CN102824231A - Mechanical suture type artificial heart valve and suture method thereof - Google Patents

Abstract

The invention discloses a mechanical suture type artificial heart valve and a suture method thereof. A suture valve ring (10) of an artificial heart valve takes a plastic valve ring (13) as a bracket; a concave-convex lantern ring (14) is sleeved on the plastic valve ring (13); an outer edge of the concave-convex lantern ring (14) is wrapped by a polyester ring sleeve (15); and a metal valve leaflet (12) is erected in an inner hole (K) of a metal valve ring (11) of a mechanical valve. A mechanical suture device is arranged at the front end of a tube-shaped anastomat (4); the suture valve ring (10) is arranged on the outer edge of a disk of a combined disk bottom anvil support (7); and the plastic valve ring (13) and the polyester ring sleeve (15) are sleeved on the inner edge of the disk. The preliminary suture is carried out after the combined disk bottom anvil support (7) is placed. A cutting and positioning suture method comprises the following steps of: pushing an annular tube cutter (9) to cut off a pathological mitral valve (Q) sleeved on an inner ring of the suture valve ring (10); suturing the suture valve ring (10) with a heart chamber (R) by a staple (17); taking out the combined disk bottom anvil support (7); and then sheathing the mechanical valve with the suture valve ring (10). The mechanical suture type artificial heart valve disclosed by the invention has the advantages of accuracy in positioning, favorable suture quality, high efficiency and success rate of an operation. The pains of patients are alleviated.

Description

A kind of mechanical stitch formula artificial heart valve and sewing method thereof

Technical field

The present invention relates to treat the utensil and the method for heart mitral lesion, relate in particular to artificial heart valve and method for using thereof.

Background technology

The common method of the heart of clinical medicine treatment both at home and abroad mitral lesion is mitral valve replacement (being the replacement prosthetic heart valve) at present; The utensil of mitral valve replacement and method; Commonly used is that operation is operated on, and the artificial heart valve of band terylene suture ring is inserted heart, carries out manual suture.In application process, at first set up extracorporeal circulation system, go into the heart-lung machine to the hypoxia venous blood drain of returning heart; Lung oxygenate through the heart-lung machine makes venous blood become the arterial blood of hyperoxia; Squeeze into aorta to arterial blood by artificial heart again, put out with heart is spacious, make no blood in the heart; Cut heart then open and carry out operation on heart, keep the blood circulation of whole body simultaneously.Heart injects root of ascending aorta at Cardioprotective liquid; Make cardiac arrest; Cut right atrium, interatrial septum then, with the heart mitral valve excision of pathological changes, in position through the terylene ring of continuously artificial or interrupted suture artificial heart valve and lobe ring and the nubbin valve after the cardiac valve excision.After the seamed, need to sew up interatrial septum and atrium otch, recover blood supply then, recovering beat of heart is removed cardiopulmonary bypass unit, recovers cardiac pumping function.Though this modus operandi can effectively be implemented the heart mitral valve replacement; But not enough below existing: the cardiac valve excision is irregular; The needle gage and the back gauge of manual suture are inhomogeneous, sew up edge unbalance stress etc., and the operation stitching time is long: in case artificial heart valve loses merit; The secondary changing valve operation is complicated, increases patient's misery and financial burden.

Summary of the invention

The object of the invention just provides a kind of artificial heart valve of new construction, improves the method for heart mitral valve replacement, adopts the mechanical stitch mode to carry out the stitching of artificial heart valve and heart; Easy to operate, safe and reliable, sewing needle is even apart from, back gauge, stressed equalization; Shorten operating time, improve success rate of operation, the secondary changing valve operation is simple; Alleviate patient's misery and financial burden, have wide range of applications, be easy to promote.

Task of the present invention is to accomplish like this: design a kind of artificial mechanical valve prosthesis's stitching devices mechanical stitch formula artificial heart valve, artificial heart valve comprises sews up lobe ring, mechanical valve prosthesis, matches with the mechanical stitch device; Sew up the lobe ring and be made up of plastics lobe ring, the concavo-convex collar, terylene ring set, mechanical valve prosthesis is assembled by metal lobe ring, metal lobe leaf, and sewing up the lobe ring is support with plastics lobe ring; The concavo-convex collar that memorial alloy is processed is sleeved on plastics lobe ring outer rim; Terylene ring set liner latex ring in plastics lobe ring and the concavo-convex collar be wrapped in, evenly has several square type holes at interval on the circumference anchor ring of plastics lobe ring; The concavo-convex collar is embedded in the square type hole by plastics lobe ring outer rim to each projecting inward section; End face inner edge near ventricle one side has edge, and the metal lobe ring of mechanical valve prosthesis and metal lobe leaf adopt carbon alloy to process, and metal lobe leaf is the semicircle blades of two lobes; Two ends respectively are provided with short lobe rachis; Be erected on the inner hole wall groove of metal lobe ring outer face, the semicircle blade activity of metal lobe leaf is installed on the lobe rachis, and the periphery outer ring of metal lobe ring has cannelure; End face annular distance internal marginal zone near ventricle one side has edge; The mechanical stitch device comprises pin nail bin groupware, the holder of combination disk bottom anvil, and the pin nail bin groupware is become by pin nail bin, pin nail, the ring tube knife tackle of band edge face nailing anvil, is installed in the pin nail bin connecting tube front end of tube type anastomat.Mechanical stitch formula artificial heart valve, the pin nail bin of pin nail bin groupware are cylindric interlayer sleeve, and the outer threaded inner bolt hole with the connecting tube of pin nail bin of tail end is equipped; Suit ring tube cutter in the mesopore, ring tube cutter is the tube-like thin-wall cutter, tail end is connected with ring tube cutter propeller; The end face nail anvil of pin nail bin end is the flange dish type around centre bore; Evenly have several on the end face nail anvil circumferential plane at interval and axially go out the nail mouth, interior dress pin nail, each goes out a nail mouthful outer rim correspondence and has two radial needle nail track grooves.The holder of combination disk bottom anvil is the discoid collet that the amalgamation of bottom anvil holder subassembly is formed; The center is vertical holder handle; Radially evenly be divided into six bottom anvil holder subassemblys from the holder handle center of circle to the outer rim of discoid collet; The center of circle angle of every bottom anvil holder subassembly is 60 °, evenly has some above the disk edge and radially sews up the track groove.The sewing method of mechanical stitch formula artificial heart valve adopts artificial heart valve to be sewn to and substitutes the heart Bicuspid valve on the ventricle; During stitching and mechanical stitch device fit applications; With sewing up the disk inner edge that the lobe ring is seated in the holder of combination disk bottom anvil, disk inner edge suit is sewed up the plastics lobe ring of lobe ring, and the circle fan edge sheathing of terylene ring set is installed on above the disk edge of combination disk bottom anvil holder; The pin nail bin is installed in the pin nail bin connecting tube front end of tube type anastomat; Ring tube cutter propeller is connected with nail pushing device, and ring tube cutter propeller promotes ring tube cutter and pin nail synchronization action, will sew up the lobe circumferential weld according to the mechanical stitch step and be combined on the ventricle; Mechanical valve prosthesis is linked in again and sews up on the lobe ring, stitching step is: lay the holder of combination disk bottom anvil and tentatively sew up; The excision pathological changes of coincideing mitral valve positions stitching; Take out the holder of combination disk bottom anvil; Socket mechanical valve prosthesis and stitching lobe ring.The operating process of laying the preliminary stitching step of combination disk bottom anvil holder carrying out is: cut off the chordae tendineae of ventricle earlier, the holder of combination disk bottom anvil is enclosed within to be sewed up on the lobe ring, and the holder handle stretches in the holder handle hoop in the pin nail bin mesopore; Fix by jump ring; Discoid collet is put into ventricle, and pathological changes mitral valve chordae tendineae stump seam is pricked on the holder handle, rotates the knob of tube type anastomat rear end; Holder handle hoop pull bar pulling combination disk bottom anvil holder in the tube type anastomat inner chamber is drawn close to the pin nail bin; The flexible handle of the type that gently holds a writing brush or pen-write anastomat makes nail pushing device promote edge and stitching lobe ring that the pin nail passes ventricle, gets into the stitching track groove of combination disk bottom anvil holder disk border; The stitch of pin nail is inwardly turned back after stretching out and sewing up track groove outer rim, gets into the ventricle incisxal edge once more.The operating process that the excision pathological changes of coincideing mitral valve positions stitching step is: the flexible handle of the type that gently holds a writing brush or pen-write anastomat; Ring tube cutter propeller slowly promotes ring tube cutter forward; After adjusting to locations at predetermined, the flexible handle of the tube type anastomat of holding with a firm grip contacts fixed handle, and ring tube cutter propeller accentuated push rotating ring tube cutter is protruded forward fast; Carry out osculating; With the pathological changes mitral valve excision of sewing up snare in the lobe ring mesopore, the stitch of pin nail is turned back to extreme position backward, will sew up lobe ring and ventricle and be stitched together.The operating process of taking out combination disk bottom anvil holder step is: unclamp flexible handle; The knob of backward rotation tube type anastomat rear end; Holder handle hoop in the pin nail bin mesopore is bounced back backward and make up the holder of disk bottom anvil and unclamp, break away from; It is external that tube type anastomat withdraws from the patient through the edge of a knife, and the bottom anvil holder subassembly of combination disk bottom anvil holder scatters naturally and is divided into six lobes, then with bottom anvil holder subassembly by taking out respectively by lobe in the mesopore of sewing up the lobe ring.The socket mechanical valve prosthesis with the operating process of sewing up lobe ring step is: with holding the lobe device with mechanical valve prosthesis horizontal sliding forward, in the mesopore of the plastics lobe ring of embedded suture lobe ring inner ring, rotate the position of inlaying of the metal lobe ring of adjusting mechanical valve prosthesis; After confirming correct position; The bundle lobe line on the lobe device is held in cut-out, will hold the lobe device and withdraw from externally, makes heart recover blood supply; More than the temperature recovery to 34 ℃; The concavo-convex collar that memorial alloy is processed is from dynamic deformation, and each section stretches out corresponding each square type hole on the plastics lobe ring to the inner protruding part, embeds the outer ring annular groove of periphery of metal lobe ring; To sew up the tight fit of lobe ring and mechanical valve prosthesis and connect as one, and then scalpel edge implemented to sew up.

During practical operation; Mechanical valve prosthesis with sew up the lobe ring and assemble being lower than under 34 ℃ of temperature environments; The concavo-convex collar adopts the temperature memory alloy to make, and in the time of more than 34 ℃, the inside protruding back of a bow of the concavo-convex collar is inserted in square type hole; In the time of below 34 ℃, the protruding back of a bow of concavo-convex collar retraction automatically covers in outside, square type hole.When 34 ℃ of following temperature were implemented assembling, the ventricle edge of plastics lobe ring had edge to separate the metal lobe ring of mechanical valve prosthesis, makes the intermediary cannelure in concavo-convex collar positive alignment metal lobe ring outer ring.When temperature rose to more than 34 ℃, the concavo-convex collar resiled, and plastics lobe ring square type hole inner face is stretched at the protrusion position, and the concavo-convex collar blocks the intermediary cannelure of metal lobe ring outer circumference surface, and suit can rotate after cooperating relatively, adjustment valve orifice direction.The holder handle is long rib body in the middle of the holder of combination disk bottom anvil, and suture trough is semicircle, and groove and bottom anvil holder outer rim intersect, and the pin nail passes annulus of mitral valve, and the suture trough cross section is triangular groove, and pin nail cross section is a rhombus, prevents that the pin nail from changing direction when becoming track.Supporting tubular anastomat front end installing pin nail bin groupware, when coincideing with the heart Bicuspid valve, by ring tube cutter incisxal edge excision unwanted lobe membrane tissue in sewing up the lobe ring, the bore that coincide is consistent, and artificial valve and heart mitral annulus are involutory neat, and it is solid and reliable to coincide.If artificial valve loses merit, can reduce the heart temperature through operation and simply take out, insert new artificial heart valve then, the process of inserting is with inserting for the first time.Simplify the process of changing lobe once more, reduced less patient suffering, improved success rate.

The present invention is rational in infrastructure, method is proper, adopts mechanical type to sew up and replaces manual suture, accurate positioning; Needle gage, back gauge are even, and stressed equalization is easy to operate; Safe and reliable, mechanical implement coincide, excision is carried out simultaneously, sews up coordination and implements; Can improve the suture operation success rate, shorten operating time, reduce infringement patient body.It is simple to change the lobe process once more, and surgical wound is little, is applicable under Wicresoft and the full thoracoscope to carry out operation on heart, and quality is good, and efficient is high, is easy to apply, and has reached predetermined purpose preferably.

Description of drawings

Fig. 1 is the installation site figure of pin nail bin groupware of the present invention on tube type anastomat 4;

Fig. 2 is pin nail bin 8 andring tube cutter 9 structural representations;

Fig. 3 sews uplobe ring 10 and the equipped sketch map of mechanical valve prosthesis;

Fig. 4 is the generalized section of Fig. 3;

Fig. 5 is that thestitching lobe ring 10 of Fig. 3 splits sketch map withmetal lobe ring 11;

Fig. 6 is thatmetal lobe ring 11,plastics lobe ring 13 split structural representation with the concavo-convex collar 14;

Fig. 7 be Fig. 6metal lobe ring 11,plastics lobe ring 13 and the concavo-convex collar 14 suits combination partly cut open sketch map;

Fig. 8 is the structural representation of the bottom anvil holder subassembly N of combination diskbottom anvil holder 7;

Fig. 9 is bottom anvil holder subassembly N andpin nail 17 equipped sketch maps;

Figure 10 is the generalized section that the present invention waits the state that excises when being applied to operation on heart;

Figure 11 is the generalized section that Figure 10 excises pathological changes mitral valve Q.

Among the figure, 1-knob, 2-fixed handle, 3-flexible handle, 4-tube type anastomat; 5-bend pipe, the connecting tube of 6-pin nail bin, the holder of 7-combination disk bottom anvil, 8-pin nail bin, 9-ring tube cutter; 10-stitching lobe ring, 11-metal lobe ring, 12-metal lobe leaf, 13-plastics lobe ring, the 14-concavo-convex collar; 15-terylene ring set, 16-latex ring, 17-pin nail, 18-positioning sleeve, 19-holder handle hoop; P-end face nail anvil, D-mesopore, C-pin nail track groove, V-go out nail mouthful, K-endoporus; F-square type hole, W-cannelure, X-suture hole, B-holder handle, J-stitching track groove; N-bottom anvil holder subassembly, R-ventricle, H-jump ring, T-ring tube cutter propeller; E-nail pushing device, Q-pathological changes mitral valve, L-bundle lobe line, Z-holder handle hoop pull bar.。

The specific embodiment

Below in conjunction with accompanying drawing practical implementation of the present invention is explained.

Consult Fig. 1, mechanical stitch device of the present invention is created tube type anastomat 4 fit applications that the hole is used with the existing stomach of sewing up.The body section of tube type anastomat 4 is equipped with pin nail bin 8 through the pin nailbin connecting tube 6 ofbend pipe 5 connection front ends, but installation and combination diskbottom anvil holder 7 foremost.The rear end of tube type anastomat 4 is a knob 1, is installed on thefixed handle 2, and top is flexible handle 3.Theholder 7 of combination disk bottom anvil and other pin nail bin groupwares and the 8 supporting installings of pin nail bin.

Consult Fig. 2, pin nail bin 8 is a double-layered cylinder shape container, and front end face is end face nail anvil P; Suitring tube cutter 9 in the mesopore D, evenly be provided with on the end face nail anvil P flange dish type plane around mesopore D some in the nail mouthful V that goes out ofdress pins nail 17 follow closely track groove C with pin, pin nail bin 8 tail ends have external screw thread; Pin nailbin connecting tube 6 inner bolt holes that cooperate installing tube type anastomat 4 front ends; P is outside for the end face nail anvil, cooperates withholder 7 of combination disk bottom anvil andstitching valve 10, sews up.

Consult Fig. 3, Fig. 4; Sew uplobe ring 10 and be sleeved on mechanical valve prosthesis, mechanical valve prosthesis comprisesmetal lobe ring 11 andmetal lobe leaf 12, andmetal lobe ring 11 is sleeved in the mesopore of sewing uplobe ring 10;Metal lobe leaf 12 is two semicircle shape blades; Be installed among the endoporus K ofmetal lobe ring 11, the endoporus K wall of edge andmetal lobe ring 11 flexibly connects, can unidirectional folding in endoporus K.

Consult Fig. 5, Fig. 6, Fig. 7, sew uplobe ring 10 and the interior mechanical valve prosthesis partition structure of mesopore, sew uplobe ring 10 and formed byplastics lobe ring 13, the concavo-convex collar 14, terylene ring set 15 fits, mechanical valve prosthesis is made up ofmetal lobe ring 11 endoporus K installing metal lobe leaf 12.Plastics lobe ring 13 is a closed round ring, evenly offers several square types hole F on the circumference wall face, and some suture hole X gather on the wall of both ends of the surface about square type hole F.The concavo-convex collar 14 is the concavo-convex ring of an opening, and circumference wall face is concavo-convex interval, be installed in the annular space between terylene ring set 15 and theplastics lobe ring 13, and among the square type hole F of theplastics lobe ring 13 of the interior convex surface embedding inner ring of the concavo-convex collar 14, fixed with relative positions.Themetal lobe leaf 12 of mechanical valve prosthesis is two lobe semicircle shape blades, and activity is inlaid on the mesopore K inwall ofmetal lobe ring 11, can only unidirectional folding.Offer a ring annular groove W on the outer circumference surface ofmetal lobe ring 11, in the time of inmetal lobe ring 11 is sleeved onplastics lobe ring 13 mesopores of sewing up in thelobe ring 10, the interior convex surface of the concavo-convex collar 14 of protrusion square type hole F can be inlaid in the cannelure W of metal lobe ring 11.Metal lobe ring 11 can only rotate alongplastics lobe ring 13 endoporus peripheries at this moment, can not make axial action.When turning to the appropriate location ofplastics lobe ring 13 endoporus,metal lobe ring 11 corresponding location.

Consult Fig. 8, Fig. 9, the center of combination diskbottom anvil holder 7 is vertical stock holder handle B, asks the center of circle of handle B radially to be divided into uniform six bottom anvil holder subassembly N to the outer rim of discoid collet certainly, and the center of circle angle of every bottom anvil holder subassembly N is 60 °.Evenly have some above the disk border of combination diskbottom anvil holder 7 and radially sew up track groove J; Disk inner edge suit is sewed up theplastics lobe ring 13 in thelobe ring 10; The base of terylene ring set 15 is stuck on the disk border of combination diskbottom anvil holder 7, and the circle fan edge sheathing of terylene ring set 15 is on disk border.Holder handle B stretches outplastics lobe ring 13 endoporus centers, the interior convex surface of the concavo-convex collar 14 of setting-in in each square type hole F ofplastics lobe ring 13, butplastics lobe ring 13 endoporus set metal lobe rings 11.Pin nail 17 passes the inner ring of sewing up track groove J and compresses into to disk collet inner face, and stitch is bent upwards by the outer ring notch of sewing up track groove J, and replication is sewed up the inner ring position of track groove J gradually, forms the sutured state.

Consult Figure 10, combination diskbottom anvil holder 7 andstitching lobe ring 10 combined completes embed in the ventricle R inner chamber, and pathological changes mitral valve Q that will be to be excised by bundle lobe line L partly tightens the leading portion at holder handle B, and holder handle B back segment is fitted in and holds in the palm in thehandle hoop 19, is tightened by jump ring H.Askhandle hoop 19 rear ends to connect holder handle hoop pull bar Z, be sleeved in the positioning sleeve 18, positioning sleeve 18 is installed in the ring tube cutter propeller T mesopore ofring tube cutter 9 and rear end connection.The front end of pin nail bin 8 is end face nail anvil P, and the circumference uniform distribution of end face nail anvil P is some to go out a nail mouthful V, interior dress pin nail 17.Aring tube cutter 9 is installed in pin nail bin 8 mesopores, and the ring tube cutter propeller T that is connected is sleeved in the pin nailbin connecting tube 6, andring tube cutter 9 rear portion outer rims connect nail pushing device E, and nail pushing device E front end stretches into going out in the nail mouthful V metapore of pin nail bin 8, contacts with the rear end of pin nail 17.But ring tube cutter propeller T push-and-pullring tube cutter 9 and nail pushing device E are forward or retraction; Holder handle hoop pull bar Z can spurholder handle hoop 19 and drive combination diskbottom anvil holders 7 forward or retreat.

Consult Figure 11, rotation tube type anastomat 4 rear end knobs 1 make holder handle hoop pull bar Z pullingholder handle hoop 19; Driving combination diskbottom anvil holder 7 reclaims backward; Make the front end of sewing uplobe ring 10 and pin nail bin 8 near, adjust to locations at predetermined after, the flexible handle 3 and thefixed handle 2 of the tube type anastomat 4 of holding with a firm grip; Make ring tube cutter propeller T promotering tube cutter 9 forward, the pathological changes Bicuspid valve Q of the ventricle R of snare inlobe ring 10 mesopores is sewed up in excision.The nail pushing device E ofring tube cutter 9 connections simultaneously pushespin nail 17 forward;Pin nail 17 passes the edge and stitchinglobe ring 10 of ventricle R under pressure; Get into the stitching track groove J of combination diskbottom anvil holder 7 disk borders; The pin nail track groove C that the stitch ofpin nail 17 is turned back upstream end face nailing anvil P more backward will sew uplobe ring 10 once more forward and be stitched together with ventricle R.Unclamp flexible handle 3 then; Knob 1 after the reverse rotation, makes holder handle hoop pull bar Z pullingholder handle hoop 19 retraction backward, unclamps, breaks away from combination diskbottom anvil holder 7; Bottom anvil holder subassembly N is scattered naturally; Again tube type anastomat 4 is slowly withdrawed from patient's edge of a knife, then bottom anvil holder subassembly N is pursued lobe by taking out in the mesopore of sewing uplobe ring 10, again socket mechanical valve prosthesis andstitching lobe ring 10.

When adopting the present invention to carry out artificial heart valve stitching operation on heart; The pin nail bin groupware is installed in pin nailbin connecting tube 6 front ends of tube type anastomat 4; Equipped with the nail pushing device E of ring tube cutter propeller T and front end,ring tube cutter 9 can promote synchronization action by ring tube cutter propeller T and nail pushing device E with pin nail 17.The step of mechanical stitch is: lay combination diskbottom anvil holder 7 and tentatively sew up; The excision pathological changes of coincideing mitral valve Q positions stitching; Take out combination diskbottom anvil holder 7; Socket mechanical valve prosthesis andstitching lobe ring 10, the suture operation edge of a knife.Laying the combination diskbottom anvil holder 7 preliminary operating process of sewing up is: the chordae tendineae that cuts off the pathological changes mitral valve Q that connects ventricle R earlier; To make up diskbottom anvil holder 7 suits and sew uplobe ring 10; Middle holder handle B stretches in theholder handle hoop 19 in pin nail bin 8 mesopores; Combination diskbottom anvil holder 7 suits are sewed uplobe ring 10 and are put into ventricle R, and cardiac valve chordae tendineae stump seam is pricked on holder handle B.Rotation tube type anastomat 4 rear end knobs 1; Make holder handle hoop pull bar Z pullingholder handle hoop 19; Drive theholder 7 of combination disk bottom anvil and pin nail bin 8 near, the flexible handle 3 of the shape anastomat 4 that gently holds a writing brush or pen-write makes nail pushing device E slowly forward;Pin nail 17 passes the edge andstitching lobe ring 10 of ventricle R under pressure, get into the stitching track groove J of combination diskbottom anvil holder 7 disk borders.The stitch ofpin nail 17 is turned back after stretching out and sewing up track groove J outer rim, gets into ventricle R incisxal edge once more.The operating process of the excision pathological changes of coincideing mitral valve Q key approximation suture is: the rear end knob 1 that rotates tube type anastomat 4; Ring tube cutter propeller T and nail pushing device E are pushed forward; After adjusting to locations at predetermined; The flexible handle 3 of tube type anastomat 4 held with a firm grip withstandsfixed handle 2, makes ring tube cutter propeller T accentuated push rotatingring tube cutter 9 fast forward, and the pathological changes mitral valve Q of the ventricle R of snare inlobe ring 10 mesopores is sewed up in excision; The stitch ofpin nail 17 is turned back to extreme position backward, will sew uplobe ring 10 and be stitched together with ventricle R.The operating process of taking out combination diskbottom anvil holder 7 is: unclamp flexible handle 3, the back knob 1 of reverse rotation tube type anastomat 4 makes holder handle hoop pull bar Z pullingholder handle hoop 19 break away from combination diskbottom anvil holder 7, and tube type anastomat 4 is slowly withdrawed from patient's edge of a knife.The bottom anvil holder subassembly N that makes up diskbottom anvil holder 7 this moment scatters naturally and is divided into 6 lobes, and bottom anvil holder subassembly N is taken out by pursuing lobe in the mesopore of sewing up lobe ring 10.Carry out the socket mechanical valve prosthesis then and sew uplobe ring 10; Operating process is: with holding the lobe device with mechanical valve prosthesis horizontal sliding forward; In the mesopore of theplastics lobe ring 13 of embeddedsuture lobe ring 10 inner rings, the position is inlayed in 11 adjustment of the metal lobe ring of rotary machine valve, suitable after; The bundle lobe line L on the lobe device is held in cut-out, and will holding the lobe device, to withdraw from the patient external.Make heart recover blood supply then; More than the temperature recovery to 34 ℃; The concavo-convex collar 14 that memorial alloy is processed is from dynamic deformation; Corresponding each square type hole F on theplastics lobe ring 13 is stretched out at each section protrusion position, and ring annular groove W outside being embedded inmetal lobe ring 11 peripheries will sew uplobe ring 10 and be integrated with the mechanical valve prosthesis adapter sleeve.At last, scalpel edge is implemented to sew up, accomplish whole mechanical stitch artificial heart valve operation.

If the artificial mechanical valve prosthesis loses merit, when carrying out twice replaced operation, needn't sew upwhole stitching valve 10 once more; Only need heart is cooled to 34 ℃; The concavo-convex collar 14 that memorial alloy is processed resiles, and bounces back on theplastics lobe ring 13 in the corresponding square type hole F to projecting inward position, takes out mechanical valve prosthesis; Repeat above-mentioned socket mechanical valve prosthesis and the operating process of sewing uplobe ring 10, can accomplish the secondary valve replacement.Convenient, safety, success rate is high, alleviates patient's misery.

Claims (8)

1. mechanical stitch formula artificial heart valve; It is characterized in that artificial heart valve comprises stitching lobe ring (10), mechanical valve prosthesis, match, sew up lobe ring (10) and form by plastics lobe ring (13), the concavo-convex collar (14), terylene ring set (15) with the mechanical stitch device; Mechanical valve prosthesis is assembled by metal lobe ring (11), metal lobe leaf (12); Sewing up lobe ring (10) is support with plastics lobe ring (13), and the concavo-convex collar (14) that memorial alloy is processed is sleeved on plastics lobe ring (13) outer rim, terylene ring set (15) liner latex ring (16); In plastics lobe ring (13) and the concavo-convex collar (14) be wrapped in; At interval evenly have several square type holes (F) on the circumference anchor ring of plastics lobe ring (13), the concavo-convex collar (14) is embedded in the square type hole (F) by plastics lobe ring (13) outer rim to each projecting inward section, has edge near the end face inner edge of ventricle (R) side; The metal lobe ring (11) of mechanical valve prosthesis adopts carbon alloy to process with metal lobe leaf (12); Metal lobe leaf (12) is the semicircle blades of two lobes, and two ends respectively are provided with short lobe rachis, are erected on endoporus (K) the wall groove of metal lobe ring (11) outer face; The semicircle blade activity of metal lobe leaf (12) is installed on the lobe rachis; The periphery outer ring of metal lobe ring (11) has cannelure (W), near the end face annular distance internal marginal zone of ventricle (R) side edge is arranged, and the mechanical stitch device comprises pin nail bin groupware, combination disk bottom anvil holder (7); The pin nail bin groupware is made up of pin nail bin (8), pin nail (17), the ring tube cutter (9) of band edge face nailing anvil (P), is installed in pin nail bin connecting tube (6) front end of tube type anastomat (4).

2. according to the described mechanical stitch formula of claim 1 artificial heart valve; The pin nail bin (8) that it is characterized in that described pin nail bin groupware is cylindric interlayer sleeve; The outer threaded inner bolt hole with pin nail bin connecting tube (6) of tail end is equipped; Mesopore (D) interior suit ring tube cutter (9), ring tube cutter (9) is the tube-like thin-wall cutter, tail end is connected with ring tube cutter propeller (T); The end face nail anvil (P) of pin nail bin (8) end is the flange dish type around centre bore; Evenly have several on end face nail anvil (P) circumferential plane at interval and axially go out nail mouthful (V), interior dress pin nail (17), each goes out nail mouthful (V) outer rim correspondence and has two radial needle nail track grooves (C).

3. according to the described mechanical stitch formula of claim 1 artificial heart valve; It is characterized in that the discoid collet that described combination disk bottom anvil holder (7) is formed for bottom anvil holder subassembly (N) amalgamation; The center is a vertical holder handle (B); Radially evenly be divided into six bottom anvil holder subassemblys (N) from holder handle (B) center of circle to the outer rim of discoid collet, the center of circle angle of every bottom anvil holder subassembly (N) is 60 °, evenly has some above the disk edge and radially sews up track groove (J).

4. the sewing method of a mechanical stitch formula artificial heart valve; It is characterized in that it being to adopt the described artificial heart valve of claim 1 to be sewn to ventricle (R) to go up alternative heart Bicuspid valve; During stitching,, will sew up the disk inner edge that lobe ring (10) is seated in combination disk bottom anvil holder (7) with mechanical stitch device fit applications; Disk inner edge suit is sewed up the plastics lobe ring (13) of lobe ring (10); The circle fan edge sheathing of terylene ring set (15) is installed on above the disk edge of combination disk bottom anvil holder (7), and pin nail bin (8) is installed in pin nail bin connecting tube (6) front end of tube type anastomat (4), and ring tube cutter propeller (T) is connected with nail pushing device (E); Ring tube cutter propeller (T) promotes ring tube cutter (9) and pin nail (17) synchronization action; To sew up lobe ring (10) according to the mechanical stitch step and be sewn on the ventricle (R), and mechanical valve prosthesis will be linked in sew up on the lobe ring (10) again, stitching step is: lay combination disk bottom anvil holder (7) and tentatively sew up; The excision pathological changes mitral valve (Q) that coincide positions stitching; Take out combination disk bottom anvil holder (7); Socket mechanical valve prosthesis and stitching lobe ring (10).

5. according to the sewing method of the described mechanical stitch formula of claim 4 artificial heart valve; It is characterized in that describedly laying the operating process that combination disk bottom anvil holder (7) carries out preliminary stitching step and being: the chordae tendineae that cuts off ventricle (R) earlier; Combination disk bottom anvil holder (7) is enclosed within to be sewed up on the lobe ring (10); Holder handle (B) stretches in the holder handle hoop (19) in pin nail bin (8) mesopore, and fixing by jump ring (H), discoid collet is put into ventricle (R); Pathological changes mitral valve (Q) chordae tendineae stump seam is pricked on holder handle (B); Rotate the knob (1) of tube type anastomat (4) rear end, make holder handle hoop pull bar (Z) the pulling combination disk bottom anvil holder (7) in tube type anastomat (4) inner chamber draw close the flexible handle (3) of the type that gently holds a writing brush or pen-write anastomat (4) to pin nail bin (8); Make nail pushing device (E) promote edge and stitching lobe ring (10) that pin nail (17) passes ventricle (R); Get into the stitching track groove (J) of combination disk bottom anvil holder (7) disk border, the stitch of pin nail (17) is inwardly turned back after stretching out and sewing up track groove (J) outer rim, gets into ventricle (R) incisxal edge once more.

6. according to the sewing method of the described mechanical stitch formula of claim 46 artificial heart valve; It is characterized in that the operating process that described identical excision pathological changes mitral valve (Q) positions stitching step is: the flexible handle (3) of the type that gently holds a writing brush or pen-write anastomat (4); Ring tube cutter propeller (T) slowly promotes ring tube cutter (9) forward; After adjusting to locations at predetermined, the flexible handle (3) of the tube type anastomat of holding with a firm grip (4) contacts fixed handle (2), and ring tube cutter propeller (T) accentuated push rotating ring tube cutter (9) is protruded forward fast; Carry out osculating; To sew up pathological changes mitral valve (Q) excision of snare in lobe ring (10) mesopore, the stitch of pin nail (17) is turned back to extreme position backward, will sew up lobe ring (10) and be stitched together with ventricle (R).

7. according to the sewing method of the described mechanical stitch formula of claim 4 artificial heart valve; The operating process that it is characterized in that described taking-up combination disk bottom anvil holder (7) step is: unclamp flexible handle (3); The knob (1) of backward rotation tube type anastomat (4) rear end; Holder handle hoop (19) in pin nail bin (8) mesopore bounce back backward and make up disk bottom anvil holder (7) and unclamp, break away from; It is external that tube type anastomat (4) withdraws from the patient through the edge of a knife, and the bottom anvil holder subassembly (N) of combination disk bottom anvil holder (7) scatters naturally and is divided into six lobes, then bottom anvil holder subassembly (N) taken out respectively by pursuing lobe in the mesopore of sewing up lobe ring (10).

8. according to the sewing method of the described mechanical stitch formula of claim 4 artificial heart valve; It is characterized in that described socket mechanical valve prosthesis and the operating process of sewing up lobe ring (10) step are: with holding the lobe device, in the mesopore of the plastics lobe ring (13) of embedded suture lobe ring (10) inner ring, rotate the position of inlaying of the metal lobe ring (11) of adjusting mechanical valve prosthesis with mechanical valve prosthesis horizontal sliding forward; After confirming correct position; The bundle lobe line on the lobe device is held in cut-out, will hold the lobe device and withdraw from externally, makes heart recover blood supply; More than the temperature recovery to 34 ℃; The concavo-convex collar (14) that memorial alloy is processed is from dynamic deformation, and each section stretches out plastics lobe ring (13) to the inner protruding part and go up corresponding each square type hole (F), embeds the outer ring annular groove (W) of periphery of metal lobe ring (11); To sew up lobe ring (10) and connect as one, and then scalpel edge implemented to sew up with the tight fit of mechanical valve prosthesis.

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