CN103431931A - Pulmonary artery support and pulmonary artery valve replacement device with same - Google Patents
Pulmonary artery support and pulmonary artery valve replacement device with same Download PDFInfo
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- CN103431931A CN103431931A CN2013102577057A CN201310257705A CN103431931A CN 103431931 A CN103431931 A CN 103431931A CN 2013102577057 A CN2013102577057 A CN 2013102577057A CN 201310257705 A CN201310257705 A CN 201310257705A CN 103431931 A CN103431931 A CN 103431931A
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Abstract
The invention discloses a pulmonary artery support and a pulmonary artery valve replacement device with the same. The pulmonary artery support comprises a tubular support net rack, an inflow section and an outflow section, wherein the inflow section and the outflow section are connected to two axial ends of the support net rack and are radially expanded to form flareouts; the part, adjacent to the outflow section, of the support network rack is provided with a plurality of first cells distributed in the circumferential direction; the outflow section is composed of a plurality of positioning strips which are sequentially distributed in the circumferential direction of the support network rack; the middle of each positioning strip is bent toward the outflow direction; two ends of each positioning strip are connected with the top points of two separated first cells. The pulmonary artery valve replacement device comprises the pulmonary artery support, and a prosthesis valve fixed in the pulmonary artery support. The pulmonary artery support disclosed by the invention is unlikely to cause damage to blood vessels and has little blocking effect on blood flow.
Description
Technical field
The present invention relates to technical field of medical instruments, relate in particular to a kind of lung arterial support and there is the cusps of pulmonary valve displacement apparatus of this lung arterial support.
Background technology
The cyanotic congenital heart disease patient of stenosis of right ventricular outflow tract, need to implement in early days under extracorporeal circulation and open the breast heart and entangle and control art infant or child.
Modal in the livid purple type Congenital Heart disease of stenosis of right ventricular outflow tract is Fa Luoshi tetra logy (TOF).Child medical center, Shanghai data shows that TOF operation most commonly encountered diseases people's age is 6 months～3 years old, and this age level surgical patient accounts for 74% of total operation number.Classical operation comprises that VSD repairs, the narrow releasing of right ventricular outflow tract obstruction and pulmonary artery (lobe ring and valve).
Usually, most of Fa Luoshi tetra logy merges supravalvular pulmonary stenosis (main pulmonary artery and [Dan arterial bifurcation are narrow), and main the employing from outflow tract of right ventricle (RVOT) enlarges urethroptasty across valve of pulmonary trunk to main pulmonary artery (MPA) and [Dan arterial bifurcation (LPA and RPA) sticking patch.Child medical center, Shanghai data shows: in April, 1999 to 2011 year December, all TOF surgical patients record is transferred 1999,2000, calendar year 2001,2002,2003,2005,2007,2009,2011 and is added up to 9 years statistical number totally 1851 examples, wherein having done this type of sticking patch expansion urethroptasty has 1569 examples, accounts for sum 84.76%.
The sticking patch used in operation, the growth that can not comply with human body, be easy to produce narrow or valve pathological changes again, and with advancing age, the state of an illness can be more and more heavier.In addition, due to without valve, the concurrent serious pulmonary incompetence of postoperative meeting (PR).The PR of severe can cause the right ventricular volume load to roll up, and can cause for a long time the right ventricle chamber to enlarge in the past, and right ventricle shrinks ejection function decline thereupon, and the patient moving tolerance obviously descends, and arrhythmia even occurs.The prompting of foreign study data is as right ventricle End-diastolic volume/body surface area (RV EDV Index)>150ml/m
2the time, the patient even can die suddenly.Therefore, needs of patients is accepted again open chest surgery and is inserted new artificial lung arterial valve.But secondary or perform the operation more than secondary that not only operating difficulty is large, and higher danger and mortality rate are arranged.
Application interventional therapy mode implanting pulmonary artery valve replacement device has not only effectively stopped Pulmonicly backflowing in a large number, improves lung tissue blood circulation and right ventricular function and has reached therapeutic purposes, and avoided open chest surgery again.
Cusps of pulmonary valve displacement apparatus of the prior art, the network of being made by memory metal material, and make in this support can unidirectional opening the SANYE valve form, Figure 10 has shown a kind of lung arterial support of existing cusps of pulmonary valve displacement apparatus, be netted shape of a saddle cylindrical structure, network structure is comprised of regular rhombus, this lung arterial support is positioned at the top that an end end of the close pulmonary artery branch of pulmonary artery is the circumferential rhombus distributed, sharp-pointed and fine and close, in the support dispose procedure, blood vessel is very easily poked at sharp-pointed top, operating difficulty and operation risk have been increased, this place's rhombus of lung arterial support forms fine and close in addition, barrier effect to blood flow is strong, having affected Pulmonic blood flow flows out in the [Dan arterial branch smoothly.
Summary of the invention
The invention provides a kind of lung arterial support, be difficult for blood vessel is damaged, and less to the barrier effect of blood flow.
A kind of lung arterial support, the support rack that comprises tubulose, and be connected to and support the axial two ends of rack and expanded radially is the inflow segment of enlarging and flows out section, the contiguous section position of flowing out of described support rack has the some first module lattice around circumferential distribution, the described section that flows out is by forming around supporting the circumferential some positioning strips that distribute successively of rack, the middle part of each positioning strip is towards flowing out the direction bending, and the two ends of each positioning strip are connected with the summit of two first module lattice separately.
After lung arterial support expands in human body, the radial support power of support (lung arterial support) can make it be fixed on blood vessel, now, the inflow segment of lung arterial support is positioned at outflow tract of right ventricle, and the outflow section is positioned at the position of the contiguous pulmonary artery branch of main pulmonary artery substantially, inflow segment and outflow Duan Jun are enlarging, after making lung arterial support implant, be difficult for being shifted downwards with the motion of heart, and the middle part of each positioning strip can make support effectively be supported on the main pulmonary artery position all towards flowing out the direction bending.After the outflow section is carried out to particular design, can form the hollow out zone between positioning strip and support rack, and the two ends of positioning strip are connected with the summit of two first module lattice separately, not only the quantity of required positioning strip is few, and the area in hollow out zone is larger, reduced the resistance that support causes blood flow, what the assurance blood flow was unimpeded flows into pulmonary artery branch from main pulmonary artery, and the outflow section of this structure is difficult for poking main pulmonary artery or pulmonary artery branch.
Preferably, the described development length of section on the support rack is axial that flow out is less than or equal to inflow segment.Flow out section to support the development length of rack on axially shorter, further reduced the barrier effect to blood flow, also effectively prevented from flowing out the section blood vessel that stabs.Preferably, the development length of described outflow section on the support rack is axial is 1:1～2.5 with the ratio of inflow segment.
Usually, between two first module lattice that are connected with positioning strip, the first module lattice quantity at interval is more, the area in hollow out zone is larger, but the steadiness of support location can be subject to certain impact, therefore, preferably, between between described two first module lattice separately, be separated with first module lattice.
Further preferred, surround the hollow out zone between each positioning strip and support rack, described hollow out zone is surrounded by the base of W shape and the top margin limited by positioning strip, and the two ends of positioning strip are connected across the two-end-point place on W shape base.
The shape of first module lattice there is no strict demand, can be rhombus, ellipse, irregularly shaped etc., due to support before not discharging in compressive state, be the compression performance of raising support, the first module lattice can adopt rhombus.
Preferably, described positioning strip is bent into obtuse angle or circular arc.With acute angle, with right angle, compare, the positioning strip of obtuse angle or circular arc is difficult for poking blood vessel, can more effectively avoid support to damage blood vessel.
Preferably, all positioning strips all wrap up rete.Rete can adopt Cor Sus domestica peplos or other soft films to make, and can further avoid positioning strip to damage blood vessel.
Preferably, the bore of described inflow segment is greater than the bore that flows out section.The dissect physiology structure that not only meets patient, can also prevent that valve from flowing to main pulmonary artery.Be appreciated that it is benchmark that this place's bore all be take diameter maximum separately.
Further preferred, described outflow section is 1:1.05～1.5 with the relative aperture of inflow segment.
Preferably, the end of described inflow segment has the some second unit lattice around circumferential distribution, and the quantity of second unit lattice is greater than positioning strip.The quantity of positioning strip is few, makes the structure of inflow segment sparse, weakens the barrier effect of support to blood flow.
For ease of support is fixed on induction system, the summit of described second unit lattice is with connector.
Preferably, the summit of relative two the second unit lattice in position is with the U-shaped latch fitting.Be easy to install, and the U-shaped latch fitting is level and smooth, survivable outflow tract of right ventricle heart tissue structure.
Further preferred, the base of described U-shaped latch fitting is straight flange.
The present invention also provides a kind of cusps of pulmonary valve displacement apparatus, comprises described lung arterial support, and the prosthetic valve that is fixed on described support rack inside.
Wherein, the support rack of described lung arterial support and the equal overlay film of inflow segment, weak link that can the Enforcement surgery sticking patch.
Prosthetic valve can be made the inwall at lung arterial support, also can adopt existing additive method to install fixing.
If there is no specified otherwise in the present invention, when describing the structure of lung arterial support and cusps of pulmonary valve displacement apparatus, all refer to the structure under complete spreading state in human body.
The present invention carries out appropriate design to the lung arterial support especially section of outflow, has avoided in the implantation process of support stabbing main pulmonary artery or pulmonary artery branch blood vessel, greatly reduces operating difficulty, has evaded operation risk.
Lung arterial support of the present invention effectively reduces the barrier effect to blood flow, has guaranteed that blood flow is unimpeded, and the lung arterial support installation firmly, in vivo firm difficult displacement the in location.
The accompanying drawing explanation
The perspective view that Fig. 1 is lung arterial support of the present invention;
The front view that Fig. 2 is the lung arterial support shown in Fig. 1;
The upward view that Fig. 3 is the lung arterial support shown in Fig. 2;
The top view that Fig. 4 is the lung arterial support shown in Fig. 2;
The perspective view that Fig. 5 is one of them angle of cusps of pulmonary valve displacement apparatus of the present invention;
The perspective view that Fig. 6 is another angle of cusps of pulmonary valve displacement apparatus shown in Fig. 5;
Fig. 7 is the cusps of pulmonary valve displacement apparatus front view shown in Fig. 5;
Fig. 8 is the cusps of pulmonary valve displacement apparatus upward view shown in Fig. 7;
Fig. 9 is the cusps of pulmonary valve displacement apparatus top view shown in Fig. 7;
The structural representation that Figure 10 is lung arterial support in prior art;
Wherein, 1-supports rack; 2-flows out section; The 3-inflow segment; The 4-positioning strip;
5-first module lattice; 6-second unit lattice; 7-U shape latch fitting; The 8-prosthetic valve.
The specific embodiment
Below in conjunction with specific embodiment, the present invention is further explained.
Fig. 1～Fig. 4 shows the structure of the present embodiment lung arterial support, comprises and supports rack 1, inflow segment 3 and flow out section 1.
Flow out section 2 and be connected to and support an axial end and the expanded radially of rack 1 and be enlarging, flowing out section 2 is 1:2.2 supporting the development length of rack on axially with the ratio of inflow segment.Support contiguous section 2 positions of flowing out of rack 1 and have 12 first module lattice 5 around circumferential distribution, these first module lattice 5 assume diamond in shape.Flowing out section 2 consists of six positioning strips 4, these six positioning strips 4 are around supporting circumferentially distributing successively of rack 1, the two ends of each positioning strip 4 all with two separately the summit of first module lattice 5 be connected, be separated with first module lattice 5 between between these two first module lattice 5 separately, the middle part of each positioning strip 4 is bent into obtuse angle towards flowing out direction, and the angle at obtuse angle is 120 °.Thus, surround six hollow out zones between positioning strip 4 and support rack 1.All positioning strips 4 all wrap up the Cor Sus domestica coating layer, and the positioning strip of only take in Fig. 1 describes (other positioning strip situations are identical with it) as example, fills the part parcel Cor Sus domestica coating layer of hatching.
The end of inflow segment 3 has 12 second unit lattice 6 around circumferential distribution, the area of second unit lattice 6 is greater than first module lattice 5, for ease of support, be installed on induction system, as shown in Figure 6, the summit of two second unit lattice 6 that position is relative is with not showing in U-shaped latch fitting 7(Fig. 1～4), the base of this U-shaped latch fitting 7 is straight flange.
The present embodiment also provides a kind of cusps of pulmonary valve displacement apparatus, as shown in Fig. 5～Fig. 9, comprises lung arterial support and prosthetic valve 8.
Lung arterial support can adopt structure recited above, is the weak link of Enforcement surgery sticking patch, the support rack 1 of lung arterial support and the equal overlay film of inflow segment 3, and film can adopt Cor Sus domestica peplos, and the inside of supporting rack 1 is sewed with prosthetic valve 8.
The lung arterial support of the present embodiment can adopt the self-expansion type Ultimum Ti to make, and need not discharge valve by foley's tube, relieve patient ' s burden.The displacement apparatus of valve of pulmonary trunk shown in Fig. 5 of take is example, during use, the valve of pulmonary trunk displacement apparatus is fixed on special induction system, femoral vein first punctures, induction system is being carried the valve of pulmonary trunk displacement apparatus, from the entrance of blood vessel through postcava, right atrium, Tricuspid valve, right ventricle, walk to main pulmonary artery, pulmonary artery branch is adjusted to suitable position, the cusps of pulmonary valve displacement apparatus is discharged gradually, after lung arterial support expands in human body, the radial support power of support can make it be fixed on blood vessel, now, the enlarging of outflow section positioning strip is positioned at the crossover sites of the contiguous pulmonary artery branch of main pulmonary artery, prevent that lung arterial support from gliding being subject to cardiac motion signals influencing, the area in hollow out zone is large, the assurance blood flow is unimpeded, and the outflow section of this structure is difficult for poking main pulmonary artery or pulmonary artery branch, reduced the barrier effect to blood flow.The inflow segment enlarging of lung arterial support is positioned at outflow tract of right ventricle, not easily be shifted by the impact of blood flow after making lung arterial support implant.Obvious, when carrying out the cusps of pulmonary valve displacement, also can adopt other operation pathway.
Claims (10)
1. a lung arterial support, the support rack that comprises tubulose, and be connected to and support the axial two ends of rack and expanded radially is the inflow segment of enlarging and flows out section, the contiguous section position of flowing out of described support rack has the some first module lattice around circumferential distribution, it is characterized in that, the described section that flows out is by forming around supporting the circumferential some positioning strips that distribute successively of rack, the middle part of each positioning strip is towards flowing out the direction bending, and the two ends of each positioning strip are connected with the summit of two first module lattice separately.
2. lung arterial support as claimed in claim 1, is characterized in that, the described development length of section on the support rack is axial that flow out is less than or equal to inflow segment.
3. lung arterial support as claimed in claim 1, it is characterized in that, surround the hollow out zone between each positioning strip and support rack, described hollow out zone is surrounded by the base of W shape and the top margin limited by positioning strip, and the two ends of positioning strip are connected across the two-end-point place on W shape base.
4. lung arterial support as claimed in claim 1, is characterized in that, is separated with first module lattice between between described two first module lattice separately.
5. lung arterial support as claimed in claim 1, is characterized in that, described positioning strip is bent into obtuse angle or circular arc.
6. lung arterial support as claimed in claim 1, is characterized in that, all positioning strips all wrap up rete.
7. lung arterial support as claimed in claim 1, is characterized in that, the bore of described inflow segment is greater than the bore that flows out section.
8. lung arterial support as claimed in claim 1, is characterized in that, the end of described inflow segment has the some second unit lattice around circumferential distribution, and the quantity of second unit lattice is greater than positioning strip.
9. lung arterial support as claimed in claim 8, is characterized in that, the summit of described second unit lattice is with connector.
10. a cusps of pulmonary valve displacement apparatus, is characterized in that, comprise as the described lung arterial support of right 1～9 any one, and the prosthetic valve that is fixed on described support rack inside.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201310257705.7A CN103431931B (en) | 2013-06-25 | 2013-06-25 | Lung arterial support and there is the pulmonary artery valve replacement device of this lung arterial support |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201310257705.7A CN103431931B (en) | 2013-06-25 | 2013-06-25 | Lung arterial support and there is the pulmonary artery valve replacement device of this lung arterial support |
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| CN103431931A true CN103431931A (en) | 2013-12-11 |
| CN103431931B CN103431931B (en) | 2015-10-28 |
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Cited By (9)
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| CN104720937A (en) * | 2015-03-26 | 2015-06-24 | 杭州启明医疗器械有限公司 | Valve support for decreasing compression length and valve replacement device with valve support |
| CN104720936A (en) * | 2015-03-26 | 2015-06-24 | 杭州启明医疗器械有限公司 | Valve stent safe to use and valve replacement device with same |
| CN105287051A (en) * | 2015-09-30 | 2016-02-03 | 复旦大学附属中山医院 | Artificial aortic valve ring system implanted through peripheral arterial approach |
| CN108024850A (en) * | 2015-08-17 | 2018-05-11 | 杭州启明医疗器械有限公司 | Replacement of aorta valve |
| CN113648533A (en) * | 2021-08-26 | 2021-11-16 | 复旦大学 | Transcatheter implanted flexible dual lumen accessory device for providing circulatory power to a Fontan patient |
| US11857441B2 (en) | 2018-09-04 | 2024-01-02 | 4C Medical Technologies, Inc. | Stent loading device |
| US11931253B2 (en) | 2020-01-31 | 2024-03-19 | 4C Medical Technologies, Inc. | Prosthetic heart valve delivery system: ball-slide attachment |
| 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 |
| US11957577B2 (en) | 2017-01-19 | 2024-04-16 | 4C Medical Technologies, Inc. | Systems, methods and devices for delivery systems, methods and devices for implanting prosthetic heart valves |
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| CN108024850A (en) * | 2015-08-17 | 2018-05-11 | 杭州启明医疗器械有限公司 | Replacement of aorta valve |
| CN105287051A (en) * | 2015-09-30 | 2016-02-03 | 复旦大学附属中山医院 | Artificial aortic valve ring system implanted through peripheral arterial approach |
| US11957577B2 (en) | 2017-01-19 | 2024-04-16 | 4C Medical Technologies, Inc. | Systems, methods and devices for delivery systems, methods and devices for implanting prosthetic heart valves |
| 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 |
| US11857441B2 (en) | 2018-09-04 | 2024-01-02 | 4C Medical Technologies, Inc. | Stent loading device |
| US11931253B2 (en) | 2020-01-31 | 2024-03-19 | 4C Medical Technologies, Inc. | Prosthetic heart valve delivery system: ball-slide attachment |
| CN113648533A (en) * | 2021-08-26 | 2021-11-16 | 复旦大学 | Transcatheter implanted flexible dual lumen accessory device for providing circulatory power to a Fontan patient |
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Address after: 310051 311, 3 building, 2 building, 88 Jiangling Road, Binjiang District, Hangzhou, Zhejiang. Patentee after: Hangzhou Qiming Medical Devices Co., Ltd. Address before: 310000 East Building 201, Tax Youyou Building, 3738 Nanhuan Road, Binjiang District, Hangzhou City, Zhejiang Province Patentee before: Hangzhou Qiming Medical Device Co., Ltd. |