JP3174177U - Blood cannula for cardiac surgery - Google Patents

Abstract

There is provided a blood feeding cannula capable of reducing the size of an aortic incision formed for insertion while reducing the blood flow velocity of arterial blood when supplied from the blood feeding cannula.
A large number of small holes 2 are formed on a side surface of a distal end portion of a blood feeding cannula 1 inserted into an aorta from an incision site of the aorta. The diameter and the number of the small holes 2 are set so that the total opening area of the blood feeding cannula 1 into the aorta is larger than the inner diameter cross-sectional area of the blood feeding cannula 1. By using the balloon 3 attached to the blood feeding cannula 1 and the elastic belt 10 wound around the outer periphery of the aorta, the aorta can be blocked.
[Selection] Figure 3

Description

  The present invention relates to a blood cannula for use in cardiac surgery.

  When the heart is opened, arterial blood from the heart-lung machine is supplied to the patient via the blood cannula, and venous blood from the patient is returned to the heart-lung machine via the blood removal cannula. The blood supply cannula is inserted into the aorta (usually the ascending aorta), while the aorta base is blocked by an A0 (Aorta = aorta base) clamp so that arterial blood does not flow back to the heart. .

  Patent Document 1 discloses a contrast catheter for supplying a contrast medium, in which a plurality of small holes are formed in the side surface of the distal end portion so that the contrast medium can be supplied safely and reliably to a desired contrast position. It is disclosed. Patent Document 2 discloses a technique in which a plurality of small holes are formed on the side surface of the distal end of a sheath part for transcutaneously sending blood into a blood vessel so that blood can be smoothly fed into the blood vessel. Has been.

JP 2000-84087 A Japanese Patent Laid-Open No. 3-66379

  The blood cannula is inserted into, for example, the ascending aorta, and the following is desired for this blood cannula. That is, as a first request, the blood flow velocity of arterial blood to be supplied from the blood supply cannula in order to avoid the danger caused by the blood flow velocity of arterial blood supplied from the blood supply cannula into the artery being too fast. It is desired to reduce the size. As a second requirement, in order to prevent or suppress damage to the aorta, it is desired to reduce the incision size of the aorta that is performed when the blood feeding cannula is inserted into the aorta.

  In addition, the clamp using A0 clamp may increase the possibility of damage to the aorta and cause the risk of dropping the adhering material on the inner wall of the aortic base into the blood vessel. In some cases, a technique that can block the aorta without clamping it is desired.

  In order to reduce the blood flow velocity of arterial blood supplied from the blood cannula into the artery, it is conceivable to increase the diameter of the blood cannula. However, in this case, there arises a problem that the size of the incision portion of the aorta necessary for inserting the blood feeding cannula into the aorta is increased. Conversely, if the diameter of the blood cannula is reduced, the incision size of the aorta can be reduced, but the blood flow velocity of arterial blood supplied from the blood supply cannula becomes too large. As described above, if one of the first request and the second request described above is satisfied, the other cannot be satisfied, and the present situation is that the requests are contradictory to each other.

  The present invention has been made in view of the above circumstances. The first object of the present invention is to insert a blood cannula while reducing the blood flow velocity of arterial blood when the blood is supplied from the blood cannula into the artery. An object of the present invention is to provide a blood supply cannula for use in cardiac surgery that can reduce the size of the incision formed in the aorta.

  The second object of the present invention is to be used for a heart operation in which the aorta can be blocked by a completely new technique that is not a clamp type by effectively using the blood cannula capable of achieving the first object. The object is to provide a combination structure of a blood delivery cannula.

In order to achieve the first object, the present invention adopts the following solution. That is, as described in claim 1,
A blood cannula inserted into the aorta from the incision site of the aorta and used for cardiac surgery to supply arterial blood into the aorta,
A number of small holes for arterial blood supply are formed on the side of the tip,
A total opening area into the aorta including the plurality of small holes is larger than an inner diameter cross-sectional area of the blood feeding cannula;
It is like that. According to the above solution, since the total opening area into the aorta including a plurality of small holes is larger than the inner diameter cross-sectional area of the blood feeding cannula, all arterial blood is supplied from the distal opening of the blood feeding cannula. Compared with the conventional case, the blood flow velocity of arterial blood when supplied into the aorta can be reduced. Further, since it is not necessary to increase the diameter of the blood sending cannula, the incision size of the aorta can be reduced.

Preferred embodiments based on the above solution are as described in claims 2 to 7 in the claims. That is,
The total opening area of the large number of small holes is set to be twice or more the inner diameter cross-sectional area of the blood feeding cannula (corresponding to claim 2). In this case, the blood flow velocity of arterial blood supplied from the blood supply cannula into the aorta can be sufficiently reduced while making the blood supply cannula sufficiently small in diameter, and the effect corresponding to claim 1 can be further enhanced. it can.

The blood cannula has a tip opening;
The opening area of the tip opening is smaller than the inner diameter cross-sectional area of the blood cannula,
(Corresponding to claim 3). In this case, it is preferable to prevent a large amount of arterial blood from being partially supplied from the distal end opening of the blood supply cannula.

  The tip of the blood cannula is closed, and a part of the large number of small holes is formed on the closed tip surface (corresponding to claim 4). In this case, a large amount of arterial blood is not supplied from the distal end side of the blood supply cannula, and it is preferable for supplying arterial blood into the aorta by being widely dispersed through a large number of small holes as a whole.

  A balloon that abuts against the inner wall surface of the aorta when inflated and blocks the aorta at the position where it does not interfere with the small hole is disposed at the distal end of the blood cannula (corresponding to claim 5). . In this case, by inflating the balloon, arterial blood can be supplied into the aorta with the tip of the blood cannula properly positioned in the aorta. In addition, the aorta can be blocked by a balloon, and the problems caused by blocking by the clamp can be solved.

  The balloon is positioned on the proximal end side of the blood supply cannula with respect to the small hole (corresponding to claim 6). In this case, a structure suitable for use with the tip of the blood supply cannula facing the heart is provided.

The tip of the blood cannula is occluded,
The balloon is located on the distal side of the blood feeding cannula from the small hole,
(Corresponding to claim 7). In this case, a structure suitable for use in a state where the tip of the blood supply cannula is directed toward the heart is provided.

In order to achieve the second object, the present invention adopts the following solution. That is, as described in claim 8,
A combined structure of a blood-feeding cannula that is inserted into the aorta from the incision site of the aorta and used for cardiac surgery to supply arterial blood into the aorta, and an elastic belt that is wound around the outer periphery of the aorta,
The blood feeding cannula is formed with a large number of small holes for supplying arterial blood on the side surface of the distal end,
The total open area into the aorta including the multiple small holes is larger than the inner diameter cross-sectional area of the blood cannula;
A balloon that contacts the inner wall surface of the aorta when inflated and blocks the aorta at the position where it does not interfere with the small hole is disposed at the distal end of the blood feeding cannula,
The elastic belt is wound around the outer periphery of the aorta at a position corresponding to the balloon, thereby suppressing excessive expansion of the aorta when the balloon is inflated.
It is like that.

  According to the above solution, the elastic belt can reliably prevent the aorta from being excessively inflated by the inflated balloon while obtaining the effect corresponding to the fifth aspect. In particular, even when the inflation pressure of the balloon is increased, since the inflation of the aorta is restricted by the elastic belt, the blocking effect is high. Moreover, since it is an elastic belt, it can be appropriately fitted to the aorta, and the aorta is not damaged by the elastic belt itself.

A preferred mode based on the above solution is as described in claim 9 and subsequent claims. That is,
The elastic belt is
A band-shaped body having elasticity;
One side connection surface formed on one end surface of the main body;
Formed on the back surface of the other end portion of the main body, and connected to the one side connection surface by press contact with the other end side connection surface;
have,
(Corresponding to claim 9). In this case, after the belt-shaped body is wound around the outer periphery of the aorta, the state where the elastic belt is wound around the outer periphery of the aorta can be easily obtained by a simple operation of pressing the one side connection surface and the other side connection surface. Obtainable.

The one side connection surface is a female side surface of the Velcro fastener,
The other side connection surface is a male side surface of the Velcro fastener,
(Corresponding to claim 10). In this case, each connecting surface can be configured using a thin, inexpensive and easily available velcro fastener.

  The width of the main body is made larger than the width of the balloon when inflated (corresponding to claim 11). In this case, it is preferable to easily and easily position the elastic belt at a position corresponding to the position of the balloon.

  ADVANTAGE OF THE INVENTION According to this invention, the size of the incision part formed in an aorta for blood feeding cannula insertion can be made small, reducing the blood flow rate of the arterial blood supplied in aorta from a blood feeding cannula. Further, the blocking of the aorta using a balloon, particularly the blocking of the aorta using both a balloon and an elastic belt, can solve problems that may occur when blocking with a clamp.

The partial cross section side view which shows the front-end | tip part of the blood feeding cannula to which this invention was applied. The partial cross section side view which shows the use condition of the blood feeding cannula shown in FIG. The perspective view which shows an example of the elastic belt shown in FIG. The 2nd Embodiment of this invention is shown, and the partial cross section side view corresponding to FIG.

  In FIG. 1, 1 is a blood-feeding cannula. This blood feeding cannula 1 is formed of an elastic tube as is known. A large number of small holes 2 are formed on the side surface of the distal end portion of the blood feeding cannula 1. Further, the distal end of the blood feeding cannula 1 is closed, and a small hole 2 is formed on the distal end surface. The opening area of each small hole 2 is sufficiently smaller than the inner diameter cross-sectional area of the blood feeding cannula 1. And in embodiment, the opening area of each small hole 2 is made the same, and the total opening area which totaled the opening area of each small hole 2 is made much larger than the internal-diameter cross-sectional area of the blood feeding cannula 1. .

  For example, the inner diameter (diameter) of the blood feeding cannula 1 is 8 mm, the total number of the small holes 2 is 33, and the diameter of each small hole 2 is 2 mm. That is, the inner diameter cross-sectional area of the blood feeding cannula 1 is 50.24 square mm. On the other hand, the opening area of each small hole 2 is 3.14 square mm, and the total number of the small holes 2 is 33. Therefore, the total opening area of many small holes 2 is 103.52 square mm. The total opening area of the large number of small holes 2 is more than twice the inner diameter cross-sectional area of the blood feeding cannula 1.

  A balloon 3 is attached to the blood feeding cannula 1 in the vicinity of a large number of small holes 2 and on the proximal end side. The balloon 3 is set so that its diameter is somewhat larger than the inner diameter of the aorta when inflated. Note that an air supply tube 4 for supplying an inflation gas (usually compressed air) is connected to the balloon 3 along the blood supply cannula 1.

  An elastic belt 10 as shown in FIG. 2 is prepared in association with the balloon 3. The elastic belt 10 has a band-shaped main body 11 made of an elastic sheet having elasticity that can be expanded and contracted. The main body 11 has a one-side connection surface (component member) 12 integrated with the surface of one end thereof. Further, the other side connection surface (component member) 13 is integrated with the back surface of the other end portion of the main body 11. The connecting surfaces 12 and 13 are connected (integrated) by being pressed against each other in a state where they are overlapped with each other. In the embodiment, the connecting surfaces 12 and 13 are configured using a velcro fastener. That is, the one side connection surface 12 is constituted by one side member of the female side and the male side of the Velcro fastener, and is constituted by the other side member of the female side and the male side of the other side connection surface 132 Velcro fastener.

  The length of the main body 10 is longer than the outer peripheral length of the aorta 20. In addition, the width of the main body 10 is larger than the width of the balloon 3 when expanded (the size in the longitudinal direction of the blood feeding cannula 1).

  Next, the operation of the above configuration will be described with reference to FIG. In order to insert the blood feeding cannula 1 into the aorta (ascending aorta) 20, first, the side wall of the aorta 20 is incised (the incision site is indicated by reference symbol α). Next, the blood cannula 1 with the balloon 3 deflated is inserted into the aorta 20 through the incision site α, and the insertion depth is set such that the balloon 3 is inserted into the aorta 20. In addition, at the time of insertion, the front-end | tip of the blood feeding cannula 1 is made to face the opposite side to a heart. In addition, the incision site α is hemostatic by a known method.

  After the distal end portion of the blood feeding cannula 1 including the balloon 3 is inserted into the aorta 20, the elastic belt 10 is wound around the outer periphery of the aorta 20 at a position corresponding to the balloon 3. The connecting surfaces 12 and 13 are used for maintenance. When the elastic belt 10 is wound around the outer periphery of the aorta 20, the elastic belt 10 is in close contact with the aorta 20 so that the aorta 20 is not strongly compressed.

  Thereafter, an inflation gas (CO 2), physiological saline, or the like is supplied to the balloon 3 through the air supply tube 4. As a result, the balloon 3 is inflated, and the inflated balloon 3 strongly contacts the inner wall surface of the aorta 20 as shown in FIG. Even if the balloon 3 is inflated with a large inflation pressure, the elastic belt 10 prevents the aorta 20 from being greatly inflated. Further, since the width of the main body 11 of the elastic belt 10 is larger than the width of the balloon 3, the elastic belt 10 can be easily and reliably positioned at a position corresponding to the balloon 3.

  With the balloon 3, the positioning of the blood cannula 1 in the aorta 20 (positioning in the longitudinal direction and the radial direction of the aorta 20) is properly maintained at a desired position. In particular, the blood feeding cannula 1 is positioned at the radial center of the aorta 20, and a large number of small holes 2 that serve as blood feeding portions from the blood feeding cannula 1 into the aorta 20 are separated from the inner wall of the aorta 20. The state in which blood is smoothly transferred from the small hole 2 into the aorta 20 is ensured.

  In addition, the aorta 20 is blocked by the balloon 3. However, by using the elastic belt 10 in particular, the balloon 3 can be strongly pressed against the inner wall of the aorta 20, and a strong blocking action can be obtained. In such a state, arterial blood is supplied into the blood sending cannula 1, and arterial blood is supplied into the aorta 20 from a large number of small holes 2. Then, the blood flow velocity of arterial blood supplied from the blood cannula 1 into the aorta 20 is sufficiently small, and the danger due to the blood flow velocity being too high is avoided.

  Since it is not necessary to increase the outer diameter of the blood sending cannula 1 in order to decrease the blood flow velocity, the size of the incision site α with respect to the aorta 20 does not need to be larger than before. By increasing the total opening area of the large number of small holes 2, the outer diameter of the blood sending cannula 1 can be reduced, and the size of the incision site α can be made much smaller than before. In order to supply a predetermined amount of arterial blood per unit time into the aorta 20, the flow velocity of the arterial blood flowing in the blood cannula 1 increases as the outer diameter of the blood cannula 1 (inner diameter) decreases. Will be.

  FIG. 4 shows a second embodiment of the present invention. The same components as those of the above embodiment are given the same reference numerals, and the description thereof is omitted. In the present embodiment, the distal end of the blood feeding cannula 1 is completely closed, and the balloon 3 is attached to the distal end side of the blood feeding cannula 1 rather than many small holes 2. That is, there is no arterial blood supply port into the aorta 20 on the tip side of the balloon 3. In this embodiment, the blood feeding cannula 1 is inserted into the aorta 20 so that the balloon 3 faces the heart.

  Here, the distal end opening of the blood feeding cannula 1 is an opening larger than the inner diameter sectional area by using a fully opened one having the same opening area as the inner diameter sectional area of the blood feeding cannula 1 or by obliquely cutting, as in the prior art. It may have an area. Also in this case, by providing a large number of small holes 2, the blood flow velocity of arterial blood supplied into the aorta 20 from the distal end opening of the blood feeding cannula 1 can be reduced. It can be distributed and supplied into the aorta 20. In the case where the blood feeding cannula 1 has an opening at the tip, the opening area of the tip opening is larger than the small hole 2 but may be smaller than the inner diameter cross-sectional area of the blood feeding cannula 1. it can.

  Although the embodiment has been described above, the present invention is not limited to the embodiment, and includes, for example, the following cases. The balloon 3 may be provided but the elastic belt 10 may not be provided (in this case, at least the positioning of the blood feeding cannula 1 in the aorta 20 is ensured). The balloon 3 and the elastic belt 10 may not be provided. The plurality of small holes 2 may be set so as to have a plurality of different opening areas without having the same opening area (for example, a first small hole having a small diameter and a second small hole having a medium diameter). 3 types of small holes, such as a large diameter third small hole). Of course, the purpose of the present invention also implicitly includes providing a substantially preferred or expressed aspect.

  The present invention is suitable as a blood supply cannula for use in cardiac surgery.

α: incision site 1: blood supply cannula 2: small hole 3: balloon 4: air supply tube 10: elastic belt 11: main body 12: one side connection surface 13: other side connection surface

Claims (11)

A blood cannula inserted into the aorta from the incision site of the aorta and used for cardiac surgery to supply arterial blood into the aorta,
A number of small holes for arterial blood supply are formed on the side of the tip,
A total opening area into the aorta including the plurality of small holes is larger than an inner diameter cross-sectional area of the blood feeding cannula;
A blood cannula for use in cardiac surgery. In claim 1,
A blood supply cannula for use in cardiac surgery, wherein the total opening area of the plurality of small holes is at least twice the inner diameter cross-sectional area of the blood supply cannula. In claim 1 or claim 2,
The blood cannula has a tip opening;
The opening area of the tip opening is smaller than the inner diameter cross-sectional area of the blood cannula,
A blood cannula for use in cardiac surgery. In claim 1 or claim 2,
A blood supply cannula for use in cardiac surgery, wherein a tip of the blood supply cannula is closed, and a part of the plurality of small holes is formed on the closed tip surface. In any one of Claims 1 thru | or 4,
A balloon used for cardiac surgery is provided at the distal end of the blood feeding cannula at a position where it does not interfere with the small hole, and a balloon that abuts against the inner wall of the aorta and blocks the aorta when inflated. Blood cannula. In claim 5,
The blood supply cannula for use in cardiac surgery, wherein the balloon is positioned on the proximal end side of the blood supply cannula with respect to the small hole. In claim 3,
The tip of the blood cannula is occluded,
The balloon is located on the distal side of the blood feeding cannula from the small hole,
A blood cannula for use in cardiac surgery. A combined structure of a blood-feeding cannula that is inserted into the aorta from the incision site of the aorta and used for cardiac surgery to supply arterial blood into the aorta, and an elastic belt that is wound around the outer periphery of the aorta,
The blood feeding cannula is formed with a large number of small holes for supplying arterial blood on the side surface of the distal end,
The total open area into the aorta including the multiple small holes is larger than the inner diameter cross-sectional area of the blood cannula;
A balloon that contacts the inner wall surface of the aorta when inflated and blocks the aorta at the position where it does not interfere with the small hole is disposed at the distal end of the blood feeding cannula,
The elastic belt is wound around the outer periphery of the aorta at a position corresponding to the balloon, thereby suppressing excessive expansion of the aorta when the balloon is inflated.
A combined structure of a blood feeding cannula and an elastic belt used for cardiac surgery. In claim 8,
The elastic belt is
A band-shaped body having elasticity;
One side connection surface formed on one end surface of the main body;
Formed on the back surface of the other end portion of the main body, and connected to the one side connection surface by press contact with the other end side connection surface;
have,
A combined structure of a blood feeding cannula and an elastic belt used for cardiac surgery. In claim 9,
The one side connection surface is a female side surface of the Velcro fastener,
The other side connection surface is a male side surface of the Velcro fastener,
A combined structure of a blood feeding cannula and an elastic belt used for cardiac surgery. In any one of Claims 8 to 10,
A combined structure of a blood-feeding cannula and an elastic belt used for cardiac surgery, wherein the width of the main body is larger than the width of the balloon when inflated.

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