WO2024139169A1 - 瓣膜修复装置及系统 - Google Patents

瓣膜修复装置及系统 Download PDF

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Publication number
WO2024139169A1
WO2024139169A1 PCT/CN2023/106957 CN2023106957W WO2024139169A1 WO 2024139169 A1 WO2024139169 A1 WO 2024139169A1 CN 2023106957 W CN2023106957 W CN 2023106957W WO 2024139169 A1 WO2024139169 A1 WO 2024139169A1
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WO
WIPO (PCT)
Prior art keywords
wire
elastic
valve repair
clamping
elastic wall
Prior art date
Application number
PCT/CN2023/106957
Other languages
English (en)
French (fr)
Inventor
魏勇强
王思琪
刘祥
Original Assignee
杭州端佑医疗科技有限公司
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Application filed by 杭州端佑医疗科技有限公司 filed Critical 杭州端佑医疗科技有限公司
Publication of WO2024139169A1 publication Critical patent/WO2024139169A1/zh

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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
    • A61F2/2442Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/246Devices for obstructing a leak through a native valve in a closed condition
    • 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
    • A61F2/2442Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2463Implants forming part of the valve leaflets
    • 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
    • A61F2/2442Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2466Delivery devices therefor

Definitions

  • the present invention relates to the technical field of medical devices, and in particular to a valve repair device and system.
  • Heart valves refer to valves between the atria and ventricles or between the ventricles and arteries, which are used to achieve unidirectional flow of blood. When the valve is not fully closed, blood will flow back. This reflux can cause patients to suffer from heart failure and other symptoms, seriously affecting their daily life and work.
  • mitral regurgitation or tricuspid regurgitation are the two most common symptoms of valvular heart disease. At this stage, they are mainly treated with safer interventional surgeries, such as valve replacement or clamp repair.
  • severe reflux will be directly replaced by valve replacement, while for moderate and mild reflux, a clip can be used to perform edge-to-edge double-hole repair of the mitral or tricuspid valve leaflets to suppress the reflux problem.
  • the clamps on the market can be divided into mechanical clamps and elastic clamps.
  • the clamping stress of mechanical clamps is large, which can easily cause the valve leaflets to tear, while the clamping force of elastic clamps is achieved by the elastic force of the elastic element itself. If the clamping force is not appropriate or irreversible or reversible plastic deformation occurs during the working process of the elastic element, it will cause the capture radius to change, seriously affecting the application range of the valve leaflets and the clamping effect of the valve leaflets.
  • the present invention provides a valve repair device, comprising a support component and a clamping component;
  • the support assembly comprises a support body, a fixing member, an elastic wall and a connector; the elastic wall is respectively The fixing member is connected to the distal end of the support body and the connector; the fixing member is connected to the distal end of the support body and is arranged along the central axis of the support body;
  • the clamping assembly comprises an elastic clamp and a support plate; the elastic clamp and the support plate are both connected to one side of the elastic wall close to the support body.
  • the fixing member includes a fixing wire ring and a guide tube, and the fixing wire ring is sleeved on the proximal end of the guide tube;
  • the wire fixing ring has a wire fixing hole, and the distal end of the support body is connected to the wire fixing hole;
  • the inner cavity of the wire fixing ring is connected with the inner cavity of the guide tube to form a guide hole; the push wire extends into the connecting head through the guide hole to push and pull the connecting head away from or close to the supporting body.
  • the fixing wire ring and the guide tube are integrally formed or detachably connected.
  • the elastic clip has a first clamping portion and a second clamping portion; one end of the first clamping portion and the second clamping portion are connected to each other, and the other ends of the first clamping portion and the second clamping portion are close to each other so as to clamp the valve leaflet; a barb structure is provided on one side of the first clamping portion facing the second clamping portion; and the second clamping portion is connected to the support plate and the elastic wall;
  • the support plate is arranged between the first clamping part and the second clamping part, or the support plate is arranged on the side of the second clamping part away from the first clamping part; and the area where the clamping assembly is connected to the elastic wall is larger than the area of the side of the second clamping part facing the elastic wall.
  • the shape of the support plate includes: "U” shape, “V” shape, “W” shape, “O” shape, wavy shape and polygonal shape.
  • the connector includes a pressure ring, a wire push tube, a distal connection ring and a cover plate; wherein the pressure ring is respectively connected to the distal connection ring and the elastic wall to support the elastic wall; the wire push tube passes through the distal connection ring and can be connected to the cover plate Disassembly connection; and, the distal connecting ring has a connecting hole, and one end of the elastic wall is connected to the connecting hole.
  • the support assembly further includes a proximal connecting ring, and the proximal connecting ring is connected to the proximal end of the support body.
  • the present invention also provides a valve repair system, comprising the valve repair device, a push wire and a control wire; wherein the push wire passes through the support body and the fixing member in sequence, and is connected to the connector to push and pull the connector to switch the state of the valve repair device; the control wire passes back through the elastic clip to control the opening and closing of the elastic clip.
  • the present invention provides a valve repair device and system.
  • the valve repair device includes a support assembly and a clamping assembly.
  • the support assembly includes a support body, a fixing member, an elastic wall and a connector; the elastic wall is connected to the distal end of the support body and the connector respectively; the fixing member is connected to the distal end of the support body to avoid deformation of the distal end of the support body and improve the stability of the support body.
  • the fixing member is arranged along the central axis of the support body to apply a vertical force to the support body along the central axis of the support body to avoid the overall tilt deformation of the support body, thereby avoiding the left and right twisting or inward extrusion of the elastic wall, and preventing the bending point of the elastic arm from shifting at the bend, so as to ensure a larger capture radius and improve the clamping effect.
  • the clamping assembly includes an elastic clip and a support plate; the elastic clip and the support plate are both connected to the side of the elastic wall close to the support body, then under the attachment of the support plate, the rigidity of the elastic wall is enhanced, and the elastic wall is further prevented from deformation to ensure the size of the capture radius, thereby improving the clamping and fastening effect.
  • FIG1 is a schematic structural diagram of a valve repair device according to an embodiment of the present invention.
  • FIG. 2 is a schematic structural diagram of a fixing member in an embodiment of the present invention.
  • FIG. 3 is a cross-sectional view of a fixing member according to an embodiment of the present invention.
  • FIG. 4 is a cross-sectional view of a valve repair device according to an embodiment of the present invention.
  • FIG. 5 is a schematic diagram of the assembly of the connector according to the embodiment of the present invention.
  • FIG. 6 is a schematic diagram of the structure of a pressure ring in an embodiment of the present invention.
  • FIG. 7 is a top view of the valve repair device according to an embodiment of the present invention.
  • FIG. 8 is a schematic structural diagram of a proximal connecting ring in an embodiment of the present invention.
  • FIG. 9 is a schematic structural diagram of a clamping assembly in an embodiment of the present invention.
  • FIG. 10 is a schematic diagram of the structure of an elastic clip in an embodiment of the present invention.
  • FIG. 11 is a schematic structural diagram of a support plate in an embodiment of the present invention.
  • FIG. 12 is a schematic structural diagram of the valve repair device in an extended state according to an embodiment of the present invention.
  • FIG. 13 is a schematic structural diagram of the valve repair device in a captured state according to an embodiment of the present invention.
  • FIG. 14 is a schematic structural diagram of the valve repair device in a closed state according to an embodiment of the present invention.
  • 21-elastic clip 21-elastic clip; 211-first clamping portion; 212-second clamping portion; 213-barb structure; 214-baffle;
  • C1-wire fixing hole C2-guide hole; C3-groove; C4-fixing hole; C5-first hole; C6-second hole; C7-pore; C8-wire threading hole; L-central axis of the support body.
  • proximal end generally refers to the end of the medical device that is close to the operator during normal operation
  • distal end generally refers to the end of the medical device that first enters the patient's body during normal operation
  • This embodiment provides a valve repair device, including a support assembly and a clamping assembly;
  • the support assembly includes a support body 11, a fixing member 12, an elastic wall 13 and a connector 14;
  • the elastic wall 13 is respectively connected to the distal end of the support body 11 and the connector 14;
  • the fixing member 12 is connected to the distal end of the support body 11 and is arranged along the central axis L of the support body 11;
  • the clamping assembly includes an elastic clip 21 and a support plate 22; the elastic clip 21 and the support plate 22 are both connected to the side of the elastic wall 13 close to the support body 11.
  • the fixing member 12 in the valve repair device can not only prevent the distal end of the support body 11 from being deformed and improve the stability of the support body 11, but also apply a vertical force to the support body 11 to prevent the overall tilt deformation of the support body 11, thereby preventing the elastic wall 13 from being twisted left and right or squeezed inward, and preventing the bending point of the elastic arm 13 from being offset at the bend, so as to ensure a larger capture radius and improve the clamping effect.
  • the attachment of the support plate 22 can increase the rigidity of the elastic wall 13, further prevent the elastic wall 13 from being deformed, so as to ensure the size of the capture radius, thereby improving the clamping and tightening effect.
  • the distal connection ring 143 is an annular member, and the two barb-shaped ends can extend into the ring of the distal connection ring 143 and hook on the ring wall of the distal connection ring 143 to achieve the connection between the pressure ring 141 and the distal connection ring 143.
  • the ring body of the pressure ring 141 has a certain elasticity so as to provide an elastic force to the elastic wall 13.
  • a fixing hole C4 is also provided on the ring body.
  • the fixing hole C4 is used to connect with the elastic wall 13 to fix the pressure ring 141 on the elastic wall 13.
  • each elastic wall 13 is provided with a corresponding pressure ring 141, and the two pressure rings 141 are installed back to back.
  • each elastic wall 13 can be connected to more than two pressure rings 141.
  • the area where the clamping assembly is connected to the elastic wall 13 is larger than the area of the elastic clip 21 facing the elastic wall 13.
  • the contact area between the support plate 22 and the second clamping portion 212 and the elastic wall 13 is larger than the area of the second clamping portion 212 facing the elastic wall 13 after the support plate 22 is connected. That is, after the support plate 22 is provided, the contact area between the elastic wall 13 and the clamping assembly is increased, thereby enhancing the rigidity of the elastic wall 13, so as to avoid the elastic wall 13 from twisting or curling due to insufficient rigidity during the repair process, thereby ensuring A larger capture radius improves the clamping effect.
  • the outer surface of the valve repair device is coated with a polymer film to prevent at least part of the metal surface and/or metal sharp edges of the valve repair device from directly contacting the native valve tissue, thereby reducing or avoiding damage to the native valve tissue or the occurrence of adverse reactions such as allergies and inflammation.

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  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic 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)
  • Valve Housings (AREA)

Abstract

本发明提供一种瓣膜修复装置及系统。其中,所述瓣膜修复装置包括支撑组件和夹持组件。所述支撑组件包括支撑体、固定件、弹性壁和连接头;弹性壁分别与支撑体的远端和连接头相连接,固定件与支撑体的远端相连接,以避免支撑体的远端发生形变。且固定件沿支撑体的中心轴线设置,以沿支撑体的中心轴线向支撑体施加垂向作用力,避免支撑体整体倾斜形变,进而避免弹性壁发生左右扭曲或向内挤压的情况,并防止弹性壁在弯折处的弯折点发生偏移,以能够保证捕捉半径,提高夹紧效果。以及,夹持组件包括弹性夹和支撑板;弹性夹和支撑板均连接于弹性壁靠近支撑体的一侧,则在支撑板的附着下,增强了弹性壁的刚度,进一步防止弹性壁发生形变,提高夹合紧固效果。

Description

瓣膜修复装置及系统 技术领域
本发明涉及医疗器械技术领域,特别涉及一种瓣膜修复装置及系统。
背景技术
心脏瓣膜是指心房与心室之间或心室与动脉间的瓣膜,用于实现血液的单向流动。当瓣膜出现关闭不全时,会导致血液反流。这种反流会使得患者出现心力衰竭等病症,严重影响患者的日常生活和工作。其中,二尖瓣反流或三尖瓣反流是心脏瓣膜病中最常见的两种病症,现阶段主要是采用较为安全的介入手术进行治疗,例如瓣膜置换或钳夹修复等。一般情况下重度反流会直接进行瓣膜置换,而对于中轻度反流可以采用夹合器对二尖瓣或三尖瓣的瓣叶进行缘对缘双孔修复,以抑制反流问题。
目前,市场上的夹合器可以分为机械夹合器和弹性夹合器。但机械夹合器的夹合应力较大,容易造成瓣膜的瓣叶撕裂,而弹性夹合器的夹合力是靠弹性元件本身的弹性力来实现,如果夹合力不合适或者弹性元件工作过程中发生不可逆或可逆的塑性变形,会导致捕捉半径变化,严重影响瓣叶的适用范围以及瓣叶的夹紧效果。
因此,亟需一种新的瓣叶夹合装置,来避免瓣叶撕裂或变形导致的缘对缘贴合不紧的问题,以保证二尖瓣反流或者三尖瓣反流的治疗效果,并降低治疗后反流复发的风险。
发明内容
本发明的目的在于提供一种瓣膜修复装置及系统,以解决如何避免夹合时瓣叶撕裂,如何避免夹合器形变导致的夹合不牢及捕捉半径变化导致的缘对缘贴合不紧中的至少一个问题。
为解决上述技术问题,本发明提供一种瓣膜修复装置,包括支撑组件和夹持组件;
所述支撑组件包括支撑体、固定件、弹性壁和连接头;所述弹性壁分别 与所述支撑体的远端和所述连接头相连接;所述固定件与所述支撑体的远端相连接,且沿所述支撑体的中心轴线设置;
所述夹持组件包括弹性夹和支撑板;所述弹性夹和所述支撑板均连接于所述弹性壁靠近所述支撑体的一侧。
可选的,在所述的瓣膜修复装置中,所述固定件包括固丝环和导向管,且所述固丝环套接于所述导向管的近端;其中,
所述固丝环具有固丝孔,所述支撑体的远端连接于所述固丝孔内;
所述固丝环的内腔和所述导向管的内腔相连通,以形成导向孔;推送丝经所述导向孔伸入至所述连接头内,以推拉所述连接头远离或靠近所述支撑体。
可选的,在所述的瓣膜修复装置中,所述固丝环和所述导向管一体成型或可拆卸连接。
可选的,在所述的瓣膜修复装置中,所述弹性夹具有第一夹持部和第二夹持部;所述第一夹持部和所述第二夹持部的一端相互连接,所述第一夹持部和所述第二夹持部的另一端相互靠近,以能够夹持瓣叶;所述第一夹持部朝向所述第二夹持部的一侧设置有倒刺结构;所述第二夹持部与所述支撑板和所述弹性壁相连接;
其中,所述支撑板设置于所述第一夹持部和所述第二夹持部之间,或所述支撑板设置于所述第二夹持部远离所述第一夹持部的一侧;且所述夹持组件与所述弹性壁相连接的面积大于所述第二夹持部朝向所述弹性壁的一侧的面积。
可选的,在所述的瓣膜修复装置中,所述第一夹持部具有穿丝孔,以使控制丝经所述穿丝孔与所述第一夹持部相连。
可选的,在所述的瓣膜修复装置中,所述支撑板的形状包括:“U”形、“V”形、“W”形、“O”形、波浪形和多边形。
可选的,在所述的瓣膜修复装置中,所述连接头包括压环、推丝管、远端连接环和盖板;其中,所述压环分别与所述远端连接环和所述弹性壁相连接,以支撑所述弹性壁;所述推丝管贯穿所述远端连接环,并与所述盖板可 拆卸连接;以及,所述远端连接环具有连接孔,所述弹性壁的一端连接于所述连接孔内。
可选的,在所述的瓣膜修复装置中,所述支撑组件设置有两个所述弹性壁;两个所述弹性壁相对所述支撑体的中心轴线呈对称分布;且每一所述弹性壁与至少一个所述压环相连接。
可选的,在所述的瓣膜修复装置中,所述支撑组件还包括近端连接环,所述近端连接环与所述支撑体的近端相连接。
基于同一发明构思,本发明还提供一种瓣膜修复系统,包括所述的瓣膜修复装置、推送丝和控制丝;其中,所述推送丝依次贯穿所述支撑体和所述固定件,并与所述连接头相连接,以推拉所述连接头切换所述瓣膜修复装置的状态;所述控制丝回穿于所述弹性夹上,以控制所述弹性夹的开闭。
综上所述,本发明提供一种瓣膜修复装置及系统。其中,所述瓣膜修复装置包括支撑组件和夹持组件。所述支撑组件包括支撑体、固定件、弹性壁和连接头;所述弹性壁分别与所述支撑体的远端和所述连接头相连接;所述固定件与所述支撑体的远端相连接,以避免所述支撑体的远端发生形变,提高所述支撑体的稳定性。且所述固定件沿所述支撑体的中心轴线设置,以沿所述支撑体的中心轴线向所述支撑体施加垂向作用力,避免所述支撑体整体倾斜形变,进而避免所述弹性壁发生左右扭曲或向内挤压的情况,并防止所述弹性臂在弯折处的弯折点发生偏移,以能够保证较大的捕捉半径,提高夹紧效果。以及,所述夹持组件包括弹性夹和支撑板;所述弹性夹和所述支撑板均连接于所述弹性壁靠近所述支撑体的一侧,则在所述支撑板的附着下,增强了所述弹性壁的刚度,进一步防止所述弹性壁发生形变,以保证捕捉半径的尺寸,从而提高夹合紧固效果。
附图说明
图1是本发明实施例中瓣膜修复装置的结构示意图。
图2是本发明实施例中固定件的结构示意图。
图3是本发明实施例中固定件的剖视图。
图4是本发明实施例中瓣膜修复装置的剖视图。
图5是本发明实施例中连接头的装配示意图。
图6是本发明实施例中压环的结构示意图。
图7是本发明实施例中瓣膜修复装置的俯视图。
图8是本发明实施例中近端连接环的结构示意图。
图9是本发明实施例中夹持组件的结构示意图。
图10是本发明实施例中弹性夹的结构示意图。
图11是本发明实施例中支撑板的结构示意图。
图12是本发明实施例中瓣膜修复装置呈延展状态的结构示意图。
图13是本发明实施例中瓣膜修复装置呈捕捉状态的结构示意图。
图14是本发明实施例中瓣膜修复装置呈闭合状态的结构示意图。
其中,附图标记为:
11-支撑体;
12-固定件;121-固丝环;122-导向管;123-螺栓;
13-弹性壁;
14-连接头;141-压环;142-推丝管;143-远端连接环;144-盖板;
15-近端连接环;
21-弹性夹;211-第一夹持部;212-第二夹持部;213-倒刺结构;214-挡板;
22-支撑板;
31-推送丝;
32-控制丝;
33-推送管;
C1-固丝孔;C2-导向孔;C3-凹槽;C4-固定孔;C5-第一孔洞;C6-第二孔洞;C7-孔隙;C8-穿丝孔;L-支撑体的中心轴线。
具体实施方式
为使本发明的目的、优点和特征更加清楚,以下结合附图和具体实施例对本发明作进一步详细说明。需说明的是,附图均采用非常简化的形式且未 按比例绘制,仅用以方便、明晰地辅助说明本发明实施例的目的。此外,附图所展示的结构往往是实际结构的一部分。特别的,各附图需要展示的侧重点不同,有时会采用不同的比例。还应当理解的是,除非特别说明或者指出,否则说明书中的术语“第一”、“第二”、“第三”等描述仅仅用于区分说明书中的各个组件、元素、步骤等,而不是用于表示各个组件、元素、步骤之间的逻辑关系或者顺序关系等。其中,说明书中“近端”和“远端”的定义为:“近端”通常是指该医疗设备在正常操作过程中靠近操作者的一端,而“远端”通常指该医疗设备在正常操作过程中首先进入患者体内的一端。
请参阅图1,本实施例提供一种瓣膜修复装置,包括支撑组件和夹持组件;所述支撑组件包括支撑体11、固定件12、弹性壁13和连接头14;所述弹性壁13分别与所述支撑体11的远端和所述连接头14相连接;所述固定件12与所述支撑体11的远端相连接,且沿所述支撑体11的中心轴线L设置;所述夹持组件包括弹性夹21和支撑板22;所述弹性夹21和所述支撑板22均连接于所述弹性壁13靠近所述支撑体11的一侧。
可见,本实施例提供的所述瓣膜修复装置中所述固定件12不仅能够避免所述支撑体11的远端发生形变,提高所述支撑体11的稳定性,还能够向所述支撑体11施加垂向作用力,避免所述支撑体11整体倾斜形变,进而避免所述弹性壁13发生左右扭曲或向内挤压的情况,并防止所述弹性臂13在弯折处的弯折点发生偏移,以能够保证较大的捕捉半径,提高夹紧效果。此外,所述支撑板22的附着能够提高所述弹性壁13的刚度,进一步防止所述弹性壁13发生形变,以保证捕捉半径的尺寸,从而提高夹合紧固效果。
以下结合附图1~14具体说明本实施例提供的所述瓣膜修复装置。
请继续参阅图1,所述瓣膜修复装置包括所述支撑组件和所述夹持组件。其中,所述支撑组件包括所述支撑体11、所述固定件12、所述弹性壁13和所述连接头14。所述支撑体11用于在拉扯瓣叶至贴合状态时起到缓冲阻挡作用,避免拉应力过大而导致瓣叶撕裂。进一步的,所述支撑体11为筒体结构。可选的,所述支撑体11经金属丝编织而成,且经热定型工艺实现形态固定,并具有超弹性。为保证瓣叶所受的拉应力均匀,所述支撑体11优选为变径状, 且直径从远端朝向近端递增。
请参阅图1~3,所述固定件12用于避免所述支撑体11和所述弹性壁13发生形变,进而保证较大的捕捉半径,提高缘对缘贴合的紧密度。进一步的,所述固定件12与所述支撑体11的远端相连接,以固定所述支撑体11的远端的形貌,避免其发生形变。其中,所述固定件12包括固丝环121和导向管122,所述固丝环121套接于所述导向管122的近端。可选的,所述固丝环121和所述导向管122一体成型或经螺栓123可拆卸连接。所述固丝环121具有固丝孔C1,所述支撑体11的远端的编织丝穿设于所述固丝孔C1内,以与所述固丝环121固定连接。可选的,所述连接方式包括但不限于为焊接、粘接以及缝合。进一步的,本实施例提供的所述支撑体11为对称结构,则所述支撑体11的远端形貌也为对称形状。因此,为保证所述支撑体11的远端各处受力均衡,所述固丝孔C1的形貌与所述支撑体11的远端的端口形貌相同或相似,例如为环形或弧形;或者,所述固丝环121上设置有多个所述固丝孔C1,且各个所述固丝孔C1均匀分布,以与所述支撑体11的远端相对应。此外,所述固丝环121的内腔和所述导向管122的内腔相连通,以形成导向孔C2。所述导向孔C2用于为推送丝提供导向作用,避免所述推送丝的位置偏离,则所述推送丝能够经所述导向孔C2伸入至所述连接头14内,与所述连接头14相连接。并且,通过推拉所述推送丝,带动所述连接头14远离或靠近所述支撑体11,能够实现所述瓣膜修复装置的状态切换。
更进一步的,所述固定件12沿所述支撑体11的中心轴线L设置。换言之,所述固定件12沿着所述支撑体11的轴向设置,且所述固定件12的中心轴线与所述支撑体11的中心轴线L重合。因此,在重力的作用下,所述固定件12能够向所述支撑体11施加均衡的垂向作用力,避免所述支撑体11整体倾斜形变,进而避免所述弹性壁13发生左右扭曲或向内挤压的情况,并防止所述弹性臂13在弯折处的弯折点发生偏移,以保证所述弹性壁13提供较大的捕捉半径,提高夹紧效果。
请继续参阅图1,所述弹性壁13用于在捕捉过程中向所述夹持组件提供支撑力,以及在闭合过程中向瓣叶施加夹持应力,以夹紧所述瓣叶。为避免 夹持应力过大导致瓣叶撕裂,所述弹性壁13优选为编织结构,具有一定的弹性。其中,所述弹性壁13的一端与所述支撑体11的远端相连接,另一端与所述连接头14相连接。优选的,所述弹性壁13与所述支撑体11由多根金属丝一体编织而成。在本实施例中所述支撑组件包括两个所述弹性壁13,以便于实现分别夹持二尖瓣中的两个瓣叶。此外,所述瓣膜修复装置也可以适用于三尖瓣。本实施例对于所述弹性壁13的数量不做具体限定,但为避免夹持过程因受力不均匀导致所述弹性壁13和支撑体11扭曲,当设置两个以上所述弹性壁13时,各个所述弹性壁13相对所述支撑体11的中心轴线L呈对称分布。
请参阅图1和图4~6,所述连接头14包括压环141、推丝管142、远端连接环143和盖板144。其中,所述压环141用于支撑所述弹性壁13,以在修复过程中实现所述弹性壁13的聚拢和延展。进一步的,所述压环141为非闭合的环形结构,具有相互靠近的两个端部。且每一所述端部具有一凹槽C3,则所述端部呈倒钩状。所述远端连接环143为一环形件,两个呈倒钩状的所述端部能够伸入所述远端连接环143的环内,并钩挂在所述远端连接环143的环壁上,以实现所述压环141与所述远端连接环143的连接。所述压环141的环体具有一定的弹性,以能够向所述弹性壁13提供弹性作用力。且所述环体上还设置有固定孔C4。所述固定孔C4用于与所述弹性壁13连接,以将所述压环141固定于所述弹性壁13上。优选的,当设置两个以上所述弹性壁13时,每一所述弹性壁13对应设置一个所述压环141,且两个所述压环141背对背安装。当然,为增强支撑效果,每一所述弹性壁13可以对应连接两个以上所述压环141。
所述推丝管142用于固定所述推送丝。所述推丝管142内设置有螺纹结构,且与所述推送丝远端的螺纹结构相适配,以使得在修复过程中,所述推送丝伸入所述推丝管142内,并经旋拧实现螺纹连接;且在回撤所述推送丝时,反向旋拧所述推送丝即可实现所述推送丝与所述推丝管142分离。以及,所述盖板144朝向所述推丝管142的一侧具有螺纹结构,以能够伸入至所述推丝管142的远端,实现与所述推丝管142螺纹连接,增强所述连接头14的 稳定性。进一步的,所述推丝管142的外壁还设置有多个凸出部,所述凸出部能够抵接于所述远端连接环143的环内壁上,则所述远端连接环143能够固定套接于所述推丝管142的外壁上。其中,各个所述凸出部之间具有间隙,所述压环141的端部可容置于所述间隙中,以保证所述压环141的两个端部与所述远端连接环143相连接。更进一步的,所述远端连接环143的环壁上设置有连接孔,所述弹性壁13的一端的编织丝能够伸入所述连接孔内,且与所述远端连接环143固定连接。可选的,所述连接方式包括但不限于为焊接、粘接以及缝合。
请参阅图1和图7~8,所述支撑组件还包括近端连接环15。所述近端连接环15与所述支撑体11的近端相连接,以固定所述支撑体11的近端的形貌;以及,所述近端连接环15还与所述瓣膜修复装置的推送管相连接,以稳定输送所述瓣膜修复装置。其中,所述近端连接环15的内环为第一孔洞C5,所述推送丝能够经所述第一孔洞C5伸入至所述支撑体11的内腔。所述近端连接环15的环壁具有第二孔洞C6,所述支撑体11的近端处的编织丝可固定于所述第二孔洞C6内。所述连接方式包括但不限于为焊接、粘接以及缝合。
请参阅图1和图9~11,所述夹持组件用于夹持瓣叶,且设置于所述弹性壁13上。其中,所述夹持组件包括弹性夹21和支撑板22。可选的,所述弹性夹21和所述支撑板22均为金属板件。进一步的,所述弹性夹21用于夹持瓣叶,且所述弹性夹21具有层叠设置的第一夹持部211和第二夹持部212。可选的,所述第一夹持部211和第二夹持部212为矩形板件。所述第一夹持部211和所述第二夹持部212各自的一端相互连接,所述第一夹持部211和所述第二夹持部212各自相对的另一端相互靠近,具有相贴合的运动趋势,以能够夹持住所述瓣叶。其中,所述第一夹持部211朝向所述第二夹持部212的一侧设置有倒刺结构213。所述倒刺结构213设于所述第一夹持部211,用于锚定住瓣叶,以增强所述弹性夹21的夹持稳定性。优选的,所述倒刺结构213包括长短不同的倒刺,以增强锚定性。且所述倒刺结构213可采用激光切割和热定型工艺实现。
进一步的,所述第一夹持部211的中心位置设置有孔隙C7,以避免所述 第二夹持部212向所述第一夹持部211的板体贴合时产生的夹持力过大,导致瓣叶损毁。优选的,所述孔隙C7的宽度大于或等于所述第二夹持部212的宽度。对此,为避免所述第二夹持部212穿过所述孔隙C7,所述夹持组件还设置有挡板214。所述挡板214设置于所述第一夹持部211和所述第二夹持部212之间,可以与所述第一夹持部211或所述第二夹持部212固定连接。其中,所述挡板214的宽度大于所述孔隙C7的宽度,以能够阻挡所述第二夹持部212穿入所述孔隙C7,保证所述弹性夹21的可实施性。需要说明的是,本实施例中所指的宽度方向是指与轴向相互垂直的方向。更进一步的,所述第一夹持部211还具有穿丝孔C8。所述穿丝孔C8位于所述第一夹持部211不与所述第二夹持部212相连接的一端。控制丝可回穿于所述穿丝孔C8内,以实现所述控制丝与所述第一夹持部211相连。基于此,在术中通过拉动所述控制丝,能够驱使所述第一夹持部211远离所述第二夹持部212,则所述弹性夹21打开,所述瓣叶能够伸入至所述第一夹持部211和所述第二夹持部212之间。继而,回松所述控制丝,使得所述第一夹持部211靠近所述第二夹持部212,从而夹持住所述瓣叶。
请继续参阅图1和图9~11,所述弹性夹21和所述支撑板22相互靠近设置。可选的,所述支撑板22设置于所述第一夹持部211和所述第二夹持部212之间,或所述支撑板22设置于所述第二夹持部212远离所述第一夹持部211的一侧。其中,所述支撑板22可以直接与所述第二夹持部212相连接,或与第二夹持部212上固定连接的挡板214相连接,亦或者所述支撑板22和所述第二夹持部212分别与所述弹性壁13相连接,且连接方式包括但不限于为缝合、焊接或粘接。
在某一实施例中,所述夹持组件与所述弹性壁13相连接的面积大于所述弹性夹21朝向所述弹性壁13的一侧的面积。换言之,所述支撑板22和所述第二夹持部212连接后与所述弹性壁13的接触面积大于所述第二夹持部212朝向所述弹性壁13的一侧的面积。即,设置所述支撑板22后,所述弹性壁13与所述夹持组件的接触面积增大,从而增强了所述弹性壁13的刚度,以避免在修复过程中所述弹性壁13因刚度不足而出现扭曲、卷缩的情况,保证了 较大尺寸的捕捉半径,提高夹合效果。示例性的,当所述弹性夹21和所述支撑板22均呈矩形状或近似矩形的形状,即具有相对的长度和宽度,则所述支撑板22的最大长度m1大于所述第二夹持部212的最大长度m2,和/或,所述支撑板22的最大宽度n1大于所述第二夹持部212的最大宽度n2。基于此,当所述支撑板22位于所述第一夹持部211和所述第二夹持部212之间时,所述支撑板22会相对所述第二夹持部212伸出部分结构直接与所述弹性壁13相连接,以增强所述弹性壁13的支撑力。当所述支撑板22位于所述第二夹持部212远离所述第一夹持部211的一侧时,所述支撑板22的中间可以呈镂空状,部分或全部所述第二夹持部212位于镂空的间隙中,则所述第二夹持部212和所述支撑板22组合成一个整体的板件,以附着于所述弹性壁13上,增强所述弹性壁13的刚度。或者,所述第二夹持部212直接叠置并固定于所述支撑板22上,所述支撑板22直接与所述弹性壁13相连接。并且,所述支撑板22相对所述弹性壁13的一侧的面积大于所述第二夹持部212相对所述弹性壁13的面积,同样能够增大接触面积,以增强所述弹性壁13的刚度。可选的,所述支撑板22的形状包括但不限于为“U”形、“V”形、“W”形、“O”形、波浪形和多边形;以及,当采用缝合的连接方式时,所述支撑板22和所述第二夹持部212上还可以设置多个孔洞,以便于穿线缝合。
优选的,所述瓣膜修复装置的外表面均包覆有高分子膜,以防止所述瓣膜修复装置的至少部分金属表面和/或金属锐边与原生瓣膜组织直接接触,从而减少或避免原生瓣膜组织损伤或出现过敏、炎症等不良反应。
基于同一发明构思,本实施例还提供一种瓣膜修复系统。请参阅图12~14,所述瓣膜修复系统包括所述瓣膜修复装置、推送丝31和控制丝32;其中,所述推送丝31依次贯穿所述支撑体11和所述固定件12,并与所述连接头14相连接,以推拉所述连接头14切换所述瓣膜修复装置的状态;所述控制丝32回穿于所述弹性夹21上,以控制所述弹性夹21的开闭。进一步的,所述瓣膜修复系统还包括推送管33和输送鞘管等装置,以便于实施完成瓣膜修复。
需要说明的是,在瓣膜修复过程中,所述瓣膜修复装置具有延展状态、捕捉状态和闭合状态。在输送所述瓣膜修复装置之前,先将所述近端连接环 15与所述推送管33相连接。然后,将所述推送丝31依次穿过所述推送管33、所述近端连接环15、所述支撑体11和所述固定件12,并固定连接于所述连接头14内;以及,将所述控制丝32回穿于所述弹性夹21上。然后,调整所述瓣膜修复装置呈延展状态,以便于压缩装载于所述输送鞘管中。如图12所示,推动所述推送丝31,以使所述连接头14远离所述支撑体11,所述压环141和所述弹性壁13均沿所述支撑体11的轴向延展,且朝向所述推送丝31的外周靠近。进一步的,经过设备压缩,所述瓣膜修复装置的轴向延伸且宽度向缩短,以便于入鞘输送。
当所述瓣膜修复装置输送至目标位置处之后,释放所述瓣膜修复装置,并使所述瓣膜修复装置进入捕捉状态。如图13所示,先回收部分所述推送丝31,所述压环141撑开所述弹性壁13,以使所述弹性壁13、所述压环141和所述推送丝31组成呈稳定的三角形状态。即,所述弹性壁13的内侧部分呈水平状态,所述推送丝31呈垂直状态,所述压环141呈倾斜状态。再拉动所述控制丝32,以使所述弹性夹21的第一夹持部211被提起,所述弹性夹21呈张开状态;继而逐步将所述弹性壁13放置于瓣叶的下方,调整并确定夹持位置后,回放所述控制丝32以使所述弹性夹21的第一夹持部211落下,所述弹性夹21呈闭合状态,实现对所述瓣叶的捕捉。其中,所述第一夹持部211中的倒刺结构213能够稳定地扎入所述瓣叶中,以增强锚定效果。可选的,逐一对每一所述弹性夹21进行开闭操作,以根据捕捉情况分别进行调整;也可以同时对所有所述弹性夹21进行开闭操作。
当完成捕捉瓣叶之后,所述瓣膜修复装置进入闭合状态,以夹紧所述瓣叶。如图14所示,继续回收所述推送丝31,以使所述连接头14靠近所述固定件12。同时,会带动所述压环141朝向所述支撑体11的中心轴线L聚拢。相应的,所述弹性壁13和所述弹性夹21也随之朝向所述支撑体11的中心轴线L聚拢。基于此,所述瓣叶在所述弹性夹21的夹持下朝向所述支撑体11的中心轴线L聚拢,从而实现瓣叶的闭合夹紧。最后,撤出所述推送丝31、所述控制丝32、所述推送管33以及所述输送鞘管,即完成瓣膜修复。
综上所述,本实施例提供的所述瓣膜修复装置及系统,通过设置所述固 定件12,避免所述支撑体11的远端发生形变,提高所述支撑体11的稳定性。以及,所述固定件12还能够向所述支撑体11施加垂向作用力,避免所述支撑体11整体倾斜形变,进而避免所述弹性壁13发生左右扭曲或向内挤压的情况,并防止所述弹性臂13在弯折处的弯折点发生偏移,以能够保证较大的捕捉半径,提高夹紧效果。此外,所述瓣膜修复装置及系统还设置有支撑板22,且所述夹持组件与所述弹性壁13相连接的面积大于所述弹性夹21朝向所述弹性壁13的一侧的面积。则在所述支撑板22的附着下,增强了所述弹性壁13的刚度,进一步防止所述弹性壁13发生形变,以保证捕捉半径的尺寸,从而提高夹合紧固效果。
此外还应该认识到,虽然本发明已以较佳实施例披露如上,然而上述实施例并非用以限定本发明。对于任何熟悉本领域的技术人员而言,在不脱离本发明技术方案范围情况下,都可利用上述揭示的技术内容对本发明技术方案作出许多可能的变动和修饰,或修改为等同变化的等效实施例。因此,凡是未脱离本发明技术方案的内容,依据本发明的技术实质对以上实施例所做的任何简单修改、等同变化及修饰,均仍属于本发明技术方案保护的范围。

Claims (10)

  1. 一种瓣膜修复装置,其特征在于,包括支撑组件和夹持组件;
    所述支撑组件包括支撑体、固定件、弹性壁和连接头;所述弹性壁分别与所述支撑体的远端和所述连接头相连接;所述固定件与所述支撑体的远端相连接,且沿所述支撑体的中心轴线设置;
    所述夹持组件包括弹性夹和支撑板;所述弹性夹和所述支撑板均连接于所述弹性壁靠近所述支撑体的一侧。
  2. 根据权利要求1所述的瓣膜修复装置,其特征在于,所述固定件包括固丝环和导向管,且所述固丝环套接于所述导向管的近端;其中,
    所述固丝环具有固丝孔,所述支撑体的远端连接于所述固丝孔内;
    所述固丝环的内腔和所述导向管的内腔相连通,以形成导向孔;推送丝经所述导向孔伸入至所述连接头内,以推拉所述连接头远离或靠近所述支撑体。
  3. 根据权利要求2所述的瓣膜修复装置,其特征在于,所述固丝环和所述导向管一体成型或可拆卸连接。
  4. 根据权利要求1所述的瓣膜修复装置,其特征在于,所述弹性夹具有第一夹持部和第二夹持部;所述第一夹持部和所述第二夹持部的一端相互连接,所述第一夹持部和所述第二夹持部的另一端相互靠近,以能够夹持瓣叶;所述第一夹持部朝向所述第二夹持部的一侧设置有倒刺结构;所述第二夹持部与所述支撑板和所述弹性壁相连接;
    其中,所述支撑板设置于所述第一夹持部和所述第二夹持部之间,或所述支撑板设置于所述第二夹持部远离所述第一夹持部的一侧;且所述夹持组件与所述弹性壁相连接的面积大于所述第二夹持部朝向所述弹性壁的一侧的面积。
  5. 根据权利要求4所述的瓣膜修复装置,其特征在于,所述第一夹持部具有穿丝孔,以使控制丝经所述穿丝孔与所述第一夹持部相连。
  6. 根据权利要求1所述的瓣膜修复装置,其特征在于,所述支撑板的形状包括:“U”形、“V”形、“W”形、“O”形、波浪形和多边形。
  7. 根据权利要求1所述的瓣膜修复装置,其特征在于,所述连接头包括压环、推丝管、远端连接环和盖板;其中,所述压环分别与所述远端连接环和所述弹性壁相连接,以支撑所述弹性壁;所述推丝管贯穿所述远端连接环,并与所述盖板可拆卸连接;以及,所述远端连接环具有连接孔,所述弹性壁的一端连接于所述连接孔内。
  8. 根据权利要求7所述的瓣膜修复装置,其特征在于,所述支撑组件设置有两个所述弹性壁;两个所述弹性壁相对所述支撑体的中心轴线呈对称分布;且每一所述弹性壁与至少一个所述压环相连接。
  9. 根据权利要求1所述的瓣膜修复装置,其特征在于,所述支撑组件还包括近端连接环,所述近端连接环与所述支撑体的近端相连接。
  10. 一种瓣膜修复系统,其特征在于,包括如权利要求1~9中任意一项所述的瓣膜修复装置、推送丝和控制丝;其中,所述推送丝依次贯穿所述支撑体和所述固定件,并与所述连接头相连接,以推拉所述连接头切换所述瓣膜修复装置的状态;所述控制丝回穿于所述弹性夹上,以控制所述弹性夹的开闭。
PCT/CN2023/106957 2022-12-30 2023-07-12 瓣膜修复装置及系统 WO2024139169A1 (zh)

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