CN113995563B

CN113995563B - A self-expanding transcatheter valve surgical extractor

Info

Publication number: CN113995563B
Application number: CN202111410370.9A
Authority: CN
Inventors: 陈澍; 杨琼; 王诗龄; 廖曼; 董念国; 夏家红
Original assignee: Union Hospital Tongji Medical College Huazhong University of Science and Technology
Current assignee: Union Hospital Tongji Medical College Huazhong University of Science and Technology
Priority date: 2021-11-25
Filing date: 2021-11-25
Publication date: 2025-05-27
Anticipated expiration: 2041-11-25
Also published as: CN113995563A

Abstract

The application discloses a self-expanding transcatheter valve surgical extractor, and relates to the technical field of medical appliances. The self-expanding transcatheter valve surgical extractor of the present application includes a disk-shaped base, a sliding disk, a screw, and a catch arm. The disc-shaped base comprises an inner rotating disc and an outer rotating disc which are concentrically arranged, wherein relative rotation can be generated between the inner rotating disc and the outer rotating disc, one end of a screw rod is fixed on the inner rotating disc, the screw rod is connected with a central threaded hole of the sliding disc, one end of a capturing arm is hinged with the outer rotating disc, the capturing arm penetrates through a through hole of the sliding disc, and the other end of the capturing arm is provided with a hook ring which is used for hooking a self-expansion bracket of the self-expanding transcatheter valve. When in use, the hook ring of the capturing arm is firstly used for hooking the self-expansion bracket of the self-expansion transcatheter valve. And then the screw rod is rotated, the screw rod drives the sliding disc to move downwards, and the tail end of the capturing arm is folded, so that the self-expansion bracket of the transcatheter valve is driven to be folded, and the damage to myocardial tissues caused by the metal tail end of the self-expansion bracket in the taking-out process is avoided.

Description

Self-expanding transcatheter valve surgical extractor

Technical Field

The invention relates to the technical field of medical equipment, in particular to a self-expanding transcatheter valve surgical extractor.

Background

Heart valve disease affects approximately 300,000 people worldwide each year. These diseases translate into abnormal leaflet tissue, e.g., overgrowth of tissue, tissue degradation/rupture, or tissue hardening/calcification, some of which may also translate into abnormal tissue locations in the cardiac cycle of the heart, e.g., annular expansion or ventricular remodeling. Such abnormal leaflet tissue and abnormal tissue locations may lead to degradation of valve function, including leakage/regurgitation (valve insufficiency) or forward flow resistance of blood (valve stenosis).

Valve replacement surgery is a minimally invasive procedure in which a defective heart valve of a patient is repaired. Thus, abnormal leaflet tissue or abnormal tissue locations may be repaired in order to restore the operability of the heart valve. In valve replacement surgery, the transcatheter valve is delivered to the patient's native heart valve without removing the patient's native heart valve, the function of the transcatheter valve being replaced with the native heart valve.

Currently, the commonly used transcatheter valve is a self-expanding transcatheter valve prosthesis. The valve prosthesis includes leaflets and a self-expanding stent supporting the leaflets. During the replacement operation, the valve prosthesis can be positioned at a required position in a compressed or contracted delivery state, then the self-expanding stent is released, so that the valve prosthesis is expanded to return to a deployment state and fixed at the required position.

Because of the useful life of the prosthetic valve components within the stent structure, the valve prosthesis may need to be replaced after a period of time in the body. However, the self-expanding stent cannot be compressed back after being released, so that the metallic end of the self-expanding stent is easy to damage myocardial tissue during the process of taking out the valve prosthesis.

Disclosure of Invention

The embodiment of the application solves the problem that the metal tail end of the self-expanding transcatheter valve self-expanding stent is easy to cause myocardial tissue injury in the prior art by providing the self-expanding transcatheter valve surgical extractor, and improves the extraction safety of the self-expanding transcatheter valve.

Embodiments of the present application provide a self-expanding transcatheter valve surgical extractor comprising:

the disc-shaped base comprises an inner rotating disc and an outer rotating disc which are concentrically arranged, and relative rotation can be generated between the inner rotating disc and the outer rotating disc;

A sliding disk having a central threaded hole and a through hole;

A screw rod, one end of which is fixed on the inner rotary disk and is connected with the central threaded hole of the sliding disk, and

The capturing arm and the screw are positioned on the same side of the disc-shaped base, one end of the capturing arm is hinged with the outer rotating disc, the capturing arm penetrates through the through hole of the sliding disc, a hook ring is arranged at the other end of the capturing arm and used for capturing the first end of the self-expanding bracket of the self-expanding transcatheter valve.

Further, the self-expanding transcatheter valve surgical extractor further comprises a telescopic sleeve having a metal mesh structure, one end of the telescopic sleeve being fixed to a side of the sliding disk adjacent to the shackle of the capturing arm.

Further, the length of the capturing arm is 7.5-8.5 cm.

Further, the stroke of the sliding disc is 6-8 cm.

Further, the disc-shaped base further comprises a fixed disc fixedly connected with the outer rotating disc, the fixed disc is provided with a central through hole, the screw rod penetrates through the central through hole, and one end of the capturing arm is hinged to the fixed disc.

Further, the self-expanding transcatheter valve surgical extractor has a plurality of the capturing arms, the number of the through holes on the sliding tray is equal to the number of the capturing arms, and the centers of the through holes are all located on the same concentric circle with the center of the sliding tray.

Further, the self-expanding transcatheter valve surgical extractor has 2-4 of the capture arms.

Further, the distance between the center of the through hole on the sliding disc and the center of the sliding disc is 2.5-4 cm.

Further, a rotary handle is arranged on one side of the inner rotary table opposite to the screw rod.

Further, the rotary handle is fixed on the inner turntable through a hard connecting rod.

One or more technical solutions provided in the embodiments of the present application at least have the following technical effects or advantages:

The self-expanding transcatheter valve surgical extractor includes a disk-shaped base, a sliding disk, a screw, and a capture arm. The disc-shaped base comprises an inner rotating disc and an outer rotating disc which are concentrically arranged, the inner rotating disc and the outer rotating disc can rotate relatively, the sliding disc is provided with a central threaded hole and a through hole, one end of a screw rod is fixed on the inner rotating disc and connected with the central threaded hole of the sliding disc, the capturing arm and the screw rod are located on the same side of the disc-shaped base, one end of the capturing arm is hinged with the outer rotating disc, the capturing arm penetrates through the through hole of the sliding disc, and a hook ring is arranged at the other end of the capturing arm and used for hooking a self-expansion bracket of the self-expandable transcatheter valve. When in use, the hook ring of the capturing arm is firstly used for hooking the self-expansion bracket of the self-expansion transcatheter valve. And then the inner rotary table and the screw rod fixed on the inner rotary table are driven to rotate by rotating the handle, the screw rod drives the sliding plate to move downwards, so that the tail end of the capturing arm is folded, the self-expansion bracket passing through the catheter valve is driven to be folded, and the damage to myocardial tissues caused by the metal tail end of the self-expansion bracket in the taking-out process is avoided.

Drawings

FIG. 1 is a schematic illustration of a conventional self-expanding transcatheter valve;

FIG. 2 is a top view of a schematic structural diagram of a conventional self-expanding transcatheter valve;

FIG. 3 is a schematic illustration of a self-expanding transcatheter valve surgical extractor according to an embodiment of the present invention;

FIG. 4 is a detail view of a disk-shaped base of a self-expanding transcatheter valve surgical extractor according to an embodiment of the present invention;

FIG. 5 is a detail view of a sliding tray of a self-expanding transcatheter valve surgical extractor according to an embodiment of the present invention;

FIG. 6 is a schematic view of a sleeve in a contracted state in an embodiment of the invention;

fig. 7 is a schematic view of a sleeve in an expanded state in an embodiment of the invention.

Reference numerals:

Disc base 210, inner hub 211, outer hub 212, rotating handle 213, hard connecting rod 214, fixed hub 215, sliding hub 220, central threaded bore 221, through bore 222, screw 230, catch arm 240, shackle 241, telescoping sleeve 250, valve prosthesis 100, expandable stent 102, leaflet 104, boss 108.

Detailed Description

For the purpose of making the objects, technical solutions and advantages of the present invention more apparent, the embodiments of the present invention will be described in further detail with reference to the accompanying drawings.

Fig. 1 is a schematic structural view of a conventional self-expanding transcatheter valve, and fig. 2 is a schematic structural top view of the conventional self-expanding transcatheter valve. As shown in fig. 1 and 2, the valve prosthesis 100 includes leaflets 104 and a self-expanding stent 102 supporting the leaflets 104. The leaflets 104 are capable of blocking blood flow in one direction to regulate blood flow through the valve prosthesis 100 via the leaflets 104, which leaflets 104 can form a mitral or tricuspid replacement valve. Fig. 2 shows an exemplary tricuspid replacement valve having three leaflets 104. The self-expanding stent 102 is self-expanding and is capable of returning from a compressed or contracted delivery state to an expanded, deployed state, the self-expanding stent 102 in the deployed state including an enlarged first end 116, a lumbar region 117 and a second end 118 so as to better secure in a desired position when the self-expanding stent 102 is deployed. The self-expanding stent 102 may also include a boss 108 extending from a first end 116 thereof for positioning in a delivery catheter.

FIG. 3 is a schematic view of a self-expanding transcatheter valve surgical extractor according to an embodiment of the present invention. As shown, the self-expanding transcatheter valve surgical extractor includes a disk-shaped base 210, a sliding disk 220, a screw 230, and a catch arm 240.

Fig. 4 is a detail view of a disk-shaped base 210 of a self-expanding transcatheter valve surgical extractor according to an embodiment of the present invention, wherein the disk-shaped base 210 comprises an inner disk 211 and an outer disk 212 concentrically disposed, and wherein relative rotation is provided between the inner disk 211 and the outer disk 212, as shown in fig. 4. Specifically, the inner rotary disc 211 may be a disc, the outer rotary disc 212 may be an annular member, and the inner rotary disc 211 is embedded into an annular middle hollow portion of the outer rotary disc 212, so that relative rotation may be generated between the inner rotary disc 211 and the outer rotary disc 212.

Fig. 5 is a detail view of a sliding tray 220 of a self-expanding transcatheter valve surgical extractor according to an embodiment of the present invention, the sliding tray 220 having a central threaded hole 221 and a through hole 222 as shown in fig. 5.

Referring to fig. 3, 4 and 5, one end of a screw 230 is fixed to the inner rotary plate 211, and the screw 230 is coupled with a central screw hole 221 of the sliding plate 220. The capturing arm 240 and the screw 230 are located on the same side of the disc-shaped base 210, one end of the capturing arm 240 is hinged to the outer rotating disc 212, the capturing arm 240 passes through the through hole 222 of the sliding disc 220, a hook ring 241 is arranged at the other end of the capturing arm 240, and the hook ring 241 is used for capturing the first end 116 of the self-expanding transcatheter valve at the self-expanding stent 102.

In use, the catch arms 240 are first hooked on the self-expanding stent with the shackles 241. By rotating the inner rotary table 211, the inner rotary table 211 and the screw 230 fixed on the inner rotary table 211 are driven to rotate, the screw 230 drives the sliding plate 220 to move downwards, so that the tail end of the capturing arm 240 is folded, the first end 116 of the self-expanding stent 102 of the transcatheter valve is driven to be folded, the diameter of the first end 116 is reduced, and the damage to myocardial tissues caused by the metal tail end of the self-expanding stent 102 in the taking-out process is avoided.

Further, a rotary handle 213 is provided on the inner rotor 211 at a side opposite to the screw 230. Specifically, the rotating handle 213 may be fixed to the inner rotary table 211 by a hard connection rod 214 to facilitate the rotation of the inner rotary table 211.

Further, the length of the capturing arm 240 is 7.5-8.5 cm, preferably 8cm. The travel of the sliding plate 220 is 6-8 cm, preferably 7cm.

In some embodiments, the disc-shaped base 210 further includes a fixed disc 215, the fixed disc 215 is fixedly connected to the outer rotating disc 212, the fixed disc 215 has a central through hole (not shown in the figure), the screw 230 passes through the central through hole, and one end of the capturing arm 240 is hinged to the fixed disc 215. Specifically, one end of the capture arm 240 may be hinged to the fixed disk 215 near the center to expand the deployment angle of the capture arm 240, reduce the travel of the screw 230, and facilitate miniaturization of the self-expanding transcatheter valve surgical extractor.

Alternatively, the radius of the fixed disk 215 is the same as that of the outer rotating disk 212, and the outer edges of the fixed disk 215 and the outer rotating disk 212 are fixed by a connecting rod.

Further, the self-expanding transcatheter valve surgical extractor has a plurality of the capture arms 240, and the number of through holes 222 on the sliding tray 220 is equal to the number of the capture arms 240. Referring to fig. 5, the centers of the through holes 222 are all located on the same concentric circle with the center of the sliding plate 220, so that the strokes and the opening and closing angles of the plurality of capturing arms 240 are the same, and the opening and closing operations of the capturing arms 240 are facilitated.

Further, the distance L between the center of the through hole 222 on the sliding plate 220 and the center of the sliding plate 220 is 2.5-4 cm, preferably L is 3cm.

Further, the self-expanding transcatheter valve surgical extractor has 2-4 of the capture arms 240. By way of example, only 2 catch arms 240 are shown in fig. 3, but not as a limitation of the application. In other embodiments, the self-expanding transcatheter valve surgical extractor may also be provided with 3 or 4 catch arms 240.

In some embodiments, the self-expanding transcatheter valve surgical extractor further comprises a telescoping sleeve 250 of metal mesh structure having one end fixed to the side of the sliding disk 220 adjacent to the shackle 241 of the capture arm 240. Illustratively, the telescoping sleeve may be constructed of a wire mesh. In particular, the telescoping sleeves may be multi-segmented and telescoped together to reduce volume when contracted and pulled out from the distal end when extended.

Referring to fig. 6 and 7, after the end of the capturing arm 240 hooks the self-expanding stent of the self-expanding transcatheter valve, the retractable sleeve is deployed, and the remaining self-expanding transcatheter valve can be further retracted into the retractable sleeve, thereby physically isolating the self-expanding stent from the myocardial tissue and further improving the safety of the self-expanding transcatheter valve during removal.

The foregoing description of the preferred embodiments of the invention is not intended to be limiting, but rather to enable any modification, equivalent replacement, improvement or the like to be made within the spirit and principles of the invention.

Claims

1. A self-expanding transcatheter valve surgical extractor, characterized in that the self-expanding transcatheter valve surgical extractor comprises:

A disc-shaped base (210), the disc-shaped base (210) comprising an inner rotating disk (211) and an outer rotating disk (212) which are arranged concentrically, and the inner rotating disk (211) and the outer rotating disk (212) can generate relative rotation;

A sliding plate (220) having a central threaded hole (221) and a through hole (222);

a screw rod (230), one end of which is fixed on the inner rotating disk (211), and the screw rod (230) is connected to the central threaded hole (221) of the sliding disk (220); and

A capture arm (240), wherein the capture arm (240) and the screw rod (230) are located on the same side of the disc-shaped base (210), one end of the capture arm (240) is hinged to the outer rotating disk (212), the capture arm (240) passes through the through hole of the sliding disk (220), and the other end of the capture arm (240) is provided with a hook ring (241), and the hook ring (241) is used to capture the first end (116) of the self-expanding stent (102) of the self-expanding transcatheter valve.

2. The self-expanding transcatheter valve surgical extractor according to claim 1 is characterized in that the self-expanding transcatheter valve surgical extractor also includes a retractable sleeve (250), the retractable sleeve (250) is a metal mesh structure, and one end of the retractable sleeve (250) is fixed to one side of the sliding disk (220) close to the hook ring (241) of the capture arm (240).

3. The self-expanding transcatheter valve surgical extractor according to claim 1 is characterized in that the disc-shaped base also includes a fixed disk (215), the fixed disk (215) is fixedly connected to the outer rotating disk (212), the fixed disk (215) has a central through hole, the screw (230) passes through the central through hole, and one end of the capture arm (240) is hinged on the fixed disk.

4. The self-expanding transcatheter valve surgical extractor according to claim 1, characterized in that the length of the capture arm (240) is 7.5 to 8.5 cm.

5. The self-expanding transcatheter valve surgical extractor according to claim 1, characterized in that the travel of the sliding disk (220) is 6 to 8 cm.

6. The self-expanding transcatheter valve surgical extractor according to any one of claims 1 to 5, characterized in that the self-expanding transcatheter valve surgical extractor has a plurality of the capturing arms (240), the number of the through holes (222) on the sliding disk is equal to the number of the capturing arms (240), and the centers of the through holes (222) are all located on the same concentric circle with the center of the sliding disk (220).

7. The self-expanding transcatheter valve surgical extractor according to claim 6, characterized in that the self-expanding transcatheter valve surgical extractor has 2 to 4 of the capture arms (240).

8. The self-expanding transcatheter valve surgical extractor according to claim 6, characterized in that the distance between the center of the through hole (222) on the sliding disk (220) and the center of the sliding disk (220) is 2.5 to 4 cm.

9. The self-expanding transcatheter valve surgical extractor according to any one of claims 1 to 5, characterized in that a rotating handle (213) is provided on the side of the inner rotating disk (211) opposite to the screw rod (230).

10. The self-expanding transcatheter valve surgical extractor according to claim 9, characterized in that the rotating handle (213) is fixed to the inner rotating disk via a hard connecting rod (214).