CN102860846A - Tricuspid valve edge-to-edge clip device capable of being implanted through catheter - Google Patents
Tricuspid valve edge-to-edge clip device capable of being implanted through catheter Download PDFInfo
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- CN102860846A CN102860846A CN2012103264318A CN201210326431A CN102860846A CN 102860846 A CN102860846 A CN 102860846A CN 2012103264318 A CN2012103264318 A CN 2012103264318A CN 201210326431 A CN201210326431 A CN 201210326431A CN 102860846 A CN102860846 A CN 102860846A
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Abstract
The invention relates to a tricuspid valve edge-to-edge clip device capable of being implanted through a catheter. The tricuspid valve edge-to-edge clip device comprises a rotating propelling operating rod, a main body support threaded rod and a nickel-titanium alloy dish-shaped dish, wherein the rotating propelling operating rod covers outside a connecting pushing rod, the connecting pushing rod is connected with the main body support threaded rod arranged under the connecting pushing rod through a cylindrical pin arranged at the lower end of the connecting pushing rod, the external side of the main body support threaded rod is in sleeved connection with a rotating support mechanism, connecting rods extending out of two sides of the rotating support mechanism are respectively connected with needle plates on the tricuspid valve arranged at two sides, the lower ends of the needle plates on tricuspid valve is connected with the lower end of the main body support threaded rod, two sides of the lower end of the main body support threaded rod are symmetrically connected with and provided with an outwards-extended base plate under the tricuspid valve, and the middle of the base plate under the tricuspid valve is fixed with the elliptic nickel-titanium alloy dish-shaped dish in a clamping way. The tricuspid valve edge-to-edge clip device is simple in structure, good in biocompatibility and tracing performance, good in mechanical support force, good in compliance and shape memory ability, and has little wound to patients in use.
Description
Technical field
Medical instruments field of the present invention particularly relates to a kind of Tricuspid valve edge-to-edge jaw device that can implant through conduit.
Background technology
Cardiovascular disease is the No.1 killer of present harm humans health, and wherein valvular heart disease has occupied very large proportion.Common valve disease comprises that the function and structure of single or multiple valve structures is unusual.The past people are higher to the degree of concern of aortic valve and mitral valve disease, and new Therapeutic Method emerges in an endless stream, and effectively given treatment to a large amount of valve patients.Along with people's deepening continuously to valvular heart disease understanding, the Tricuspid valve disease more and more receives publicity, and the heart failure problem that especially tricuspid regurgitation is caused is because treatment means is very limited, and the effect extreme difference is becoming the hot issue of present valvular heart disease research field.
The Tricuspid valve anatomical structure comprises lobe ring, lobe leaf, chordae tendineae and papillary muscles.The lobe leaf is comprised of front lobe, back lobe, septal leaflet, and the lobe ring is the attachment margin of three lobe leaves.Minale is inhomogeneous, the most obvious in some position expansion of forward and backward lobe ring in the expansion of nineteen ninety discovery feature tricuspid regurgitation patient's tricuspid annulus, and the septal leaflet cyclic group is originally constant.But after have domestic scholars statistics back lobe ring compared with normal to enlarge 80%, front lobe ring can enlarge 40%, the septal leaflet ring only can enlarge 10% because of the restriction that is subjected to interventricular septum
[18]Thus, the tricuspid valvular insufficiency mainly has obvious expansion at forward and backward lobe ring, in fact only forward and backward valve annulus is formed, and does not process the septal leaflet ring, also is a kind of strategy.The selectivity Tri An that Minale proposes is namely based on such consideration, this operation is exactly in front posterior valve leaflet and front and back lobe boundary the lobe blade root to be cut, select to enlarge the most significant lobe ring portion position and carry out the folded seam contracting, at last remaining lobe ring and lobe leaf are sewed up continuously, finished the reconstruction of dissection and function.Therefore think, the forward and backward lobe leaf of Tricuspid valve is carried out suitable intervention, equally also can reach the purpose of correcting tricuspid incompetence.
At present, the processing of tricuspid incompetence is still take Tri An as main, and the tricuspid valve replacement not only causes conduction block easily, and long-term effect is poor, and mechanical prosthetic valve also relates to the inconveniences such as Anticoagulation, so use clinically less.With the mitral valve incompetence Therapeutic Method be not both, tricuspid valvular insufficiency Therapeutic Method is more, but at present, also is acknowledged as optimal method without any a kind of method.The interventional therapy for valve disease technology that occurs is in recent years obtaining people's common concern, can use the method treatment tricuspid valvular insufficiency of Wicresoft, it is a brand-new problem, because the interventional therapy wound is little, healing is fast, patient is acceptant, can the characteristics such as intervene in early days in pathological changes, determines that this technology will be a kind of revolutionary Therapeutic Method.
The Wicresoft that carries out the Tricuspid valve edge-to-edge gets involved repairs, need to implant a kind of jaw device, this device designing requirement need to be avoided the impact on valvular function on the one hand, on the other hand, need to select to have the material of good biocompatibility, can reach in the short period of time endothelialization, avoid the formation of thrombosis.
Along with the maturation of frontal lobe and the posterior lobe of mitral valve being carried out edge-to-edge's recovery technique through conduit, design the jaw device that meets anterior tricuspid leaflet, posterior lobe anatomical features, carry out through the forward and backward leaf reparation of conduit tricuspid valve, make a hole lobe, become two hole lobes, correct the tricuspid valvular regurgitation, be finish feasible, can imagine that effect is desirable, the more important thing is by less invasive techniques and just can intervene at the early stage of pathological changes generation, the progress of control pathological changes.Particularly along with the progress of material, to develop the Ultimum Ti jaw device and finish feasiblely, operative installations can significantly reduce the generation of this technology complication.
Summary of the invention
Technical problem to be solved by this invention provides a kind of Tricuspid valve edge-to-edge jaw device that can implant through conduit, simple in structure, biocompatibility and spike performance are good, and mechanical support power is good, good compliance and shape memory are arranged, and use procedure is less to the wound that patient causes.
The technical solution adopted for the present invention to solve the technical problems is: a kind of Tricuspid valve edge-to-edge jaw device that can implant through conduit is provided, comprise rotation forward operation bar, connect push rod, body supports threaded rod and Nitinol dished wheel, described rotation forward operation bar is enclosed within the outside that connects push rod, described connection push rod is connected with the body supports threaded rod of below by the straight pin of its lower end, the outside of described body supports threaded rod has been evenly arranged the spiral type projection, the outside of described body supports threaded rod is socketed with rotary support mechanism, the connecting rod that stretch out described rotary support mechanism both sides is connected with the middle hypomere of needle plate on the lobe that lateral symmetry is arranged respectively, and the lower end of needle plate is connected with body supports threaded rod lower end on the described lobe.Both sides, the junction symmetry of needle plate and body supports threaded rod is connected and installed and outwardly directed lobe lower shoe on the described lobe, and the middle part of described lobe lower shoe clamps and is fixed with oval-shaped Nitinol dished wheel.
The lower end intermediate arrangement of described rotation forward operation bar has a circular projection, and the upper end has a dovetail breach in the middle of the described rotary support mechanism, and the size of described dovetail breach and circular projection match.
The lower end of described body supports threaded rod is connected with ball head.
Described rotation forward operation bar can slide up and down in the outside that connects push rod, and needle plate can rotate around its junction point with the body supports threaded rod on the described lobe.
Be evenly arranged several circular buckles on the side relative with the lobe lower shoe on the needle plate on the described lobe, be furnished with the circular hole corresponding with circular buckle on the needle plate on the lobe on the medial surface of described lobe lower shoe.
Describedly turn the forward operation bar, connect push rod, needle plate and lobe lower shoe adopt nickel-titanium alloy material to make on the body supports threaded rod, rotary support mechanism, lobe.
Beneficial effect
The present invention relates to a kind of Tricuspid valve edge-to-edge jaw device that can implant through conduit, it is simple in structure, has the following advantages: 1. have good biocompatibility, can keep effective support of long period; 2. enough mechanical support power, can be in the valve clamping overcome in early days the partial tension that the valve activity causes; 3. have good compliance and shape memory, can compress by delivery sheath and discharge; 4. have good spike performance, convenient by locating under X-ray examination or the ultrasonic guidance.
Description of drawings
Fig. 1 is the decomposing schematic representation of structure of the present invention;
Fig. 2 is the assembling sketch map of structure of the present invention;
Fig. 3 is the scheme of installation of Nitinol dished wheel of the present invention;
Fig. 4 is the sketch map of the supporting structure for conveying of the present invention.
The specific embodiment
Below in conjunction with specific embodiment, further set forth the present invention.Should be understood that these embodiment only to be used for explanation the present invention and be not used in and limit the scope of the invention.Should be understood that in addition those skilled in the art can make various changes or modifications the present invention after the content of having read the present invention's instruction, these equivalent form of values fall within the application's appended claims limited range equally.
Shown in Fig. 1-4, embodiments of the present invention relate to a kind of Tricuspid valve edge-to-edge jaw device that can implant through conduit, comprise rotation forward operation bar 1, connect push rod 2, body supports threaded rod 3 and Nitinol dished wheel 8, described rotation forward operation bar 1 is enclosed within the outside that connects push rod 2, described connection push rod 2 is connected with the body supports threaded rod 3 of below by the straight pin of its lower end, the outside of described body supports threaded rod 3 has been evenly arranged the spiral type projection, the outside of described body supports threaded rod 3 is socketed with rotary support mechanism 4, the connecting rod that stretch out described rotary support mechanism 4 both sides is connected with the middle hypomere of needle plate 9 on the lobe that lateral symmetry is arranged respectively, and the lower end of needle plate 9 is connected with body supports threaded rod 3 lower ends on the described lobe.Needle plate 9 is connected and installed and outwardly directed lobe lower shoe 7 with both sides, the junction symmetry of body supports threaded rod 3 on the described lobe, and the middle part of described lobe lower shoe 7 clamps and is fixed with oval-shaped Nitinol dished wheel 8.The lower end intermediate arrangement of described rotation forward operation bar 1 has a circular projection 11, and the upper end has a dovetail breach 10 in the middle of the described rotary support mechanism 4, and the size of described dovetail breach 10 and circular projection 11 match.The lower end of described body supports threaded rod 3 is connected with ball head 6, several circular buckles 5 have been evenly arranged on the side relative with lobe lower shoe 7 on the needle plate 9 on the described lobe, be furnished with the circular hole 71 corresponding with circular buckle 5 on the needle plate 9 on the lobe on the medial surface of described lobe lower shoe 7, describedly turn forward operation bar 1, connect that needle plate 9 and lobe lower shoe 7 adopt the Ultimum Ti materials to make on push rod 2, body supports threaded rod 3, rotary support mechanism 4, the lobe.
Embodiment 1
(a) set up first tricuspid valvular insufficiency animal model
About healthy experiment goat 40kg, the puncture femoral vein, by femoral vein scabbard is sent into the right room of arrival, become semi-moon shaped coronary artery guiding catheter to send the tricuspid valve by scabbard external plastotype, semi-moon shaped guiding catheter head section catches on chordae tendineae of tricuspid valve, from guiding catheter, send into the Misgurni anguillicaudati seal wire, pass chordae tendineae, withdraw from guiding catheter, send into the right coronary artery angiography catheter along scabbard 12, snare is delivered to Sub-tricuspid from angiography catheter, pull out the Misgurni anguillicaudati seal wire that passes chordae tendineae, slightly exert oneself, break chordae tendineae, withdraw from the sheath pipe.Right ventricle is settled the temporary cardiac pacing moving electrode simultaneously, gives 180 times/minutes 2 weeks of pace-making, confirms that through inspections such as breast color Doppler, radiography, cardiac catheter, dissections model is successfully established.
(b) implantation process of jaw device
Get the experiment sheep of successfully setting up the tricuspid incompetence model, the puncture femoral vein, carry out right room radiography, determine tricuspid position, send into and add hard wire and arrive pulmonary artery, set up delivery track, scabbard is delivered in the right ventricle, to rotate first forward operation bar 1 and fix with being connected push rod 2, and have a dovetail breach 10 with the middle upper end of rotary support mechanism 4 again and be connected.Jaw 14 in the conveyer device sketch map shown in Figure 4 is clamped circular projection 11 places of rotation forward operation bar, along scabbard 12, whole device is delivered to the end of right ventricle sheath pipe, push conveyer device, below Tricuspid valve, discharge first lobe lower shoe 7, pull back and make the lobe lower shoe hold tricuspid valve leaflets, after fixing, recession scabbard 12, rotate handgrip 13 and make the conveyer device rotation, so that forward operation bar 1 and the rotation of rotary support mechanism dovetail breach discharge needle plate 9 on the lobe gradually, it is connected with lobe lower shoe 7, and the clamp valve, unclamp jaw 11, recession rotation forward operation bar 1, push rod 2 is rotatably connected, can body supports threaded rod 3 and ball head 6 be separated by handgrip 13 rotations, so that ball head 6 stays in the body, body supports threaded rod 3 is by withdrawing from external with its fixing connection push rod 2, it is separated with jaw device, discharge jaw device.Postoperative can be assessed by cardiac ultrasonic the function of tricuspid valve.
Claims (6)
1. the Tricuspid valve edge-to-edge jaw device that can implant through conduit, comprise rotation forward operation bar (1), connect push rod (2), body supports threaded rod (3) and Nitinol dished wheel (8), it is characterized in that, described rotation forward operation bar (1) is enclosed within the outside that connects push rod (2), described connection push rod (2) is connected with the body supports threaded rod (3) of below by the straight pin of its lower end, the outside of described body supports threaded rod (3) has been evenly arranged the spiral type projection, the outside of described body supports threaded rod (3) is socketed with rotary support mechanism (4), the connecting rod that stretch out described rotary support mechanism (4) both sides is connected with the middle hypomere of needle plate (9) on the lobe that lateral symmetry is arranged respectively, the lower end of needle plate on the described lobe (9) is connected with body supports threaded rod (3) lower end, needle plate on the described lobe (9) is connected and installed and outwardly directed lobe lower shoe (7) with both sides, the junction symmetry of body supports threaded rod (3), and the middle part of described lobe lower shoe (7) clamps and is fixed with oval-shaped Nitinol dished wheel (8).
2. a kind of Tricuspid valve edge-to-edge jaw device that can implant through conduit according to claim 1, it is characterized in that: the lower end intermediate arrangement of described rotation forward operation bar (1) has a circular projection (11), the upper end has a dovetail breach (10) in the middle of the described rotary support mechanism (4), and the size of described dovetail breach (10) and circular projection (11) match.
3. a kind of Tricuspid valve edge-to-edge jaw device that can implant through conduit according to claim 1, it is characterized in that: the lower end of described body supports threaded rod (3) has been threaded connection ball head (6).
4. a kind of Tricuspid valve edge-to-edge jaw device that can implant through conduit according to claim 1, it is characterized in that: described rotation forward operation bar (1) can slide up and down in the outside that connects push rod (2), and needle plate on the described lobe (9) can rotate around its junction point with body supports threaded rod (3).
5. a kind of Tricuspid valve edge-to-edge jaw device that can implant through conduit according to claim 1, it is characterized in that: needle plate on the described lobe (9) has been evenly arranged several circular buckles (5) on the upper side relative with lobe lower shoe (7), is furnished with the circular hole (71) corresponding with circular buckle (5) on the needle plate (9) on the lobe on the medial surface of described lobe lower shoe (7).
6. a kind of Tricuspid valve edge-to-edge jaw device that can implant through conduit according to claim 1 is characterized in that: describedly turn forward operation bar (1), connect on push rod (2), body supports threaded rod (3), rotary support mechanism (4), the lobe needle plate (9) and lobe lower shoe (7) employing Ultimum Ti material and make.
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Cited By (11)
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CN106175986A (en) * | 2016-07-26 | 2016-12-07 | 复旦大学附属中山医院 | A kind of valve clamping machine |
CN106491245A (en) * | 2015-09-06 | 2017-03-15 | 先健科技(深圳)有限公司 | Valve clamping device |
CN107280713A (en) * | 2017-06-08 | 2017-10-24 | 董念国 | Bicuspid valve clamping machine |
CN107595436A (en) * | 2017-10-19 | 2018-01-19 | 上海捍宇医疗科技有限公司 | A kind of valve clamping machine |
CN107595437A (en) * | 2017-10-27 | 2018-01-19 | 上海捍宇医疗科技有限公司 | A kind of valve clamping system |
CN110338857A (en) * | 2019-08-02 | 2019-10-18 | 上海纽脉医疗科技有限公司 | A kind of leaflet reparation clamper |
CN110664513A (en) * | 2019-08-26 | 2020-01-10 | 科凯(南通)生命科学有限公司 | Conveying device for valve stent |
CN111449708A (en) * | 2019-01-21 | 2020-07-28 | TauPNU医疗有限公司 | Assembled tricuspid valve regurgitation surgical instrument |
WO2021082822A1 (en) * | 2019-10-30 | 2021-05-06 | 杭州德晋医疗科技有限公司 | Adjustable valve clipping system |
WO2021185324A1 (en) * | 2020-03-18 | 2021-09-23 | 杭州德晋医疗科技有限公司 | Valve clamping device and valve clamping system |
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WO2018018873A1 (en) | 2016-07-26 | 2018-02-01 | 复旦大学附属中山医院 | Valve clip |
JP2018525080A (en) * | 2016-07-26 | 2018-09-06 | 復旦大学附属中山医院Zhongshan Hospital Of Fudan University | Valvular closure |
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CN107280713A (en) * | 2017-06-08 | 2017-10-24 | 董念国 | Bicuspid valve clamping machine |
CN107595436A (en) * | 2017-10-19 | 2018-01-19 | 上海捍宇医疗科技有限公司 | A kind of valve clamping machine |
US11602432B2 (en) | 2017-10-19 | 2023-03-14 | Shanghai Hanyu Medical Technology Co., Ltd | Valve clamping device |
CN107595437A (en) * | 2017-10-27 | 2018-01-19 | 上海捍宇医疗科技有限公司 | A kind of valve clamping system |
CN111449708A (en) * | 2019-01-21 | 2020-07-28 | TauPNU医疗有限公司 | Assembled tricuspid valve regurgitation surgical instrument |
CN110338857A (en) * | 2019-08-02 | 2019-10-18 | 上海纽脉医疗科技有限公司 | A kind of leaflet reparation clamper |
CN110338857B (en) * | 2019-08-02 | 2024-03-29 | 上海纽脉医疗科技有限公司 | Clamp holder for repairing valve leaflet |
CN110664513A (en) * | 2019-08-26 | 2020-01-10 | 科凯(南通)生命科学有限公司 | Conveying device for valve stent |
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