in the descending aorta, an antegrade endotracheal tube access is selected, the temperature is controlled at 25-30 ℃, the Perfusion rate is 1-2L/min, and until the aortic arch reconstruction is completed, the lower body Perfusion is stopped, as shown in FIG. 2. The method is to use the existing trachea cannula as a substitute, the diameter of the trachea cannula is thicker, and the operation of anastomosis between the covered stent and the distal end of the artificial blood vessel is affected. And balloon length is shorter, if can not fine whole blocking after the tectorial membrane support is put into to the descending aorta, can have blood reflux to influence the operation field to influence lower body perfusion effect.
Disclosure of Invention
The utility model aims to design a balloon perfusion tube for perfusion of the distal end of a descending aorta, which is based on the existing femoral artery intubation, is externally provided with a long balloon, is internally provided with a lining steel wire, has good flexibility, can randomly change angles without being folded and twisted, has longer balloon length, and can cover the whole covered stent.
In order to achieve the above purpose, the technical scheme adopted by the utility model is as follows:
a balloon perfusion tube for aortic dissection surgery descending aortic distal perfusion, characterized in that: including filling the intubate body and including operation portion, body, antegrade exit end and rear end portion, the front end of body is the antegrade exit end, is equipped with on the lateral wall of body simultaneously and blocks the sacculus, and the rear end penetrates the inner core, the medium pipe sets up operation portion department and extends to body front end and blocks the sacculus intercommunication, and the medium passes through the medium pipe and reachs and block the sacculus and make its inflation, the inside lining steel wire of body can make descending aorta sacculus portion block the blood circulation in the descending aorta and supply the perfusion of descending aorta and distal end limbs in the operation of treating heart great vessels through above-mentioned technical scheme.
Furthermore, the inlet end of the medium pipe is provided with a locking switch, and the medium adopts normal saline.
Further, the lining steel wire can be embedded in the wall of the body part or arranged on the surface of the inner wall of the body part to form a steel wire supporting layer.
Further, the body model of the pouring tube is 15Fr, the diameter is 4.95mm, and the length of the body is 250mm.
Further, the blocking balloon had a length of 38mm and a width of 40mm when inflated.
Further, the length of the operation portion was 50mm, and the model was 33Fr.
The following beneficial effects can be obtained through the technical scheme:
reasonable in design structure, modern design, based on a large amount of intraoperative detection data, more accord with hemodynamics in the use, reduce blood destruction simultaneously, can reduce vascular endothelial damage that blood turbulence caused. In the operation of treating the great vessels of the heart, the descending aorta is blocked by the cannula, and the spinal cord and the abdominal organs are perfused by the tip of the blocking saccule, so that the descending aorta is blocked but the blood perfusion is still provided for the descending aorta by the cannula, thereby better protecting the visceral function and the blood coagulation function of a patient. The utility model further optimizes the operation mode, has simple operation and reliable perfusion, improves the operation safety and reduces the occurrence of complications.
The utility model has the core points that the operation of descending aortic stent distal end in aortic dissection operation is basically not needed to be operated in a deep low-temperature circulation stopping mode, thereby playing a great role in protecting the brain and spinal cord, changing the mode that the existing aortic dissection operation needs deep low-temperature circulation stopping, protecting the blood supply of abdominal organs and spinal cord and reducing the occurrence of paraplegia after aortic dissection operation.
Drawings
Fig. 1 is a schematic representation of a descending aortic balloon occlusion method.
Fig. 2 is a schematic illustration of a balloon catheterization procedure.
Fig. 3 is a schematic view of the structure of the present utility model.
Fig. 4 is a cross-sectional view of a body.
Fig. 5 is a schematic view of the blocking balloon in operation.
Fig. 6 is a rendering of the occlusion balloon in an operational state.
Fig. 7 is a dimensional view of the structure of the present utility model.
In the figure:
in the figure: 1. an inner core; 2. a medium pipe; 3. an operation unit; 4. a body; 5. blocking the balloon; 6. an antegrade outlet end; 7. a rear end portion.
Detailed Description
The utility model is further described with reference to the accompanying drawings:
as shown in fig. 3-7, a perfusion tube with a balloon for the distal perfusion of the descending aorta of an aortic dissection operation comprises a perfusion cannula body, which sequentially comprises a rear end 7, an operation part 3, a body part 4, a blocking balloon 5 and an antegrade outlet end 6 from left to right, wherein the rear end 7 penetrates into an inner core 1, the front end of the body part 4 is the antegrade outlet end 6, meanwhile, the blocking balloon 5 is arranged on the side wall of the body part 4, the medium tube 2 is provided with the operation part 3 and extends to the front end of the body part 4 to be communicated with the blocking balloon 5, and the medium reaches the blocking balloon 5 through the medium tube to expand the blocking balloon 5, and the body part 4 is lined with steel wires. The descending aorta sacculus part can block blood circulation in the descending aorta and supply perfusion to the inner part of the descending aorta and the far-end limb in the operation of treating the great cardiac blood vessel.
The inlet end of the medium pipe 2 is provided with a locking switch, and the medium adopts normal saline.
The lining steel wire can be embedded in the wall of the body 4 or arranged on the inner wall surface of the body 4 to form a steel wire supporting layer.
As shown in FIG. 7, the perfusion tube has a body model of 15Fr, a diameter of 4.95mm and a length of 250mm. The blocking balloon 5 had a length of 38mm and a width of 40mm when inflated. The length of the operation portion 3 was 50mm and the model number was 33Fr.
As a detailed description of the present embodiment, the medium tube 2 may be a balloon-filled tube penetrating the perfusion cannula body and having a front end communicating with the inside of the blocking balloon 5, so as to facilitate the subsequent injection and discharge of physiological saline into and from the blocking balloon 5. The balloon connector is arranged at the medium pipe 2 and is used for connecting an external normal saline injection source, in order to achieve a better blocking effect, the length of the blocking balloon 5 is preferably 38mm, and the width of the blocking balloon 5 is more preferably 40mm.
With reference to the attached drawings, the blocking balloon 5 is inserted into the opening of the aortic intima, a locking switch of a medium pipe (balloon water filling pipe) is opened, physiological saline is injected into the balloon to expand and block the descending aorta, the balloon water filling pipe locking switch is closed, an arterial filling pipe of the extracorporeal circulation machine is connected to a filling pipe body, and blood starts to perfuse the spinal cord and abdominal organs of a patient through an antegrade outlet end of the aortic balloon filling part after air exhaust.
Further, at the downstream exit end may be a mofei orifice, alongside which is a semi-compliant balloon (blocking balloon 5). The utility model can be operated in a deep low-temperature stop circulation mode basically when the distal operation of the descending aortic stent is carried out in aortic dissection operation, and has great protection effect on brain and spinal cord. Changing the mode that the prior aortic dissection operation needs deep cryogenic stop circulation. Thus protecting the blood supply of the abdominal organs and spinal cord and reducing the paraplegia after aortic dissection.
In conclusion, the blood vessel endothelial injury device has the advantages of reasonable structure, novel design, more reasonable design based on a large amount of intraoperative detection data, more accords with hemodynamics in the use process, reduces blood damage, and can reduce vascular endothelial injury caused by blood turbulence. In the operation of treating the great vessels of the heart, the descending aorta is blocked by the cannula, and the spinal cord and the abdominal organs are perfused by the tip of the blocking saccule, so that the descending aorta is blocked but the blood perfusion is still provided for the descending aorta by the cannula, thereby better protecting the visceral function and the blood coagulation function of a patient. The utility model further optimizes the operation mode, has simple operation and reliable perfusion, improves the operation safety and reduces the occurrence of complications.
The foregoing is a preferred embodiment of the present utility model, and modifications, obvious to those skilled in the art, of the various equivalent forms of the present utility model can be made without departing from the principles of the present utility model, are intended to be within the scope of the appended claims.
Claims (6)
1. A balloon perfusion tube for aortic dissection surgery descending aortic distal perfusion, characterized in that: including filling the intubate body and including operating portion (3), body (4), antegrade exit end (6) and rear end portion (7), the front end of body (4) is antegrade exit end (6), is equipped with on the lateral wall of body (4) simultaneously and blocks sacculus (5), and rear end portion (7) penetrate inner core (1), and medium pipe (2) set up operating portion (3) department and extend to body (4) front end and block sacculus (5) intercommunication, and the medium passes through the medium pipe and reaches and block sacculus (5) and make its inflation, body (4) inside lining steel wire.
2. A balloon perfusion tube for aortic dissection surgery descending aortic distal perfusion according to claim 1, wherein: the inlet end of the medium pipe (2) is provided with a locking switch, the medium adopts gas or liquid, and the liquid adopts normal saline.
3. A balloon perfusion tube for aortic dissection surgery descending aortic distal perfusion according to claim 1, wherein: the lining steel wire can be embedded in the pipe wall of the body part (4) or arranged on the inner wall surface of the body part (4) to form a steel wire supporting layer.
4. A balloon perfusion tube for aortic dissection surgery descending aortic distal perfusion according to claim 1, wherein: the model of the body of the perfusion tube is 15Fr, the diameter is 4.95mm, and the length of the body is 250mm.
5. A balloon perfusion tube for aortic dissection surgery descending aortic distal perfusion according to claim 1, wherein: the blocking balloon (5) had a length of 38mm and a width of 40mm when inflated.
6. A balloon perfusion tube for aortic dissection surgery descending aortic distal perfusion according to claim 1, wherein: the length of the operation part (3) is 50mm, and the model is 33Fr.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202321644199.2U CN220193786U (en) | 2023-06-27 | 2023-06-27 | Balloon perfusion tube for descending aorta distal perfusion in aortic dissection operation |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202321644199.2U CN220193786U (en) | 2023-06-27 | 2023-06-27 | Balloon perfusion tube for descending aorta distal perfusion in aortic dissection operation |
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| Publication Number | Publication Date |
|---|---|
| CN220193786U true CN220193786U (en) | 2023-12-19 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202321644199.2U Active CN220193786U (en) | 2023-06-27 | 2023-06-27 | Balloon perfusion tube for descending aorta distal perfusion in aortic dissection operation |
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| Country | Link |
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| CN (1) | CN220193786U (en) |
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2023
- 2023-06-27 CN CN202321644199.2U patent/CN220193786U/en active Active
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