JPH04673B2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention aims to repair the atrial septal defect, which is frequently seen as a congenital heart disease, by repairing the defect hole through a vein without performing open heart surgery. The present invention relates to a transvenous atrial septal defect closure device that aims at treatment by inserting and indwelling a closing structure.

[Prior Art] Atrial septal defect is a congenital defect in the atrial septum, which is the dividing wall between the right atrium and the left atrium. It is a disease that causes a decline in heart function, pulmonary hypertension, and lung infections. It is the most common congenital heart disease, and if the defect is not closed surgically during elementary or junior high school age, it will cause irreversible damage to the heart and lung system, which is why cardiac surgery is so important. It has become a major target. Conventionally, in order to surgically close this defect hole, the method was to make an incision in the thorax and the heart, and to stitch the defect hole under the use of an artificial heart-lung machine or to sew a special patch.

[Problems to be Solved by the Invention] As described above, even with the above-mentioned conventional techniques, it is possible to treat atrial septal defect through surgery, and this surgery has also improved due to recent medical advances. It's pretty safe.

However, this surgery requires advanced techniques and equipment similar to what is called cardiac surgery, and it also involves a large degree of invasion of the living body, causing anxiety for the patient and his family, and psychological effects due to the scars left on the chest after the surgery. It had problems that cannot be ignored.

The present invention solves these problems and closes the defect in the atrial septum by using a defect closure structure inserted through a small incision in a peripheral vein such as the jugular vein, without making an incision in the chest area or the heart. The purpose of the present invention is to perform treatment by the simple means of closure, and to eliminate most of the problems in the conventional techniques mentioned above.

[Means for Solving the Problem] As described in the claims, the means for solving the above object is an atrial septum that is attached to the tip of a tubular means inserted through an incision in a vein such as the neck. The defect hole closing means is a transvenous atrium having a structure in which an enlarged part located on the left atrium side and an enlarged part located on the right atrium are connected via an atrial septum that can pass through the defect hole. It is a septal defect closure device. The device is inserted by tubular means via a vein into the defect in the atrial septum and placed to close the defect and prevent backflow of blood from the left atrium to the right atrium.

Hereinafter, the effects and the like of the present invention will be explained based on Examples.

[Example] (Description of drawings related to the example) Figures 1 to 29 are diagrams showing five types of examples based on the present invention.

First of all, FIGS. 1 to 12 show a first embodiment, and are diagrams showing the structure and installation procedure when the defect hole closing structure is a structure in which three independent balloons are integrally joined. Figure 1 is an assembled external view of the entire device, Figure 2 is an external view of the deflated balloon, and Figure 3 is an external view of the balloon in the deflated state.
The figure is an enlarged view of the external end of the connecting pipe, Figure 4 is an external view of the plug for closing the end of the thin tube inside the connecting pipe, Figure 5 is an external view of the cap for closing the external end of the connecting pipe, and Figure 6 is FIGS. 7 to 12 are perspective views showing the state of connection between each balloon portion and the tubule, and are views showing the operating process from insertion of the balloon through the incision to completion of closing the atrial septal defect.

13 to 15 show a second embodiment, which is a balloon-like structure in which the defect hole closing structure is integrally connected and the inside thereof is communicated, and the left atrium,
FIG. 7 is a diagram showing the gradual change in shape of each balloon during closure of an atrial septal defect when the atrial septal portion and the right atrium each have different elongation rates with respect to pressure.

16 to 22 show a third embodiment, in which the defect hole closing structure is formed by integrally forming a membranous left atrium insertion part and a balloon-shaped atrial septal insertion part, and further forming them independently. FIG. 4 is a diagram showing the structure and insertion procedure of a structure in which a membrane-like right atrium insertion portion is connected with a magnet. Figure 16 is an external view of the membranous left atrium insertion part and balloon-shaped atrial septal insertion part attached to the tip of the injection tubule, as well as an external view of the membranous right atrium insertion part; Figures 1 to 21 are diagrams showing the operational process from insertion to completion of atrial septal defect closure. FIG. 22 is a partial side sectional view when the defect hole closing structure has been inserted in this embodiment.

23 to 28 show a fourth embodiment, which consists of a membranous left atrium insertion part and a right atrium insertion part in which the defect hole closing structure is formed independently, and each membranous insertion part FIG. 3 is a diagram showing the structure and insertion procedure when the structure is connected by a magnet.
FIG. 23 is an external view of a membranous left atrium insertion part and a membranous right atrium insertion part attached to the tip of the injection thin tube. Moreover, FIGS. 24 to 27 are diagrams showing the operational process from insertion to completion of closure of the atrial septal defect hole, and FIG. 28 is a partial side sectional view at the time of completion of attachment of the defect hole closure structure in this embodiment.

FIG. 29 is a diagram showing a fifth embodiment, in which only the defect hole closing structure is placed in the defect hole portion, and the connecting tube for operating the structure is removed.

In Figures 1 to 29, 1 is the balloon inserted into the left atrium, 2 is the balloon inserted into the atrial septum, 3 is the balloon inserted into the right atrium, and 4 is the balloon inserted through the incision. A communication tube that communicates the defect hole closing structure with the outside; 5, 6, and 7 are thin tubes that are installed inside the communication tube and open inside the balloons 1, 2, and 3; 8, 9, and 10 are thin tubes 5, respectively. , 6 and 7 into the balloons 1, 2, and 3, an expansion material injector/discharge device for injecting liquid or gas into the balloons to inflate them or discharging them to deflate them; 11 is a stopper for closing the end of a capillary tube;
12 is a cap for closing the communicating tube, 13 is the jugular vein, 1
4 is the skin incision line, 15 is the superficial jugular vein incision, 16 is the superior vena cava, 17 is the inferior vena cava, 18 is the right atrium, 19
is the atrial septum, 20 is the left atrium, 21 is the right ventricle, 22
23 is a left ventricle, 23 is an atrial septal defect hole, 24 is a hollow catheter, 25 is a membrane inserted into the left atrium, 26
is a membrane inserted into the right atrium; 27 and 28 are magnets;
29 is a fixed thread, 30, 31, 32 are thin tubes 5,
Needles 33, 34, 35 that communicate between 6, 7 and the inside of the balloons 1, 2, 3 are partition walls made of a soft and flexible material.

(First Example) First, a first example will be described based on FIGS. 1 to 12. In this example, superficial jugular vein incision wound 1
5 to the superior vena cava 16, the atrial septal defect hole 23 through the right atrium 18, and the balloon 1 to the left atrium 20.
2, 3 are inserted, and inflation material inject/discharge devices 8, 9, 1 are inserted through thin tubes 5, 6, 7 communicating with each balloon.
The left atrium 2 is injected with liquid, gas, or resin depending on the conditions, and the inflated balloons 1, 2, and 3 are placed in the atrial septal defect hole.
This prevents the backflow of blood from the right atrium 18 to the right atrium 18 and treats abnormalities in blood flow dynamics caused by atrial septal defect.

Each balloon is sufficiently thin and flexible so as not to damage the inner wall of each organ when inserted into or removed from blood vessels or the heart, or left in the heart for long periods of time, and is also sufficiently thin and flexible to avoid the formation of blood clots. For example, it is made of Teflon, Dacron, Gore-Tex or silicone rubber, etc.
As shown in the figure, it is composed of three independent parts: a balloon 1 located in the left atrium 20, a balloon 2 located in the atrial septal defect hole 23, and a balloon 3 located in the right atrium 18. Each balloon 1, 2, 3 is provided with a thin tube 5, 6, 7 which is opened independently and communicated with the atmosphere. The three thin tubes 5, 6, and 7 are assembled into one bundle and, like a balloon, are sufficiently flexible so as not to damage the inner walls of each organ when inserted, withdrawn, or placed in blood vessels or the heart. , and is inserted into a connecting tube 4 made of, for example, a silicone-coated tube that does not form a blood clot. Each balloon and the communication tube 4 are integrally formed and smoothly formed, and each material is mixed with an X-ray opaque substance in advance so that insertion and attachment into the heart can be performed completely by X-ray observation. I'll keep it.

As shown in FIGS. 3 to 5, the open ends of the thin tubes 5, 6, and 7 inserted into the connecting tube 4 on the outside air side are provided with thin tubes to prevent the inflation material from flowing back after injection. The structure includes an end-closing plug 11 and a connecting pipe closing cap 12 for preventing the plug 11 from escaping.

Next, the procedure from insertion of the defect hole closing structure to attachment at a predetermined position in this example will be explained.

First, as shown in Figure 7, a small incision is made on the neck skin to expose and incise the small jugular veins (superficial jugular veins). Insert it while manually pushing it forward.

As shown in FIGS. 7 to 9, each balloon portion and the communicating tube 4 integrated therewith can be easily connected from the superior vena cava 16 to the right atrium 18 and further to the atrial septal defect hole 2.
3 into the left atrium 20, all of the operations described below, including that operation, are performed under observation using X-ray fluoroscopy or cardiac ultrasound.

Next, as shown in FIG. 10, for example, physiological saline is injected from the atmospheric side end of the thin tube 5 using the inflation material injector/discharge device 8. The end-closing stopper 11 is inserted to close the thin tube 5.

Next, as shown in FIG. 11, the entire connecting tube 4 is pulled lightly, and while the balloon 1 is brought into close contact with the atrial septum 19, saline is similarly injected from the atmospheric side end of the thin tube 6, and the balloon 2 is inflated, and the capillary tube 6 is closed with the cap 11 for closing the capillary end.

Next, as shown in FIG. 12, while being careful not to loosen the tension on the connecting tube 4, physiological saline is similarly injected through the thin tube 7 to inflate the balloon 3 in the right atrium 18, and the end of the thin tube is inflated. The capillary tube 7 is closed by means of a closure stopper 11 . As a result, the atrial septal defect hole 23 is separated by the balloon 1 on the left atrium 20 side, the balloon 2 on the atrial septal defect hole 23, and the right atrium 18.
It is closed by being sandwiched in an H shape by the side balloons 3, and the basic abnormality of atrial septal defect, which is the backflow of blood from the left atrium 20 to the right atrium 18, is almost corrected.

Finally, a cap 12 for closing the connecting tube 4 is attached to the terminal end of the connecting tube 4 to completely prevent leakage of the physiological saline as the inflation material injected into the balloon. The communication tube 4 is sufficiently fixed to the inserted vein with surgical thread, the excess end is buried subcutaneously, and the skin incision is sutured to complete the entire operation.

In addition, if you want to replace the balloon with a larger balloon as the patient grows, or if it becomes necessary to replace the balloon due to breakage of the balloon for some reason, we will first insert the balloon instead of inserting the balloon. 3. Next, the injected and inflated material of balloon 2 and balloon 1 is extracted by the inflatable material injector/discharge devices 10, 9, and 8, respectively, and each balloon can be deflated and easily removed and replaced.

In addition, even if the balloon breaks for some reason, the inflation material inside the balloon is physiological saline if it is a liquid, or carbon dioxide if it is a gas, so that there is no risk of injury to the human body due to leakage. does not pose any danger to

(Second Example) Figures 13 to 15 show the second example.
In contrast to the balloon for closing the atrial septal defect hole 23 in the first embodiment, the left atrium 20, the atrial septum 19, and the right atrium 18 each formed independent chambers via a septum. Therefore, the balloon for closing the atrial septal defect hole 23 in this example was used to close the left atrium 20.
The balloon, the atrial septum 19, and the right atrium 18 are integrally formed with internal communication, and each balloon has a structure that maintains different expansion rates against pressure. That is, by changing the material or thickness of each balloon, the elongation rate in response to pressure can be changed.For example, the 20th part of the left atrium is _100mmH2O , the 19th part of the atrial septum is _200mmH2O , and the 18th part of the right atrium is 300mmH2O.
The predetermined shapes and dimensions can be maintained by the pressure of H ₂ O.

When inserting into the atrial septal defect hole 23, each balloon portion and the communicating tube 4 integrated therewith are first inserted through the superficial jugular vein incision 15 using substantially the same method as in the first embodiment. After confirming that the balloon A1 has reached the left atrium 20, a liquid or gaseous inflation material is injected through the thin tube 5 inserted into the communication tube 4. Since the insides of balloon 1, balloon B2, and balloon 3 are communicated with each other, each balloon is filled with the injected inflation material. Furthermore, continue to inject the expansion material and increase the pressure to 100mmH ₂ O.
13, the balloon 1 in the left atrium 20 first inflates and maintains a predetermined shape. Next, the connecting tube 4 is pulled to bring the balloon 1 into close contact with the atrial septum 19, and the injection of the inflation material is continued to increase the pressure to 200 _mmH2O . Accordingly, the balloon 2 is inflated to a predetermined size as shown in FIG. 14, and the atrial septal defect hole 23 is closed. Furthermore, when the pressure of the injected expansion material is increased to 300 mmH ₂ O while being careful not to loosen the tension on the connecting tube 4, the balloon 3 inflates within the right atrium 18 as shown in FIG. 15 and reaches a predetermined shape. Then, as in the first embodiment, the ends of the thin tube 5 and the communicating tube 4 are closed, and after the ends are sufficiently fixed to the incised vein with surgical thread, the skin incision is sutured. As a result, the atrial septal defect hole 23 is connected to the balloon 1 on the left atrium 20 side, the balloon 2 in the atrial septal defect hole 23, and the right atrium 18.
It is closed by being sandwiched in an H shape by the side balloons 3, and the backflow of blood from the left atrium 20 to the right atrium 18 is corrected.

(Third Example) Next, a third example will be described based on FIGS. 16 to 22. In this embodiment, the defect hole closing means includes a membrane 25 inserted into the left atrium 20 and a balloon inserted into the atrial septum 19 and integrally formed with the membrane 25, as shown in FIG. 2, a tubule 6 connected thereto, and an independently formed membrane 26 inserted into the right atrium 18. The procedure for inserting the defect hole closing structure into the atrial septal defect hole 23 based on this example will be described below.

First, as shown in FIG. 17, a thin tube 6 with a membrane 25 for the left atrium 20 made of thin Teflon or the like and a balloon 2 for the atrial septum 19 formed integrally with the membrane 2 at its tip is inserted into a hollow catheter. Pass it within 24 days. The hollow catheter 24 is made of a silicone-coated tube or the like, and by pushing the hollow catheter 24 through the incision 15, the membrane 25 at the tip and the balloon 2 pass through the blood vessel and first enter the right atrium 18. It passes through the atrial septal defect hole 23 and enters the left atrium 20. The balloon 25 is folded toward the balloon 2 side when passing through a narrow part such as a blood vessel, but while it is indwelled in the left atrium 20, it unfolds into a flat plate shape as shown in FIG. Next, as shown in FIG.
The inflation material is injected into the balloon 2 through the thin tube 6 while in contact with the balloon 2 . As a result, the balloon 2 is inflated and the atrial septal defect hole 23 is closed.

Next, while maintaining this state by pulling the thin tube 6, only the hollow catheter 24 is removed, and as shown in FIG. 20, a membrane 25 made of the same material as the membrane 25 is
The thin tube 6 is passed through a small hole made in the magnet 28 attached to the center of the membrane C26, and the hollow catheter 24 is placed over the thin tube 6 again, and the hollow catheter 24 is inserted into the atrial septal defect hole 23. Insert the membrane C26 to the atrial septal defect hole 23 by pushing it to the side. The membrane 26 inserted into the right atrium 18 naturally unfolds into a flat plate while indwelling within the heart. A magnet 27 is attached near the center of the end of the balloon 2 on the right atrium 18 side, and a magnet 28 is attached near the center of the membrane 26 on the left atrium 20 side. As a result, as shown in FIG. 21, the balloon 2 and the membrane 2 are integrated with the membrane 25.
6 is firmly attached by magnetic force, and the atrial septal defect hole 23 is closed as shown in FIG. Thereafter, the hollow catheter 24 is removed and the thin tube 6 is closed in the same manner as in the first and second embodiments. Then, the end of the tubule b6 is fixed to the incised vein with surgical thread, and the skin incision is sutured to complete the entire operation. membrane 25,
As a means for coupling the balloon 2 and the membrane 26, a mechanical coupling means other than a magnet can be used.

(Fourth Example) A fourth example will be described based on FIGS. 23 to 28. The defect hole closing means in this embodiment is the second
As shown in Figure 3, a membrane 2 is inserted into the left atrium 20.
5. It is formed by a membrane 26 that is inserted into the right atrium 18 and a connecting means that connects these membranes.
Both the membrane 25 and the membrane 26 are made of thin Teflon or the like, and a magnet 27 with a height approximately equal to the thickness of the atrial septum 19 is installed in the center of the membrane 25. Fixed thread 2 in the center
9 is fixedly installed. There is also a magnet 2 in the center of the membrane 26.
8 is attached, and a small hole through which the fixing thread 29 can pass is bored in the center. Atrial septal defect hole 23
The procedure for inserting the catheter into the membrane 25 is as follows: First, the hollow catheter 24 made of a silicone-coated tube or the like is inserted so that the fixing thread 29 fixed to the membrane 25 is passed through it. The membrane 25 is folded toward the fixing thread 29 side, and the superficial jugular vein incision 1 is opened in the same manner as in the third embodiment.
It is inserted from the 5th section and pushed forward with the hollow catheter 24. Accordingly, the membrane 25 passes through the blood vessel and first enters the right atrium 18, as shown in FIG. 24, and then passes through the atrial septal defect hole 23 and enters the left atrium 20. The membrane 25 that was folded at the time of insertion is the left atrium 2.
While indwelling in 0, it develops into a flat plate shape as shown in Figure 25. In this state, the fixing thread 29 and the hollow catheter 24 are pulled lightly, and the hollow catheter 24 is removed from the fixing thread 29 with the membrane 25 in contact with the atrial septum 19. Next, the fixing thread 29 is passed through a small hole made in the center of the membrane 26, and the hollow catheter 24 is attached to cover the fixing thread 29, and the hollow catheter 24 is inserted into the atrial septal defect hole 23.
By pushing the membrane 26 to the side, the atrial septal defect hole 2 is removed.
Insert up to 3 copies. The membrane 26 inserted into the right atrium 18 naturally unfolds into a flat plate while indwelling within the heart. A magnet 27 is installed near the center of the end of the membrane 25 on the right atrium 18 side, and a magnet 28 is installed near the center of the membrane 26 on the left atrium 20 side.
As shown in FIG. 7, the membranes 25 and 26 are firmly adhered by magnetic force, and the atrial septal defect hole 23 is closed as shown in FIG. 28. Thereafter, the hollow catheter 24 is removed, the end of the fixing thread 29 near the incision is connected to the incised vein, and the skin incision is sutured to complete the entire operation. Mechanical coupling means other than magnets can also be used as the coupling means for the films 25 and 26.

(Fifth Example) In the atrial septal defect closing devices described in the first to fourth examples above, the connecting tube used for inserting the defect closing means into the atrial septal defect hole is 4. A thin tube 6 or a fixing thread 29 is connected inside the body near the superficial jugular vein incision 15.

On the other hand, the fifth embodiment shown in FIG. 29 is an example in which only the defect hole closing means is left in the heart, and the means for attaching it is removed from the body. In the example shown in this figure, there are independent balloons 1, 2, and 3, respectively, as in the first embodiment, and between balloon 1 and balloon 2, there is a partition wall 33 made of a flexible material such as silicone rubber. A similar partition wall 34 is provided between the balloon 2 and the balloon 3, and a similar partition wall 35 is provided between the balloon 3 and the communication tube 4. each balloon and tubule 5,
6 and 7, needles 30, 31, and 32 are provided so as to penetrate through partition wall portions 33, 34, and 35. The procedure for attaching this to the defect hole is the same as in the first embodiment, but in this embodiment, the thin tubes 5, 6,
When 7 is removed, the needles 30, 31, 3 are removed along with it.
2 is removed through the partitions 33, 34, and 35, but since the partitions are made of a soft and flexible material, the removal holes are closed and the fluid inside does not leak out. There is. Thereafter, by further removing and pulling out the communicating tube 4 from the septum 35, only the atrial septal defect closing device consisting of the balloons 1, 2, and 3 can be left in the heart.

In addition, for example, when the defect hole closing structure is composed of a balloon structure in which the inside is communicated as in the second embodiment, a non-return check made of the same material as the communicating tube 4 is provided on the superior vena cava side of the balloon in the right atrium 18. A valve is provided inside, and a removable fitting part is provided at the connecting part between the connecting pipe 4 and the balloon, and when the balloon is inserted, an inflation material is injected from the connecting pipe 4 through the check valve to inflate the balloon. After completion of attachment, it is also possible to remove the communication tube 4 from the removable fitting portion and withdraw it from the body, leaving only the defect hole closing structure indwelled within the heart. If it becomes necessary to replace the defect hole closing structure in the future due to growth of the patient, etc., the connecting tube 4 is inserted again and connected to the defect hole closing structure using the removable fitting part. Furthermore, the check valve is pushed open using a thin tube inserted into the communication tube 4, and the expansion material is discharged from the body through the communication tube 4, and the deflated defect hole closing structure is easily taken out of the body through the vein, and a new one is prepared. It is also possible to replace the defect with a defect closure structure.

[Effects of the Invention] As explained in the above embodiments, the present invention has the following effects:
When treating atrial septal defect, which is the most commonly seen congenital heart disease, the conventional practice is to make an incision in the chest area and the heart, and use a heart-lung machine to close the defect hole or use a special patch. In contrast to the method of suturing up the atrial septal defect, we insert a balloon-like or thin membrane-like material that can be expanded and contracted by injecting and expelling an inflatable material through a small incision in the jugular vein. In addition to accurately inserting and closing the hole, the defect hole closing structure can also be easily replaced as the patient grows. Therefore, in addition to simplifying the sophisticated techniques and equipment required to perform conventional surgeries, it also greatly reduces the surgical invasion of the living body and the anxiety caused to the patient and his or her family. This has an excellent effect that can sufficiently eliminate problems such as psychological effects caused by subsequent scars.

[Brief explanation of drawings]

1 to 12 show a first embodiment of the present invention,
Figure 1 is an assembled external view of the entire device, Figure 2 is an external view of the balloon-shaped deflated state, Figure 3 is an enlarged view of the external end of the connecting tube, and Figure 4 is for closing the end of the thin tube inside the connecting tube. Fig. 5 is an external view of the cap for closing the external end of the connecting tube, Fig. 6 is a perspective view showing the state of connection between each balloon part and the thin tube, and Figs. 7 to 12 are the incisions of the balloon. FIG. 4 is a diagram showing the operational process from insertion to completion of atrial septal defect closure. 13th-1
Figure 5 shows the second embodiment, in which the defect hole closing structure is a balloon-like structure that is integrally connected and has different elongation rates with respect to pressure. It is a figure which shows the transition of a shape. Figures 16 to 22 show the third embodiment, and Figure 16 shows the membranous left atrial insertion part attached to the tip of the injection tubule and the balloon-shaped atrial septum before insertion through the incision. An external view of the insertion part and an external view of the membranous right atrium insertion part before installation. Figures 17 to 21 are diagrams showing the operation process from insertion to completion of atrial septal defect hole closure.
FIG. 2 is a partial side sectional view when the defect hole closing structure in this embodiment is completely installed. Figures 23 to 28 show the fourth embodiment, and Figure 23 is an external view of the membranous left atrium insertion part attached to the tip of the injection tubule before insertion through the incision, and a diagram before insertion. External view of the membranous right atrium insertion part, Figures 24 to 27 are diagrams showing the operation process from insertion to completion of atrial septal defect hole closure, Figure 28
The figure is a partial side sectional view of the present embodiment when the defect hole closing means is completely installed. FIG. 29 is a perspective view showing the fifth embodiment. 1... Balloon, 2... Balloon, 3... Balloon, 4... Connecting tube, 5, 6, 7... Thin tube, 8,
9, 10... Expansion material injector/discharge device, 11... Plug for closing the capillary tube end, 12... Cap for closing the connecting tube,
13... Jugular vein, 14... Skin incision line, 15...
Superficial jugular vein incision, 16...superior vena cava, 17...inferior vena cava, 18...right atrium, 19...atrial septum, 2
0... Left atrium, 21... Right ventricle, 22... Left ventricle, 23... Atrial septal defect, 24... Hollow catheter, 25... Membrane, 26... Membrane, 27, 28...
...Magnet, 29... Fixed thread, 30, 31, 32...
Needles, 33, 34, 35... septum part.

Claims (1)

[Scope of Claims] 1. A means for closing a defect in the atrial septum that is attached to the distal end of a tubular means inserted through a vein, and the means for closing a defect in the left atrium and the right atrium are removed. 1. A transvenous atrial septal defect closure device, characterized in that the aperture is connected via an atrial septum that is penetrable. 2. Claim 1, wherein all or part of the defect hole closing means is in the form of a balloon that can be expanded by injection of fluid.
A transvenous atrial septal defect closure device as described. 3. The transvenous atrial septal defect closure device according to claim 1, wherein the left atrium side enlarged portion and the right atrium side enlarged portion of the defect hole closure means are membranous. 4. The transvenous atrial septal defect closure device according to claim 1, wherein the defect closure means uses a combination of a balloon-like structure and a membrane-like structure. 5. The transvenous system according to claim 1, wherein the left atrium side enlarged part, the atrial septum, and the right atrium side enlarged part of the defect hole closing means are integrally formed, and each is made of an independent balloon-like structure with a septum interposed therebetween. Atrial septal defect closure device. 6. The defect hole closing means is composed of a balloon-like structure in which the left atrium, the atrial septum, and the right atrium are integrally formed and communicate with each other, and each balloon-like structure has different elongation in response to pressure. 2. The transvenous atrial septal defect closure device according to claim 1, wherein the transvenous atrial septal defect closure device has a 7. The transvenous atrial septal defect closure device according to claim 1, wherein the left atrium side enlarged portion and the right atrium side enlarged portion of the defect hole closure means are formed independently, and the atrial septum is the connecting means. . 8. Claim 1, wherein the defect hole closing means is such that the left atrial enlarged part and the atrial septum are integrally formed, and are connected to the independently formed right atrial enlarged part by a connecting means. A transvenous atrial septal defect closure device as described.