CN211157660U - A device for assisting left ventricular function in refractory heart failure - Google Patents

Abstract

The utility model discloses a left ventricular function auxiliary device for refractory heart failure. A suction head is designed with a plurality of suction tubes and capsule cavity tunnels. Conical cavity, a one-way valve is designed at the place where the pipeline communicates with the cavity, which communicates with the cavity of the balloon through the one-way valve. The pipette is connected to the drop-shaped suction tip through a single channel across the valve, and the distal end communicates with the balloon chamber. The outer wall of the trapezoidal side is provided with a one-way valve, which is communicated with the airbag chamber through the channel; there are 4 one-way valves on the outside of the airbag, and the upper end is conical and connected with the air cavity tunnel through the trachea; the branch bronchus passes downward through The air bag chamber is opened on the inner side of the air bag wall, and merges upward to form the main trachea, which is communicated with the body through the artery, and the lower end of the guide wire is communicated with the drop-shaped suction head. The beneficial effect of the utility model is that under the condition of loss of left ventricular function, it can also work continuously, so as to gain time for clinical rescue or heart transplantation.

Description

A device for assisting left ventricular function in refractory heart failure

technical field

The utility model belongs to the technical field of medical devices, and relates to a left ventricular function auxiliary device for refractory heart failure.

Background technique

Acute heart failure: Mainly manifested as decreased left ventricular function, that is, decreased left ventricular pumping function, insufficiency of cardiac pumping, decreased work work, and left ventricular congestion, resulting in pulmonary congestion and difficulty breathing. The device can assist the work of the left ventricle, reduce pulmonary congestion, thereby reduce the work of the left ventricle, restore the pump function of the left ventricle, relieve the pulmonary congestion and pulmonary edema caused by acute left ventricular insufficiency, and relieve the symptoms of dyspnea and wheezing of patients. , to help patients successfully pass through acute myocardial infarction, acute left ventricular insufficiency and other high-risk periods caused by other reasons, and successfully achieve recovery. At present, the heart failure assist devices that have been used clinically in various countries in the world mainly include: 1. TandemHear device, TandemHeart percutaneous transseptal ventricular assist (PTVA), PTVA system is a left ventricular assist device LVAD, designed as a short-term circulatory support system, Complete cardiopulmonary access surgery is not required. The system consists of three parts: the TandemHeart pump, which provides the circulatory power to draw oxygenated blood from the left atrium and advance it to the systemic arterial circulation; the TandemHeart cannula assembly, which connects the pump through 2 transcutaneous access points in the groin Get up; the TandemHeart controller, which powers the pump and supplies the pump with lubricant. 2. The Impella system, a constant-speed operation system, requires arterial incision and implantation. Although the operation is convenient, it can be used for left or right ventricular auxiliary circulation; but it also requires the preservation of left ventricular function, so the patient's tolerance is poor. In addition, the device cannot simulate the rhythmic pulsation of human blood flow, so it will cause the blood vessels such as the aorta to continue to expand, causing the patient's blood pressure to rise and cause headaches and other discomforts. 3. ^A-Med® Systems pLVAD, the pump is outside the body and needs to be implanted in the chest. The pump tube is connected to the device through the skin, and the pump with different power and cardiac output can be replaced as needed without replacing the catheter system; but Significantly increase the patient's risk of tolerance to surgery and increase the risk of infection. 4. Extracorporeal membrane oxygenation, ECMO is the extracorporeal "membrane lung", which sends the blood from the venous system to the extracorporeal membrane oxygenator for sufficient oxygenation and then transports it to the arterial system, also known as Fullcardiopulmonary support. The characteristic is that the oxygenation is very good, but it cannot really directly achieve the "unloaded" work of the heart, and the cardiac afterload is increased due to the establishment of venous-ECMO-arterial access in the peripheral blood vessels. Suitable for ACS with severe hypoxemia. 5. The aortic balloon counterpulsation device (IBAP) is minimally invasively implanted into the descending aorta through the femoral artery, and the ECG gate controls the inflation and deflation. Assists blood flow and realizes the function of supplying blood to various organs of the body.

The above devices have their own advantages and disadvantages. The main disadvantage is that they completely replace the left ventricle, or they all require the left ventricular systolic pump function to be preserved, that is, either the left ventricle is completely replaced and cannot achieve physiological pumping, or the left ventricular function is required to be preserved and only a very small part is required. It assists the left ventricle to work, but cannot replace the function of the left ventricle to a large extent. Most of the acute left ventricular failure, especially the acute myocardial infarction caused by the acute occlusion of the anterior descending coronary artery, is caused by the loss of the left ventricular pump function. The application indications are more limited and the effect is poor. Moreover, the above devices 1 and 2 require open-heart cardiac replacement, or partial cardiac replacement, which is traumatic and has poor effects, especially in the long-term, with many complications. Most of the left ventricular assist devices currently in clinical use are non-ECG-gated types, which cannot be synchronized with ventricular contraction, so they cannot simulate human hemodynamics well, and have poor blood perfusion effects on organs. The device of the utility model is applied in the early stage, and is a temporary cardiac function assistance technology applied for sudden and staged cardiac insufficiency, and also for the late cardiac function loss, allogeneic heart replacement, or artificial heart replacement in the transition period to replace the left ventricular auxiliary device .

Utility model content

The purpose of the present utility model is to provide a left ventricular function auxiliary device for refractory heart failure. Working to buy time for clinical rescue or heart transplantation can effectively reduce the mortality rate due to left ventricular function decline and pump failure.

The technical scheme adopted by the utility model includes a spiral-shaped suction pipe and a water drop-shaped suction head. The suction head is designed with a plurality of suction pipes and capsule cavity tunnels. The end cone-shaped cavity is designed with a one-way valve in the pipe that communicates with the cavity, which communicates with the cavity of the airbag through the one-way valve. The pipette is connected to the drop-shaped suction head through a single channel across the valve, and the distal end is connected to the airbag chamber. The outer wall of the trapezoidal side is provided with a one-way valve, the valve opens outward, and the one-way valve communicates with the airbag chamber through the channel; the airbag is a cylindrical structure and is composed of shape memory alloy, which is in a contracted state outside the body, and is released after reaching the body. That is to form a cylinder, the lower end communicates with the ventricle, the outer side is provided with 4 one-way valves, the valves are open to the outside, the upper end is conical and connected to the air cavity tunnel through the trachea; , which converges upward into the main trachea, communicates with the body through the artery, and communicates with the drop-shaped tip at the lower end of the guide wire.

Further, the length of the transvalvular segment of the straw is 30-50 cm, and the shape is flat leaf.

Further, the capsule body is a 360-degree Coanda design.

Further, the airbag locking point is the upper 1/3 position of the lower part.

Description of drawings

Figure 1 is a schematic diagram of the structure of the device of the present invention.

In the figure, 1. Guide wire; 2. Drop-shaped suction tip; 3. Suction hole; 4. Spiral suction tube; 5. One-way valve; 6. Proximal conical cavity; 7. Balloon chamber; Body; 9. Branched bronchi; 10. Ascending segment of trachea; 11. Arch of trachea; 12. Descending segment of trachea; 13. ECG-gated air pump; 14. ECG lead wire; 15. Straw and cystic tunnel; 16. Trachea With the air cavity tunnel; 17, the suction tube across the valve segment; 18, the cyst cavity.

Detailed ways

The present invention will be described in detail below in conjunction with specific embodiments.

The device of this utility model is shown in Figure 1. The indoor section is divided into two parts: a helical suction pipe 4 and a water-drop suction head 2. The suction head is designed with a plurality of suction pipes and a capsule cavity tunnel 15, and the external suction hole 3 is opened in the suction head. The lower wall and the outer side lead inward to the proximal conical balloon cavity 6, and a one-way valve is designed in the pipe connecting with the balloon cavity 18, which is communicated with the balloon cavity through the one-way valve 5. After the blood is inhaled, it is guaranteed In the balloon inflation stage, the blood does not flow back, and will be discharged into the aorta through the one-way valve 5 of the balloon cavity. The length of the straw transvalvular section 17 is 30-50cm, with a flat leaf-shaped design, a single channel is connected to the drop-shaped tip 2, the distal end is communicated with the air bag chamber 7, and the outer wall of the trapezoid side is designed with one-way valve 5, the number is 4, The valve is opened outwards to ensure coronary blood supply while avoiding damage to the coronary opening by ejection of blood. The one-way valve 5 communicates with the inner cavity of the balloon chamber 7 through a channel. The balloon body 8 is designed with a 360-degree wall attached. In the exhaust stage, the balloon retracts, the space of the balloon cavity 18 increases, and it is under negative pressure. The blood is simultaneously drained to the proximal end of the aortic sinus and the aortic arch to ensure the blood supply of the coronary arteries, subclavian arteries, carotid arteries and peripheral arteries.

The airbag locking point is the upper 1/3 of the lower part, and the lower part is inflated first to ensure that the lower wall airbag is inflated first, so as to ensure that one-third of the blood perfuses the coronary arteries and two-thirds of the blood is shunted to the aorta, preventing more Blood perfuses the coronary arteries, damaging their coronary ostia.

Capsule 8, this part is a cylindrical structure and is made of shape memory alloy. It is in a contracted state outside the body. After reaching the body, it is released to form a cylinder. The lower end communicates with the ventricle. It is open to the outside, and the upper end is conical and connected to the air cavity tunnel 16 through the trachea.

The branch bronchioles 9 are 2-4, which pass downward through the balloon chamber and open on the inner side of the balloon wall, merge upward into the main trachea, and communicate with the body through the femoral artery. The lower end of the guide wire 1 is communicated with the drop-shaped suction head. First, the guide wire 1 is sent to the left ventricle, and the water drop suction head 2 is introduced along the exchange track. The ascending section 10 of the trachea, the arch section 11 of the trachea, and the descending section 12 of the trachea are connected to the outside of the body. The ECG-gated air pump 13 needs to be ECG-gated, and is triggered by the R wave of the ascending branch of the ECG, that is, the R wave starts to exhaust in the early systolic phase—that is, suction, and the T wave starts in the early ventricular diastole, when the aorta The valve closes and begins to inflate. At this time, the aortic valve closes and blood is discharged into the aorta. This device is a nitrogen-driven device, and the nitrogen is continuously cooled from the outside for inflation and deflation. The device can also assist coronary intervention in acute myocardial infarction at the same time.

The device of the utility model is driven by an external air pump, controlled by an electrocardiogram, connected with the patient through an electrocardiogram lead wire 14, connected with the air bag in the body through an outer tracheal tube, inflated and deflated through the air bag, simulates and synchronizes the left ventricular contraction process, and assists the left ventricular beat. blood, reducing left ventricular preload.

The working process of the device of the utility model: 1. The air bag is deflated at the end of ventricular diastole. At this time, the air bag is retracted, the space of the air bag is expanded, and it is in a negative pressure state. Left ventricular systolic preload, reduce left ventricular work, reduce myocardial oxygen consumption, and improve cardiac function. 2. Inflation starts at the end of systole, that is, in the very early period of diastole. At this time, the balloon is inflated, the space of the sac is compressed, and it is in a positive pressure state. 15-20ml of blood is drawn from the left ventricle, and it is discharged through the proximal and distal ends of the device. The blood hole discharges blood to the aorta, which can actively assist the closure of the aortic valve, thereby improving coronary and peripheral blood supply.

The device of the utility model also has the advantages of relieving late left heart insufficiency, prolonging the life of patients, improving the prognosis of patients with acute left heart failure caused by acute myocardial infarction, no reflow during PCI operation, and TIMI blood flow level 0-1. It can replace the current clinical use of IBAP.

The above is only a preferred embodiment of the present invention, and does not limit the present invention in any form. Any simple modifications made to the above embodiments according to the technical essence of the present invention, equivalent changes and modifications, All belong to the scope of the technical solution of the present invention.

Claims (4)

1. an auxiliary device for left ventricular function of refractory heart failure, characterized in that: comprise a helical suction pipe and a water droplet type suction head, a plurality of suction pipes and cystic cavity tunnels are designed inside the suction head, and an external suction hole is opened at the bottom of the suction head. The wall and the outer side lead inward to the conical cavity at the proximal end, and a one-way valve is designed at the place where the pipeline communicates with the cavity, which communicates with the inner cavity of the balloon through the one-way valve. The head is connected, the distal end is communicated with the air bag chamber, the outer wall of the trapezoid side is provided with a one-way valve, the valve is open to the outside, and the one-way valve is communicated with the air bag chamber through the channel; the bag body is a cylindrical structure and is composed of shape memory alloy , it is in a contracted state in vitro, and when it reaches the body, it is released to form a cylinder, the lower end communicates with the ventricle, and there are 4 one-way valves on the outside, the valves open to the outside, and the upper end is conical through the trachea and connected to the air cavity tunnel; The lower end passes through the air bag chamber and opens on the inner side of the air bag wall, merges upward to form the main trachea, communicates with the body through the artery, and the lower end of the guide wire communicates with the water drop-shaped suction head. 2 . The device for assisting left ventricular function in refractory heart failure according to claim 1 , wherein the length of the suction tube across the valve segment is 30-50 cm, and it is of a flat leaf type. 3 . 3 . The device for assisting left ventricular function in refractory heart failure according to claim 1 , wherein the balloon body is a 360-degree wall-attached design. 4 . 4 . The device for assisting left ventricular function in refractory heart failure according to claim 1 , wherein the airbag locking point is the upper 1/3 position of the lower part. 5 .

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