CN110123392B - Accurate location aortic valve passes through device - Google Patents

Abstract

The invention provides a device for accurately positioning aortic valve passing through, comprising a main catheter, a support frame and a control guide wire; the main catheter sequentially includes a head end, a pipe body and a tail end; a support frame is connected to the peripheral part of the side wall of the head end; The wire is installed inside the main pipe, the control guide wire is fixed inside the head end, passes through the pipe body, and protrudes from the tail end; the tail end is provided with a support switch and a direction control device, the support switch is connected with the support frame and used to control The opening and closing of the support frame, the direction control device is connected with the control guide wire and used to control the direction of the head end. Aiming at the alignment problem of the aortic valve passing device, the present invention connects the support frame at the head end of the catheter to avoid the problem of slippage of the main catheter; the support frame also plays the role of fixing the movement range of the head end and preventing it from damaging the intima of the blood vessel. It can ensure the success of the operation within the number of times, reduce the pain of the patient, reduce the operation time, and at the same time reduce the exposure time of the patient and the operator under the X-ray, and reduce the operation risk.

Description

A device for precise positioning of aortic valve passage

technical field

The invention relates to the field of medical devices, in particular to a device for accurately positioning aortic valve passing through.

Background technique

Valvular heart disease is a common heart disease, mainly manifested as structural or functional changes in the mitral valve, aortic valve, tricuspid valve and pulmonary valve due to various reasons, resulting in abnormal cardiac hemodynamics and ultimately cardiac exhaustion. The incidence of valvular heart disease also increases markedly with an aging population. Surgical treatment is still the first choice for patients with severe valvular disease, but for patients with advanced age, multi-organ disease, history of thoracotomy, and poor cardiac function, surgical mortality is high, and some patients even lose the opportunity for surgery. . In recent years, transcatheter valve replacement or repair has gradually matured and been widely used, and has become a routine method of heart valve surgery for elderly high-risk patients in Europe and the United States. In 2002, the world's first successful transcatheter aortic valve replacement (TAVR) opened a new era of interventional therapy for valvular disease. So far, 65 countries have carried out TAVR technology, and the cumulative number of patients has exceeded 300,000.

A very critical step in the TAVR operation is to pass the guide wire into the left ventricle through the narrowed aortic valve. Only after this step can be completed, the subsequent steps can be carried out. The existing method is to help select the appropriate transvalvular angle through preoperative imaging evaluation. Using the left coronary angiography catheter as the guiding catheter and using a straight guide wire to repeatedly try to pass through the stenotic aortic valve may sometimes take a long time, and it is related to the experience and strategy of the surgeon, and different guiding catheters need to be replaced if necessary. Trying to do it will undoubtedly increase the operation time, but also increase the risk of surgery. The main reason is that there is no special aortic valve transvalvular guiding catheter, and the existing coronary angiography catheter is mainly used to replace it.

SUMMARY OF THE INVENTION

The purpose of the present invention is to provide a precise positioning aortic valve passing device in order to solve the shortcomings existing in the prior art.

To achieve the above object, the present invention has adopted the following technical solutions:

An accurate positioning aortic valve passing device, comprising a main catheter, a support frame and a control guide wire;

The main pipe sequentially includes a head end, a pipe body and a tail end; the support frame is connected to the periphery of the side wall of the head end, and the support frame is an openable and closable structure. The support frame is clamped on the aortic valve vessel wall; the control guide wire is installed inside the main guide tube, the control guide wire is fixed inside the head end, passes through the tube body, and extends from the tail end Extend; the tail end is provided with a support switch and a direction control device, the support switch is connected with the support frame and used to control the opening and closing of the support frame, and the direction control device is connected with the control guide wire connected and used to control the direction of the head end.

Preferably, the support frame is an open and closed umbrella structure, the support frame includes a support bone, and the support bone is connected at the junction of the head end and the pipe body; when the support bone is closed In the state, the support frame is in close contact with the peripheral portion of the side wall of the head end; when the support bone is in the open state, the support frame abuts against the inner wall of the aortic valve vessel.

Preferably, the support frame is in the shape of a mesh, and the support frame is surrounded by the circumference of the head end; or the support frame is in a radial shape, the support bones are elongated, and the number of the support bones is different. less than 3.

Preferably, the adhering part of the support frame and the inner wall of the aortic vessel is a smooth and soft material.

Preferably, the support frame is embedded in the side wall of the head end, and when the support frame is in a closed state, the outer diameter of the support frame is the same as the outer diameter of the pipe body.

Preferably, the support frame is two airbags arranged on both sides of the head end.

Preferably, the airbag is spindle-shaped.

Preferably, the control guide wire includes a turning node, the turning node is located at the junction of the head end and the tube body, and the turning node is a flexible structure that can rotate 360 degrees.

Preferably, the direction control device is a nut knob or a pull rod, and the rotation of the steering node is controlled by rotating or pulling the control guide wire, so as to realize the rotation of the head end.

Compared with the prior art, the beneficial effects of the present invention are:

Aiming at the alignment problem of the aortic valve passing device, the present invention connects the support frame at the head end of the catheter, and when the catheter extends to the front of the aortic valve, the support frame is stuck on the inner wall of the aortic valve blood vessel, so that the catheter can be stuck, and the catheter will not be stuck because of The impact of blood flow causes the catheter to slip; in addition, the catheter is clamped with a support frame to facilitate the change of direction of the head end, and the valve opening of the aortic valve can be successfully probed in a few times to allow the device to pass through, reducing the pain of the patient and reducing the operation time. time, while reducing the exposure time of the patient and the operator to X-rays, reducing the risk of surgery.

Description of drawings

Fig. 1 is a sectional view of a kind of accurate positioning aortic valve passing device in which the support frame is a mesh structure;

FIG. 2 is a cross-sectional view of a precise positioning aortic valve passing device with a support frame as a balloon.

Detailed ways

In order to have a further understanding of the purpose, structure, features, and functions of the present invention, the following detailed descriptions are given in conjunction with the embodiments.

Please refer to FIG. 1 and FIG. 2 , the present invention provides a device for accurately positioning the aortic valve passing through, including a main catheter 1 , a support frame 2 and a control guide wire 3 .

The main pipe 1 includes a head end 11, a pipe body 12 and a tail end 13 in turn; a support frame 2 is connected to the peripheral part of the side wall of the head end 11, and the support frame 2 is an openable and closable structure. When the support frame 2 is opened, the support frame 2 is stuck on the aortic valve vessel wall; the control guide wire 3 is installed inside the main catheter 1, and the control guide wire 3 is fixed inside the head end 11, passes through the tube body 12, and protrudes from the tail end 13; the tail end 13 is provided with The support switch 131 and the direction control device 132 are connected with the support frame 2 and used to control the opening and closing of the support frame 2 , and the direction control device 132 is connected with the control wire 3 and used to control the direction of the head end 11 .

When in use, the support frame 2 is in a closed state, the catheter penetrates into the patient's body, and the X-ray is guided to reach the aortic valve. The support frame 2 is opened through the support switch 131, and the support frame 2 abuts against the inner wall of the patient's aortic blood vessel. , which can prevent the main catheter 1 from being impacted and retreated due to the blood spurting in the heart, which plays a fixed role. In addition, after the main catheter 1 is fixed by the support frame 2, it will not retreat, and the aortic intima of the patient will not be damaged, causing secondary damage to the patient. After the support frame 2 fixes the head end 11, the control guide wire 3 in the main catheter 1 can be controlled by the direction control device 132 of the tail end 13, so as to control the change of the direction of the head end 11 and adjust the gap on the aortic valve. Accurate to ensure successful alignment of the gap and passage of the main conduit 1 in a small number of trials. After alignment, the support frame 2 can be retracted through the support switch 131, so that the device can pass smoothly.

In one embodiment, the support frame 2 is an open and closed umbrella-like structure, the support frame 2 includes a support bone, and the support frame is connected at the junction of the head end 11 and the pipe body 12; when the support frame is in a closed state, the support frame 2 It is in close contact with the periphery of the side wall of the head end 11; when the supporting bone is in a stretched state, the supporting frame 2 abuts against the inner wall of the aortic valve vessel. The structure of the support frame 2 is similar to that of an umbrella. The support bone and the support switch 131 are connected by connecting rods or guide wires, and finally connected to the support switch 131. The support switch 131 can be toggled up and down or left and right to drive the connecting rod. Or a guide wire to achieve control over the opening and closing of the supporting bone. After the support bone is opened, it abuts against the inner wall of the blood vessel, and fixes the head end 11 of the main duct 1 in the center of the support frame 2, which not only plays a fixing role, prevents the main duct 1 from slipping out, but also prevents the main duct 1 from being in the bloodstream. Shaking from side to side under impact, unable to guide the guide wire through the narrow valve orifice. After the support frame 2 is retracted, it is in close contact with the side wall of the head end 11 of the main catheter 1, which is beneficial to the main catheter 1 passing through the aortic valve smoothly. The material of the scaffold bone can be the same as that of the main catheter 1, and the surface is relatively soft medical silica gel to prevent damage to the intima of the blood vessel.

Further, the support frame 2 is in the shape of a mesh, and the support frame 2 surrounds the circumference of the head end 11; the mesh support frame can further prevent the head end 11 from changing directions to try to align and pass the aortic valve while ensuring the support effect. , Accidentally, the intima of the blood vessel is damaged too much, causing discomfort and injury to the patient. The mesh-shaped support frame 2 does not hinder the flow of blood flow from the heart to the artery, and can also reduce the impact of the blood flow on the body 12 of the main catheter 1 . Alternatively, the support frame 2 is radial, the support bones are elongated, and the number of support bones is not less than three. At least three supporting bones can fix the head end 11 of the main catheter 1 in the center and ensure the stability of the supporting frame 2 .

Preferably, the fitting part of the support frame 2 and the inner wall of the aortic vessel is a smooth and soft material, so that when the support frame 2 is stretched, the support frame 2 abuts against the inner wall of the blood vessel, and the patient will not feel great pain. At the same time, the support frame 2 is close to the side wall of the head end 11 when folded, and the surface will be a little uneven, and the soft material can avoid scratches when the main catheter 1 enters the patient's body and reduce friction.

Preferably, the support frame 2 is embedded in the side wall of the head end 11. When the support frame 2 is in the closed state, the outer diameter of the support frame 2 is the same as the outer diameter of the pipe body 12, that is, the support frame 2 is in close contact with the The thickness of the side wall of the head end 11 is the same as the thickness of the tube body 12 , so that the patient will not be uncomfortable due to the different thickness of the main catheter 1 during use.

In another embodiment, the support frame 2 is two airbags disposed on both sides of the head end 11 ; preferably, the airbags are spindle-shaped. When the support frame 2 is an airbag, the support switch 131 is an inflatable port, and the support switch 131 and the airbag for support are connected by an inflation pipe diameter. The airbag in the closed state has better fit than the umbrella-shaped support frame 2, and causes less irritation to the patient during the insertion of the main catheter 1 into the patient's body. In addition, the balloon sticks to the vessel wall after inflation, which is more stable, and the relatively smoother and softer balloon wall is less irritating than the umbrella-shaped support bone. The spindle-shaped volume balloon can be fixed against the blood vessel wall only by the circle with the largest diameter in the center, not only the diameters at both ends become smaller, but a gap is left so that the blood in the heart can flow to the aorta, and the head end 11 of the main catheter 1 is returned. Allow enough room for maneuver to turn the probe for alignment.

In one embodiment, the control guide wire 3 includes a steering node 31, the steering node 31 is located at the junction of the head end 11 and the tube body 12, the steering node 31 is a flexible structure that can rotate 360 degrees, and the control guide wire 3 is mainly divided into two parts. One section is located inside the head end 11 of the main pipe 1, and another section is located inside the pipe body 12 and the tail end 13 of the main pipe 1, and the middle is connected by the steering node 31, and the rotation of the steering node 31 can drive the entire head end 11 to rotate, The force application point of the entire control guide wire 3 is clarified, making the control more precise and simple. Preferably, the direction control device 132 is a nut knob or a pull rod, and the rotation of the steering node 31 is controlled by rotating or pulling the control guide wire 3 to realize the rotation of the head end 11 . There is a simple mechanical link structure between the direction control device 132 and the control guide wire 3, and the deflection angle of the control guide wire 3 located in front of the steering node 31 and located inside the head end 11 is controlled through the different movement operations of the direction control device 132. The steering node 31 is relatively soft, so the entire control guide wire 3 is bent at the steering node 31 to realize the angle deviation of the head end 11 of the main catheter 1, and different angles can be adjusted during the operation to try.

From the above, the present invention aims at the alignment problem of the aortic valve passing device, and the support frame is connected to the head end of the main catheter. The main catheter is stuck, and the main catheter will not slip due to the impact of blood flow; in addition, the main catheter is clamped with a support frame, the head end of the main catheter is a structure that can change the direction, and the aorta can be successfully probed in a small number of times The valve orifice of the valve allows the device to pass through, reducing pain for the patient, reducing the time of the operation, and reducing the exposure time of the patient and the operator to X-rays. Because the patient's condition is generally more serious, the tolerance is poor, and the operation time is shortened, which can reduce the anesthesia time and reduce the operation risk.

The present invention has been described by the above-mentioned related embodiments, however, the above-mentioned embodiments are only examples for implementing the present invention. It must be pointed out that the disclosed embodiments do not limit the scope of the present invention. On the contrary, changes and modifications made without departing from the spirit and scope of the present invention belong to the scope of patent protection of the present invention.

Claims (5)

1. a precise positioning aortic valve through device, is characterized in that: comprise main conduit, support frame and control guide wire; The main pipe sequentially includes a head end, a pipe body and a tail end; the support frame is connected to the periphery of the side wall of the head end, and the support frame is an openable and closable structure. The support frame is clamped on the aortic valve vessel wall; the control guide wire is installed inside the main guide tube, the control guide wire is fixed inside the head end, passes through the tube body, and extends from the tail end Extend; the tail end is provided with a support switch and a direction control device, the support switch is connected with the support frame and used to control the opening and closing of the support frame, and the direction control device is connected with the control guide wire connected and used to control the direction of the head end; The support frame is an open-close umbrella-like structure, and the support frame includes a support bone, which is connected at the junction of the head end and the pipe body; the support frame is connected to the support switch. They are connected by connecting rods or guide wires, and finally connected to the support switch. The support switch is toggled up and down or left and right to drive the connecting rods or guide wires to control the opening and closing of the support bones; When the support bone is in a closed state, the support frame is closely attached to the peripheral portion of the side wall of the head end; when the support bone is in a stretched state, the support frame abuts against the inner wall of the aortic valve vessel; the support The frame is in the form of a mesh, and the support frame surrounds the circumference of the head end; The control guide wire includes a steering node, the steering node is located at the junction of the head end and the tube body, and the steering node is a flexible structure that can rotate 360 degrees; the control guide wire is mainly divided into two sections , a section is located inside the head end of the main pipe, and another section is located inside the pipe body and the tail end of the main pipe, and the middle is connected by the steering node, and the rotation of the steering node drives the entire head end to rotate; the The direction control device is a nut knob or a pull rod, and the rotation of the steering node is controlled by rotating or pulling the control guide wire, so as to realize the rotation of the head end. 2 . The accurate positioning aortic valve passing device according to claim 1 , wherein the adhering part of the support frame and the inner wall of the aortic vessel is a smooth and soft material. 3 . 3 . The accurate positioning aortic valve passing device according to claim 1 , wherein the support frame is embedded in the side wall of the head end, and when the support frame is in a closed state, the outer surface of the support frame is 3. 4 . The diameter is the same as the outer diameter of the tube body. 4 . The accurate positioning aortic valve passing device according to claim 1 , wherein the support frame is two balloons disposed on both sides of the head end. 5 . 5 . The precise positioning aortic valve passing device according to claim 4 , wherein the balloon is spindle-shaped. 6 .

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