Detailed Description
In order to better understand the technical solutions in the embodiments of the present application, the following description will clearly and completely describe the technical solutions in the embodiments of the present application with reference to the accompanying drawings in the embodiments of the present application, and it is obvious that the described embodiments are only some embodiments of the present application, not all embodiments. All other embodiments, which are derived by a person skilled in the art based on the embodiments of the present application, shall fall within the scope of protection of the embodiments of the present application.
A detachable delivery gripping device 100 according to an embodiment of the present invention is described below with reference to the drawings, the detachable delivery gripping device 100 being usable for implantation within a heart structure 8 to grip a regurgitant gap between a leaflet 81 and a sealing leaflet 81. The detachable transport clamping device 100 may comprise a clamping assembly 2.
As shown in connection with fig. 1-14, the clamping assembly 2 may include an upper clamping assembly 21 and a lower clamping assembly 22, the upper clamping assembly 21 and the lower clamping assembly 22 being disposed in correspondence, and the leaflet 81 being clamped between the upper clamping assembly 21 and the lower clamping assembly 22, the leaflet 81 being effectively captured and clamped by the cooperation of the upper clamping assembly 21 and the lower clamping assembly 22.
The upper clamping assembly 21 and the lower clamping assembly 22 are detachably matched, that is, the upper clamping assembly 21 and the lower clamping assembly 22 are respectively and independently arranged, that is, the upper clamping assembly 21 and the lower clamping assembly 22 are detachably and independently movable, and the valve leaflet 81 can be clamped between the upper clamping assembly 21 and the lower clamping assembly 22 by respectively adjusting the positions of the upper clamping assembly 21 and the lower clamping assembly 22 so as to be capable of effectively capturing the valve leaflet 81 when the valve leaflet 81 is clamped.
The clamping assembly 2 has an expanded state and a closed state and is movable between the expanded state and the closed state, i.e. the clamping assembly 2 is switchable between the expanded state and the closed state. Wherein when the clamping assembly 2 is in the closed condition, as shown in fig. 6 and 7, one of the upper clamping assembly 21 and the lower clamping assembly 22 is retracted within the other of the upper clamping assembly 21 and the lower clamping assembly 22 to be adapted for placement within the sheath tube assembly 7, and when the clamping assembly 2 is in the expanded condition, the upper clamping assembly 21 and the lower clamping assembly 22 are separately expanded and adjustable to be adapted for clamping the leaflet 81.
Specifically, the detachable delivery clip 100 may be mated with the sheath tube assembly 7, for example, the sheath tube assembly 7 may include a tearable sheath, a delivery sheath, and an outer sheath, the detachable delivery clip 100 may be pushed into the outer sheath from the tearable sheath through the delivery sheath, the tearable sheath is torn off, the outer sheath is left to form a passageway, the passageway established from the outer sheath is moved to a designated position, the outer sheath is pushed out through the delivery sheath, and the detachable delivery clip 100 is kept in a closed state.
In other words, the clamping assembly 2 is adapted to cooperate with the sheath assembly 7 in the closed state for implantation into the heart structure 8 through the sheath assembly 7, when the upper clamping assembly 21 and the lower clamping assembly 22 are retracted one within the other, which not only reduces the volumetric dimensions of the sheath assembly 7 and the detachable delivery clamping device 100, but also reduces the length of the detachable delivery clamping device 100 in the closed state to increase the over-bending capability of the detachable delivery clamping device 100 for delivery and implantation of the detachable delivery clamping device 100. After the detachable delivery gripping device 100 is implanted within the heart structure 8, the gripping assembly 2 is in the deployed state, the upper and lower gripping assemblies 21, 22 are separated and opened, and the positions of the upper and lower gripping assemblies 21, 22 are adjustable so that the upper and lower gripping assemblies 21, 22 cooperate to effectively capture the gripping leaflets 81.
In some embodiments of the present invention, the upper clamping assembly 21 may include at least two upper clamping arms 211, the lower clamping assembly 22 may include at least two lower clamping arms 221 engaged with the upper clamping arms 211, that is, the upper clamping assembly 21 may include two or more upper clamping arms 211, the lower clamping assembly 22 may include two or more lower clamping arms 221, the upper clamping arms 211 are disposed above the lower clamping arms 221 and are disposed in one-to-one correspondence with the lower clamping arms 221, the upper clamping arms 211 and the lower clamping arms 221 are separately controllable and adjustable by the upper clamping arms 211 and the lower clamping arms 221, respectively, so as to facilitate capturing the clamping leaflets 81.
As shown in fig. 2 and fig. 5 to fig. 7, when the clamping assembly 2 is in the closed state, the upper clamping arm 211 rotates downward and contracts, the lower clamping arm 221 moves upward and is folded on the outer side of the upper clamping arm 211, and when the clamping assembly 2 is in the expanded state as shown in fig. 3 to fig. 4, the lower clamping arm 221 is separated from the upper clamping arm 211 and expands, and at the same time, the upper clamping arm 211 is released and rotates upward to restore to the expanded state.
Alternatively, the upper and lower clamp arms 211 and 221 are rotatable and movable in an up-down direction to be adapted to capture the clamping leaflet 81, such that, when capturing the leaflet 81, the upper and lower clamp arms 211 and 221 are adjustable, the upper and lower clamp arms 211 and 221 are rotated and moved in the up-down direction to adjust a clamping space between the upper and lower clamp arms 211 and 221 to enable the leaflet 81 to be positioned between the upper and lower clamp arms 211 and 221, and when the leaflet 81 is positioned between the upper and lower clamp arms 211 and 221, the clamping assembly 2 can effectively capture the clamping leaflet 81 by adjusting a distance between the upper and lower clamp arms 211 and 221 and an angle with respect to a horizontal or vertical direction.
Further, the detachable conveying and clamping device 100 further comprises a push rod assembly 3, the push rod assembly 3 comprises a plurality of push rods, the axial length of the push rod assembly is adjustable, the clamping assembly 2 is arranged on the push rod assembly 3, and the clamping assembly 2 can be adjusted by adjusting the push rod assembly 3, so that the clamping assembly 2 can move in the up-down direction. Wherein the upper clamping assembly 21 and the lower clamping assembly 22 can be arranged at different positions of the push rod assembly 3, and the relative movement of the upper clamping assembly 21 and the lower clamping assembly 22 in the up-down direction can be realized by moving different push rods of the push rod assembly 3.
Optionally, the detachable conveying clamping device 100 further includes a first pull wire 41, one end of the upper clamping arm 211 is rotatably connected with the push rod assembly 3, the other end of the upper clamping arm 211 is formed as a free end, the first pull wire 41 is connected with the free end of the upper clamping arm 211 to drive the upper clamping arm 211 to rotate, and since one end of the upper clamping arm 211 is fixed, the free end of the upper clamping arm 211 can be pulled to move in the up-down direction through the first pull wire 41, so that the upper clamping arm 211 can be driven to rotate, and the angle between the upper clamping arm 211 and the push rod assembly 3 is changed to adjust the position of the upper clamping arm 211.
The detachable conveying and clamping device 100 further comprises a rotating arm 222, wherein the rotating arm 222 is arranged below the lower clamping arm 221, is arranged between the push rod assembly 3 and the lower clamping arm 221, and is respectively and rotatably connected with the lower clamping arm 221 and the push rod assembly 3, and the rotating arm 222 rotates to drive the lower clamping arm 221 to rotate relative to the push rod assembly 3. Specifically, the number of the rotating arms 222 is at least two, each rotating arm 222 is respectively connected with the lower clamping arm 221 in a one-to-one correspondence manner, two ends of each rotating arm 222 are respectively connected with the push rod assembly 3 and the corresponding lower clamping arm 221, wherein each rotating arm 222 is obliquely arranged, the lower end of each rotating arm 222 is rotatably connected with the tail end of the push rod assembly 3, and the upper end of each rotating arm 222 is rotatably connected with the lower clamping arm 221, so that when the push rod assembly 3 is adjusted, the push rod assembly 3 drives the lower end of each rotating arm 222 to move up and down, the inclination angle of each rotating arm 222 is changed, and as the arm length of each rotating arm 222 is unchanged, the upper end of each rotating arm 222 moves to drive the corresponding lower clamping arm 221 to rotate, and therefore the inclination angle of the corresponding lower clamping arm 221 to the push rod assembly 3 can be adjusted to better capture the clamping valve leaflet 81.
As shown in fig. 3 to 7, the push rod assembly 3 may include a first push rod 31, a second push rod 32 and a push rod 33, the upper clamping assembly 21 is provided on the first push rod 31 and detachably connected with the first push rod 31, the first push rod 31 is movable to drive the upper clamping assembly 21 to move in an up-down direction, the second push rod 32 is installed in the first push rod 31 and slidably connected with the first push rod 31, the push rod 33 is detachably connected with the second push rod 32, and the rotating arm 222 is movably connected with the push rod. Like this, first push rod 31 is movable relative to second push rod 32, can drive and go up clamping assembly 21 and reciprocate, and push rod 33 activity can drive the swinging boom 222 activity in order to drive down clamping assembly 22 expansion or shrink, goes up clamping assembly 21 and first push rod 31 and dismantle the connection, push rod 33 and second push rod 32 and dismantle the connection, like this, after detachable shutoff clamping device 100 dissociates, first push rod 31 and second push rod 32 can withdraw from, remain clamping assembly 2 and push rod 33, swinging boom 222 equals in the heart structure 8, clamping assembly 2 centre gripping lamella 81 this moment.
The lower clamping assembly 22 further comprises a base 5 and a second stay wire 42, the push rod 33 is detachably connected with the second push rod 32 through a first channel 90 on the base 5, the base 5 is provided with a first threading hole 51 suitable for the second stay wire 42 to pass through, the second stay wire 42 passes through the bottom of the base 5 from the first threading hole 51, two ends of the second stay wire 42 are connected with an operation handle, and the lower clamping arm 221 is rotatably arranged on the base 5. In other words, the base 5 is mounted on the push rod 33, both ends of the second pull wire 42 are connected to the operating handle, at least two first threading holes 51 are provided on the base 5, the second pull wire 42 passes through the bottom of the base 5 from one first threading hole 51 and then passes out from the other first threading hole 51, the lower end of the lower clamping arm 221 is rotatably connected to the base 5, so that the position of the base 5 can be controlled and adjusted by the second pull wire 42, and the position of the lower clamping arm 221 relative to the push rod 33 is controlled. Referring to fig. 1 and 8-10, when the position of the second pull wire 42 is kept unchanged, the position of the lower clamping arm 221 is kept unchanged and is in an open state, and the first push rod 31 is pushed to move downwards to drive the upper clamping assembly 21 to move towards the lower clamping assembly 22 until the upper clamping assembly 21 is connected with the base 5, and when the second push rod 32 drives the push rod 33 to move towards the base 5, the push rod 33 is connected with the rotating arm 222 to drive the rotating arm 222 to move, and the upper end of the rotating arm 222 is connected with the lower clamping arm 221 to drive the lower clamping arm 221 to rotate.
As shown in fig. 15 and 16, the detachable conveying clamping device 100 further includes a locking piece 52, the locking piece 52 is disposed in the base 5, the locking piece 52 is provided with a locking hole 53 and a second threading hole 54, the push rod 33 is connected to the second push rod 32 through the locking hole 53 and the base 5, and the second threading hole 54 is used for passing through the second pull wire 42.
The lock piece 52 has a locked state and an unlocked state, when the second wire 42 is in the loose state, the lock hole 53 is in the locked state to lock the push rod 33, the push rod 33 cannot move in the lock hole 53, as shown in fig. 32, the axis of the second wire 54 is located at a vertical distance L from the axis of the first wire 51, when the second wire 42 is in the tensioned state, the lock hole 53 is deformed to unlock the push rod 33, the push rod 33 is movable in the lock hole 53, as shown in fig. 33, the vertical distance W between the axis of the second wire 54 and the axis of the first wire 51 is W < L, that is, the central axis of the second wire 54 is not coincident with the central axis of the first wire 51, and the central axis of the second wire 54 is located adjacent to the push rod 33, so that when the second wire 42 is in the loose state, the push rod 33 cannot move, when the second wire 42 is tensioned, the second wire 54 is aligned with the first wire 51, the second wire 42 drives the lock hole 52 to move a large distance W, that the lock hole 53 can move in the lock hole 53.
The push rod 33 is arranged in the lock hole 53 and the base 5 in a penetrating way and is detachably connected with the second push rod 32, so that the second push rod 32 is convenient to withdraw when the second push rod 32 is detached.
In other embodiments of the invention, the detachable delivery gripping device 100 may further comprise an occluding device 1, the occluding device 1 being configured to occlude the regurgitant gap between the leaflets 81 such that regurgitation is reduced, the gripping assembly 2 being configured to capture the gripping leaflets 81. As shown in fig. 1-14, the occluding device 1 is disposed above the clamping assembly 2 such that after the clamping assembly 2 clamps the leaflets 81, the occluding device 1 is capable of occluding the regurgitation gap between the leaflets 81 to reduce regurgitation.
In some embodiments of the present invention, the upper clamping assembly 21 is disposed above the lower clamping assembly 22, the stopper 1 is disposed above the upper clamping assembly 21, and when the clamping assembly 2 is in the closed state, the upper clamping assembly 21 is folded downward, and the lower clamping assembly 22 is folded upward outside the upper clamping assembly 21. When the clamping assembly 2 is switched to the unfolding state, the lower clamping assembly 22 is separated from the upper clamping assembly 21 to be unfolded, and the upper clamping assembly 21 is unfolded after being out of the restraint of the lower clamping assembly 22.
The upper clamping assembly 21 may include at least two upper clamping arms 211, the lower clamping assembly 22 may include at least two lower clamping arms 221 engaged with the upper clamping arms 211, that is, the upper clamping assembly 21 may include two or more upper clamping arms 211, the lower clamping assembly 22 may include two or more lower clamping arms 221, the upper clamping arms 211 are disposed above the lower clamping arms 221 and are disposed in one-to-one correspondence with the lower clamping arms 221, the upper clamping arms 211 and the lower clamping arms 221 are separately controllable and adjustable by the upper clamping arms 211 and the lower clamping arms 221, respectively, so as to facilitate capturing the clamping leaflets 81.
As shown in fig. 2 and fig. 5 to fig. 7, when the clamping assembly 2 is in the closed state, the upper clamping arm 211 rotates downward and contracts, the lower clamping arm 221 moves upward and is folded on the outer side of the upper clamping arm 211, and when the clamping assembly 2 is in the expanded state as shown in fig. 3 to fig. 4, the lower clamping arm 221 is separated from the upper clamping arm 211 and expands, and at the same time, the upper clamping arm 211 is released and rotates upward to restore to the expanded state.
Alternatively, the upper and lower clamp arms 211 and 221 are rotatable and movable in an up-down direction to be adapted to capture the clamping leaflet 81, such that, when capturing the leaflet 81, the upper and lower clamp arms 211 and 221 are adjustable, the upper and lower clamp arms 211 and 221 are rotated and moved in the up-down direction to adjust a clamping space between the upper and lower clamp arms 211 and 221 to enable the leaflet 81 to be positioned between the upper and lower clamp arms 211 and 221, and when the leaflet 81 is positioned between the upper and lower clamp arms 211 and 221, the clamping assembly 2 can effectively capture the clamping leaflet 81 by adjusting a distance between the upper and lower clamp arms 211 and 221 and an angle with respect to a horizontal or vertical direction.
Further, the upper clamping assembly 21 may be fixedly connected to the occluder 1, the upper clamping assembly 21 is connected to the lower end of the occluder 1, the upper clamping assembly 21 includes a plurality of upper clamping arms 211, the plurality of upper clamping arms 211 are distributed along the circumference of the occluder, when the upper clamping assembly 211 is in the unfolded state, the plurality of upper clamping arms 211 are unfolded and the occluder 1 is located in an opening formed by the unfolding of the plurality of upper clamping arms 211.
Further, the detachable conveying clamping device 100 further comprises a push rod assembly 3, the push rod assembly 3 comprises a plurality of push rods, the axial length of the push rod assembly is adjustable, the plugging device 1 and the upper clamping assembly 21 are arranged on the push rod assembly 3, and the plugging device 1 and the upper clamping assembly 21 can be adjusted by adjusting the push rod assembly 3, so that the upper clamping assembly 21 and the plugging device 1 can move in the up-down direction. Wherein the upper clamping assembly 21 and the lower clamping assembly 22 can be arranged at different positions of the push rod assembly 3, and the upper clamping assembly 21, the lower clamping assembly 22 and the plugging device 1 can relatively move in the up-down direction by moving different push rods of the push rod assembly 3.
The detachable conveying clamping device 100 further comprises a first stay wire 41, one end of the upper clamping arm 211 is rotatably connected with the push rod assembly 3, the other end of the upper clamping arm 211 is formed into a free end, the first stay wire 41 is connected with the free end of the upper clamping arm 211 to drive the upper clamping arm 211 to rotate, and as one end of the upper clamping arm 211 is fixed, the free end of the upper clamping arm 211 can be pulled to move in the up-down direction through the first stay wire 41, so that the upper clamping arm 211 can be driven to rotate, and the angle between the upper clamping arm 211 and the push rod assembly 3 is changed to adjust the position of the upper clamping arm 211. The plurality of upper clamping arms 211 may be pulled toward the position of the upward sealer 1 by, for example, the first pull wire 41 to adjust the position of the upper clamping arms 211 to facilitate clamping the leaflet 81.
The detachable conveying and clamping device 100 further comprises a rotating arm 222, wherein the rotating arm 222 is obliquely connected between the push rod assembly 3 and the lower clamping arm 221 and is respectively and rotatably connected with the lower clamping arm 221 and the push rod assembly 3, and the rotating arm 222 rotates to drive the lower clamping arm 221 to rotate relative to the push rod assembly 3.
As shown in fig. 3 to 7, the push rod assembly 3 may include a first push rod 31, a second push rod 32 and a push rod 33, the stopper 1 and the upper clamping assembly 21 are provided on the first push rod 31 and detachably connected with the first push rod 31, the first push rod 31 is movable to drive the stopper 1 and the first clamping assembly 2 to move in the up-down direction, the second push rod 32 is installed in the first push rod 31 and slidably connected with the first push rod 31, the push rod is detachably connected with the second push rod 32, and the rotating arm 222 is movably connected with the push rod 33. Like this, first push rod 31 is movable relative to second push rod 32, can drive upper clamp assembly 21 and stopper 1 and reciprocate, and push rod 33 is movable can drive the swinging boom 222 and move, and stopper 1 and upper clamp assembly 21 can dismantle with first push rod 31 and be connected, and push rod 33 can dismantle with second push rod 32 to be connected, like this, after detachable shutoff clamping device 100 dissociates, first push rod 31 and second push rod 32 can withdraw from, keep clamp assembly 2 and stopper 1 and push rod 33, swinging boom 222 equal in heart structure 8, and clamp assembly 2 centre gripping valve leaf 81 this moment, the back flow clearance between stopper 1 shutoff valve leaf 81.
The lower clamping assembly 22 further comprises a base 5 and a second stay wire 42, the push rod 33 penetrates through the base 5 to be detachably connected with the second push rod 32, the base 5 is provided with a first threading hole 51 suitable for the second stay wire 42 to penetrate through, the second stay wire 42 penetrates through the bottom of the base 5 from the first threading hole 51, two ends of the second stay wire 42 are connected with an operation handle, and the lower clamping arm 221 is rotatably arranged on the base 5. In other words, the base 5 is mounted on the push rod 33, both ends of the second pull wire 42 are connected to the operating handle, at least two first threading holes 51 are provided on the base 5, the second pull wire 42 passes through the bottom of the base 5 from one first threading hole 51 and then passes out from the other first threading hole 51, the lower end of the lower clamping arm 221 is rotatably connected to the base 5, so that the position of the base 5 can be controlled and adjusted by the second pull wire 42, and the position of the lower clamping arm 221 relative to the push rod 33 is controlled. Referring to fig. 1 and 8-10, when the position of the second pull wire 42 is kept unchanged, the position of the lower clamping arm 221 is kept unchanged and is in an open state, and the first push rod 31 is pushed to move downwards to drive the stopper 1 and the clamping assembly 2 to move towards the lower clamping assembly 22 until the stopper 1 is connected with the upper clamping assembly 21 and the base 5, and when the second push rod 32 drives the push rod 33 to move towards the base 5, the push rod 33 is connected with the rotating arm 222 to drive the rotating arm 222 to move, and the upper end of the rotating arm 222 is connected with the lower clamping arm 221 to drive the lower clamping arm 221 to rotate.
As shown in fig. 15 and 16, the detachable conveying clamping device 100 further comprises a locking plate 52, the locking plate 52 is arranged in the base 5, the locking plate 52 is provided with a locking hole 53 and a second threading hole 54, the pushing rod 33 passes through the locking hole 53 and the base 5 and is connected with the second pushing rod 32, the second threading hole 54 is used for passing through the second threading hole 54, when the second threading hole 42 is in a loose state, the locking hole 53 locks the pushing rod 33, the pushing rod 33 cannot move in the locking hole 53, as shown in fig. 32, at the moment, the vertical distance between the axis of the second threading hole 54 and the axis of the first threading hole 51 is L, when the second threading hole 42 is in a tightening state, the locking hole 53 is deformed to loosen the pushing rod 33, the pushing rod 33 is movable in the locking hole 53, as shown in fig. 33, at the moment, the axis of the second threading hole 54 is not coincident with the axis of the first threading hole 51, and when the second threading hole 54 is in a loose state, that is W < L, that is, namely, the central axis of the second threading hole 54 is not coincident with the central axis of the first threading hole 51, and the central axis of the second threading hole 33 is adjacent to the central axis of the pushing rod 33, so that when the second threading hole 54 is in a loose state, the second threading hole 33 is in a tightening state, the second threading hole 53, and the second threading hole 33 can move in a state, so that the second threading hole 53 can not move in a tightening state, and can move in the locking hole 53, when the second threading hole and can be in a tightening state, and can move in a state, when the second threading hole, and a pulling hole, and can be in a state, and can move.
The push rod 33 is arranged in the lock hole 53 and the base 5 in a penetrating way and is detachably connected with the second push rod 32, so that the second push rod 32 is convenient to withdraw when the second push rod 32 is detached.
A detachable transport gripping device 100 according to a specific example of the present invention is described below with reference to the drawings.
As shown in fig. 1 to 20, the detachable delivery clip device 100 includes an occluding device 1, a clip assembly 2, a push rod assembly 3, a rotation arm 222, a first pull wire 41, a second pull wire 42, a base 5, a locking piece 52, and the like.
Specifically, the push rod assembly 3 may include a first push rod 31, a second push rod 32, and a push rod 33 coaxially disposed, where the first push rod 31 is slidably coupled with the second push rod 32 and is mounted on the second push rod 32, and the push rod 33 is disposed below the second push rod 32 and is detachably coupled with the second push rod 32.
The clamping assembly 2 comprises an upper clamping arm 211 and a lower clamping arm 221, wherein the upper clamping arm 211 and the lower clamping arm 221 are arranged in a one-to-one correspondence manner, and the upper clamping arm 211 is arranged above the lower clamping arm 221. As shown in fig. 1 to 13, the number of the upper clamping arms 211 and the lower clamping arms 221 may be two, and the two upper clamping arms 211 are respectively disposed on two radial sides of the push rod assembly 3, where the two upper clamping arms 211 are respectively fixedly connected with the occluder 1 and can be shaped into an open state by material characteristics.
The plugging device 1 and the upper clamping arm 211 are installed on the first push rod 31 and are detachably connected with the first push rod 31, the first push rod 31 slides to drive the plugging device 1 and the upper clamping arm 211 to move, the first pull wire 41 is connected with the upper end of the upper clamping arm 211, the position of the upper end of the upper clamping arm 211 can be adjusted by pulling the first pull wire 41, when the first pull wire 41 is tensioned, the upper end of the upper clamping arm 211 is closed towards the direction of the first push rod 31, when the first pull wire 41 is loosened, the upper clamping arm 211 is restored to an initial opening state, the position of the upper clamping arm 211 which is opened can be adjusted by adjusting the length of the first pull wire 41, and therefore the valve leaflet 81 can be repeatedly captured, and effective capture of the valve leaflet 81 can be achieved.
As shown in fig. 1, fig. 1 shows that the upper clamp arm 211 can be pulled by the first wire 41 to move between being retracted in the first push rod 31 and being far away from the first push rod 31. The first wire 41 and the upper clamp arm 211 are in the position when they are in the unfolded state in fig. 1, and the first wire 41 'and the upper clamp arm 211' are in the position when they are moved to another position after pulling the first wire 41 in fig. 1.
The base 5 is mounted on the push rod 33, the locking plate 52 is arranged in the base 5 and is provided with a locking hole 53 which is suitable for the push rod 33 to pass through, wherein the locking plate 52 can be made of elastic materials, the shape of the locking hole 53 can be changed, so that the push rod 33 can be locked and released, the base 5 is provided with a first threading hole 51, the locking plate 52 is provided with a second threading hole 54, the second pull wire 42 passes through the first threading hole 51 and the second threading hole 54 to pass through the bottom of the base 5, two ends of the second pull wire 42 are respectively connected with an operation handle, and the positions of the base 5 and the lower clamping arm 221 can be controlled through the second pull wire 42.
The locking plate 52 has a horizontal surface, the locking hole 53 and the second threading hole 54 are both arranged on the horizontal surface and penetrate through the horizontal surface, when the second pulling wire 42 is in a loose state, the locking hole 53 is a square hole, and when the second pulling wire 42 is in a tensioned state, the locking hole 53 is a diamond hole.
Specifically, when the second wire 42 is released, the locking piece 52 locks the push rod, when the second wire 42 is pulled taut, the second wire 42 is straightened, since the central axes of the first wire passing hole 51 and the second wire passing hole 54 have a certain gap, when the second wire 42 is straightened, the second wire passing hole 54 moves outward, the second wire 42 drives the locking piece 52 to deform, whereby the locking hole 53 deforms to increase, for example, as shown in fig. 17 to 20, when the locking piece 52 is in the locked state, the locking hole 53 may be formed in a diamond shape, when the locking piece 52 deforms, the locking hole 53 gradually becomes close to a square shape from the diamond shape, so that the locking hole 53 increases, so that the locking piece 52 becomes in the released state from the locked state, and thus the push rod 33 can move up and down within the locking hole 53. The locking shape and the shape upon deformation of the lock hole 53 are not limited to a diamond shape and a square shape, but may be any other suitable shape.
The lower end of the lower clamp arm 221 is rotatably connected to the base 5, for example, the lower end of the lower clamp arm 221 may be connected to the base 5 by shaft hole and rotation shaft fitting. The rotating arm 222 is obliquely arranged below the lower clamping arm 221, the lower end of the rotating arm 222 is rotatably connected with the lower end of the push rod 33, and the upper end of the rotating arm 222 is rotatably connected with the lower clamping arm 221. Referring to fig. 8-14, when the lower clamping arm 221 and the upper clamping arm 211 are in a clamping state, the first push rod 31 drives the stopper 1 to move toward the base 5 to be connected with the base 5, wherein the stopper 1 is suitable for being in snap connection with the base 5, so as to facilitate connection and fixation of the stopper 1 and the base 5. When the second push rod 32 drives the push rod 33 to move towards the base 5, the lower end of the push rod 33 is connected with the lower end of the rotating arm 222 to drive the rotating arm 222 to move, and the upper end of the rotating arm 222 is connected with the lower clamping arm 221 to drive the lower clamping arm 221 to close so as to retract towards the occluder 1.
The process and method of using the detachable transport gripping device 100 according to one embodiment of the present invention is described below with reference to the accompanying drawings.
The detachable delivery gripping device 100 may be connected to a delivery device 62 and a control device 61, wherein the control device 61 may be used to control the target direction of the instrument, the delivery device 62 is used to move the instrument to access the target point, and the detachable delivery gripping device 100 is used for implantation within the heart structure 8.
As shown in fig. 21, the detachable delivery clip device 100 reaches the left atrium 82 through the control device 61 and the delivery device 62, at which time the detachable delivery clip device 100 is stabilized in the left atrium 82 at the control device 61 and the delivery device 62, at which time the detachable delivery clip device 100 is in the closed state as shown in fig. 2 and 6. As shown in fig. 22 and in combination with fig. 3 and 4, the second wire 42 passes through the base 5 and the locking piece 52, and the second wire 42 is pulled, when the second wire 42 is pulled, the locking piece 52 is opened, and the push rod 33 can move up and down in the locking hole 53, so that the base 5 moves towards the occluder 1 under the action of the second wire 42, and the lower clamping arm 221 connected to the base 5 is opened.
As shown in fig. 23 in combination with fig. 1, the occluding device 1 is connected to the clamping assembly 2 in the left atrium 82, specifically, the clamping assembly 2 is maintained in a deployed state under the force of the second pull wire 42, the base 5 and the push rod 33, and the occluding device 1 is moved to the left ventricle 83 by the first push rod 31 until the lower end of the occluding device 1 is connected to the base 5.
As shown in fig. 24, the upper clamping arm 211 is folded toward the occluding device 1 by adjusting the first pull wire 41 to rotate the upper clamping arm 211, and as shown in fig. 25, the detachable delivery clamping device 100 is moved to the left ventricle 83 by the first push rod 31, at this time, the lower clamping arm 221 is unfolded, and the occluding device 1 and the clamping assembly 2 are made to be close to the edge of the lower surface of one leaflet 81 by adjusting the delivery device 62 and the first push rod 31.
As shown in fig. 26, the length and tightness of the first pull wire 41 are adjusted to control the capturing state of one upper and lower clamping arms 211 and 221, and when the upper clamping arm 211 is adjusted to a proper position, the upper clamping arm 211 is released from the first pull wire 41 and restored to the unfolded state, the upper surface edge of the leaflet 81 is pressed when the upper clamping arm 211 is restored, in particular, the upper surface edge of the leaflet 81 can be better captured by operating the first pull wire 41 a plurality of times.
As shown in fig. 26, the tightness of the first string 41 is adjusted to control the capturing state of the other set of upper and lower clip arms 211 and 221, and when the other first string 41 is released, the other set of upper clip arms 211 resumes pressing the upper surface edge of the other leaflet 81, and the first string 41 is operated a plurality of times to make an adjustment to better capture the upper surface edge of the other leaflet 81.
As shown in fig. 27 and in combination with fig. 9-14, the first push rod 31 and the occluder 1 are stabilized by the delivery device 62, the adjusting push rod 33 moves towards the occluder 1 and the base 5, the push rod 33 drives the rotating arm 222 to rotate to push the lower clamping arm 221 to close at the same time to retract towards the occluder 1, and after the control device 61 and the delivery device 62 are detached, the first push rod 31 and the second push rod 32 are withdrawn, so that only the clamping assembly 2, the occluder 1 and the rotating arm 222 remain.
Another process and method of using the detachable transport clamping device 100 according to an embodiment of the present invention is described below in conjunction with fig. 21-22 and fig. 28-31.
The detachable delivery gripping device 100 may be connected to a delivery device 62 and a control device 61, wherein the control device 61 may be used to control the target direction of the instrument, the delivery device 62 is used to move the instrument to access the target point, and the detachable delivery gripping device 100 is used for implantation within the heart structure 8.
As shown in fig. 21, the detachable delivery clip device 100 reaches the left atrium 82 through the control device 61 and the delivery device 62, at which time the detachable delivery clip device 100 is stabilized in the left atrium 82 at the control device 61 and the delivery device 62, at which time the detachable delivery clip device 100 is in the closed state as shown in fig. 2 and 6. As shown in fig. 22 and in combination with fig. 3 and 4, the second wire 42 passes through the base 5 and the locking piece 52, and the second wire 42 is pulled, when the second wire 42 is pulled, the locking piece 52 is opened, and the push rod 33 can move up and down in the locking hole 53, so that the base 5 moves towards the occluder 1 under the action of the second wire 42, and the lower clamping arm 221 connected to the base 5 is opened.
As shown in fig. 28, the clamping assembly 2 moves the lower surface edge of the leaflet 81 across the valve, and when the clamping assembly 2 is in the deployed state, the lower clamping assembly 22 is moved entirely to the lower surface edge of the leaflet 81 by the second push rod 32. As shown in fig. 29, after the lower clamp assembly 22 is stabilized by the push rod 33 and the delivery device 62, the occluding device 1 is moved by the first push rod 31 to engage the upper clamp assembly 21 with the lower clamp assembly 22 while the upper clamp assembly 21 captures the upper surface edge of the leaflet 81 during movement.
As shown in fig. 30, the position adjustment of the catching leaflet 81, specifically, the open and close state of the upper clamping arm 211 is controlled by the tightness of the first and second pull wires 41 and 42, when the first pull wire 41 is released, the upper clamping arm 211 is restored to the open state and presses the upper surface edge of the leaflet 81 upon restoration, wherein the upper surface edge of the leaflet 81 can be better caught by operating the first pull wire 41 a plurality of times. The same method can adjust the clamping state of the other upper clamping arms 211, the first pull wire 41 and the leaflet 81.
Referring to fig. 30 and 31, when the first push rod 31 and the occluder 1 are stabilized by the delivery device, the adjusting push rod 33 moves towards the occluder 1 and the base 5, the push rod 33 drives the rotating arm 222 to rotate to push the lower clamping arm 221 to close at the same time to retract towards the occluder 1, and after the control device 61 and the delivery device 62 are detached, the first push rod 31 and the second push rod 32 are withdrawn, so that only the clamping assembly 2, the occluder 1 and the rotating arm 222 are remained.
In an embodiment of the application, the stretching unit is a second pull wire. In an embodiment of the present application, the control unit is an operation handle, but the present application is not limited to the above embodiment. In an embodiment of the application, the positioning member is a first threading hole.
34-37, In another embodiment of the present application, the locking piece 52 has a first surface 521 and a second surface 522, the second surface 522 is connected to the first surface 521, the second surface 522 can rotate 521 relative to the first surface, the locking hole 53 is provided on the second surface 522, the second threading hole 54 is provided on the first surface 521, when the second pulling wire 42 is in a loose state, the second surface 522 forms an angle θ with the first surface 521, the locking piece 52 locks the push rod, and when the second pulling wire 42 is in a tensioned state, the second surface 522 rotates relative to the first surface 521, so that the angle θ becomes larger, and the locking piece 52 releases the push rod, and the push rod can move up and down. The second threading holes 54 may be one, two or more.
When the second stay wire 42 is in a loose state, the vertical distance between the axis of the second threading hole 54 and the axis of the first threading hole 51 is L, and when the second stay wire 42 is in a tensioned state, the vertical distance between the axis of the second threading hole 54 and the axis of the first threading hole 51 is W, wherein W < L.
It should be noted that the above-mentioned embodiments are merely for illustrating the technical solutions of the embodiments of the present application, and not for limiting the same, and although the present application has been described in detail with reference to the above-mentioned embodiments, it should be understood by those skilled in the art that the technical solutions described in the above-mentioned embodiments may be modified or some technical features may be equivalently replaced, and these modifications or substitutions do not make the essence of the corresponding technical solutions deviate from the spirit and scope of the technical solutions of the embodiments of the present application.