Prosthetic valve prosthesis conveying deviceTechnical Field
The application belongs to the technical field of interventional medical instruments, and particularly relates to a prosthetic valve prosthesis conveying device.
Background
The heart is a very important organ of human body and provides power for human body blood circulation, the heart is divided into a left part and a right part, each part comprises a ventricle and an atrium, the ventricle and the atrium are separated by a ventricular septum and a atrial septum, valves for preventing blood reflux are arranged among the atrium, the ventricle and the artery, the valves between the left atrium and the left ventricle are mitral valves, and when any structure of the mitral valves is problematic, the pathological changes of the valves are caused.
Mitral regurgitation is the majority of mitral valve lesions, the prosthetic mitral valve can be introduced into a patient through a catheter, namely, the mitral valve is placed through minimally invasive interventional operation, the operation does not need to open the chest, the wound is small, and the postoperative recovery is quick. Currently, the insertion of an interventional prosthetic heart valve into a body is usually performed by delivering the valve to a predetermined location by means of a delivery device. In the existing delivery device, when the prosthetic heart valve is released, a sheath tube for loading the prosthetic heart valve is retracted so that the prosthetic heart valve is gradually exposed and opened, in other words, the prosthetic heart valve is released from one side of the sheath tube, and when the prosthetic heart valve is in a certain size, the relative movement distance is usually required to be longer, and the risk of operation is increased when the movement distance is longer. Accordingly, there is a need for improvements in conveyor systems.
Disclosure of Invention
The application aims to solve the technical problem of providing a prosthetic valve prosthesis conveying device which can realize bidirectional release of a prosthetic valve prosthesis.
The application adopts the following technical scheme to solve the technical problems:
A prosthetic valve prosthesis conveying device, which comprises a hand-held part and a valve prosthesis accommodating component in transmission connection with the hand-held part, wherein the valve prosthesis accommodating component comprises a distal end part and a proximal end part which can be sleeved and connected, and a valve carrier arranged in an accommodating space formed after the distal end part and the proximal end part are sleeved and connected;
The hand-held part is provided with a first driving mechanism for adjusting the relative position distance between the distal end part and the valve carrier and a second driving mechanism for adjusting the relative position distance between the proximal end part and the valve carrier.
The application can realize the adjustment of the relative position distance between the distal end part and the valve carrier through the first driving mechanism, and can realize the adjustment of the relative position distance between the proximal end part and the valve carrier through the second driving mechanism. When the artificial heart valve is implanted, the valve carrier and the distal end part and the proximal end part on the conveying device can move relatively, so that the adjustable operation of the double-side position distance of the valve carrier when the artificial mitral valve is released can be conveniently realized, and the surgical difficulty and the surgical risk can be reduced.
Preferably, the handpiece is connected to the valve prosthesis receiving assembly by a sliding catheter set comprising a first catheter, a second catheter extending within and through the first catheter, and a third catheter extending within and through the second catheter;
the distal end of the first catheter is connected to the proximal end, the distal end of the second catheter is connected to the valve carrier, and the distal end of the third catheter is connected to the distal end.
In the implementation process, the transmission connection between the handheld part and the valve prosthesis accommodating assembly can be conveniently realized through the sliding guide tube group, and at the moment, the relative position distance among the proximal part, the valve carrier and the distal part can be regulated and controlled through the relative sliding movement among the first guide tube, the second guide tube and the third guide tube.
Preferably, the first driving mechanism comprises a first sliding block and a first cylinder sleeve for controlling the sliding of the first sliding block;
The first sliding block is arranged in the handheld part, and the proximal end of the third catheter is connected with the first sliding block.
In the above implementation process, the sliding motion of the first sliding block may be controlled by the first sleeve, and the third catheter is driven to move by the sliding of the first sliding block, so as to drive the distal end portion to move.
Preferably, the second driving mechanism comprises a second sliding block and a second barrel sleeve for controlling the sliding of the second sliding block;
The second sliding block is arranged in the handheld part, and the proximal end of the first catheter is connected with the second sliding block.
In the implementation process, the sliding motion of the second sliding block can be controlled through the second cylinder sleeve, and the first guide pipe is driven to move through the sliding of the second sliding block, so that the proximal end portion is driven to move.
Preferably, the hand-held part comprises a main cylinder body, and the main cylinder body is provided with a first chute for mounting the first sliding block and a second chute for mounting the second sliding block;
the proximal end of the second conduit is connected with the main cylinder, and the joint of the second conduit and the main cylinder is positioned between the first chute and the second chute.
In the implementation process, the coordination of the first sliding block and the second sliding block in sliding motion can be improved through the first sliding groove and the second sliding groove.
Preferably, the first sliding block and the second sliding block are respectively provided with a threaded connection part, and the threaded connection parts respectively protrude out of the first sliding groove and the second sliding groove;
the first cylinder sleeve and the second cylinder sleeve are both rotatably arranged outside the main cylinder, and matched threads connected with the threaded connection parts are arranged in the first cylinder sleeve and the second cylinder sleeve.
Preferably, a third driving mechanism is arranged on the handheld part, and comprises a mounting sleeve and an adjusting sleeve;
The remote end of the main cylinder body protrudes into the installation cylinder sleeve, and the adjustment cylinder sleeve is used for adjusting the relative position distance between the main cylinder body and the installation cylinder sleeve.
In the implementation process, the motion of the main cylinder body can be controlled through the adjusting cylinder sleeve, and the synchronous movement of the first sliding block, the main cylinder body and the second sliding block is realized through the relative movement between the main cylinder body and the mounting cylinder sleeve, so that the synchronous movement of the proximal end part, the valve carrier and the distal end part is driven.
Preferably, one end of the adjusting sleeve is movably connected with the mounting sleeve, and the adjusting sleeve can rotate relative to the mounting sleeve;
the remote end of the main cylinder body protrudes into the mounting cylinder sleeve and the adjusting cylinder sleeve, the inner side surface of the adjusting cylinder sleeve and the outer side surface of the main cylinder body are respectively provided with a thread structure, and the main cylinder body is in threaded transmission connection with the adjusting cylinder sleeve.
Preferably, the device comprises a guide tube, wherein the proximal end of the guide tube is connected with the mounting barrel sleeve;
The valve prosthesis receiving assembly is slidably partially into the guide tube under the drive of the third drive mechanism.
In the implementation process, the coordination of the valve prosthesis accommodating assembly in moving can be improved conveniently through the guide tube.
Preferably, a guide tapered surface is provided at a distal end of the distal end portion, and a first developing groove is provided on the guide tapered surface.
Preferably, the developing device comprises a plurality of second developing grooves which are arranged on the outer peripheral surface of the distal end part around the axis of the distal end part;
The second developer tank is disposed at a proximal end of the distal portion.
In the implementation process, through the first developing tank and the second developing tank, when the valve is matched with ultrasonic developing equipment, the current position of the distal end part can be fed back more clearly and accurately, so that an operator can judge the valve release position conveniently.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings that are needed in the embodiments of the present application will be briefly described below, it should be understood that the following drawings only illustrate some embodiments of the present application and should not be considered as limiting the scope, and other related drawings can be obtained according to these drawings without inventive effort for a person skilled in the art.
Fig. 1 is a schematic perspective view of a conveying device according to the present application.
Fig. 2 is a schematic cross-sectional view of the delivery device of the present application.
Fig. 3 is a schematic view of the connection structure of the sliding catheter set and the valve prosthesis receiving assembly of the present application.
Fig. 4 is a schematic cross-sectional view of a valve prosthesis containment assembly of the present application.
Fig. 5 is a schematic perspective view of the distal end portion of the present application.
Fig. 6 is a schematic side view of the distal portion of the present application.
Fig. 7 is a schematic view of an installation structure of the sliding catheter set of the present application.
Fig. 8 is a schematic perspective view of a hand-held portion according to the present application.
Fig. 9 is a schematic cross-sectional view of the hand-held portion of the present application.
FIG. 10 is a schematic view showing the installation structure of the sliding block on the main cylinder body.
Fig. 11 is a schematic perspective view of a slider according to the present application.
Fig. 12 is a schematic diagram showing a released state of the delivery device according to the present application.
Marking:
1-valve prosthesis accommodation assembly, 10-accommodation space, 11-distal end, 111-guide cone, 112-first developing tank, 113-second developing tank, 12-valve carrier, 13-proximal end;
2-sliding catheter group, 21-first catheter, 22-second catheter, 23-third catheter;
3-hand-held part, 30-main cylinder, 301-first chute, 302-second chute, 303-screw structure, 31-first driving mechanism, 311-first sliding block, 312-first sleeve, 32-second driving mechanism, 321-second sliding block, 322-second sleeve, 33-third driving mechanism, 331-mounting sleeve, 332-adjusting sleeve, 34-screw connection part;
4-a guide cylinder.
Detailed Description
In order that the above-recited objects, features and advantages of the present application will be more clearly understood, a more particular description of the application will be rendered by reference to the appended drawings and appended detailed description. The embodiments of the present application and the features in the embodiments may be combined with each other without collision. In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present application, and the described embodiments are merely some, rather than all, embodiments of the present application. All other embodiments, which can be made by those skilled in the art based on the embodiments of the present application without making any inventive effort, are intended to fall within the scope of the present application.
It should be noted that all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs unless defined otherwise. The terminology used herein in the description of the application is for the purpose of describing particular embodiments only and is not intended to be limiting of the application. Like reference numerals and letters denote like items in the following figures, and thus once an item is defined in one figure, no further definition or explanation thereof is necessary in the following figures. Meanwhile, in the description of the present application, the terms "first", "second", and the like are used only to distinguish the description, and are not to be construed as indicating or implying relative importance. The terms "distal" and "proximal" are used primarily by the operator as a primary reference, i.e., the end proximal to the practitioner or the end distal to the patient may be considered the "proximal end" and the end distal to the practitioner or the end proximal to the patient may be considered the "distal end".
As shown in fig. 1 to 12, the prosthetic valve prosthesis delivery device provided in this embodiment includes a valve prosthesis accommodating assembly 1, a sliding catheter set 2 and a handheld portion 3, where the valve prosthesis accommodating assembly 1 and the handheld portion 3 are in transmission connection through the sliding catheter set 2.
As shown in fig. 3-6, the valve prosthesis accommodating assembly 1 in this embodiment includes a distal end portion 11, a valve carrier 12, and a proximal end portion 13, where the proximal end of the distal end portion 11 and the distal end of the proximal end portion 13 can be sleeved with each other, an accommodating space 10 is formed after the distal end portion 11 and the proximal end portion 13 are sleeved, and the valve carrier 12 is located in the formed accommodating space 10 before the prosthetic valve prosthesis is released.
In a preferred embodiment, a guiding tapered surface 111 is provided at the distal end of the distal end portion 11, a first developing groove 112 is provided on the guiding tapered surface 111 as shown in fig. 5 and 6, and a plurality of second developing grooves 113 are provided at the proximal end of the distal end portion 11, and the plurality of second developing grooves 113 are provided on the outer peripheral surface of the distal end portion 11 around the axis of the distal end portion 11 as shown in fig. 5 and 6. Through the first developing tank 112 and the second developing tank 113, when the valve is matched with the ultrasonic developing device, the current position of the distal end portion 11 can be fed back more clearly and accurately, so that an operator can judge the valve release position conveniently.
Further, as shown in fig. 7, the sliding catheter set 2 includes a first catheter 21, a second catheter 22 extending within the first catheter 21 and penetrating the first catheter 21, and a third catheter 23 extending within the second catheter 22 and penetrating the second catheter 22. The distal end of the first catheter 21 is connected to the proximal end 13, the distal end of the second catheter 22 is connected to the valve carrier 12, and the distal end of the third catheter 23 is connected to the distal end 11. At this time, the relative positional distances among the proximal portion 13, the valve carrier 12 and the distal portion 11 can be regulated by the relative sliding movement among the first catheter 21, the second catheter 22 and the third catheter 23.
Further, as shown in fig. 8 to 11, in the present embodiment, the hand-held portion 3 includes a main cylinder 30, and a first drive mechanism 31, a second drive mechanism 32, and a third drive mechanism 33 are provided on the main cylinder 30.
As a preferred solution, the first driving mechanism 31 includes a first sliding block 311 and a first sleeve 312, and the main cylinder 30 is provided with a first sliding groove 301. In this embodiment, the first sliding groove 301 penetrates from two sides of the main cylinder 30, the first sliding block 311 is embedded in the first sliding groove 301, and the first sliding block 311 can perform sliding motion relative to the first sliding groove 301, and the first sliding groove 301 is provided to make the first sliding block 311 have better coordination during sliding.
Further, in this embodiment, threaded connection portions 34 are disposed on both sides of the first sliding block 311, and the threaded connection portions 34 protrude from both sides of the first sliding groove 301. The first sleeve 312 is sleeved outside the main cylinder 30, and the first sleeve 312 can rotate relative to the main cylinder 30. Wherein, the inner side surface of the first sleeve 312 is provided with a matching thread connected with the threaded connection part 34, so that the sliding movement of the first sliding block 311 in the first sliding groove 301 can be controlled by controlling the rotation of the first sleeve 312.
Further, the proximal end of the third catheter 23 is connected to the first sliding block 311, and at this time, the third catheter 23 is driven to move by sliding the first sliding block 311, so as to drive the distal end portion 11 to move, so as to adjust the relative position distance between the distal end portion 11 and the valve carrier 12.
As a preferred solution, the second driving mechanism 32 includes a second sliding block 321 and a second sleeve 322, and the main cylinder 30 is provided with a second sliding slot 302. In this embodiment, the second sliding groove 302 is also disposed to penetrate from two sides of the main cylinder 30, the second sliding block 321 is embedded in the second sliding groove 302, and the second sliding block 321 can slide relative to the second sliding groove 302, so that the second sliding block 321 has better coordination during sliding through the disposed second sliding groove 302.
Further, in the present embodiment, the threaded connection portions 34 are also disposed on two sides of the second sliding block 321, and at this time, the threaded connection portions 34 protrude from two sides of the second sliding groove 302. The second sleeve 322 is sleeved outside the main cylinder 30, and the second sleeve 322 can rotate relative to the main cylinder 30. The mating threads are also disposed on the inner side surface of the second sleeve 322, and the mating threads disposed on the second sleeve 322 are connected with the threaded connection portion 34 disposed on the second sliding block 321, so that the sliding movement of the second sliding block 321 in the second sliding groove 302 can be controlled by controlling the rotation of the second sleeve 322.
Further, the proximal end of the first catheter 21 is connected to the second sliding block 321, and at this time, the first catheter 21 may be driven to move by sliding the second sliding block 321, so as to drive the proximal end 13 to move, so as to adjust the relative position distance between the proximal end 13 and the valve carrier 12.
As a preferred option, the proximal end of the second conduit 22 is connected to the main cylinder 30, and the connection of the second conduit 22 to the main cylinder 30 is located between the first chute 301 and the second chute 302.
In this embodiment, the adjustment of the relative position distance between the distal end portion 11 and the valve carrier 12 is achieved by providing the first driving mechanism 31, as shown in fig. 12, and the adjustment of the relative position distance between the proximal end portion 13 and the valve carrier 12 is achieved by providing the second driving mechanism 32, as shown in fig. 12. When the artificial heart valve is implanted, the valve carrier 12 and the distal end 11 and the proximal end 13 of the delivery device can move relatively, so that the adjustable operation of the bilateral position distance of the valve carrier 12 when the artificial heart valve (such as the artificial mitral valve) is released can be realized, and the difficulty in operation can be reduced conveniently.
As a preferred solution, the third driving mechanism 33 includes a mounting sleeve 331 and an adjusting sleeve 332, one end of the adjusting sleeve 332 is movably connected with the mounting sleeve 331, the adjusting sleeve 332 is rotatable relative to the mounting sleeve 331, and the distal end of the main cylinder 30 protrudes into the mounting sleeve 331 and the adjusting sleeve 332, as shown in fig. 8 and 9.
Further, in this embodiment, the adjusting sleeve 332 is sleeved outside the main cylinder 30, and the inner side surface of the adjusting sleeve 332 and the outer side surface of the main cylinder 30 are both provided with a threaded structure 303, and the main cylinder 30 and the adjusting sleeve 332 are in threaded transmission connection through the threaded structure 303. At this time, the relative position distance between the main cylinder 30 and the mounting sleeve 331 can be adjusted by controlling the rotation of the adjusting sleeve 332, and the first sliding block 311, the second sliding block 321 and the second pipe 22 are disposed on the main cylinder 30, so that when the relative movement occurs between the main cylinder 30 and the mounting sleeve 331, the proximal portion 13, the valve carrier 12 and the distal portion 11 can be driven to move synchronously, thereby adjusting the overall distance based on the main cylinder 30, and facilitating the use of the conveying device.
As a preferred solution, a guide tube 4 is further provided in this embodiment, the proximal end of the guide tube 4 is connected to the mounting sleeve 331, and the valve prosthesis housing assembly 1 is driven by the third driving mechanism 33 to slidably partially enter the guide tube 4.
As one example of an application thereof, the valve prosthesis containment assembly 1 is slid entirely within the guide tube 4 when the adjustment sleeve 332 is rotated to move the main cylinder 30 relative to the mounting sleeve 331. When only the second sleeve 322 is turned to move the proximal portion 13 relative to the distal portion 11 and the valve carrier 12, the relative positions of the distal portion 11 and the valve carrier 12 remain unchanged, and the proximal portion 13 slides within the guide tube 4. By providing the guide tube 4, it is possible to facilitate an improved coordination of the valve prosthesis receiving assembly 1 when moving.
The prosthetic valve prosthesis delivery device provided in this embodiment is used as follows:
When the conveying device approaches the operation position but has a relatively large moving distance, the adjusting sleeve 332 can be rotated to drive the main cylinder 30 to move relative to the mounting sleeve 331 so as to drive the whole valve prosthesis accommodating assembly 1 to move relative to the guide tube 4, so that the whole valve prosthesis accommodating assembly 1 is quickly close to the operation position, and the judgment of the operation position can be fed back through the cooperation of the first developing groove 112, the second developing groove 113 and the ultrasonic developing device arranged on the distal end part 11.
When the valve prosthesis receiving assembly 1 is in the critical operative position, the second sleeve 322 is rotated to move the proximal portion 13 proximally through the first catheter 21, such that the proximal portion 13 is relatively disengaged from the distal portion 11 to expose a portion of the prosthetic heart valve, since the prosthetic heart valve is not fully released at this time, there is also some space for positional adjustment, so that the tolerance in the procedure can be higher, while the proximal portion 13 is controlled to move in the proximal direction in a safer manner than the control means.
When the operation position is confirmed, the first sleeve 312 is rotated at this time to drive the distal end portion 11 to move distally through the third catheter 23, and at this time, the proximal end portion 13 and the distal end portion 11 are disengaged from the valve carrier 12, so that the prosthetic heart valve is completely released.
The above description is only specific embodiments of the present application and is not intended to limit the scope of the present application, and various modifications and variations will be apparent to those skilled in the art. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present application should be included in the protection scope of the present application. Variations and substitutions will be readily apparent to those skilled in the art within the scope of the present disclosure, and are intended to be encompassed within the scope of the present disclosure. Therefore, the protection scope of the present application shall be subject to the protection scope of the claims.
It is noted that relational terms such as first and second, and the like are used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. Moreover, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Without further limitation, an element defined by the phrase "comprising one does not exclude the presence of other like elements in a process, method, article, or apparatus that comprises an element.