CN110495931A - An Electric Intracardiac Cardiac Cutter - Google Patents

Abstract

The invention relates to an electric intracardiac myocardial cutter, which comprises a shell, and also includes a puncture needle assembly coaxially arranged from inside to outside, a cutting knife assembly, and an outer tube assembly. One end of the outer tube assembly is fixedly connected to the shell, and the other end Sealing, the side of the sealing end is provided with a cutting window and a negative pressure suction window, and the needle head of the puncture needle assembly and the blade of the cutting knife assembly are matched with the cutting window; connection; the cutting knife assembly is connected with the cutting knife drive assembly, and the puncture needle assembly is connected with the puncture needle drive assembly; it also includes a negative pressure suction component, which includes a negative pressure tube, and one end of the negative pressure tube is sealed and connected with the negative pressure suction window, The other end is connected to an external negative pressure machine and a syringe. The invention is easy to operate, can accurately cut the myocardium, has a small wound, and facilitates postoperative recovery; integrates the functions of tissue cutting and recovery, and prevents peripheral arterial embolism caused by the loss of the cut myocardial tissue.

Description

An Electric Intracardiac Cardiac Cutter

technical field

The invention relates to the technical field of minimally invasive heart surgery instruments, in particular to an electric intracardiac myocardial cutter.

Background technique

The current treatment methods for hypertrophic obstructive cardiomyopathy mainly include drug therapy, dual-chamber pacing therapy, transcoronary septal alcohol ablation and open septal myectomy (Morrow procedure and modified Morrow procedure). Among them, drugs and dual-chamber pacing can only reduce myocardial oxygen consumption to a certain extent, relieve symptoms of heart failure, and enhance the patient's exercise tolerance, but cannot fundamentally eliminate the cause. Alcohol ablation injects absolute alcohol into the first septal branch of the left anterior descending coronary artery to cause partial myocardial infarction and thin the basal segment of the hypertrophic interventricular septum, thereby reducing left ventricular outflow tract obstruction. However, this method still has great limitations: ①It may lead to myocardial infarction in non-target areas, causing abnormal myocardial movement and aggravating the condition; ②High incidence of complications such as atrioventricular block and ventricular arrhythmia due to myocardial scar formation; ③Due to the The variation of the first septal branch makes about 5% to 8% of patients not suitable for alcohol ablation; ④The short-term and long-term curative effect is inferior to that of open ventricular septal myectomy; ⑤Unable to deal with mitral papillary muscle deformity and complicated valves Abnormal structure. In addition, a small number of heart centers have tried to perform radiofrequency ablation of the ventricular septum through percutaneous catheters, but due to many complications, it has not been widely used. Therefore, septal myectomy remains the best treatment for hypertrophic obstructive cardiomyopathy.

Nevertheless, the traditional ventricular septal myectomy still faces many problems: ①Because the heart is resected in a stopped state, the thickness and texture of the heart are different from those in a beating state, and the extent of resection is difficult to evaluate before operation; It completely depends on the experience of the surgeon, so only a very small number of experienced cardiac centers can perform the operation well, and it is difficult to popularize; ②After the resection, the resection effect cannot be evaluated in real time, and if the resection is too wide, it may lead to ventricular septal perforation and conduction bundle injury, and incomplete resection will lead to poor surgical efficacy; ③ median thoracotomy, open heart surgery and surgical trauma caused by cardiopulmonary bypass, myocardial injury and systemic inflammatory response. Therefore, the surgical method of ventricular septal myectomy still needs to be improved urgently, and the supporting surgical instruments also need to be improved urgently. At present, there is an urgent need for a surgical instrument that is simple to operate, less traumatic, conducive to patient recovery, and can accurately cut the myocardium. After completion, it is also a problem to be solved to prevent the detached myocardium from entering the blood vessel to form embolism.

Contents of the invention

Aiming at the technical problems existing in the prior art, the present invention provides an electric intracardiac myocardium cutter, which is easy to operate, can complete the myocardium resection operation only through a small incision, and has precise positioning, and will not cut abnormal parts by mistake. The target area is resected, and after the resection is completed, the detached myocardial tissue is fixed and adsorbed in the cavity of the outer tube assembly by means of negative pressure suction to prevent it from entering the blood vessel and preventing the detached myocardium from causing vascular embolism.

The technical solution of the present invention to solve the above-mentioned technical problems is as follows: an electric intracardiac myocardial cutter, including a shell, and also includes a puncture needle assembly, a cutting knife assembly, and an outer tube assembly coaxially arranged from the inside to the outside. Sliding fit between any two, one end of the outer tube assembly is fixedly connected to the housing, the other end of the outer tube assembly is set as a sealing end, and the sealing end is provided with a cutting window and a negative pressure suction window, so The puncture needle assembly includes a needle head and a needle shaft that are fixedly connected in sequence, and the needle head of the puncture needle assembly and the blade of the cutting knife assembly are matched in the cutting window; a cutting knife driving assembly, a puncture needle A driving assembly and a controller, the cutting knife driving assembly and the puncture needle driving assembly are respectively electrically connected to the controller; the end of the cutting knife assembly away from the blade is connected to the cutting knife driving assembly, so One end of the puncture needle assembly away from the needle head is connected to the puncture needle driving assembly; a negative pressure suction assembly is also included, and the negative pressure suction assembly includes a negative pressure tube, and one end of the negative pressure tube is connected to the negative pressure suction The window is sealed and connected, and the other end of the negative pressure tube is connected to an external negative pressure machine.

The invention is easy to operate and reliable in use. Under the guidance of esophageal ultrasound, it can accurately cut the myocardial target area. At the same time, it can monitor the pressure difference of the left ventricular outflow tract in real time through ultrasound to determine the amount of myocardium to be cut without accidental injury. To the myocardium of the non-target area, the operator does not need to rely on experience to judge the amount of myocardium to be resected, which increases the safety of the operation; and the volume of the part that needs to be inserted into the chest cavity of the present invention is small, and the operation can be completed with only a small wound , which is beneficial to the postoperative rehabilitation of patients; it integrates the functions of tissue harvesting and recovery to prevent peripheral arterial embolism caused by the shedding of the harvested myocardial tissue.

On the basis of the above technical solutions, the present invention can also be improved as follows.

Preferably, the cutter assembly includes a coaxial cutter barrel and a hollow screw, one end of the cutter barrel is set as an annular blade, and the other end is airtightly connected to the end of the hollow screw, and the hollow screw is far away from the One end of the knife barrel is slidably and airtightly connected with the outer wall of the puncture needle assembly. The cutting knife assembly and the outer tube assembly are also airtightly connected through the second sealing plug, and the end of the hollow screw rod and the needle bar of the puncture needle assembly are airtightly connected through the first sealing plug. Prevent high-pressure blood from rushing out through the gap between the outer tube assembly, cutting knife assembly, and puncture needle assembly during operation.

Preferably, the cutter drive assembly includes a first micro motor, a driving gear, and a driven gear, the first micro motor is fixedly mounted on the housing, and the output shaft of the first micro motor is connected to the driving gear. Coaxially arranged and fixedly connected, the driving gear meshes with the driven gear, and the hollow screw is coaxially arranged with the driven gear; the hollow screw is provided with a straight groove and a threaded groove in sequence, and the straight The groove is arranged parallel to the central axis of the hollow screw, and the driven gear is provided with a first pin, which slides and fits with the straight groove; a second pin is fixedly installed on the shell, and the first pin The two pins cooperate with the thread grooves of the hollow screw. Under the control of the controller, the cutting knife driving assembly drives the first micro motor to perform forward and reverse rotation. Under the action of the gear transmission, the hollow screw rotates forward or backward, thereby driving the blade of the cutting knife assembly to rotate and cut or retreat.

Preferably, the puncture needle drive assembly includes a second micromotor, a lead screw, and a slider, the second micromotor is fixedly mounted on the housing, and the output shaft of the second micromotor is the same as that of the lead screw. The shaft is set and fixedly connected, the slider is provided with a through hole, the through hole is provided with an internal thread, the internal thread is matched with the screw, and the slider is connected to the outer wall of the puncture needle assembly Fixed connection. Under the control of the controller, the puncture needle driving assembly can be rotated forward and reverse, so as to achieve the technical effect of driving the puncture needle assembly forward or backward through the lead screw, so as to locate the target area.

Preferably, the negative pressure suction mechanism further includes a three-way connector, the puncture needle assembly is a hollow structure, and the first end of the three-way connector is airtightly connected to the end of the puncture needle assembly away from the needle The second end of the three-way connector is airtightly connected to the negative pressure suction window, and the third end of the three-way connector is airtightly connected to an external negative pressure machine. When cutting, the negative pressure machine generates negative pressure, so that the myocardium is effectively fixed under the negative pressure suction of the puncture needle assembly and the negative pressure tube to prevent displacement and facilitate more accurate cutting; Next, the cut myocardium is taken out of the wound by a cutter to prevent vascular embolism.

Preferably, the third end of the three-way connector is also connected to a syringe, and the syringe, the negative pressure machine, and the third end of the three-way connector are connected through a three-way valve. When the cutter of the present invention is liquid-sealed, close the negative pressure machine, open the syringe, and pre-fill the heparin saline to eliminate the gas in the cutter, and then control the cutter assembly to rotate and advance until the requirement of liquid seal is reached; at the same time Heparin saline is used to remove the gas in the negative pressure tube through the negative pressure tube.

Preferably, the cutting edge of the cutting knife assembly is an annular cutting edge. Under the driving action of the cutter driving assembly, the annular blade can accurately cut off the myocardium in the target area when it rotates and advances.

Preferably, the sealing end of the outer tube assembly is configured as a tapered bullet. The head end of the outer tube assembly is sealed and bullet-shaped, which is convenient for insertion into the heart cavity and at the same time avoids damage to other tissues in the heart cavity.

Preferably, the inner side of the sealing end of the outer tube assembly is also provided with a silicone pad, and the silicone pad is fixedly connected with the cutting window. Cooperate. The silicone liner is located on the upper edge of the cutting window. The silicone liner can be used as a cutting board to provide reverse shearing force for the circular blade when cutting tissue, making it easier to cut muscle tissue, and at the same time provide a liquid seal for the cutting knife assembly.

Preferably, the negative pressure tube is arranged along the outer wall of the outer tube assembly. When the operation is performed, the negative pressure tube is along the outer wall of the outer tube, which reduces the resistance when the device extends into the wound during the operation, and can further reduce the size requirement of the wound, which is beneficial to the recovery of the patient.

Preferably, a control panel is provided on the housing, and a control button is provided on the control panel, and the control button is connected to the controller. Through the control buttons on the operation panel, the operator can conveniently control the puncture needle assembly to advance or retreat, and the cutting knife to rotate forward or backward, so as to complete the positioning and cutting of the target area.

Preferably, the housing is further provided with a power interface, and the controller is connected to a power supply through the power interface. In order to ensure the stability of the operation of the cutter, an external power supply is used to power the cutter.

The beneficial effects of the present invention are: the present invention is easy to operate and reliable in use. Under the guidance of esophageal ultrasound, it can accurately cut the myocardial target area. While cutting, it can monitor the pressure difference of the left ventricular outflow tract in real time through ultrasound to determine the target area to be cut. The amount of myocardium will not accidentally injure the myocardium of the non-target area, and the operator does not need to rely on experience to judge the amount of myocardium to be resected, which increases the safety of the operation; The operation can be completed through the wound, which is beneficial to the postoperative recovery of the patient; the function of tissue cutting and recovery is integrated to prevent the loss of the cut myocardial tissue and cause peripheral artery embolism.

Description of drawings

Fig. 1 is a schematic diagram of the external structure of the present invention;

Fig. 2 is a schematic diagram of the kinematic mechanism of the present invention;

Fig. 3 is a schematic diagram of an oblique view of the kinematic mechanism of the present invention;

Fig. 4 is an enlarged view of the structure of part A in Fig. 3 of the present invention;

Fig. 5 is a schematic structural view of the driven gear of the present invention;

Fig. 6 is a schematic diagram of the structure of the cutting window of the present invention;

Fig. 7 is a structural schematic diagram of the negative pressure suction assembly of the present invention;

Fig. 8 is a structural schematic diagram of the cutting knife assembly of the present invention;

Fig. 9 is a block diagram of the system structure of the present invention.

In the accompanying drawings, the list of parts represented by each label is as follows:

1. Shell, 101. Control panel, 102. Control button, 2. Outer tube assembly, 201. Sealing end, 202. Cutting window, 203. Negative pressure suction window, 204. Silicone pad, 3. Cutting knife assembly, 301 , circular blade, 302, knife barrel, 4, puncture needle assembly, 401, needle head, 402, needle bar, 5, cutter driving assembly, 501, first micro motor, 502, driving gear, 503, driven gear, 504 , hollow screw, 505, first sealing plug, 506, first coupling, 507, second sealing plug, 508, first pin, 509, second pin, 6, puncture needle driving assembly, 601, second micro Motor, 602, lead screw, 603, slider, 604, second coupling, 7, negative pressure suction assembly, 701, negative pressure tube, 702, three-way connector, 703, negative pressure machine, 704, syringe, 705, three-way valve, 8, controller, 9, power supply.

Detailed ways

The principles and features of the present invention are described below in conjunction with the accompanying drawings, and the examples given are only used to explain the present invention, and are not intended to limit the scope of the present invention.

An electric intracardiac myocardial cutter as shown in Figures 1 to 8 includes a housing 1, and a puncture needle assembly 4 coaxially arranged from inside to outside, a cutting knife assembly 3, and an outer tube assembly 2. Sliding fit between any adjacent two, one end of the outer tube assembly 2 is fixedly connected to the housing 1, the other end of the outer tube assembly 2 is set as a sealing end 201, and the side of the sealing end 201 is provided with The cutting window 202 and the negative pressure suction window 203, the puncture needle assembly 4 includes a needle head 401 and a needle bar 402 fixedly connected in sequence, the needle head 401 of the puncture needle assembly 4, the blade of the cutting knife assembly 3 The window 202 matches; the casing 1 is provided with a cutting knife driving assembly 5, a puncture needle driving assembly 6, and a controller 8, and the cutting knife driving assembly 5 and the puncture needle driving assembly 6 are respectively connected to the controller 8. Electric connection, because the function of this cutter is relatively simple, controller 8 adopts commonly used ARM9 single-chip microcomputer and gets final product; On described cutter assembly 3, one end away from described blade is connected with described cutter drive assembly 5, and described puncture needle One end of the component 4 away from the needle 401 is connected to the puncture needle drive component 6; it also includes a negative pressure suction component 7, which includes a negative pressure tube 701, and one end of the negative pressure tube 701 is connected to the The negative pressure suction window 203 is sealed and connected, and the other end of the negative pressure tube 701 is connected to an external negative pressure machine. The negative pressure suction window 203 is a plurality of small through holes scattered and distributed on the side of the sealing end 201 of the outer tube assembly 2 , and the multiple small through holes are located within the nozzle range of the negative pressure tube 701 .

In this embodiment, the cutter assembly 3 includes a coaxial cutter cylinder 302 and a hollow screw 504, one end of the cutter cylinder 302 is set as an annular blade 301, and the other end is airtightly connected with the end of the hollow screw 504 The end of the hollow screw 504 away from the knife barrel 302 is slidably and hermetically connected to the outer wall of the puncture needle assembly 4 . The cutting knife assembly 3 and the outer tube assembly 2 are airtightly connected through the second sealing plug 507 , and the end of the hollow screw 504 is airtightly connected with the needle shaft 402 of the puncture needle assembly 4 through the first sealing plug 505 . Prevent the high-pressure blood from rushing out through the gap between the outer tube assembly 2 , the cutting knife assembly 3 and the puncture needle assembly 4 during the operation.

In this embodiment, the cutting knife drive assembly 5 includes a first micromotor 501, a driving gear 502, and a driven gear 503. The first micromotor 501 is fixedly installed on the housing 1, and the first micromotor The output shaft of 501 is set coaxially with the driving gear 502 and is fixedly connected through the first coupling 506, the driving gear 502 meshes with the driven gear 503, and the hollow screw 504 and the driven gear 503 set coaxially; the hollow screw 504 is provided with a straight groove and a threaded groove in sequence, the straight groove is arranged parallel to the central axis of the hollow screw 504, the driven gear 503 is provided with a first pin 508, the The first pin 508 is slidingly matched with the straight groove; the second pin 509 is fixedly installed on the housing 1 , and the second pin 509 is matched with the threaded groove of the hollow screw 504 . The cutting knife driving assembly 5 drives the first micro motor 501 to perform positive and negative rotation under the control of the controller 8, and under the action of the gear transmission, the screw rod rotates forward or backward, thereby driving the blade of the cutting knife assembly 3 to perform rotary cutting or step back.

In this embodiment, the puncture needle drive assembly 6 includes a second micromotor 601, a lead screw 602, and a slider 603, the second micromotor 601 is fixedly installed on the housing 1, and the second micromotor 601 The output shaft and the screw 602 are coaxially arranged and fixedly connected through the second coupling 604, the slider 603 is provided with a through hole, and the through hole is provided with an internal thread, and the internal thread is connected with the The lead screw 602 is matched, and the slider 603 is fixedly connected with the outer wall of the puncture needle assembly 4 . Under the control of the controller 8 , the puncture needle driving assembly 6 can be rotated forward and backward to achieve the technical effect of driving the puncture needle assembly 4 forward or backward through the lead screw 602 to locate the target area.

In this embodiment, the negative pressure suction mechanism further includes a three-way connector 702, the puncture needle assembly 4 is a hollow structure, and the first end of the three-way connector 702 is airtightly connected to the puncture needle assembly 4 away from the The end of the needle 401 and the second end of the three-way connector 702 are airtightly connected to the negative pressure suction window 203 , and the third end of the three-way connector 702 is airtightly connected to an external negative pressure machine. When cutting, the negative pressure machine generates negative pressure, so that the myocardium is effectively fixed under the negative pressure suction of the puncture needle assembly 4 and the negative pressure tube 701, preventing displacement, which is conducive to more accurate cutting; Under the action of the cutter, the cut myocardium is taken out of the wound to prevent vascular embolism.

In this embodiment, the third end of the three-way connector 702 is also connected to the syringe 704, and the syringe 704, the negative pressure machine, and the third end of the three-way connector 702 are connected through a three-way valve 705 . When the cutter of the present invention is liquid-sealed, the negative pressure machine is turned off, the syringe 704 is opened, and the heparin saline is pre-filled to remove the gas in the cutter, and then the cutter assembly 3 is controlled to rotate and advance until the requirement of the liquid seal is reached ; At the same time, heparin saline gets rid of the gas in the negative pressure tube 701 through the negative pressure tube 701 . Negative pressure pipe 701 and puncture needle assembly 4 are connected to three-way valve 705, and are connected to syringe 704 and negative pressure machine 703 through three-way valve 705, so as to facilitate liquid sealing, exhaust, pressure measurement and flushing of the cutter.

In this embodiment, the blade of the cutting blade assembly 3 is an annular blade 301 . Under the driving action of the cutting knife driving assembly 5 , the annular cutting edge 301 can accurately cut off the myocardium in the target area when it rotates forward.

In this embodiment, the sealing end 201 of the outer tube assembly 2 is set in a tapered bullet shape. The head end of the outer tube assembly 2 is sealed and bullet-shaped, which is convenient for insertion into the heart cavity and at the same time avoids damage to other tissues in the heart cavity.

In this embodiment, a silicone pad 204 is provided inside the sealing end 201 of the outer tube assembly 2, and the silicone pad 204 is fixedly connected to the cutting window 202. When the annular blade 301 is stretched out, the The silicone pad 204 matches with the annular blade 301 . The silicone liner is located on the upper edge of the cutting window 202. The silicone liner is convenient to provide reverse shearing force for the annular blade 301 as a chopping board when cutting tissue, which makes it easier to cut muscle tissue, and can provide a liquid seal for the cutting knife assembly 3 at the same time.

In this embodiment, the negative pressure tube 701 is arranged along the outer wall of the outer tube assembly 2 . During the operation, the negative pressure tube 701 is along the outer wall of the outer tube, which reduces the resistance when the device is inserted into the wound during the operation, and can further reduce the size requirement of the wound, which is beneficial to the recovery of the patient.

In this embodiment, the housing 1 is provided with a control panel 101, and the control panel 101 is provided with control buttons 102, and the control buttons 102 include safety lock buttons, "1", "2", "3", "4" "Five operation buttons, the control button 102 is connected with the controller 8. Among them, the safety lock button provides power 9 switch functions, and the four buttons "1", "2", "3", and "4" respectively provide control of the puncture needle assembly 4 to advance or retreat, and the cutting knife to rotate forward or backward according to the needs of the operation process. Back function. Through the control button 102 on the operation panel, the operator can conveniently control the puncture needle assembly 4 to move forward or backward, and the cutting knife to rotate forward or backward, so as to complete the positioning and cutting of the target area.

In this embodiment, the housing 1 is further provided with a power interface, and the controller 8 is connected to the power supply 9 through the power interface. In order to ensure the stability of the operation of the cutter, an external power supply 9 is used to supply power to the cutter.

In order to prevent the cutter made of metal from affecting the ultrasonic image, the outer surface of the outer tube assembly 2 is coated with a coating that prevents the metal from producing an acoustic shadow under the ultrasonic.

working principle:

The head end of the outer tube assembly 2 is sealed and bullet-shaped, which is convenient for insertion into the heart cavity and at the same time avoids damage to other tissues in the heart cavity; the side wall of the sealed end 201 of the outer tube assembly 2 is provided with a cutting window 202 , can embed the protruding hypertrophic myocardial tissue, and at the same time, the wall behind the cutting window 202 can protect the tissue in the heart cavity behind the cutter and prevent accidental injury by the blade of the cutting component; the negative pressure suction component 7 is arranged on the outer tube component 2 On the outside, the externally connected negative pressure machine 703 is used to absorb and fix the embedded myocardial tissue, so as to prevent the fallen myocardial tissue from falling and blocking the peripheral arteries; Composition, a second sealing plug 507 is provided between the hollow screw 504 and the outer tube assembly 2, which can prevent the high-pressure blood in the heart from leaking out along the gap between the inner and outer sleeves after the cutter enters, and the top of the knife barrel 302 is provided with an annular blade 301 for The cutting knife assembly 3 cuts the myocardium when it rotates and advances; the cutting knife driving assembly 5 that drives the cutting knife assembly 3 to rotate and advance is composed of a gear set and a first micro-motor 501, through the connection between the gear set and the hollow screw 504, the cutting knife assembly 3 is driven to rotate Forward and backward; the puncture needle assembly 4 is sleeved in the screw rod, and is composed of a needle rod 402 and a needle head 401. The needle rod 402 and the hollow screw rod 504 are slidingly fitted, and a first sealing ring is provided between the two to prevent the cutter from entering the core. The high-pressure blood in the heart behind the cavity leaks out along the gap between the needle bar 402 and the hollow screw 504. The needle head 401 of the puncture needle assembly 4 is set at the head end of the needle bar 402, which can puncture and fix the hypertrophic myocardial tissue embedded in the cutting window 202; drive the puncture needle The cutting knife drive assembly 5 of the assembly 4 advances and retreats, and consists of a screw 602, a slider 603 and a second micro motor 601, and is connected through the slider 603 between the screw 602 and the needle bar 402 to drive the puncture needle assembly 4 Advance or retreat along the axial direction; the cutting knife drive assembly 5 and the puncture needle drive assembly 6 are integrated in the casing 1, the shape of the casing 1 is designed to be suitable for human hands, and the rear end is provided with a control panel 101. The control panel 101 includes a safety The lock button and the four step operation buttons "1", "2", "3" and "4" can be pressed in order to realize the retreat of the puncture needle assembly 4 and the knife barrel 302 (open the cutting window 202), and the puncture needle assembly 4 The forward puncture is fixed, and the knife cylinder 302 is screwed into the cutting process.

work process:

During the resection of hypertrophic myocardium, enter the pericardium through a small incision in the 4th and 5th intercostal spaces on the left anterior chest wall of the patient, expose the apex of the heart, make a purse at the apex, puncture the center of the purse into the left ventricle with a sheath, withdraw the sheath, and use The dilator expands the apical entrance, and the purse bag is tightened as the dilator is withdrawn. Connect the syringe 704 through the three-way valve 705 interface of the negative pressure suction assembly 7 to perform heparin saline pre-filled liquid sealing, remove the air in the outer tube assembly 2 and the cutting knife assembly 3, and seal the sealing end 201 of the cutter in this embodiment. end into the left ventricular cavity, under the guidance of transesophageal ultrasound and transesophageal three-dimensional ultrasound, locate the basal segment of the hypertrophic interventricular septum to be resected, align the cutting window 202 with the resection target area, press the safety lock button to unlock, and press "1" and "2", make the cutting knife assembly 3 and the puncture needle assembly 4 retreat to open the cutting window 202, confirm again under the three-dimensional ultrasound that the chordae and papillary muscles will not be injured and at the same time determine the cutting thickness, open the connection to the negative pressure The external negative pressure machine 703 of the suction assembly 7 sucks the target myocardial tissue into the cutting window 202 for fixation, presses the button "3", the puncture needle assembly 4 advances to puncture the target myocardium for further fixation, and then presses the button "4" to cut The knife assembly 3 is screwed in to cut off the target myocardium and put it in the knife barrel 302 to complete the cutting; after confirming the cut tissue, slowly withdraw the cutter from the heart chamber; press the knobs "1" and "2" again to open the cutting window 202 and take it out For the excised myocardial tissue, the outer tube assembly 2 and the cutting knife assembly 3 are flushed with heparin saline through the syringe 704; the resection effect is checked under esophageal ultrasound, and the pressure difference of the left ventricular outflow tract is measured by Doppler ultrasound. If the resection range is not satisfactory, repeat the above cutting process again to expand the resection range until the operation effect is satisfactory. The apical incision was sutured, and the chest wall incision was closed layer by layer.

The invention is easy to operate and reliable in use. Under the guidance of esophageal ultrasound, it can accurately cut the myocardial target area. At the same time, it can monitor the pressure difference of the left ventricular outflow tract in real time through ultrasound to determine the amount of myocardium to be cut without accidental injury. The myocardium in the non-target area does not require the operator to rely on experience to judge the amount of myocardium to be resected, which increases the safety of the operation; and the volume of the part that needs to be inserted into the chest cavity of the present invention is small, and the operation can be completed with only a small wound, which is beneficial The patient recovers after surgery; the function of tissue harvesting and recovery is integrated to prevent peripheral arterial embolism caused by the shedding of the harvested myocardial tissue.

The above descriptions are only preferred embodiments of the present invention, and are not intended to limit the present invention. Any modifications, equivalent replacements, improvements, etc. made within the spirit and principles of the present invention shall be included in the protection of the present invention. within range.

Claims (10)

1. An electrocardiographic intracavity myocardial cutter, comprising a shell (1), is characterized in that, also includes a puncture needle assembly (4), a cutting knife assembly (3), and an outer tube assembly coaxially arranged from the inside to the outside (2), one end of the outer tube assembly (2) is fixedly connected to the housing (1), the other end of the outer tube assembly (2) is set as a sealing end (201), and the sealing end (201) A cutting window (202) and a negative pressure suction window (203) are provided on the side of the puncture needle assembly (4) including a fixedly connected needle head (401) and needle bar (402), The needle (401), the blade of the cutting knife assembly (3) are matched in the cutting window (202); the casing (1) is provided with a cutting knife driving assembly (5), a puncture needle driving assembly (6) , a controller (8), the cutting knife driving assembly (5) and the puncture needle driving assembly (6) are electrically connected to the controller (8) respectively; the cutting knife assembly (3) is far away from the One end of the blade is connected to the cutting knife drive assembly (5), and the end of the puncture needle assembly (4) away from the needle (401) is connected to the puncture needle drive assembly (6); also includes negative pressure suction assembly (7), the negative pressure suction assembly (7) includes a negative pressure tube (701), one end of the negative pressure tube (701) is sealed with the negative pressure suction window (203), and the negative pressure tube ( 701) The other end is connected to an external negative pressure machine (703). 2. An electric intracardiac myocardial cutter according to claim 1, characterized in that, the cutting knife assembly (3) comprises a coaxially arranged knife barrel (302) and a hollow screw (504), the One end of the knife barrel (302) is set as an annular blade (301), and the other end is airtightly connected with the end of the hollow screw (504), and the end of the hollow screw (504) away from the knife barrel (302) is connected with the The outer wall of the puncture needle assembly (4) is slidably and airtightly connected. 3. An electric intracardiac myocardial cutter according to claim 2, characterized in that, the cutting knife driving assembly (5) comprises a first micro motor (501), a driving gear (502), a driven gear (503), the first micromotor (501) is fixedly mounted on the housing (1), and the output shaft of the first micromotor (501) is coaxially arranged and fixedly connected to the driving gear (502) , the driving gear (502) meshes with the driven gear (503), and the hollow screw (504) is arranged coaxially with the driven gear (503); the hollow screw (504) is sequentially provided with Straight grooves and threaded grooves, the straight grooves are arranged parallel to the central axis of the hollow screw (504), the driven gear (503) is provided with a first pin (508), and the first pin (508) and The straight grooves are slidingly fitted; a second pin (509) is fixedly installed on the shell (1), and the second pin (509) matches the threaded groove of the hollow screw (504). 4. An electric intracardiac myocardial cutter according to claim 2 or 3, characterized in that, the puncture needle drive assembly (6) includes a second micro motor (601), a lead screw (602), a slide block (603), the second micromotor (601) is fixedly mounted on the housing (1), and the output shaft of the second micromotor (601) is coaxially arranged and fixed with the lead screw (602) connection, the slider (603) is provided with a through hole, and the through hole is provided with an internal thread, and the internal thread is matched with the screw (602), and the slider (603) and the The outer wall of the puncture needle assembly (4) is fixedly connected. 5. An electric intracardiac myocardial cutter according to claim 1, characterized in that, the negative pressure suction mechanism further comprises a three-way connector (702), and the puncture needle assembly (4) is a hollow structure , the first end of the three-way connector (702) is airtightly connected to the end of the puncture needle assembly (4) away from the needle (401), and the second end of the three-way connector (702) is airtight The negative pressure suction window (203) is connected, and the third end of the three-way connector (702) is airtightly connected to an external negative pressure machine (703). 6 . An electric intracardiac myocardial cutter according to claim 1 , characterized in that, the sealing end ( 201 ) of the outer tube assembly ( 2 ) is set in a tapered bullet shape. 7 . 7. An electric intracardiac myocardial cutter according to claim 2 or 6, characterized in that a silicone pad (204) is also provided inside the sealing end (201) of the outer tube assembly (2), The silica gel pad (204) is fixedly connected with the cutting window (202), and when the annular blade (301) protrudes, the silica gel pad (204) cooperates with the annular blade (301). 8. An electric intracardiac myocardial cutter according to claim 1, characterized in that, the negative pressure tube (701) is arranged along the outer wall of the outer tube assembly (2). 9. An electric intracardiac myocardial cutter according to claim 1, characterized in that, the housing (1) is provided with a control panel (101), and the control panel (101) is provided with control buttons (102), the control button (102) is connected with the controller (8). 10. An electric intracardiac myocardial cutter according to claim 1, characterized in that, the housing (1) is also provided with a power interface, and the controller (8) communicates with the power supply through the power interface (9) CONNECTION.