RU35217U1 - Conduit of the ascending aorta - Google Patents

Description

CONDITION OF THE RISING AORTA.

The utility model relates to medicine, namely to bioprosthetics of blood vessels.

Known biological valve-containing aortic conduit used for surgical treatment of ascending aortic aneurysms with aortic valve lesion (RF Patent N 2082352, IPC A61F 2/06, 1997).

The conduit is a xenopericardium tube evenly spaced and fixed to the rigid support element, and the locking element is represented by three flaps of biological tissue attached to the rigid support element of the heart valve prosthesis seat. Outside, the support element is sheathed with a polyester fiber sheath to form an implant cuff.

The disadvantages of this product are:

1. Synthetic tissue, which in the lumen of the conduit serves as a place for thrombosis in the initial stages after implantation of the prosthesis.

2. A rigid support element, narrowing the lumen of the conzita and reducing the passage opening. In addition, it restricts the natural movement of the obturator during heart contractions.

The use of a rigid support element for fixing the flaps of the locking element is not always possible, especially with a small conduit diameter, since in this case, narrowing of the conduit lumen by the support element leads to the development of heart overload after surgery.

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IPC A 61 F 2/06

is a decrease in the risk of thrombosis and an improvement in the hemodynamic properties of conduit.

Figure 1 shows a conduit, consisting of two parts: the upper 1, forming a tube, and the lower 2, serving as a supporting element, between which the locking element 3 is hemmed in the form of three half-moon flaps. The lower part 2 serves to form the cuff 4 necessary for implantation of the conduit. In the proximal section, the tube is sewn with a twisted suture 5 with a length of about 2 cm.

Conduit works as follows.

When excessive pressure occurs in the left ventricle of the heart, blood rushes into the aorta, in Fig. 1, the direction is indicated by an arrow. In this case, the valves of the locking element open and are pressed by the flow of blood to the walls of the tube. When a reverse blood flow occurs, the blood fills three half-moon cavities on the valves, the valves close tightly together, and the locking element of the conduit closes.

The technical result of the implementation of the utility model is achieved by using a supporting element made of soft biological tissue and hemming the locking element using an external seam.

An example of a conduit.

The conduit is cut out in the form of two strips of fabric - the upper one forming the tube, and the lower one forming the cuff for hemming the conduit with half-moon cutouts in the form of a locking element. The width of the strips is equal to the circumference of the conduit of the required diameter with an allowance for stitching with a twisted seam.

flow and different for each conduit diameter. On the lower side of the conduit, a cuff is formed from excess tissue of the lower strip, which serves to facilitate the implantation of the valve in the operating room.

The locking element is cut out in the form of three half-moon cusps, connected in the commissure area by a 5 mm jumper. The total length of the locking element corresponds to the width of the base of the conduit, taking into account the allowance for stitching.

The locking element flaps are hemmed with a continuous curling seam from the outside along the contour of the conduit with the edge of the upper and lower strips with a cuff being seized in the seam, after which the conduit strips are rolled into a cylinder and sewn on the mandrel of the corresponding diameter with a curved seam.

At the same time, commissures between adjacent flaps are stitched with an upholstered seam with a capture of the tube walls into a small roller. This ensures a tight closure of the valves in the area of commissures and eliminates the backflow of blood near the line of sutures. One of the commissures formed is the longitudinal suture of the conduit, which is unfinished, which allows the operation to simulate the natural confusion of the aorta. In this case, excess tissue from the edges of the tube can be cut off, after which the longitudinal seam of the conduit is completed by the surgeon himself during the operation.

The use of a support element made of soft biological tissue allows to increase the passage diameter of the conduit and reduce the risk of thrombosis due to the absence of synthetic tissue in its lumen. The use of the external suture allows you to remove the area of its overlap from the lumen of the conduit, thereby increasing the area of the passage opening, and to eliminate the formation of vortex flows during blood flow, which improves hemodynamic properties and reduces the risk of thrombosis.

Tests showed a decrease in the pressure gradient on the locking element by 8 mm Hg. and an increase in throughput of 15% on average compared to the prototype. The product has been clinically tested. To date, 5 products have been implanted. The results of operations are positive. There were no cases of thrombosis.

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Claims (1)

Conduit of the ascending aorta containing a tube and a tricuspid locking element with biological tissue commissures mounted on a supporting element with a cuff, characterized in that the supporting element and cuff are made of soft biological tissue, and the commissures are formed and the locking element is fixed with a suture on the outer surface conduit.