Valve clampTechnical Field
The present invention relates to the field of medical devices, and in particular to a valve clip for treating mitral regurgitation and tricuspid regurgitation.
Background
The mitral valve is a two-piece valve attached to the periphery of the left atrioventricular orifice (as shown in fig. 1), and chordally attached to the papillary muscles, has the effect of preventing blood from flowing back into the left atrium.
Mitral Regurgitation (MR) is a series of pathophysiological changes caused by poor anterior and posterior She Wenge of the mitral valve due to organic or functional changes in the mitral valve leaflets and their associated structures, and the regurgitation of blood flow from the left ventricle to the left atrium. Severe MR causes left ventricular enlargement, eventually leading to left heart contractile failure dysfunction and heart failure, while left atrial pressure also increases due to regurgitation, easily leading to left atrial enlargement, atrial fibrillation, and pulmonary hypertension. MR prognosis is poor, the annual mortality rate of symptomatic and non-operating persons is around 5%, and the 5-year mortality rate of severe heart failure patients reaches 60%. Meanwhile, MR is also one of the most common heart diseases. The incidence of people over the ages of 65 and 75 was counted as 6.4% and 9.3%, respectively. With the development of the economic society and the aging of the population, the incidence of mitral regurgitation is in a markedly rising state.
Surgical valve repair or replacement is considered a standard treatment for this disease. However, surgery has the disadvantages of large trauma, obvious postoperative pain, slow recovery, high risk, and the like, and in addition, some patients who are old, have history of chest opening, have poor cardiac function, and incorporate multiple organ insufficiency are often rejected from the surgery because of the large risk of the surgery. Therefore, there is a great social and market need to develop minimally invasive, low risk, interventional therapeutic devices for the treatment of MR. In recent years, with the breakthrough development of valve interventional therapy technology, an MR interventional instrument has become one of the important directions for developing domestic and foreign cardiovascular instruments.
Among them, the valve clamping mechanism developed according to the surgical valve edge-to-edge suturing technology principle is most affirmed at present because of high safety, simple technology principle and high feasibility. The surgical valve edge-to-edge suturing technique principle is shown in figure 2, namely, when the mitral valve is in regurgitation, the two valve leaf edges cannot be closed in a closing way in systole to form a gap, so that blood flow of the left ventricle returns to the left atrium from the gap, and the surgical edge-to-edge suturing is used for suturing the middle points of the two valve leaf edges of the mitral valve, so that the gap between the valve leaf is disappeared or becomes smaller in systole, thereby reducing mitral valve regurgitation (figure 2 a), and the mitral valve is opened into a double-hole shape in diastole, and blood flow into the left ventricle is not influenced (figure 2 b). The only minimally invasive interventional instrument commercially available from International for therapeutic MR is MITRACLIP from Evalve, which is a valve clamping device.
CN201610594219 discloses a valve clamp that captures the clamping operation from the ventricular side of the valve. However, the device still has the defects that the operation space required for capturing the valve is too large, the wound entering from the apex of the heart is still bigger, the operation can still be performed only through the ventricular side, chordae tendineae are easy to wind, the atrial top is easy to damage, and only two sides of the valve can be captured simultaneously.
Accordingly, those skilled in the art have been directed to developing a novel valve clip locking mechanism and valve clip provided with the same to further shorten the clip axial operating space.
Disclosure of Invention
The invention aims to provide a valve clamp, which shortens the axial operation space of the clamp, changes the operation direction, performs capturing and clamping operation from the atrial surface of a valve, reduces the risk of damage to atria and chordae during operation, shortens the length of the clamp, shortens the implanted clamp, reduces the risk of thrombus formation, and reduces the possibility of damage to heart tissues caused by parts exposed on the ventricular side of the clamp.
In order to achieve the above purpose, the invention adopts the following technical scheme:
A valve clamp, comprising a clamping component, a coupling mechanism, a base and a locking mechanism, wherein the clamping component comprises a first clamping component and a second clamping component, the first clamping component is provided with at least two first clamping arms, the second clamping component is provided with a corresponding number of second clamping arms, each first clamping arm and the corresponding second clamping arm form a group of clamps, the first clamping arms and the second clamping arms are arranged at the far end of the coupling mechanism, the coupling mechanism is of a hollow structure, a first connecting structure and a second connecting structure which are respectively used for being connected with a delivery sheath and the locking mechanism are arranged on the coupling mechanism, the locking mechanism is arranged on the base, a third connecting structure which corresponds to the second connecting structure and a fourth connecting structure which is used for being connected with a pushing rod are arranged on the locking mechanism, the base is movably connected with the second clamping arms through a connecting rod, and the base can be connected with the second connecting structure on the third connecting structure and the locking mechanism on the locking mechanism through the third connecting structure;
Correspondingly, the first clamping arms and the second clamping arms are made of elastic materials, a shaping included angle is formed between the first clamping arms, and an included angle of 0-300 degrees can be formed between the second clamping arms;
Correspondingly, the end part of the free end of the first clamping arm is provided with a threading hole, pull wires are respectively arranged in the threading holes in a penetrating mode, the first clamping arm can be independently controlled to be closed through the pull wires, and when the first clamping arm is required to restore the shaping included angle so as to capture target tissues, the pulling force of the pull wires on the first clamping arm is relieved;
Correspondingly, a rough structure is arranged on one side of the first clamping arm relative to the second clamping arm, the rough structure comprises a tooth structure, a barb structure or a bulge structure, a groove structure is arranged on one side of the second clamping arm relative to the first clamping arm, and the first clamping arm can better capture and clamp target tissues in the groove structure of the second clamping arm through the rough structure, so that the clamping force of the clamping component on the target tissues is improved;
Correspondingly, the lengths of the tooth-shaped structures, the barb structures or the bulge structures are gradually shortened from the near free end to the far free end;
Correspondingly, the end part of the free end of the second clamping arm is provided with a flanging fillet, so that the damage of the end part of the second clamping arm to tissues is reduced;
Correspondingly, the first connecting structure comprises a first wavy curve wall axially arranged at the proximal end of the coupling mechanism and a second wavy curve wall arranged at the distal end of the delivery sheath, wherein the first wavy curve wall and the second wavy curve wall are correspondingly arranged and are used for limiting the axial displacement of the connection between the coupling mechanism and the delivery sheath;
correspondingly, the first connecting structure comprises a first bump and a connector which are arranged on the outer side wall of the coupling mechanism, the connector comprises a hollow connecting seat and an arc-shaped groove wall which is arranged on the connecting seat, the connecting seat is arranged at the far end of the conveying sheath, the arc-shaped groove wall is made of elastic materials and is shaped into a flaring shape, a first notch is arranged on the arc-shaped groove wall, opposite connecting pieces are arranged on the inner sides of the arc-shaped groove wall, and a pore canal which is convenient for a pushing rod to pass through is arranged on the connecting pieces;
Correspondingly, the first connecting structure comprises a second notch arranged on the outer side wall of the coupling mechanism and at least two elastic arms which are made of elastic materials and shaped to be close to the center, the elastic arms are arranged at the distal end of the conveying sheath, and a second lug is arranged on each elastic arm; when the pushing rod passes through the delivery sheath and the coupling mechanism, the elastic arm is outwards supported, so that the second lug on the elastic arm is driven to be clamped into the second notch, stable connection between the coupling mechanism and the delivery sheath is realized, after the pushing rod is withdrawn, the elastic arm is restored to the close state, and then the second lug is driven to be withdrawn from the second notch, so that the coupling mechanism and the delivery sheath are separated, and as the elastic arm is arranged on the delivery sheath, the elastic arm is withdrawn from the body along with the delivery sheath after clamping is completed and is not left in the body;
Correspondingly, the second connecting structure comprises a first bayonet arranged on the side wall of the coupling mechanism, the third connecting structure comprises a first base, a first elastic piece, a clamping piece and a first clamping block, the first base is of a hollow structure, the far end of the first base is arranged on the base, the inner side wall of the first base is provided with a fourth connecting structure, the fourth connecting structure comprises an internal thread, the first elastic piece is made of elastic materials and is shaped into an outwards inclined shape, the first elastic piece is arranged on the near end of the first base, the inner side wall and the outer side wall of the first elastic piece are respectively provided with the clamping piece and the first clamping block, and the clamping piece is provided with a through hole which is convenient for a pushing rod to pass through; when the push rod passes through the through hole, the first elastic sheet is pulled into the hollow structure of the coupling mechanism through the clamping piece, the capturing state of the second clamping arm to the target tissue is adjusted through pushing and pulling of the push rod, when an ideal capturing position is found, the push rod and the first base are spirally separated and withdrawn from the through hole, after the limiting force of the push rod to the first elastic sheet is removed, the first elastic sheet is expanded outwards to restore the shaping shape, and then a first clamping block on the first elastic sheet is driven to be clamped into the first clamping opening, so that the locking between the locking mechanism and the coupling mechanism is realized, and then the clamping state of the current clamping component to the target tissue is locked;
Correspondingly, the second connecting structure comprises a second bayonet arranged on the side wall of the coupling mechanism, the second bayonet comprises a vertical bayonet and a transverse bayonet, the third connecting structure comprises a hollow lower clamping table and a hollow upper clamping table, the far end of the lower clamping table is arranged on the base, the near end of the lower clamping table is provided with a groove, the far end of the upper clamping table is correspondingly provided with a back-off buckle with the groove, a second clamping block is arranged on the outer side wall of the upper clamping table, in addition, the inner side walls of the lower clamping table and the upper clamping table are provided with a fourth connecting structure, the fourth connecting structure comprises internal threads, the back-off buckle is clamped in a clamping groove to realize the clamping connection between the upper clamping table and the lower clamping table, when the push rod is not separated from the locking mechanism, the push rod can be pushed and pulled freely to adjust the capturing state of the second clamping arm to the target tissue, when the ideal capturing position is found, the push rod and the lower clamping block and the upper clamping block are separated from the spiral, the second clamping block moves along with the outer pulling rod of the push rod along with the vertical bayonet, then the clamping rod is separated from the clamping table, and then the locking mechanism is locked to realize the locking state of the target tissue.
Correspondingly, the second connecting structure comprises a clamping window and a limiting bulge which are arranged on the side wall of the coupling mechanism, the clamping window comprises a first clamping window and a second clamping window which are respectively arranged on two sides of the limiting bulge, the third connecting structure comprises a torsion spring, a hollow upper end block and a hollow lower end block, the proximal end of the torsion spring is arranged on the side wall of the coupling mechanism, the distal end of the torsion spring is connected with the proximal end of the upper end block, a third waveform curve wall is axially arranged at the distal end of the upper end block, a fourth waveform curve wall is correspondingly arranged at the proximal end of the lower end block and the third waveform curve wall, the distal end of the lower end block is arranged on the base, a limiting block is arranged on the outer side wall of the upper end block, the limiting block can move in the first clamping window along the height direction of the first clamping window, can not move in the first clamping window along the width direction of the first clamping window, can move in the second clamping window along the width direction of the second clamping window, and can not move in the second clamping window along the width direction of the second clamping window, and the fourth connecting structure comprises a fourth inner side wall and the inner side wall; when the pushing rod is not separated from the locking mechanism, the limiting block is limited in the first clamping window by the limiting protrusion, so that the third wavy curve wall and the fourth wavy curve wall are in an unclamped state, the pushing rod can be freely pushed and pulled to adjust the capturing state of the second clamping arm on the target tissue, when an ideal capturing position is found, the pushing rod, the lower end block and the upper end block are spirally separated, the upper end block is driven to radially move by the spiral separation of the pushing rod in the process of separating and withdrawing the pushing rod, and then the limiting block is driven to move along the height direction of the first clamping window, therefore, the limiting height of the limiting protrusion is exceeded, the limiting block is clamped into the second clamping window under the torsion force of the torsion spring, meanwhile, the third waveform curve wall and the fourth waveform curve wall are clamped, locking between the locking mechanism and the coupling mechanism is achieved, and then the clamping state of the current clamping component to the target tissue is locked;
Correspondingly, the second connecting structure comprises a second elastic sheet arranged on the coupling mechanism, the second elastic sheet is made of elastic materials and shaped into a shape inclined towards the inside of the coupling mechanism, a pull rope is arranged on the second elastic sheet in a penetrating mode, the third connecting structure comprises a hollow second base, the second base is provided with a rough outer side wall, the far end of the second base is arranged on the base, the inner side wall of the second base is provided with a fourth connecting structure, the fourth connecting structure comprises an inner thread, the pull rope is pulled up, the capturing state of the second clamping arm to target tissues is adjusted through pushing and pulling of the push rod, when an ideal capturing position is found, the push rod and the second base are separated in a spiral mode and are withdrawn, the pull rope is put down, the second elastic sheet restores the inner inclined shaping shape of the second elastic sheet, the rough outer side wall of the second base is in a friction locking mode, locking between the locking mechanism and the coupling mechanism is achieved, and then the clamping state of the current clamping component to the target tissues is locked.
In the present invention, the terms "proximal" and "distal" refer to the relative positions of the valve and the operator during the valve operation. Wherein the proximal end refers to an end proximal to the operator and the distal end refers to an end distal from the operator. The "shaping" refers to the shape or the included angle of the structure in the natural structure without external force through the earlier process, for example, the "shaping included angle" refers to the angle naturally presented between the first clamping arms without external force. The elastic material refers to a material which is deformed by force and returns to the original shape after the acting force is removed.
The beneficial effects of the invention are as follows:
1) The clamping angles of the first clamping arms are shaped, the closing angle in the operation process of the first clamping arms can be independently adjusted through a pull wire, the clamping angles of the second clamping arms are adjusted in a pushing mode through a pushing rod, the final clamping angles are locked by means of connection between the locking mechanism and the coupling mechanism, and compared with the clamping arms which are respectively shaped or can only be synchronously adjusted, the first clamping arms and the second clamping arms can be independently adjusted, and target tissues with different thickness shapes can be captured by the more suitable clamping angles, so that the clamping effect is better;
2) The coupling mechanism is arranged, so that the connection and the disconnection between the clamp and the conveying sheath are simpler and more convenient, and the locking mechanism is arranged, so that the connection and the disconnection between the clamp and the pushing rod are simpler and more convenient, and the locking mechanism and the coupling mechanism are used for locking the clamping state of the second clamping arm, so that the locking is simple and easy to operate, and the clamping locking efficiency is improved;
3) Through the setting of coupling mechanism and locking mechanical system, on the one hand, shorten the clamp axial operation space, change the operation direction, carry out capturing and clamping operation from the other side of valve namely the atrium face, reduce its risk of damage to atrium and chordae tendineae in the operation course, on the other hand, shorten the clamp length, make the clamp of implantation shorter, reduce the risk of thrombosis, with the reduction exposes to the possible damage of clamp ventricular side part to heart tissue, in addition, this valve clamp system adopts and carries out the path of clamp from the atrium after the interval of femoral vein puncture room, do not need to cut open intercostal and puncture apex, the operation wound is less.
Drawings
FIG. 1 is a schematic representation of the anatomy of a heart;
In the figure, 1 is an upper vena cava, 2 is a lower vena cava, 3 is a right atrium, 4 is a tricuspid valve, 5 is a right ventricle, 6 is a pulmonary valve, 7 is a pulmonary artery, 8 is a pulmonary vein, 9 is a left atrium, 10 is a mitral valve, 11 is a left ventricle, 12 is an aortic valve, 13 is an aorta, 14 is a descending aorta, 15 is an oxygen-containing blood flow direction, and 16 is an oxygen-deficient blood flow direction;
FIG. 2 is a schematic diagram of a surgical mitral valve edge-to-edge suturing technique, wherein 2a is mitral valve closure and 2b is mitral valve patency;
FIGS. 3a-3d are schematic perspective views of a valve clip according to an embodiment of the present invention;
FIG. 4a is a schematic side view of a valve clip according to one embodiment of the present invention;
fig. 4b is a schematic structural view of the coupling mechanism according to the first, second or third embodiments of the present invention;
fig. 4c is a schematic structural diagram of the coupling mechanism and the delivery sheath according to the first, second or third embodiments of the present invention;
FIG. 4d is a schematic view of a mating structure of a locking mechanism and a coupling mechanism according to an embodiment of the present invention;
FIG. 5a is a schematic side view of a valve clip according to a second embodiment of the present invention;
Fig. 5b is a schematic structural diagram of a card loading table according to a second embodiment of the invention;
FIG. 5c is a schematic view of a locking mechanism and coupling mechanism according to a second embodiment of the present invention;
FIG. 6a is a schematic side view of a valve clip according to a third embodiment of the present invention;
FIGS. 6b and 6c are schematic diagrams illustrating a locking mechanism according to a third embodiment of the present invention;
FIGS. 6d and 6e are schematic views showing the mating structures of the locking mechanism and the coupling mechanism according to the third embodiment of the present invention;
FIG. 7a is a schematic side view of a valve clip according to a fourth embodiment of the present invention;
Fig. 7b is a schematic structural diagram of a connector according to a fourth embodiment of the invention;
FIG. 8a is a schematic side view of a valve clip according to a fifth embodiment of the present invention;
FIG. 8b is a schematic view of a resilient arm according to a fifth embodiment of the present invention;
In the figure:
110. The first clamping arm, 111, a barb structure, 112, a threading hole, 113 and a stay wire;
120. The second clamping arm, 121, groove structure, 122, flanging fillet;
200. A coupling mechanism;
211. 212, a second wavy curve wall;
221. Connecting seat, 222, arc groove wall, 223, first notch, 224, connecting piece;
231. 232, elastic arms 233, second lugs;
240. a first bayonet;
251. 252, transverse bayonet;
261. the first clamping window 262, the second clamping window 263, the limit bulge;
271. 272, pulling rope;
300. a base;
400. a locking mechanism;
411. the first base, 412, the first elastic sheet, 413, the clamping piece, 414, the first clamping block;
421. 422, upper clamping table, 423, groove, 424, back-off, 425, internal thread, 426, second clamping block;
431. Torsion spring 432, upper end block 433, lower end block 434, third wave curve wall 435, fourth wave curve wall 436, limit block;
441. A second base;
500. a connecting rod;
600. A delivery sheath;
700. Pushing rod.
Detailed Description
In the description of the present invention, it should be understood that the terms "center", "longitudinal", "lateral", "length", "width", "thickness", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", "clockwise", "counterclockwise", etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings are merely for convenience in describing the present invention and simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present invention.
Furthermore, the terms "first," "second," and the like, are used for descriptive purposes only and are not to be construed as indicating or implying a relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defining "a first" or "a second" may explicitly or implicitly include one or more such feature. In the description of the present invention, the meaning of "a plurality" is two or more, unless explicitly defined otherwise.
In the present invention, unless explicitly specified and limited otherwise, the terms "mounted," "connected," "secured," and the like are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected, mechanically connected, electrically connected, directly connected, indirectly connected via an intervening medium, or in communication between two elements. The specific meaning of the above terms in the present invention can be understood by those of ordinary skill in the art according to the specific circumstances.
In one embodiment of the invention, the valve clamp includes a clamping member, a coupling mechanism 200, a base 300, and a locking mechanism 400;
As shown in fig. 3a-3d, the clamping members comprise a first clamping member having two first clamping arms 110 and a second clamping member having a corresponding number of second clamping arms 120, each first clamping arm 110 forming a set of clamps with its corresponding second clamping arm 120. The first clamping arm 110 and the second clamping arm 120 are made of elastic materials, such as nickel-titanium alloy, wherein the first clamping arm 110 can be fixedly arranged on the coupling mechanism 200 by welding or the like, and the second clamping arm 120 can be rotatably arranged on the coupling mechanism 200, such as by hinging. The first clamping arms 110 are provided with a shaping included angle therebetween, the shaping included angle is an included angle when capturing a clamped target tissue, the end part of the free end of the first clamping arms 110 is provided with a threading hole 112, pull wires 113 are respectively arranged in the threading holes 112 in a penetrating manner, and the included angle between the first clamping arms 110 can be independently controlled through the pull wires 113 in the process of conveying the clamping device or capturing the target tissue, for example, in order to facilitate the shrinkage conveying of the first clamping arms 110, the pull wires 113 can be tensioned, so that the first clamping arms 110 are vertically arranged on the coupling mechanism 200, and the required conveying pipe diameter can be reduced to the greatest extent. The push rod 700 is pushed and pulled to drive the locking mechanism 400 and the base 300 fixedly arranged with the locking mechanism 400 to move, and the movement of the base 300 drives the second clamping arms 120 to open or close by means of the connecting rod 500, so that an included angle of 0-300 degrees can be formed between the second clamping arms 120. In addition, a rough structure is arranged on one side of the first clamping arm 110 relative to the second clamping arm 120, the rough structure comprises a tooth structure, a barb structure 111 or a bulge structure, the length of the tooth structure, the barb structure 11 or the bulge structure gradually shortens from the free end of the first clamping arm 110 to the free end of the first clamping arm 110, a groove structure 121 is arranged on one side of the second clamping arm 120 relative to the first clamping arm 110, the first clamping arm 110 better captures and clamps target tissues in the groove structure 121 of the second clamping arm 120 through the rough structure, the clamping force of clamping components on the target tissues is improved, and the end part of the free end part of the second clamping arm 120 is provided with a flanging fillet 122, so that the damage of the end part of the second clamping arm 120 on the tissues is reduced;
The coupling mechanism 200 is a hollow structure, a first connecting structure and a second connecting structure which are respectively used for being connected with the delivery sheath 600 and the locking mechanism 400 are arranged on the coupling mechanism 200, the locking mechanism 400 is arranged on the base 300, and a third connecting structure corresponding to the second connecting structure and a fourth connecting structure used for being connected with the pushing rod 700 are arranged on the locking mechanism 400;
In one embodiment of the present invention, as shown in fig. 4a-4d, the first connection structure includes a first wavy curved wall 211 axially disposed at the proximal end of the coupling mechanism 200 and a second wavy curved wall 212 axially disposed at the distal end of the delivery sheath 600, the first wavy curved wall 211 and the second wavy curved wall 212 are correspondingly disposed, the connection between the coupling mechanism 200 and the delivery sheath 600 is achieved by the snap-fit engagement of the first wavy curved wall 211 and the second wavy curved wall 212, and of course, in order to facilitate operation, the distal end of the delivery sheath 600 is generally disposed directly as a wavy curved wall, in which case the second wavy curved wall 212 may be regarded as a butt joint structure disposed on the delivery sheath 600, in another embodiment of the present invention, as shown in fig. 7a and 7b, the first connection structure includes a first bump and a connector disposed on the outer side wall of the coupling mechanism 200, the connector includes a hollow connector 221 and an arc-shaped groove wall 222 disposed on the connector 221, the connector 221 is disposed at the distal end of the delivery sheath 600, for example, the connector 221 may be fixedly disposed on the delivery sheath 600 by welding or the like, in which case the connector 221 may be integrally disposed on the delivery sheath 600. In still another embodiment of the present invention, as shown in fig. 8a and 8b, the first connection structure comprises a second notch 231 formed on the outer side wall of the coupling mechanism 200 and at least two elastic arms 232 formed by elastic materials and shaped to be close to the center, the elastic arms 232 are disposed at the distal end of the delivery sheath 600, for example, the elastic arms 232 can be fixedly disposed on the delivery sheath 600 by welding or the like, and in the same way, the elastic arms 232 can be integrally or separately disposed on the delivery sheath 600 for operation convenience, and at this time, the elastic arms 232 can be regarded as a butt joint structure disposed on the delivery sheath 600, and the second protrusions 233 are disposed on the elastic arms 232;
In one embodiment of the present invention, as shown in fig. 4a and 4d, the second connection structure comprises a first bayonet 240 disposed on a sidewall of the coupling mechanism 200, the third connection structure comprises a first base 411, a first elastic piece 412, a clamping piece 413 and a first clamping block 414, the first base 411 is a hollow structure, a distal end of the first base 411 is disposed on the base 300, a fourth connection structure is disposed on an inner sidewall of the first base 411, in this embodiment, the fourth connection structure is disposed as an internal thread, the first elastic piece 412 is made of an elastic material and is shaped into an outwardly inclined shape, and is disposed on a proximal end of the first base 411, the clamping piece 413 and the first clamping block 414 are disposed on an inner sidewall and an outer sidewall of the first elastic piece 412, and a through hole for facilitating the push rod 700 to pass through is disposed on the clamping piece 413, in another embodiment of the present invention, as shown in fig. 5a, 5b and 5c, the second connection structure comprises a second bayonet disposed on the sidewall of the coupling mechanism 200, the second bayonet comprises a vertical bayonet 251 and a horizontal bayonet 252, the third connection structure comprises a hollow lower clamping table 421 and a hollow upper clamping table 422, the distal end of the lower clamping table 422 is disposed on the base 300, the proximal end of the lower clamping table 422 is provided with a groove 423, the distal end of the upper clamping table 421 is provided with a back-off 424 corresponding to the groove 423, and a second clamping block 426 is disposed on the outer sidewall of the upper clamping table 422, in addition, the inner sidewalls of the lower clamping table 421 and the upper clamping table 422 are provided with a fourth connection structure, in this embodiment, the fourth connection structure is provided with internal threads 425, in yet another embodiment of the invention, as shown in fig. 6a-6e, the second connection structure comprises clamping windows and limiting protrusions 263 disposed on the sidewall of the coupling mechanism, the clamping windows comprise a first clamping window 261 and a second clamping window 262 disposed on both sides of the limiting protrusions 263, and the third connection structure comprises a torsion spring 431, The hollow upper end block 432 and the hollow lower end block 433, the proximal end of the torsion spring 431 is arranged on the side wall of the coupling mechanism 200, the distal end of the torsion spring 431 is connected with the proximal end of the upper end block 432, the distal end of the upper end block 432 is axially provided with a third wavy curve wall 434, the proximal end of the lower end block 433 and the third wavy curve wall 434 are correspondingly provided with a fourth wavy curve wall 435, the distal end of the lower end block 433 is arranged on the base 300, the outer side wall of the upper end block 432 is provided with a limiting block 436, the limiting block 436 can move in the first clamping window 261 along the height direction of the first clamping window 261, can not move in the first clamping window 261 along the width direction of the second clamping window 262, can not move in the second clamping window 262 along the height direction of the second clamping window 262, and the inner side walls of the upper end block 432 and the lower end block 433 are provided with fourth connecting structures, in this embodiment, the fourth connecting structures are provided with internal threads; in a further embodiment of the present invention, as shown in fig. 8a and 8b, the second connection structure includes a second elastic piece 271 disposed on the coupling mechanism, the second elastic piece 271 is made of elastic material and shaped into a shape inclined to the inside of the coupling mechanism 200, a pull rope 272 is inserted through the second elastic piece 271, the third connection structure includes a hollow second base 441, the second base 441 has a rough outer side wall, a distal end thereof is disposed on the base 300, and a fourth connection structure is disposed on an inner side wall of the second base 441, in this embodiment, the fourth connection structure is configured as an internal thread;
The base 300 is movably connected with the second clamping arm 120 through a connection rod 500, for example, one end of the connection rod 500 is hinged with the base 300, and the other end of the connection rod 500 is hinged with the second clamping arm 120.
According to the foregoing valve clip, several embodiments are possible as follows:
Example 1
As shown in fig. 4a to 4d, the coupling mechanism 200 adopts a mode of clamping the wavy curve wall and the delivery sheath 600, and simultaneously, the locking mechanism 400 adopts a mode of locking the coupling mechanism 200 adopting the first base 411, the first elastic sheet 412, the clamping piece 413, the first clamping block 414 and the first bayonet 240;
The coupling mechanism 200 and the delivery sheath 600 are anastomosed and clamped by the first wavy curve wall 211 and the second wavy curve wall 212, axial displacement cannot be directly generated between the coupling mechanism 200 and the delivery sheath 600, then the push rod 700 sequentially passes through the delivery sheath 600, the coupling mechanism 200 and the through hole and is in threaded connection with the first base 411, radial displacement between the coupling mechanism 200 and the delivery sheath 600 is limited by the push rod 700, connection stability between the coupling mechanism 200 and the delivery sheath 600 is ensured, meanwhile, the push rod 700 inclines the first outer inclined elastic sheet 412 into the hollow structure of the coupling mechanism 200 through the clamping piece 413, and in this state, the push rod 700 can be freely pushed and pulled, so that the locking mechanism 400 moves in the coupling mechanism 200. The pushing and pulling of the pushing rod 700 drives the locking mechanism 400 and the base 300 fixedly arranged with the first base 411 to move, and the movement of the base 300 drives the second clamping arm 120 to open or close through the connecting rod 500, and similarly, the pushing rod 700 can also be rotated to drive the second clamping arm 120 to rotate. When the second clamping arm 120 finds a suitable clamping position, the push rod 700 is used to pull the locking mechanism 400 to a position convenient to lock with the coupling mechanism 200, the push rod 700 is reversely rotated to release the threaded connection between the push rod 700 and the first base 411 and withdraw the push rod 700, after the limiting force of the push rod 700 on the first elastic sheet 412 is removed, the first elastic sheet 412 is obliquely restored to the shaping shape, and then the first clamping block 414 on the first elastic sheet is driven to be clamped into the first clamping opening 240, so that the locking between the locking mechanism 400 and the coupling mechanism 200 is realized, and then the clamping state of the current clamping component on the target tissue is locked. Meanwhile, the pushing rod 700 is withdrawn to lack radial limitation between the first wavy curved wall 211 and the second wavy curved wall 212, so that radial dislocation can be performed between the first wavy curved wall 211 and the second wavy curved wall 212, and the decoupling between the coupling mechanism 200 and the delivery sheath 600 and withdrawal of the delivery sheath 600 can be realized through radial dislocation and axial displacement in sequence, so that the clip can be independently implanted in a patient.
Example two
As shown in fig. 5a-5c, the coupling mechanism 200 adopts a mode of clamping the wave-shaped curve wall and the conveying sheath 600, and simultaneously, the locking mechanism 400 adopts a mode of locking the lower clamping table 421, the upper clamping table 422 and the coupling mechanism 200 adopting a second bayonet;
The upper clamping table 422 and the lower clamping table 421 are clamped in the clamping groove 423 through the back-off 424, the coupling mechanism 200 and the delivery sheath 600 are clamped by the first wavy curved wall 211 and the second wavy curved wall 212 in an anastomotic manner, axial displacement cannot be directly generated between the coupling mechanism 200 and the delivery sheath 600, then the push rod 700 sequentially passes through the delivery sheath 600, the coupling mechanism 200, the upper clamping table 422 and the lower clamping table 421 and is in threaded connection with the push rod 700, radial displacement between the coupling mechanism 200 and the delivery sheath 600 is limited by the push rod 700, connection stability between the coupling mechanism 200 and the delivery sheath 600 is ensured, and in view of the fact that the outer diameters of the upper clamping table 422 and the lower clamping table 421 are smaller than the inner diameter of the delivery sheath 600, the push rod 700 can be freely pushed and pulled under the state, and the locking mechanism 400 can move in the coupling mechanism 200. The pushing and pulling of the pushing rod 700 drives the locking mechanism 400 and the base 300 fixedly arranged with the lower clamping table 421 to move, and the movement of the base 300 drives the second clamping arm 120 to open or close through the connecting rod 500, and similarly, the pushing rod 700 can also be rotated to drive the second clamping arm 120 to rotate. When the second clamping arm 120 finds a suitable capturing clamping position, it is ensured that the second clamping block 426 is at a position capable of moving along the vertical bayonet 251, the pushing rod 700 is reversely rotated to sequentially release the threaded connection between the pushing rod 700 and the lower clamping table 421 and the threaded connection between the pushing rod 700 and the upper clamping table 422, and withdraw from the pushing rod 700, more specifically, the pushing rod 700 is firstly spirally released from the connection between the pushing rod 700 and the lower clamping table 421, and in the spiral process, the upper clamping table 422 is driven to move a certain distance until the second clamping block 426 is clamped at the limit position of the vertical bayonet 251, and along with the rotation and dissociation direction of the pushing rod 700 and the upper clamping table 422, the second clamping block 426 is clamped into the transverse bayonet 252, so that the locking between the locking mechanism 400 and the coupling mechanism 200 is realized, and then the clamping state of the current clamping component on the target tissue is locked. Meanwhile, the pushing rod 700 is withdrawn to lack radial limitation between the first wavy curved wall 211 and the second wavy curved wall 212, so that radial dislocation can be performed between the first wavy curved wall 211 and the second wavy curved wall 212, and the decoupling between the coupling mechanism 200 and the delivery sheath 600 and withdrawal of the delivery sheath 600 can be realized through radial dislocation and axial displacement in sequence, so that the clip can be independently implanted in a patient.
Example III
As shown in fig. 6a-6e, the coupling mechanism 200 adopts a mode of clamping the wave-shaped curve wall and the conveying sheath 600, and simultaneously, the locking mechanism 200 adopts a mode of locking the torsion spring 431, the upper end block 432, the lower end block 433 and the coupling mechanism 200 adopting the clamping window and the limiting protrusion 263;
The coupling mechanism 200 and the delivery sheath 600 are anastomosed and clamped by the first wavy curve wall 211 and the second wavy curve wall 212, axial displacement cannot be directly generated between the coupling mechanism 200 and the delivery sheath 600, then the push rod 700 sequentially passes through the delivery sheath 600, the coupling mechanism 200 and the upper end table 432 and the lower end table 433 to be in threaded connection, and the limit protrusions 263 are positioned in the first clamping window 261, so that the third wavy curve wall 434 and the fourth wavy curve wall 435 are in an unclamped state, and in view of the fact that the outer diameters of the upper end table 432 and the lower end table 433 and the axial outer diameter of the torsion spring 431 are smaller than the inner diameter of the delivery sheath 600, the push rod 700 can be freely pushed and pulled in the state, and the locking mechanism 400 can move in the coupling mechanism 200 within the height limit of the first clamping window 261. The pushing and pulling of the pushing rod 700 drives the locking mechanism 400 and the base 300 fixedly arranged with the lower end table 433 to move, and the movement of the base 300 drives the second clamping arm 120 to open or close through the connecting rod 500, so that the second clamping arm 120 can be driven to rotate by rotating the pushing rod 700 within the width limit of the first clamping window 261. When the second clamping arm 120 finds a suitable capturing clamping position, the pushing rod 700 is reversely rotated to sequentially release the threaded connection between the pushing rod 700 and the lower end table 433 and the threaded connection between the upper end table 432, and withdraw from the pushing rod 700, more specifically, the pushing rod 700 is firstly spirally released and connected with the lower end table 433, in the spiral process, the upper end table 432 is driven to move a certain distance, and then the limiting block 436 is driven to move along the height direction of the first clamping window 261, so that the limiting height of the limiting projection 263 is overcome, the limiting block 436 is clamped into the second clamping window 262 under the torsion force of the torsion spring 431, meanwhile, the third waveform curve wall 434 and the fourth waveform curve wall 435 are clamped, so that the locking between the locking mechanism 400 and the coupling mechanism 200 is realized, and then the clamping state of the current clamping component to the target tissue is locked. Meanwhile, the pushing rod 700 is withdrawn to lack radial limitation between the first wavy curved wall 211 and the second wavy curved wall 212, so that radial dislocation can be performed between the first wavy curved wall 211 and the second wavy curved wall 212, and the decoupling between the coupling mechanism 200 and the delivery sheath 600 and withdrawal of the delivery sheath 600 can be realized through radial dislocation and axial displacement in sequence, so that the clip can be independently implanted in a patient.
Example IV
As shown in fig. 7a and 7b, the coupling mechanism 200 is in a manner of clamping the first bump, the connector and the delivery sheath 600, and meanwhile, any one of the three embodiments is adopted among the locking mechanism 400, the coupling mechanism 200 and the pushing rod 700;
The connecting seat 221 of the connector is arranged at the far end of the conveying sheath 600 in a welding, sleeving or integrated die-closing mode, the pushing rod 700 sequentially passes through the conveying sheath 600, the coupling mechanism 200 and the pore canal, and the distance between the arc-shaped groove walls 222 is shortened, so that the arc-shaped groove walls 222 are wrapped on the outer side wall of the coupling mechanism 200, and the first protruding block is clamped into the first notch 223, so that stable connection between the coupling mechanism 200 and the conveying sheath 600 is realized. After the push rod 700 is withdrawn, the arc-shaped groove wall 222 restores the flaring shape, and then drives the first notch 223 to be outwards away, so that the first bump is separated from the first notch 223, and the decoupling between the coupling mechanism 200 and the delivery sheath 600 is realized, and the connector is arranged on the delivery sheath 600, so that the connector is withdrawn from the body along with the delivery sheath 600 after clamping is completed, and the connector is not left in the body. In view of the fact that the connection and disconnection between the locking mechanism 400, the coupling mechanism 200 and the push rod 700 have been described in the first three embodiments, respectively, a description thereof will not be repeated in this embodiment.
Example five
As shown in fig. 8a and 8b, the coupling mechanism 200 is locked by the second slot 231, the elastic arm 232, the second protrusion 233 and the delivery sheath 600, and the locking mechanism 400 is locked by the second base 441 and the coupling mechanism 200 using the second elastic piece 271 and the pull rope 272;
The elastic arm 232 is arranged at the far end of the conveying sheath 600 in a welding, sleeving or integrated die-closing mode, the pushing rod 700 sequentially passes through the conveying sheath 600 and the coupling mechanism 200 and is in threaded connection with the second base 441, when the pushing rod 700 passes through the conveying sheath 600 and the coupling mechanism 200, the elastic arm 232 is outwards supported, so that the second lug 233 on the elastic arm is driven to be clamped into the second notch 231, stable connection between the coupling mechanism 200 and the conveying sheath 600 is realized, the pull rope 272 is pulled up, under the condition that friction clamping is not caused on the second base 441 by the second elastic piece 271, the pushing rod 700 can be freely pushed and pulled, and the locking mechanism 400 moves in the coupling mechanism 200. The pushing and pulling of the pushing rod 700 drives the locking mechanism 400 and the base 300 fixedly arranged with the second base 441 to move, and the movement of the base 300 drives the second clamping arm 120 to open or close through the connecting rod 500, and similarly, the pushing rod 700 can also be rotated to drive the second clamping arm 120 to rotate. When the second clamping arm 120 finds a suitable capturing clamping position, the pushing rod 700 is reversely rotated to sequentially release the threaded connection between the pushing rod 700 and the second base 441 and withdraw the pushing rod 700, the pull rope 272 is loosened, so that the second elastic sheet 271 is restored to its shaped form, the second base 441 is clamped in a friction manner, and the locking between the locking mechanism 400 and the coupling mechanism 200 is realized, so that the clamping state of the current clamping component to the target tissue is locked. Meanwhile, after the push rod 700 is withdrawn, the elastic arm 232 is restored to the close state, and then the second protrusion 233 is driven to separate from the second notch 231, so that the coupling mechanism 200 and the delivery sheath 600 are separated, and the elastic arm 232 is arranged on the delivery sheath 600, so that the delivery sheath 600 is withdrawn from the body after clamping is completed, the elastic arm is not left in the body, and the rest of the clamping devices are independently implanted in the patient.
In addition, it should be specifically noted that the delivery sheath 600 and the pushing rod 700 are all delivery devices for delivering valve holders known in the art, and of course, the delivery device includes other commonly used structures, such as a catheter sheath and a loader, in addition to the two delivery structures of the delivery sheath 600 and the pushing rod 700, and therefore, description will be omitted in view of the fact that there is no direct connection between the rest of the structures in the delivery device and the holders involved in the present invention.
The foregoing describes in detail preferred embodiments of the present invention. It should be understood that numerous modifications and variations can be made in accordance with the concepts of the invention by one of ordinary skill in the art without undue burden. Therefore, all technical solutions which can be obtained by logic analysis, reasoning or limited experiments based on the prior art by the person skilled in the art according to the inventive concept shall be within the scope of protection defined by the claims.