RU2790968C1 - Clamp for isolation of left atrial appendage - Google Patents

Abstract

FIELD: medical equipment.

SUBSTANCE: invention relates to medical equipment and can be used for permanent anatomical and electrical isolation of the left atrial appendage during surgical correction of atrial fibrillation to prevent thromboembolic stroke in patients with atrial fibrillation. The clamp for the left atrial appendage isolation contains two tubular working parts, connected an by an elastic jumper in the form of a cylindrical compression spring at one end and at the other end by a locking connection consisting of two lugs, on one of which a loop is installed, and there is a locking groove on the opposite tubular working part.

EFFECT: use of the invention enables preventing injury to the heart structures located near the left atrial appendage: the left ventricle and the left atrium, the pulmonary artery and the left pulmonary veins.

1 cl, 2 dwg

Description

SUBSTANCE: invention relates to medicine, namely to cardiovascular surgery, and can be used for permanent anatomical and electrical isolation of the left atrial appendage during surgical correction of atrial fibrillation to prevent thromboembolic stroke in patients with atrial fibrillation.

Known clip for isolation of the left atrial appendage (RU 2640014 C1). The clamp consists of two tubular working parts arranged in parallel, connected on one side by a curved elastic bridge, and on the other hand, by a locking joint consisting of two loops and a lavsan thread passed through them, ensuring the reduction and retention of the working parts in this position.

The disadvantage of the known clamp is mechanical injury to the pulmonary artery and left ventricle, which is due to the use in the design as an elastic jumper connecting the tubular working parts, a wire spring ring, the diameter of which exceeds the maximum thickness of the tissues on which it can be applied to ensure uniform and complete overlap passage of the left atrial appendage.

This disadvantage is overcome by replacing the wire spring ring with a cylindrical compression spring, which reduces the dimensions of the protruding parts of the clamp.

The technical result of the invention is the exclusion of injury to the structures of the heart located near the left atrial appendage: the left ventricle and the left atrium, the pulmonary artery and the left pulmonary veins.

Clamp for isolating the left atrial appendage contains two tubular working parts connected at one end by an elastic jumper in the form of a cylindrical compression spring, and at the other end by a locking connection consisting of an eyelet, a cap loop and a fixing groove.

In FIG. 1 and 2 shows a longitudinal section of the clamp for isolating the left atrial appendage in the open and collapsed state, respectively, where 1, 2 are tubular working parts, 3 is a fixing groove, 4 is a cylindrical compression spring, 5 is lugs, 6 is a cap loop.

The technical result is achieved by the fact that as an elastic jumper located at one end of the tubular working parts, a cylindrical compression spring is used with the insertion of its ends inside the tubular working parts and their fixation to the locking joints, consisting of lugs, with a loop loop installed in one of them , and a fixing groove located on the opposite tubular working part for fixing the loop loop and holding the clamp in the closed state.

Example

диаметра трубчатой рабочей части и отогнули получившийся сегмент на угол 45°.On one side of each tubular working part 1, 2, a transverse cut was made to a depth

diameter of the tubular working part and bent the resulting segment at an angle of 45°.

диаметра трубчатой рабочей части. К концам цилиндрической пружины сжатия 4 прикрепили две проволоки, не формируя при этом на их свободных концах проушины 5. Затем со стороны отогнутых сегментов внутрь каждой трубчатой рабочей части 1, 2, ввели цилиндрическую пружину сжатия 4 с прикрепленными к ее концам проволоками таким образом, чтобы свободные концы проволок вышли с противоположных сторон трубчатых рабочих частей 1, 2. Обеспечивая предварительное натяжение цилиндрической пружины сжатия 4 изгибом концов проволок, формировали проушины 5. Накидную петлю 6 помещали в проушину 5 сформированную на трубчатой рабочей части 2.On the tubular working part 1, to form a fixing groove 3, a transverse cut was made on

diameter of the tubular working part. Two wires were attached to the ends of the cylindrical compression spring 4, without forming lugs 5 on their free ends. the free ends of the wires came out from opposite sides of the tubular working parts 1, 2. Providing a preliminary tension of the cylindrical compression spring 4 by bending the ends of the wires, lugs 5 were formed.

During the operation, to install the clamp, the left atrial appendage is placed in the space between the opened working parts 1, 2. The working parts 1, 2 are brought together and, turning the loop loop 6, insert it into the groove 3, fixing the clamp in the closed position, which ensures complete overlap of the lumen left atrial appendage.

In a chronic experiment on two domestic pigs, after applying the clamp, a Doppler study was performed, which showed the absence of blood circulation between the atrium and the ear, as well as an echocardiographic study, which showed an even distribution of tissues between the working parts and the absence of tissue damage. The animals were observed for 3 months. They underwent echocardiography and transesophageal echocardiography under sedation, as well as plain chest radiography. There were no deaths of animals before the withdrawal from the experiment (3 months). Pathological anatomical examination (macro- and microscopic) showed no signs of intracardiac and systemic thromboembolism. There is complete isolation of the left atrial appendage and no signs of injury to the structures of the heart located next to the left atrial appendage: the left ventricle and left atrium, pulmonary artery and left pulmonary veins.

Claims (1)

Clamp for the left atrial appendage, containing two tubular working parts, connected at one end by an elastic jumper in the form of a cylindrical compression spring, and at the other end by a locking connection, consisting of two lugs, one of which has a loop loop, and on the opposite tubular working parts is a locking groove.

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