SU1271508A1 - Искусственный клапан сердца - Google Patents
Искусственный клапан сердца Download PDFInfo
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Abstract
Изобретение относитс к медицине , точнее к протезированию клапанов сердца. Цель изобретени - снижение травматичности за счет конструктивных особенностей клапана, функционирующего следующим образом. Через второй канал 6 катетера 4 в герметически замкнутой оболочке 2 создают отрицательнее давление и она опадает. Оболочка и мембрана 1 укладываютс вокруг катетера и клапан ввод т в бедренную артерию и по ней продвигают до восход щего отдела аорты. В оболочку через канал 6 катетера под давлением ввод т контрастную жидкость или газ. Оболочка надуваетс , кра ее упираютс в стенку аорты, фиксиру клапан в просвете аорты. Поток крови после выброса из желудочка отжимает кра оболочки от стенок аорты и проходит в образовавшийс просвет . При обратном токе крови карманы 3 мембраны наполн ютс кровью и плотно прижимаютс к стенкам аорты, перекрыва поток крови. Функцию клас пана оценивают путем измерени давлени в надклапанной области через отверсти 7 и путем введени контрастной жидкости в надклапанную область через канал 5. Отсутствие регургитации контрастной жидкости в заклапанное пространство свидетельствует о хорошей функции клапана.3 ил. o tiOiA. О
Description
Изобретение относ тс к медицинской технике, точнее к протезированию клапанов сердца.
Цель 1- зобретени - снижение травматнчиости сосудов путем конструктивных особенностей клапана.
На фиг. 1 изображен клапан,, продольный разрез аорты; на фиг. 2 -клапан в закрытом положенирц на фиг. 3 - то же, в открытом положении .
Искусственный клапан сердца содержит мембрану в виде зонтика 1, герметично замкнутую оболочку 2, выполненную из эластичного материала в виде тела вращени со сход щимис на конус концами, причем оболочка содерШ1Т складки с у- или к-образными сечением , оболочка напо1И1ена газом или жидкостью, карманы 3, образова5и;ые ме;кду поверхностью оболочки 2 и мембраной 1 катетером 4 с двум каналами 5 и 6, причем мембрана 1 закреплена по центру на катетере 4 так, что его первый кана.л 5 имеет боковое отверстие 7, выход щее в аорту, а второй анал 6 через другие боковые отверсти 8 соедииен с полостью оболочки 1.
Клапан функционирует следующим образом.
Через второй капал б катетера 4 в герметически замкнутой оболочке 2 создаетс отрицательное дггвление и она спадает. Оболочка и мембрана укладываютс вокруг катетера клапан ввод.итс в бедренную артерию и, по ней продвига.етс до восход щего отдела аорты. Через канал 6 катетера 4 в оболочку 2 клапана под избыточным давлением вводитс контрастна жидкость или газ 5 в результате этого оболочка 2 1адуваетс и ее кра упираютс в стенку аорты, тем самым фиксиру клапан п просвете аорты. Степень фиксации регулируетс путем .: ;менени уровн давлени в полОсти кпапана, при этом зонтгп-ша мембра а 1 расправл етс и клапан начинае- - фу1чкциониро;зать,
После выброса крови из желудоч1с;| поток, крови отжимает кргг оболочки О: ./.Cl -ы И прохо,1Ц:1т В образо: ;:-) просвет. При обрагилзм IO;:Q крСНИ кармггг1ы 3 мембра: 1 1-Ы::с;;.п ютс кровью и плотно при;ки -;а1отс,1 к СТ-: икам aopTbjj перекрыва поток крови (фиг. 2), Положение клапана в
аорте контролируетс визуально при рентгеноскопии. Функци клапана оцениваетс с помощью измерени давлени в надклапанной области через от- i
версти 7 и путем введени контрастной жидкости в надклапанную область через канал 5. Отсутствие регургитаЦ1И контрастной жидкости в заклапанное пространство будет свидетельствовать о хорошей функции клапана. При необходимости выведени клапана из его оболочки отсасываетс жидкость или газ, оболочка спадает и клапан выводитс из аорты. Выведение
5 должно быть прерывистым и осуществл тьс только в период движени крови на периферию. В процессе выведени катетер вращаетс вокруг своей оси, что облегчает выведение .клапана. В аортальной позиции возможно применение крестообразного или пр моугольного сечени . Преимуществом крестообразного сечени вл етс боj:ee жестка и прочна фиксаци клапана в просвете аорты, недостатком большее сопротивление току крови. Кланан с пр моугольным сечением обладает меньшим сопротивлением току крови, но менее хлестко фиксируетс в центре аорты.
Мембрана 1 может фиксироватьс к герметически замкнутой оболочке 2 в любой ее части, li аортальной позиции целесообразнее ее фиксаци в дистальной части оболочки, так как в этом перекрытие тока крови будет происходить ближе к месту естественного его перекрыти . По этой же причине мембрану 1 лучше фиксировать блихсе к проксимальному концу оболочки 2, когда клапан ршпользуетс в пульмональной позиции. При использовании клапана в митральной и трику- спидальной позици х мембрану 1 целесообразнее фиксировать в средней части оболочки 2.
Количество отверстий 8, соедин ющих герметически замкнутую оболочку и второй канал 6 катетера, зависит от местоположени зонтичной мембрг ны 1 . При ее фиксации к дистальному концу оболочки дл успешного введени жидкости или газа в оболочку достаточно иметь одно такое отверстие . При фиксации мембраны 1 в средней ча.сти оболочки 2 необходимо имет минимум два отверсти ,так как части оболочки 2, наход щиес над и под
31
мембраной 1, разделены друг от друга этой мембраной и дл введени и удалени жидкости или газа необходимо два отверсти .
Предлагаемый искусственный клапан сердца позвол ет увеличить надежност фиксации за счет упругости ребер замкнутой оболочки, уменьшить опасность тромбообразовани за счет ; уменьшени объема зоны засто , снизить травматичность сосудов при работе клапана и при его введении и выведении , что дает возможность оказывать помощь больным с декомпенсированной недостаточностью клапанов сердца, кроме того, искусственный клапан может использоватьс дл предоперационной подготовки больного.
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Claims (1)
- Формула изобретениИскусственный клапан сердца, содержащий эластичную мембрану в виде зонтика и катетер с полым каналом и отверстием в его рабочей части, причем мембрана по ее центру закреплена на катетере, отличающийс тем, что, с целью уменьшени травматичности сосудов, он снабжен эластичной оболочкой со сход щимис на конусе концами, причем оболочка содержит складки, расположенные по окружности , катетер содержит второй канал с ополнительными отверсти ми, оболочка закреплена на катетере и соединена через дополнительные отверсти с вторым каналом, а мембрана закреплена на оболочке с образованием карманов .Фиг.2Фиг. J
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SU843818336A SU1271508A1 (ru) | 1984-11-29 | 1984-11-29 | Искусственный клапан сердца |
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SU843818336A SU1271508A1 (ru) | 1984-11-29 | 1984-11-29 | Искусственный клапан сердца |
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