JP2014233539A - Biological valve - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a biological valve that has neither stent-posts nor stents and facilitates valve replacement.SOLUTION: A biological valve 1 has multiple membranal valve leaflets 10a to 10c arranged in series and includes aortic suture sections 11a to 11d to be sutured to aorta between the valve leaflets 10a to 10c. The valve leaflets 10a to 10c and the aortic suture sections 11a to 11d are cut out of one bovine pericardium and are formed in the shape of a string. The biological valve 1 facilitates valve replacement and realizes shortening of operation time because it is usable without measuring a size of patient's valve leaflet during the valve replacement and producing a valve leaflet having the size. The biological valve 1 impairs neither a shape of aortic annulus nor a valve area and is expected to perform opening and closing operations similar to those of a native valve because it has neither stent-posts nor stents.

Description

  The present invention relates to a biological valve.

  With the increase in the number of elderly people, aortic valve disease is increasing, mainly aortic valve stenosis. In aortic valve disease, valve replacement to a biological valve is usually performed. In valve replacement surgery, biological valves that include an annular stent post and a stent protruding from the stent post have been widely used. With such a biological valve, there is a concern that a valve opening area larger than that of the stent post cannot be obtained, or that blood flow is retained in the stent post portion and there is a risk of thrombus formation.

  In addition, valve replacement for a living body valve without a stent post and a stent has been devised. Patent Document 1 discloses a valve leaflet forming device and its components that can easily determine the shape and size of the valve leaflet when the valve leaflet is formed using its own biological membrane to repair the aortic valve or the like. Yes. In this cusp former and its parts, a cusp sizer for determining the cusp size according to the size of the heart valve and a cusp-shaped line on the self pericardium according to the measured cusp size. Has a template to draw.

JP 2009-77838 A

  In the invention of Patent Document 1, after removing the leaflets of the patient, the size of the removed leaflets is measured, and the leaflets matching the measured size are made from the self pericardium or the like to perform valve replacement. . In addition, when the self pericardium is used, bovine pericardium or biocompatible membrane must be supplemented at the location where the pericardium is cut out. Furthermore, the cut pericardium must be used after being immersed in a tissue fixing solution such as glutaraldehyde for a certain time. For this reason, valve replacement is complicated and the operation time is increased.

  This invention is made | formed in view of the said matter, The objective is to provide the biological valve which does not have a stent post and a stent but can perform valve replacement easily.

The biological valve according to the present invention is
A plurality of membranous leaflets are arranged in series, and have an aortic suture portion that is sutured to the aorta between the leaflets,
The valve leaflets and the aortic suture part are cut out from a single bovine pericardium and formed in a chain.
It is characterized by that.

  Further, it is preferable that a boundary portion between the aortic suture portion and the leaflet is stitched to form a commissure portion where the adjacent leaflets are connected to each other, and the aortic suture portion protrudes from the commissure portion.

  Moreover, it is preferable that a plurality of the valve leaflets are connected to each other to be formed into an annular body, and all the aortic suture portions protrude to the outside of the annular body.

  Moreover, it is preferable that an annulus suture edge reinforcing material is disposed on the annulus suture edge of the leaflet to be sutured to the aortic annulus.

  Moreover, it is preferable that an aortic suture part reinforcing material is disposed in the aortic suture part.

  In the biological valve according to the present invention, the size of the leaflet of the patient is measured during the valve replacement operation, and the valve leaflet of that size is not prepared and used. Time can be shortened. In addition, since the biological valve does not have a stent post and a stent, the shape and the area of the valve opening of the aortic annulus are not impaired, and opening and closing operations similar to those of a natural valve can be expected.

It is a perspective view of a biological valve. It is a top view of a biological valve. It is an expanded view of a biological valve. It is a schematic diagram which shows the state which sutured the biological valve to the aortic annulus and the aorta. It is a schematic diagram which shows the state in which the biological valve is open. It is a schematic diagram which shows the state which the biological valve has closed. It is a perspective view of the biological valve which concerns on another form. It is a perspective view of the biological valve which concerns on another form. It is a perspective view of the biological valve which concerns on another form. It is an expanded view of the biological valve which concerns on another form.

  Hereinafter, the biological valve according to the present embodiment will be described with reference to the drawings. As shown in FIGS. 1 and 2, the biological valve 1 includes three leaflets 10a to 10c, aortic suture portions 11a to 11d, and commissure portions 12a to 12c.

  The biological valve 1 is formed from bovine pericardium. The biological valve 1 is formed by cutting out from a single bovine pericardium as shown in the developed view of FIG. That is, from one bovine pericardium, the aortic suture part 11a, the leaflet 10a, the aortic suture part 11b, the leaflet 10b, the aortic suture part 11c, the leaflet 10c, and the aortic suture part 11d are connected in series. A single film-like body is cut out and formed. The biological valve 1 is cut out from the bovine pericardium using a mold having the shape shown in the development view of FIG. 3 or other known means.

  Then, the boundary portion between the leaflet 10a and the aortic suture portion 11b and the boundary portion between the leaflet 10b and the aortic suture portion 11b are sutured with a suture, so that commissures are connected portions of the leaflet 10a and the leaflet 10b. A portion 12a is formed. Further, the boundary portion between the leaflet 10b and the aortic suture portion 11c and the boundary portion between the leaflet 10c and the aortic suture portion 11c are stitched with a suture, so that commissures are connected portions of the leaflet 10b and the leaflet 10c. A portion 12b is formed. Further, the boundary portion between the leaflet 10a and the aortic suture portion 11a and the boundary portion between the leaflet 10c and the aortic suture portion 11d are sutured with a suture, so that the commissural portion that is a connection portion between the leaflet 10c and the leaflet 10a is sewn. 12c is formed.

  Thereby, the biological valve 1 which is an annular body in which the leaflets 10a to 10c are connected in series via the commissures 12a to 12c is formed. The aortic suture portions 11a to 11d are formed so as to protrude from the commissure portions 12a to 12c to the outside of the annular body, respectively. The aortic suture portions 11a to 11d are portions that are sutured to the artery, and the length of the aortic suture portion (the length in the connecting direction of the leaflets 10a to 10c) is set to a length that allows suture to the artery. It only has to be done.

  Each leaflet 10a to 10c has annulus suture edges 13a to 13c that are sutured to the aortic annulus and curved outwardly. Further, the opposite edges of the respective annulus suture edges 13a to 13c also have edges (open edges) curved in a convex shape toward the outside, and the open edges of the adjacent leaflets 10a to 10c are in contact with each other. It functions to suppress the backflow of blood.

  The three leaflets 10a to 10c may be the same size or different sizes.

  The biological valve 1 described above is used as follows in the valve replacement. First, a biological valve 1 corresponding to the size of the aortic annulus of a patient undergoing valve replacement is prepared. For example, by preparing the biological valve 1 having a plurality of sizes such as a tubular body having a diameter of 19 mm, 21 mm, 23 mm, and 25 mm, the size of the patient's aortic annulus and aorta is measured during valve replacement, The valve replacement is performed by selecting the biological valve 1 having a size corresponding to the size.

  Then, all three leaflets of the patient's aortic valve (right coronary leaflet, left coronary leaflet, and no coronary leaflet) are removed and removed.

  Thereafter, as shown in FIG. 4, the biological valve 1 is sutured to the aortic annulus 40 and the aorta 41. First, the annulus suture edges 13a to 13c of the leaflets 10a to 10c are sutured to the aortic annulus 40 using the suture thread La.

  Further, the aortic suture parts 11a to 11d of the biological valve 1 are sutured to the aorta 41 using the suture Lb. Since the aortic suture parts 11b and 11c are formed in an annular shape, they are folded and sutured to the aorta 41. Further, the holding member 30 may be used for suturing the aortic suture portions 11a to 11d to the aorta 41. By suturing the aorta wall between the aorta stitching portions 11a to 11d and the holding member 30, the aorta can be firmly sewn and sewn, and an excessive load is applied to the aorta to cause a crack or the like. Can be suppressed.

  5 and 6 show a state in which the aortic valve is replaced with the biological valve 1, and both show a state in which the lower side of the drawing is the heart. FIG. 5 shows the time when the left ventricle contracts and blood is pumped from the heart, and the biological valve 1 is opened by the flow of blood pumped from the left ventricle. This causes blood to flow from the left ventricle into the artery as indicated by the arrow.

  On the other hand, as shown in FIG. 6, when the left ventricle expands, the biological valve 1 is closed and the artery is occluded. Further, since the aortic suture portions 11a to 11d are stitched to the aortic wall, the leaflets 10a to 10c do not turn over to the heart side (on the paper surface, the lower side). Thereby, the backflow of blood from the artery to the left ventricle is suppressed.

  In the biological valve 1 according to the present embodiment, the size of the valve leaflet of the patient is measured during the valve replacement operation, and the valve leaflet of that size is not prepared and used. Therefore, the valve replacement operation can be easily performed. The operation time can be shortened.

  Moreover, the biological valve 1 does not include a stent post and a stent, and has flexibility because it is formed from bovine pericardium. For this reason, there is an advantage that the half-moon shape of the aortic annulus is not impaired and the valve opening area is not reduced. Moreover, opening and closing are performed like a natural valve.

  Further, since the biological valve 1 is flexible, it can be applied to a narrow aortic annulus. Moreover, since the stent post is not provided, there is no risk of thrombus formation due to blood flow stagnation in the stent post portion.

  In the above, an example in which the aortic suture parts 11b and 11c are formed in an annular shape has been described. However, as shown in FIG. 7, the aortic suture parts 11b and 11c are respectively cut and aortic suture parts 11ba, 11bb, 11ca, 11cb may be used.

  In addition, the biological valve 1 is stored in a flat plate shape shown in the development view of FIG. 3, and when performing valve replacement, as described above, the aortic suture parts 11 a to 11 d and the leaflets 10 a to 10 c These boundaries may be sewn to form commissures 12a to 12c.

  Alternatively, as shown in FIG. 8, the commissures 12a and 12b are stored in a formed state, and the aortic sutures 11a and 11d are sutured to the arteries during valve replacement, so that the commissures 12c It may be formed.

  Moreover, as shown in FIGS. 9 and 10, the annulus suture edge reinforcing member 20 may be disposed on the annulus suture edges 13a to 13c of the leaflets 10a to 10c. Furthermore, the aortic suture part reinforcing member 21 may be disposed in the aortic suture parts 11a to 11d. Examples of the annulus suture edge reinforcing member 20 and the aortic suture portion reinforcing member 21 include biocompatible and strong materials such as polyester cloth and membranes. By providing the annulus suture edge reinforcing member 20 and the aortic suture part reinforcement member 21, damage to the annulus suture edges 13a to 13c and the aortic suture parts 11a to 11d can be suppressed.

  The annulus suture edge reinforcing member 20 and the aortic suture part reinforcing member 21 may be arranged on one surface of the annulus suture edges 13a to 13c and the aortic suture parts 11a to 11d and sutured using a suture thread. . Alternatively, the annulus suture edges 13a to 13c and the aortic suture parts 11a to 11d are arranged and stitched on both sides, and the annulus suture edge reinforcing member 20 and the aortic suture part reinforcing member 21 are used as the annulus suture edges. 13a-13c and the aortic suture parts 11a-11d may be sewn together.

  The biological valve according to the present invention can be used for aortic valve replacement in aortic valve diseases such as aortic stenosis.

DESCRIPTION OF SYMBOLS 1 Living body valve 10a-10c Valve leaflet 11a-11d Aortic suture part 11ba, 11bb, 11ca, 11cb Aortic suture part 12a-12c Commissural part 13a-13c Annulus suture edge reinforcement member 20 Aortic suture edge reinforcement member 21 Aortic suture part reinforcement member 30 Holding member 40 Aortic annulus 41 Aorta La, Lb Suture

Claims (5)

A plurality of membranous leaflets are arranged in series, and have an aortic suture part that is sutured to the aorta between the leaflets,
The valve leaflets and the aortic suture part are cut out from a single bovine pericardium and formed in a chain.
A biological valve characterized by that. The commissures where the borders between the aortic suture part and the leaflets are stitched together and the adjacent leaflets are connected are formed, and the aortic suture part protrudes from the commissures,
The biological valve according to claim 1. A plurality of the valve leaflets are connected to each other and formed into an annular body, and all the aortic suture portions protrude outside the annular body.
The biological valve according to claim 2. An annulus suture edge reinforcing material is disposed on the annulus suture edge of the leaflet to be sutured to the aortic annulus,
The biological valve according to any one of claims 1 to 3, wherein The aortic suture part reinforcing material is disposed in the aortic suture part,
The biological valve according to any one of claims 1 to 4, wherein:

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