JPH1119088A - Heart pressing device for coronary artery bypass surgery - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a device which can minimize the effect of heart beating when performing a coronary artery bypass surgery while the heart is acting. SOLUTION: In this heart pressing device used for coronay artery bypass surgery, a pressing plate 1 which presses the perimeter of a site subject to operation of a heart released is formed roughly in a shape of a horse shoe on plane and a handle rod 2 deformably bent is securely connected to the pressing plate while a blood sucking material 4 having a buffering function and a locking function is mounted on the pressing plate.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a cardiac pressing device used for coronary artery bypass surgery for treating angina pectoris and myocardial infarction due to stenosis of a coronary artery, and more particularly to one end of an internal thoracic artery while the heart is moving. The present invention relates to a heart pressing device used in a bypass operation for connecting a blood vessel to a coronary artery.

[0002]

2. Description of the Related Art In order to keep the heart working, blood carrying nutrients flows from the coronary arteries. When the blood vessels are blocked, myocardial infarction causes heart failure and sudden death. In order to treat angina pectoris and myocardial infarction due to such stenosis of coronary arteries (blood vessels), there are two typical methods of blood flow reconstruction. One is called percutaneous coronary balloon dilatation (PTCA)
Another method is to open a blood vessel with a balloon, and another method is a coronary artery bypass surgery (CABG) in which a blood vessel is taken from another part of the body and a bypass is created. Either is selected according to the patient's condition and the condition of the blood vessels.

[0003] As a blood vessel used for coronary artery bypass surgery targeted by the present invention, a method using a great saphenous vein of the foot, which has been generally used until now, has recently used an internal thoracic artery and further a gastric omental artery. The method has been adopted. And the bypass operation performs extracorporeal circulation using a heart-lung machine,
A method of interrupting blood flow by stopping the movement of the heart and performing the operation during that time is generally adopted. Recently, a method of performing a coronary artery bypass operation while the heart is moving has been devised.

[0004]

However, in the state where the heart is moving, the chest is opened, the internal thoracic artery is taken, and the end of the internal thoracic artery is anastomosed to the distal side of the coronary artery. There is a problem that the operation site is also wavy due to the pulsation, and the connection of the internal thoracic artery is difficult. In addition, since the above-mentioned operation is performed while the heart is moving, blood naturally flows out and the visual field of the anastomotic part deteriorates, and it is necessary to frequently suck blood with gauze or the like in order to solve this. Become.

[0005] The present invention has been made in view of the above-mentioned problems of the prior art.
An object of the present invention is to provide a device capable of minimizing the influence of pulsation when performing coronary artery bypass surgery while the heart is moving.

[0006]

SUMMARY OF THE INVENTION In order to solve the above-mentioned problems, a technical measure taken by the present invention is to cut one end of an internal thoracic artery in order to treat a stenosis of a coronary artery which feeds blood to the heart muscle. A heart pressing tool used for coronary artery bypass surgery connected to the coronary artery, wherein a pressing plate that opens a treatment site of the heart and presses the periphery thereof is formed in a substantially horseshoe shape in a plane, and the pressing plate can be bent and deformed. And a blood-absorbing material having a buffering function and a non-slip function is attached to the pressing plate.

The pressing plate is made of a metal plate and is formed in a substantially horseshoe shape, U-shape or V-shape, and one end of a handle rod made of a bendable metal wire is connected and fixed to a substantially central portion of the pressing plate. A grip having a thickness and a length that is easy to grasp is attached to the other end of the handle. In addition, as a blood-absorbing material attached to the pressing plate, a sponge sheet that absorbs blood flowing out during the operation to improve the visual field of the treatment site (anastomosis portion), and softly and stably presses the heart;
A belt-like knit, a nonwoven fabric, a gauze, and the like can be given. And
As a mounting form of the blood-absorbing material, a blood-absorbing material cut in the same shape as the pressing plate is adhered via an adhesive layer or formed into a cover shape (bag shape) that can be attached to and detached from the pressing plate. Furthermore,
The pressing plate itself may be formed into a predetermined shape (flat horseshoe shape, U-shape, V-shape, etc.) with the above-mentioned blood-absorbing material, and it may be detachably attached to the handle rod.

According to the above configuration, if the pressing tool is set and pressed so that the treatment site is located at the center of the inside of the pressing plate, the pulsation of the treatment site is pressed by the pressing plate, so that the inside of the inside is suppressed. The pulsation becomes quiet, and the anastomosis of blood vessels can be performed accurately. Since the blood-absorbing material having a buffering function and a non-slip function is attached to the pressing plate of the pressing tool, the treatment site can be gently and stably pressed down, and the outflowing blood is blood-sucking. Since the material is sucked, the visual field of the treatment site (anastomosis part) is improved, and the above-described anastomosis operation can be performed smoothly.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a perspective view showing the pressing tool A,
One end of the handlebar 2 is fixed via a washer 2 'to the center of the curved portion of the surface of the pressing plate 1 in which a flat metal plate is formed in a substantially horseshoe shape,
A grip 3 having a thickness and length that is easy to hold is attached to the other end of the handle rod 2, and a blood absorbing material 4 is adhered and fixed to the lower surface of the pressing plate 1 via an adhesive layer.

Since the outer peripheral edge of the pressing plate 1 is directly applied to the myocardium, the corner is rounded so as not to be damaged. The handle rod 2 fixed to the pressing plate 1 uses a bendable metal wire that can be bent to an arbitrary angle by applying a certain amount of force. Thus, the pressing tool A is appropriately variably adjusted to an angle at which the pressing tool A can be easily pressed against the myocardium. Note that the handle rod 2 may be fixed to the pressing plate 1 by directly welding or the like without using the washer 2 '.

The blood-absorbing material 4 attached to the pressing plate 1 is formed by cutting a sponge sheet having the function of absorbing blood and having a buffering function and a non-slip function into the same shape as the pressing plate 1. Pasted through is fixed. Therefore, the blood-absorbing material 4 can be peeled off from the pressing plate 1, and after use, the blood-absorbing material 4 that has absorbed the blood is peeled off and discarded. Become.

As shown in FIG. 3, the blood-absorbing material 4 is formed on a cover formed with a bag portion 5 on the upper surface of which the pressing plate 1 is inserted and removed, so that the blood-absorbing material 4 can be replaced more easily. You may be able to. Further, as shown in FIG. 4, the pressing plate 1 itself may be formed in a substantially horseshoe shape with the blood-absorbing material described above, and this may be detachably attached to the handle rod 2 to constitute a pressing tool. In this case, the detachable connecting means is selected depending on the material of the blood absorbing material constituting the pressing plate.

The above-mentioned pressing tool A cuts the chest as shown in FIG. 5, holds the portion open with an instrument, cuts off one end of the internal thoracic artery b, and inserts the cut off end into the heart c. Is connected to the coronary artery a of the
By pressing against the inner side of the pressing plate 1, the pulsation of the treatment site can be calmed down, whereby the anastomosis operation can be performed smoothly. Moreover, since the blood-absorbing material 4 having a buffering function and a non-slip function is attached to the lower surface of the pressing plate 1, the pressing can be performed gently on the myocardium without any deviation and stably, and furthermore, the blood flowing out. Since the blood is absorbed by the blood-absorbing material 4, the visual field of the treatment site can be improved, and a smooth operation can be performed. Further, since the pressing plate 1 has a horseshoe shape and the inside and outside communicate with each other, after connecting the internal thoracic artery b to the coronary artery a, the pressing device A connects the connected internal thoracic artery b through the cutout of the pressing plate 1. Can be removed.
In the figure, reference numerals 6, 6 'denote occluders for blocking blood flow in the coronary artery a, 6 denotes a central occluder, and 6' denotes a peripheral occluder.

[0014]

According to the pressing device of the present invention, the coronary artery bypass operation performed while the heart is moving can be performed while minimizing the influence of pulsation. That is, by attaching a blood absorbing material having a cushioning function and a non-slip function to a flat substantially horseshoe-shaped pressing plate,
When the pressing plate is pressed, the pulsation of the myocardium inside the pressing plate becomes quiet, and the outflowing blood is sucked and the visual field of the anastomosis is secured, so that the connection work of the internal thoracic artery is accurate and smooth. Can be done. According to the second and third aspects, the blood-absorbing material can be attached to and detached from the pressing plate. Further, according to the fourth aspect, it is possible to provide a pressing tool which is rich in economy.

[Brief description of the drawings]

FIG. 1 is a perspective view showing an example of a pressing tool according to the present invention.

FIGS. 2A and 2B show a portion of a pressing plate, wherein FIG. 2A is a plan view and FIG. 2B is a cross-sectional view taken along line (X)-(X).

FIG. 3 is a perspective view showing another example (cover shape) of a blood absorbing material attached to a pressing plate.

FIG. 4 is a perspective view showing an embodiment in which the pressing plate itself is formed of a blood-absorbing material and is detachably attached to a handle rod.

FIG. 5 is a perspective view showing a use state of the present instrument.

[Explanation of symbols]

 A: Pressing tool a: Coronary artery b: Internal thoracic artery c: Heart 1: Pressing plate 2: Handle rod 4: Blood-absorbing material

Claims (4)

[Claims] 1. A heart pressing device for use in coronary artery bypass surgery in which one end of an internal thoracic artery is cut and connected to the coronary artery to treat a stenosis in a coronary artery that feeds blood to the heart muscle. A pressing plate that opens the part and presses the periphery thereof is formed in a substantially horseshoe shape in a plane, and a bending rod that can be bent and deformed is connected and fixed to the pressing plate, and a blood absorbing material having a buffer function and a non-slip function is attached to the pressing plate. A heart pressing device for coronary artery bypass surgery, which is attached. 2. The heart pressing device for coronary artery bypass surgery according to claim 1, wherein the blood-absorbing material is adhered and fixed to the lower surface of the pressing plate via an adhesive layer. 3. The heart pressing device for coronary artery bypass surgery according to claim 1, wherein the blood-absorbing material is formed in a replaceable cover shape surrounding the pressing plate. 4. The cardiac pressing device for coronary artery bypass surgery according to claim 1, wherein the pressing plate is formed of a blood-absorbing material and is detachably attached to the handle rod.