WO2020135262A1 - 一种人工瓣膜的输送导管及输送装置 - Google Patents

一种人工瓣膜的输送导管及输送装置 Download PDF

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Publication number
WO2020135262A1
WO2020135262A1 PCT/CN2019/127067 CN2019127067W WO2020135262A1 WO 2020135262 A1 WO2020135262 A1 WO 2020135262A1 CN 2019127067 W CN2019127067 W CN 2019127067W WO 2020135262 A1 WO2020135262 A1 WO 2020135262A1
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WO
WIPO (PCT)
Prior art keywords
tube
artificial valve
sheath
delivery catheter
inner tube
Prior art date
Application number
PCT/CN2019/127067
Other languages
English (en)
French (fr)
Inventor
吴旭闻
梅杰
桂宝珠
陈国明
李�雨
Original Assignee
上海微创心通医疗科技有限公司
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 上海微创心通医疗科技有限公司 filed Critical 上海微创心通医疗科技有限公司
Priority to US17/418,118 priority Critical patent/US20220054265A1/en
Priority to AU2019412317A priority patent/AU2019412317B2/en
Priority to JP2021537763A priority patent/JP7289917B2/ja
Priority to EP19901791.4A priority patent/EP3903744B1/en
Priority to KR1020217021768A priority patent/KR102564673B1/ko
Publication of WO2020135262A1 publication Critical patent/WO2020135262A1/zh

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Classifications

    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart 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
    • A61F2/2427—Devices for manipulating or deploying heart valves during implantation
    • A61F2/2436—Deployment by retracting a sheath
    • 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
    • A61F2/0095—Packages or dispensers for prostheses or other implants
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart 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
    • A61F2/2412—Heart 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
    • A61F2/2418—Scaffolds therefor, e.g. support stents
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart 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
    • A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2466—Delivery devices therefor
    • 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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/9517—Instruments specially adapted for placement or removal of stents or stent-grafts handle assemblies therefor
    • 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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/9522—Means for mounting a stent or stent-graft onto or into a placement instrument
    • 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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • 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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • A61F2002/9665—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod with additional retaining means

Definitions

  • Delivery catheter and delivery device for artificial valve Delivery catheter and delivery device for artificial valve
  • the present invention relates to the technical field of medical devices, in particular to a delivery catheter and delivery device for artificial valves.
  • the artificial valve In heart valve replacement surgery, the artificial valve needs to be accurately released. Due to the complexity of the human anatomy, artificial valves are often designed into irregular shapes. For example, in order to achieve the anchoring of the artificial valve, it is designed to conform to the shape of the anatomical structure, and the cross section of the stent is designed to be D-shaped, polygonal, or the like. In order to accurately release the artificial valve of irregular cross-section to the anatomical position, the conveyor needs to be able to adjust the angle of the artificial valve.
  • the object of the present invention is to provide a new type of artificial valve delivery catheter and delivery device, to solve the problem of irregular cross-section artificial valve difficult to accurately release.
  • a delivery catheter for an artificial valve including an outer tube assembly and an inner tube assembly
  • the outer tube assembly includes a sheath tube that can receive the artificial valve and one end with the sheath tube Fixed A connected outer tube
  • the inner tube assembly includes an inner tube and a fixed head fixedly connected to the inner tube, the inner tube assembly is arranged in a cavity of the outer tube assembly, the sheath tube and the fixed head Form a circumferential positioning fit.
  • the inner wall of the sheath tube and the outer wall of the fixed head form a nested structure.
  • the inner wall of the sheath tube is provided with protrusions or grooves
  • the outer wall of the fixed head is provided with a protrusion or groove matching with the inner wall of the sheath tube Grooves or protrusions.
  • the outer wall of the fixed head is provided with at least one insertion section, and the friction force generated between the insertion section and the sheath is greater than that between the valve and the sheath Friction generated between.
  • the static friction coefficient between the embedded section and the sheath is in the range of 0.1-1.5.
  • the embedded section includes a first strip-shaped unit and a second strip-shaped unit, the first strip-shaped unit and the second strip-shaped unit are connected between The first spring and the second spring.
  • the delivery catheter further includes a pull wire, the pull wire is provided in the first strip-shaped unit and the second strip-shaped unit and the first spring or At the connection of the second spring, the pull wire passes through the inner tube.
  • the first strip-shaped unit and the second strip-shaped unit are arranged axisymmetrically on the outer wall of the fixed head.
  • the sheath tube and the outer tube are connected by a bearing or an elastic material.
  • the outer tube is a polymer tube or a composite tube of metal and polymer.
  • the inner tube is a single lumen tube or a multi-lumen tube.
  • a prosthetic valve delivery device including a handle and a delivery catheter connected to the handle, the handle is provided with an outer tube movable member and an inner tube movable member, The movable part of the outer tube is connected to the outer tube to drive the outer tube to perform axial movement, and the inner tube moves The components are connected to the inner tube to drive the inner tube to rotate in the circumferential direction.
  • the above-mentioned artificial valve delivery device further includes a pull wire, and the handle is fixedly connected to the pull wire.
  • the delivery catheter of the artificial valve of the present invention forms a circumferential positioning cooperation between the sheath tube and the fixed head, which can realize the inner tube to drive the fixed head and the sheath tube to rotate cooperatively in the circumferential direction To adjust the match between the artificial valve and the native annulus to maintain the three-dimensional configuration required for positioning.
  • the outer tube serves as the driving force for the sheath.
  • the sheath needs to perform axial movement, the sheath is driven to move in the axial direction to achieve the purpose of releasing the artificial valve.
  • FIG. 1 is a schematic structural view of an artificial valve delivery catheter according to an embodiment of the present invention.
  • FIG. 2 is a schematic diagram of the structure of the guide head and the inner tube assembly according to an embodiment of the present invention
  • FIG. 3 is a schematic structural view of an artificial valve delivery device according to an embodiment of the present invention.
  • FIG. 4 is a schematic diagram of a handle structure according to an embodiment of the present invention.
  • FIG. 5 is a cross-sectional view of a nested fitting structure of a sheath tube and a fixed head according to an embodiment of the present invention
  • FIG. 6 is a schematic diagram of the structure of the convex and concave shapes of the sheath and the fixed head according to the embodiment of the present invention.
  • FIG. 7 is an enlarged view of the structure of the shape matching part of the sheath tube and the fixed head of FIG. 6;
  • FIG. 8 is a cross-sectional view of a structure of an embedded section provided on an outer wall of a fixed head according to an embodiment of the present invention.
  • FIG. 9 is a schematic structural diagram of an embedded section according to an embodiment of the present invention.
  • FIG. 10 is a schematic view of the state of the separation structure of the sheath tube and the fixed head when the cable is tightened according to an embodiment of the present invention
  • FIG. 11 is an enlarged view of a part of the structure of the sheath of FIG. 10 separated from the fixed head;
  • FIG. 12 is a schematic view of the state of the locking structure of the sheath tube and the fixed head when the cable is loosened according to an embodiment of the present invention
  • FIG. 13 is an enlarged view of a part of the structure of the locked state of the sheath tube and the fixed head of FIG. 12;
  • a delivery catheter for an artificial valve provided by an embodiment of the present invention includes an outer tube assembly and an inner tube assembly.
  • the outer tube assembly includes a sheath tube 12 that can receive the artificial valve 3 and a sheath tube 12
  • the outer tube 13 is fixedly connected at one end
  • the inner tube assembly includes an inner tube 15 and a fixed head 14 fixedly connected to the inner tube 15, the inner tube assembly is arranged in a cavity of the outer tube assembly.
  • the delivery catheter of the artificial valve of the present invention further includes a guide head 11, the guide head 11 being connected to the inner tube 15.
  • the guide head 11 of the present invention has a streamlined shape structure, which can avoid scratching the inner wall of the blood vessel, and is also beneficial to guide the entire delivery catheter to advance along the blood vessel channel.
  • the sheath tube 12 and the outer tube 13 are smoothly fixedly connected, the outer surface of the catheter of the delivery system is generally smooth, the outer diameter of the sheath tube 12 is greater than or equal to the outer diameter of the outer tube 13, if the outer diameter of the sheath tube 12 Different from the outer diameter of the outer tube 13, the connection between the sheath tube 12 and the outer tube 13 is uniformly reduced in diameter from the distal end to the proximal end, and no protrusions, grooves, steps, etc. are formed on the outer surfaces of the two.
  • the outer tube 13 serves as the driving force for the sheath tube 12. When the sheath tube 12 needs to perform axial movement, the sheath tube 12 is driven to move in the axial direction to successfully realize the loading and releasing of the artificial valve 3.
  • a circumferential positioning fit is formed between the sheath 12 and the fixed head 14 of the present invention.
  • the inner tube 15 serves as the driving force for the fixed head 14
  • the fixed head 14 serves as the driving force for the sheath tube 12 to drive the sheath tube 12 to move in the circumferential direction.
  • the guide head 1 since the inner tube 15 is also connected to the guide head 11, the guide head 1 will rotate while the outer tube 13 does not move at this time to maintain the three-dimensional configuration required for the positioning of the delivery catheter.
  • a delivery device for an artificial valve provided by an embodiment of the present invention includes a handle 2 and a delivery catheter 1 connected to the handle 2.
  • the present invention refers to the direction toward the delivery catheter 1 as the distal end, and the direction toward the handle 2 as the proximal end.
  • the handle 2 of the present invention is provided with an outer tube movable part 21 and an inner tube movable part 22.
  • the outer tube movable part 21 is connected to the outer tube 13 to drive the outer tube 13 to perform axial movement
  • the inner tube movable part 22 is connected to the inner tube 15 to drive the inner tube 15 to rotate in the circumferential direction.
  • the present invention drives the bearing 2 to drive the inner tube movable member 22 to rotate in the circumferential direction, thereby causing the inner tube 15 to drive the fixed head 14 and the sheath tube 12 to rotate together to adjust the artificial valve 3 and the original Petal Ring matching.
  • the handle 2 drives the bearing to drive the axial movement of the outer tube movable part 21, so that the outer tube 13 drives the sheath tube 12 to move axially relative to the inner tube 15, so that the artificial valve 3 is loaded and released.
  • the driving of the handle in the embodiment of the present invention may be performed by means of electric driving or manual driving.
  • the implementation manner of forming a circumferential positioning cooperation between the sheath 12 and the fixed head 14 specifically includes the following two types:
  • Embodiment 1 As shown in FIG. 5, the inner wall of the sheath tube 12 and the outer wall of the fixing head 14 form a nested structure, and the nested structure can achieve the fixing of the sheath tube 12 and the fixing head 14 in the circumferential direction. Specifically, as shown in FIGS. 6-7, the inner wall of the sheath tube 12 is provided with protrusions or grooves (C), and the outer wall of the fixing head 14 is provided with grooves that cooperate with the inner wall protrusions or grooves of the sheath tube 12 Or raised.
  • C protrusions or grooves
  • the shapes of the protrusions or grooves on the inner wall of the sheath tube 12 and the outer wall of the fixed head 14 may be square, triangular, circular, or other irregular patterns.
  • the number of protrusions or grooves may be one or more.
  • the plurality of protrusions or grooves may be the same shape or different shapes, and may be uniformly distributed in the circumferential direction of the outer wall of the fixed head 14 and the inner wall of the sheath tube 12, or may be unevenly distributed In the circumferential direction of the outer wall of the fixed head 14 and the inner wall of the sheath tube 12.
  • a plurality of protrusions or grooves are evenly distributed on the outer wall of the fixed head 14 and the inner wall of the sheath tube 12 in the circumferential direction.
  • the concave-convex shape of the sheath tube 12 and the fixed head 14 in the embodiment of the present invention can be changed, but because the wall thickness of the sheath tube 12 is small, it is more excellent to make the inner wall of the sheath tube 12 into a convex structure s Choice.
  • Embodiment 2 As shown in FIG. 8, the outer wall of the fixed head 14 is provided with at least one insertion section 141, and the friction force generated between the insertion section 141 and the sheath 12 is greater than that of the artificial valve 3 and the sheath 12 The friction force generated between the fixed head 14 and the sheath 12 is greater than the valve release force and recovery force. In this embodiment, the sheath 12 and the fixed head 14 are locked by friction to achieve coordinated rotation.
  • a certain section or sections of material with a high friction coefficient is embedded in the outer wall of the fixed head 14, and the outer diameter of the insertion section 141 may be changed to achieve frictional locking and unlocking with the sheath tube 12.
  • the static friction coefficient between the embedding section 141 and the sheath 12 ranges from 0.1 to 1.5.
  • the embedding section 141 of the present invention includes a first strip-shaped unit 1411 and a second strip-shaped unit Two parts of element 1412, a first spring 1 is also connected between the first strip-shaped unit 1411 and the second strip-shaped unit 1412
  • the embodiment of the present invention further includes a pull wire 142, the pull wire 142 is disposed in the first strip-shaped unit 1411 and the second strip-shaped unit 1412 and the first spring 1421 or the first At the junction of the two springs 1422, the pull wire 142 passes through the inner tube 15 and is connected to the handle 2.
  • the pull wire 142 may be a single-strand wire or a multi-strand wire, including but not limited to a single solid metal wire, a multi-strand wound metal rope, and the like.
  • the present invention can axially pull the pull wire 142 to adjust the outer diameter of the embedded section 141.
  • the first strip-shaped unit 1411 and the second strip-shaped unit 14 12 are arranged on the outer wall of the fixed head 14 in an axisymmetric distribution, which is convenient for the pull wire 142 to connect all the embedded segments on one side .
  • the sheath tube 12 and the outer tube 13 of the present invention are connected by a bearing or an elastic material.
  • Elastic materials include, but are not limited to, silicone materials, PU materials, Pebax nylon elastomer engineering polymers, and so on.
  • the sheath tube 12 and the outer tube 13 are connected by a bearing, which can achieve unlimited rotation in the circumferential direction.
  • the sheath tube 12 and the outer tube 13 are connected by a spring or an elastic material, and have a limit angle when rotating in the circumferential direction. The limit angle will be determined according to the characteristics of the spring or the elastic material itself.
  • the handle 2 drives the bearing to drive the axial movement of the outer tube movable member 21, so that the outer tube 13 drives the sheath tube 12 to move axially relative to the inner tube 15, so that the artificial valve 3 is loaded and freed.
  • the bearing 2 drives the bearing to drive the inner tube movable part 22 to rotate in the circumferential direction, so that the inner tube 15 drives the fixed head 14 and the sheath tube 12 to perform cooperative rotation, thereby realizing the adjustment of the release angle of the artificial valve 3 to achieve precise release the goal of.
  • the outer tube 13 of the present invention may be a polymer tube or a metal-polymer composite tube and other controllable bending tube materials.
  • the outer tube 13 is a polymer composite tube provided with a metal structure on the inner surface, at least one metal wire is embedded in the outer tube 13, and the bending angle, position and position of the outer tube 13 are controlled by drawing different metal wires Direction.
  • multiple metal wires are embedded in the controllable bending pipe.
  • the inner tube 15 of the present invention is a single-lumen tube or a multi-lumen tube. Since the pull wire 142 passes through the inner tube 15, and the inner tube 15 also has a function of threading the guide wire, the inner tube 15 is preferably a multi-lumen tube.
  • the multi-lumen tube can not only provide a channel for the pull wire 142, but also provide a channel for the guide wire to ensure that the two play their respective roles without affecting each other
  • the artificial valve loading process in the embodiment of the present invention is as follows: The handle 2 is driven to retract the sheath 12 until the front end surface of the sheath 12 is located on the back side of the fixed head 14, exposing the fixed head 14, and then the self-expandable artificial valve 3 is stuck in the fixed head 14, after the artificial valve 3 is stabilized, the outer tube 13 is driven forward until the sheath 12 completely surrounds the artificial valve 3, and the front end surface of the sheath 12 bears against the end surface of the guide head 11, the artificial valve is loaded complete.
  • the artificial valve delivery process of the embodiment of the present invention is as follows: The entire artificial valve delivery device is extended into the puncture port along the guide wire and enters the human body. Then, along the vascular access of the femoral vein, the sheath 12 holding the artificial valve 3 is passed through the interatrial septum and delivered to the diseased annulus.
  • the process of releasing the artificial valve according to the embodiment of the present invention is as follows: First, the outer tube 13 controls the bending, and after being adjusted in place, the outer tube 13 is fixed. At this time, the inner tube 15 is driven to rotate circumferentially by the handle 2, and the circumferential rotation of the inner tube 15 can simultaneously drive the fixed head 14 and the sheath tube 12 to rotate cooperatively, thereby adjusting the relative position of the artificial valve 3 and the native annulus, to Ensure that the artificial valve 3 fits the native annulus better.
  • the handle 2 drives the outer tube 13 to drive the sheath 12 to move axially to the proximal end, and starts to release the prosthetic valve 3 until the prosthetic valve 3 is completely released to the designated position and disengaged from the delivery device.
  • the release of the artificial valve 3 can be suspended at any time, and the rotation action of the circumferential alignment of the inner tube 15 can be switched to better achieve the real time of the artificial valve 3 Alignment and precise release.
  • the outer tube 13 serves as the driving force for the sheath tube 12, but the fixed head 14 is fixed and the sheath tube 12 needs to perform circumferential movement.
  • the inner tube 15 serves as the driving force for the fixed head 14, and the fixed head 14 serves as the driving force for the sheath tube 12, which drives the sheath tube 12 to move in the circumferential direction, while the outer tube 13 does not move, so that the sheath tube 12 and the fixed head 14 cooperate in circumferential movement.
  • the axial motion does not interfere; and the sheath tube 12 is driven by the outer tube 13 for axial motion, but the circumferential motion is not affected by the beneficial effects of interference.
  • the overall configuration of the delivery device remains unchanged, that is, the artificial valve can move in the circumferential direction under the condition that the outer control bends and remains immobile, thereby solving the problem of accurate release of irregular cross-section artificial valves question.

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  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

一种人工瓣膜的输送导管及输送装置，输送导管（1）包括外管组件和内管组件，外管组件包括可收容人工瓣膜（3）的鞘管（12）以及与鞘管（12）的一端固定连接的外管（13），内管组件包括内管（15）以及与内管固定连接的固定头（14），内管组件布置于外管组件的腔中，鞘管（12）与固定头（14）之间形成周向定位配合，可以实现内管（15）在周向转动时带动固定头（14）和鞘管（12）转动，来调整人工瓣膜（3）与原生瓣环的匹配，外管（13）可带动鞘管（12）沿轴向运动，以释放人工瓣膜（3）。

Description

一种人工瓣膜的输送导管及输送装置
技术领域
[0001] 本发明涉及医疗器械技术领域， 具体涉及一种人工瓣膜的输送导管及输送装置 背景技术
[0002] 随着社会经济的发展和人口的老龄化， 瓣膜性心脏病的发病率明显增加， 研究 表明 75岁以上的老年人群瓣膜性心脏病发病率高达 13.3%。 目前， 采用传统外科 手术治疗仍是重度瓣膜病变患者的首选治疗手段， 但是对于高龄、 合并多器官 疾病、 有开胸手术史以及心功能较差的患者来说， 传统外科手术的风险大、 死 亡率高， 部分患者甚至没有手术的机会。 经导管心脏瓣膜的置换术具有无需开 胸、 创伤小、 患者恢复快等优点， 受到了专家学者的广泛关注。
发明概述
技术问题
[0003] 心脏瓣膜置换手术中， 需要对人工瓣膜进行精确的释放。 由于人体解剖结构复 杂， 人工瓣膜常常被设计成不规则形状。 例如， 为了实现人工瓣膜的锚固， 将 其设计成贴合解剖结构的形状， 支架的横截面设计成 D型、 多边形等。 为了让不 规则截面的人工瓣膜准确释放到解剖位置， 需要输送器能够调节人工瓣膜的角 度。 但是， 由于股动脉、 股静脉的输送通路非直线型， 且输送装置的最终构型 不在一个平面上， 因此， 对于传统的输送系统来说， 无法同时实现周向旋转且 保持构型不变。
问题的解决方案
技术解决方案
[0004] 针对上述现有技术的缺点， 本发明的目的是提供一种新型人工瓣膜的输送导管 与输送装置， 以解决不规则截面的人工瓣膜难以精确释放的问题。
[0005] 根据本发明的一个方面， 提供了一种人工瓣膜的输送导管， 包括外管组件和内 管组件， 所述外管组件包括可收容人工瓣膜的鞘管以及与所述鞘管的一端固定 连接的外管， 所述内管组件包括内管以及与所述内管固定连接的固定头， 所述 内管组件布置于所述外管组件的腔中， 所述鞘管与所述固定头之间形成周向定 位配合。
[0006] 进一步地， 上述人工瓣膜的输送导管中， 所述鞘管的内壁与所述固定头的外壁 形成嵌套式结构。
[0007] 进一步地， 上述人工瓣膜的输送导管中， 所述鞘管的内壁设有凸起或凹槽， 所 述固定头的外壁设有与所述鞘管的内壁凸起或凹槽相配合的凹槽或凸起。
[0008] 进一步地， 上述人工瓣膜的输送导管中， 所述固定头的外壁设有至少一段嵌入 段， 所述嵌入段与所述鞘管之间产生的摩擦力大于瓣膜与所述鞘管之间产生的 摩擦力。
[0009] 进一步地， 上述人工瓣膜的输送导管中， 所述嵌入段与所述鞘管之间的静摩擦 系数的范围为 0.1-1.5。
[0010] 进一步地， 上述人工瓣膜的输送导管中， 所述嵌入段包括第一条状单元和第二 条状单元， 所述第一条状单元和所述第二条状单元之间连接有第一弹簧和第二 弹簧。
[0011] 进一步地， 上述人工瓣膜的输送导管中， 所述输送导管还包括拉线， 所述拉线 设置于所述第一条状单元和所述第二条状单元在与所述第一弹簧或所述第二弹 簧的连接处， 所述拉线从所述内管中穿出。
[0012] 进一步地， 上述人工瓣膜的输送导管中， 所述第一条状单元和所述第二条状单 元在所述固定头的外壁呈轴对称分布设置。
[0013] 进一步地， 上述人工瓣膜的输送导管中， 所述鞘管与所述外管之间通过轴承或 弹性材料连接。
[0014] 进一步地， 上述人工瓣膜的输送导管中， 所述外管为高分子管或金属与高分子 的复合管。
[0015] 进一步地， 上述人工瓣膜的输送导管中， 所述内管为单腔管或多腔管。
[0016] 根据本发明的另一个方面， 提供了一种人工瓣膜的输送装置， 包括手柄以及与 所述手柄相连接的输送导管， 所述手柄内设有外管活动部件和内管活动部件， 所述外管活动部件和所述外管连接以驱动所述外管做轴向运动， 所述内管活动 部件和所述内管连接以驱动所述内管做周向转动。
[0017] 进一步地， 上述人工瓣膜的输送装置中， 还包括拉线， 所述手柄与所述拉线固 定连接。
[0018] 与现有技术相比， 本发明人工瓣膜的输送导管， 鞘管与固定头之间形成周向定 位配合， 可以实现内管在周向转动时带动固定头和鞘管整体做协同转动， 来调 整人工瓣膜与原生瓣环的匹配， 维持定位所需的三维构型。 在调整到位后， 外 管作为鞘管的驱动力， 在鞘管需要做轴向运动时， 带动鞘管沿轴向运动， 以达 到释放人工瓣膜的目的。
发明的有益效果
对附图的简要说明
附图说明
[0019] 图 1为本发明实施例人工瓣膜输送导管结构示意图；
[0020] 图 2为本发明实施例引导头与内管组件组成结构示意图；
[0021] 图 3为本发明实施例人工瓣膜输送装置结构示意图；
[0022] 图 4为本发明实施例手柄结构示意图；
[0023] 图 5为本发明实施例鞘管与固定头嵌套配合结构剖视图；
[0024] 图 6为本发明实施例鞘管与固定头凹凸形状配合结构示意图；
[0025] 图 7为图 6鞘管与固定头形状配合部分结构放大图；
[0026] 图 8为本发明实施例固定头外壁设置嵌入段结构剖视图；
[0027] 图 9为本发明实施例嵌入段结构示意图；
[0028] 图 10为本发明实施例拉线拉紧时鞘管与固定头分离结构状态示意图；
[0029] 图 11为图 10鞘管与固定头分离状态部分结构放大图；
[0030] 图 12为本发明实施例拉线放松时鞘管与固定头锁定结构状态示意图；
[0031] 图 13为图 12鞘管与固定头锁定状态部分结构放大图；
[0032] 1-输送导管； 2 -手柄； 3 -人工瓣膜； 11-引导头； 124肖管； 13 -外管； 14 -固定头
; 15 -内管； 21 -外管活动部件； 22 -内管活动部件； 141 -嵌入段； 1411 -第一条状 单元； 1412 -第二条状单元； 1421 -第一弹簧； 1422 -第二弹簧； 142 -拉线。
发明实施例 本发明的实施方式
[0033] 为了使本发明的创作特征、 技术手段与达成目的易于明白理解， 以下结合具体 实施例进一步阐述本发明。
[0034] 如图 1所示， 本发明实施例提供的人工瓣膜的输送导管， 包括外管组件和内管 组件， 所述外管组件包括可收容人工瓣膜 3的鞘管 12以及与鞘管 12的一端固定连 接的外管 13， 所述内管组件包括内管 15以及与内管 15固定连接的固定头 14， 所 述内管组件布置于所述外管组件的腔中。
[0035] 如图 1-2所示， 本发明人工瓣膜的输送导管中， 还包括引导头 11， 所述引导头 1 1与内管 15连接。 优选地， 本发明引导头 11具有流线型外形结构， 可以避免划伤 血管内壁， 也有利于引导整个输送导管沿血管通道推进。
[0036] 本发明实施中， 鞘管 12与外管 13平滑地固定连接， 输送系统导管一般外表面光 滑， 鞘管 12的外径大于等于外管 13的外径， 若鞘管 12的外径与外管 13的外径有 差异， 鞘管 12与外管 13的连接处从远端至近端均匀缩径， 二者的外表面不产生 凸起、 凹槽、 台阶等。 外管 13作为鞘管 12的驱动力， 在鞘管 12需要做轴向运动 时， 带动鞘管 12沿轴向运动， 以成功实现人工瓣膜 3的装载和释放。
[0037] 本发明鞘管 12与固定头 14之间形成周向定位配合。 在鞘管 12需要做周向运动时 ， 内管 15作为固定头 14的驱动力， 固定头 14作为鞘管 12的驱动力， 带动鞘管 12 周向运动。
[0038] 具体实施中， 由于内管 15还连接着引导头 11， 因此引导头 1地会转动， 而此时 外管 13不动， 以维持输送导管定位所需的三维构型。
[0039] 如图 3所示， 本发明实施例提供的人工瓣膜的输送装置包括手柄 2以及与所述手 柄 2相连接的输送导管 1。 实施中， 本发明将往输送导管 1的方向称为远端， 往手 柄 2的方向称为近端。
[0040] 如图 4所示， 本发明手柄 2内设有外管活动部件 21和内管活动部件 22。 外管活动 部件 21和外管 13连接以驱动外管 13做轴向运动， 内管活动部件 22和内管 15连接 以驱动内管 15做周向转动。
[0041] 具体实施中， 本发明通过手柄 2驱动轴承带动内管活动部件 22的周向转动， 进 而使内管 15带动固定头 14和鞘管 12整体做协同转动， 来调整人工瓣膜 3与原生瓣 环的匹配。 在调整到位后， 手柄 2驱动轴承带动外管活动部件 21的轴向移动， 进 而使外管 13带动鞘管 12相对于内管 15做轴向移动， 实现对人工瓣膜 3的装载和释 放。
[0042] 可选地， 本发明实施例手柄驱动可以采用电动驱动或者手动驱动的方式进行。
[0043] 本发明实施例， 鞘管 12与固定头 14之间形成周向定位配合的实现方式具体包括 以下两种：
[0044] 实施例一： 如图 5所示， 鞘管 12的内壁与固定头 14的外壁形成嵌套式结构， 该 嵌套式结构可以实现鞘管 12与固定头 14在周向上的固定。 具体地， 如图 6-7所示 ， 鞘管 12的内壁设有凸起或凹槽 （C） ， 固定头 14的外壁设有与鞘管 12的内壁凸 起或凹槽相配合的凹槽或凸起。
[0045] 可选地， 鞘管 12内壁和固定头 14外壁的凸起或凹槽的形状可以为方形、 三角形 、 圆形或其他不规则图形等。 而且， 凸起或凹槽的数量可以为 1个， 也可以为多 个。
[0046] 可选地， 多个凸起或凹槽可以是相同的形状， 也可以是不同的形状， 且可以均 匀分布在固定头 14外壁和鞘管 12内壁的周向上， 也可以不均匀分布于固定头 14 外壁和鞘管 12内壁的周向上。 优选地， 多个凸起或凹槽均匀分布于固定头 14外 壁和鞘管 12内壁的周向上。
[0047] 本发明实施例鞘管 12与固定头 14的凹凸形状配合虽然可以转换， 但因为鞘管 12 管材的壁厚较小， 故将鞘管 12的内壁做成凸起结构是更为优异的选择。
[0048] 实施例二： 如图 8所示， 固定头 14的外壁设有至少一段嵌入段 141， 所述嵌入段 141与鞘管 12之间产生的摩擦力大于人工瓣膜 3与鞘管 12之间产生的摩擦力， 以 使固定头 14与鞘管 12产生的摩擦力大于瓣膜释放力与回收力。 本实施例鞘管 12 与固定头 14之间通过摩擦力锁定来实现协同转动。
[0049] 具体地， 在固定头 14的外壁嵌入某一段或数段摩擦系数高的材料， 该嵌入段 14 1的外径可以变化， 以实现其与鞘管 12的摩擦锁定和解锁。
[0050] 优选地， 上述人工瓣膜的输送装置中， 所述嵌入段 141与鞘管 12之间的静摩擦 系数的范围为 0.1-1.5。
[0051] 进一步地， 如图 9所示， 本发明嵌入段 141包括第一条状单元 1411和第二条状单 元 1412两部分， 第一条状单元 1411和第二条状单元 1412之间还连接有第一弹簧 1
421和第二弹簧 1422。
[0052] 进一步地， 如图 10所示， 本发明实施例还包括拉线 142， 所述拉线 142设置于所 述第一条状单元 1411和第二条状单元 1412在与第一弹簧 1421或第二弹簧 1422的 连接处， 所述拉线 142从内管 15中穿过连接至手柄 2。
[0053] 优选地， 拉线 142可以为单股线或多股线， 包括但不限于单根实心金属丝、 多 股缠绕的金属绳等。 实施中， 本发明轴向拉动拉线 142, 可以调整嵌入段 141的 外径。
[0054] 如图 10-11所示， 在拉线 142拉紧时， 第一弹簧 1421 （或第二弹簧 1422） 被压缩 ， 嵌入段 141的第一条状单元 1411和第二条状单元 1412两个部分被迫靠近， 固定 头 14与鞘管 12分离， 两者的运动不受对方影响。 如图 12-13所示， 在拉线 142放松 时， 嵌入段 141的第一条状单元 1411和第二条状单元 1412两个部分向外抵住鞘管 12, 固定头 14与鞘管 12通过嵌入段 141的摩擦力锁定来实现协同转动。
[0055] 优选地， 本发明人工瓣膜的输送装置中， 第一条状单元 1411和第二条状单元 14 12在固定头 14的外壁呈轴对称分布设置， 方便拉线 142连接单边所有嵌入段。
[0056] 可选地， 本发明鞘管 12与外管 13之间通过轴承或弹性材料连接。 弹性材料包括 但不限于硅胶材料、 PU材料、 Pebax尼龙弹性体工程聚合物等。 优选地， 鞘管 12 与外管 13之间通过轴承连接， 可以实现周向无限制旋转。 鞘管 12与外管 13之间 通过弹簧或弹性材料连接， 周向旋转时具有极限角度， 该极限角度将根据弹簧 或弹性材料本身的特性决定。
[0057] 本发明实施例通过手柄 2驱动轴承带动外管活动部件 21的轴向移动， 进而使外 管 13带动鞘管 12相对于内管 15做轴向移动， 实现对人工瓣膜 3的装载和释放。 另 夕卜， 通过手柄 2驱动轴承带动内管活动部件 22的周向转动， 使得内管 15带动固定 头 14和鞘管 12做协同转动， 实现对于人工瓣膜 3释放角度的调整， 以达到精准释 放的目的。
[0058] 可选地， 本发明外管 13可以为高分子管或金属与高分子的复合管等可控弯管材 。 实施中， 外管 13是内表面设置有金属结构的高分子复合管， 在外管 13内埋设 有至少一根金属丝， 通过抽拉不同的金属丝来控制外管 13的弯曲角度、 位置及 方向。 优选地， 为了提升控弯的精准性， 在该可控弯管材内埋设多根金属丝。
[0059] 可选地， 本发明内管 15为单腔管或多腔管。 由于拉线 142从内管 15中穿过， 内 管 15也具有穿引导丝的功能， 所以内管 15优选多腔管。 该多腔管不仅可以为拉 线 142提供通道， 还可以为导丝提供通道， 确保两者发挥各自的作用， 互不影响
[0060] 本发明实施例人工瓣膜装载过程如下： 驱动手柄 2使得鞘管 12后退， 直至鞘管 1 2的前端面位于固定头 14的后侧， 露出固定头 14, 然后将自膨式人工瓣膜 3卡在 固定头 14内， 待人工瓣膜 3稳定后， 驱动外管 13前进， 直至鞘管 12完全包裹住人 工瓣膜 3 , 且鞘管 12的前端面顶住引导头 11的端面， 人工瓣膜装载完毕。
[0061] 本发明实施例人工瓣膜输送过程如下： 沿着导丝将整个人工瓣膜输送装置伸入 穿刺口， 进入人体。 然后顺着股静脉的血管通路， 将压握人工瓣膜 3的鞘管 12穿 过房间隔， 输送至病变瓣环处。
[0062] 本发明实施例人工瓣膜释放过程如下： 首先通过外管 13控弯， 待调整到位后， 外管 13固定不动。 此时， 通过手柄 2驱动内管 15进行周向转动， 内管 15的周向转 动可同时带动固定头 14和鞘管 12做协同转动， 从而调整人工瓣膜 3与原生瓣环的 相对位置， 以保证人工瓣膜 3更好地贴合原生瓣环。 在人工瓣膜 3周向调整到位 后， 手柄 2驱动外管 13带动鞘管 12向近端做轴向运动， 开始释放人工瓣膜 3 , 直 至人工瓣膜 3完全释放到指定位置并脱离输送装置。
[0063] 优选地， 本发明实施例在人工瓣膜释放过程中， 可随时暂停人工瓣膜 3的释放 ， 并切换至内管 15周向对位的转动动作， 以更好地实现人工瓣膜 3的实时对位与 精确释放。
[0064] 综上， 本发明实施例鞘管 12需要做轴向运动时， 外管 13作为鞘管 12的驱动力， 但固定头 14固定不动， 而鞘管 12需要做周向运动时， 内管 15作为固定头 14的驱 动力， 固定头 14作为鞘管 12的驱动力， 带动鞘管 12周向运动， 而外管 13不动， 实现鞘管 12与固定头 14周向运动协同， 轴向运动不干涉； 且鞘管 12被外管 13带 动轴向运动， 但周向运动不受干涉的有益效果。
[0065] 本发明实施例在输送装置的整体构型保持不变， 即在外管控弯， 保持不动的情 况下， 人工瓣膜可以周向运动， 从而解决了不规则截面人工瓣膜的精确释放问 题。
[0066] 以上显示和描述了本发明的基本原理、 主要特征和本发明的优点。 本行业的技 术人员应该了解， 本发明不受上述实施例的限制， 上述实施例和说明书中描述 的只是说明本发明的原理， 在不脱离本发明精神和范围的前提下本发明还会有 各种变化和改进， 这些变化和改进都落入要求保护的本发明范围内。 本发明要 求保护范围由所附的权利要求书及其等同物界定。

Claims

权利要求书
[权利要求 1] 一种人工瓣膜的输送导管， 其特征在于， 包括外管组件和内管组件， 所述外管组件包括可收容人工瓣膜 （3） 的鞘管 （12） 以及与鞘管 （1 2） 的一端固定连接的外管 （13） ， 所述内管组件包括内管 （15） 以 及与所述内管 （15） 固定连接的固定头 （14） ， 所述内管组件布置于 所述外管组件的腔中， 所述鞘管 （12） 与所述固定头 （14） 之间形成 周向定位配合。
[权利要求 2] 根据权利要求 1所述的人工瓣膜的输送导管， 其特征在于， 所述鞘管 （12） 的内壁与所述固定头 （14） 的外壁形成嵌套式结构。
[权利要求 3] 根据权利要求 2所述的人工瓣膜的输送导管， 其特征在于， 所述鞘管 （12） 的内壁设有凸起或凹槽， 所述固定头 （14） 的外壁设有与所述 鞘管 （12） 的内壁凸起或凹槽相配合的凹槽或凸起。
[权利要求 4] 根据权利要求 1所述的人工瓣膜的输送导管， 其特征在于， 所述固定 头 （14） 的外壁设有至少一段嵌入段 （141） ， 所述嵌入段 （141） 与 所述鞘管 （12） 之间产生的摩擦力大于所述人工瓣膜 （3） 与所述鞘 管 （12） 之间产生的摩擦力。
[权利要求 5] 根据权利要求 4所述的人工瓣膜的输送导管， 其特征在于， 所述嵌入 段 （141） 与所述鞘管 （12） 之间的静摩擦系数的范围为 0.1-1.5。
[权利要求 6] 根据权利要求 4或 5所述的人工瓣膜的输送导管， 其特征在于， 所述嵌 入段 （141） 包括第一条状单元 （1411） 和第二条状单元 （1412） ， 所述第一条状单元 （1411） 和所述第二条状单元 （1412） 之间连接有 第一弹簧 （1421） 和第二弹簧 （1422） 。
[权利要求 7] 根据权利要求 6所述的人工瓣膜的输送导管， 其特征在于， 所述输送 导管还包括拉线 （142） ， 所述拉线 （142） 设置于所述第一条状单元 （1411） 和所述第二条状单元 （1412） 在与所述第一弹簧 （1421） 或 所述第二弹簧 （1422） 的连接处， 所述拉线 （142） 从所述内管 （15 ） 中穿出。
[权利要求 8] 根据权利要求 7所述的人工瓣膜的输送导管， 其特征在于， 所述第一 条状单元 （1411） 和所述第二条状单元 （1412） 在所述固定头 （14） 的外壁呈轴对称分布设置。
[权利要求 9] 根据权利要求 1所述的人工瓣膜的输送导管， 其特征在于， 所述鞘管
（12） 与所述外管 （13） 之间通过轴承或弹性材料连接。
[权利要求 10] 根据权利要求 1所述的人工瓣膜的输送导管， 其特征在于， 所述外管
（13） 为高分子管或金属与高分子的复合管。
[权利要求 11] 根据权利要求 1所述的人工瓣膜的输送导管， 其特征在于， 所述内管 （15） 为单腔管或多腔管。
[权利要求 12] 一种人工瓣膜的输送装置， 其特征在于， 包括手柄 （2） 以及与所述 手柄 （2） 相连接的如权利要求 1至 12任一项所述的输送导管， 所述手 柄 （2） 内设有外管活动部件 （21） 和内管活动部件 （22） ， 所述外 管活动部件 （21） 和所述外管 （13） 连接以驱动所述外管 （13） 做轴 向运动， 所述内管活动部件 （22） 和所述内管 （15） 连接以驱动所述 内管 （15） 做周向转动。
[权利要求 13] 根据权利要求 12所述的人工瓣膜的输送装置， 其特征在于， 还包括拉 线 （142） ， 所述手柄 （2） 与所述拉线 （142） 固定连接。
PCT/CN2019/127067 2018-12-27 2019-12-20 一种人工瓣膜的输送导管及输送装置 WO2020135262A1 (zh)

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JP2021537763A JP7289917B2 (ja) 2018-12-27 2019-12-20 人工弁のための送達カテーテル及び送達デバイス
EP19901791.4A EP3903744B1 (en) 2018-12-27 2019-12-20 Delivery catheter and delivery device for artificial valve
KR1020217021768A KR102564673B1 (ko) 2018-12-27 2019-12-20 인공 판막 용 전달 카테터 및 전달 장치

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