CN112168426A - Aortic valve stop device - Google Patents

Abstract

The invention relates to the field of cardiovascular medical treatment, and particularly discloses an aortic valve limiting device which comprises a bracket and a fixing part, wherein the bracket is used for being placed in a left ventricular outflow tract; the support is a communicated structure which is communicated along the blood flow direction, and the upper end surface of the support is provided with a supporting part which is used for contacting the bottom end of the aortic valve and supporting the aortic valve. The present invention is useful for effectively restoring the function of a prolapsed aortic valve while reducing trauma. Compared with the existing valve replacement operation or aortic valve shaping operation, the implementation of the invention is beneficial to effectively recovering the function of prolapsed aortic valve on the premise of reducing trauma, and meanwhile, the invention also improves the operation safety and the operation efficiency and reduces the treatment cost; the invention meets the social needs, has strong practicability and is beneficial to promoting the further development of cardiovascular medical technology.

Description

Aortic valve stop device

Technical Field

The invention relates to the field of cardiovascular medical treatment, in particular to an aortic valve limiting device.

Background

Heart valves are either between the atria and ventricles or between the ventricles and the arteries, and play a key role in the blood circulation activity of the heart which is never stopped, preventing the backflow of blood in the atria (atrioventricular valve) or ventricles (semilunar valve) that have just left. The aortic valve, which is located between the left ventricle and the aorta, is generally composed of three semilunar valves, with the leaflet attachment edge crossing the ventricular-arterial junction in an arc; when the ventricle contracts, the blood flow rushes upwards to push the aortic valve leaflet away from the center of the aortic cavity; when the ventricle relaxes, the valve leaf falls into the center of the aorta cavity passively; when the valve is properly configured, the three leaflets coapt along the commissure edges and support the column of blood in the aorta to prevent regurgitation into the ventricle.

Aortic Valve Prolapse (AVP) refers to the prolapse of one or more aortic valve leaflets into the Left Ventricular Outflow Tract (LVOT) at late diastole, with or without Aortic Insufficiency (AI); after 1 Marfan's syndrome AI caused by AVP is discovered by Haseby in 1958 necropsy, the reports of AVP caused by other reasons are increasing day by day; echocardiography (UCG), particularly cross-sectional UCG, has led to an increase in the detection rate of AVP and has been considered to be one of the important causes of AI.

Aortic valve insufficiency and regurgitation caused by aortic valve prolapse cause increased pulse pressure difference, coronary insufficiency, left ventricular preload increase, left ventricular dilatation and heart failure, which are absolute indications of surgical operations; at present, the surgical operation widely adopts valve replacement (replacing biological valve or mechanical valve) for treatment, patients face risks of open chest surgery and postoperative anticoagulation, or aortic valve forming surgery is adopted for treatment (patent CN111481323A discloses an aortic valve forming ring), but the success rate is still low at present, and most patients need to be operated again; the above-mentioned surgery is more traumatic and risky for the elderly patients.

Therefore, how to effectively recover (recover for a long time or temporarily) the function of the prolapsed aortic valve on the premise of reducing trauma is an international problem to be solved urgently in the field of cardiovascular medical treatment at present.

Disclosure of Invention

In view of the above, the present invention provides an aortic valve positioning apparatus, which is beneficial to effectively recover the function of a prolapsed aortic valve on the premise of reducing trauma.

In order to achieve the purpose, the invention provides an aortic valve limiting device, which is characterized in that: comprises a bracket for being placed in the left ventricular outflow tract and a fixing piece connected with the bracket and used for positioning the bracket in the left ventricular outflow tract; the support is a communicated structure which is communicated along the blood flow direction, and the upper end surface of the support is provided with a supporting part which is used for contacting the bottom end of the aortic valve and supporting the aortic valve.

As a further improvement of the technical scheme of the invention, the support comprises an inner ring body and an outer ring body, the inner ring body and the outer ring body are connected by a plurality of radially distributed struts, gaps are formed between adjacent struts, and the upper end surfaces of the struts form a supporting part together.

As a further improvement of the technical scheme of the invention, the inner ring body and the outer ring body are concentrically arranged, and the supporting rods are uniformly distributed along the circumferential direction on the circumference which takes the center of the bracket as the center of a circle.

As a further improvement of the technical scheme of the invention, the outer ring body is of a soft membrane tube structure, the supporting rods are of an elastic rod structure and can be compressed and released towards the central axis of the inner ring body, and the supporting rods are arranged along the radial direction of the inner ring body after being completely released.

As a further improvement of the technical scheme of the invention, the support rod is made of shape memory alloy.

As a further improvement of the technical scheme of the invention, the inner ring body is provided with a central through hole.

As a further improvement of the technical scheme of the invention, the fixing piece comprises a first fixing ear for anchoring to the human body compartment, and the upper end edge of the first fixing ear is connected to the outer ring body.

As a further improvement of the technical scheme of the invention, the fixing piece also comprises a second fixing ear positioned between the anterior mitral valve and the aortic valve, and the upper end edge of the second fixing ear is connected with the outer ring body.

As a further improvement of the technical scheme of the invention, the bracket is provided with a developing indicating mark.

Compared with the prior art, the invention has the following beneficial technical effects:

according to the aortic valve limiting device provided by the invention, the stent is implanted into the left ventricular outflow tract position below the aortic valve of a patient suffering from aortic valve prolapse through the apex of the heart, and then the stent is positioned through the fixing part, so that the installation of the device is realized; when the aortic valve of systole is open, blood flows out behind the support, and when the aortic valve of diastole was closed, the aortic valve of former prolapse can be supported spacingly by the supporting part, can not take off to the left ventricle to make the aortic valve close completely, can not arouse the palirrhea.

Compared with the existing valve replacement operation or aortic valve shaping operation, the implementation of the invention is beneficial to effectively recovering the function of prolapsed aortic valve on the premise of reducing trauma, and meanwhile, the invention also improves the operation safety and the operation efficiency and reduces the treatment cost; the invention meets the social needs, has strong practicability and is beneficial to promoting the further development of cardiovascular medical technology.

Drawings

Fig. 1 is a schematic top view of the present invention.

Detailed Description

In order to make the technical solutions of the present invention better understood, the following detailed description of the present invention is provided with reference to the accompanying drawings and specific embodiments; of course, the drawings are simplified schematic drawings, and the scale of the drawings does not limit the patented products.

Examples

As shown in fig. 1: the embodiment provides an aortic valve limiting device which comprises abracket 1 and afixing part 2, wherein thebracket 1 is used for being placed in a left ventricular outflow tract, and thefixing part 2 is connected to thebracket 1 and is used for positioning thebracket 1 in the left ventricular outflow tract; thestent 1 is a communicated structure which is communicated along the blood flow direction, and a supporting part which is used for contacting with the bottom end of the aortic valve and supporting the aortic valve is arranged on the upper end surface of thestent 1.

The left ventricle of the human body is divided into an inflow channel and an outflow channel, the inflow channel is a ventricular cavity from the mouth of the left ventricle to a section of apex, and a mitral valve is attached to a fibrous ring around the mouth of the left ventricle; the outflow tract is a section of left ventricular cavity from the apex of the heart to the orifice of the aorta, also known as the aortic vestibulum; the outlet of the outflow tract is an aortic orifice, and three semilunar valves, namely aortic valves, are attached to the fibrous ring around the orifice; the inner cavity between the valve and the artery wall is an aortic sinus which can be divided into a left sinus, a right sinus and a rear sinus, and the artery wall of the left sinus and the artery wall of the right sinus are respectively provided with openings of a left coronary artery and a right coronary artery; normally, when the ventricle contracts, the mitral valve closes, the aortic valve opens, blood flows into the aorta, and when the ventricle relaxes, the aortic valve closes, preventing blood from flowing back into the ventricle, while the mitral valve opens, allowing blood from the left atrium to flow into the left ventricle.

When the operation is carried out, an operator can implant thestent 1 to the position of a left ventricular outflow tract below an aortic valve of a patient suffering from aortic valve prolapse through the apex of the heart (or in an interventional mode), and then position thestent 1 through thefixing piece 2 to realize the installation of the device; when the aortic valve of systole is open, becausesupport 1 is the connected structure, can not block the flow of blood, blood flows out behind throughsupport 1, and when diastole aortic valve closed, the aortic valve of former prolapse can be supported by the supporting part spacing, can not take off to the left ventricle to make aortic valve close completely, can not arouse the palirrhea.

For the convenience of operation, thestent 1 may be provided with a visualization marker (not shown in the figure) for facilitating visualization positioning by radiation, and the visualization marker may be, for example, a visualization wire attached to the surface of thestent 1, or a visualization wire provided inside thestent 1; of course, thestent 1 may be positioned by ultrasonic positioning without providing a visualization marker.

Thestent 1 may be, for example, a compressible and releasable circular mesh, or may be other suitable structures for placement and support.

Preferably, in this embodiment, thestent 1 includes aninner ring 11 and anouter ring 12, theinner ring 11 and theouter ring 12 are connected by a plurality of radially distributedstruts 13, agap 14 is provided betweenadjacent struts 13, and the upper end surfaces of thestruts 13 together form a support portion; the number of thestruts 13 can be set as required; blood can flow through eachgap 14; theinner ring body 11 and theouter ring body 12 are concentrically arranged, thestruts 13 are uniformly distributed along the circumferential direction on the circumference with the center of the stent 1 (i.e. the center of theinner ring body 11 and the center of the outer ring body 12) as the center, and the included angles between theadjacent struts 13 are equal. In order to realize the compression, transportation and release of thestent 1, theouter ring body 12 is a soft membrane tube structure, thestruts 13 are elastic rod structures and can be compressed and released towards the central axis of theinner ring body 11, after the struts are completely released, thestruts 13 are arranged along the radial direction of theinner ring body 11, theinner ring body 11 is a hard ring, theouter ring body 12 and thestruts 13 can be compressed on a commonly used transportation device (for example, transportation devices shown in patents CN 106618822A and CN 104622600 a) during the operation in a cavity through the action of external force, when thestent 1 reaches a proper position, the external force is released, and theouter ring body 12 and thestruts 13 can restore to the original shape; for the convenience of transportation, theinner ring body 11 is provided with a central throughhole 11a, and the flow obstruction to blood is further reduced; thestrut 13 may be made of a shape memory alloy. Thestent 1 having this structure can prevent the formation of thrombus because there is no dead space where blood flows strike.

Thefixing member 2 is used for positioning thestent 1 as long as this function is achieved.

Preferably, in the present embodiment, thefixing member 2 includes afirst fixing ear 21 for anchoring to the human body compartment, and an upper end edge of thefirst fixing ear 21 is connected to theouter ring body 12; thefirst fixing lug 21 can be made of dacron or medical plastic, for example, and is anchored to the interventricular septum by a medical rivet after being released, thereby providing a positioning force for thestent 1. In addition, thefixing member 2 further comprises asecond fixing ear 22 for positioning between the anterior mitral valve and the aortic valve, and the upper end edge of thesecond fixing ear 22 is connected to theouter ring body 12; thesecond fixing ears 22 can also be made of terylene or medical plastics, and thesecond fixing ears 22 and thefirst fixing ears 21 can be arranged on the left side and the right side of theouter ring body 12; thesecond fixing ear 22 can be clamped in the annulus fibrosus between the anterior mitral valve and the aortic valve, and provides positioning acting force for thestent 1 together with thefirst fixing ear 21, so as to ensure stable positioning of thestent 1.

Finally, the principle and embodiments of the present invention are explained by using specific examples, and the above descriptions of the examples are only used to help understand the core idea of the present invention, and the present invention can be modified and modified without departing from the principle of the present invention, and the modified and modified examples also fall into the protection scope of the present invention.

Claims (9)

1. An aortic valve stop device which characterized in that: comprises a bracket for being placed in the left ventricular outflow tract and a fixing piece connected with the bracket and used for positioning the bracket in the left ventricular outflow tract; the support is a communicated structure which is communicated along the blood flow direction, and the upper end surface of the support is provided with a supporting part which is used for contacting the bottom end of the aortic valve and supporting the aortic valve.

2. The aortic valve positioning apparatus of claim 1, wherein: the support comprises an inner ring body and an outer ring body, the inner ring body and the outer ring body are connected through a plurality of radially distributed supporting rods, gaps are formed between every two adjacent supporting rods, and the upper end faces of the supporting rods jointly form a supporting portion.

3. The aortic valve positioning apparatus of claim 2, wherein: the inner ring body and the outer ring body are arranged concentrically, and the supporting rods are uniformly distributed along the circumferential direction on the circumference which takes the center of the support as the center of a circle.

4. The aortic valve positioning apparatus of claim 2, wherein: the outer ring body is of a soft membrane tube structure, the supporting rods are of elastic rod structures and can be compressed and released towards the central axis of the inner ring body, and the supporting rods are arranged along the radial direction of the inner ring body after being completely released.

5. The aortic valve positioning apparatus of claim 4, wherein: the support rod is made of shape memory alloy.

6. The aortic valve positioning apparatus of claim 2, wherein: the inner ring body is provided with a central through hole.

7. An aortic valve positioning device as claimed in any one of claims 2 to 6, wherein: the fixing piece comprises first fixing ears for anchoring in human body chambers, and the upper end edges of the first fixing ears are connected to the outer ring body.

8. The aortic valve positioning apparatus of claim 7, wherein: the fixation member further comprises a second fixation ear for positioning between the anterior mitral valve and the aortic valve, an upper end edge of the second fixation ear being connected to the outer ring body.

9. An aortic valve stop according to any one of claims 1 to 6 wherein: and the bracket is provided with a developing indicating mark.

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