Inner anchor conveying device
Technical Field
The invention belongs to the technical field of medical appliances, and particularly relates to an inner anchor conveying device.
Background
Left ventricular wall tumor (Left ventricular aneurysm, LVA) is a common complication of myocardial infarction. This is because after coronary artery myocardial infarction, partial ventricular muscle ischemia necrosis is caused. The necrotic ventricular muscle loses contractile function and when the heart contracts, this portion of the necrotic myocardium bulges outward, forming a ventricular tumor, also called scar tissue. Due to the compensation effect of the heart, the heart can continuously increase, and heart failure, pulmonary congestion and the like occur.
The left ventricular volume reduction is a ventricular reinforcing method and can be used for solving the scar tissue problem of patients with ischemic cardiomyopathy after myocardial infarction. The left ventricular volume reduction device delivers multiple pairs of anchors (inner and outer). They clamp the left ventricle and allow other surgical instruments to enter the heart through small incisions in the body surface. Such minimally invasive systems may also be used in conventional open chest procedures to effect ventricular repair. The internal anchor conveying device of the ventricular volume reduction device in the current market is generally very complex in structure, a great amount of blood is lost in the operation process, the tie rod of the internal anchor is supported by integral PEEK, the processing finished product is high, the compliance of the guide part of the tie rod is poor, and the operation is inconvenient.
Disclosure of Invention
The invention aims at the technical problem that the structure of an inner anchor conveying device in the prior art is complex, and aims to provide a conveying device with a simple structure.
The inner anchor delivery device of the present invention comprises:
a delivery wire having a distal end insertable within the inner anchor;
A conveying sheath tube, the conveying metal wire is penetrated in the conveying sheath tube;
a handle housing, a proximal end of the delivery sheath being secured to a distal end of the handle housing;
The proximal end of the conveying metal wire is fixed in the pushing tube, and the pushing tube can be axially movably arranged in the handle shell in a penetrating mode.
Preferably, the distal section of the delivery sheath has an anchor slot for receiving the inner anchor, and the distal end of the delivery sheath further has a safety closure.
It is preferred that the first and second heat sinks,
The handle shell is provided with a through hole which is axially arranged;
The pushing block is arranged outside the pushing pipe in an axial mode, is located in the through hole of the handle shell and can axially slide along the through hole.
Preferably, the push tube has:
a push tube body;
The tail cover is connected to the proximal end of the push tube body, and the proximal end of the conveying metal wire penetrates through the push tube body and is fixed on the tail cover through a pin.
Preferably, the proximal section of the push tube protrudes from the proximal end of the handle housing.
Preferably, the distal end of the push tube body is provided with a limiting support ring, and the conveying metal wire passes through the limiting support ring.
Preferably, the inner anchor delivery device further has:
the proximal end of the transition conical tube is connected with the distal end of the handle shell, the distal end of the transition conical tube is fixedly connected with the proximal end of the delivery sheath, and the proximal end of the delivery sheath is fixed at the distal end of the handle shell through the transition conical tube.
Preferably, a stress tube is inserted into the distal end of the transition cone, and the distal end of the transition cone is fixedly connected with the proximal end of the delivery sheath tube through the stress tube.
Preferably, an isolation pad is arranged in the proximal end of the transition conical tube, a sealing pad is arranged on one side of the isolation pad, and the conveying metal wire penetrates through the isolation pad and the sealing pad.
Preferably, the inner anchor has:
an inner anchor body having a contact surface for abutting the left ventricular side wall and a non-contact surface facing away from the contact surface;
A wire hole penetrating the inner anchor body along the length direction of the inner anchor body;
And the hinge end is arranged at the middle position of the non-contact surface.
Preferably, the inner anchor delivery device further has:
A tie rod, the proximal end of the tie rod being hinged to the hinged end of the inner anchor.
Preferably, the inner anchor delivery device has:
and the exhaust valve is integrally communicated and connected with the inside of the transition conical pipe by a TUP pipe.
Preferably, the evacuation valve has:
a valve seat having a seat passage therein;
A directional connector and a first luer connector which are respectively integrally extended from two sides of the valve seat, wherein a connector channel is respectively arranged in the directional connector and the first luer connector, and the directional connector is connected with the TUP pipe;
Wherein, the
Two sides of the valve seat are respectively provided with a transition passage,
One end of the transition channel is in barrier-free communication with the seat channel;
The other end of the transition passage is in barrier-free communication with the joint passage.
Preferably, the inner diameter of one end of the transition passage is the same size as the inner diameter of the seat passage.
Preferably, the inner diameter of the other end of the transition passage is the same as the inner diameter of the joint passage.
Preferably, the inner diameter of the transition channel gradually and continuously increases from one end to the other end, and an angle alpha formed by the side edge of the transition channel and the axis is 5-12 ℃.
It is preferred that the first and second heat sinks,
The valve seat has a core hole perpendicular to the seat passage;
The evacuation valve is further provided with a valve core, the valve core is rotatably arranged in the core hole in a penetrating mode, and the valve core is provided with a core channel which can be communicated with the seat channel in a straight line without obstruction.
Preferably, the evacuation valve further has:
one end of the movable joint is vertically arranged on the valve seat, and a movable channel which can be communicated with the seat channel is arranged in the movable joint.
Preferably, the movable joint is provided with a sealing nut.
Preferably, the inner diameter of the seat channel is 0.5-1:1.
The conveying wire of the present invention is, for example, a steel wire.
The invention has the positive progress effects that:
1) The inner anchor delivery device of the present invention has only a circular handle housing, push tube and transition cone except for the delivery sheath and delivery wire. The structure is very simple, the circular tubular objects are all provided, and the cost is low.
2) The internal anchor delivery device of the invention reduces bleeding by adding the evacuation valve and introducing physiological saline.
3) According to the invention, the push block on the push tube protruding out of the proximal end of the handle shell can be used for rapidly pushing and pulling the conveying metal wire through the movement of the push block, so that the implantation of the inner anchor is controlled.
Drawings
FIGS. 1A-1C are schematic structural views of an inner anchor delivery device according to the present invention;
FIG. 2A is a schematic illustration of the structure of the inner anchor and tie rod of the present invention;
FIG. 2B is a schematic structural view of the tie rod of the present invention;
FIGS. 2C-2D are schematic views of the structure of the inner anchor and tie rod of the present invention on a delivery sheath;
FIG. 3 is a schematic view of a push tube according to the present invention;
fig. 4a to 4b are schematic structural views of the evacuation valve according to the present invention.
Detailed Description
In order that the manner in which the invention is practiced, as well as the features and objects and functions thereof, will be readily understood and appreciated, the invention will be further described in connection with the accompanying drawings.
In the field of interventional medical devices, a "distal" and a "proximal" are defined as the end of the surgical procedure that is distal to the operator, and a "proximal" and a "distal" are defined as the end of the surgical procedure that is proximal to the operator.
In the present invention, unless explicitly specified and limited otherwise, the terms "mounted," "connected," "secured," and the like are to be construed broadly, and are for example, as being fixedly connected, as being detachably connected, as being integrally formed, as being directly connected, as being indirectly connected through intermediaries, as being in communication with each other between two elements or as being in interaction with each other, unless explicitly specified otherwise. The specific meaning of the above terms in the present invention can be understood by those of ordinary skill in the art according to the specific circumstances.
As shown in fig. 1a to 1c, the inner anchor delivery device of the present invention has a delivery wire 10, a delivery sheath 20, a transition cone 30, a handle housing 40, a push tube 50, and an evacuation valve 60. In another preferred example, the inner anchor delivery device may also include an inner anchor 70 being delivered and a tie bar 80.
As shown in fig. 2A, in this example, the minimally invasive interventional medical device to be delivered is an inner anchor 70 on the left ventricular volume reduction device. The inner anchor 70 is generally a flat cuboid shape that can rest against the left ventricular septum and cooperate with the outer anchor that rests against the outer wall of the left ventricle to compress the left ventricle to reduce its volume. The inner anchor 70 has an inner anchor body 71, the inner anchor body 71 having a contact surface for spacing against the left ventricle and a non-contact surface facing away from the contact surface. The wire hole 72 penetrates the inner anchor body 71 along the longitudinal direction of the inner anchor body 72, and the hinge end 73 is provided at a middle position of the non-contact surface. The proximal end of the tie rod 80 is hinged to the hinged end 73 of the non-contact surface of the inner anchor body 71 through a hinge hole.
As shown in fig. 2B, the tie rod 80 functions to puncture the left ventricular septum and the left ventricular outer wall, and the tie rod 80 acts as a bridge across the entire left ventricle. One end of the tie rod 80 is connected to the inner anchor 70 such that the inner anchor 70 rests against the left ventricular septum, the other end of the tie rod 80 that spans the left ventricle is connected to the outer anchor, and the outer anchor is used to compress the left ventricular outer wall, reducing the left ventricular volume. After the left ventricle reaches the proper volume, the outer anchors are locked on the tie-rods 80, and the redundant tie-rods are sheared off, thereby completing the whole left ventricle volume reduction operation. In this example, the tie bar 80 has a square connecting section 81 to which the inner anchor 70 and the outer anchor are fixed, and the tie bar 80 has a circular section 82 with a guide wire passage inside the circular section 82, and the circular section 82 has a guide hole 83 near the square connecting section 81 for the guide wire to pass through. The rounded segment 82 is primarily intended for use in a delivery procedure, requires a certain length, and requires the provision of a guidewire channel for threading the guidewire.
In this example, the delivery wire 10 is an elongated wire or cable as the delivery member for delivering the inner anchor 70. The delivery wire 10 has a distal end that is threaded into the wire bore 72 of the contact surface of the inner anchor 70.
As shown in fig. 2c to 2d, in this example, the delivery sheath 20 is a hollow elongated tube, the delivery wire 10 is inserted through the interior of the delivery sheath 20, the distal section of the delivery sheath 20 has an anchor groove 21 capable of accommodating the inner anchor 70, the shape of the anchor groove 21 matches with that of the inner anchor 70, the inner anchor 70 can be clamped in the anchor groove 21, and thus the inner anchor 70 and the delivery sheath 20 can be fused together better due to the matching of the shapes, so that the whole volume is reduced during delivery, and the delivery is facilitated. The distal end of the delivery sheath 20 also has a safety cap 22 that is over the distal end of the delivery sheath 20. During delivery, the sharp distal end of delivery sheath 20 is prevented from causing secondary injury to the human body.
As shown in fig. 1b to 1c, in this example, the handle housing 40 is a circular hollow tube body, so as to be convenient for holding during the conveying process. The handle housing 40 has a through hole 41 formed therein in the axial direction. The proximal section of the delivery wire 10 is threaded within the handle housing 40. The distal end of the handle housing 40 may be indirectly connected to the proximal end of the delivery sheath 20, particularly in an indirect connection manner referred to as the configuration of the transition cone 30.
As shown in fig. 1 b-1 c and fig. 3, in this example, the body of the push tube 50 is also a circular tube body, which is the push tube body 51, but the outer diameter of the push tube body 51 is slightly smaller than the inner diameter of the handle housing 40. The distal section of the push tube 50 may thus be inserted within the proximal section of the handle housing 40 and may be free to move axially along the handle housing 40. The proximal section of the push tube 50 protrudes from the proximal end of the handle housing 40. The pushing block 52 is axially fixed on the outer wall of the distal section of the pushing tube body 51, for example, fixed on the outer wall of the pushing tube body 51 by using a screw, or integrally formed on the outer wall of the pushing tube body 51, or other connection manners are possible. The push block 52 is located in the through hole 41 of the handle case 40, so that the push block 51 can be pushed axially along the through hole 41. The push tube 50 can be pushed distally within the handle housing 40 by means of the push block 51. The proximal end of the delivery wire 10 extends all the way through the push tube 50 and is secured to the proximal end of the push tube 50. The push tube 50 has a tail cap 53 attached to the proximal end of the push tube body 51. The proximal end of the tail cap 53 and the push tube body 51 may be coupled in a variety of ways, such as by threading, bonding, welding, etc. The proximal end of the delivery wire 10 is threaded into the push tube body 51 and secured to the tail cap 53 by a pin, such as a screw (not shown). The distal end of the push tube body 51 has a limit support ring 511 through which the delivery wire 10 passes to substantially support the delivery wire 10.
As further shown in fig. 1b to 1c, in this example, the inner anchor delivery device further has a transition tapered tube 30, the interior of which is hollow and through which the delivery wire 10 is threaded. The transition cone 30 is generally cone-shaped with a small cylindrical tube section at each of the distal and proximal ends of the cone. The cylinder pipe section of the far end is thinner, and the cylinder pipe section of the near section is thicker and keeps consistent with the inner diameter and the outer diameter of the handle shell. The proximal end of the transition cone 30 is connected to the distal end of the handle housing 40 by a proximal thicker cylindrical tube segment, such as by a snap-in connection with each other, or by a threaded connection, or by welding, bonding, etc. are possible. The proximal end of the transition cone 30 is provided with a spacer 32 at the distal junction of the handle housing 40, and one side of the spacer 32 is provided with a gasket (not shown) in a shape and size consistent with the spacer 32 and arranged side by side. The delivery wire 10 passes through the spacer 32 and the gasket. The spacer 32 and gasket arrangement may provide isolation of the interior of the delivery device from the environment. The stress tube 31 is inserted into the small section of the cylindrical tube body section at the distal end of the transition conical tube 30, the proximal end of the delivery sheath 20 is fixedly connected in the stress tube 31, and the distal end of the transition conical tube 30 is fixedly connected with the proximal end of the delivery sheath 20 by the stress tube 31. The placement of the stress tube 31 reduces kinking of the proximal end of the delivery sheath 20. In this manner, the proximal end of delivery sheath 20 is indirectly connected to the distal end of handle housing 40 by way of transition cone 30.
As shown in fig. 4 a-4 b, in this example, the inner anchor delivery device also has an evacuation valve 60 in communication with the interior of the transition cone 30 via a TUP tube 670. The evacuation valve can be a two-way valve, a three-way valve or a four-way valve. In this example, a three-way valve is taken as an example, a valve seat 620 is provided on the body of the three-way valve, a seat channel 621 is provided in the valve seat 620, for example, the size of the seat channel is set to be 2.7-3.6 mm, and the valve seat 620 has a core hole perpendicular to the seat channel 621. The valve body 630 is rotatably installed in the valve body hole as in the valve body of the related art, and the valve body 630 has a core passage which can be in straight line unobstructed communication with the seat passage 621, e.g., the core passage is identical to the inner diameter of the seat passage 621, thereby unobstructed communication. When the valve core 630 is rotated clockwise, for example, by 90 ° clockwise, the core channel of the valve core 630 is in seamless butt communication with the seat channel 621, so that fluid can smoothly circulate in the three-way valve. When the valve body 630 is rotated counterclockwise, for example, by an angle of 90 degrees, the valve body 630 is completely displaced from the seat passage 621, and the three-way valve is closed.
In this example, the three-way valve body has a directional nipple 640 and a first luer nipple 650 at both sides thereof, respectively, the directional nipple 640 may be connected with a TUP tube 670, the directional nipple 640 integrally extends from one side of the valve seat 620, and a nipple passage 641 is provided inside the directional nipple 640. The first luer 650 integrally extends from the other side of the valve seat 620, the first luer 650 is provided with a joint channel 651 inside, and the inner diameter of the seat channel 621 is 0.5-1:1 as the inner diameters of the joint channels 641 and 651. The valve seat 620 has transition passages 623a, 623b on one side and on the other side, respectively, inside. The inner diameter of one end of the transition channel 623a, 623b is consistent with the inner diameter of the seat channel 621, the inner diameter of the other end of the transition channel 623a, 623b is consistent with the inner diameter of the joint channel 641, 651, so that one end of the transition channel 623a, 623b is in unobstructed communication with the seat channel 621, the other end of the transition channel 623a, 623b is in unobstructed communication with the joint channel 641, 651, and the inner diameters of the transition channel 623a, 623b gradually and continuously increase from one end to the other, for example, the angle alpha formed by the side edges of the transition channel 623a, 623b and the axial lead is between 5-12 ℃, thus forming a straight line type unobstructed communication channel between the whole seat channel 621, the transition channel 623a, 623b and the joint channel 641, 651, fluid can smoothly circulate without resistance in the whole channel, and the possibility of congestion occurrence is reduced.
The three-way connection valve has a second luer 660, the second luer 660 is vertically disposed on the pipe of the directional joint 640, the inner surface of the directional joint 640 has a bayonet, the inside of the bayonet is connected with the TUP pipe 670, the inside diameter of the joint channel 641 of the directional joint 640 is identical with the inside diameter of the TUP pipe 670, and in the case of identical inside diameter, no obstruction flow is formed here.
The foregoing has shown and described the basic principles, principal features and advantages of the invention. It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, and that the above embodiments and descriptions are merely illustrative of the principles of the present invention, and various changes and modifications may be made without departing from the spirit and scope of the invention, which is defined in the appended claims. The scope of the invention is defined by the appended claims and equivalents thereof.