WO2019154124A1 - Prosthetic valve and prosthetic valve device - Google Patents

Prosthetic valve and prosthetic valve device Download PDF

Info

Publication number
WO2019154124A1
WO2019154124A1 PCT/CN2019/073156 CN2019073156W WO2019154124A1 WO 2019154124 A1 WO2019154124 A1 WO 2019154124A1 CN 2019073156 W CN2019073156 W CN 2019073156W WO 2019154124 A1 WO2019154124 A1 WO 2019154124A1
Authority
WO
WIPO (PCT)
Prior art keywords
sealing film
prosthetic valve
leaflet
valve
stitching
Prior art date
Application number
PCT/CN2019/073156
Other languages
French (fr)
Chinese (zh)
Inventor
史欢欢
周庆亮
可大年
孟坚
Original Assignee
北京迈迪顶峰医疗科技有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 北京迈迪顶峰医疗科技有限公司 filed Critical 北京迈迪顶峰医疗科技有限公司
Publication of WO2019154124A1 publication Critical patent/WO2019154124A1/en

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A61F2/2415Manufacturing methods
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A61F2/2418Scaffolds therefor, e.g. support stents

Definitions

  • the invention relates to a heart valve technology in the field of medical instruments, and belongs to the field of interventional treatment instruments, in particular to a prosthetic valve and a prosthetic valve device.
  • Congenital heart disease is a congenital cardiovascular system malformation caused by abnormal heart and blood vessels during fetal period. It is the most common heart disease in childhood. According to statistics, 6 to 7 out of every 1,000 newborns have congenital heart malformations. According to demographers, there are about 10 million people suffering from congenital heart disease in China, and about 200,000 children with congenital heart disease are added each year, of which complex congenital heart disease accounts for about 20%. Many complex congenital heart disease lesions can seriously affect the right ventricular outflow tract and require surgical reconstruction. Pulmonary valve regurgitation or restenosis often occurs after surgery, so the right ventricular outflow tract needs to be reconstructed again by surgery.
  • Transcatheter pulmonary valve replacement can not only correct stenosis, but also treat valvular regurgitation. This technique is used to place the artificial valve stent through the catheter into the autologous pulmonary valve through the peripheral venous approach, replacing the lost pulmonary valve to achieve treatment. purpose.
  • the causes of pulmonary regurgitation are as follows: 1 complete congenital pulmonary valve malformation: can be completely missing, single-leaf pulmonary valve and other malformations, common in patients with tetralogy of Fallot. 2 Ma Fang Syndrome: The lesion mainly involves the aortic valve and the mitral valve, but it has been reported that about 26.9% of the patients have pulmonary valve involvement and pulmonary regurgitation. 3 cardiac tumors: papillary fibroelastoma is closely related to pulmonary valve disease, showing that the tumor has multiple lobes and is attached to the endocardium through the pedicle. Common in the aortic valve or pulmonary valve ventricle.
  • Increased adherent tumor volume may result in moderate to severe pulmonary regurgitation, with or without pulmonary stenosis.
  • RVOT right ventricular outflow tract
  • the stenosis may expand and expand the annulus, causing pulmonary regurgitation.
  • 5 iatrogenic It is the most clinically significant and most common factor in the clinic, and it is also the most suitable group for percutaneous pulmonary valve implantation (PPVI).
  • RVOT transvalvular surgery longitudinal incision of the pulmonary artery and then patch to enlarge the diameter of the lumen
  • RVOT transvalvular surgery longitudinal incision of the pulmonary artery and then patch to enlarge the diameter of the lumen
  • RVOT transvalvular surgery longitudinal incision of the pulmonary artery and then patch to enlarge the diameter of the lumen
  • it will enlarge the pulmonary valve annulus, and the valve leaflets will be poorly combined, resulting in obvious pulmonary shunt.
  • Many foreign heart centers will place valved artificial blood vessels in the ROVT, although there will be no pulmonary regurgitation in the short term, but long-term After application, the artificial blood vessels will be calcified and cause outflow obstruction, and the biological valve will be degraded and cause valve insufficiency or stenosis.
  • This type of population is currently the main application group of PPVI.
  • Bonhoeffer's team reported the first clinical use of PPVI, which successfully performed a PPVI procedure in a 12-year-old patient with pulmonary stenosis and reflux after Fello-Fed disease repair. This technique was then used for more patients.
  • Bonhoeffer reported on PPTV in 100 patients with congenital diseases such as pulmonary regurgitation or RVOT obstruction aged 16-35 years during the TCT meeting. There was no death after 0.5-5 years of follow-up, and the right ventricular pressure decreased significantly after surgery. The exercise tolerance is significantly improved.
  • the Melody device is a three-lobed bovine jugular vein valve sewed on a platinum-rhodium balloon-expandable alloy stent.
  • the inner diameter of the implanted valve during expansion is varied from 10 to 22 mm, which is attributed to the good elasticity of the leaflets made by the venous valve and the larger leaflet interface.
  • the conventional size is 18 to 22 mm.
  • the other is Edwards' SAPIEN balloon dilatation interventional valve.
  • the stent of the SAPIEN valve is made of stainless steel and uses a durable bovine pericardium as the leaflet material, while the seal cuff is also made higher to reduce the occurrence of paravalvular leakage.
  • the valve is currently available in 23mm, 26mm and other models. Their structures are straight and the pulmonary annulus is 16 to 22 mm in diameter, which is not suitable for patients with pulmonary valve annulus and major pulmonary malformations.
  • the technical problem to be solved by the present invention is to provide a prosthetic valve and a prosthetic valve device for improving pulmonary regurgitation, and to improve the safety and effectiveness of transcatheter reconstruction of a pulmonary valve.
  • the prosthetic valve of the present invention comprises a sealing membrane and a leaflet, the sealing membrane is in the shape of a cylinder, and an outer flare is provided at each end of the sealing membrane, and the port of the outer flare is a toothed structure.
  • the middle portion of the sealing film has a straight cylindrical shape, the inner diameter of the outer flare is larger than the inner diameter of the middle portion of the sealing film, and the sealing film is stitched by at least three sealing film units, and the leaflets are at least three petals
  • the leaf unit is sutured to form an annular structure, the leaflets being disposed in the middle of the sealing film.
  • the upper and lower ends of the sealing film unit are respectively inclined outwardly, and the upper and lower ends of the sealing film unit are respectively provided with reinforcing ears, and the reinforcing ears constitute the outer flare port
  • the toothed structure has a rectangular shape in a middle portion of the sealing film unit, and both sides of the sealing film unit are stitched edges.
  • the prosthetic valve of the present invention wherein the sewn edge penetrates from the upper end of the sealing film unit to the lower end of the sealing film unit.
  • the prosthetic valve of the present invention wherein the sewn side is a groove-like side having a width of 0.5 to 3 mm.
  • the leaflet unit comprises an upper rectangular shape and a lower rectangular shape, wherein the upper rectangular shape and the lower rectangular shape are connected by respective long sides, and the long side length of the upper rectangular shape is larger than The length of the long side of the rectangle is described, and the two corners of the lower side of the lower rectangle are removed and rounded, the two short sides of the upper rectangle are the stitching ears, and the edges of the lower rectangle are fixed edges.
  • the width of the fixed side is 0.5 to 3 mm.
  • the prosthetic valve of the present invention wherein the leaflet unit of the leaflet is evenly arranged in the circumferential direction of the middle portion of the sealing film.
  • the sealing film is sutured by three sealing film units, and the leaflets are formed by suturing and connecting three leaflet units.
  • the suturing manner of the suture edges of two adjacent sealing film units is a spiral stitching method or a rack stitching method in which two sides are alternately passed or a matrix stitching method or a cross stitching method.
  • the distance between the adjacent two needle insertion points along the sewn side is 1 to 4 mm.
  • the suturing manner of the suture edges of two adjacent sealing film units is a manner in which the ferrule is knotted, and the distance between adjacent two knotting nodes is 1 to 4 mm.
  • the suture method of the leaflet on the sealing film is a rack stitching method or a spiral stitching method or a matrix stitching method in which the fixed edge of the leaflet unit alternates between the sealing film and the leaflet. Or zigzag stitching.
  • the distance between the adjacent two needle insertion points along the fixed side is 1 to 4 mm.
  • the suture of the leaflet on the sealing film is alternately passed between the sealing film and the leaflet along the fixed edge of the leaflet so that each node is T-shaped, and two adjacent nodes are The distance between them is 1 to 4 mm.
  • the prosthetic valve device of the present invention comprises a prosthetic valve and a valve frame, wherein the valve frame has a lattice structure in which both ends are in a lotus shape and a straight tube in the middle, and the leaf frame is upper, middle and lower in order from top to bottom.
  • the upper part and the lower part are in the shape of a lotus flower, and the middle part is in the shape of the straight tube, each part is formed by a plurality of rhomboids connected to each other, the artificial valve is the artificial valve described above, and the sealing film is two
  • the outer flares of the ends are respectively matched with the lotus-like ends of the valve holder, the middle portion of the sealing film is matched with the middle portion of the valve holder, and the sealing film is sewn to the inner wall of the valve holder.
  • the prosthetic valve device of the present invention wherein the upper and middle portions of the valve holder and between the middle portion and the lower portion are connected by a rigid vertical rod.
  • the rigid vertical rod connecting the upper portion and the middle portion is evenly arranged along the circumferential direction of the valve holder, and the rigid vertical rod connecting the middle portion and the lower portion is arranged in a one-to-one correspondence between the rhomboid shape in the middle portion and the rhomboid portion in the lower portion. between.
  • both ends of the sealing film are respectively sutured at one end of the valve frame in a one-to-one manner in a wrapped manner.
  • the suture manner of the artificial valve on the valve frame is a manner in which the upper and lower ends are knotted by the ferrule, and the remaining positions are the steps of the rhomboid rod along the valve frame.
  • the semi-annular way is stitched around the rod.
  • the suture is wound around the rod in a stepped semi-annular manner, and the distance between adjacent two half rings is 1 to 5 mm.
  • the prosthetic valve of the present invention is different from the prior art in that the prosthetic valve sutures the leaflet in the interior of the sealing film having a bowl-shaped end, and the highest point of the leaflet is lower than the upper edge of the sealing film.
  • the leaflets are completely wrapped in the sealing membrane.
  • the blood returning from the upper end of the prosthetic valve is completely confined in the space formed by the sealing membrane and the closed leaflets, improving the pulmonary valve regurgitation.
  • the flow, the outward lotus-like structure at both ends ie, the external flare of the toothed structure
  • the leaflet structure of the prosthetic valve conforms to the fluid dynamic structure, and the suture of the prosthetic valve is firm and reliable, improving the safety and effectiveness of use.
  • the present invention also provides a prosthetic valve device which is simple in structure, has a fixed artificial valve suture, and can reduce blood reflux.
  • Figure 1 is a schematic view showing the structure of a sealing film unit in the present invention
  • FIG. 2 is a schematic structural view of a sealing film in the present invention
  • FIG. 3 is a schematic structural view of a leaflet unit in the present invention.
  • Figure 4 is a schematic view showing the structure of the leaflets in the present invention.
  • Figure 5 is a schematic view showing the structure of a prosthetic valve in the present invention.
  • Figure 6 is a schematic structural view of a prosthetic valve device in the present invention.
  • Figure 7 is a schematic view showing the manner in which the ferrule is knotted and stitched in the present invention.
  • Figure 8 is a schematic view of a spiral stitching method in the present invention.
  • Figure 9 is a schematic view showing a rack-shaped suturing method in the present invention.
  • Figure 10 is a schematic view of a matrix stitching method in the present invention.
  • Figure 11 is a schematic view of a cross stitching method in the present invention.
  • Figure 12 is a schematic view showing a zigzag stitching manner in the present invention.
  • Figure 13 is a schematic view of a T-shaped suture method in the present invention.
  • Figure 14 is a schematic view of a stepped semi-annular suture in the present invention.
  • the prosthetic valve of the present invention includes a sealing film 110 and a leaflet 210.
  • the sealing film 110 has a cylindrical shape, and each end of the sealing film 110 has an external expansion.
  • the port of the outer flared port has a tooth-shaped structure.
  • both ends of the sealing film 110 are in the shape of a lotus flower, and the middle portion of the sealing film 110 has a straight cylindrical shape, and the inner diameter of the outer flared opening is larger than the inner diameter of the middle portion of the sealing film 110.
  • the sealing film 110 is sewn by at least three sealing film units 100.
  • the leaflets 210 are an annular structure in which at least three leaflet units 200 are stitched and connected, and the leaflets 210 are disposed in the middle of the sealing film 110.
  • the upper and lower ends of the sealing membrane unit 100 are respectively inclined outwardly, and the upper and lower ends of the sealing membrane unit 100 are respectively provided with reinforcing ears 102, and the reinforcing ears 102 constitute an external flare.
  • the tooth-shaped structure at the port can be seen that the sealing film unit 100 has a crown shape with both ends outward, the middle portion of the sealing film unit 100 is rectangular, the two sides of the sealing film unit 100 are the stitching edges 101, and the stitching edges 101 are wide. Groove-like sides of 0.5 to 3 mm.
  • the prosthetic valve of the present invention wherein the leaflet unit 200 comprises an upper rectangle and a lower rectangle integrally formed, the upper rectangle and the lower rectangle are connected by respective long sides, and the long side length of the upper rectangle is larger than the lower rectangle.
  • the length of the long side, the two corners of the lower side of the lower rectangle are removed and rounded, the two short sides of the upper rectangle are the stitching ears 201, the edges of the lower rectangle are the fixed sides 202, and the width of the fixed side 202 is 0.5 ⁇ 3mm.
  • the prosthetic valve in the present invention in which the leaflet unit 200 of the leaflet 210 is evenly arranged in the circumferential direction of the central portion of the sealing film 110.
  • the suturing manner of the suture edge 101 of two adjacent sealing film units is a spiral stitching method or a rack stitching method or a matrix stitching method or a cross which alternately passes through two sides. Stitching method.
  • the suturing manner of the suture edge 101 of two adjacent sealing membrane units is a manner in which the ferrule is knotted, and the distance between two adjacent knotting nodes is 1 to 4 mm. .
  • the prosthetic valve of the present invention wherein the suture of the leaflet 210 on the sealing membrane 110 is alternated between the sealing membrane 110 and the leaflet 210 along the fixed edge 202 of the leaflet unit Through the rack stitching or spiral stitching or matrix stitching or zigzag stitching.
  • the distance between the adjacent two needle insertion points along the fixed side 202 is 1 to 4 mm.
  • the prosthetic valve of the present invention wherein the leaflet 210 is sutured on the sealing film 110, alternately passes between the sealing film 110 and the leaflet 210 along the leaflet fixed edge 202 so that each node is T-shaped, the distance between two adjacent nodes is 1 to 4 mm, and the above-mentioned suture method is a T-shaped suture method.
  • the prosthetic valve device 400 of the present invention includes a prosthetic valve 300 and a valve holder 500.
  • the valve holder 500 has a lattice structure in which both ends are lotus-shaped and have a straight cylindrical shape in the middle, and the valve holder 500 is from top to bottom.
  • the upper part, the middle part and the lower part are in the shape of a lotus flower, and the upper part and the lower part are in a lotus shape, and the middle part is a straight tube shape, and each part is formed by a plurality of rhomboids connected to each other.
  • the artificial valve 300 is the above-mentioned artificial valve, and the outer ends of the sealing film 110 are expanded.
  • the mouths are respectively matched with the lotus-like ends of the valve holder 500, the middle portion of the sealing film 110 is matched with the middle portion of the valve holder 500, and the sealing film 110 is sewn to the inner wall of the valve holder 500.
  • the prosthetic valve device 400 of the present invention wherein the upper and middle portions of the valve holder 500 and between the middle portion and the lower portion are connected by a rigid vertical rod, and the rigid vertical rods connecting the upper portion and the middle portion are evenly arranged along the circumferential direction of the valve holder 500.
  • the connecting central portion and the lower rigid vertical rod are arranged in one-to-one correspondence between the rhomboid shape in the middle portion and the rhomboid shape in the lower portion, as shown in FIG. 6, that is, the rhomboids corresponding to the middle portion and the lower portion pass through a rigidity.
  • the vertical rods are connected, and the two ends of the sealing film 110 are respectively sutured in a one-to-one manner on the two ends of the valve holder 500.
  • the suture manner of the artificial valve 300 on the valve holder 500 is a manner in which the upper and lower ends are knotted by the ferrule. (As shown in Fig. 7), the remaining positions are the rhomboid-shaped rods along the valve holder 500, which are stitched around the rod in a stepped semi-annular manner (as shown in Fig. 14), and the distance between adjacent two half rings is 1 ⁇ . 5mm.
  • the prosthetic valve 300 of the present invention sutures the leaflets 210 inside the sealing film 110 having a bowl-shaped end, and the highest point of the leaflets 210 is lower than the upper end edge of the sealing film 110, so that the leaflets 210 are completely wrapped Among the sealing films 110, when the leaflets 210 are closed, the blood returning from the upper end of the prosthetic valve 300 is completely confined in the space formed by the sealing membrane 110 and the closed leaflets 210, improving pulmonary regurgitation,
  • the outward lotus-like structure at both ends ie, the flared outer shape of the toothed structure
  • the leaflet structure of the prosthetic valve conforms to the fluid dynamic structure, and the suture of the prosthetic valve is firm and reliable, improving the safety and effectiveness of use.
  • the present invention also provides a prosthetic valve device 400 which is simple in structure, has a fixed artificial valve suture, and can reduce blood reflux.
  • the sealing film 110 in this embodiment is formed by stitching the stitching edges 101 on the three sealing film units two by two, and the leaflets 210 are stitched and connected by three leaflet units 200, and the stitching edge 101 of the sealing film unit is The upper end of the sealing film unit 100 is penetrated to the lower end of the sealing film unit 100.
  • the central portion of the sealing film 110 is provided with a leaflet 210 in a straight cylindrical shape.
  • the leaflet 210 is an annular structure formed by stitching the stitching ears 201 on the leaflet unit 200.
  • the suture path of the leaflet 210 on the sealing film 110 is the fixed side 202 of the leaflet unit, and the suture ears 201 after the leaflet unit 200 are connected are evenly distributed in the circumferential direction of the middle of the sealing film 110.
  • the sealing membrane 110 and the suture ears 201 of the leaflets 210 are both fixed on the valve holder 500 which is straight in the shape of a lotus flower at both ends, and the valve holder 500 has a mesh structure; the valve holder 500 is composed of three parts from top to bottom. Each part is made up of several rhomboids connected to each other.
  • the prosthetic valve 300 is sutured to a matching valve holder 500 to form a prosthetic valve device 400.
  • a plurality of reinforcing portions are distributed at both ends of the sealing film unit 100, and the reinforcing portions are sewn to the opposite ends of the corresponding valve holder 500.
  • the leaflet unit 200 is in the shape of a flower pot.
  • the fixed side 202 is a crescent-shaped side formed by the stitching ear 201 at one end of the leaflet unit 200 along the lower end curve to the other end, and the fixed side is 0.5 to 3 mm wide.
  • the leaflet unit 200 of the leaflets is evenly distributed in the circumferential direction of the central portion of the sealing film 110.
  • the stitching manner of the two sealing film unit stitching edges 101 is a ferrule tying manner or a spiral stitching method or a rack stitching method in which two sides are alternately passed or a matrix stitching method or a cross stitching method.
  • the stitching manner of the two sealing film unit stitching edges 101 is a manner in which the ferrule is knotted, and the distance between adjacent two knotting nodes is 1 to 4 mm.
  • the suture pattern of the leaflet 210 on the sealing film 110 is a rack stitching method or a spiral stitching method or a stitching method along the fixed side matrix or a sawtooth pattern along the fixed leaf edge of the sealing film 110 and the leaflet 210 along the fixed edge 202 of the leaflet unit. Shape stitching or T-stitching.
  • the suture of the leaflet 210 on the sealing membrane 110 is alternately passed between the sealing membrane 110 and the leaflet 210 along the leaflet fixed edge 212 so that each node is T-shaped, and the distance between two adjacent nodes is 1 to 4 mm.
  • the upper and lower portions of the valve holder 500 are outwardly shaped like a lotus flower, and the central portion of the valve holder 500 is tubular.
  • the three portions of the valve holder 500 are connected by a rigid vertical rod, wherein the connection between the upper portion and the middle portion is a non-one-to-one uniform distribution, that is, the rigid vertical rod connecting the upper portion and the middle portion is evenly arranged along the circumferential direction of the valve holder 500, the middle portion
  • the full connection with the lower connection is a one-to-one correspondence, that is, the central and lower rigid vertical rods are arranged in one-to-one correspondence between the middle rhomboid and the lower rhomboid, as shown in FIG. 6, that is, the middle portion
  • the rhomboids corresponding to the lower portions are each connected by a rigid vertical rod which helps to improve the compliance of the valve holder 500 in the release position.
  • the lotus shape at both ends of the sealing film 110 is matched with the lotus shape of the upper and lower portions of the valve holder 500, and both ends of the sealing film 110 are stitched to the valve holder 500 in a one-to-one manner in a wrapped manner.
  • the suture mode of the prosthetic valve 300 on the valve frame 500 is such that the upper and lower ends are knotted by the ferrule, and the rest of the positions are stitched around the rod in a stepped semi-annular manner along all the rods of the valve holder 500, and the adjacent two half rings The distance is 1 to 5 mm.
  • the present invention mainly relates to a prosthetic valve, the unique lotus-like structure at both ends of the invention makes the invention more suitable for patients with pulmonary artery enlargement or deformity.
  • the upper end of the prosthetic valve is its blood outflow channel and the lower end is its blood inflow channel.
  • the sealing film 110 in this embodiment is formed by stitching three sealing film units 100 through two stitching edges 101, due to the two ends of the sealing film unit.
  • the crown-like structure is such that the entire sealing film after stitching exhibits a lotus-like shape at both ends and a straight cylindrical structure at the center, and a splicing line 113 is formed.
  • the stitching edge 101 is a recessed groove-like structure, and the upper and lower edges 111, 112 of the sealing film have a toothed structure.
  • 114 is a boundary line between the straight section of the sealing film and the lotus-shaped section, and a leaflet 210 is disposed between the two boundary lines 114.
  • the reinforcing portion on the sealing film unit 100 that is, the reinforcing ear 102, is designed to increase the strength and stability of the sealing film when it is sewn to the valve frame, and is designed with a matching edge 103 to the valve holder.
  • the stitching at the seam edge between the sealing film units has a ferrule knotting method or a spiral stitching method or a rack stitching method or a matrix stitching method or a cross stitching method in which two sides are alternately passed, as shown in Fig. 7-14.
  • the quilting of the ferrule is accomplished by using a suture to tie the two stitching edges at each needle point, which makes the connection between the sealing film units more secure.
  • the spiral stitching method is to pass a suture thread from the same direction through the two stitching edges, and the path is substantially a spiral shape.
  • the racking method in which the two sides alternately pass through is that the suture passes through the exposed faces of the two stitching edges in sequence.
  • the matrix stitching method is formed by reciprocating the rack stitching method once.
  • the cross stitching method is formed by spiral stitching once and for all. In the above stitching method, the distance between adjacent two needle insertion points along the stitching edge is 1 to 4 mm.
  • the leaflets 210 disposed between the sealing film boundary lines 114 are formed by stitching the three leaflet unit 200 through the stitching ears 201 thereon, forming three stitching ear splicing segments. 211, and the fixed edges of the three leaflet units are spliced to form the leaflet fixed edge 212.
  • the suture ear splice segment 211 and the leaflet fixed edge 212 are the suture path 301 of the leaflet 210 in the sealing film 110, and the prosthetic valve can control the blood flow direction by relying on the free edge 203 of each leaflet unit.
  • the stitching manner of the stitching path 301 is a rack stitching method or a spiral stitching method in which two sides alternately pass through, or a fixed edge matrix stitching method or a zigzag stitching method or a T-shaped stitching manner, as shown in FIG.
  • the rack stitching method, the spiral stitching method, and the stitching along the fixed side matrix are the same as the sealing film stitching manner.
  • the zigzag stitching method is derived from the matrix stitching method, that is, the needle point is alternately shifted up and down.
  • the T-stitching method is formed by alternately passing a suture between the two faces.
  • the leaflet 210 sewn in the sealing film 110 and the upper end of the sealing film form a space with good sealing performance, which can effectively reduce the paravalvular leakage and reflux. .
  • the second embodiment as shown in FIG. 6, the artificial valve 300 is installed in the valve holder 500 having the shape memory effect and can be self-expanded to form the artificial valve device 400.
  • the suture method of the artificial valve on the valve frame is The upper and lower ends are the way of ferrule tying, and the rest of the positions are stitched around the rod in a stepped semi-annular manner along all the rods of the bracket (as shown in Fig. 14), and the distance between adjacent two half rings is 1 to 5 mm.
  • Each rod of the valve holder is sewn together with a sealing membrane of the prosthetic valve.
  • the prosthetic valve of the first embodiment uses the prosthetic valve of the first embodiment.
  • the prosthetic valve and the prosthetic valve device of the embodiment of the invention suture the leaflets in the interior of the sealing membrane with a bowl-shaped mouth at both ends, and the highest point of the leaflets is lower than the upper edge of the sealing membrane, so that the leaflets are completely wrapped Among the sealing membranes, when the leaflets are closed, the blood returning from the upper end of the prosthetic valve is completely confined in the space formed by the sealing membrane and the closed leaflets, improving the pulmonary valve regurgitation, and the outward lotus at both ends
  • the structure can be applied to lesions of pulmonary artery enlargement or deformity.
  • the leaflet structure of the prosthetic valve conforms to the fluid dynamic structure, and the suture of the prosthetic valve is firm and reliable, improving the safety and effectiveness of use.
  • the prosthetic valve and prosthetic valve device of the embodiments of the present invention can be mass-produced.

Abstract

A prosthetic valve (300) and a prosthetic valve device (400). The prosthetic valve (300) comprises a sealing membrane (110) and a valve leaflet (210). The sealing membrane (110) has a cylindrical shape, and both ends thereof are respectively provided with an outward expansion port. The ends of the outward expansion ports have tooth-shaped structures. A middle part of the sealing membrane (110) is a straight cylinder. The inner diameter of the outward expansion ports is greater than the inner diameter of the middle part of the sealing membrane (110). The sealing membrane (110) is formed by suturing at least three sealing membrane units (100). The valve leaflet (210) is a circular structure formed by suturing and connecting at least three valve leaflet units (200). The valve leaflet (210) is provided at the middle part of the sealing membrane (110). The prosthetic valve device (400) comprises the prosthetic valve (300) and a valve support (500). The aim of the present invention is to provide a prosthetic valve (300) and a prosthetic valve device (400) for improving pulmonary regurgitation, and to improve safety and efficacy of use.

Description

人工瓣膜及人工瓣膜装置Artificial valve and prosthetic valve device
本发明是要求由申请人提出的,申请日为2018年02月06日,申请号为CN201810116225.1,名称为“人工瓣膜及人工瓣膜装置”的申请的优先权。以上申请的全部内容通过整体引用结合于此。The present invention claims priority from the applicant's application, which is filed on February 6, 2018, with the application number of CN201810116225.1, entitled "Prosthetic Valve and Prosthetic Valve Device". The entire contents of the above application are hereby incorporated by reference in its entirety.
技术领域Technical field
本发明涉及医疗器械领域的心脏瓣膜技术,属于介入治疗器械领域,特别涉及一种人工瓣膜及人工瓣膜装置。The invention relates to a heart valve technology in the field of medical instruments, and belongs to the field of interventional treatment instruments, in particular to a prosthetic valve and a prosthetic valve device.
发明背景Background of the invention
先天性心脏病,是胎儿时期心脏和血管发育异常所导致的先天性心血管系统畸形,是小儿时期最常见的心脏病。据统计,每1000名新生儿中,有6~7名有先天心脏畸形。据人口学家估计,我国大约有1千万人患先心病,每年约新增20万名先心病患儿,其中复杂型先心病约占20%。许多复杂型先心病病变会严重累及右心室流出道,需要通过外科手术重建,而在手术后经常会发生肺动脉瓣反流或者再狭窄,因此需要再次通过外科手术重建右心室流出道。Congenital heart disease is a congenital cardiovascular system malformation caused by abnormal heart and blood vessels during fetal period. It is the most common heart disease in childhood. According to statistics, 6 to 7 out of every 1,000 newborns have congenital heart malformations. According to demographers, there are about 10 million people suffering from congenital heart disease in China, and about 200,000 children with congenital heart disease are added each year, of which complex congenital heart disease accounts for about 20%. Many complex congenital heart disease lesions can seriously affect the right ventricular outflow tract and require surgical reconstruction. Pulmonary valve regurgitation or restenosis often occurs after surgery, so the right ventricular outflow tract needs to be reconstructed again by surgery.
经导管肺动脉瓣膜置换术不仅能纠正狭窄,也可处理瓣膜反流,该技术经外周静脉途径,通过导管将人工带瓣膜支架置入自体肺动脉瓣处,代替已失去功能的肺动脉瓣膜,以达到治疗目的。Transcatheter pulmonary valve replacement can not only correct stenosis, but also treat valvular regurgitation. This technique is used to place the artificial valve stent through the catheter into the autologous pulmonary valve through the peripheral venous approach, replacing the lost pulmonary valve to achieve treatment. purpose.
肺动脉反流的原因如下:①先天性肺动脉瓣完全畸形:可为完全缺失、单叶肺动脉瓣及其他畸形,常见于法洛四联症患者。②马方综合征:病变主要累及主动脉瓣和二尖瓣,但是有报道约26.9%的患者病变累及肺动脉瓣并有肺动脉瓣反流。③心脏肿瘤:乳头状纤维弹性组织瘤与肺动脉瓣病变关系密切,可见肿瘤呈多个分叶并通过叶蒂附着于心内膜。一般常见于主动脉瓣或肺动脉瓣心室面。附着肿瘤体积增大,可能导致中重度肺动脉瓣反流,伴或不伴肺动脉瓣狭窄。④肺动脉瓣瓣环扩张:如长期肺动脉高压可导致肺动脉及瓣环扩张,从而导致肺动脉 瓣反流。右心室流出道(RVOT)狭窄、梗阻患者,可出现狭窄后扩张而使瓣环扩大,从而引起肺动脉反流。⑤医源性:是目前临床上最具临床意义、最常见的因素,也是目前经皮肺动脉瓣置入术(PPVI)最主要适合的人群。在国内,法洛四联症等有肺动脉瓣狭窄的患者行手术矫正过程中普遍行RVOT跨瓣补片术(RVOT、肺动脉纵向切开后再加补片以扩大官腔内径)以解除肺动脉瓣狭窄,但会使得肺动脉瓣瓣环扩大,瓣叶对合不良,导致明显的肺动脉分流;而国外许多心脏中心则会在ROVT置入带瓣膜人工血管,虽然短期内不会有肺动脉反流,但长期应用后,人工血管会出现钙化而导致流出道梗阻,且其生物瓣膜会出现功能退化而导致瓣膜关闭不全或狭窄,这类人群是目前PPVI主要应用人群。The causes of pulmonary regurgitation are as follows: 1 complete congenital pulmonary valve malformation: can be completely missing, single-leaf pulmonary valve and other malformations, common in patients with tetralogy of Fallot. 2 Ma Fang Syndrome: The lesion mainly involves the aortic valve and the mitral valve, but it has been reported that about 26.9% of the patients have pulmonary valve involvement and pulmonary regurgitation. 3 cardiac tumors: papillary fibroelastoma is closely related to pulmonary valve disease, showing that the tumor has multiple lobes and is attached to the endocardium through the pedicle. Common in the aortic valve or pulmonary valve ventricle. Increased adherent tumor volume may result in moderate to severe pulmonary regurgitation, with or without pulmonary stenosis. 4 pulmonary valve annulus dilatation: such as long-term pulmonary hypertension can lead to pulmonary artery and annulus dilatation, leading to pulmonary regurgitation. In patients with stenosis of the right ventricular outflow tract (RVOT) and obstruction, the stenosis may expand and expand the annulus, causing pulmonary regurgitation. 5 iatrogenic: It is the most clinically significant and most common factor in the clinic, and it is also the most suitable group for percutaneous pulmonary valve implantation (PPVI). In China, patients with pulmonary stenosis such as tetralogy of Fallot have undergone RVOT transvalvular surgery (RVOT, longitudinal incision of the pulmonary artery and then patch to enlarge the diameter of the lumen) to relieve pulmonary stenosis. However, it will enlarge the pulmonary valve annulus, and the valve leaflets will be poorly combined, resulting in obvious pulmonary shunt. Many foreign heart centers will place valved artificial blood vessels in the ROVT, although there will be no pulmonary regurgitation in the short term, but long-term After application, the artificial blood vessels will be calcified and cause outflow obstruction, and the biological valve will be degraded and cause valve insufficiency or stenosis. This type of population is currently the main application group of PPVI.
2000年10月,Bonhoeffer的团队报道了首例应用于临床的PPVI,他们对一名12岁接受法洛四联症修复术后出现肺动脉瓣狭窄合并反流的患者成功实施了PPVI手术。随后,该技术被用于更多的患者。2005年,Bonhoeffer在TCT会议期间报道了对100例16-35岁的肺动脉瓣关闭不全或RVOT梗阻等先天性疾病患者行PPTV的情况,随访0.5-5年无死亡,术后右心室压力明显下降,运动耐量显著提高。In October 2000, Bonhoeffer's team reported the first clinical use of PPVI, which successfully performed a PPVI procedure in a 12-year-old patient with pulmonary stenosis and reflux after Fello-Fed disease repair. This technique was then used for more patients. In 2005, Bonhoeffer reported on PPTV in 100 patients with congenital diseases such as pulmonary regurgitation or RVOT obstruction aged 16-35 years during the TCT meeting. There was no death after 0.5-5 years of follow-up, and the right ventricular pressure decreased significantly after surgery. The exercise tolerance is significantly improved.
相对于外科开胸手术经皮肺动脉瓣置换术的优点在于:(1)不需要长期抗凝;(2)置换后接近正常的血液动力学;(3)能维持长期组织学上与功能的完整性;(4)创伤小、伤害轻。The advantages of percutaneous pulmonary valve replacement compared with surgical thoracotomy are: (1) no long-term anticoagulation is required; (2) near normal hemodynamics after replacement; (3) maintenance of long-term histological and functional integrity Sex; (4) small trauma and light injury.
在经皮心脏瓣膜置换术中常用的人工心脏瓣膜有两种:一种为Medtronic公司的Melody球囊扩张介入瓣膜。Melody装置为在铂-铱球囊扩张式合金支架上缝制有三叶式牛颈静脉瓣膜。扩张时植入瓣膜的内径变化范围较大,为10~22mm,这归功于静脉瓣所制瓣叶的良好弹性和较大的瓣叶结合面。常规尺寸为18~22mm。另一种为Edwards公司的SAPIEN球囊扩张介入瓣膜。SAPIEN瓣膜的支架采用不锈钢为材料,并使用耐用的牛心包做为瓣叶材料,同时密封袖口也变得更高已减少瓣周漏的产生。该瓣膜目前有23mm、26mm等型号。他们的结构都是直筒型,使用的肺动脉瓣环直径在16~22mm,这对于肺动脉瓣环扩大和主肺动脉畸形的患者并不适合。There are two types of prosthetic heart valves commonly used in percutaneous heart valve replacement: one is Medtronic's Melody balloon dilatation interventional valve. The Melody device is a three-lobed bovine jugular vein valve sewed on a platinum-rhodium balloon-expandable alloy stent. The inner diameter of the implanted valve during expansion is varied from 10 to 22 mm, which is attributed to the good elasticity of the leaflets made by the venous valve and the larger leaflet interface. The conventional size is 18 to 22 mm. The other is Edwards' SAPIEN balloon dilatation interventional valve. The stent of the SAPIEN valve is made of stainless steel and uses a durable bovine pericardium as the leaflet material, while the seal cuff is also made higher to reduce the occurrence of paravalvular leakage. The valve is currently available in 23mm, 26mm and other models. Their structures are straight and the pulmonary annulus is 16 to 22 mm in diameter, which is not suitable for patients with pulmonary valve annulus and major pulmonary malformations.
发明内容Summary of the invention
本发明要解决的技术问题是提供一种改善肺动脉瓣反流的人工瓣膜及人工瓣膜装置,提高经导管重建肺动脉瓣膜的安全性和有效性。The technical problem to be solved by the present invention is to provide a prosthetic valve and a prosthetic valve device for improving pulmonary regurgitation, and to improve the safety and effectiveness of transcatheter reconstruction of a pulmonary valve.
本发明中的人工瓣膜,包括密封膜和瓣叶,所述密封膜呈筒状,所述密封膜的两端各设有一个外扩口,所述外扩口的端口处为齿形结构,所述密封膜的中部呈直筒状,所述外扩口的内径大于所述密封膜中部的内径,所述密封膜由至少三个密封膜单元缝合而成,所述瓣叶为至少三个瓣叶单元缝合连接成的环形结构,所述瓣叶设于所述密封膜的中部。The prosthetic valve of the present invention comprises a sealing membrane and a leaflet, the sealing membrane is in the shape of a cylinder, and an outer flare is provided at each end of the sealing membrane, and the port of the outer flare is a toothed structure. The middle portion of the sealing film has a straight cylindrical shape, the inner diameter of the outer flare is larger than the inner diameter of the middle portion of the sealing film, and the sealing film is stitched by at least three sealing film units, and the leaflets are at least three petals The leaf unit is sutured to form an annular structure, the leaflets being disposed in the middle of the sealing film.
本发明中的人工瓣膜,其中所述密封膜单元的上下两端分别向外侧倾斜设置,所述密封膜单元的上下两端分别设有加固耳,所述加固耳构成所述外扩口端口处的齿形结构,所述密封膜单元的中部为矩形,所述密封膜单元的两侧为缝合边。In the artificial valve of the present invention, the upper and lower ends of the sealing film unit are respectively inclined outwardly, and the upper and lower ends of the sealing film unit are respectively provided with reinforcing ears, and the reinforcing ears constitute the outer flare port The toothed structure has a rectangular shape in a middle portion of the sealing film unit, and both sides of the sealing film unit are stitched edges.
本发明中的人工瓣膜,其中所述缝合边从密封膜单元的上端贯穿至密封膜单元的下端。The prosthetic valve of the present invention, wherein the sewn edge penetrates from the upper end of the sealing film unit to the lower end of the sealing film unit.
本发明中的人工瓣膜,其中所述缝合边为宽0.5~3mm的凹槽状边。The prosthetic valve of the present invention, wherein the sewn side is a groove-like side having a width of 0.5 to 3 mm.
本发明中的人工瓣膜,其中所述瓣叶单元包括一体构成的上矩形和下矩形,所述上矩形和所述下矩形均通过各自的长边连接,所述上矩形的长边长度大于所述下矩形的长边长度,所述下矩形下侧的两个角去掉并倒圆角,所述上矩形的两个短边处为缝合耳,所述下矩形的边缘处为固定边。The prosthetic valve of the present invention, wherein the leaflet unit comprises an upper rectangular shape and a lower rectangular shape, wherein the upper rectangular shape and the lower rectangular shape are connected by respective long sides, and the long side length of the upper rectangular shape is larger than The length of the long side of the rectangle is described, and the two corners of the lower side of the lower rectangle are removed and rounded, the two short sides of the upper rectangle are the stitching ears, and the edges of the lower rectangle are fixed edges.
本发明中的人工瓣膜,其中所述固定边的宽度为0.5~3mm。In the artificial valve of the present invention, the width of the fixed side is 0.5 to 3 mm.
本发明中的人工瓣膜,其中所述瓣叶的瓣叶单元在所述密封膜中部的圆周方向上均匀布置。The prosthetic valve of the present invention, wherein the leaflet unit of the leaflet is evenly arranged in the circumferential direction of the middle portion of the sealing film.
本发明中的人工瓣膜,其中所述密封膜由三个密封膜单元缝合而成,所述瓣叶为三个瓣叶单元缝合连接而成。In the artificial valve of the present invention, the sealing film is sutured by three sealing film units, and the leaflets are formed by suturing and connecting three leaflet units.
本发明中的人工瓣膜,其中相邻两个密封膜单元缝合边的缝合方式为螺旋缝合方式或者两面交替穿过的齿条缝合方式或者矩阵缝合方式或者十字交叉缝合方式。In the artificial valve of the present invention, the suturing manner of the suture edges of two adjacent sealing film units is a spiral stitching method or a rack stitching method in which two sides are alternately passed or a matrix stitching method or a cross stitching method.
本发明中的人工瓣膜,其中相邻两个所述密封膜单元缝合边的缝合方式中, 相邻两个穿针点沿着缝合边的距离为1~4mm。In the artificial valve of the present invention, in the suturing manner of the suture edges of two adjacent sealing film units, the distance between the adjacent two needle insertion points along the sewn side is 1 to 4 mm.
本发明中的人工瓣膜,其中相邻两个密封膜单元缝合边的缝合方式为套圈打结的方式,相邻两个打结节点之间的距离为1~4mm。In the artificial valve of the present invention, the suturing manner of the suture edges of two adjacent sealing film units is a manner in which the ferrule is knotted, and the distance between adjacent two knotting nodes is 1 to 4 mm.
本发明中的人工瓣膜,其中所述瓣叶在密封膜上的缝合方式为沿瓣叶单元固定边在密封膜与瓣叶两面间交替穿过的齿条缝合方式或者螺旋缝合方式或者矩阵缝合方式或者锯齿形缝合方式。In the artificial valve of the present invention, the suture method of the leaflet on the sealing film is a rack stitching method or a spiral stitching method or a matrix stitching method in which the fixed edge of the leaflet unit alternates between the sealing film and the leaflet. Or zigzag stitching.
本发明中的人工瓣膜,其中所述瓣叶在密封膜上的缝合方式中,相邻两个穿针点沿着固定边的距离为1~4mm。In the artificial valve of the present invention, in the suturing manner of the leaflets on the sealing film, the distance between the adjacent two needle insertion points along the fixed side is 1 to 4 mm.
本发明中的人工瓣膜,其中所述瓣叶在密封膜上的缝合方式为沿瓣叶固定边在密封膜与瓣叶两面间交替穿过使每一个节点呈T形,相邻两个节点之间的距离为1~4mm。In the artificial valve of the present invention, the suture of the leaflet on the sealing film is alternately passed between the sealing film and the leaflet along the fixed edge of the leaflet so that each node is T-shaped, and two adjacent nodes are The distance between them is 1 to 4 mm.
本发明中的人工瓣膜装置,包括人工瓣膜和瓣架,所述瓣架为两端呈莲花状、中间呈直筒状的网格结构,所述瓣架从上至下依次为上部、中部和下部,所述上部和下部呈所述莲花状,所述中部呈所述直筒状,每一部均由多个长菱形相互连接而成,所述人工瓣膜为上述的人工瓣膜,所述密封膜两端的外扩口分别与所述瓣架呈莲花状的两端相匹配,所述密封膜的中部与所述瓣架的中部相匹配,所述密封膜缝合于所述瓣架的内壁上。The prosthetic valve device of the present invention comprises a prosthetic valve and a valve frame, wherein the valve frame has a lattice structure in which both ends are in a lotus shape and a straight tube in the middle, and the leaf frame is upper, middle and lower in order from top to bottom. The upper part and the lower part are in the shape of a lotus flower, and the middle part is in the shape of the straight tube, each part is formed by a plurality of rhomboids connected to each other, the artificial valve is the artificial valve described above, and the sealing film is two The outer flares of the ends are respectively matched with the lotus-like ends of the valve holder, the middle portion of the sealing film is matched with the middle portion of the valve holder, and the sealing film is sewn to the inner wall of the valve holder.
本发明中的人工瓣膜装置,其中所述瓣架的上部与中部之间以及中部与下部之间均通过刚性竖杆连接。The prosthetic valve device of the present invention, wherein the upper and middle portions of the valve holder and between the middle portion and the lower portion are connected by a rigid vertical rod.
本发明中的人工瓣膜装置,其中连接上部与中部的刚性竖杆沿瓣架的周向均匀布置,连接中部与下部的刚性竖杆一一对应地布置在中部的长菱形与下部的长菱形之间。In the artificial valve device of the present invention, the rigid vertical rod connecting the upper portion and the middle portion is evenly arranged along the circumferential direction of the valve holder, and the rigid vertical rod connecting the middle portion and the lower portion is arranged in a one-to-one correspondence between the rhomboid shape in the middle portion and the rhomboid portion in the lower portion. between.
本发明中的人工瓣膜装置,其中所述密封膜的两端分别以包裹的方式一一对应地缝合在所述瓣架的两端。In the artificial valve device of the present invention, both ends of the sealing film are respectively sutured at one end of the valve frame in a one-to-one manner in a wrapped manner.
本发明中的人工瓣膜装置,其中所述人工瓣膜在瓣架上的缝合方式为上下端部为套圈打结的方式,其余位置为沿着瓣架的组成所述长菱形的杆以阶梯型半环形方式绕杆缝合。In the artificial valve device of the present invention, the suture manner of the artificial valve on the valve frame is a manner in which the upper and lower ends are knotted by the ferrule, and the remaining positions are the steps of the rhomboid rod along the valve frame. The semi-annular way is stitched around the rod.
本发明中的人工瓣膜装置,其中所述以阶梯型半环形方式绕杆缝合中,相邻两个半环的距离为1~5mm。In the prosthetic valve device of the present invention, the suture is wound around the rod in a stepped semi-annular manner, and the distance between adjacent two half rings is 1 to 5 mm.
本发明中的人工瓣膜与现有技术不同之处在于:所述人工瓣膜将瓣叶缝合在两端呈碗口状的密封膜的内部,并且瓣叶的最高点低于密封膜的上端缘,使得瓣叶被完全的包裹在密封膜之中,在瓣叶闭合时,人工瓣膜上端回流的血液被完全的限制在了以密封膜和闭合状态的瓣叶所形成的空间内,改善肺动脉瓣反流,两端的向外的莲花状结构(即呈齿形结构的外扩口)能够适用于肺动脉膨大或畸形的病变。所述人工瓣膜的瓣叶结构符合流体动力学结构,并且人工瓣膜的缝合牢固可靠,提高使用安全性和有效性。The prosthetic valve of the present invention is different from the prior art in that the prosthetic valve sutures the leaflet in the interior of the sealing film having a bowl-shaped end, and the highest point of the leaflet is lower than the upper edge of the sealing film. The leaflets are completely wrapped in the sealing membrane. When the leaflets are closed, the blood returning from the upper end of the prosthetic valve is completely confined in the space formed by the sealing membrane and the closed leaflets, improving the pulmonary valve regurgitation. The flow, the outward lotus-like structure at both ends (ie, the external flare of the toothed structure) can be applied to lesions of pulmonary enlargement or deformity. The leaflet structure of the prosthetic valve conforms to the fluid dynamic structure, and the suture of the prosthetic valve is firm and reliable, improving the safety and effectiveness of use.
为了改善现有技术的不足,本发明还提供了一种结构简单,所附带人工瓣膜缝合牢固,能减少血液返流的人工瓣膜装置。In order to improve the deficiencies of the prior art, the present invention also provides a prosthetic valve device which is simple in structure, has a fixed artificial valve suture, and can reduce blood reflux.
下面结合附图对本发明作进一步说明。The invention will now be further described with reference to the accompanying drawings.
附图简要说明BRIEF DESCRIPTION OF THE DRAWINGS
图1为本发明中的密封膜单元结构示意图;Figure 1 is a schematic view showing the structure of a sealing film unit in the present invention;
图2为本发明中的密封膜结构示意图;2 is a schematic structural view of a sealing film in the present invention;
图3为本发明中的瓣叶单元结构示意图;3 is a schematic structural view of a leaflet unit in the present invention;
图4为本发明中的瓣叶结构示意图;Figure 4 is a schematic view showing the structure of the leaflets in the present invention;
图5为本发明中的人工瓣膜结构示意图;Figure 5 is a schematic view showing the structure of a prosthetic valve in the present invention;
图6为本发明中的人工瓣膜装置结构示意图;Figure 6 is a schematic structural view of a prosthetic valve device in the present invention;
图7为本发明中的套圈打结缝合方式示意图;Figure 7 is a schematic view showing the manner in which the ferrule is knotted and stitched in the present invention;
图8为本发明中的螺旋缝合方式示意图;Figure 8 is a schematic view of a spiral stitching method in the present invention;
图9为本发明中的齿条形缝合方式示意图;Figure 9 is a schematic view showing a rack-shaped suturing method in the present invention;
图10为本发明中的矩阵缝合方式示意图;Figure 10 is a schematic view of a matrix stitching method in the present invention;
图11为本发明中的十字交叉缝合方式示意图;Figure 11 is a schematic view of a cross stitching method in the present invention;
图12为本发明中的锯齿形缝合方式示意图;Figure 12 is a schematic view showing a zigzag stitching manner in the present invention;
图13为本发明中的T形缝合方式示意图;Figure 13 is a schematic view of a T-shaped suture method in the present invention;
图14为本发明中的阶梯型半环形缝合方式示意图。Figure 14 is a schematic view of a stepped semi-annular suture in the present invention.
其中,图中各附图标记:Among them, the various reference numerals in the figure:
100-密封膜单元,101-密封膜单元的缝合边,102-密封膜单元的加固耳,103-与支架的匹配边线,110-密封膜,111-密封膜上边沿,112-密封膜下边沿,113-密封膜拼接线,114-密封膜中部与两端的交界线,200-瓣叶单元,201-缝合耳,202-瓣叶单元固定边,203-瓣叶单元游离边,210-瓣叶,211-缝合耳拼接段,212-瓣叶固定边,300-人工瓣膜,301-瓣叶在密封膜中的缝合路径,400-人工瓣膜装置,500-瓣架。100-sealing membrane unit, 101-sealing edge of sealing film unit, 102-reinforcing ear of sealing film unit, 103-matching edge with bracket, 110-seal film, 111-seal upper edge, 112-seal lower edge , 113-sealing film splicing line, 114- sealing film at the middle and the end of the boundary line, 200-valve unit, 201-sewed ear, 202-valve unit fixed side, 203-valve unit free side, 210-valve , 211-stitched ear splicing section, 212-valve fixed edge, 300-prosthetic valve, suture path of 301-valve leaf in sealing membrane, 400-prosthetic valve device, 500-valve.
实施本发明的方式Mode for carrying out the invention
如图5所示,并结合图1-4所示,本发明中的人工瓣膜,包括密封膜110和瓣叶210,密封膜110呈筒状,密封膜110的两端各设有一个外扩口,外扩口的端口处为齿形结构,由此可见,密封膜110的两端均呈莲花状,密封膜110的中部呈直筒状,外扩口的内径大于密封膜110中部的内径,密封膜110由至少三个密封膜单元100缝合而成,瓣叶210为至少三个瓣叶单元200缝合连接成的环形结构,瓣叶210设于密封膜110的中部。As shown in FIG. 5, and in conjunction with FIG. 1-4, the prosthetic valve of the present invention includes a sealing film 110 and a leaflet 210. The sealing film 110 has a cylindrical shape, and each end of the sealing film 110 has an external expansion. The port of the outer flared port has a tooth-shaped structure. Thus, both ends of the sealing film 110 are in the shape of a lotus flower, and the middle portion of the sealing film 110 has a straight cylindrical shape, and the inner diameter of the outer flared opening is larger than the inner diameter of the middle portion of the sealing film 110. The sealing film 110 is sewn by at least three sealing film units 100. The leaflets 210 are an annular structure in which at least three leaflet units 200 are stitched and connected, and the leaflets 210 are disposed in the middle of the sealing film 110.
如图2所示,本发明中的人工瓣膜,其中密封膜单元100的上下两端分别向外侧倾斜设置,密封膜单元100的上下两端分别设有加固耳102,加固耳102构成外扩口端口处的齿形结构,由此可见,密封膜单元100为两端向外的皇冠状,密封膜单元100的中部为矩形,密封膜单元100的两侧为缝合边101,缝合边101为宽0.5~3mm的凹槽状边。As shown in FIG. 2, in the prosthetic valve of the present invention, the upper and lower ends of the sealing membrane unit 100 are respectively inclined outwardly, and the upper and lower ends of the sealing membrane unit 100 are respectively provided with reinforcing ears 102, and the reinforcing ears 102 constitute an external flare. The tooth-shaped structure at the port can be seen that the sealing film unit 100 has a crown shape with both ends outward, the middle portion of the sealing film unit 100 is rectangular, the two sides of the sealing film unit 100 are the stitching edges 101, and the stitching edges 101 are wide. Groove-like sides of 0.5 to 3 mm.
如图3所示,本发明中的人工瓣膜,其中瓣叶单元200包括一体构成的上矩形和下矩形,上矩形和下矩形均通过各自的长边连接,上矩形的长边长度大于下矩形的长边长度,下矩形下侧的两个角去掉并倒圆角,上矩形的两个短边处为缝合耳201,下矩形的边缘处为固定边202,固定边202的宽度为0.5~3mm。As shown in FIG. 3, the prosthetic valve of the present invention, wherein the leaflet unit 200 comprises an upper rectangle and a lower rectangle integrally formed, the upper rectangle and the lower rectangle are connected by respective long sides, and the long side length of the upper rectangle is larger than the lower rectangle. The length of the long side, the two corners of the lower side of the lower rectangle are removed and rounded, the two short sides of the upper rectangle are the stitching ears 201, the edges of the lower rectangle are the fixed sides 202, and the width of the fixed side 202 is 0.5~ 3mm.
本发明中的人工瓣膜,其中瓣叶210的瓣叶单元200在密封膜110中部的圆周方向上均匀布置。The prosthetic valve in the present invention, in which the leaflet unit 200 of the leaflet 210 is evenly arranged in the circumferential direction of the central portion of the sealing film 110.
如图8-11所示,本发明中的人工瓣膜,其中相邻两个密封膜单元缝合边101的缝合方式为螺旋缝合方式或者两面交替穿过的齿条缝合方式或者矩阵缝合方式或者十字交叉缝合方式。As shown in FIG. 8-11, in the artificial valve of the present invention, the suturing manner of the suture edge 101 of two adjacent sealing film units is a spiral stitching method or a rack stitching method or a matrix stitching method or a cross which alternately passes through two sides. Stitching method.
如图7所示,本发明中的人工瓣膜,其中相邻两个密封膜单元缝合边101的缝合方式为套圈打结的方式,相邻两个打结节点之间的距离为1~4mm。As shown in FIG. 7 , in the prosthetic valve of the present invention, the suturing manner of the suture edge 101 of two adjacent sealing membrane units is a manner in which the ferrule is knotted, and the distance between two adjacent knotting nodes is 1 to 4 mm. .
如图8、9、10、12所示,本发明中的人工瓣膜,其中瓣叶210在密封膜110上的缝合方式为沿瓣叶单元固定边202在密封膜110与瓣叶210两面间交替穿过的齿条缝合方式或者螺旋缝合方式或者矩阵缝合方式或者锯齿形缝合方式。8, 9, 10, 12, the prosthetic valve of the present invention, wherein the suture of the leaflet 210 on the sealing membrane 110 is alternated between the sealing membrane 110 and the leaflet 210 along the fixed edge 202 of the leaflet unit Through the rack stitching or spiral stitching or matrix stitching or zigzag stitching.
瓣叶210在密封膜110上的缝合方式中,相邻两个穿针点沿着固定边202的距离为1~4mm。In the stitching manner of the leaflets 210 on the sealing film 110, the distance between the adjacent two needle insertion points along the fixed side 202 is 1 to 4 mm.
如图13所示,本发明中的人工瓣膜,其中瓣叶210在密封膜110上的缝合方式为沿瓣叶固定边202在密封膜110与瓣叶210两面间交替穿过使每一个节点呈T形,相邻两个节点之间的距离为1~4mm,上述的缝合方式为T形缝合方式。As shown in FIG. 13, the prosthetic valve of the present invention, wherein the leaflet 210 is sutured on the sealing film 110, alternately passes between the sealing film 110 and the leaflet 210 along the leaflet fixed edge 202 so that each node is T-shaped, the distance between two adjacent nodes is 1 to 4 mm, and the above-mentioned suture method is a T-shaped suture method.
如图6所示,本发明中的人工瓣膜装置400,包括人工瓣膜300和瓣架500,瓣架500为两端呈莲花状、中间呈直筒状的网格结构,瓣架500从上至下依次为上部、中部和下部,上部和下部呈莲花状,中部呈直筒状,每一部均由多个长菱形相互连接而成,人工瓣膜300为上述的人工瓣膜,密封膜110两端的外扩口分别与瓣架500呈莲花状的两端相匹配,密封膜110的中部与瓣架500的中部相匹配,密封膜110缝合于瓣架500的内壁上。As shown in FIG. 6, the prosthetic valve device 400 of the present invention includes a prosthetic valve 300 and a valve holder 500. The valve holder 500 has a lattice structure in which both ends are lotus-shaped and have a straight cylindrical shape in the middle, and the valve holder 500 is from top to bottom. The upper part, the middle part and the lower part are in the shape of a lotus flower, and the upper part and the lower part are in a lotus shape, and the middle part is a straight tube shape, and each part is formed by a plurality of rhomboids connected to each other. The artificial valve 300 is the above-mentioned artificial valve, and the outer ends of the sealing film 110 are expanded. The mouths are respectively matched with the lotus-like ends of the valve holder 500, the middle portion of the sealing film 110 is matched with the middle portion of the valve holder 500, and the sealing film 110 is sewn to the inner wall of the valve holder 500.
本发明中的人工瓣膜装置400,其中瓣架500的上部与中部之间以及中部与下部之间均通过刚性竖杆连接,连接上部与中部的刚性竖杆沿瓣架500的周向均匀布置,连接中部与下部的刚性竖杆一一对应地布置在中部的长菱形与下部的长菱形之间,如图6所示,也就是说,中部与下部相对应的长菱形之间均通过一刚性竖杆连接,密封膜110的两端分别以包裹的方式一一对应地缝合在瓣架500的两端,人工瓣膜300在瓣架500上的缝合方式为上下端部为套圈打 结的方式(如图7所示),其余位置为沿着瓣架500的组成长菱形的杆以阶梯型半环形方式绕杆缝合(如图14所示),相邻两个半环的距离为1~5mm。The prosthetic valve device 400 of the present invention, wherein the upper and middle portions of the valve holder 500 and between the middle portion and the lower portion are connected by a rigid vertical rod, and the rigid vertical rods connecting the upper portion and the middle portion are evenly arranged along the circumferential direction of the valve holder 500. The connecting central portion and the lower rigid vertical rod are arranged in one-to-one correspondence between the rhomboid shape in the middle portion and the rhomboid shape in the lower portion, as shown in FIG. 6, that is, the rhomboids corresponding to the middle portion and the lower portion pass through a rigidity. The vertical rods are connected, and the two ends of the sealing film 110 are respectively sutured in a one-to-one manner on the two ends of the valve holder 500. The suture manner of the artificial valve 300 on the valve holder 500 is a manner in which the upper and lower ends are knotted by the ferrule. (As shown in Fig. 7), the remaining positions are the rhomboid-shaped rods along the valve holder 500, which are stitched around the rod in a stepped semi-annular manner (as shown in Fig. 14), and the distance between adjacent two half rings is 1~. 5mm.
本发明中的人工瓣膜300将瓣叶210缝合在两端呈碗口状的密封膜110的内部,并且瓣叶210的最高点低于密封膜110的上端缘,使得瓣叶210被完全的包裹在密封膜110之中,在瓣叶210闭合时,人工瓣膜300上端回流的血液被完全的限制在了以密封膜110和闭合状态的瓣叶210所形成的空间内,改善肺动脉瓣反流,两端的向外的莲花状结构(即呈齿形结构的外扩口)能够适用于肺动脉膨大或畸形的病变。人工瓣膜的瓣叶结构符合流体动力学结构,并且人工瓣膜的缝合牢固可靠,提高使用安全性和有效性。The prosthetic valve 300 of the present invention sutures the leaflets 210 inside the sealing film 110 having a bowl-shaped end, and the highest point of the leaflets 210 is lower than the upper end edge of the sealing film 110, so that the leaflets 210 are completely wrapped Among the sealing films 110, when the leaflets 210 are closed, the blood returning from the upper end of the prosthetic valve 300 is completely confined in the space formed by the sealing membrane 110 and the closed leaflets 210, improving pulmonary regurgitation, The outward lotus-like structure at both ends (ie, the flared outer shape of the toothed structure) can be applied to lesions of pulmonary artery enlargement or deformity. The leaflet structure of the prosthetic valve conforms to the fluid dynamic structure, and the suture of the prosthetic valve is firm and reliable, improving the safety and effectiveness of use.
如图6所示,为了改善现有技术的不足,本发明还提供了一种结构简单,所附带人工瓣膜缝合牢固,能减少血液返流的人工瓣膜装置400。As shown in Fig. 6, in order to improve the deficiencies of the prior art, the present invention also provides a prosthetic valve device 400 which is simple in structure, has a fixed artificial valve suture, and can reduce blood reflux.
本实施例中的密封膜110是由3个密封膜单元上的缝合边101两两缝合而成的,瓣叶210由3个瓣叶单元200缝合连接而成,密封膜单元的缝合边101从密封膜单元100的上端贯穿至密封膜单元100的下端,密封膜110的中部直筒状设有瓣叶210,瓣叶210是由瓣叶单元200上的缝合耳201两两缝合连接成的环形结构,瓣叶210在密封膜110上的缝合路径为瓣叶单元的固定边202,瓣叶单元200相连接后的缝合耳201在密封膜110中部的圆周方向均布。密封膜110和瓣叶210的缝合耳201均被固定在两端呈莲花状中间呈直筒状的瓣架500上,瓣架500为网格结构;瓣架500从上至下由三个部分组成,每个部分由若干个长菱形相互连接而成。人工瓣膜300缝合在与其相匹配的瓣架500上,组成人工瓣膜装置400。The sealing film 110 in this embodiment is formed by stitching the stitching edges 101 on the three sealing film units two by two, and the leaflets 210 are stitched and connected by three leaflet units 200, and the stitching edge 101 of the sealing film unit is The upper end of the sealing film unit 100 is penetrated to the lower end of the sealing film unit 100. The central portion of the sealing film 110 is provided with a leaflet 210 in a straight cylindrical shape. The leaflet 210 is an annular structure formed by stitching the stitching ears 201 on the leaflet unit 200. The suture path of the leaflet 210 on the sealing film 110 is the fixed side 202 of the leaflet unit, and the suture ears 201 after the leaflet unit 200 are connected are evenly distributed in the circumferential direction of the middle of the sealing film 110. The sealing membrane 110 and the suture ears 201 of the leaflets 210 are both fixed on the valve holder 500 which is straight in the shape of a lotus flower at both ends, and the valve holder 500 has a mesh structure; the valve holder 500 is composed of three parts from top to bottom. Each part is made up of several rhomboids connected to each other. The prosthetic valve 300 is sutured to a matching valve holder 500 to form a prosthetic valve device 400.
密封膜单元100两端分布有若干加固部分(即上述的加固耳102),加固部分缝合于对应的瓣架500两端。A plurality of reinforcing portions (i.e., the reinforcing ears 102 described above) are distributed at both ends of the sealing film unit 100, and the reinforcing portions are sewn to the opposite ends of the corresponding valve holder 500.
瓣叶单元200为花盆状。固定边202为从瓣叶单元200一端的缝合耳201沿下端曲线至另一端的缝合耳201所形成的月牙形边,固定边宽0.5~3mm。The leaflet unit 200 is in the shape of a flower pot. The fixed side 202 is a crescent-shaped side formed by the stitching ear 201 at one end of the leaflet unit 200 along the lower end curve to the other end, and the fixed side is 0.5 to 3 mm wide.
瓣叶的瓣叶单元200在密封膜110中部直筒状的圆周方向上均布。The leaflet unit 200 of the leaflets is evenly distributed in the circumferential direction of the central portion of the sealing film 110.
两个密封膜单元缝合边101的缝合方式是套圈打结的方式或螺旋缝合方 式或两面交替穿过的齿条缝合方式或矩阵缝合方式或十字交叉缝合方式。The stitching manner of the two sealing film unit stitching edges 101 is a ferrule tying manner or a spiral stitching method or a rack stitching method in which two sides are alternately passed or a matrix stitching method or a cross stitching method.
优选的,两密封膜单元缝合边101的缝合方式是套圈打结的方式,相邻两个打结节点的距离为1~4mm。Preferably, the stitching manner of the two sealing film unit stitching edges 101 is a manner in which the ferrule is knotted, and the distance between adjacent two knotting nodes is 1 to 4 mm.
瓣叶210在密封膜110上的缝合方式是沿瓣叶单元固定边202在密封膜110与瓣叶210两面间交替穿过的齿条缝合方式或螺旋缝合方式或沿固定边矩阵缝合方式或锯齿形缝合方式或T形缝合方式。The suture pattern of the leaflet 210 on the sealing film 110 is a rack stitching method or a spiral stitching method or a stitching method along the fixed side matrix or a sawtooth pattern along the fixed leaf edge of the sealing film 110 and the leaflet 210 along the fixed edge 202 of the leaflet unit. Shape stitching or T-stitching.
优选的,瓣叶210在密封膜110上的缝合方式是沿瓣叶固定边212在密封膜110与瓣叶210两面间交替穿过使每一个节点呈T形,相邻两个节点的距离为1~4mm。Preferably, the suture of the leaflet 210 on the sealing membrane 110 is alternately passed between the sealing membrane 110 and the leaflet 210 along the leaflet fixed edge 212 so that each node is T-shaped, and the distance between two adjacent nodes is 1 to 4 mm.
瓣架500的上部和下部均呈向外的莲花状,瓣架500的中部呈管状。The upper and lower portions of the valve holder 500 are outwardly shaped like a lotus flower, and the central portion of the valve holder 500 is tubular.
瓣架500的三个部分由刚性竖杆连接,其中上部与中部的连接为非一一对应的均布型连接,即连接上部与中部的刚性竖杆沿瓣架500的周向均匀布置,中部与下部的连接为一一对应的全连接,即连接中部与下部的刚性竖杆一一对应地布置在中部的长菱形与下部的长菱形之间,如图6所示,也就是说,中部与下部相对应的长菱形之间均通过一刚性竖杆连接,此结构有助于改善瓣架500在释放位置的顺应性。The three portions of the valve holder 500 are connected by a rigid vertical rod, wherein the connection between the upper portion and the middle portion is a non-one-to-one uniform distribution, that is, the rigid vertical rod connecting the upper portion and the middle portion is evenly arranged along the circumferential direction of the valve holder 500, the middle portion The full connection with the lower connection is a one-to-one correspondence, that is, the central and lower rigid vertical rods are arranged in one-to-one correspondence between the middle rhomboid and the lower rhomboid, as shown in FIG. 6, that is, the middle portion The rhomboids corresponding to the lower portions are each connected by a rigid vertical rod which helps to improve the compliance of the valve holder 500 in the release position.
密封膜110两端的莲花状与瓣架500上部和下部的莲花状相匹配,并且密封膜110两端以包裹的方式一一对应的缝合在瓣架500上。The lotus shape at both ends of the sealing film 110 is matched with the lotus shape of the upper and lower portions of the valve holder 500, and both ends of the sealing film 110 are stitched to the valve holder 500 in a one-to-one manner in a wrapped manner.
人工瓣膜300在瓣架500上的缝合方式为上下端部是套圈打结的方式,其余位置为沿着瓣架500的所有杆以阶梯型半环形方式绕杆缝合,相邻两个半环的距离为1~5mm。The suture mode of the prosthetic valve 300 on the valve frame 500 is such that the upper and lower ends are knotted by the ferrule, and the rest of the positions are stitched around the rod in a stepped semi-annular manner along all the rods of the valve holder 500, and the adjacent two half rings The distance is 1 to 5 mm.
下面结合附图对本发明作进一步描述。本发明主要涉及一种人工瓣膜,其两端独特的莲花状结构使得本发明能更好的应用于肺动脉膨大或畸形的患者。人工瓣膜的上端是其血液流出道,下端是其血液流入道。The invention is further described below in conjunction with the drawings. The present invention mainly relates to a prosthetic valve, the unique lotus-like structure at both ends of the invention makes the invention more suitable for patients with pulmonary artery enlargement or deformity. The upper end of the prosthetic valve is its blood outflow channel and the lower end is its blood inflow channel.
第一种实施例:如图1-2所示,本实施例中的密封膜110是由三片密封膜单元100通过彼此间的缝合边101两两拼接缝合而成,由于密封膜单元两端的皇冠状结构,使得缝合后整个密封膜呈现出两端的莲花状和中间的直筒状结 构,并且形成拼接线113。缝合边101为向内凹的凹槽状结构,密封膜上下边沿111、112为齿形结构。114是密封膜直筒状段与莲花状段的交界线,在两交界线114之间设有瓣叶210。在密封膜单元100上的加固部分即加固耳102是为增加密封膜缝于瓣架上时的强度与稳固性而设计,并设计有与瓣架的匹配边线103。First Embodiment: As shown in FIG. 1-2, the sealing film 110 in this embodiment is formed by stitching three sealing film units 100 through two stitching edges 101, due to the two ends of the sealing film unit. The crown-like structure is such that the entire sealing film after stitching exhibits a lotus-like shape at both ends and a straight cylindrical structure at the center, and a splicing line 113 is formed. The stitching edge 101 is a recessed groove-like structure, and the upper and lower edges 111, 112 of the sealing film have a toothed structure. 114 is a boundary line between the straight section of the sealing film and the lotus-shaped section, and a leaflet 210 is disposed between the two boundary lines 114. The reinforcing portion on the sealing film unit 100, that is, the reinforcing ear 102, is designed to increase the strength and stability of the sealing film when it is sewn to the valve frame, and is designed with a matching edge 103 to the valve holder.
密封膜单元之间的缝合边处的缝合有套圈打结的方式或螺旋缝合方式或两面交替穿过的齿条缝合方式或矩阵缝合方式或十字交叉缝合方式,如图7-14所示。套圈打结的缝合方式是使用一根缝合线在每一个穿针点打一个活结将两缝合边绑在一起,这种方式使得密封膜单元间的连接更为牢靠。螺旋缝合方式是将一根缝合线始终从同一个方向穿过两缝合边,其路径大致为一螺旋形状。两面交替穿过的齿条缝合方式是缝合线依次从两缝合边的暴露面穿过。矩阵缝合方式为齿条缝合方式往返一次所形成。十字交叉缝合方式为螺旋缝合方式往返一次所形成。以上缝合方式中,相邻两个穿针点沿着缝合边的距离为1~4mm。The stitching at the seam edge between the sealing film units has a ferrule knotting method or a spiral stitching method or a rack stitching method or a matrix stitching method or a cross stitching method in which two sides are alternately passed, as shown in Fig. 7-14. The quilting of the ferrule is accomplished by using a suture to tie the two stitching edges at each needle point, which makes the connection between the sealing film units more secure. The spiral stitching method is to pass a suture thread from the same direction through the two stitching edges, and the path is substantially a spiral shape. The racking method in which the two sides alternately pass through is that the suture passes through the exposed faces of the two stitching edges in sequence. The matrix stitching method is formed by reciprocating the rack stitching method once. The cross stitching method is formed by spiral stitching once and for all. In the above stitching method, the distance between adjacent two needle insertion points along the stitching edge is 1 to 4 mm.
如图3-5所示,设在密封膜交界线114之间的瓣叶210是由三片瓣叶单元200通过其上的缝合耳201两两缝合连接而成,形成三个缝合耳拼接段211,而三个瓣叶单元的固定边拼接形成了瓣叶固定边212。其中缝合耳拼接段211与瓣叶固定边212即为瓣叶210在密封膜110中的缝合路径301,依靠各瓣叶单元的游离边203即可实现人工瓣膜对血流方向的控制。缝合路径301的缝合方式有两面间交替穿过的齿条缝合方式或螺旋缝合方式或沿固定边矩阵缝合方式或锯齿形缝合方式或T形缝合方式,如图7-14所示。两面间交替穿过的齿条缝合方式、螺旋缝合方式、沿固定边矩阵缝合方式与密封膜的缝合方式相同。锯齿形缝合方式是由矩阵缝合方式衍变而来,即将转针点上下交替偏移即可。T形缝合方式是使用一根缝合线在两面之间交替穿过而形成。As shown in FIG. 3-5, the leaflets 210 disposed between the sealing film boundary lines 114 are formed by stitching the three leaflet unit 200 through the stitching ears 201 thereon, forming three stitching ear splicing segments. 211, and the fixed edges of the three leaflet units are spliced to form the leaflet fixed edge 212. The suture ear splice segment 211 and the leaflet fixed edge 212 are the suture path 301 of the leaflet 210 in the sealing film 110, and the prosthetic valve can control the blood flow direction by relying on the free edge 203 of each leaflet unit. The stitching manner of the stitching path 301 is a rack stitching method or a spiral stitching method in which two sides alternately pass through, or a fixed edge matrix stitching method or a zigzag stitching method or a T-shaped stitching manner, as shown in FIG. The rack stitching method, the spiral stitching method, and the stitching along the fixed side matrix are the same as the sealing film stitching manner. The zigzag stitching method is derived from the matrix stitching method, that is, the needle point is alternately shifted up and down. The T-stitching method is formed by alternately passing a suture between the two faces.
如图5所示,缝合在密封膜110中的瓣叶210与密封膜上端(即人工瓣膜的血流出口端)形成了一个密封性能很好的空间,能有效的减少瓣周漏和反流。As shown in FIG. 5, the leaflet 210 sewn in the sealing film 110 and the upper end of the sealing film (ie, the blood outlet end of the prosthetic valve) form a space with good sealing performance, which can effectively reduce the paravalvular leakage and reflux. .
第二种实施例:如图6所示,本实施例将人工瓣膜300安装在具有形状记 忆效应能自行扩张的瓣架500内制成人工瓣膜装置400,人工瓣膜在瓣架上的缝合方式为上下端部是套圈打结的方式,其余位置为沿着支架的所有杆以阶梯型半环形方式绕杆缝合(如图14所示),相邻两个半环的距离为1~5mm。瓣架的每一条杆均与人工瓣膜的密封膜缝合在一起。本实施例中的人工瓣膜采用实施例一中的人工瓣膜。The second embodiment: as shown in FIG. 6, the artificial valve 300 is installed in the valve holder 500 having the shape memory effect and can be self-expanded to form the artificial valve device 400. The suture method of the artificial valve on the valve frame is The upper and lower ends are the way of ferrule tying, and the rest of the positions are stitched around the rod in a stepped semi-annular manner along all the rods of the bracket (as shown in Fig. 14), and the distance between adjacent two half rings is 1 to 5 mm. Each rod of the valve holder is sewn together with a sealing membrane of the prosthetic valve. The prosthetic valve of the first embodiment uses the prosthetic valve of the first embodiment.
以上所述的实施例仅仅是对本发明的优选实施方式进行描述,并非对本发明的范围进行限定,在不脱离本发明设计精神的前提下,本领域普通技术人员对本发明的技术方案作出的各种变形和改进,均应落入本发明权利要求书确定的保护范围内。The embodiments described above are only intended to describe the preferred embodiments of the present invention, and are not intended to limit the scope of the present invention, and various embodiments of the present invention may be made by those skilled in the art without departing from the spirit of the invention. Modifications and improvements are intended to fall within the scope of the invention as defined by the appended claims.
工业实用性Industrial applicability
本发明实施例的人工瓣膜及人工瓣膜装置将瓣叶缝合在两端呈碗口状的密封膜的内部,并且瓣叶的最高点低于密封膜的上端缘,使得瓣叶被完全的包裹在密封膜之中,在瓣叶闭合时,人工瓣膜上端回流的血液被完全的限制在了以密封膜和闭合状态的瓣叶所形成的空间内,改善肺动脉瓣反流,两端的向外的莲花状结构能够适用于肺动脉膨大或畸形的病变。所述人工瓣膜的瓣叶结构符合流体动力学结构,并且人工瓣膜的缝合牢固可靠,提高使用安全性和有效性。本发明实施例的人工瓣膜及人工瓣膜装置能够批量生产制造。The prosthetic valve and the prosthetic valve device of the embodiment of the invention suture the leaflets in the interior of the sealing membrane with a bowl-shaped mouth at both ends, and the highest point of the leaflets is lower than the upper edge of the sealing membrane, so that the leaflets are completely wrapped Among the sealing membranes, when the leaflets are closed, the blood returning from the upper end of the prosthetic valve is completely confined in the space formed by the sealing membrane and the closed leaflets, improving the pulmonary valve regurgitation, and the outward lotus at both ends The structure can be applied to lesions of pulmonary artery enlargement or deformity. The leaflet structure of the prosthetic valve conforms to the fluid dynamic structure, and the suture of the prosthetic valve is firm and reliable, improving the safety and effectiveness of use. The prosthetic valve and prosthetic valve device of the embodiments of the present invention can be mass-produced.

Claims (20)

  1. 一种人工瓣膜,其特征在于:包括密封膜和瓣叶,所述密封膜呈筒状,所述密封膜的两端各设有一个外扩口,所述外扩口的端口处为齿形结构,所述密封膜的中部呈直筒状,所述外扩口的内径大于所述密封膜中部的内径,所述密封膜由至少三个密封膜单元缝合而成,所述瓣叶为至少三个瓣叶单元缝合连接成的环形结构,所述瓣叶设于所述密封膜的中部。A prosthetic valve comprising: a sealing film and a leaflet, wherein the sealing film has a cylindrical shape, and each of the two ends of the sealing film is provided with an external flare, and the port of the external flare is toothed a structure in which a middle portion of the sealing film has a straight cylindrical shape, an inner diameter of the outer flare is larger than an inner diameter of a middle portion of the sealing film, and the sealing film is sewn by at least three sealing film units, and the leaflets are at least three The leaflet unit is sutured to form an annular structure, and the leaflet is disposed in the middle of the sealing film.
  2. 根据权利要求1所述的人工瓣膜,其特征在于:所述密封膜单元的上下两端分别向外侧倾斜设置,所述密封膜单元的上下两端分别设有加固耳,所述加固耳构成所述外扩口端口处的齿形结构,所述密封膜单元的中部为矩形,所述密封膜单元的两侧为缝合边。The prosthetic valve according to claim 1, wherein the upper and lower ends of the sealing film unit are respectively inclined outwardly, and the upper and lower ends of the sealing film unit are respectively provided with reinforcing ears, and the reinforcing ear is configured The toothed structure at the outer flare port, the middle portion of the sealing film unit is rectangular, and both sides of the sealing film unit are stitched edges.
  3. 根据权利要求2所述的人工瓣膜,其特征在于:所述缝合边从密封膜单元的上端贯穿至密封膜单元的下端。The prosthetic valve according to claim 2, wherein the sewn edge penetrates from the upper end of the sealing film unit to the lower end of the sealing film unit.
  4. 根据权利要求3所述的人工瓣膜,其特征在于:所述缝合边为宽0.5~3mm的凹槽状边。The prosthetic valve according to claim 3, wherein the sewn side is a groove-like side having a width of 0.5 to 3 mm.
  5. 根据权利要求4所述的人工瓣膜,其特征在于:所述瓣叶单元包括一体构成的上矩形和下矩形,所述上矩形和所述下矩形均通过各自的长边连接,所述上矩形的长边长度大于所述下矩形的长边长度,所述下矩形下侧的两个角去掉并倒圆角,所述上矩形的两个短边处为缝合耳,所述下矩形的边缘处为固定边。The prosthetic valve according to claim 4, wherein the leaflet unit comprises an upper rectangular shape and a lower rectangular shape, the upper rectangular shape and the lower rectangular shape being connected by respective long sides, the upper rectangular shape The length of the long side is greater than the length of the long side of the lower rectangle, and the two corners of the lower side of the lower rectangle are removed and rounded, and the two short sides of the upper rectangle are the stitching ears, and the edges of the lower rectangle It is a fixed side.
  6. 根据权利要求5所述的人工瓣膜,其特征在于:所述固定边的宽度为0.5~3mm。The prosthetic valve according to claim 5, wherein the fixed side has a width of 0.5 to 3 mm.
  7. 根据权利要求6所述的人工瓣膜,其特征在于:所述瓣叶的瓣叶单元在所述密封膜中部的圆周方向上均匀布置。The prosthetic valve according to claim 6, wherein the leaflet unit of the leaflet is evenly arranged in the circumferential direction of the central portion of the sealing film.
  8. 根据权利要求7所述的人工瓣膜,其特征在于:所述密封膜由三个密封膜单元缝合而成,所述瓣叶为三个瓣叶单元缝合连接而成。The prosthetic valve according to claim 7, wherein the sealing film is sewn by three sealing film units, and the leaflets are stitched and joined by three leaflet units.
  9. 根据权利要求8所述的人工瓣膜,其特征在于:相邻两个所述密封膜 单元缝合边的缝合方式为螺旋缝合方式或者两面交替穿过的齿条缝合方式或者矩阵缝合方式或者十字交叉缝合方式。The prosthetic valve according to claim 8, wherein the suturing manner of the suture edges of two adjacent sealing film units is a spiral stitching method or a rack stitching method in which two sides are alternately passed or a matrix stitching method or a cross stitching method. the way.
  10. 根据权利要求9所述的人工瓣膜,其特征在于:相邻两个所述密封膜单元缝合边的缝合方式中,相邻两个穿针点沿着缝合边的距离为1~4mm。The prosthetic valve according to claim 9, wherein in the suturing manner of the suture edges of two adjacent sealing film units, the distance between adjacent two needle insertion points along the sewn side is 1 to 4 mm.
  11. 根据权利要求8所述的人工瓣膜,其特征在于:相邻两个所述密封膜单元缝合边的缝合方式为套圈打结的方式,相邻两个打结节点之间的距离为1~4mm。The prosthetic valve according to claim 8, wherein the suturing manner of the suture edges of two adjacent sealing film units is a manner in which the ferrule is knotted, and the distance between two adjacent knotting nodes is 1 to 4mm.
  12. 根据权利要求9或11所述的人工瓣膜,其特征在于:所述瓣叶在所述密封膜上的缝合方式为沿所述瓣叶单元固定边在密封膜与瓣叶两面间交替穿过的齿条缝合方式或者螺旋缝合方式或者矩阵缝合方式或者锯齿形缝合方式。The prosthetic valve according to claim 9 or 11, wherein the suture of the leaflet on the sealing membrane is alternately passed between the sealing membrane and the leaflet along the fixed edge of the leaflet unit. Rack stitching or spiral stitching or matrix stitching or zigzag stitching.
  13. 根据权利要求12所述的人工瓣膜,其特征在于:所述瓣叶在密封膜上的缝合方式中,相邻两个穿针点沿着固定边的距离为1~4mm。The prosthetic valve according to claim 12, wherein in the suturing manner of the leaflets on the sealing film, the distance between adjacent two needle insertion points along the fixed side is 1 to 4 mm.
  14. 根据权利要求9或11所述的人工瓣膜,其特征在于:所述瓣叶在所述密封膜上的缝合方式为沿瓣叶固定边在密封膜与瓣叶两面间交替穿过使每一个节点呈T形,相邻两个节点之间的距离为1~4mm。The prosthetic valve according to claim 9 or 11, wherein the suture of the leaflet on the sealing membrane is alternately passed between the sealing membrane and the leaflet along the fixed edge of the leaflet to make each node It is T-shaped, and the distance between two adjacent nodes is 1 to 4 mm.
  15. 一种人工瓣膜装置,包括人工瓣膜和瓣架,其特征在于:所述瓣架为两端呈莲花状、中间呈直筒状的网格结构,所述瓣架从上至下依次为上部、中部和下部,所述上部和下部呈所述莲花状,所述中部呈所述直筒状,每一部均由多个长菱形相互连接而成,所述人工瓣膜为权利要求1~8任一项所述的人工瓣膜,所述密封膜两端的外扩口分别与所述瓣架呈莲花状的两端相匹配,所述密封膜的中部与所述瓣架的中部相匹配,所述密封膜缝合于所述瓣架的内壁上。The invention relates to a prosthetic valve device, which comprises a prosthetic valve and a valve frame, wherein the valve frame is a lattice structure with lotus flowers at both ends and a straight tube shape in the middle, and the valve frame is upper and middle in order from top to bottom. And the lower part, wherein the upper part and the lower part are in the shape of a lotus flower, and the middle part is in the shape of the straight tube, each part is formed by connecting a plurality of rhomboids, and the artificial valve is any one of claims 1 to 8. In the artificial valve, the outer flares at both ends of the sealing film are respectively matched with the lotus-shaped ends of the valve holder, and the middle portion of the sealing film is matched with the middle portion of the valve holder, and the sealing film Stitched to the inner wall of the valve holder.
  16. 根据权利要求15所述的人工瓣膜装置,其特征在于:所述瓣架的上部与中部之间以及中部与下部之间均通过刚性竖杆连接。The prosthetic valve device according to claim 15, wherein the upper and middle portions of the valve holder and between the middle portion and the lower portion are connected by a rigid vertical rod.
  17. 根据权利要求16所述的人工瓣膜装置,其特征在于:连接上部与中部的所述刚性竖杆沿所述瓣架的周向均匀布置,连接中部与下部的所述刚性竖 杆一一对应地布置在中部的长菱形与下部的长菱形之间。The prosthetic valve device according to claim 16, wherein the rigid vertical rod connecting the upper portion and the middle portion is evenly arranged along the circumferential direction of the valve holder, and the rigid rods connecting the middle portion and the lower portion are in one-to-one correspondence It is arranged between the rhomboid in the middle and the rhomboid in the lower part.
  18. 根据权利要求17所述的人工瓣膜装置,其特征在于:所述密封膜的两端分别以包裹的方式一一对应地缝合在所述瓣架的两端。The prosthetic valve device according to claim 17, wherein both ends of the sealing film are respectively sutured in a one-to-one manner at both ends of the valve holder.
  19. 根据权利要求18所述的人工瓣膜装置,其特征在于:所述人工瓣膜在所述瓣架上的缝合方式为上下端部为套圈打结的方式,其余位置为沿着瓣架的组成所述长菱形的杆以阶梯型半环形方式绕杆缝合。The prosthetic valve device according to claim 18, wherein the suture manner of the prosthetic valve on the valve frame is such that the upper and lower ends are knotted by the ferrule, and the remaining positions are along the composition of the valve holder. The rhomboid-shaped rod is stitched around the rod in a stepped semi-annular manner.
  20. 根据权利要求19所述的人工瓣膜装置,其特征在于:所述以阶梯型半环形方式绕杆缝合中,相邻两个半环的距离为1~5mm。The prosthetic valve device according to claim 19, wherein said suture is wound around the rod in a stepped semi-annular manner, and the distance between adjacent two half rings is 1 to 5 mm.
PCT/CN2019/073156 2018-02-06 2019-01-25 Prosthetic valve and prosthetic valve device WO2019154124A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN201810116225.1A CN108125732A (en) 2018-02-06 2018-02-06 Artificial valve and prosthetic valve apparatus
CN201810116225.1 2018-02-06

Publications (1)

Publication Number Publication Date
WO2019154124A1 true WO2019154124A1 (en) 2019-08-15

Family

ID=62430371

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CN2019/073156 WO2019154124A1 (en) 2018-02-06 2019-01-25 Prosthetic valve and prosthetic valve device

Country Status (2)

Country Link
CN (1) CN108125732A (en)
WO (1) WO2019154124A1 (en)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022036022A1 (en) * 2020-08-12 2022-02-17 Edwards Lifesciences Corporation Prosthetic heart valve
US11471282B2 (en) 2019-03-19 2022-10-18 Shifamed Holdings, Llc Prosthetic cardiac valve devices, systems, and methods
US11672657B2 (en) 2018-10-05 2023-06-13 Shifamed Holdings, Llc Prosthetic cardiac valve devices, systems, and methods
US11833034B2 (en) 2016-01-13 2023-12-05 Shifamed Holdings, Llc Prosthetic cardiac valve devices, systems, and methods

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108125732A (en) * 2018-02-06 2018-06-08 北京迈迪顶峰医疗科技有限公司 Artificial valve and prosthetic valve apparatus
CN109549751B (en) * 2018-11-21 2024-01-09 杭州创心医学科技有限公司 Valved conduit and method for manufacturing same
CN109172041B (en) * 2018-11-21 2024-03-12 杭州创心医学科技有限公司 Valved pipeline and preparation method thereof
CN114025712A (en) * 2019-08-12 2022-02-08 爱德华兹生命科学公司 Artificial heart valve

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102113921A (en) * 2009-12-30 2011-07-06 微创医疗器械(上海)有限公司 Intervention-type heart valve
CN102202610A (en) * 2008-10-29 2011-09-28 西美蒂斯股份公司 Methods and systems for stent-valve manufacture and assembly
US20120083879A1 (en) * 2006-03-28 2012-04-05 Medtronic, Inc. Prosthetic Cardiac Valve from Pericardium Material and Methods of Making Same
CN202892148U (en) * 2012-10-16 2013-04-24 北京迈迪顶峰医疗科技有限公司 Support valve and conveying device thereof
CN104114127A (en) * 2011-12-09 2014-10-22 爱德华兹生命科学公司 Prosthetic heart valve improved commissure supports
CN104257442A (en) * 2014-09-25 2015-01-07 北京迈迪顶峰医疗科技有限公司 Intrusive replacement valve and controllable conveying device thereof
CN108125732A (en) * 2018-02-06 2018-06-08 北京迈迪顶峰医疗科技有限公司 Artificial valve and prosthetic valve apparatus

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120083879A1 (en) * 2006-03-28 2012-04-05 Medtronic, Inc. Prosthetic Cardiac Valve from Pericardium Material and Methods of Making Same
CN102202610A (en) * 2008-10-29 2011-09-28 西美蒂斯股份公司 Methods and systems for stent-valve manufacture and assembly
CN102113921A (en) * 2009-12-30 2011-07-06 微创医疗器械(上海)有限公司 Intervention-type heart valve
CN104114127A (en) * 2011-12-09 2014-10-22 爱德华兹生命科学公司 Prosthetic heart valve improved commissure supports
CN202892148U (en) * 2012-10-16 2013-04-24 北京迈迪顶峰医疗科技有限公司 Support valve and conveying device thereof
CN104257442A (en) * 2014-09-25 2015-01-07 北京迈迪顶峰医疗科技有限公司 Intrusive replacement valve and controllable conveying device thereof
CN108125732A (en) * 2018-02-06 2018-06-08 北京迈迪顶峰医疗科技有限公司 Artificial valve and prosthetic valve apparatus

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11833034B2 (en) 2016-01-13 2023-12-05 Shifamed Holdings, Llc Prosthetic cardiac valve devices, systems, and methods
US11672657B2 (en) 2018-10-05 2023-06-13 Shifamed Holdings, Llc Prosthetic cardiac valve devices, systems, and methods
US11471282B2 (en) 2019-03-19 2022-10-18 Shifamed Holdings, Llc Prosthetic cardiac valve devices, systems, and methods
WO2022036022A1 (en) * 2020-08-12 2022-02-17 Edwards Lifesciences Corporation Prosthetic heart valve

Also Published As

Publication number Publication date
CN108125732A (en) 2018-06-08

Similar Documents

Publication Publication Date Title
WO2019154124A1 (en) Prosthetic valve and prosthetic valve device
JP7036556B2 (en) Stent with valve for replacement of heart mitral and tricuspid valves
US11395734B2 (en) Prosthetic valve and prosthetic valve implanting method
US20220280288A1 (en) Heart valve prosthesis anchored to interventricular septum and conveying and releasing method thereof
CN108578016B (en) Trans-apex implantable mitral valve device
US10543081B2 (en) Heart valve prosthesis
JP2018047242A5 (en)
CN105455924B (en) For treating the implantable device of heart valve regurgitation
CN105520792B (en) A kind of D-shaped insertion type artificial cardiac valve
JP4022234B2 (en) Aortic valve recovery device
JP5597626B2 (en) Quick release annuloplasty ring holder
CN109199641A (en) A kind of artificial valve prosthese with fixing piece
US7862610B2 (en) Bicuspid vascular valve and methods for making and implanting same
JP2016517751A (en) Prosthetic valve and related devices, systems, and methods
SG188528A1 (en) Percutaneously deliverable heart or blood vessel valve with frame having abluminally situated tissue membrane
CN109199640B (en) Artificial valve prosthesis
WO2022007384A1 (en) Composite-type skirt for prosthetic heart valve and prosthetic heart valve
CN114073603B (en) Valve support and artificial heart valve
CN109498213A (en) A kind of valve bracket and valve prosthesis
CN111110403A (en) Heart valve device with anchoring ring and using method thereof
CN212382790U (en) Heart valve device with anchoring ring
CN108245281A (en) Valve prosthesis
RU2670661C9 (en) Method for production seal-containing conduite and seal-containing conduite
CN113599023A (en) Intervention type artificial heart valve
CN208808749U (en) Artificial valve and prosthetic valve apparatus

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 19750820

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 19750820

Country of ref document: EP

Kind code of ref document: A1