WO2020075684A1 - Kit d'entraînement - Google Patents

Kit d'entraînement Download PDF

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Publication number
WO2020075684A1
WO2020075684A1 PCT/JP2019/039525 JP2019039525W WO2020075684A1 WO 2020075684 A1 WO2020075684 A1 WO 2020075684A1 JP 2019039525 W JP2019039525 W JP 2019039525W WO 2020075684 A1 WO2020075684 A1 WO 2020075684A1
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WO
WIPO (PCT)
Prior art keywords
commissure
recess
training
leaflet
training kit
Prior art date
Application number
PCT/JP2019/039525
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English (en)
Japanese (ja)
Inventor
重之 尾崎
Original Assignee
重之 尾崎
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 重之 尾崎 filed Critical 重之 尾崎
Publication of WO2020075684A1 publication Critical patent/WO2020075684A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/76—Means for assembling, fitting or testing prostheses, e.g. for measuring or balancing, e.g. alignment means
    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B9/00—Simulators for teaching or training purposes

Definitions

  • the present invention relates to a training kit.
  • This training kit has a blood vessel model that is made of a plastic material and imitates an aorta, and a pedestal that supports the blood vessel model.
  • the upper end of the blood vessel model is open, and a valve leaflet model imitating a leaflet can be sutured to the inner wall.
  • the distance between commissures after excision of the leaflets is measured by, for example, the leaflet sizer disclosed in Patent Document 1, and leaflets corresponding to the measured distances are collected from the patient. It is formed using the pericardium. Since the distance between the commissures differs depending on the patient, it is preferable to perform training with a plurality of blood vessel models having different diameters when training for aortic valve reconstruction. However, in the case of the training kit disclosed in Patent Document 1, since the diameter of the blood vessel model cannot be changed, when training on aortas of different diameters, it is necessary to arrange a plurality of blood vessel models having different diameters.
  • the present invention aims to enable training of aortic valve reconstruction surgery corresponding to aortas of multiple diameters.
  • the present invention provides a tubular portion having a tubular shape with at least one end open, at least two commissure portions formed on the inner surface of the tubular portion, and a diameter of a portion of the tubular portion where the commissure portion is formed.
  • a training kit including a changing means for changing the.
  • a plurality of marks indicating the positions where the valve leaflet model is sewn may be provided on the inner surface of the tubular portion.
  • the three commissural portions may be formed on the inner surface of the tubular portion.
  • the third angle formed by the third communicative portion and the line connecting the centers of the tubular portions may be different from each other.
  • the front view of the training kit 1 which concerns on one Embodiment of this invention.
  • the top view of the training kit 1. The perspective view of the training kit 1. The figure which showed the state which removed the 1st adjustment member 41, the 2nd adjustment member 42, and the 3rd adjustment member 43 from the cylindrical part 20. The figure which showed an example of the leaflet sizer 6. The figure which showed an example of the template 7, the sheet member 8, and the valve leaflet model 50.
  • the top view of training kit 1A concerning a modification.
  • the top view of the training kit 1B which concerns on a modification.
  • the top view of the training kit 1B which concerns on a modification.
  • FIG. 1 is a front view of a training kit 1 according to an embodiment of the present invention
  • FIG. 2 is a plan view of the training kit 1.
  • FIG. 3 is a perspective view of the training kit 1.
  • Training kit 1 is used for training tricuspid aortic valve reconstruction surgery, and is formed in a shape simulating a human aorta.
  • the training kit 1 has a tubular shape, and the upper end and the lower end are open.
  • the training kit 1 may have a configuration in which the upper end is open and the lower end is not open.
  • the material of the training kit 1 a known material for a biological model can be appropriately adopted.
  • a flexible material elastomer
  • silicone, urethane, styrene, synthetic rubber, or natural rubber is used as the material of the training kit 1.
  • the material of the training kit 1 may be a flexible material that can maintain its shape and has elasticity similar to that of living tissue.
  • the training kit 1 may be made of a single layer of flexible material, or may be formed by stacking a plurality of flexible materials in the radial direction. When the training kit 1 is composed of a plurality of layers, the material of each layer may be different.
  • the valve leaflet model 50 described later is sewn to the inner wall of the training kit 1, but, for example, the hardness of the plastic material that becomes the inner wall of the training kit 1 is determined by the hardness of the plastic material that becomes the outer wall of the training kit 1. It may be soft. With this configuration, the valve leaflet model 50 can be easily sutured to the soft inner wall while maintaining the shape of the training kit 1 by the hard outer wall.
  • the training kit 1 includes a base portion 10 and a tubular portion 20.
  • the base portion 10 has a cylindrical shape, and the inner diameter and the outer shape have predetermined diameters.
  • the tubular portion 20 has a constricted portion 24 whose inner diameter and outer shape are smaller than the base portion 10 from the lower side toward the upper side so that the inner diameter and outer shape are the smallest. Above the constricted portion 24, the inner diameter and the outer shape are larger than the constricted portion 24.
  • the waist portion 24 may have a radial thickness that is thicker than other portions.
  • the tubular portion 20 has a shape in which three circumferential positions are cut out from the upper end side toward the constricted portion 24, and has a first wall portion 21, a second wall portion 22, and a third wall portion 23.
  • the circumferential widths of the first wall portion 21, the second wall portion 22, and the third wall portion 23 are wider from the upper end toward the constricted portion 24.
  • the angle formed by the line connecting the center of the tubular portion 20 and the circumferential center of the first wall portion 21 and the line connecting the center of the tubular portion 20 and the circumferential center of the second wall portion 22 is ⁇ 1.
  • An angle formed by a line connecting the center of the tubular portion 20 and the center of the second wall portion 22 in the circumferential direction and a line connecting the center of the tubular portion 20 and the center of the third wall portion 23 in the circumferential direction. Is ⁇ 2, and a line connecting the center of the tubular portion 20 and the circumferential center of the third wall portion 23, and a line connecting the center of the tubular portion 20 and the circumferential center of the first wall portion 21.
  • the angle formed by is ⁇ 3. Although ⁇ 1, ⁇ 2, and ⁇ 3 may be the same, it is preferable that the angles are different from each other.
  • FIG. 4 is a diagram showing a state in which the first adjusting member 41, the second adjusting member 42, and the third adjusting member 43 are removed from the tubular portion 20.
  • the first adjusting member 41, the second adjusting member 42, and the third adjusting member 43 are members that adjust the distance from the center of the training unit 2 to the first wall 21, the second wall 22, and the third wall 23.
  • the first adjusting member 41, the second adjusting member 42, and the third adjusting member 43 have the same shape as the teeth of the gear formed at both ends in the circumferential direction.
  • a recess 211 into which the first adjusting member 41 is fitted and a recess 212 into which the third adjusting member 43 is fitted are formed at the upper end of the first wall portion 21.
  • a concave portion 221 into which the second adjusting member 42 is fitted and a concave portion 222 into which the first adjusting member 41 is fitted are formed at the upper end of the second wall portion 22.
  • a recess 231 into which the third adjusting member 43 is fitted and a recess 232 into which the second adjusting member 42 is fitted are formed at the upper end of the third wall portion 23.
  • the same shape as the gear tooth is formed on the center side of the training portion.
  • the first adjusting member 41, the second adjusting member 42, the third adjusting member 43, the concave portion 211, the concave portion 212, the concave portion 221, the concave portion 222, the concave portion 231, and the concave portion 232 are an example of a changing unit according to the present invention.
  • a first reference portion 31, a second reference portion 32, and a third reference portion 33, which serve as a reference when suturing the leaflet model 50, are formed inside the tubular portion 20 and above the constricted portion 24.
  • the first reference portion 31, the second reference portion 32, and the third reference portion 33 are cord-shaped and have a circular cross section.
  • the positions where the first reference portion 31, the second reference portion 32, and the third reference portion 33 are formed correspond to the positions where the leaflets are sutured in the aortic valve reconstruction operation.
  • the portion where the first reference portion 31 and the third reference portion 33 are in contact, the portion where the first reference portion 31 and the second reference portion 32 are in contact, and the portion where the second reference portion 32 and the third reference portion 33 are in contact are according to the present invention. It is an example of such a commissure part.
  • the first reference portion 31 has one end located on the first wall portion 21 and the other end located on the second wall portion 22.
  • the central portion of the first reference portion 31 is located between the first wall portion 21 and the second wall portion 22, below both ends, and above the constricted portion 24.
  • the second reference portion 32 has one end located on the second wall portion 22 and the other end located on the third wall portion 23.
  • the central portion of the second reference portion 32 is located between the second wall portion 22 and the third wall portion 23, below both ends, and above the constricted portion 24.
  • the third reference portion 33 has one end located on the third wall portion 23 and the other end located on the first wall portion 21.
  • the central portion of the third reference portion 33 is located between the third wall portion 23 and the first wall portion 21, below both ends, and above the constricted portion 24.
  • Marks 35 and 36 indicating the suturing position of the valve leaflet model 50 are formed on the surfaces of the first reference portion 31, the second reference portion 32, and the third reference portion 33.
  • the mark 35 is a mark indicating the start position of suturing when suturing the valve leaflet model 50, and is the center in the length direction of the first reference portion 31, the center in the length direction of the second reference portion 32, and the third reference portion. It is formed at the center of the length of the portion 33.
  • the mark 36 is a mark that indicates the position when the valve leaflet model 50 is sewn, and a plurality of marks 36 are formed at intervals from the mark 35 toward both ends.
  • a user who performs training for aortic valve reconstruction surgery fixes the training kit 1 on, for example, a pedestal, and measures the distance between commissures with a leaflet sizer 6 shown in FIG.
  • the leaflet sizer 6 includes a sizer block 610 having an arc surface 611 and a handle 620 attached to the sizer block 610 and gripped by an operator.
  • the sizer block 610 measures the distance between adjacent commissures, and has a circular arc surface 611 when the column is cut in advance at an angle (for example, 120 degrees) corresponding to the central angle of the commissure of the aortic valve. Since the distance between the commissures differs depending on the patient, a plurality of leaflet sizers 6 having different sizes (arc lengths) of the arc surface 611 are prepared in advance.
  • the size of the leaflet sizer 6 is, for example, the diameter of a cylindrical shape before being divided into three equal parts is used as the nominal diameter for specifying the size of the valve leaflet, and the nominal diameter is an odd number from 17 to 35. .
  • the size of the nominal diameter is described on the upper surface 613 of the sizer block 610, and in the case of the leaflet sizer 6 shown in FIG. 5, the nominal diameter is 17.
  • the nominal size of the leaflet sizer 6 may be an even number, or may be a configuration including both an odd number and an even number.
  • stylus portions 612 for contacting with the commissure portion for positioning are formed.
  • the upper surface 613 of the sizer block 610 is formed in a curved shape so that the space between the commissure portions can be seen when the stylus portions 612 at both ends are brought into contact with the commissure portions. Further, the upper surface 613 is provided with a mark 614 for identifying the center between the commissure portions.
  • the user inserts the leaflet sizer 6 into the tubular portion 20 from above, and identifies the leaflet sizer 6 in which the stylus portions 612 at both ends match the positions of adjacent commissure portions. Specifically, the user uses the leaflet sizer 6 in which the stylus portions 612 at both ends match the positions of the commissure portion in the first wall portion 21 and the commissure portion in the second wall portion 22, and the stylus needles at both ends.
  • the part 612 corresponds to the positions of the commissure part in the second wall part 22 and the commissure part in the third wall part 23, and the stylus parts 612 at both ends correspond to the commissure part in the first wall part 21.
  • the leaflet sizer 6 that matches the position of the commissure on the third wall 23 is identified.
  • the distance between the commissures is fixed in the training kit 1, the chance of training when the distance between the commissures is different is reduced. Therefore, by changing the position where the first adjusting member 41 is fitted into the recess 211 and the recess 222, the position where the second adjusting member 42 is fitted into the recess 221 and the recess 232, and the position where the third adjusting member 43 is fitted into the recess 231 and the recess 212. By changing the distance between the commissures, it is possible to perform training when the distance between the commissures is different.
  • the tooth portions of the first adjusting member 41, the second adjusting member 42, and the third adjusting member 43 are all concave portions 211, concave portions 212, concave portions 221, concave portions 222, concave portions 231, and 232. If the first wall portion 21, the second wall portion 22, and the third wall portion 23 are located closer to the center, the distance between the commissure portions becomes shorter. Further, when the adjusting member is fitted in the recess so that the number of teeth of the adjusting member fitted in the recess is small, the first wall portion 21, the second wall portion 22, and the third wall portion are different from the state shown in FIG. 23 spreads outward, increasing the distance between commissures. In this way, the distance between the commissure portions can be changed by changing the position when the adjusting member is fitted in the recess, and training can be performed when the distance between the commissure portions is different.
  • FIG. 6 is a view showing the template 7 and the sheet member 8 used to create the valve leaflet model 50.
  • the sheet member 8 is a flexible material such as silicone, urethane, styrene, synthetic rubber or natural rubber.
  • the sheet member 8 may be a flexible material having elasticity similar to that of living tissue.
  • the thickness of the sheet member 8 is preferably that of a human pericardium.
  • the template 7 is an instrument for drawing a leaflet-shaped line on the seat member 8 according to the specified nominal diameter of the leaflet sizer 6.
  • the template 7 describes the nominal diameter value of the leaflet sizer 6, and an opening 710 corresponding to the nominal diameter value is formed below the nominal diameter value.
  • the user places the template 7 on the sheet member 8 and calls it “17”.
  • a line is drawn with a surgical skin marker along the edge of the underlying opening 710.
  • the user places the template 7 on the sheet member 8 and sets “29”.
  • the work of forming the leaflet model 50 corresponding to the distance between commissures from the seat member 8 using the template 7 using the leaflet sizer 6 is also performed as a part of the training of the aortic valve reconstruction. .
  • the user inserts the formed valve leaflet model 50 into the tubular portion 20 and sutures the inside of the tubular portion 20.
  • the positions of the marks 35 and 36 are stitched along the first reference portion 31, the second reference portion 32, and the third reference portion 33.
  • the distance between the commissure portions of the tubular portion 20 can be changed, it is possible to perform training corresponding to aortas having a plurality of diameters in aortic valve reconstruction surgery training.
  • the training kit 1 includes the first reference portion 31, the second reference portion 32, and the third reference portion 33, but the first reference portion 31, the second reference portion 32, and the third reference portion.
  • the configuration may not include the section 33.
  • FIG. 7 is a diagram showing an example of a configuration that does not include the first reference portion 31, the second reference portion 32, and the third reference portion 33.
  • the training kit 1A includes a first commissure part 37, a second commissure part 38 and a third commissure part 39 in place of the first reference part 31, the second reference part 32 and the third reference part 33.
  • the first communicator 37 projects from the first wall 21, the second communicator 38 projects from the second wall 22, and the third communicator 39 projects from the third wall 23.
  • the first commissure part 37, the second commissure part 38, and the third commissure part 39 are formed at positions corresponding to the commissure parts of the leaflets.
  • the first communicator 37, the second communicator 38, and the third communicator 39 are not limited to the projecting structure, and may be, for example, a recessed structure, and a mark is drawn. The configuration may be changed. Also in the training kit 1A, the distance between the first commissure part 37 and the second commissure part 38, the distance between the second commissure part 38 and the third commissure part 39, the first commissure part 37 and the third commissure part 39. It is possible to change the distance between the two and 39 and perform training corresponding to aortas of a plurality of diameters in aortic valve reconstruction surgery training.
  • FIG. 7 has three commissures corresponding to the case of three leaflets, but the training kit for aortic valve reconstruction may have a configuration corresponding to the case of two leaflets.
  • FIG. 8 is a plan view of the training kit 1B corresponding to the case of bicuspid.
  • the tubular portion 20 has a tubular shape.
  • the tubular portion 20 is provided with a plurality of cuts 90 downward from the upper end, and a first commissure portion 37 and a second commissure portion 38 are formed.
  • the cut 90 is preferably provided at a position that is not a position where a new commissure portion can be formed. For example, within a predetermined range from a position 120 ° clockwise from the first communicator 37, within a predetermined range from a position 120 ° counterclockwise from the first communicator 37, and a second communicator 38.
  • the cutout portion 90 is not provided within a predetermined range from a position of 120 ° in the clockwise direction from the above and within a predetermined range from a position of 120 ° in the counterclockwise direction from the second commissure portion 38.
  • a groove 100 is provided at the upper end of the tubular portion 20, and a ring 101 is fitted in the groove 100.
  • the ring 101 has a plurality of diameters, and by changing the ring 101 fitted in the groove 100, the diameter of the tubular portion 20 can be increased as shown in FIG.
  • the groove 100, the ring 101, and the notch 90 are an example of a changing unit according to the present invention.
  • the user inserts the valve cusp sizer 6 on the left side of the first communicator 37 and the second communicator 38, and the valve in which the stylus portions 612 at both ends coincide with the positions of the first communicator 37 and the second commissure 38.
  • the nominal diameter of the pointed sizer 6 is specified.
  • the user inserts the leaflet sizer 6 on the right side of the first communicator 37 and the second communicator 38, and the stylus portions 612 at both ends match the positions of the first communicator 37 and the second commissure 38.
  • the nominal diameter of the leaflet sizer 6 is specified.
  • the user adds the two specified nominal diameters and divides by 3 to obtain a value. If the calculated value matches any of the nominal diameters of the leaflet sizer 6, use the leaflet sizer 6 with the same nominal diameter, and use a skin marker at the new commissure position and the suture start position. Draw a landmark. For example, when the value obtained by adding the two specified nominal diameters and dividing by 3 is 21, the leaflet sizer 6 having the nominal diameter of 21 is inserted into the left side of the first communicator 37 and the second communicator 38.
  • the user brings one of the stylus parts 612 of the inserted leaflet sizer 6 into contact with the first commissure part 37, and draws a mark of the commissure part with a skin marker at a position where the other stylus part 612 is in contact, A suture start position mark is drawn with a skin marker at a position where the mark 614 is in contact. Further, the user inserts the leaflet sizer 6 having a nominal diameter of 21 into the right side of the first communicator 37 and the second communicator 38.
  • the user brings one of the stylus parts 612 of the inserted leaflet sizer 6 into contact with the first commissure part 37, and draws a mark of the commissure part with a skin marker at a position where the other stylus part 612 is in contact, A suture start position mark is drawn with a skin marker at a position where the mark 614 is in contact.
  • the value obtained by adding the two specified nominal sizes and dividing by 3 may not match the nominal size of the leaflet sizer 6.
  • the three leaflet sizers 6 are selected so that the total value of the nominal diameters of the three leaflet sizers 6 matches the addition result of the nominal diameters.
  • the total value of the specified nominal diameters is 65
  • the value divided by 3 does not match the nominal diameters of the leaflet sizers 6 of odd numbers from 17 to 35.
  • three leaflet sizers 6 having nominal diameters of 23, 21, and 21 are selected so as to match the total value.
  • the user first inserts the leaflet sizer 6 having a nominal diameter of 23 into the left side of the first commissure portion 37, brings one of the stylus portions 612 into contact with the first commissure portion 37, and the other of the stylus portion 612 becomes A mark of the commissure portion is drawn with a skin marker at the contacting position, and a mark of the suture start position is drawn with the skin marker at the contacting position of the mark 614.
  • the user inserts the leaflet sizer 6 having a nominal diameter of 21 into the right side of the first communicator 37, brings one of the stylus portions 612 into contact with the first commissure portion 37, and the other of the stylus portions 612 is A mark of the commissure portion is drawn with a skin marker at the contacting position, and a mark of the suture start position is drawn with the skin marker at the contacting position of the mark 614.
  • the user inserts the leaflet sizer 6 having a nominal diameter of 21, the stylus portion 612 contacts one of the drawn marks of the commissure, and the stylus portion 612 contacts one of the drawn marks of the commissure. Check if
  • the first commissure part 37 and the second commissure part 38 are formed, but like the training kit 1A shown in FIG. 7, the first commissure part 37, the second commissure part 38, and the second commissure part 38.
  • the configuration may be such that the three commissure portions 39 are formed.
  • the training kit 1B described above includes the notch 90, but if the material is a material that expands and contracts in the radial direction, the notch 90 may be provided.
  • the distance between the commissure portions is changed by the first adjusting member 41, the second adjusting member 42, and the third adjusting member 43.
  • the configuration is not limited to the above.
  • the ring 101 may be used to change the distance between the commissures.

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  • General Physics & Mathematics (AREA)
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Abstract

La présente invention concerne lorsque toutes les parties des dents d'un premier élément de réglage (41), d'un second élément de réglage (42), et d'un troisième élément de réglage (43) sont réglées dans un renfoncement (211), un renfoncement (212), un renfoncement (221), un renfoncement (222), un renfoncement (231), et un renfoncement (232), une première partie de paroi (21), une seconde partie de paroi (22), et une troisième partie de paroi (23) se déplacent vers le centre et la distance entre les commissures diminue. Également, lorsqu'un élément de réglage est réglé dans un renfoncement afin que moins de dents de l'élément de réglage s'ajustent dans le renfoncement, la première partie de paroi (21), la seconde partie de paroi (22), et la troisième partie de paroi (23) s'étalent vers l'extérieur et la distance entre les commissures augmente. Ainsi, la distance entre les commissures est modifiée en changeant la position lors de l'ajustement d'un élément de réglage dans un renfoncement, et l'entraînement peut être effectué pour un cas où la distance entre les commissures diffère.
PCT/JP2019/039525 2018-10-09 2019-10-07 Kit d'entraînement WO2020075684A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2018190674A JP6462176B1 (ja) 2018-10-09 2018-10-09 トレーニングキット
JP2018-190674 2018-10-09

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WO2020075684A1 true WO2020075684A1 (fr) 2020-04-16

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120115118A1 (en) * 2010-11-08 2012-05-10 Marshall M Blair Suture training device
JP2016212233A (ja) * 2015-05-08 2016-12-15 株式会社日本医療機器開発機構 大動脈弁再建術トレーニングキット
US20180250129A1 (en) * 2017-02-23 2018-09-06 Edwards Lifesciences Corporation Heart valve manufacturing devices and methods

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120115118A1 (en) * 2010-11-08 2012-05-10 Marshall M Blair Suture training device
JP2016212233A (ja) * 2015-05-08 2016-12-15 株式会社日本医療機器開発機構 大動脈弁再建術トレーニングキット
US20180250129A1 (en) * 2017-02-23 2018-09-06 Edwards Lifesciences Corporation Heart valve manufacturing devices and methods

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JP2020060640A (ja) 2020-04-16

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