CN203290964U

CN203290964U - Device for loop ligature and closing of left auricle through epicardium under intracardiac assistant positioning

Info

Publication number: CN203290964U
Application number: CN2013203522201U
Authority: CN
Inventors: 孔祥清; 孙伟
Original assignee: Jiangsu Province Hospital
Current assignee: Jiangsu Province Hospital
Priority date: 2013-06-19
Filing date: 2013-06-19
Publication date: 2013-11-20
Anticipated expiration: 2023-06-19

Abstract

Disclosed is a device for loop ligature and closing of a left auricle through an epicardium under intracardiac assistant positioning. The device is composed of a positioner and a loop ligature machine. The device is characterized in that the section of the positioner is in the shape of a rose bud, a groove structure is arranged at a position close to the bottom of the positioner and formed by a plurality of self-expanding shape memory nickel-titanium alloy wires at intervals, and the bottom is connected with an operating rod to be loaded in a catheter for conveying and automatically expands to return to be rose-bud-shaped. Implanting an extra device in a heart cavity is not needed, no residual cavity or residual shunt is left after loop ligature, and thrombus and cardiac tamponade risks are low. The device is convenient to operate, operation risk can be lowered, operation time can be shortened, and operation success rate can be increased.

Description

Under intracardiac auxiliary positioning, the transexocardial cover is pricked the device of sealing left auricle

Technical field

This utility model relates to a kind of medical apparatus and instruments, especially a kind of cardiac treatment assistive device, specifically a kind of for left auricle being overlapped to the bundle sealing, with the device of transexocardial cover bundle sealing left auricle under the intracardiac auxiliary positioning that improves operation efficiency and success rate.

Background technology

As everyone knows, atrial fibrillation is modal arrhythmia clinically.Thrombotic stroke is the major complications that is secondary to atrial fibrillation, is to cause dead and disabled one of the main reasons.Left auricle be atrial fibrillation patients generation thrombosis main position [J. L. Blackshear and J. A. Odell, Annals of Thoracic Surgery, 61 (2): 755 – 759,1996.].The sealing left auricle can effectively reduce the stroke event of patients with atrial fibrillation.At present, be used to the technology of sealing left auricle, comprise: 1. surgery left auricle excision; 2. through the conduit left atrial appendage occlusion.The shortcomings such as the surgical resection left auricle exists wound large, and complication is many are not used substantially.It through the conduit left atrial appendage occlusion, is the new technique that has in recent years just grown up.For clinical left atrial appendage occlusion device, comprise at present: the 1.WATCHMAN stopper, by U.S. Boston Scientific company, produced; 2. AMPLATZER Cardiac Plug (ACP) stopper, produced by U.S. St. Jude Medical company.Yet all there is following shortcoming in above-mentioned two kinds of stoppers: 1. the stopper implantation position is wayward, easily forms the left auricle lumen,residual, causes postoperative thrombosis risk; 2. shutoff is incomplete, has residual leakage, increases the thrombosis risk; 3. after shutoff, there is the thrombosis risk on the apparatus surface; 4. the stopper risk that comes off; 5. in art, postoperative certain cardiac tamponade incidence rate arranged, severe patient needs the emergency treatment open chest surgery to repair.

Summary of the invention

The purpose of this utility model is to have location difficulty for existing left atrial appendage occlusion device, thrombosis, come off and the problem of cardiac tamponade risk, design transexocardial cover under a kind of intracardiac auxiliary positioning and prick the device that seals left auricle, the left auricle looping and binding device that percutaneous puncture, visceral pericardium are implanted, this looping and binding device adopts the cover bundling device of knotting in advance, through interatrial septum, be placed in advance under the guiding of the auxiliary locator in left auricle, by the ligation of left auricle root, sealing left auricle fully.

The technical solution of the utility model is:

Under a kind of intracardiac auxiliary positioning, the transexocardial cover is pricked the device of sealing left auricle, it is comprised of localizer and looping and binding device two parts, it is characterized in that described localizer section is Flos Rosae Rugosae flower bud shape, the fluted structure in nearly bottom, by some self-expanding shape memory nitinol alloy wire intervals, formed, after the attended operation bar of bottom, be loaded in conduit and carry, leave conduit after automatic expansion recover to be Flos Rosae Rugosae flower bud shape.

Described localizer consists of the self-expanding shape memory nitinol alloy wire of 8 intervals 45 degree, and half of the shape of every self-expanding shape memory nitinol alloy wire and Flos Rosae Rugosae flower bud section profile line is identical.

Described looping and binding device consists of set rolling circle and outside control device, the ligature that in set rolling circle, assembling is tied a knot in advance; Ligature is assemblied in delivery sheath with the set rolling circle by medical plastic cement manufacture, and sheath pipe top is equipped with cable cutter, and sheath pipe afterbody is provided be used to controlling set rolling circle size control device, on control device, is furnished with simultaneously ligature tensioner and tangent control device.

The beneficial effects of the utility model:

This utility model need to not be implanted into extra means at the chambers of the heart, and cover is not left over residual cavity or residual leakage after pricking, and thrombosis and cardiac tamponade risk are low.

This utility model is easy to operate, can reduce operation risk, shortens operating time, improves success rate of operation.

The accompanying drawing explanation

Fig. 1 is that this utility model using state is used schematic diagram.

Fig. 2 is the generalized section of localizer of the present utility model.

Fig. 3 is the top view of Fig. 2.

Fig. 4 is the view of localizer of the present utility model in delivery conduit.

Fig. 5 is looping and binding device using state schematic diagram of the present utility model.

Fig. 6 is the enlarged diagram of the control device part on looping and binding device of the present utility model.

The specific embodiment

Below in conjunction with drawings and Examples, this utility model is further described.

As shown in Fig. 1-6.

under a kind of intracardiac auxiliary positioning, the transexocardial cover is pricked the device of sealing left auricle, it is comprised of localizer 1 and looping and binding device 2 two parts, the section of described localizer is Flos Rosae Rugosae flower bud shape 1(Fig. 2), the fluted structure 3 in nearly bottom, self-expanding shape memory nitinol alloy wire 6 intervals by 8 intervals, 45 degree form (as Fig. 3), half of the shape of every self-expanding shape memory nitinol alloy wire 6 and Flos Rosae Rugosae flower bud section profile line is identical, during concrete enforcement, the quantity of the self-expanding shape memory nitinol alloy wire 6 of half Flos Rosae Rugosae flower bud of composition is Self-adjustment as required, as can be 10, 12 ... etc., the top 7 of all self-expanding shape memory nitinol alloy wires 6 is integrally welded, after their bottom 8 is also integrally welded with after action bars 4 is connected, be loaded into the interior conveying of conduit 5 as shown in Figure 4, leave the rear automatic expansion of conduit 5 and return to Flos Rosae Rugosae flower bud shape 1 shown in Figure 2.Described looping and binding device 2 consists of set rolling circle 9 and outside control device 10, the ligature 11 that the interior assembling of set rolling circle 9 is tied a knot in advance; Ligature 11 is assemblied in delivery sheath 12 with the set rolling circle 9 by medical plastic cement manufacture, delivery sheath 12 tops are equipped with cable cutter 13, delivery sheath 12 afterbodys are provided be used to controlling set rolling circle size control device 10, as shown in Figure 5, the flexible control 13 of set rolling circle is installed on control device 10, toe-in tensioner 14, on cable cutter control 15.

Using method of the present utility model is:

As shown in Figure 1, at first periphery and left atrium passage are set up in the percutaneous puncture interatrial septum, along this pathway, send into auxiliary locator, under x-ray and ultrasonic guidance, localizer 1 is positioned in left auricle 16, and the position of adjusting localizer 2 makes its groove structure 3 be positioned at the left auricle root.The percutaneous puncture pericardium, looping and binding device 2 is through pericardium---the visceral pericardium approach, entangle left auricle, and set rolling circle 9 is positioned over the left auricle root, by looping and binding device control 10, shrink the set rolling circle cover and prick groove structure 3 places at localizer 1, toe-in tensioner 14 on operator 10 is progressively strained to knotting, slowly regain simultaneously localizer 1, away from left auricle, after sealing is fully confirmed in x-ray and ultrasonic examination, enable cable cutter control 15 and cut off suture, withdraw from all apparatuses, complete operative treatment.

This utility model does not relate to partly all prior aries that maybe can adopt same as the prior art to be realized.

Claims

1. A device for closing the left atrial appendage by epicardial ligation under intracardiac assisted positioning. It is composed of a locator and a ligation device. It is characterized in that the section of the locator is rose-shaped, and there are The groove structure is composed of several self-expanding shape-memory nickel-titanium alloy wires at intervals. The bottom is connected to the operating rod and then loaded into the catheter for delivery. After leaving the catheter, it automatically expands and restores to a rosette shape.

2. The device for closing the left atrial appendage by transepicardial ligation under assisted intracardiac positioning according to claim 1, characterized in that the locator is composed of 8 self-expandable shape memory nickel-titanium alloy wires at intervals of 45 degrees , the shape of each self-expanding shape-memory nickel-titanium alloy wire is the same as half of the profile line of the rosebud.

3. The device for closing the left atrial appendage through epicardial ligation under intracardiac assisted positioning according to claim 1, characterized in that the ligation device is composed of a ligation ring and an external manipulator, and the ligation ring is assembled Pre-knotted ligature; the ligature is assembled in the delivery sheath along with the ligation ring made of medical plastic, the top of the sheath is equipped with a thread cutter, and the tail of the sheath is equipped with a controller for controlling the size of the ligation ring. Equipped with a ligature tensioner and a thread trimmer controller.