CN101152111B - Pulmonary artery coarctation bracket for pulmonary hypertension surgery treatment - Google Patents
Pulmonary artery coarctation bracket for pulmonary hypertension surgery treatment Download PDFInfo
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- CN101152111B CN101152111B CN 200710018613 CN200710018613A CN101152111B CN 101152111 B CN101152111 B CN 101152111B CN 200710018613 CN200710018613 CN 200710018613 CN 200710018613 A CN200710018613 A CN 200710018613A CN 101152111 B CN101152111 B CN 101152111B
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- pulmonary artery
- coarctation
- pulmonary
- stake body
- support
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- 210000001147 pulmonary artery Anatomy 0.000 title claims abstract description 68
- 208000002815 pulmonary hypertension Diseases 0.000 title claims abstract description 20
- 238000001356 surgical procedure Methods 0.000 title abstract description 7
- -1 polytetrafluoroethylene Polymers 0.000 claims abstract description 5
- 229920001343 polytetrafluoroethylene Polymers 0.000 claims abstract description 5
- 239000004810 polytetrafluoroethylene Substances 0.000 claims abstract description 5
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 claims description 9
- 229910052737 gold Inorganic materials 0.000 claims description 9
- 239000010931 gold Substances 0.000 claims description 9
- 238000003466 welding Methods 0.000 claims description 9
- 238000011477 surgical intervention Methods 0.000 claims description 7
- 239000000956 alloy Substances 0.000 claims description 5
- 229940058401 polytetrafluoroethylene Drugs 0.000 claims description 4
- 229920000295 expanded polytetrafluoroethylene Polymers 0.000 claims description 3
- 229950000845 politef Drugs 0.000 claims description 3
- 229910001285 shape-memory alloy Inorganic materials 0.000 claims description 2
- 208000002330 Congenital Heart Defects Diseases 0.000 abstract description 5
- 208000028831 congenital heart disease Diseases 0.000 abstract description 5
- 208000007536 Thrombosis Diseases 0.000 abstract description 4
- 206010020772 Hypertension Diseases 0.000 abstract 1
- 210000004204 blood vessel Anatomy 0.000 abstract 1
- 239000012528 membrane Substances 0.000 abstract 1
- 210000002489 tectorial membrane Anatomy 0.000 abstract 1
- 210000003191 femoral vein Anatomy 0.000 description 10
- 230000005540 biological transmission Effects 0.000 description 6
- 208000003287 Eisenmenger Complex Diseases 0.000 description 4
- 208000020686 Eisenmenger syndrome Diseases 0.000 description 4
- 230000004872 arterial blood pressure Effects 0.000 description 4
- 230000017531 blood circulation Effects 0.000 description 4
- 238000000034 method Methods 0.000 description 4
- 210000000481 breast Anatomy 0.000 description 3
- QSHDDOUJBYECFT-UHFFFAOYSA-N mercury Chemical compound [Hg] QSHDDOUJBYECFT-UHFFFAOYSA-N 0.000 description 3
- 229910052753 mercury Inorganic materials 0.000 description 3
- 208000035478 Interatrial communication Diseases 0.000 description 2
- MWUXSHHQAYIFBG-UHFFFAOYSA-N Nitric oxide Chemical compound O=[N] MWUXSHHQAYIFBG-UHFFFAOYSA-N 0.000 description 2
- 208000001910 Ventricular Heart Septal Defects Diseases 0.000 description 2
- 229910045601 alloy Inorganic materials 0.000 description 2
- 210000001367 artery Anatomy 0.000 description 2
- 208000013914 atrial heart septal defect Diseases 0.000 description 2
- 206010003664 atrial septal defect Diseases 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 238000006073 displacement reaction Methods 0.000 description 2
- 208000003278 patent ductus arteriosus Diseases 0.000 description 2
- 230000037361 pathway Effects 0.000 description 2
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- 210000005241 right ventricle Anatomy 0.000 description 2
- 210000000779 thoracic wall Anatomy 0.000 description 2
- 201000003130 ventricular septal defect Diseases 0.000 description 2
- 241001232809 Chorista Species 0.000 description 1
- 208000032170 Congenital Abnormalities Diseases 0.000 description 1
- 206010011703 Cyanosis Diseases 0.000 description 1
- 206010019280 Heart failures Diseases 0.000 description 1
- 206010039163 Right ventricular failure Diseases 0.000 description 1
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- 210000004013 groin Anatomy 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
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- 210000003516 pericardium Anatomy 0.000 description 1
- 150000003180 prostaglandins Chemical class 0.000 description 1
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Abstract
The present invention belongs to the medical technology field and relates in particular to a blood vessel support for a tectorial membrane implanted in a pulmonary artery for a patient with congenital heart disease pulmonary hypertension, which is a constrictive support used for a surgical treatment of a pulmonary artery hypertension; the invention is characterized in that a pulmonary artery constrictive support body (9) is a hollow body of which the diameter of two ends are large, and the center diameter of the hollow body is small; both ends of the hollow body are provided with a releasable wave-shaped entry (1) and a wave-shaped exit (4); the surface of the pulmonary artery constrictive support body (9) has a polytetrafluoroethylene membrane (3), which adheres in a pulmonary artery and can be accurately positioned; the invention is capable of lowering arising possibility of a thrombus, and is suitable for people of different ages and makes a doctor operation simple and reliable.
Description
Technical field
The invention belongs to field of medical technology, be particularly related to and a kind ofly open the breast mode by femoral vein or surgery, the intravascular stent of the overlay film that the patient who congenital heart disease is merged pulmonary hypertension is implanted in pulmonary artery promptly is used for the constriction support of pulmonary hypertension surgical intervention.
Background technology
Pulmonary hypertension is meant that the caused pulmonary artery pressure persistency of a variety of causes increases, when pulmonary arterial systolic pressure surpasses 4.0 kPas (30 millimetres of mercury), diastolic pressure surpasses and is called pulmonary hypertension when 2.0 kPas (15 millimetres of mercury) or mean pressure are higher than 2.7 kPas (20 millimetres of mercury).Can be divided into constitutional (unknown cause, special send out property) pulmonary hypertension and condary pulmonary hypertension according to cause of disease pulmonary hypertension, wherein because the condary pulmonary hypertension that congenital heart disease causes is the most common, the harm maximum that human health is caused.The condary pulmonary hypertension that congenital heart disease causes, usually because there are the shunting (as atrial septal defect, ventricular septal defect, patent ductus arteriosus etc.) on the left-hand right side in heart inside or trunk level, cause the pulmonary circulation blood flow amount to increase, initial stage is the dynamic property pulmonary hypertension, continue development and can cause that pulmonary artery pressure continues to increase, even surmount aortic pressure, pulmonary vascular resistance raises, cause blood to pass through intracardiac or the two-way or right-left shunt of the outer unusual path generation of the heart, occur cyanosis and right heart failure clinically, be called eisenmenger syndrome.The outer deformity of various intracardiac, the hearts all might develop into eisenmenger syndrome as atrial septal defect, ventricular septal defect, patent ductus arteriosus etc.Eisenmenger syndrome can't be treated by routine operation, generally can only select combined heart and lung transplantation, but the surgery cost height, the survival rate at a specified future date of performing the operation is also lower, and the eisenmenger syndrome patient of operative treatment does not mainly die from heart failure and the Secondary cases pulmonary infection that causes because of pulmonary hypertension.
At present, aspect the pulmonary hypertension that causes of treatment congenital heart disease, medicines such as employing nitric oxide, prostaglandin only can the respite symptom, can not stop further developing of pulmonary hypertension.The surgical intervention aspect can be encircled (banding) operation of contracting with pulmonary artery by the mode of band by the mode of open chest surgery at present.But this method needs general anesthesia, opens breast, and operation wound is big, and cost is high, and the probability that develops complications also obviously increases, and simultaneously, for the patient that needs are performed the operation once more, this method causes the tissue adhesion, has increased the time and the mortality rate of operation once more.
Nearest research attempts to be undertaken by the means of interventional minimally-invasive the surgical intervention of pulmonary hypertension, and its representational example is disclosed in people's such as Hu Xiaoman the utility model patent 03241986.4.This device is the funnel-form support of hollow, utilizes the memorial alloy fabrication techniques, and the porch is a cylindrical portion, and the exit is an infundibulum, and outside overlay film, outer surface have the reversed acanthoid barb to prevent the support displacement.In the real work, will be positioned back release in the pulmonary artery, reach the minimizing PBF, reduce the purpose of pulmonary artery pressure by the femoral vein path.This device has easy to use, high reliability features.But simultaneously owing to be designed to funnel-form, utilize the reversed acanthoid barb to prevent that the technology of support displacement is difficult to guarantee simultaneously inlet and exports combine closely with pulmonary artery simultaneously in actual applications, thereby can cause seepage in various degree to reach the anti-phenomenon of stream, eddy current, increased the formation probability of thrombosis; Be unfavorable for accurately being placed into the position of expection simultaneously; Once more, this device only can be by the femoral vein path with in the support implanting pulmonary artery, has limitation for patients' such as young patient and femoral vein blood vessel be tiny application; At last, device adopts Ultimum Ti to make, though have in the characteristics of 37 ℃ of refresh memory forms, but the quality of alloy is soft partially, be difficult to guarantee closely that with combining of overlay film frame be unfavorable for simultaneously being deployed in fully in the pulmonary artery, what the generation support was shifted may be bigger.
Summary of the invention
At above-mentioned defective, the object of the present invention is to provide a kind of coarctation of pulmonary artery support that is used for the pulmonary hypertension surgical intervention, so that realizing the coarctation of pulmonary artery support firmly is covered in the pulmonary artery, can accurately locatees, can reduce the occurrence probability of thrombosis, adapt to all ages and classes, operation is simple and reliable to make the doctor.
To achieve these goals, the invention provides a kind of coarctation of pulmonary artery support that is used for the pulmonary hypertension surgical intervention, it is characterized in that: coarctation of pulmonary artery stake body 9 is the hollow cavity shape that the two ends diameter is big, mid diameter is little; Two ends have and releasablely are wavy inlet 1 and are wavy outlet 4, and there is poly tetrafluoroethylene 3 on coarctation of pulmonary artery stake body 9 surfaces.
Described coarctation of pulmonary artery stake body 9 is alloy materials.
Described coarctation of pulmonary artery stake body 9 is memory alloy materials.
Described coarctation of pulmonary artery stake body 9 has gold welding mark 8.
Described gold welding mark 8 is at coarctation of pulmonary artery stake body 9 two ends.
Described coarctation of pulmonary artery stake body 9 two ends variation in diameter scopes are between 4mm-30mm.
Described coarctation of pulmonary artery stake body 9 centres and two ends ratio are between 0.1-0.9.
The present invention can be firmly secured to the coarctation of pulmonary artery support in the pulmonary artery because coarctation of pulmonary artery support two ends promptly enter the mouth and/or export and are wavy.The internal diameter of mid-stent is little, controls blood flow in the support by the little cross-sectional area of mid-stent, so that reduce the occurrence probability of thrombosis.The internal diameter of mid-stent has different internal diameter specifications to select, and adapts to the patient of all ages and classes.During conveying, the coarctation of pulmonary artery support of overlay film can close in the sheath pipe external, and cone head, delivery sheath and conveying lever carry out safe implantation by femoral vein path or little otch through the thoracic wall mode, have avoided surgery to open the wound and the related complication of breast.The gold welding mark is all carried out at two ends at support, can know development under the X line, is convenient to accurate location.
Description of drawings
The present invention will be further described below in conjunction with the embodiment accompanying drawing.
Fig. 1 is the structural representation after integrality of the present invention or coarctation of pulmonary artery support are regained fully;
Fig. 2 is the structural representation after coarctation of pulmonary artery support head discharges;
Fig. 3 is the structural representation after the coarctation of pulmonary artery support discharges fully.
Among the figure: 1, inlet; 2, mid-stent; 3, poly tetrafluoroethylene; 4, outlet; 5, cone head; 6, delivery sheath; 7, conveying lever; 8, gold welding mark; 9, coarctation of pulmonary artery stake body.
The specific embodiment
Fig. 1 is described to be that coarctation of pulmonary artery stake body 9 is regained the external structural representation of back in the sheath pipe fully.
Coarctation of pulmonary artery stake body 9 is the hollow cavity shape that the two ends diameter is big, mid-stent 2 diameters are little, and two ends have and releasablely are wavy inlet 1 and are wavy outlet 4, and coarctation of pulmonary artery stake body 9 two ends diameters discharge mobility scales between 4mm-30mm.Centre and two ends rate variable are between 0.1-0.9.There is poly tetrafluoroethylene 3 on coarctation of pulmonary artery stake body 9 surfaces.
It is by carrying body to finish, carrying body to comprise delivery sheath 6, cone head 5 and conveying lever 7 that coarctation of pulmonary artery stake body 9 is packed into.When packing into, coarctation of pulmonary artery stake body 9 is completely retracted in the delivery sheath 6, and coarctation of pulmonary artery stake body 9 is generally collapsible goes into 12-24F delivery sheath 6.Delivery sheath 6 inboards are inserted in cone head 5 bottoms, and conveying lever 7 inserts in delivery sheath 6 opposite sides.All there is gold welding mark 8 at coarctation of pulmonary artery stake body 9 two ends, are convenient to accurately locate under the X line.Coarctation of pulmonary artery stake body 9 two ends diameters are greater than the diameter of mid-stent 2.Inlet 1 interconnects with cone head 5, and outlet 4 is connected with conveying lever 7.Overall package is in delivery sheath 6.
What Fig. 2 provided is that inlet 1 discharges, and coarctation of pulmonary artery stake body 9 begins inwardly to cover politef (ePTFE) film 3 since gold welding mark 8 places, and the application of politef (ePTFE) film 3 can prevent that blood from overlay film frame seepage taking place.Because mid-stent 2 internal diameters are less than the inlet 1 at two ends and the diameter of outlet 4, can control and reduce blood flow in the support by the internal diameter of mid-stent 2.The internal diameter of mid-stent 2 has different internal diameter specifications to select, and adapts to the patient of all ages and classes.
Fig. 3 is described to be structural representation after coarctation of pulmonary artery stake body 9 heads discharge.The coarctation of pulmonary artery support discharges after breaking away from the conveying body, and inlet 1 and exit 4 fully are released into the hole enlargement shape.
Specify using method of the present invention below in conjunction with two kinds of operation plans:
1. the operation plan of coarctation of pulmonary artery support femoral vein pathway:
Under groin, do a stringer otch that is about 4cm, surgery dissecting exposes femoral vein, the puncture femoral vein is set up femoral vein-postcava-right ventricle-pulmonary artery path by seal wire, and coarctation of pulmonary artery support and transmission system are packed in the femoral vein, along the path set up in the X line guiding down with support and transmission system as for pulmonary artery in, discharge support, measure the pressure gradient of the far and near end of main pulmonary artery, remove sheath pipe and transmission system, sew up femoral vein, finish operation.
2. the operation plan of coarctation of pulmonary artery support thoracic wall pathway:
Do a transverse incision that is about 4cm in left border of sternum the 4th intercostal, chorista successively, the suspention pericardium, expose outflow tract of right ventricle and sew up pocket, the puncture outflow tract of right ventricle, set up right ventricle-pulmonary artery path by seal wire, with coarctation of pulmonary artery support and transmission system along the path of having set up in the X line guiding down with support and transmission system as for pulmonary artery in, discharge support, measure the pressure gradient of the far and near end of main pulmonary artery, remove sheath pipe and transmission system, tighten up the pocket that has preset, place drain, successively close otch, finish operation.
The device that the patent of mentioning with background technology relates to is compared, and characteristics of the present invention are can firmly be covered in the pulmonary artery and can accurately locate, and controls and reduces blood flow in the pulmonary artery by shelf inner diameter, reaches the purpose that reduces pulmonary artery pressure.
Claims (1)
1. be used for the coarctation of pulmonary artery support of pulmonary hypertension surgical intervention, it is characterized in that: coarctation of pulmonary artery stake body (9) is the hollow cavity shape that the two ends diameter is big, mid diameter is little; Two ends have and releasablely are wavy inlet (1) and are wavy outlet (4), and the coarctation of pulmonary artery support breaks away from and discharges after carrying body; There is poly tetrafluoroethylene (3) on coarctation of pulmonary artery stake body (9) surface; Coarctation of pulmonary artery stake body (9) is a memory alloy material; Coarctation of pulmonary artery stake body (9) has gold welding mark (8); Coarctation of pulmonary artery stake body (9) two ends variation in diameter scope is between 4mm-30mm; Described coarctation of pulmonary artery stake body (9) centre and two ends ratio are between 0.1-0.9; Described gold welding mark (8) is at coarctation of pulmonary artery stake body (9) two ends; Locate beginning since gold welding mark (8) and inwardly cover politef (ePTFE) film.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 200710018613 CN101152111B (en) | 2007-09-07 | 2007-09-07 | Pulmonary artery coarctation bracket for pulmonary hypertension surgery treatment |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 200710018613 CN101152111B (en) | 2007-09-07 | 2007-09-07 | Pulmonary artery coarctation bracket for pulmonary hypertension surgery treatment |
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| Publication Number | Publication Date |
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| CN101152111A CN101152111A (en) | 2008-04-02 |
| CN101152111B true CN101152111B (en) | 2010-07-14 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 200710018613 Expired - Fee Related CN101152111B (en) | 2007-09-07 | 2007-09-07 | Pulmonary artery coarctation bracket for pulmonary hypertension surgery treatment |
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| CN (1) | CN101152111B (en) |
Cited By (1)
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| CN102462565A (en) * | 2011-10-25 | 2012-05-23 | 张石江 | Recoverable adjustable interventional stent for constriction in blood vessel |
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| CN102462564A (en) * | 2011-10-25 | 2012-05-23 | 张石江 | Recyclable interventional stent for constricting blood vessels |
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| US6120534A (en) * | 1997-10-29 | 2000-09-19 | Ruiz; Carlos E. | Endoluminal prosthesis having adjustable constriction |
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| CN1901851A (en) * | 2003-11-19 | 2007-01-24 | 内奥瓦斯克医疗有限公司 | Vascular implant |
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Cited By (4)
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| CN102462565A (en) * | 2011-10-25 | 2012-05-23 | 张石江 | Recoverable adjustable interventional stent for constriction in blood vessel |
| WO2013060265A1 (en) * | 2011-10-25 | 2013-05-02 | 南京医科大学第一附属医院 | Recyclable and adjustable interventional stent for intravascular constriction |
| EP2772233A4 (en) * | 2011-10-25 | 2015-05-06 | First Affiliated Hospital Nanjing Medical Univ | RECYCLABLE AND ADJUSTABLE INTERVENTIONAL STENT FOR INTRAVASCULAR CONSTRICTION |
| US9814564B2 (en) | 2011-10-25 | 2017-11-14 | The First Affiliated Hospital Of Nanjing Medical University | Recyclable and adjustable interventional stent for intravascular constriction |
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| CN101152111A (en) | 2008-04-02 |
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