RU2789041C1 - Implantable prosthetic heart valve - Google Patents

Abstract

FIELD: medical equipment.

SUBSTANCE: implantable prosthetic heart valve comprises valve flaps attached to a large ring, wherein a small ring and gears connected to spirals are positioned rotatably inside of said large ring. The large ring has through sockets configured for the spirals to be passed through them. The small ring is configured to rotate by means of an external drive and has ribs engaging with the gear teeth, configured to rotate the rotatable gears, unwind the spirals configured to pass through the sockets, and then pierce the heart tissue while attaching the large ring to the heart tissue around the perimeter.

EFFECT: higher reliability and duration of fixation.

10 cl, 8 dwg

Description

SUBSTANCE: invention relates to medicine, cardiac surgery, namely to heart valve prosthetics, and can be used for surgical treatment of heart valvular dysfunction by prosthetics.

Currently, most of the operations for the correction of valvular defects are performed by surgical prosthetics of altered heart valves by sewing the cuff of the prosthesis ring with threads to the heart tissues in the projection of the fibrous ring of the native valve.

There are implantable bioexpandable prosthetic heart valves (BRVs).

The optimal use of BRKS for the treatment of aortic valve dysfunction, due to anatomical features, the correction of mitral valve disease is difficult to achieve. There are also a number of contraindications, for example, the Perceval S prosthesis can only be used for aortic valve stenosis. Also, anatomical features remain a problem for their use, for example, the localization of the origin of the coronary arteries. There are frequent cases of postoperative cardiac conduction disorders, such as blockade of the His bundle, atrioventricular blockade, which requires further follow-up or implantation of a pacemaker.

There are several options for ligature fixation of the prosthetic heart valve ring. Closest to the claimed invention is a heart valve prosthesis (RF patent No. 2624313 C1), which is implanted in the intraannular or supraannular position, with different types of surgical suture. This heart valve prosthesis is selected as a prototype of the claimed invention.

The disadvantages of the prototype heart valve prosthesis are the lack of reliability of its fixation, as well as the high complexity of its installation due to the duration of the surgical operation to fix it, since the valve prosthesis ring is sewn to the aorta manually during open heart surgery, which implies: a high level of skills surgeon, acquired in the course of long-term training; the risk of failure of individual sutures, which leads to paraprosthetic regurgitation; long time required for suturing, which increases the time of cardiopulmonary bypass.

The technical result of the invention is the creation of an implantable heart valve prosthesis with increased reliability of fixation, as well as less complexity and duration of fixation, due to fixation using spirals that extend from the large ring, pierce the heart tissue and thereby fix the prosthesis on the heart tissue.

The stated technical result is achieved by creating an implantable heart valve prosthesis containing valve leaflets that are attached to a large ring, inside which, with the possibility of rotation, a small ring and gears connected to spirals are located, and the large ring also has through holes made with the possibility of passing through itself of spirals, and the small ring is made with the possibility of rotation with the help of an external drive and has ribs that engage with the teeth of the gear and are made with the possibility of transmitting rotation to the gears, which are made with the possibility of rotation, while unwinding the spirals, which are made with the possibility of passing through holes, after which piercing the heart tissue, while attaching a large ring around the perimeter of the heart tissue.

In the preferred embodiment of the prosthesis, the large ring consists of a base ring and two semi-rings fixed on it from above, while a groove is made inside the semi-rings, inside which a small ring is located, and the base ring and semi-rings have nests, inside which, between the base ring and the semi-rings, there are spiral gears.

In a preferred embodiment of the prosthesis, the base ring and half rings have sockets connected to the sockets, each of which is configured to pass through itself one helix between the base ring and the half ring.

In a preferred embodiment of the prosthesis, the helices are pointed and metallic.

In a preferred embodiment of the prosthesis, the gears have a cylindrical axis to which the spirals are soldered.

In a preferred embodiment of the prosthesis, the large ring and small ring are made from a biocompatible material selected from a set containing titanium and surgical steel.

In a preferred embodiment of the prosthesis, the coils are made from a biocompatible material selected from a set of materials containing nitinol and a platinum-iridium alloy.

In the preferred embodiment of the prosthesis, the outer surfaces of the prosthesis elements in contact with organic tissues are covered with a material selected from a set of materials containing a titanium foam layer, a non-woven material, and biologically compatible polymers.

In a preferred embodiment of the prosthesis, the outer surfaces of the prosthesis elements in contact with organic tissues contain medicinal components with an effect selected from a set of effects containing athrombogenic, cytostatic and antibacterial effects.

In a preferred embodiment of the prosthesis, the external drive is in the form of a delivery vehicle for the prosthesis.

For a better understanding of the claimed invention, the following is a detailed description with the corresponding drawings.

Fig. 1. Implantable prosthetic heart valve assembly, made according to the invention: a) side view; b) top view; c) bottom view; d) oblique projection.

Fig. 2. Semirings made according to the invention: a) side view; b) top view; c) bottom view; d) oblique projection.

Fig. 3. Ring base, made according to the invention: a) side view; b) top view; c) bottom view; d) oblique projection.

Fig. 4. Small ring made according to the invention: a) side view; b) top view; c) bottom view; d) oblique projection.

Fig. 5. Gear with a spiral (in compressed and working condition), made according to the invention: a) in a compressed state, side view; b) in working order, side view; c) top view.

Fig. 6. Large ring in section, made according to the invention.

Fig. 7. An implantable heart valve prosthesis in an activated form, without leaflets, with spirals extended outward, made according to the invention.

Fig. 8. Heart with installed implantable prosthetic heart valves, made according to the invention.

Elements:

1 - half ring;

2 - ring base;

3 - nest;

4 - technological fasteners;

5 - small ring;

6 - hole;

7 - groove;

8 - gear;

9 - spiral;

10 - gear axis;

11 - ribs.

Let us consider in more detail the embodiment of the claimed implantable heart valve prosthesis (Fig. 1 - 8).

The prosthesis of the heart valve contains valve leaflets, which are attached to a large ring, which consists of two half-rings 1 and a base ring 2 interconnected by technological fasteners 4. The half-rings have a groove 7, inside which a small ring 5 is located. The base ring 2 and half-rings 1 have nests 3. Inside the nests 3, between the base ring 2 and half rings 1, gears 8 with spirals 9 are located. Gears 8 are connected to spirals 9. The base ring and half rings have 3 holes connected to the sockets 6. The small ring 5 has ribs 11, which are included in gear teeth engagement 8.

Half rings 1, base ring 2 and small ring 5 are made of titanium. Spirals 9 are made of platinum-iridium alloy. The outer surfaces of the prosthesis elements in contact with organic tissues are covered with a layer of foamed titanium and contain medicinal components with an athrombogenic effect.

The prosthetic heart valve is installed as follows. The altered biological leaflets of the patient's heart valve are removed and, if necessary, decalcified. Using a meter, determine the appropriate size of the prosthetic heart valve. Using the delivery device, the implantable prosthesis is positioned in the selected projection, after which, using the delivery device, the small ring 5 is rotated. half rings 1 and base ring 2 are attached along the perimeter to the tissues.

Although the embodiment of the claimed invention described above has been set forth for the purpose of illustrating the claimed invention, it will be clear to those skilled in the art that various modifications, additions and substitutions are possible without departing from the scope and spirit of the claimed invention as disclosed in the appended claims.

Claims (10)

1. An implantable heart valve prosthesis containing valve leaflets that are attached to a large ring, inside which a small ring and gears connected to spirals are rotatably located, and the large ring also has through holes made with the possibility of passing spirals through itself, and the small the ring is rotatable by means of an external drive and has ribs that engage with the gear teeth and are configured to transfer rotation to the gears that are rotatable, while unwinding the spirals that are configured to pass through the holes, after which the tissue is pierced heart, while attaching a large ring around the perimeter to the tissue of the heart. 2. The prosthesis according to claim 1, characterized in that the large ring consists of a base ring and two half rings fixed on it from above, while a groove is made inside the half rings, inside which a small ring is located, and the base ring and half rings have sockets, inside which, between the base ring and half rings, gears with spirals are located. 3. The prosthesis according to claim 1 or 2, characterized in that the base ring and half rings have sockets connected to the sockets, each of which is configured to pass through itself one spiral between the base ring and the half ring. 4. The prosthesis according to claim. 1, characterized in that the spirals are made of pointed and metal. 5. The prosthesis according to claim 1, characterized in that the gears have a cylindrical axis, to which the spirals are soldered. 6. The prosthesis according to claim. 1, characterized in that the large ring and the small ring are made of a biologically compatible material selected from a set containing titanium and surgical steel. 7. Prosthesis according to claim 1, characterized in that the coils are made of a biologically compatible material selected from a set of materials containing nitinol and a platinum-iridium alloy. 8. The prosthesis according to claim 1, characterized in that the outer surfaces of the prosthesis elements in contact with organic tissues are covered with a material selected from a set of materials containing a titanium foam layer, non-woven material, biocompatible polymers. 9. The prosthesis according to claim 1, characterized in that the outer surfaces of the prosthesis elements in contact with organic tissues contain medicinal components with an effect selected from a set of effects containing athrombogenic, cytostatic and antibacterial effects. 10. The prosthesis according to claim. 1, characterized in that the external drive is made in the form of a means of delivery of the prosthesis.

Images