CN101953728A - Conveniently-implantable artificial valve replacement device and scaffold - Google Patents

Conveniently-implantable artificial valve replacement device and scaffold Download PDF

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Publication number
CN101953728A
CN101953728A CN201010150780XA CN201010150780A CN101953728A CN 101953728 A CN101953728 A CN 101953728A CN 201010150780X A CN201010150780X A CN 201010150780XA CN 201010150780 A CN201010150780 A CN 201010150780A CN 101953728 A CN101953728 A CN 101953728A
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CN
China
Prior art keywords
support
epitheca
valve
ear
prosthetic replacement
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Legal status (The legal status 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 status listed.)
Granted
Application number
CN201010150780XA
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Chinese (zh)
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CN101953728B (en
Inventor
孙启明
王约翰
张启明
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Hangzhou Qiming Medical Devices Co., Ltd.
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HANGZHOU QIMING MEDICAL DEVICE CO Ltd
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Priority to CN201010150780XA priority Critical patent/CN101953728B/en
Publication of CN101953728A publication Critical patent/CN101953728A/en
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Publication of CN101953728B publication Critical patent/CN101953728B/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A61F2/2418Scaffolds therefor, e.g. support stents
    • 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
    • A61F2/2427Devices for manipulating or deploying heart valves during implantation
    • A61F2/2436Deployment by retracting a sheath

Abstract

The invention discloses a conveniently-implantable artificial valve replacement device and a scaffold. The scaffold has a reticulated cylindrical structure consisting of an aorta scaffold, a valve scaffold and an inlet flow channel scaffold connected in turn, wherein the top edge of the aorta scaffold is provided with at least two fixing lugs, and the projection position, of the top edge of each fixing lug, on the axial line of the scaffold is in crisscross distribution, namely the heights of the top edges of a plurality of the fixing lugs are inconsistent, and each two of the heights are different. The artificial valve replacement device and the scaffold are convenient for implantation, and can be positioned and used for a plurality of times.

Description

A kind of convenient valvular prosthetic replacement's device and support of implanting
Technical field
The present invention relates to technical field of medical instruments, relate in particular to a kind of valvular prosthetic replacement's device.
Background technology
, because causing variation, congenital or acquired disease when causing valve normally not open and close, can impact when patient's self cardiac valve healthy living and even life.Valvular variation can be divided into open incomplete and incompetence, and both of these case can cause cardiac load to increase, and whether heart can also operate as normal be whether decider's systemic heart valve should metathetical main foundation under this load.
When patient need change valve, existing method was to adopt surgical operation to change lobe, and the doctor will open breast with cardiac arrest for patient, is attempted by on the external cardiopulmonary circulatory system.Open the cardiac valve excision of heart of patient then, artificial replacement's lobe seam is put in position gone up again, at last heart and thoracic cavity are sewed up pathological changes.This is a very large operation process of wound, and certain mortality risk is arranged, and patients ' recovery is chronic, and health can't bear a lot of patients because operation wound is big, can not undergo surgery although need change lobe.
U.S. Pat 5370685, US5411552 discloses the method and the valvular prosthetic replacement's device that are used for non-open chest surgery replacement heart valve among US5718725 and the US6425916, and the breast that can reduce to perform the operation out changes wound and the misery that lobe causes.
A kind of displacement apparatus is also disclosed in Chinese invention patent application 200710007443.3 in addition, the network of making by memory metal material, and seam put in this support can unidirectional opening the SANYE valve constitute, location for the ease of the use of support, referring to Fig. 1, support in this technology is divided into the bigger aortic stents of diameter 1, less valve bracket 2 and the moderate right ventricle of diameter of diameter flows to support 3 three parts, support back in place is conformed to the cardiac structure characteristics, be difficult for dislocation.
When valvular prosthetic replacement's device is implanted heart by femoral artery, all mentioned conveyer device in Chinese invention patent application 200710007443.3 and U.S. Pat 2002/0151970A1, the guiding by conveyer device makes that valvular prosthetic replacement's device is in place.For valvular prosthetic replacement's device is fixed on conveyer device, on the support of valvular prosthetic replacement's device, be provided with fixedly ear, be used for matching with conveyer device.
When the quantity of fixing ear during greater than one, the top of a plurality of fixedly ears is identical along the projected position on the axis of support in the existing patent, the height that is the edge, top of a plurality of fixedly ears is consistent, but can bring a problem like this, when being fixed to support on the conveyer device, need be simultaneously that a plurality of fixedly ears are in place, acquire a certain degree of difficulty in the operation.
Conveyer device of the prior art is that valvular prosthetic replacement's device is fixed on the support fixing head, this support fixing head front end has fairshaped seeker, the rear end is connected with conduit, when implanting, at first valvular prosthetic replacement's device card is incorporated in the support fixing head of conveyer device, valvular prosthetic replacement's device is pushed to the valve position of pathological changes by conduit from the porch of blood vessel, discharge valvular prosthetic replacement's device again, valvular prosthetic replacement's device its support under the effect of body temperature can expand, the blade of human body valve is pressed to finishes in placely on the blood vessel wall, and then conduit and support fixing head and seeker extracted out.
But conveyer device of the prior art only is dependence seeker contact blood vessel in the time of need turning when stretching in the human vas, realizes turning under the stopping of blood vessel, but so might cause scratch or damage to the inwall of blood vessel or organ.Moreover after discharging valvular prosthetic replacement's device, because valvular prosthetic replacement's device is the meeting spreading under the effect of body temperature, and in case find its in place or position words devious and just can't handle, be difficult to realize that the adjustment of position or secondary are in place, control accuracy during so not only to operation requires high, and has certain risk.
Summary of the invention
The invention provides a kind of can conveniently inserting, support that can repeatedly localized valvular prosthetic replacement's device and the valvular prosthetic replacement's device that adopts this support.
A kind of support of convenient valvular prosthetic replacement's device of implanting, described support serve as reasons the successively aortic stents, the valve bracket that connect and flow to and prop up the netted tubular construction that is configured to, the top of aortic stents is along being provided with at least two fixedly ears, and each fixedly is interspersed along the projected position on the axis of support on the top of ear.The height that is the edge, top of a plurality of fixedly ears is inconsistent, and different between two.
Invention like this, when being fixed to support on the conveyer device, can be successively that a plurality of fixedly ears are in place, at first be that the top is earlier in place along the highest fixedly ear, successively that all fixedly ears is in place highly from high to low according to the edge, top then, like this operation can be much convenient.
Described fixedly ear is positioned at the edge, top of support, promptly is positioned at the edge, top of described aortic stents, and for the ease of processing, described fixedly ear and support are the structures of one.
Fixedly the quantity of ear is preferred two~four, be evenly distributed on the edge, top of aortic stents, but the fixing shape various ways of ear, its common ground is by head and is used for this head is connected the cervical region that aortic stents is pushed up the edge, as its name suggests, comparatively speaking cervical region is thinner, and head is thicker, head also can be that the top of cervical region forms by expansion or bending, so just can be fastened on the conveyer device.In theory if described head along the projected area of the axis direction of support greater than cervical region projected area just can guarantee that bracket clamp is combined on the conveyer device, can avoid support before release with respect to the displacement of conveyer device generation along the axis direction of support.For example, described fixedly ear can be T-shape structure, inverted "L" shaped or loop configuration etc.
Sidewall at described valve bracket is distributed with three hollow out zones, and the vertical position of three valves is corresponding during respectively with the SANYE valve-open.These three hollow out zones are used for the top that holds three valves respectively when the SANYE valve-open.
Existing support adopts memory metal material to make; it all is netted structure; in order to keep necessary support strength; the grid of netted support is generally all smaller; the inwall of support all can be clashed in the top of three valves during the SANYE valve-open; cause wearing and tearing to valve; and the sidewall that can come in contact collision in the support of the present invention on the top with three valves has been held three holes that area is bigger; be described three hollow out zones; like this; corresponding hollow out zone is inserted on the top of three valves just respectively during the SANYE valve-open, can avoid the bump to valve bracket, has protected the SANYE valve.
The restriction that the shape in described hollow out zone is not strict generally can be circle, ellipse, rhombus etc., can according to other regional vein structures on the valve bracket in other words the shape of unit grid determine.
As preferably, described valve bracket is made of a plurality of unit grids of continuous distribution, and described hollow out zone is merged by adjacent some unit grids and constitutes.For example when the cell of valve bracket be shaped as rhombus the time, can the plurality of units lattice be merged in the zone that needs the large tracts of land hollow out, promptly remove the venation of intra-zone, form described hollow out zone.Like this not only be convenient to processing, and good integral strength, can not produce partial turn up or containing.
Need to prove,, therefore say that from structure the hollow out zone has a lot, but vertical three zones that hold three valves on the valve bracket when the SANYE valve-open are respectively refered in particular in hollow out of the present invention zone because support is netted on the whole.
If the hollow out zone is too small, during the SANYE valve-open, the top of three valves or edge also can come in contact with valve bracket, if the hollow out zone is excessive, can reduce the bulk strength of the support of valve bracket and valvular prosthetic replacement's device.As preferably, described hollow out zone is 1/6~1/4 of a described stent length along the length of the support axis direction of valvular prosthetic replacement's device.Because the shape in hollow out zone has various ways, the length of calculating the hollow out zone herein is meant that the length in single hollow out zone, the length in hollow out zone are meant that the hollow out zone is along the support axis direction length at long position.
Described hollow out zone is 1/9~1/6 of a described support girth along the length of the support circumferencial direction of valvular prosthetic replacement's device.Because the shape in hollow out zone has various ways, the length of calculating the hollow out zone herein is meant that single hollow out zone is along the support circumferencial direction length at long position, because the different position girth of support may be also inequality, support girth described here then refers to it is the pairing support girth in the longest position, described hollow out zone.
As preferably, the described bottom that flows to support inwardly draw in or the outer wall of this bottom parallel with the axis of support.
Because the bottom of prior art medium-height trestle expands outwardly, promptly court tilts away from the direction of the axis of support, like this after valvular prosthetic replacement's device is positioned in the heart, the bottom that its support extends out might contact or strike wall of the heart, and the position of wall of the heart near bracket bottom is sinuatrial node just, sinuatrial node sends stable bioelectric current and is passed to cardiac muscle, just makes heart keep rhythmical beating.In case and frame bottom contact or strike sinuatrial node will to make sinuatrial node send bioelectrical signals no longer stable directly causes arrhythmia, and patient is caused further harmful effect.
Inwardly draw in or the parallel stimulation that can avoid sinuatrial node with the axis of support of its outer wall the described bottom that flows to support, belongs to same thinking, but inwardly draw in as the bottom of preferred streams access support.
The height of bottom described here is 1~3cm, can be slightly variant according to the size of support overall dimension, can be when inwardly draw in described bottom along straight path, and the angle of the axis of this gathering position and support is 10~30 degree, as further preferred, the angle of the axis of this gathering position and support is 15~20 degree, and suitable angle not only can have been avoided the stimulation of sinuatrial node but also can keep the proper supporting direction, guaranteed the unimpeded of blood runner.
Also can be when inwardly draw in described bottom along arc trajectory, the angle of the axis of the line of this camber line Origin And Destination and support is 10~30 degree equally, as further preferred, the angle of the line of this camber line Origin And Destination and the axis of support is 15~20 degree.
Because the SANYE valve in valvular prosthetic replacement's device is unidirectional opening, but the SANYE valve is closed during blood back flow, the back-pressure that blood of human body produces valve can make whole pressurized of valvular prosthetic replacement's device and extruding downwards, valvular prosthetic replacement's device might be shifted downwards gradually, depart from original position.
In order to address this problem, the invention provides a kind of valvular prosthetic replacement's device of good stability in place, at described valve bracket or flow to the position that support contacts with heart and be provided with the location thorn, this location is stung from valve bracket or is flow to that the outer wall of support is downward-sloping to be stretched out and away from the support axis.
As preferably, the angle of inclination that relative support axis is stung in described location is 15~45 degree.
Described location thorn can be that to be structure as a whole with support also can be to be welded on the support, the shape of location thorn is not strict with, but need have at least one tip, the location thorn can have several, being distributed in valve bracket or flowing to the outer wall of support, generally is the axis uniform distribution around support, and one or more layers can be arranged, when multilamellar was arranged, the location of adjacent layer thorn preferably was dislocatedly distributed.
As further preferred, the length of described location thorn is 0.3~1.5cm, for just with processing, the node of the unit grid of support can be cut, the freely swinging part of this node top is turned up and has just been formed the location thorn.
As further preferred, described location thorn has 3~6, is evenly distributed on valve bracket or flows to the position that support contacts with heart.
The present invention also provides a kind of valvular prosthetic replacement's device, comprises support of the present invention and is fixed on the interior SANYE valve of this support.
Described SANYE valve seam is put the inwall at valve bracket, and the SANYE valve can adopt the material of prior art and the seam method of putting to fix.
The present invention also provides a kind of being used for that valvular prosthetic replacement's device is delivered to the intravital conveyer device of people, comprising:
Seeker;
Sheath in piped;
The support fixing head of band through hole, the outer wall of the fixing first end of support has the locating slot that matches with the support of valvular prosthetic replacement's device, and the other end is connected with interior sheath;
Hauling rope, an end are connected with seeker after passing the through hole of support fixing head, and the other end passes interior sheath;
Piped epitheca, sheath and support fixing head outside in being enclosed within.
Described seeker is a pyramidal structure, the termination portion of seeker has streamlined contour, can avoid scratching blood vessel, also helps guiding whole conveyer device to advance along blood vessel, the afterbody of seeker is a planar structure, is used to push against the support of valvular prosthetic replacement's device.
Described piped interior sheath is socketed in the afterbody of support fixing head.
When valvular prosthetic replacement's device is loaded on the described conveyer device, support one end of valvular prosthetic replacement's device is fastened in the locating slot of support fixing head by fixing ear, the other end pushes against the afterbody of seeker, the afterbody of seeker is connected with hauling rope, hauling rope passes the support of valvular prosthetic replacement's device, the through hole and the interior sheath of support fixing head successively, and the part of sheath just can directly be controlled seeker in the pulling hauling rope passed.And described epitheca with interior sheath, support fixing head and valvular prosthetic replacement's device parcel within it, the termination of epitheca also pushes against the afterbody of seeker, so just valvular prosthetic replacement's device can be wrapped up within it fully, can avoid after the support of valvular prosthetic replacement's device is entering in the human body spreading immediately.
Interior sheath passes epitheca away from an end of seeker, spur the relative motion that this part just can realize interior sheath and epitheca, when valvular prosthetic replacement's device arrives the precalculated position, the pulling epitheca comes out valvular prosthetic replacement's device, the support of valvular prosthetic replacement's device just can be under the body temperature effect spreading in place, this moment, support separated with seeker, and the fixedly ear of support is also deviate from from locating slot, spurs hauling rope, interior sheath and epitheca at last seeker and the fixing first-class parts of support are extracted out.
Turn when advancing for the ease of conveyer device, be provided with bail in the housing that closes on the guiding head end of described epitheca, this bail is in the housing of axis arranged at epitheca of epitheca, axis along epitheca in the housing of epitheca has passage, this passage one end arrives at bail, the other end is along away from the direction of the seeker end until the epitheca housing, described passage is built-in with the epitheca hauling rope, epitheca hauling rope one end is connected with bail, the other end stretches out the outside that passage extends to epitheca, the part that pulling is stretched out just can directly affect bail, because bail closes on seeker, can make the effect of sheath hauling rope outside of seeker position drive whole conveyer device bending down, be convenient to control the turning of conveyer device.
For the ease of the turning of conveyer device, described in sheath, epitheca all adopt elasticity preferably biocompatible material make, concrete selecting for use of material can be adopted prior art.Described bail generally is placed in the housing of epitheca by preembedded mode.
Described epitheca promptly requires to keep the hot strength of necessity, also to avoid when it is crooked, keeping the unobstructed of inside, as being distributed with spiral metal wire around the epitheca axis in the tubular shell of preferred described epitheca, when epitheca is crooked, spiral metal wire can support its housing, keeps the unobstructed of inside.
Moreover, be distributed with netted fortifying fibre in the tubular shell of described epitheca, can make it keep higher draw tensile strength like this, avoid unnecessary deformation.
Conveyer device of the present invention generally is that epitheca is drawn back certain distance when discharging valvular prosthetic replacement's device, holder part is exposed in the human body environment, promptly at first be that part discharges, generally can discharge 1/4~3/4 of stent length earlier, d/d part support spreading under the body temperature effect, like this can observe the effect in place of support according to the situation behind the spreading, can spur interior sheath if find position words devious, then drive the support fixing head, because this moment, the fixedly ear of support did not also discharge, still under the parcel of epitheca, be in the locating slot, the support fixing head just can spur fixedly, and ear makes support progress into epitheca, under the extruding of epitheca inwall, support can draw the state before being got back to release by the epitheca parcel fully gradually in, then reorientates again, discharge, like this just can the first time support in place when unsuccessful, in time adjust, until valvular prosthetic replacement's device being released in best position.
The artificial valve replacement device of the present invention is located and can be reclaimed when undesirable, carries out the adjustment of position, difficulty and risk when having reduced operation like this.
When being loaded in valvular prosthetic replacement's device on the described conveyer device, the fixedly ear that support need be pushed up the edge embeds in the locating slot of support fixing head outer wall, certainly the position of locating slot and shape are big or small matches during with fixing ear, and then sheath makes epitheca that support is wrapped in twitching, promptly under the parcel of epitheca fixedly ear be limited in the locating slot all the time, if a plurality of fixedly ears are arranged, and when fixedly the height of ear is identical, twitch interior sheath again after needing simultaneously all fixedly ears to be pressed into simultaneously locating slot, in case otherwise certain fixedly ear do not have in place and in twitching during sheath, do not have fixedly ear in place will stop epitheca even the outside of translating into epitheca.Certain degree of difficulty is arranged when therefore loading.
And in the optimized technical scheme of the present invention, the height of a plurality of fixedly ears is different, can at first highly the highest fixedly ear be pressed into locating slot when in place, sheath wraps the epitheca fixedly ear that this is in place in twitching then, because other fixedly ear height is lower, therefore when epitheca when fixedly ear wraps with first, can not influence remaining fixedly ear be pressed into corresponding locating slot, next next fixedly ear of height is pressed into corresponding locating slot, in twitching again sheath make epitheca with second fixedly ear wrap, by that analogy by highly one by one that all fixedly ear parcels is in place, like this each needs to operate a fixedly ear, promptly handle one by one and be pressed into locating slot, do not need to be pressed into simultaneously locating slot, reduced the operation easier when loading greatly.
The support that need to prove valvular prosthetic replacement's device is the state that draws in when not using, it is fine and close tubular structure, generally be that tubing by memory metal material forms through Laser cutting, and can under the body temperature effect, form fluffy tubular structure by spreading after entering human body and release, if there is not specified otherwise among the present invention, when describing the structure of valvular prosthetic replacement's device and support thereof, all be meant the structure under the complete spreading state in human body.Unless obviously can not implement in addition, otherwise the many technical characterictics of the present invention can carry out combination in any as required.
The artificial valve replacement device of the present invention does not need surgical operation just can replace the cardiac valve of pathological changes, process blood vessel during displacement, generally be to implant heart by femoral artery, and heart and aorta do not need surgical incision, and certain valvular prosthetic replacement's device of the present invention also can be inserted by the mode that spiles with the apex of the heart between chest rib.
It is convenient that the artificial valve replacement device of the present invention is implanted, long service life, and good positioning effect has not only reduced the difficulty of performing the operation, and has also realized recyclable.
Description of drawings
Fig. 1 is the supporting structure sketch map of valvular prosthetic replacement's device in the prior art.
Fig. 2 is the supporting structure sketch map of the artificial valve replacement device of the present invention.
Fig. 3 is the structural representation of the artificial valve replacement device of the present invention.
Fig. 4 is the structural representation of the another kind of embodiment of the support of the artificial valve replacement device of the present invention.
Fig. 5 discharges preceding expansion sketch map for the support of the artificial valve replacement device of the present invention.
Fig. 6 loads internal structure sketch map behind valvular prosthetic replacement's device for conveyer device of the present invention.
Fig. 7 loads the preceding internal structure sketch map of valvular prosthetic replacement's device for conveyer device of the present invention.
Fig. 8 is the internal structure sketch map of conveyer device of the present invention when valvular prosthetic replacement's device partly stretches out epitheca.
Fig. 9 is the perspective view of conveyer device medium-height trestle fixing head of the present invention.
Figure 10 is the perspective view of another angle of Fig. 9 medium-height trestle fixing head.
Figure 11 is the sketch map of Figure 10 medium-height trestle fixing head along Z direction among the figure.
Figure 12 is the profile of Figure 11 medium-height trestle fixing head.
Figure 13 is the profile along another section of Figure 11 medium-height trestle fixing head.
Figure 14 be Figure 11 medium-height trestle fixing head along trisected profile.
Figure 15 is the profile at position, epitheca termination in the conveyer device of the present invention.
Figure 16 is conveyer device of the present invention structural representation when crooked.
Figure 17 is the internal structure sketch map of epitheca in the conveyer device of the present invention.
The specific embodiment
The artificial valve replacement device of the present invention is made of support and the SANYE valve that is fixed in the support, referring to Fig. 2, support serve as reasons the successively aortic stents 4, the valve bracket 5 that connect and flow to the netted tubular construction that support 6 constitutes are identical with prior art with regard to this construction features.
Match with conveyer device when being used in the implant into body along being provided with fixedly ear 60 in aortic stents 4 tops.
Referring to Fig. 2, on the top of aortic stents 4 along having three fixedly ears, because rarely seen fixedly ear 60a and fixing ear 60b among the angle problem figure.Fixedly ear is the T-shape structure, three fixedly the height on the edge, top of ear be inconsistent.
Sidewall at valve bracket 5 is distributed with three hollow out zones 7, since the angle problem, rarely seen two hollow out zones among Fig. 2.Visible hollow out zone 7a and hollow out zone 7b are used for holding respectively the top 8a of valve and the top 8b of valve among Fig. 3 when the SANYE valve-open.What show among the figure is that the SANYE valve is open, and the top 8a of valve and the top 8b of valve insert hollow out zone 7a and hollow out zone 7b just.
The sidewall that can come in contact collision in the support of the present invention on the top with three valves has been held three the bigger hollow out of area zones; like this; corresponding hollow out zone is inserted on the top of three valves just respectively during the SANYE valve-open; bump be can avoid, SANYE valve and support protected valve bracket.
Referring to Fig. 4, be provided with location thorn 9a and location thorn 9b at the position that valve bracket contacts with heart, location thorn 9a and location thorn 9b stretch out and away from the support axis from the valve bracket outer wall is downward-sloping.
Be provided with three location thorns altogether, because 9a and location thorn 9b are stung in rarely seen location among the angle problem figure, three location are stung with three hollow out zones 7 spaced apart.
The length of location thorn is 1cm, for just with processing, the node of the unit grid of support is cut, the freely swinging part of this node top is turned up and has just been formed the location thorn.
The support of valvular prosthetic replacement's device is the state that draws in when not using, it is fine and close tubular structure, be that tubing by metal material forms through Laser cutting, Fig. 5 is the expanded view of the support after cutting, visible three highly different fixedly ears among the figure, wherein fixedly ear 60c is the highest, fixedly ear 60b secondly, and fixedly ear 60a is minimum.
Fixedly the height H 1 of ear 60c be aortic stents 4 the top along and fixedly ear 60c the top along between distance, in the present embodiment fixedly the height of ear 60c be 7mm, fixedly the height of ear 60b is 5mm, fixedly the height of ear 60a is 2.8mm.Support height H2 (fixedly ear does not count) 55mm.
Referring to Fig. 6, the present invention is used for valvular prosthetic replacement's device is delivered to the intravital conveyer device of people, comprising:
Seeker 103;
Sheath 102 in piped;
The support fixing head 105 of band through hole, the outer wall of support fixing head 105 1 ends has the locating slot 107 that matches with the support of valvular prosthetic replacement's device, and the other end is connected with interior sheath 102;
Hauling rope 104, one ends are connected with seeker 103 after passing the through hole of support fixing head 105, and the other end passes interior sheath 102, and interior sheath 102 is socketed in the afterbody of support fixing head 105.
Piped epitheca 101, sheath 102 and support fixing head 105 outsides in being enclosed within.
Seeker 103 is a pyramidal structure, the termination portion of seeker 103 has streamlined contour, can avoid scratching blood vessel, also help guiding whole conveyer device to advance along blood vessel, the afterbody of seeker 103 is a planar structure, be used to push against the support 100 of valvular prosthetic replacement's device, the fixedly ear 60 of support 100 is embedded in the corresponding locating slot 107.
Establish between visible seeker 103 and the support fixing head 105 among Fig. 7 in addition and be connected with core pipe 106, hauling rope 104 passes in core pipe 106, and core pipe 106 is weaved into by fiber, and it is soft again flexible to have good tensile strength.
Visible epitheca 101 can slide vertically with respect to other parts among Fig. 8, away from seeker 103, valvular prosthetic replacement's device is exposed release gradually when sliding backward.
Referring to Fig. 9, Figure 10, for the different fixedly ear of engagement height, the length of the locating slot of support fixing head 105 outer walls also has nothing in common with each other, visible support fixing head 105 has through hole 110 among the figure, be used to pass hauling rope 104, support fixing head 105 is the tubular structures that are made of the head 108 of slightly larger in diameter and the smaller afterbody 109 of diameter, and wherein interior sheath 102 is exactly to be socketed on the afterbody 109 of support fixing head 105.
The length of locating slot described herein is meant along the length of support fixing head 105 axis directions, as being example to adopt support shown in Figure 5, in order to cooperate three highly different fixedly ears, support fixing head 105 outer walls have the shortest locating slot 107a of length, middle locating slot 107b of length and the longest locating slot 107c of length.
Can further find out locating slot 107a in Figure 11~Figure 14, the length of locating slot 107b and locating slot 107c has nothing in common with each other.
In addition among Figure 11 as seen, be pressed in the locating slot for the ease of fixing ear, the position that the locating slot opening part promptly matches with the fixing cervical region of ear has chamfering 111, can guiding fixedly smoothly, ear enters locating slot.
Referring to Figure 15 and Figure 16, turn when advancing for the ease of conveyer device, be provided with bail 120 in the housing that closes on seeker 103 ends of epitheca 101, bail 120 around the axis arranged of epitheca 101 in the housing of epitheca 101, axis along epitheca in the housing of epitheca 101 has passage, this passage one end arrives at bail 120, the other end is along away from the direction of seeker 103 end until epitheca 101 housings, passage is built-in with epitheca hauling rope 121, epitheca hauling rope 121 1 ends are connected with bail 120, the other end stretches out the outside that passage extends to epitheca 101, the part that pulling is stretched out just can directly affect bail 120, because bail 120 closes on seeker 103, can make seeker 103 positions drive whole conveyer device bending under the effect of epitheca hauling rope 121, is convenient to control the turning of conveyer device.
For the ease of the turning of conveyer device, described in sheath, epitheca all adopt elasticity preferably biocompatible material make, concrete selecting for use of material can be adopted prior art.Described bail generally is placed in the housing of epitheca by preembedded mode.
Referring to Figure 17, epitheca 101 requires to keep the hot strength of necessity, also to avoid when it is crooked, keeping the unobstructed of inside, therefore be distributed with spiral metal wire 122 around epitheca 101 axis in the tubular shell of epitheca 101, when epitheca 101 bendings, spiral metal wire 122 can support its housing, keeps the unobstructed of inside.Also be distributed with netted fortifying fibre 123 in the tubular shell of epitheca 101, can make it keep higher draw tensile strength like this, avoid discharging support and cause distortion.
The present invention will at first be loaded on the conveyer device when artificial valve replacement device uses, at first make the support fixing head stretch out epitheca, the fixedly ear that seeker passes behind valvular prosthetic replacement's device the edge, support top of valvular prosthetic replacement's device embeds in the locating slot of support fixing head outer wall, certainly the position of locating slot and shape are big or small matches during with fixing ear, when the height of a plurality of fixedly ears is different, can at first highly the highest fixedly ear be pressed into locating slot when in place, sheath wraps the epitheca fixedly ear that this is in place in twitching then, because other fixedly ear height is lower, therefore when epitheca when fixedly ear wraps with first, can not influence remaining fixedly ear be pressed into corresponding locating slot, next next fixedly ear of height is pressed into corresponding locating slot, in twitching again sheath make epitheca with second fixedly ear wrap, by that analogy by highly one by one that all fixedly ear parcels is in place.
Valvular prosthetic replacement's device stretches to heart inside together with valvular prosthetic replacement's device by femoral artery with conveyer device after loading and finishing, and can cooperate pulling epitheca hauling rope 121 when needing to turn.
After conveyer device arrives the precalculated position, epitheca is drawn back certain distance, valvular prosthetic replacement's device partly is exposed in the human body environment, promptly at first be that part discharges, generally can discharge 1/2 of stent length earlier, d/d part support spreading under the body temperature effect, like this can observe the effect in place of support according to the situation behind the spreading, can spur interior sheath if find position words devious, then drive the support fixing head, because this moment, the fixedly ear of support did not also discharge, still under the parcel of epitheca, be in the locating slot, the support fixing head just can spur fixedly that ear makes support progress into epitheca, under the extruding of epitheca inwall, support can draw the state before being got back to release by the epitheca parcel fully gradually in, then reorientates again, discharge, until valvular prosthetic replacement's device being released in best position.
The artificial valve replacement device of the present invention does not need surgical operation just can replace the cardiac valve of pathological changes, process blood vessel during displacement, generally be to implant heart by femoral artery, and heart and aorta do not need surgical incision, and certain valvular prosthetic replacement's device of the present invention also can be inserted by the mode that spiles with the apex of the heart between chest rib.

Claims (10)

1. the support of convenient valvular prosthetic replacement's device of implanting, described support serve as reasons the successively aortic stents, the valve bracket that connect and flow to and prop up the netted tubular construction that is configured to, it is characterized in that, the top of aortic stents is along being provided with at least two fixedly ears, and fixedly the height on the edge, top of ear is different between two for each.
2. support as claimed in claim 1 is characterized in that the quantity of described fixedly ear is two~four, is evenly distributed on the edge, top of aortic stents.
3. support as claimed in claim 1 is characterized in that, described fixedly ear by head and the cervical region that is used for this head is connected edge, aortic stents top constitute.
4. support as claimed in claim 1 is characterized in that, described fixedly ear is T-shape structure, inverted "L" shaped structure or loop configuration.
5. as each described support of claim 1~4, it is characterized in that be distributed with three hollow out zones at the sidewall of described valve bracket, the vertical position of three valves is corresponding during respectively with the SANYE valve-open.
6. support as claimed in claim 5 is characterized in that, described valve bracket is made of a plurality of unit grids of continuous distribution, and described hollow out zone is made of adjacent some unit grids merging.
7. support as claimed in claim 6 is characterized in that, the described bottom that flows to support inwardly draw in or the outer wall of this bottom parallel with the axis of support.
8. as each described support of claim 7, it is characterized in that, at described valve bracket or flow to the position that support contacts with heart and be provided with the location thorn, this location is stung from valve bracket or is flow to that the outer wall of support is downward-sloping to be stretched out and away from the support axis.
9. support as claimed in claim 8 is characterized in that, the length of described location thorn is 0.3~1.5cm.
10. valvular prosthetic replacement's device is characterized in that, by constituting as each described support of claim 1~9 and the SANYE valve that is fixed in the support.
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CN101897630A (en) * 2010-08-16 2010-12-01 南京微创医学科技有限公司 Flexible compliance endoluminal stent
WO2014146557A1 (en) * 2013-03-18 2014-09-25 杭州启明医疗器械有限公司 Stent and securely-installed artificial valve replacement device having same
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US11944537B2 (en) 2017-01-24 2024-04-02 4C Medical Technologies, Inc. Systems, methods and devices for two-step delivery and implantation of prosthetic heart valve
CN111263622A (en) * 2017-08-25 2020-06-09 内奥瓦斯克迪亚拉公司 Sequentially deployed transcatheter mitral valve prosthesis
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CN109843221A (en) * 2017-09-25 2019-06-04 先健科技(深圳)有限公司 Heart valve
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US11931253B2 (en) 2020-01-31 2024-03-19 4C Medical Technologies, Inc. Prosthetic heart valve delivery system: ball-slide attachment
US11957577B2 (en) 2020-03-31 2024-04-16 4C Medical Technologies, Inc. Systems, methods and devices for delivery systems, methods and devices for implanting prosthetic heart valves
WO2022037242A1 (en) * 2020-08-20 2022-02-24 先健科技(深圳)有限公司 Valve stent and prosthetic heart valve

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