WO2023125684A1 - Prosthetic valve system and method for using same - Google Patents
Prosthetic valve system and method for using same Download PDFInfo
- Publication number
- WO2023125684A1 WO2023125684A1 PCT/CN2022/142902 CN2022142902W WO2023125684A1 WO 2023125684 A1 WO2023125684 A1 WO 2023125684A1 CN 2022142902 W CN2022142902 W CN 2022142902W WO 2023125684 A1 WO2023125684 A1 WO 2023125684A1
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- WO
- WIPO (PCT)
- Prior art keywords
- artificial valve
- stent
- valve system
- valve
- sleeve
- Prior art date
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2412—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2412—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
- A61F2/2418—Scaffolds therefor, e.g. support stents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/246—Devices for obstructing a leak through a native valve in a closed condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2463—Implants forming part of the valve leaflets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0061—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof swellable
Definitions
- the present application relates to the technical field of medical devices, in particular to an artificial valve system and its use method.
- aortic valves can be roughly divided into transcatheter interventional valves and surgically implanted valves.
- Transcatheter interventional valves have very small wounds and can be implanted without stopping the heart, without extracorporeal circulation and With general anesthesia, the patient recovers quickly, but the interventional valve also has limitations, including but not limited to: relying on structural anchoring, which requires high requirements on the patient's aortic anatomy; since there is no suture, the anti-displacement performance of the interventional valve must be evaluated ;The patient's original valve leaflet cannot be removed before implantation.
- valve-in-valve Valve-in-Valve, ViV
- Surgical implantable valves include: traditional thoracotomy surgical valves and suture-free (less suture) surgical valves.
- traditional thoracotomy surgical valves have the following advantages:
- the patient's native valve leaflets can be cut off before implantation to prevent interference with the implanted surgical valve
- Indications can basically cover all forms of valvular diseases
- valve height is very short, and the risk of blocking the coronary artery opening and damaging the vascular tissue is very small;
- surgical thoracotomy has higher requirements for the patient's age and physical condition.
- a delivery system is often used to help the prosthetic heart valve pass through and implant in the patient. Precisely positioning the prosthetic heart valve within the area, the delivery system is also used to hold the prosthetic heart valve securely in place until the sutures are completed and the sutures are tied.
- the delivery system is connected with a long and thin handle, and the surgeon manipulates the handle to manipulate the valve to its desired implantation position, and then removes the long and thin handle, and sutures the sewing ring to the native The annulus, during which the delivery system remains attached to the prosthetic valve to protect the valve, obstructs the surgeon's view during the suture procedure.
- an artificial valve and a system for implanting the artificial valve are provided.
- the delivery system compresses the artificial valve and places it into the target position accurately, which is applied to minimally invasive small incision surgery.
- An artificial valve system the artificial valve system includes an artificial valve and a delivery system that cooperate with each other.
- the support part is surrounded by a plurality of U-shaped frames and the opening of each U-shaped frame faces the outflow side, the sides of two adjacent U-shaped frames are adjacent to each other to form a joint column, and the sides of two adjacent U-shaped frames meet to the joint column top of
- annular part which is a radially deformable grid structure, and is located on the inflow side of the support part as a whole;
- the delivery system includes:
- control handle having opposing distal and proximal ends
- the valve buckles, and its periphery has a matching structure corresponding to the supporting part of the artificial valve
- the sleeve is movably arranged on the outer periphery of the valve buckle, and the sleeve can be switched between wrapping and exposing the fitting structure;
- the artificial valve When the sleeve is in the state of wrapping the matching structure, the artificial valve is in a loading state where the outflow side is gathered radially inward, and the inflow side is flaring;
- the artificial valve When the sleeve is in the state of exposing the fitting structure, the artificial valve is in the radially outward expansion of the outflow side, and the artificial valve is in a release state of a straight cylindrical structure as a whole;
- Two transmission parts nested inside and outside, and the farthest ends are respectively connected to the valve buckle and the sleeve, the proximal ends of the two transmission parts are connected to the control handle, and at least one of them is connected to the control handle.
- the active cooperation between them is adapted to the state switching of the sleeve.
- a sewing ring is provided on the outer periphery of the stent.
- the periphery of the stent is surrounded by an annular anti-circumferential leakage part, and the anti-circumferential leakage part is located on the inflow side of the sewing ring.
- the sewing ring extends along the circumference of the stent and has a wave structure, the part opposite to the inflow side is a trough, and the part opposite to the outflow side is a wave crest, and the trough is in contact with the peripheral leakage prevention part.
- the sewing ring is on the inflow side of the U-shaped frame, and there is a space between the U-shaped frame and the U-shaped frame.
- the covering film includes an outer covering film covering the radially outer side of the stent
- the anti-circumferential leakage portion includes an expandable material belt and a first part of the outer covering film, and the first part wraps The strip of expandable material.
- the outer covering film is made of PET material.
- the inner covering membrane is made of an expandable material, and the expandable material band is integrated with the inner covering membrane.
- the sewing ring includes a strip of suture material and a second portion of the outer covering film, and the second portion wraps around the strip of suture material.
- each leaflet has a fixed edge connected to the U-shaped frame and a free edge that cooperates with other leaflets to change the opening degree of the blood flow channel
- the covering film includes an inner covering covering the radial inner side of the stent
- the outflow side of the inner covering membrane is butted to the fixed edge of the valve leaflet, and both the inner covering membrane and the outer covering membrane are connected to the inflow side of the stent.
- the inner covering film and the outer covering film are integral membranes, or separate membranes.
- the expandable material band and the suture material band are independently completely wrapped by the outer covering film, or sandwiched and wrapped between the inner covering film and the outer covering film.
- the expandable material band is in the form of a band of water-absorbing swellable material that is continuously distributed in the circumferential direction of the stent, or is in the shape of a plurality of blocks arranged at intervals; the annular portion has a grid structure, and the block-shaped water-swellable The materials respectively correspond to the hollow areas of the grid structure.
- the expandable material band includes a base arranged around the periphery of the stent and a water-absorbing swellable material fixed on the base.
- threading marks are provided on the sewing ring, and in the peripheral direction of the stent, the threading marks are misaligned with the binding posts.
- the threading mark is at a trough position.
- valve buckle is columnar
- fitting structure is an anti-off groove and/or an anti-off post arranged on the outer periphery of the valve buckle.
- control handle includes:
- a housing the housing is an installation chamber, and one of the two transmission parts is fixed in the installation chamber;
- a moving seat which is slidably arranged in the installation chamber, and the other of the two transmission parts is fixed to the moving seat;
- a gear adjustment mechanism configured between the moving base and the installation chamber, and restricting the moving base to at least two gears
- the control button is connected with the moving base, and at least a part extends to the outside of the housing.
- the distal end of the sleeve is a flaring structure, and the opening edge of the flaring structure is provided with a plurality of escape grooves arranged at intervals in the circumferential direction, and the circumferential distribution positions of the escape grooves are the same as the suitable matching structure.
- the gear adjustment structure includes:
- the elastic tab is arranged on the other one of the moving seat and the inner wall of the housing, and the elastic tab is combined with the corresponding slot when the moving seat is in different positions.
- two elastic strips are fixed side by side on the moving seat, and one section of each elastic strip protrudes away from each other to form two elastic snap tongues, and the snap slots are in two rows, respectively corresponding to one of the elastic strips. Tongue.
- a locking piece is movably embedded on the housing, and the locking piece can be switched between two states of interfering with and avoiding the moving seat.
- an L-shaped limiting groove is provided on the distal side of the moving seat, and the limiting groove includes a longitudinal section extending axially along the housing and a transverse section vertically communicating with the longitudinal section, wherein the The ends of the longitudinal ends are open;
- the locking member is respectively located in the transverse section and the longitudinal section under the two states of interfering with and avoiding the moving seat.
- the delivery system has a length of 300-400mm.
- the application also provides a method for using the delivery system, comprising the steps of:
- the control handle drives the sleeve to move relative to the valve buckle to expose the valve buckle;
- the fitting structure of the valve buckle is combined with the supporting part of the artificial valve
- the driving sleeve of the control handle is in the state of wrapping the matching structure, the outflow side of the artificial valve is gathered radially inward, and the inflow side is flaring;
- the control handle driving sleeve is in the state of releasing the adapting structure, the outflow side of the artificial valve breaks away from the adapting structure and expands radially outward, and the artificial valve has a straight cylindrical structure as a whole.
- the artificial valve provided by this application is implanted in the body by surgical operation, and the delivery system accurately delivers the artificial valve to the target position after being partially compressed, and is applied to minimally invasive small incision surgery.
- Fig. 1 a is the schematic diagram of the support of artificial valve
- Fig. 1 b is the front view of the support of artificial valve
- Fig. 1c is a schematic diagram of a stent of an artificial valve connected with leaflets
- Fig. 1d is a schematic diagram of a stent of an artificial valve connected with leaflets
- Figure 1e is a schematic diagram of a stent of an artificial valve
- Figure 1f is a schematic diagram of an artificial valve
- Figure 1g is a schematic diagram of an artificial valve
- Figure 1h is a schematic diagram of an artificial valve
- Figure 1i is an exploded view of the artificial valve
- Fig. 1j is a schematic diagram of the anti-peripheral leakage part in the artificial valve
- Fig. 1k is a schematic diagram of the integrated structure of the anti-peripheral leakage part and the inner membrane in the artificial valve;
- Figure 2a is a schematic diagram of the delivery system
- Figure 2b is a schematic diagram of the delivery system
- Figure 2c is a sectional view taken along the line A-A in Figure 2b;
- Figure 2d is an exploded view of the control handle in the delivery system
- Figure 2e is an exploded view (another perspective) of the control handle in the delivery system
- Fig. 2f is a schematic diagram of the buckle of the valve in the delivery system (the sleeve structure is omitted);
- Figure 2g is a schematic diagram of the delivery system starting to load the artificial valve
- Figure 2h is a schematic diagram of the delivery system fully loaded with an artificial valve
- Fig. 2i is a schematic diagram of the delivery system fully loading the artificial valve and locking the locking member
- Fig. 2j is a schematic diagram of the delivery system placing the artificial valve into the native valve annulus
- Fig. 2k is a schematic diagram of the delivery system placing the artificial valve into the native valve annulus, and the sewing ring is fully opened;
- Figure 21 is a schematic diagram of the delivery system completely releasing the artificial valve
- Fig. 2m is a schematic diagram of the artificial valve implanted in a human body.
- 110 supporting part; 111, U-shaped frame; 112, connecting column; 113, connecting end; 114, connecting ear; 115, contact bar; 116, hollow window; 120, ring part; 121, V-shaped frame bar ; 122, deformation release area; 130, leaflet; 131, free edge; 132, fixed edge; 140, covering membrane; 141, inner covering membrane; 142, outer covering membrane; 150, sewing ring; 151, suture material belt; 160. Leakage prevention part; 161. Expandable material belt; 170. Threading mark;
- control handle 211, housing; 212, moving seat; 213, gear adjustment mechanism; 214, control button; 215, card slot; 216, elastic tongue; 217, elastic bar; 218, guide structure; Locking part; 220, sleeve; 221, escape groove; 230, valve buckle; 231, adaptation structure; 240, transmission part; 241, inner tube; 242, outer tube;
- a component when referred to as being "connected” to another component, it may be directly connected to the other component or intervening components may also exist. When a component is said to be “set on” another component, it may be set directly on the other component or there may be an intervening component at the same time.
- a stent for an artificial valve has opposite inflow sides and outflow sides, including:
- the support part 110 is surrounded by a plurality of U-shaped frames 111 and the opening of each U-shaped frame 111 faces the outflow side (the dotted line in Fig. 1a is the direction of blood flow), and the sides of two adjacent U-shaped frames 111 are adjacent to each other to form a joint column 112, the sides of two adjacent U-shaped frames 111 converge to the top of the coupling column 112;
- the annular part 120 is a grid structure deformable in the radial direction, and is located on the inflow side of the support part 110 as a whole. Corresponds to the turning point on the inflow side in the middle.
- the annular portion 120 has a deformable grid structure in the radial direction, and the grid structure is taken as a whole, and it is not strictly required that all parts in the circumferential direction have complete grids.
- the artificial valve support can be compressed to a certain extent in the radial direction.
- the size of the incision can be reduced and the damage to the patient's body can be reduced.
- the artificial valve stent of the present application is fixed to the valve annulus by surgical suture, which inherits the advantages of surgical artificial valves, such as extremely low risk of displacement, low risk of blocking coronary arteries, original diseased leaflets can be cut off, wide indications,
- the valve-in-valve function can be realized (that is, after the valve fails later, a new valve can be inserted into the valve).
- the support has a relative loaded state and a released state, wherein:
- the outflow side of the stent expands radially outward, and the stent as a whole has a straight cylinder structure.
- the starting point of radial outward expansion of the outflow side of the stent is the loaded state, and the process of outward expansion is essentially a process of restoring the stent to a straight cylindrical structure.
- the stent has a relative loading state and a releasing state, and correspondingly, the artificial valve also has a corresponding loading state and a releasing state, wherein:
- the outflow side of the artificial valve expands radially outward, and the artificial valve is in a straight cylindrical structure as a whole.
- the stent of the artificial valve is in the released state, and the stent has an overall upper straight cylinder structure.
- Fig. 2h the stent of the artificial valve is in the loaded state, and the sides of the U-shaped frame 111 of the support part 110 are close to each other, forming an inward gathering structure, the annular portion 120 is adaptively flared toward the outflow side.
- the stent has an integrated structure and adopts self-expandable and releasable memory materials. For example, a pipe made of nickel-titanium alloy is cut, and then heat-treated to obtain a stent.
- the stent of the artificial valve is made of nickel-titanium alloy material, which can be compressed to 16mm in the radial direction, reducing the difficulty of the valve descending to the annulus.
- the incision length on the patient's body surface can be controlled at 4-6cm to meet the needs of stent placement, which is much smaller than traditional surgical valves.
- the required incision length of 20 cm is placed, which reduces the number of sutures, saves the blocking time, and reduces the damage to the patient's aortic root.
- the intercostal approach can be selected for the small incision, which avoids the pain caused by the median sternotomy to the patient.
- the difficulty of implantation is reduced.
- the stent has an expandable structure and is made of nickel-titanium material, which can be anchored by the radial support force of the stent without the need for balloon expansion, reducing the complexity of the operation.
- each U-shaped frame 111 there are three U-shaped frames 111, and the turning part on the inflow side in each U-shaped frame 111 is the connecting end 113, and the annular part 120 passes through the mesh at the corresponding position.
- the vertices of the lattice structure are fixed to each connection end 113 .
- connection end 113 The turning point on the inflow side, that is, the middle position of the bottom of the U-shaped frame 111 is defined as the connection end 113 , and the connection end 113 is fixedly connected to the apex of the grid structure of the annular portion 120 .
- the frame strength of the U-shaped frame 111 is greater than that of the annular portion 120 .
- the outflow end of the valve is the working area of the leaflet, that is, the U-shaped frame 111 is the most direct support when the leaflet 130 moves.
- the frame strength of the U-shaped frame 111 is greater than that of the annular part 120.
- the U-shaped frame 111 has a higher strength and is less likely to be deformed, reducing swinging, and at the same time reducing the impact on the ring portion 120, thereby enhancing the durability of the bracket.
- the grid structure of the annular part 120 mainly plays an anchoring role. Under the premise of ensuring the radial support force, the strength of the frame strips of the annular part 120 is smaller than that of the U-shaped frame 111, which can make the annular part 120 under external pressure. The impact on the U-shaped frame 111 of the supporting part 110 is reduced by itself deforming to comply with the external force.
- the frame bars of the U-shaped frame 111 can be wider or thicker than the frame bars of the annular part 120. Considering the convenience of processing, preferably, the frame bars of the U-shaped frame 111 can be compared with the The frame bars of the ring portion 120 are wider.
- the top end of the coupling post 112 is widened in the circumferential direction of the bracket to form a connecting ear 114 adapted to the delivery system.
- the connecting ears 114 are used to connect the stent of the artificial valve to the delivery system, so that the stent can be stably installed in the delivery system.
- the connecting ear 114 can adopt various structures, and besides the substantially rectangular structure shown in Fig. 1a and Fig. 1b , other forms can also be adopted, such as semicircular or radially extending steps.
- one or more contact strips 115 are arranged between the sides of two adjacent U-shaped frames 111, and the contact strips 115 are surrounded by the joint column 112 where they are located.
- One or more cutout windows 116 are arranged between the sides of two adjacent U-shaped frames 111, and the contact strips 115 are surrounded by the joint column 112 where they are located.
- the connecting strip 115 forms a connecting structure between the sides of two adjacent U-shaped frames 111, which strengthens the connection strength between the sides of the adjacent two U-shaped frames 111 on the one hand, and does not interfere too much with the sides of the U-shaped frames 111 on the other hand. edge deformation.
- the leaflet 130 has a flanging edge wrapping part of the side of the U-shaped frame 111 , and at least one hollow window 116 is used to accommodate the flanging edge of the leaflet 130 .
- the length of the annular portion 120 is L1
- the length of the support portion 110 is L2
- L1 is smaller than L2.
- the supporting part 110 is used to fix the valve leaflet 130, and has at least an axial length compatible with the valve leaflet 130, while the annular part 120 is used for positioning in the blood vessel and carrying the structure for preventing paravalvular leakage.
- the valve is sutured on the valve annulus, and the annular part 120 is easy to meet the needs of positioning, and does not require an excessively long axial length. Under the premise, the axial length should be reduced as much as possible to reduce the adverse effect on the tissue at the implantation site.
- L1:L2 1:1.5 ⁇ 1:3.
- At least a part of the annular portion 120 in the circumferential direction is a V-shaped frame bar 121 .
- the V-shaped frame bar 121 is more likely to deform when subjected to external force, and the angle of the V-shaped clip changes.
- the existence of the V-shaped frame bar 121 makes the annular part 120 receive radial force When the external force acts, it is easier to expand outward in the circumferential direction, which is beneficial to the implantation of the new valve.
- the V-shaped frame strip conforms to the external force, reducing the impact on the support portion 110 , that is, reducing the impact on the shape of the leaflet 130 connected to the support portion 110 .
- Self-expanding valves and ball-expanding valves can be used as valve-in-valve implants. Since the V-shaped frame strip 121 of the stent can be expanded by external force, after implanting the self-expanding valve, the small incision valve can be stretched without rebounding. It is ensured that the opening area is not affected.
- the grid structure of the annular portion 120 is a unit cell arranged along the circumferential direction, and the unit cell is only one circle in the axial direction.
- the size of the annular part 120 in the axial direction is relatively short, and only one circle of cells is provided to reduce the density of the cells, so that the annular part 120 is more likely to be deformed when it is subjected to radial external force.
- the number of all cells is 9-24, which is an integer multiple of the number of U-shaped boxes 111 .
- All the cells are uniformly arranged along the circumference, or at least divided into N groups, where N is the number of U-shaped frames 111, and the number of each group is the same.
- the number of all cells is 12, and each cell is not strictly a complete circumferentially closed structure, but may be open in the circumferential direction.
- the lines connecting the vertices on the outflow side of the cells are straight lines.
- At least one unit cell is a deformation releasing cell opened on the inflow side of the annular portion 120 .
- the V-shaped frame bar 121 is the deformation release cell. Under the action of radial external force, the deformation release cell deforms preferentially to comply with the external force, and the remaining circumferentially closed cells deform subsequently.
- the other cells are roughly rhombus or hexagon.
- the shape of the cell is not a strict geometric shape, and there are local deformations based on the needs of processing, but at least it should meet the requirements of radial contraction and expansion of the scaffold.
- the number and circumferential positions of the deformation release cells correspond to the binding posts 112 one by one.
- the positions of the deformation release cells and the coupling posts 112 correspond one by one.
- the circumferentially expanded parts of the ring portion 120 and the support portion 110 are aligned with each other in the axial direction, and the deformations of the ring portion 120 and the support portion 110 are mutually aligned. There is less restraint between them, that is, when the annular portion 120 expands in the circumferential direction, it will not be restrained by the support portion 110 , and vice versa.
- the deformation releasing grid is a V-shaped frame strip 121 , and the opening of the V-shaped is facing the inflow side of the annular portion 120 .
- the V-shaped opening faces the inflow side of the annular portion 120 , and the V-shaped opening is easier to expand when subjected to radial external force.
- the present application also provides a stent for an artificial valve, which has opposite inflow sides and outflow sides, including:
- the support part 110 is surrounded by a plurality of U-shaped frames 111 and the opening of each U-shaped frame 111 faces the outflow side.
- the sides meet at the top of the bonding column 112;
- the annular part 120 is a grid structure deformable in the radial direction, and is located on the inflow side of the supporting part 110 as a whole. At least a part of the annular part 120 in the circumferential direction is a deformation release area 122. The position of the deformation release area 122 is combined with The inflow side of column 112 is aligned.
- the deformation release area 122 is more likely to deform and expand outward when it is radially stressed. Since the valve is implanted in a surgical manner, there is suture between the valve and the annulus, and the annular part The easy deformation of 120 will not adversely affect the positioning, and when valve-in-valve implantation is required, it is easier to expand circumferentially, which is beneficial to the implantation of a new valve.
- the position of the deformation release area 122 is aligned with the inflow side of the coupling column 112.
- the circumferential expansion of the ring portion 120 and the support portion 110 are aligned with each other in the axial direction, and the ring portion 120 and the support portion 110 are axially aligned.
- the deformations of the rings are less restrained by each other, that is, when the annular portion 120 expands in the circumferential direction, it will not be restrained by the supporting portion 110, and vice versa.
- the deformation release area 122 complies with the external force, reducing the impact on the supporting portion 110 , that is, reducing the impact on the shape of the leaflet 130 connected to the supporting portion 110 .
- the deformation release area 122 is a frame structure that can be stretched in the peripheral direction of the stent, and the area surrounded by the frame structure is an open area.
- the deformation releasing area 122 adopts a circumferentially stretchable frame structure. When subjected to a radial external force, the frame structure stretches to deform the deformation releasing area 122 . The setting of the open area allows a greater amount of deformation.
- the frame structure is V-shaped or W-shaped.
- the V-shaped frame structure does not require a balloon to expand, and uses the radial support force of the V-shaped frame 121 structure itself to closely fit the patient's native aortic valve ring, which enhances valve stability and reduces paravalvular leakage. The complexity of the operation is reduced.
- the number and circumferential positions of the deformation releasing regions 122 correspond to the bonding posts 112 one-to-one.
- the deformation release area 122 corresponds to the position of the coupling column 112 one by one.
- the circumferential expansion of the annular part 120 and the support part 110 are aligned with each other in the axial direction, and the deformation of the annular part 120 and the support part 110 There is less restraint between them, that is, when the ring portion 120 expands in the circumferential direction, it will not be restrained by the support portion 110 , and vice versa.
- the present application also provides an artificial valve, as shown in Fig. 1f, Fig. 1g, Fig. 1h, and Fig. 1i, including:
- the stent encloses a blood flow channel inside the stent
- each leaflet 130 has a fixed edge 132 connected to the U-shaped frame 111 and a free edge 131 that cooperates with other leaflets 130 to change the opening degree of the blood flow channel;
- Covering film 140 covering the inner and/or outer sides of the stent in the radial direction
- the sewing ring 150 is fixed on the outer periphery of the stent.
- the covering film 140 covers the inside, or outside, or both inside and outside of the stent in the radial direction.
- the sewing ring 150 is used for suturing with the valve ring to fix the position of the valve.
- an annular anti-peripheral leakage portion 160 is surrounded on the outer periphery of the stent, and the anti-peripheral leakage portion 160 is located on the inflow side of the sewing ring 150 .
- the sewing ring 150 extends along the circumferential direction of the stent and has a wave structure.
- the part opposite to the inflow side is a wave trough, and the part opposite to the outflow side is a wave peak.
- valve After the valve is implanted, on the one hand, rely on the expandable structure of the stent itself for anchoring, and on the other hand, suture between the sewing ring 150 and the valve ring to ensure the stability of the valve after implantation. To block the gap between the valve ring and the sewing ring 150, prevent blood from flowing through the gap.
- the sewing ring 150 is located at the inflow side of the U-shaped frame 111 , and there is a space between the U-shaped frame 111 and the U-shaped frame 111 .
- the spacer facilitates the sewing of the covering film 140 and the valve leaflet 130, and on the other hand, it also gives the sewing ring 150 a certain deformation space, that is, when the artificial valve is compressed and enters the delivery system, the deformation of the sewing ring 150 will not damage the valve leaflets. 130 brings greater deformation pressure.
- the covering film 140 includes an outer covering film 142 and covers the radially outer side of the stent, and the anti-circumferential leakage part 160 includes an expandable material.
- the strip 161 and the first portion of the outer covering membrane 142 wrap the strip 161 of expandable material.
- the suture ring 150 includes a suture material strip 151 and a second portion of the outer covering film 142 , and the second portion wraps the suture material strip 151 .
- the outer film 142 may have other parts besides the first part and the second part.
- the outer covering film 142 is a whole, wherein the first part wraps the expandable material strip 161 , and the second part wraps the suture material strip 151 , which reduces splicing of the outer covering film 142 , facilitates processing on the one hand, and reduces material leakage on the other hand.
- the suture material belt 151 can be made of silicone rubber, which has moderate elasticity, reduces the rigid extrusion of the valve annulus, and facilitates the suture process.
- the artificial valve is sewn on the valve annulus through 3 suture points, reducing valve displacement risk, the sewing ring 150 can fit well with the original valve ring, and to a certain extent, reduce paravalvular leakage.
- the covering film 140 includes an inner covering film 141, and is covered on the radially inner side of the stent, and the outflow side of the inner covering film 141 is connected to The fixed edge 132 of the leaflet 130, the inner covering membrane 141 and the outer covering membrane 142 meet and connect to the inflow side of the stent.
- the inner covering film 141 and the outer covering film 142 wrap the stent as a whole, reducing exposed parts.
- Both the inner covering film 141 and the outer covering film 142 are integral diaphragms, or separate diaphragms.
- the inner covering film and the outer covering film are made of different materials or the same material.
- the inner film 141 is made of PU, and the outer film is made of PET (PET fabric).
- the seam between the split diaphragms is located on the inflow side of the stent, or on the radially outer side of the stent, or on the radially inner side of the stent.
- the expandable material strip 161 and the suture material strip 151 are completely wrapped by the outer covering film 142 independently, or are clamped and wrapped inside. between the covering film 141 and the outer covering film 142 .
- the suture material band 151 extends along the circumferential direction of the stent and has a wave structure, and the inner covering film 141 and the outer covering film 142 do not change the wave configuration of the suture material band 151 when wrapping the suture material band 151, therefore, the obtained
- the sewing ring 150 also has a corrugated structure consistent with the suture material belt 151, the position opposite to the inflow side is a trough, and the position opposite to the outflow side is a crest, and the trough is adjacent to the anti-circumferential leakage portion 160.
- the expandable material belt 161 can be made of PU foam material, which has the characteristics of good elasticity and water impermeability, which is conducive to closely fitting with the valve annulus and reducing paravalvular leakage.
- the expandable material band 161 includes a base arranged around the periphery of the stent and a water-absorbing swellable material fixed on the base.
- the substrate and water-swellable material are made of polymeric materials, for example, one or more of the following materials: polyester, polyethylene terephthalate (PET), polyetheretherketone (PEEK), polypropylene ( PP), polytetrafluoroethylene (PTFE), polyurethane (PU), ultra-high molecular weight polyethylene (UHMWPE), silicone, polyoxymethylene, polyphenylsulfone, polysulfone, polyvinylidene fluoride, polyamide.
- the substrate can use polymer materials such as PET, and the water-swellable material can use water-swellable materials such as hydrogel or porous foam materials. In one of the embodiments, as shown in Fig. 1f, Fig. 1g, Fig.
- the water-absorbing swelling material is in the shape of a strip and is continuously distributed in the circumferential direction of the stent, or is in the shape of a plurality of blocks arranged at intervals;
- the annular portion 120 has a grid structure, and the block-shaped water-absorbing swelling material is respectively located in the hollowed-out areas of the grid structure.
- the water-absorbing swellable material is a plurality of blocks arranged at intervals, and the block-shaped water-absorbed swellable material protrudes toward the radially outer side of the stent relative to the stent.
- the anti-circumferential leakage portion 160 includes a strip of expandable material and a part of the inner membrane 141 , and the strip of expandable material 161 is attached to the inner membrane 141 .
- the inner covering film 141 is made of expandable material, and the expandable material band 161 and the inner covering film 141 are integrally structured.
- the expandable material band 161 is connected to the inflow side of the inner membrane 141, and is in the shape of a plurality of blocks arranged at intervals along the circumferential direction of the stent, and the annular part has a grid structure.
- the blocks of water-absorbing and swelling materials respectively correspond to the hollowed-out areas of the grid structure.
- the sewing ring 150 has a threading mark 170, and the threading mark 170 and the binding post 112 are arranged in a misalignment in the circumferential direction of the stent. That is, in the circumferential direction of the stent, a threading mark 170 is provided at the middle of two adjacent coupling columns 112 .
- the dotted line in the figure is the direction of blood flow.
- the sewing ring 150 has a wave structure extending along the circumference of the stent:
- the part on the inflow side is the trough
- the part on the outflow side is the peak.
- the bracket has a wave structure both in the loaded state and the released state, the difference lies in the difference in height between the crests and troughs.
- the sewing ring 150 is provided with a threading mark 170 , and the threading mark 170 is at a trough position.
- the application also provides a method for processing an artificial valve, including:
- the anti-peripheral leakage part is formed by adhering the anti-circumferential leakage material to the radially inner membrane of the stent, or forming the anti-circumferential leakage part by using the folds of the radially inner membrane of the stent.
- S200 wrapping the suture material with the first part of the radially outer membrane of the stent to form a second preform.
- S200 using the second part of the radially outer covering film of the stent to wrap the anti-circumferential leakage material to form a second preform.
- the seam portion and/or the peripheral leakage prevention portion are formed by using the folds of the covering film on the radially outer side of the stent to form a second preform.
- step S300 includes:
- the present application also provides a delivery system, as shown in Figure 2a, Figure 2b, Figure 2c, and Figure 2f, the delivery system includes:
- control handle 210 having opposing distal and proximal ends
- the valve buckle 230 has a matching structure 231 corresponding to the artificial valve on its periphery;
- the sleeve 220 is movably arranged on the outer periphery of the valve buckle 230, and the sleeve 220 can be switched between wrapping and exposing the fitting structure 231;
- Two transmission parts 240 are nested inside and outside, and the farthest ends are respectively connected to the valve buckle 230 and the sleeve 220.
- the proximal ends of the two transmission parts 240 are connected to the control handle 210, and at least one of them is movably matched with the control handle 210 to Adapt to the state switching of the sleeve 220 .
- the proximal end of the control handle 210 is the end close to the operator, and the distal end is the end far away from the operator.
- the delivery system shrinks the artificial valve to a small size and delivers it to the target position, as shown in Fig. 2g and Fig. 2h.
- the artificial valve is connected with the valve buckle 230 through the fitting structure 231. Operate the control handle 210 to switch the sleeve 220 from the exposed fitting structure 231 to the wrapping fitting structure 231 , and the artificial valve is compressed in the radial direction to reduce its size, so as to adapt to the placement of the small incision.
- the sleeve 220 and the valve buckle 230 are close to the artificial valve, and the occlusion is limited.
- the control handle 210 is far away from the artificial valve, so it is not easy to block the operator's sight, and it is convenient to observe the state of the valve during the delivery of the valve.
- the prosthetic valve compressed in the sleeve is smaller in size, easier to pass through the sinotubular junction, and will affect the operator's field of view during delivery.
- the sleeve 220 exposes the fitting structure 231 of the valve buckle 230, and the artificial valve is combined with the fitting structure 231 of the valve buckle 230;
- the sleeve 220 is operated to wrap the fitting structure 231 through the control handle 210, and the artificial valve is in a compressed state;
- the operator passes the suture through the original valve annulus, and passes the suture through the suture ring 150 of the artificial valve in the compressed state, and moves the compressed artificial valve along the suture to deliver to the original valve annulus;
- the artificial valve is released and gradually changes from the loading state switch to release state;
- the artificial valve is completely detached from the valve buckle 230 and returns to its original size
- the artificial valve is fully released, it is placed on the native valve annulus, the original valve annulus and the sewing ring 150 of the artificial valve are sutured, and the delivery system is withdrawn.
- the sleeve 220 can be made of transparent material.
- the two transmission parts can slide relative to each other in the axial direction, so as to realize the switch between the two states of the sleeve 220 wrapping and exposing the matching structure 231 .
- One of the transmission parts is fixed relative to the control handle 210 , and the other transmission part can move in the axial direction.
- the transmission part that can move in the axial direction can be linked with the sleeve 220 or with the valve buckle 230 .
- the distal end of the sleeve 220 is a flaring structure, and the opening edge of the flaring structure is provided with a plurality of escape grooves 221 arranged at intervals in the circumferential direction.
- the avoidance groove 221 can accommodate the folds of the sewing ring 150, reducing the radial dimension of the compressed artificial valve.
- the sleeve 220 structure is omitted in Fig. 2f, and the internal valve buckle 230 structure is shown.
- the valve buckle 230 is columnar, and the fitting structure 231 is arranged on the valve
- the circumferential distribution positions of the anti-off grooves and/or anti-off posts on the outer periphery of the buckle 230 and the avoidance grooves 221 correspond to the matching structures 231 .
- the fitting structure 231 is in order to keep the artificial valve stably on the valve buckle 230.
- the valve buckle 230 and the fitting structure 231 of the artificial valve are complementary structures.
- An anti-off groove corresponding to the shape of the anti-off ear is provided on the artificial valve; if an anti-off groove is arranged on the artificial valve, an anti-off post corresponding to the shape of the anti-off groove is arranged on the valve buckle 230 .
- the circumferential distribution position of the escape groove 221 corresponds to the fitting structure 231 , which is based on the compressed state of the artificial valve, so that the avoidance groove 221 can better accommodate the folds of the artificial valve.
- Control handle 210 includes:
- housing 211 the housing 211 is an installation room, and one of the two transmission parts is fixed to the installation room;
- the moving seat 212 is slidably arranged in the installation room, and the other of the two transmission parts is fixed to the moving seat 212;
- the gear adjustment mechanism 213 is arranged between the moving base 212 and the installation chamber, and limits the moving base 212 to at least two gear positions;
- the control button 214 is connected with the moving base 212 and at least a part extends to the outside of the casing 211 .
- control handle 210 includes:
- housing 211 the housing 211 is an installation room, and one of the transmission parts is fixed in the installation room;
- the moving seat 212 is slidably arranged in the installation room, and the other transmission part is fixed to the moving seat 212;
- the gear adjustment mechanism 213 is arranged between the moving base 212 and the installation chamber, and limits the moving base 212 to at least two gear positions;
- the control button 214 is connected with the moving base 212 and at least a part extends to the outside of the casing 211 .
- the control button 214 is connected with the movable seat 212, and the movable seat 212 can be operated to move by toggling the control button 214, and the movable seat 212 will be restricted to move when it moves to the gear position corresponding to the gear adjustment mechanism 213, unless an external force is applied through the control button 214 to overcome this limitation.
- the gear adjustment mechanism 213 has at least two gears, and the at least two gears respectively correspond to the following positions:
- the stalls that can also be set correspond to the positions of different states during the release process of the artificial valve.
- the corresponding stalls are set for the state where the sewing ring in the artificial valve is fully opened, and the sewing ring of the artificial valve is kept in a fully opened state. In the open state, the suture ring and the original valve ring are sutured. After the suturing is completed, the artificial valve is completely released and withdrawn from the delivery system.
- the complete compression of the artificial valve does not refer to the maximum possible compression state of the artificial valve, but refers to the final compression state that the artificial valve needs to achieve in the delivery system.
- Limiting the position of the moving seat 212 by the gear adjustment mechanism 213 can prevent the operator from falling off or displacing the valve due to misoperation during the operation, and ensure the safety of the operation process.
- the gear adjustment structure includes:
- the elastic tab 216 is disposed on the other one of the moving base 212 and the inner wall of the casing 211 , and the elastic tab 216 is combined with the corresponding slot 215 in different positions of the moving base 212 .
- the moving seat 212 is limited to different gear positions.
- the elastic tongue 216 is disposed on the inner wall of the housing 211 , or when the locking groove 215 is disposed on the inner wall of the housing 211 , the locking groove 215 is disposed on the inner wall of the housing 211 .
- the number of slots is the number of gears, and each gear corresponds to the position of a moving seat, and the number of slots can be set as required.
- the gear adjustment structure includes:
- Three card slots 215 arranged at intervals along the axial direction of the housing 211, and the three card slots 215 are arranged on the inner wall of the housing 211;
- the elastic tab 216 is arranged on the moving seat 212 , and the elastic tab 216 is combined with the corresponding slot 215 when the moving seat 212 is in different positions.
- two elastic strips 217 are fixed side by side on the moving seat 212, and a section of each elastic strip 217 protrudes away from each other to form two elastic tabs 216,
- the slots 215 are in two rows, respectively corresponding to one of the elastic tabs 216 .
- one row of card slots 215 is partially covered by the housing 211 .
- each pair of elastic tabs 216 is correspondingly inserted into the corresponding card slots 215 .
- the inner wall of the casing 211 is provided with a guide structure 218 for guiding the moving seat 212 .
- the guiding structure 218 is a sliding groove fixed on the inner wall of the casing 211 .
- the casing 211 is also provided with a sliding slot for guiding the movement of the control button 214 .
- the two transmission parts are tube parts, respectively the inner tube 241 connected with the valve buckle 230, and the outer tube 242 connected with the sleeve 220, the outer tube 242
- the proximal end of the inner tube is fixed to the movable base 212 , and the proximal end of the inner tube extends beyond the movable base 212 and is fixed to the housing 211 .
- the inner tube 241 remains stationary relative to the control handle 210, and by changing the position of the outer tube 242, the sleeve 220 is switched between the two states of wrapping and exposing the fitting structure 231 of the valve buckle 230 .
- a locking member 219 is movably embedded in the housing 211 , and the locking member 219 can switch between two states of interfering with and avoiding the moving seat 212 .
- the locking member 219 interferes with the movement of the moving seat 212, that is, the artificial valve is stably installed in the delivery system, and misoperation is prevented during the movement process.
- the The locking member 219 is switched to a state of avoiding the movement of the moving seat 212 .
- an L-shaped limiting groove 250 is provided on the distal side of the moving seat 212, and the limiting groove 250 includes a longitudinal section extending axially along the housing 211 and a longitudinal section connected to the longitudinal section. Vertically connected transverse sections, where the longitudinal ends are open at the ends;
- the locking member 219 is in the transverse section and the longitudinal section respectively under the two states of interfering with and avoiding the moving seat 212 .
- the locking member 219 enters the longitudinal section through the open opening. 219 is toggled along the transverse section to make the locking piece 219 away from the longitudinal section. Since the locking piece 219 interferes with the transverse section in the moving direction of the moving seat 212, the movement of the moving seat 212 is restricted.
- the locking member 219 When the artificial valve needs to be released, the locking member 219 is moved along the transverse section, so that the locking member 219 is located in the longitudinal section, and the locking member 219 can move along the longitudinal section in the moving direction of the moving seat 212 to release the movement restriction of the moving seat 212.
- the length of the delivery system (that is, the sum of the dimensions of D1 and D2) is 300-400 mm.
- the artificial valve delivered by the delivery system in this application is neither an interventional valve nor a surgical valve, and the length of the delivery system is also between the two delivery systems.
- the length D1 of the control handle in the delivery system is 100-150mm, except for the control handle.
- the length D2 of the component is 150-300 mm, the dimension D3 of the sleeve end is 15-20 mm, and the width D4 of the control handle is 15-30 mm.
- the method for using the delivery system comprises the steps of:
- the control handle drives the sleeve to move relative to the valve buckle to expose the valve buckle;
- the fitting structure of the valve buckle is combined with the supporting part of the artificial valve
- the control handle driving sleeve is in the state of wrapping the adapter structure
- the outflow side of the artificial valve is gathered radially inward, and the inflow side is flaring;
- the control handle driving sleeve is in the state of releasing the adapting structure, the outflow side of the artificial valve breaks away from the adapting structure and expands radially outward, and the artificial valve has a straight cylindrical structure as a whole.
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- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Vascular Medicine (AREA)
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Abstract
A prosthetic valve system and a method for using same. The prosthetic valve system comprises a prosthetic valve and a delivery system, which cooperate with each other. The prosthetic valve comprises: a stent, a valve leaflet (131) arranged on the stent, and a tectorial membrane (140) fitted to the stent, wherein a blood flow channel is enclosed inside the stent, and the stent has an inflow side and an outflow side, which are opposite each other. The stent comprises: a support portion (110), which is enclosed by a plurality of U-shaped frames (111), wherein an opening of each U-shaped frame (111) faces the outflow side, and side edges of every two adjacent U-shaped frames (111) are adjacent to each other to form a combination column (112), and converge at a top end of the combination column (112); and an annular portion (120), which is a radially deformable mesh structure and is integrally located on the inflow side of the support portion (110).
Description
本申请涉及医疗器械技术领域,特别是涉及一种人工瓣膜系统及使用方法。The present application relates to the technical field of medical devices, in particular to an artificial valve system and its use method.
现有技术中,人工主动脉瓣膜大致可分为经导管介入瓣膜和外科植入式瓣膜,经导管介入瓣膜的创口很小,可在心脏不停跳的情况下完成植入、无需体外循环和全身麻醉,患者恢复快,但是介入瓣膜也有局限性,包括但不限于:依靠结构锚定,对患者的主动脉解剖结构要求较高;由于没有进行缝合,必须要评估介入瓣膜的抗移位性能;植入前无法将患者原生瓣叶切除,当原生瓣叶被植入的介入瓣膜掀开后,会存在阻挡冠状动脉开口的风险;大多数介入瓣膜都存在瓣周漏风险;很少有产品设计有瓣中瓣(Valve-in-Valve,ViV)功能,瓣中瓣也即一个新的瓣膜被部署在失效的瓣膜中。In the prior art, artificial aortic valves can be roughly divided into transcatheter interventional valves and surgically implanted valves. Transcatheter interventional valves have very small wounds and can be implanted without stopping the heart, without extracorporeal circulation and With general anesthesia, the patient recovers quickly, but the interventional valve also has limitations, including but not limited to: relying on structural anchoring, which requires high requirements on the patient's aortic anatomy; since there is no suture, the anti-displacement performance of the interventional valve must be evaluated ;The patient's original valve leaflet cannot be removed before implantation. When the original valve leaflet is opened by the implanted interventional valve, there will be a risk of blocking the coronary artery opening; most interventional valves have the risk of paravalvular leakage; few products It is designed with valve-in-valve (Valve-in-Valve, ViV) function, that is, a new valve is deployed in the failed valve.
外科植入式瓣膜包括:传统开胸外科瓣膜和免缝合(少缝合)外科瓣膜,其中,传统开胸外科瓣膜具有如下优势:Surgical implantable valves include: traditional thoracotomy surgical valves and suture-free (less suture) surgical valves. Among them, traditional thoracotomy surgical valves have the following advantages:
(1)在植入前可以把患者原生瓣叶剪除,防止对植入后的外科瓣膜造成干扰;(1) The patient's native valve leaflets can be cut off before implantation to prevent interference with the implanted surgical valve;
(2)适应症可以基本覆盖所有形式的瓣膜疾病;(2) Indications can basically cover all forms of valvular diseases;
(3)瓣膜高度很短,阻挡冠状动脉开口和损伤血管组织的风险很小;(3) The valve height is very short, and the risk of blocking the coronary artery opening and damaging the vascular tissue is very small;
(4)由于缝合针数较多,无移位风险,基本没有瓣周漏;(4) Due to the large number of suturing needles, there is no risk of displacement, and there is basically no paravalvular leakage;
传统开胸外科瓣膜也有局限性,例如:Traditional open-thoracotomy valves also have limitations, such as:
(1)手术需要切开胸骨和主动脉,对患者身体的损害较大,切口大(20cm 左右)、痛苦大、恢复慢;(1) The operation requires incision of the sternum and aorta, which will cause great damage to the patient's body, with a large incision (about 20cm), great pain, and slow recovery;
(2)根据医生经验,在体外循环、心脏停跳的情况下,传统外科瓣膜需要逢90针左右(14个位置,每个位置逢6针),循环阻断时间通常需要1小时左右,相关研究表明较长的循环阻断时间存在导致不可逆脑损伤的风险;(2) According to the experience of doctors, in the case of extracorporeal circulation and cardiac arrest, traditional surgical valves need about 90 stitches (14 positions, each position has 6 stitches), and the circulatory blocking time usually takes about 1 hour. Studies have shown that longer circulatory blockades have a risk of irreversible brain damage;
(3)缝针次数多会对患者主动脉根部造成损伤;(3) Too many stitches will cause damage to the patient's aortic root;
(4)相较于介入瓣膜,外科开胸手术对于患者的年龄、身体情况等有更高的要求。(4) Compared with interventional valves, surgical thoracotomy has higher requirements for the patient's age and physical condition.
免缝合(少缝合)微创小切口外科瓣膜产品较少,可以解决传统开胸外科瓣膜手术中缝合较多带来的部分问题。There are fewer suture-free (less suture) minimally invasive small incision surgical valve products, which can solve some of the problems caused by more sutures in traditional open-thoracotomy valve surgery.
在进行微创小切口心脏瓣膜植入的手术过程中,通常采用输送系统帮助人工心脏瓣膜通递送和植入患者体内,通常情况下,输送系统能够使外科医生在心脏通道内或心脏的另一区域内精确定位人工心脏瓣膜,输送系统也用于将人工心脏瓣膜牢固地保持在合适的位置直到缝合完成且缝合线打结。During minimally invasive small-incision heart valve implantation procedures, a delivery system is often used to help the prosthetic heart valve pass through and implant in the patient. Precisely positioning the prosthetic heart valve within the area, the delivery system is also used to hold the prosthetic heart valve securely in place until the sutures are completed and the sutures are tied.
在一些小切口人工瓣膜植入的情况中,输送系统连接有细长手柄,外科医生通过操作手柄来操控瓣膜至其期望的植入位置,然后去掉该细长手手柄,将缝纫环缝合到原生瓣环,在此过程中,输送系统保持与人工瓣膜的连接用以保护瓣膜,输送系统在缝合手术期间会阻碍外科医生的观察。In the case of some small incision prosthetic valve implantation, the delivery system is connected with a long and thin handle, and the surgeon manipulates the handle to manipulate the valve to its desired implantation position, and then removes the long and thin handle, and sutures the sewing ring to the native The annulus, during which the delivery system remains attached to the prosthetic valve to protect the valve, obstructs the surgeon's view during the suture procedure.
发明内容Contents of the invention
针对人工瓣膜的植入问题,提供一种人工瓣膜以及植入所述人工瓣膜使用的系统,输送系统将人工瓣膜进行部分压缩后精确置入目标位置,应用于微创小切口手术。Aiming at the problem of artificial valve implantation, an artificial valve and a system for implanting the artificial valve are provided. The delivery system compresses the artificial valve and places it into the target position accurately, which is applied to minimally invasive small incision surgery.
一种人工瓣膜系统,所述人工瓣膜系统包括相互配合的人工瓣膜和输送系 统,所述人工瓣膜包括:支架、设置在支架上的瓣叶、附着在所述支架上的覆膜以及固定于所述支架外周的缝合环,所述支架内部围成血流通道,支架具有相对的流入侧和流出侧,所述支架包括:An artificial valve system, the artificial valve system includes an artificial valve and a delivery system that cooperate with each other. A sewing ring on the periphery of the stent, the inside of the stent is surrounded by a blood flow channel, the stent has opposite inflow sides and outflow sides, and the stent includes:
支撑部,由多个U形框围成且各U形框的开口朝向流出侧,相邻两U形框的侧边彼此邻近形成结合柱,相邻两U形框的侧边交汇至结合柱的顶端;The support part is surrounded by a plurality of U-shaped frames and the opening of each U-shaped frame faces the outflow side, the sides of two adjacent U-shaped frames are adjacent to each other to form a joint column, and the sides of two adjacent U-shaped frames meet to the joint column top of
环形部,为在径向上可形变的网格结构,且整体上位于所述支撑部的流入侧;an annular part, which is a radially deformable grid structure, and is located on the inflow side of the support part as a whole;
所述输送系统包括:The delivery system includes:
控制手柄,具有相对的远端和近端;a control handle having opposing distal and proximal ends;
瓣膜卡扣,自身的外周具有与人工瓣膜的支撑部相应的适配结构;The valve buckles, and its periphery has a matching structure corresponding to the supporting part of the artificial valve;
套筒,活动设置在所述瓣膜卡扣的外周,所述套筒可在包裹和暴露所述适配结构这两种状态间切换;The sleeve is movably arranged on the outer periphery of the valve buckle, and the sleeve can be switched between wrapping and exposing the fitting structure;
所述套筒处于包裹所述适配结构的状态时,所述人工瓣膜处于流出侧径向向内聚拢,流入侧呈扩口的装载状态;When the sleeve is in the state of wrapping the matching structure, the artificial valve is in a loading state where the outflow side is gathered radially inward, and the inflow side is flaring;
所述套筒处于暴露所述适配结构的状态时,所述人工瓣膜处于流出侧径向向外扩张,人工瓣膜整体上为直筒结构的释放状态;When the sleeve is in the state of exposing the fitting structure, the artificial valve is in the radially outward expansion of the outflow side, and the artificial valve is in a release state of a straight cylindrical structure as a whole;
两传动件,内外嵌套配合且最远端分别连接所述瓣膜卡扣和所述套筒,所述两传动件的近端连接至所述控制手柄、且至少一者与所述控制手柄之间活动配合以适应所述套筒的状态切换。Two transmission parts, nested inside and outside, and the farthest ends are respectively connected to the valve buckle and the sleeve, the proximal ends of the two transmission parts are connected to the control handle, and at least one of them is connected to the control handle. The active cooperation between them is adapted to the state switching of the sleeve.
以下还提供了若干可选方式,但并不作为对上述总体方案的额外限定,仅仅是进一步的增补或优选,在没有技术或逻辑矛盾的前提下,各可选方式可单独针对上述总体方案进行组合,还可以是多个可选方式之间进行组合。The following also provides several optional ways, but they are not used as additional limitations on the above-mentioned overall scheme, but are only further additions or optimizations. On the premise of no technical or logical contradiction, each optional way can be carried out independently for the above-mentioned overall scheme Combination can also be a combination of multiple options.
可选的,所述支架的外周设置有缝合环。Optionally, a sewing ring is provided on the outer periphery of the stent.
可选的,所述支架的外周围绕有环形的防周漏部,所述防周漏部处在所述缝合环的流入侧。Optionally, the periphery of the stent is surrounded by an annular anti-circumferential leakage part, and the anti-circumferential leakage part is located on the inflow side of the sewing ring.
可选的,所述缝合环沿支架周向延伸且具有波浪结构,相对处在流入侧的部位为波谷,相对处在流出侧的部位为波峰,所述波谷与防周漏部相贴靠。Optionally, the sewing ring extends along the circumference of the stent and has a wave structure, the part opposite to the inflow side is a trough, and the part opposite to the outflow side is a wave crest, and the trough is in contact with the peripheral leakage prevention part.
可选的,所述缝合环处在所述U形框的流入侧,且与所述U形框之间留有间隔区。Optionally, the sewing ring is on the inflow side of the U-shaped frame, and there is a space between the U-shaped frame and the U-shaped frame.
可选的,所述覆膜包括包覆于所述支架径向外侧的外覆膜,所述防周漏部包括可膨胀材料带以及所述外覆膜的第一部分,且所述第一部分包裹所述可膨胀材料带。Optionally, the covering film includes an outer covering film covering the radially outer side of the stent, the anti-circumferential leakage portion includes an expandable material belt and a first part of the outer covering film, and the first part wraps The strip of expandable material.
可选的,外覆膜采用PET材料制成。Optionally, the outer covering film is made of PET material.
可选的,所述内覆膜采用可膨胀材料,所述可膨胀材料带与内覆膜为一体结构。Optionally, the inner covering membrane is made of an expandable material, and the expandable material band is integrated with the inner covering membrane.
可选的,所述缝合环包括缝合材料带以及所述外覆膜的第二部分,且所述第二部分包裹所述缝合材料带。Optionally, the sewing ring includes a strip of suture material and a second portion of the outer covering film, and the second portion wraps around the strip of suture material.
可选的,各瓣叶具有与U形框相连的固定缘以及与其他瓣叶相配合改变血流通道开放程度的游离缘,所述覆膜包括包覆于所述支架径向内侧的内覆膜,所述内覆膜的流出侧对接至所述瓣叶的固定缘,所述内覆膜和所述外覆膜两者交汇连接于所述支架的流入侧。Optionally, each leaflet has a fixed edge connected to the U-shaped frame and a free edge that cooperates with other leaflets to change the opening degree of the blood flow channel, and the covering film includes an inner covering covering the radial inner side of the stent The outflow side of the inner covering membrane is butted to the fixed edge of the valve leaflet, and both the inner covering membrane and the outer covering membrane are connected to the inflow side of the stent.
可选的,所述内覆膜与外覆膜为一体膜片,或为分体膜片。Optionally, the inner covering film and the outer covering film are integral membranes, or separate membranes.
可选的,所述可膨胀材料带以及所述缝合材料带各自独立的被所述外覆膜完全包裹,或被夹持包裹在所述内覆膜和所述外覆膜之间。Optionally, the expandable material band and the suture material band are independently completely wrapped by the outer covering film, or sandwiched and wrapped between the inner covering film and the outer covering film.
可选的,所述可膨胀材料带为吸水膨胀材料呈带状且在支架周向上连续分布,或为间隔布置的多个的块状;所述环形部具有网格结构,块状的吸水膨胀 材料分别处对应网格结构的镂空区。Optionally, the expandable material band is in the form of a band of water-absorbing swellable material that is continuously distributed in the circumferential direction of the stent, or is in the shape of a plurality of blocks arranged at intervals; the annular portion has a grid structure, and the block-shaped water-swellable The materials respectively correspond to the hollow areas of the grid structure.
可选的,可膨胀材料带包括绕支架外围布置的基底以及固定于基底上的吸水膨胀材料。Optionally, the expandable material band includes a base arranged around the periphery of the stent and a water-absorbing swellable material fixed on the base.
可选的,所述缝合环上带有穿线标志,在支架周向上,所述穿线标志与所述结合柱的错位布置。Optionally, threading marks are provided on the sewing ring, and in the peripheral direction of the stent, the threading marks are misaligned with the binding posts.
可选的,所述缝合环上带有穿线标志,所述穿线标志处在波谷位置。Optionally, there is a threading mark on the sewing ring, and the threading mark is at a trough position.
可选的,所述瓣膜卡扣为柱状,所述适配结构为设置在所述瓣膜卡扣外周的防脱槽和/或防脱柱。Optionally, the valve buckle is columnar, and the fitting structure is an anti-off groove and/or an anti-off post arranged on the outer periphery of the valve buckle.
可选的,所述控制手柄包括:Optionally, the control handle includes:
壳体,所述壳体内为安装室,所述两传动件中的一者固定至安装室内;A housing, the housing is an installation chamber, and one of the two transmission parts is fixed in the installation chamber;
移动座,滑动设置在所述安装室内,所述两传动件中的另一者固定至所述移动座;a moving seat, which is slidably arranged in the installation chamber, and the other of the two transmission parts is fixed to the moving seat;
档位调节机构,配置在所述移动座和所述安装室之间,将所述移动座限制于至少两个档位;a gear adjustment mechanism, configured between the moving base and the installation chamber, and restricting the moving base to at least two gears;
控制钮,与所述移动座相连、且至少一部分延伸至所述壳体的外部。The control button is connected with the moving base, and at least a part extends to the outside of the housing.
可选的,所述套筒的远端为扩口结构,所述扩口结构的开口边缘设有沿周向间隔布置的多个避让槽,所述避让槽的周向分布位置与所述适配结构相对应。Optionally, the distal end of the sleeve is a flaring structure, and the opening edge of the flaring structure is provided with a plurality of escape grooves arranged at intervals in the circumferential direction, and the circumferential distribution positions of the escape grooves are the same as the suitable matching structure.
可选的,所述档位调节结构包括:Optionally, the gear adjustment structure includes:
沿壳体轴向间隔排布的多个卡槽,所述多个卡槽设置于所述移动座和所述壳体内壁中的一者;A plurality of card slots arranged at intervals along the axial direction of the housing, the plurality of card slots are arranged on one of the moving seat and the inner wall of the housing;
弹性卡舌,设置于所述移动座和所述壳体内壁中的另一者,所述弹性卡舌在所述移动座处在不同档位下与相应的卡槽结合。The elastic tab is arranged on the other one of the moving seat and the inner wall of the housing, and the elastic tab is combined with the corresponding slot when the moving seat is in different positions.
可选的,所述移动座并排固定有两根弹性条,各弹性条其中的一段彼此相 背的外凸形成两个所述弹性卡舌,所述卡槽为两排,分别对应其中一弹性卡舌。Optionally, two elastic strips are fixed side by side on the moving seat, and one section of each elastic strip protrudes away from each other to form two elastic snap tongues, and the snap slots are in two rows, respectively corresponding to one of the elastic strips. Tongue.
可选的,所述壳体上活动嵌装有锁定件,所述锁定件可在干涉和避让所述移动座这两种状态间切换。Optionally, a locking piece is movably embedded on the housing, and the locking piece can be switched between two states of interfering with and avoiding the moving seat.
可选的,所述移动座的远端侧设有L形的限位槽,该限位槽包括沿壳体轴向延伸的纵向段以及与所述纵向段垂直连通的横向段,其中所述纵向端的端部为开放口;Optionally, an L-shaped limiting groove is provided on the distal side of the moving seat, and the limiting groove includes a longitudinal section extending axially along the housing and a transverse section vertically communicating with the longitudinal section, wherein the The ends of the longitudinal ends are open;
所述锁定件在干涉和避让所述移动座这两种状态下、分别处在所述横向段和所述纵向段。The locking member is respectively located in the transverse section and the longitudinal section under the two states of interfering with and avoiding the moving seat.
可选的,所述输送系统的长度为300~400mm。Optionally, the delivery system has a length of 300-400mm.
本申请还提供了一种所述的输送系统的使用方法,包括如下步骤:The application also provides a method for using the delivery system, comprising the steps of:
控制手柄驱动套筒相对于瓣膜卡扣运动,以暴露瓣膜卡扣;The control handle drives the sleeve to move relative to the valve buckle to expose the valve buckle;
瓣膜卡扣的适配结构与人工瓣膜的支撑部相结合;The fitting structure of the valve buckle is combined with the supporting part of the artificial valve;
控制手柄驱动套筒处于包裹所述适配结构的状态,人工瓣膜的流出侧径向向内聚拢,流入侧呈扩口;The driving sleeve of the control handle is in the state of wrapping the matching structure, the outflow side of the artificial valve is gathered radially inward, and the inflow side is flaring;
控制手柄驱动套筒处于释放所述适配结构的状态,人工瓣膜的流出侧脱离适配结构径向向外扩张,人工瓣膜整体上为直筒结构。The control handle driving sleeve is in the state of releasing the adapting structure, the outflow side of the artificial valve breaks away from the adapting structure and expands radially outward, and the artificial valve has a straight cylindrical structure as a whole.
本申请提供的人工瓣膜采用外科手术的方式植入体内,输送系统将人工瓣膜进行部分压缩后精确送至目标位置,应用于微创小切口手术。The artificial valve provided by this application is implanted in the body by surgical operation, and the delivery system accurately delivers the artificial valve to the target position after being partially compressed, and is applied to minimally invasive small incision surgery.
图1a为人工瓣膜的支架的示意图;Fig. 1 a is the schematic diagram of the support of artificial valve;
图1b为人工瓣膜的支架的主视图;Fig. 1 b is the front view of the support of artificial valve;
图1c为人工瓣膜的支架连接有瓣叶的示意图;Fig. 1c is a schematic diagram of a stent of an artificial valve connected with leaflets;
图1d为人工瓣膜的支架连接有瓣叶的示意图;Fig. 1d is a schematic diagram of a stent of an artificial valve connected with leaflets;
图1e为人工瓣膜的支架的示意图;Figure 1e is a schematic diagram of a stent of an artificial valve;
图1f为人工瓣膜的示意图;Figure 1f is a schematic diagram of an artificial valve;
图1g为人工瓣膜的示意图;Figure 1g is a schematic diagram of an artificial valve;
图1h为人工瓣膜的示意图;Figure 1h is a schematic diagram of an artificial valve;
图1i为人工瓣膜的爆炸图;Figure 1i is an exploded view of the artificial valve;
图1j为人工瓣膜中防周漏部的示意图;Fig. 1j is a schematic diagram of the anti-peripheral leakage part in the artificial valve;
图1k为人工瓣膜中防周漏部与内覆膜一体结构的示意图;Fig. 1k is a schematic diagram of the integrated structure of the anti-peripheral leakage part and the inner membrane in the artificial valve;
图2a为输送系统的示意图;Figure 2a is a schematic diagram of the delivery system;
图2b为输送系统的示意图;Figure 2b is a schematic diagram of the delivery system;
图2c为图2b中的A-A向剖视图;Figure 2c is a sectional view taken along the line A-A in Figure 2b;
图2d为输送系统中控制手柄的爆炸图;Figure 2d is an exploded view of the control handle in the delivery system;
图2e为输送系统中控制手柄的爆炸图(另一视角);Figure 2e is an exploded view (another perspective) of the control handle in the delivery system;
图2f为输送系统中瓣膜卡扣的示意图(省略套管结构);Fig. 2f is a schematic diagram of the buckle of the valve in the delivery system (the sleeve structure is omitted);
图2g为输送系统开始装载人工瓣膜的示意图;Figure 2g is a schematic diagram of the delivery system starting to load the artificial valve;
图2h为输送系统完全装载人工瓣膜的示意图;Figure 2h is a schematic diagram of the delivery system fully loaded with an artificial valve;
图2i为输送系统完全装载人工瓣膜且锁定件锁定的示意图;Fig. 2i is a schematic diagram of the delivery system fully loading the artificial valve and locking the locking member;
图2j为输送系统将人工瓣膜置入原生瓣环的示意图;Fig. 2j is a schematic diagram of the delivery system placing the artificial valve into the native valve annulus;
图2k为输送系统将人工瓣膜置入原生瓣环,且缝合环完全张开的示意图;Fig. 2k is a schematic diagram of the delivery system placing the artificial valve into the native valve annulus, and the sewing ring is fully opened;
图2l为输送系统完全释放人工瓣膜的示意图;Figure 21 is a schematic diagram of the delivery system completely releasing the artificial valve;
图2m为人工瓣膜植入人体后的示意图。Fig. 2m is a schematic diagram of the artificial valve implanted in a human body.
图中:110、支撑部;111、U形框;112、结合柱;113、连接端;114、连接耳;115、联络条;116、镂空窗;120、环形部;121、V形框条;122、形变 释放区;130、瓣叶;131、游离缘;132、固定缘;140、覆膜;141、内覆膜;142、外覆膜;150、缝合环;151、缝合材料带;160、防周漏部;161、可膨胀材料带;170、穿线标志;In the figure: 110, supporting part; 111, U-shaped frame; 112, connecting column; 113, connecting end; 114, connecting ear; 115, contact bar; 116, hollow window; 120, ring part; 121, V-shaped frame bar ; 122, deformation release area; 130, leaflet; 131, free edge; 132, fixed edge; 140, covering membrane; 141, inner covering membrane; 142, outer covering membrane; 150, sewing ring; 151, suture material belt; 160. Leakage prevention part; 161. Expandable material belt; 170. Threading mark;
210、控制手柄;211、壳体;212、移动座;213、档位调节机构;214、控制钮;215、卡槽;216、弹性卡舌;217、弹性条;218、导向结构;219、锁定件;220、套筒;221、避让槽;230、瓣膜卡扣;231、适配结构;240、传动件;241、内管;242、外管;250、限位槽。210, control handle; 211, housing; 212, moving seat; 213, gear adjustment mechanism; 214, control button; 215, card slot; 216, elastic tongue; 217, elastic bar; 218, guide structure; Locking part; 220, sleeve; 221, escape groove; 230, valve buckle; 231, adaptation structure; 240, transmission part; 241, inner tube; 242, outer tube;
下面将结合本申请实施例中的附图,对本申请实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅仅是本申请一部分实施例,而不是全部的实施例。基于本申请中的实施例,本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例,都属于本申请保护的范围。The technical solutions in the embodiments of the present application will be clearly and completely described below in conjunction with the accompanying drawings in the embodiments of the present application. Obviously, the described embodiments are only some of the embodiments of the present application, not all of them. Based on the embodiments in this application, all other embodiments obtained by persons of ordinary skill in the art without making creative efforts belong to the scope of protection of this application.
为了更好地描述和说明本申请的实施例,可参考一幅或多幅附图,但用于描述附图的附加细节或示例不应当被认为是对本申请的发明创造、目前所描述的实施例或优选方式中任何一者的范围的限制。In order to better describe and illustrate the embodiments of the application, reference may be made to one or more drawings, but additional details or examples used to describe the drawings should not be regarded as an invention of the application, the presently described implementation limitations on the scope of any of the examples or preferred modes.
需要说明的是,当组件被称为与另一个组件“连接”时,它可以直接与另一个组件连接或者也可以存在居中的组件。当一个组件被认为是“设置于”另一个组件,它可以是直接设置在另一个组件上或者可能同时存在居中组件。It should be noted that when a component is referred to as being "connected" to another component, it may be directly connected to the other component or intervening components may also exist. When a component is said to be "set on" another component, it may be set directly on the other component or there may be an intervening component at the same time.
除非另有定义,本文所使用的所有的技术和科学术语与属于本申请的技术领域的技术人员通常理解的含义相同。本文中在本申请的说明书中所使用的术语只是为了描述具体的实施例的目的,不是旨在于限制本申请。Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the technical field to which this application belongs. The terms used herein in the specification of the application are only for the purpose of describing specific embodiments, and are not intended to limit the application.
参见图1a、图1b所示,一种人工瓣膜的支架,具有相对的流入侧和流出侧, 包括:Referring to Fig. 1a and Fig. 1b, a stent for an artificial valve has opposite inflow sides and outflow sides, including:
支撑部110,由多个U形框111围成且各U形框111的开口朝向流出侧(图1a中虚线为血液流动方向),相邻两U形框111的侧边彼此邻近形成结合柱112,相邻两U形框111的侧边交汇至结合柱112的顶端;The support part 110 is surrounded by a plurality of U-shaped frames 111 and the opening of each U-shaped frame 111 faces the outflow side (the dotted line in Fig. 1a is the direction of blood flow), and the sides of two adjacent U-shaped frames 111 are adjacent to each other to form a joint column 112, the sides of two adjacent U-shaped frames 111 converge to the top of the coupling column 112;
环形部120,为在径向上可形变的网格结构,且整体上位于支撑部110的流入侧,环形部120与支撑部110之间的连接部位为多处,且分别与各U形框111中处在流入侧的转折部位相对应。The annular part 120 is a grid structure deformable in the radial direction, and is located on the inflow side of the support part 110 as a whole. Corresponds to the turning point on the inflow side in the middle.
环形部120在径向上为可形变的网格结构,网格结构是从整体上而言,并不严格要求在周向上的各部位均具有完整的网格。The annular portion 120 has a deformable grid structure in the radial direction, and the grid structure is taken as a whole, and it is not strictly required that all parts in the circumferential direction have complete grids.
由于环形部120在径向上具有可形变的空间,使人工瓣膜支架在径向上可进行一定程度的压缩,在采用外科手术进行人工瓣膜植入的过程中,人工瓣膜支架处于压缩状态,相比传统的外科手术而言,可以减小切口的尺寸,减少对患者身体的损害。Since the annular portion 120 has a deformable space in the radial direction, the artificial valve support can be compressed to a certain extent in the radial direction. For surgical operations, the size of the incision can be reduced and the damage to the patient's body can be reduced.
本申请的人工瓣膜支架采用外科缝合的方式与瓣环固定,继承了外科人工瓣膜的优势,例如,移位风险极低、挡冠脉风险低、可剪除病变的原生瓣叶、适应症广、可以实现瓣中瓣的功能(也即后期瓣膜失效后,可以在瓣膜中置入新的瓣膜)。The artificial valve stent of the present application is fixed to the valve annulus by surgical suture, which inherits the advantages of surgical artificial valves, such as extremely low risk of displacement, low risk of blocking coronary arteries, original diseased leaflets can be cut off, wide indications, The valve-in-valve function can be realized (that is, after the valve fails later, a new valve can be inserted into the valve).
在其中一实施例中,参见图1a、图1b、图2h所示,支架具有相对的装载状态和释放状态,其中:In one of the embodiments, as shown in Fig. 1a, Fig. 1b, and Fig. 2h, the support has a relative loaded state and a released state, wherein:
在装载状态下,支架流出侧径向向内聚拢,支架流入侧呈扩口;In the loaded state, the outflow side of the stent is gathered radially inward, and the inflow side of the stent is flaring;
在释放状态下,支架流出侧径向向外扩张,支架整体上为直筒结构。In the released state, the outflow side of the stent expands radially outward, and the stent as a whole has a straight cylinder structure.
释放状态下,支架流出侧径向向外扩张的起点为装载状态,向外扩张的过程实质是恢复支架为直筒结构的过程。In the released state, the starting point of radial outward expansion of the outflow side of the stent is the loaded state, and the process of outward expansion is essentially a process of restoring the stent to a straight cylindrical structure.
支架具有相对的装载状态和释放状态,相应的,人工瓣膜也具有相应的装载状态和释放状态,其中:The stent has a relative loading state and a releasing state, and correspondingly, the artificial valve also has a corresponding loading state and a releasing state, wherein:
在装载状态下,人工瓣膜流出侧径向向内聚拢,人工瓣膜流入侧呈扩口;In the loaded state, the outflow side of the artificial valve gathers radially inward, and the inflow side of the artificial valve is flaring;
在释放状态下,人工瓣膜流出侧径向向外扩张,人工瓣膜整体上为直筒结构。In the released state, the outflow side of the artificial valve expands radially outward, and the artificial valve is in a straight cylindrical structure as a whole.
图1a、图1b中,人工瓣膜的支架处于释放状态,支架整体上位直筒结构,图2h中,人工瓣膜的支架处于装载状态,支撑部110的U形框111侧边相互靠拢,形成向内聚拢的结构,环形部120适应性的朝向流出侧扩口。In Fig. 1a and Fig. 1b, the stent of the artificial valve is in the released state, and the stent has an overall upper straight cylinder structure. In Fig. 2h, the stent of the artificial valve is in the loaded state, and the sides of the U-shaped frame 111 of the support part 110 are close to each other, forming an inward gathering structure, the annular portion 120 is adaptively flared toward the outflow side.
支架为一体结构,且采用可自膨释放的记忆材料。例如采用镍钛合金的管材切割,再经过热处理定型,得到支架。The stent has an integrated structure and adopts self-expandable and releasable memory materials. For example, a pipe made of nickel-titanium alloy is cut, and then heat-treated to obtain a stent.
人工瓣膜的支架采用镍钛合金材料,径向上可压缩至16mm,降低瓣膜下降至瓣环的难度,患者体表的切口长度控制在4~6cm即可满足支架放置的需求,远小于传统外科瓣膜置入所需的20cm的切口长度,减少了缝合次数,节约了阻断时间,减少对患者主动脉根部的损伤。The stent of the artificial valve is made of nickel-titanium alloy material, which can be compressed to 16mm in the radial direction, reducing the difficulty of the valve descending to the annulus. The incision length on the patient's body surface can be controlled at 4-6cm to meet the needs of stent placement, which is much smaller than traditional surgical valves. The required incision length of 20 cm is placed, which reduces the number of sutures, saves the blocking time, and reduces the damage to the patient's aortic root.
除此之外,小切口可选择肋间入路,避免了正中切开胸骨对患者造成的痛苦,此外对于窦管结合部直径较小的患者,降低了植入的难度。In addition, the intercostal approach can be selected for the small incision, which avoids the pain caused by the median sternotomy to the patient. In addition, for patients with a small diameter of the sinotubular junction, the difficulty of implantation is reduced.
支架具有可扩张结构,同时采用镍钛材质,可利用支架的径向支撑力进行锚定,不需要球囊扩张,减少手术操作的复杂程度。The stent has an expandable structure and is made of nickel-titanium material, which can be anchored by the radial support force of the stent without the need for balloon expansion, reducing the complexity of the operation.
在其中一实施例中,参见图1a、图1b所示,U形框111为三个,各U形框111中处在流入侧的转折部位为连接端113,环形部120通过对应位置的网格结构顶点与各连接端113相固定。In one of the embodiments, as shown in Fig. 1a and Fig. 1b, there are three U-shaped frames 111, and the turning part on the inflow side in each U-shaped frame 111 is the connecting end 113, and the annular part 120 passes through the mesh at the corresponding position. The vertices of the lattice structure are fixed to each connection end 113 .
流入侧的转折部位也即U形框111底部的中间位置定义为连接端113,连接端113与环形部120的网格结构顶点固定连接。The turning point on the inflow side, that is, the middle position of the bottom of the U-shaped frame 111 is defined as the connection end 113 , and the connection end 113 is fixedly connected to the apex of the grid structure of the annular portion 120 .
在其中一实施例中,参见图1a、图1b所示,U形框111的框条强度大于环形部120的框条强度。In one embodiment, as shown in FIG. 1 a and FIG. 1 b , the frame strength of the U-shaped frame 111 is greater than that of the annular portion 120 .
瓣膜的流出端为瓣叶工作区,也即U形框111作为瓣叶130活动时最直接的支撑,U形框111的框条强度大于环形部120的框条强度,在瓣叶130开闭时,U形框111具有更高的强度不易发生形变,减少摆动,同时减小对环形部120的影响,增强支架的耐久性。The outflow end of the valve is the working area of the leaflet, that is, the U-shaped frame 111 is the most direct support when the leaflet 130 moves. The frame strength of the U-shaped frame 111 is greater than that of the annular part 120. At the same time, the U-shaped frame 111 has a higher strength and is less likely to be deformed, reducing swinging, and at the same time reducing the impact on the ring portion 120, thereby enhancing the durability of the bracket.
环形部120的网格结构主要起锚定作用,在保证径向支撑力的前提下,环形部120的框条强度小于U形框111的框条强度,可以使环形部120在受到外力压迫时,通过自身发生形变顺应外力,减小对支撑部110的U形框111的影响。The grid structure of the annular part 120 mainly plays an anchoring role. Under the premise of ensuring the radial support force, the strength of the frame strips of the annular part 120 is smaller than that of the U-shaped frame 111, which can make the annular part 120 under external pressure. The impact on the U-shaped frame 111 of the supporting part 110 is reduced by itself deforming to comply with the external force.
为了实现框条强度的差异,U形框111的框条可以相较于环形部120的框条更宽或更厚,考虑加工的便捷,优选的,U形框111的框条可以相较于环形部120的框条更宽。In order to realize the difference in frame strength, the frame bars of the U-shaped frame 111 can be wider or thicker than the frame bars of the annular part 120. Considering the convenience of processing, preferably, the frame bars of the U-shaped frame 111 can be compared with the The frame bars of the ring portion 120 are wider.
在其中一实施例中,参见图1a、图1b所示,结合柱112的顶端在支架周向上加宽构成用于与输送系统相适配的连接耳114。In one embodiment, as shown in FIG. 1 a and FIG. 1 b , the top end of the coupling post 112 is widened in the circumferential direction of the bracket to form a connecting ear 114 adapted to the delivery system.
连接耳114用于将人工瓣膜的支架与输送系统连接,使支架稳定安装在输送系统中。连接耳114可以采用多种结构,除图1a、图1b中所示的大致呈矩形的结构外,也可以采用其他的形式,例如半圆形,或沿径向延伸的台阶。The connecting ears 114 are used to connect the stent of the artificial valve to the delivery system, so that the stent can be stably installed in the delivery system. The connecting ear 114 can adopt various structures, and besides the substantially rectangular structure shown in Fig. 1a and Fig. 1b , other forms can also be adopted, such as semicircular or radially extending steps.
在其中一实施例中,参见图1a、图1b所示,相邻两U形框111的侧边之间设置有一个或多个联络条115,联络条115在所在的结合柱112部位围成一个或多个镂空窗116。In one of the embodiments, as shown in Fig. 1a and Fig. 1b, one or more contact strips 115 are arranged between the sides of two adjacent U-shaped frames 111, and the contact strips 115 are surrounded by the joint column 112 where they are located. One or more cutout windows 116 .
联络条115在相邻两U形框111的侧边之间形成连接结构,一方面加强相邻两U形框111侧边之间的连接强度,另一方面也不过分干涉U形框111侧边 的形变。The connecting strip 115 forms a connecting structure between the sides of two adjacent U-shaped frames 111, which strengthens the connection strength between the sides of the adjacent two U-shaped frames 111 on the one hand, and does not interfere too much with the sides of the U-shaped frames 111 on the other hand. edge deformation.
瓣叶130在缝制过程中,具有一包裹U形框111部分侧边的翻边,至少一个镂空窗116用于容纳瓣叶130的翻边。During the sewing process, the leaflet 130 has a flanging edge wrapping part of the side of the U-shaped frame 111 , and at least one hollow window 116 is used to accommodate the flanging edge of the leaflet 130 .
在其中一实施例中,参见图1b所示,沿支架轴向,环形部120的长度为L1,支撑部110的长度为L2,且L1小于L2。In one embodiment, as shown in FIG. 1b , along the axial direction of the stent, the length of the annular portion 120 is L1, the length of the support portion 110 is L2, and L1 is smaller than L2.
支撑部110用于固定瓣叶130,至少具有与瓣叶130相适应的轴向长度,而环形部120用于在血管中定位以及承载防瓣周漏的结构,由于采用外科手术的方式,人工瓣膜缝合在瓣环上,环形部120容易满足定位的需要,不需要过长的轴向长度,同时,承载防瓣周漏结构也不需要过长的轴向长度,因此,在满足使用需求的前提下,尽可能的减少轴向长度,减少对植入部位组织的不良影响。The supporting part 110 is used to fix the valve leaflet 130, and has at least an axial length compatible with the valve leaflet 130, while the annular part 120 is used for positioning in the blood vessel and carrying the structure for preventing paravalvular leakage. The valve is sutured on the valve annulus, and the annular part 120 is easy to meet the needs of positioning, and does not require an excessively long axial length. Under the premise, the axial length should be reduced as much as possible to reduce the adverse effect on the tissue at the implantation site.
在其中一实施例中,参见图1b所示,L1:L2=1:1.5~1:3。In one embodiment, as shown in FIG. 1b, L1:L2=1:1.5˜1:3.
在其中一实施例中,参见图1a、图1b所示,环形部120在周向上的至少一部分为V形框条121。In one embodiment, as shown in FIG. 1 a and FIG. 1 b , at least a part of the annular portion 120 in the circumferential direction is a V-shaped frame bar 121 .
V形框条121在受到外力作用力,更容易发生形变,也V形夹角度数发生改变,在需要进行瓣中瓣植入时,V形框条121的存在,使环形部120受到径向外力作用时,在周向上更容易向外扩张,利于新瓣膜的植入。The V-shaped frame bar 121 is more likely to deform when subjected to external force, and the angle of the V-shaped clip changes. When valve-in-valve implantation is required, the existence of the V-shaped frame bar 121 makes the annular part 120 receive radial force When the external force acts, it is easier to expand outward in the circumferential direction, which is beneficial to the implantation of the new valve.
环形部120在径向受力向外扩张时,通过V型框条顺应外力,减少对支撑部110的影响,也即减少对支撑部110上连接的瓣叶130形态的影响。When the annular portion 120 expands outward under radial force, the V-shaped frame strip conforms to the external force, reducing the impact on the support portion 110 , that is, reducing the impact on the shape of the leaflet 130 connected to the support portion 110 .
可采用自膨瓣和球扩瓣作为瓣中瓣植入,由于支架的V形框条121受到外力作用可扩张,因此植入自膨瓣后,可以将小切口瓣膜撑开且不回弹,保证了开口面积不受影响。Self-expanding valves and ball-expanding valves can be used as valve-in-valve implants. Since the V-shaped frame strip 121 of the stent can be expanded by external force, after implanting the self-expanding valve, the small incision valve can be stretched without rebounding. It is ensured that the opening area is not affected.
在其中一实施例中,参见图1a、图1b所示,环形部120的网格结构为沿周 向排布的单元格,单元格在轴向上仅为一圈。In one embodiment, as shown in Fig. 1a and Fig. 1b, the grid structure of the annular portion 120 is a unit cell arranged along the circumferential direction, and the unit cell is only one circle in the axial direction.
环形部120在轴向上的尺寸较短,仅设置一圈单元格,减少单元格的密度,使环形部120在受到径向外力作用时,更容易发生形变,由于采用外科手术的方式植入瓣膜,瓣膜与瓣环之间存在缝合,环形部120易于形变不会对定位产生不利影响,而且在需要进行瓣中瓣植入时,更容易周向扩张,利于新瓣膜的植入。The size of the annular part 120 in the axial direction is relatively short, and only one circle of cells is provided to reduce the density of the cells, so that the annular part 120 is more likely to be deformed when it is subjected to radial external force. There are sutures between the valve and the valve ring, and the ring part 120 is easy to deform without adversely affecting the positioning, and when valve-in-valve implantation is required, it is easier to expand circumferentially, which is beneficial to the implantation of a new valve.
在其中一实施例中,参见图1a、图1b所示,所有单元格的数量为9~24个,且为U形框111数量的整数倍。In one embodiment, as shown in FIG. 1a and FIG. 1b , the number of all cells is 9-24, which is an integer multiple of the number of U-shaped boxes 111 .
所有单元格沿周向均匀排布,或至少分为N组,N为U形框111数量,各组数量相同。所有单元格的数量为12个,每个单元格并不严格为完整的周向封闭的结构,可以在周向上开放。All the cells are uniformly arranged along the circumference, or at least divided into N groups, where N is the number of U-shaped frames 111, and the number of each group is the same. The number of all cells is 12, and each cell is not strictly a complete circumferentially closed structure, but may be open in the circumferential direction.
在其中一实施例中,参见图1b所示,环形部120在展平状态下,各单元格的流出侧顶点之间的连线为直线。In one embodiment, as shown in FIG. 1 b , when the annular portion 120 is in a flattened state, the lines connecting the vertices on the outflow side of the cells are straight lines.
环形部120仅部分单元格与U形框111的连接端113连接,其余单元格不予U形框111连接,U形框111侧边与环形部120之间的形变相对独立。Only part of the cells of the annular portion 120 are connected to the connecting end 113 of the U-shaped frame 111 , and the rest of the cells are not connected to the U-shaped frame 111 . The deformation between the sides of the U-shaped frame 111 and the annular portion 120 is relatively independent.
在其中一实施例中,参见图1a、1b所示,至少一个单元格为开放于环形部120的流入侧的形变释放格。In one embodiment, as shown in FIGS. 1 a and 1 b , at least one unit cell is a deformation releasing cell opened on the inflow side of the annular portion 120 .
V形框条121即为形变释放格,在受到径向外力的作用下,形变释放格优先发生形变,以顺应外力,其余周向封闭的单元格后续发生形变。The V-shaped frame bar 121 is the deformation release cell. Under the action of radial external force, the deformation release cell deforms preferentially to comply with the external force, and the remaining circumferentially closed cells deform subsequently.
在其中一实施例中,参见图1a、1b所示,除形变释放格外,其余各单元格大致为菱形或六边形。In one embodiment, as shown in FIGS. 1 a and 1 b , except for the deformation release cell, the other cells are roughly rhombus or hexagon.
单元格的形状并非严格的几何形状,基于加工的需要存在局部的变形,但至少应满足支架径向收缩和扩展的需求。The shape of the cell is not a strict geometric shape, and there are local deformations based on the needs of processing, but at least it should meet the requirements of radial contraction and expansion of the scaffold.
在其中一实施例中,参见图1a所示,形变释放格的数量以及周向位置与结合柱112一一对应。In one embodiment, as shown in FIG. 1 a , the number and circumferential positions of the deformation release cells correspond to the binding posts 112 one by one.
形变释放格与结合柱112的位置一一对应,在受到外力作用时,环形部120与支撑部110中发生周向扩张的部位在轴向上相互对齐,环形部120和支撑部110的形变相互之间牵制较少,也即环形部120周向扩张时,不会被支撑部110牵制,反之同理。The positions of the deformation release cells and the coupling posts 112 correspond one by one. When an external force is applied, the circumferentially expanded parts of the ring portion 120 and the support portion 110 are aligned with each other in the axial direction, and the deformations of the ring portion 120 and the support portion 110 are mutually aligned. There is less restraint between them, that is, when the annular portion 120 expands in the circumferential direction, it will not be restrained by the support portion 110 , and vice versa.
在其中一实施例中,参见图1a所示,形变释放格为V形框条121,且V形的开口朝向环形部120的流入侧。In one embodiment, as shown in FIG. 1 a , the deformation releasing grid is a V-shaped frame strip 121 , and the opening of the V-shaped is facing the inflow side of the annular portion 120 .
V形的开口朝向环形部120的流入侧,在受到径向外力作用时,V形的开口更容易扩张。The V-shaped opening faces the inflow side of the annular portion 120 , and the V-shaped opening is easier to expand when subjected to radial external force.
参见图1e所示,本申请还提供了一种人工瓣膜的支架,具有相对的流入侧和流出侧,包括:Referring to Figure 1e, the present application also provides a stent for an artificial valve, which has opposite inflow sides and outflow sides, including:
支撑部110,由多个U形框111围成且各U形框111的开口朝向流出侧,相邻两U形框111的侧边彼此邻近形成结合柱112,相邻两U形框111的侧边交汇至结合柱112的顶端;The support part 110 is surrounded by a plurality of U-shaped frames 111 and the opening of each U-shaped frame 111 faces the outflow side. The sides meet at the top of the bonding column 112;
环形部120,为在径向上可形变的网格结构,且整体上位于支撑部110的流入侧,环形部120在周向上的至少一部分为形变释放区122,该形变释放区122的位置与结合柱112的流入侧对正。The annular part 120 is a grid structure deformable in the radial direction, and is located on the inflow side of the supporting part 110 as a whole. At least a part of the annular part 120 in the circumferential direction is a deformation release area 122. The position of the deformation release area 122 is combined with The inflow side of column 112 is aligned.
形变释放区122相对于环形部120的其他部位,在径向受力时,更容易发生形变,向外扩张,由于采用外科手术的方式植入瓣膜,瓣膜与瓣环之间存在缝合,环形部120易于形变不会对定位产生不利影响,而且在需要进行瓣中瓣植入时,更容易周向扩张,利于新瓣膜的植入。Compared with other parts of the annular part 120, the deformation release area 122 is more likely to deform and expand outward when it is radially stressed. Since the valve is implanted in a surgical manner, there is suture between the valve and the annulus, and the annular part The easy deformation of 120 will not adversely affect the positioning, and when valve-in-valve implantation is required, it is easier to expand circumferentially, which is beneficial to the implantation of a new valve.
形变释放区122的位置与结合柱112的流入侧对正,在受到外力作用时, 环形部120与支撑部110中发生周向扩张的部位在轴向上相互对齐,环形部120和支撑部110的形变相互之间牵制较少,也即环形部120周向扩张时,不会被支撑部110牵制,反之同理。The position of the deformation release area 122 is aligned with the inflow side of the coupling column 112. When an external force is applied, the circumferential expansion of the ring portion 120 and the support portion 110 are aligned with each other in the axial direction, and the ring portion 120 and the support portion 110 are axially aligned. The deformations of the rings are less restrained by each other, that is, when the annular portion 120 expands in the circumferential direction, it will not be restrained by the supporting portion 110, and vice versa.
环形部120在径向受力向外扩张时,通过形变释放区122顺应外力,减少对支撑部110的影响,也即减少对支撑部110上连接的瓣叶130形态的影响。When the annular portion 120 expands outward under radial force, the deformation release area 122 complies with the external force, reducing the impact on the supporting portion 110 , that is, reducing the impact on the shape of the leaflet 130 connected to the supporting portion 110 .
在其中一实施例中,参见图1e所示,形变释放区122为在支架周向上可伸展的框条结构,且框条结构所围成的区域为开放区。In one embodiment, as shown in FIG. 1 e , the deformation release area 122 is a frame structure that can be stretched in the peripheral direction of the stent, and the area surrounded by the frame structure is an open area.
形变释放区122采用周向可伸展的框条结构,在受到径向外力作用时,框条结构伸展使形变释放区122发生形变,开放区的设置允许更大的形变量。The deformation releasing area 122 adopts a circumferentially stretchable frame structure. When subjected to a radial external force, the frame structure stretches to deform the deformation releasing area 122 . The setting of the open area allows a greater amount of deformation.
在其中一实施例中,参见图1e所示,框条结构为V形或W形。In one embodiment, as shown in FIG. 1 e , the frame structure is V-shaped or W-shaped.
V形的框条结构不需要球囊进行扩张,利用V形框条121结构本身的径向支撑力,与患者原生主动脉瓣环紧密贴合,增强了瓣膜稳定性,减少了瓣周漏,降低了手术操作的复杂度。The V-shaped frame structure does not require a balloon to expand, and uses the radial support force of the V-shaped frame 121 structure itself to closely fit the patient's native aortic valve ring, which enhances valve stability and reduces paravalvular leakage. The complexity of the operation is reduced.
在其中一实施例中,参见图1e所示,形变释放区122的数量以及周向位置与结合柱112一一对应。In one embodiment, as shown in FIG. 1 e , the number and circumferential positions of the deformation releasing regions 122 correspond to the bonding posts 112 one-to-one.
形变释放区122与结合柱112的位置一一对应,在受到外力作用时,环形部120与支撑部110中发生周向扩张的部位在轴向上相互对齐,环形部120和支撑部110的形变相互之间牵制较少,也即环形部120周向扩张时,不会被支撑部110牵制,反之同理。The deformation release area 122 corresponds to the position of the coupling column 112 one by one. When an external force is applied, the circumferential expansion of the annular part 120 and the support part 110 are aligned with each other in the axial direction, and the deformation of the annular part 120 and the support part 110 There is less restraint between them, that is, when the ring portion 120 expands in the circumferential direction, it will not be restrained by the support portion 110 , and vice versa.
本申请还提供了一种人工瓣膜,参见图1f、图1g、图1h、图1i所示,包括:The present application also provides an artificial valve, as shown in Fig. 1f, Fig. 1g, Fig. 1h, and Fig. 1i, including:
支架,支架内部围成血流通道;The stent encloses a blood flow channel inside the stent;
多片瓣叶130,各瓣叶130具有与U形框111相连的固定缘132以及与其他瓣叶130相配合改变血流通道开放程度的游离缘131;A plurality of leaflets 130, each leaflet 130 has a fixed edge 132 connected to the U-shaped frame 111 and a free edge 131 that cooperates with other leaflets 130 to change the opening degree of the blood flow channel;
覆膜140,包覆于支架径向的内侧和/或外侧;Covering film 140, covering the inner and/or outer sides of the stent in the radial direction;
缝合环150,固定于支架的外周。The sewing ring 150 is fixed on the outer periphery of the stent.
覆膜140包覆于支架径向的内侧、或外侧、或同时内外侧。The covering film 140 covers the inside, or outside, or both inside and outside of the stent in the radial direction.
植入人体后,缝合环150用于与瓣环缝合,以固定瓣膜位置。After being implanted in the human body, the sewing ring 150 is used for suturing with the valve ring to fix the position of the valve.
在其中一实施例中,参见图1f所示,支架的外周围绕有环形的防周漏部160,防周漏部160处在缝合环150的流入侧。In one embodiment, as shown in FIG. 1 f , an annular anti-peripheral leakage portion 160 is surrounded on the outer periphery of the stent, and the anti-peripheral leakage portion 160 is located on the inflow side of the sewing ring 150 .
参见图1f所示,缝合环150沿支架周向延伸且具有波浪结构,相对处在流入侧的部位为波谷,相对处在流出侧的部位为波峰,波谷与防周漏部160相贴靠。As shown in FIG. 1f, the sewing ring 150 extends along the circumferential direction of the stent and has a wave structure. The part opposite to the inflow side is a wave trough, and the part opposite to the outflow side is a wave peak.
瓣膜植入后,一方面依靠支架自身的可扩张结构进行锚定,另一方面缝合环150与瓣环之间进行缝合,保证瓣膜植入后的稳定性,同时,防周漏部160可起到封堵瓣环和缝合环150间隙的作用,防止血液经由间隙流动。After the valve is implanted, on the one hand, rely on the expandable structure of the stent itself for anchoring, and on the other hand, suture between the sewing ring 150 and the valve ring to ensure the stability of the valve after implantation. To block the gap between the valve ring and the sewing ring 150, prevent blood from flowing through the gap.
在其中一实施例中,参见图1f所示,缝合环150处在U形框111的流入侧,且与U形框111之间留有间隔区。In one embodiment, as shown in FIG. 1 f , the sewing ring 150 is located at the inflow side of the U-shaped frame 111 , and there is a space between the U-shaped frame 111 and the U-shaped frame 111 .
间隔区一方面便于覆膜140以及瓣叶130的缝制,另一方面也给予缝合环150一定的形变空间,即人工瓣膜压缩后进入输送系统中时,缝合环150的形变不会给瓣叶130带来较大的形变压力。On the one hand, the spacer facilitates the sewing of the covering film 140 and the valve leaflet 130, and on the other hand, it also gives the sewing ring 150 a certain deformation space, that is, when the artificial valve is compressed and enters the delivery system, the deformation of the sewing ring 150 will not damage the valve leaflets. 130 brings greater deformation pressure.
在其中一实施例中,参见图1f、图1g、图1h、图1i所示,覆膜140包括外覆膜142,且包覆于支架径向的外侧,防周漏部160包括可膨胀材料带161以及外覆膜142的第一部分,且第一部分包裹可膨胀材料带161。In one of the embodiments, as shown in Fig. 1f, Fig. 1g, Fig. 1h, and Fig. 1i, the covering film 140 includes an outer covering film 142 and covers the radially outer side of the stent, and the anti-circumferential leakage part 160 includes an expandable material. The strip 161 and the first portion of the outer covering membrane 142 wrap the strip 161 of expandable material.
在其中一实施例中,参见图1f、图1g、图1h、图1i所示,缝合环150包括缝合材料带151以及外覆膜142的第二部分,且第二部分包裹缝合材料带151。In one embodiment, as shown in FIGS. 1f , 1g , 1h , and 1i , the suture ring 150 includes a suture material strip 151 and a second portion of the outer covering film 142 , and the second portion wraps the suture material strip 151 .
外覆膜142除第一部分和第二部分外,还可以具有其他的部分。外覆膜142 为一整体,其中第一部分包裹可膨胀材料带161,第二部分包裹缝合材料带151,减少外覆膜142的拼接,一方面便于加工,另一方面也减少材料泄露。The outer film 142 may have other parts besides the first part and the second part. The outer covering film 142 is a whole, wherein the first part wraps the expandable material strip 161 , and the second part wraps the suture material strip 151 , which reduces splicing of the outer covering film 142 , facilitates processing on the one hand, and reduces material leakage on the other hand.
缝合材料带151可以采用硅橡胶材质,具有适度的弹性,减小对瓣环的刚性挤压,同时便于缝合过程的进行,人工瓣膜通过3个缝合点缝制瓣环上,减少了瓣膜移位的风险,缝合环150与原生瓣环之间也能够很好的贴合,一定程度上,减少瓣周漏。The suture material belt 151 can be made of silicone rubber, which has moderate elasticity, reduces the rigid extrusion of the valve annulus, and facilitates the suture process. The artificial valve is sewn on the valve annulus through 3 suture points, reducing valve displacement risk, the sewing ring 150 can fit well with the original valve ring, and to a certain extent, reduce paravalvular leakage.
在其中一实施例中,参见图1f、图1g、图1h、图1i所示,覆膜140包括内覆膜141,且包覆于支架径向的内侧,内覆膜141的流出侧对接至瓣叶130的固定缘132,内覆膜141和外覆膜142两者交汇连接于支架的流入侧。In one of the embodiments, as shown in Fig. 1f, Fig. 1g, Fig. 1h, and Fig. 1i, the covering film 140 includes an inner covering film 141, and is covered on the radially inner side of the stent, and the outflow side of the inner covering film 141 is connected to The fixed edge 132 of the leaflet 130, the inner covering membrane 141 and the outer covering membrane 142 meet and connect to the inflow side of the stent.
内覆膜141和外覆膜142将支架整体包裹,减少裸露部分。The inner covering film 141 and the outer covering film 142 wrap the stent as a whole, reducing exposed parts.
内覆膜141和外覆膜142两者为一体膜片,或为分体膜片。Both the inner covering film 141 and the outer covering film 142 are integral diaphragms, or separate diaphragms.
内覆膜和外覆膜采用不同材质或相同材质。The inner covering film and the outer covering film are made of different materials or the same material.
在其中一实施例中,内覆膜141采用PU材质,外覆膜采用PET材质(PET织物)。In one embodiment, the inner film 141 is made of PU, and the outer film is made of PET (PET fabric).
分体膜片之间的拼缝位于支架的流入侧,或位于支架径向的外侧,或位于支架径向的内侧。The seam between the split diaphragms is located on the inflow side of the stent, or on the radially outer side of the stent, or on the radially inner side of the stent.
在其中一实施例中,参见图1f、图1g、图1h、图1i所示,可膨胀材料带161以及缝合材料带151各自独立的被外覆膜142完全包裹,或被夹持包裹在内覆膜141和外覆膜142之间。In one of the embodiments, as shown in FIG. 1f, FIG. 1g, FIG. 1h, and FIG. 1i, the expandable material strip 161 and the suture material strip 151 are completely wrapped by the outer covering film 142 independently, or are clamped and wrapped inside. between the covering film 141 and the outer covering film 142 .
参见图1i所示,缝合材料带151沿支架周向延伸且具有波浪结构,内覆膜141和外覆膜142在包裹缝合材料带151时,不改变缝合材料带的波浪构型,因此,得到的缝合环150也具有与缝合材料带151一致的波浪结构,相对处在流入侧的部位为波谷,相对处在流出侧的部位为波峰,波谷与防周漏部160相贴 靠。Referring to Fig. 1i, the suture material band 151 extends along the circumferential direction of the stent and has a wave structure, and the inner covering film 141 and the outer covering film 142 do not change the wave configuration of the suture material band 151 when wrapping the suture material band 151, therefore, the obtained The sewing ring 150 also has a corrugated structure consistent with the suture material belt 151, the position opposite to the inflow side is a trough, and the position opposite to the outflow side is a crest, and the trough is adjacent to the anti-circumferential leakage portion 160.
可膨胀材料带161可以采用PU发泡材料,PU发泡材料具有弹性好,不透水的特点,有利于与瓣环紧密贴合,减少瓣周漏。The expandable material belt 161 can be made of PU foam material, which has the characteristics of good elasticity and water impermeability, which is conducive to closely fitting with the valve annulus and reducing paravalvular leakage.
在其中一实施例中,参见图1f、图1g、图1h、图1i所示,可膨胀材料带161包括绕支架外围布置的基底以及固定于基底上的吸水膨胀材料。In one embodiment, as shown in Fig. 1f, Fig. 1g, Fig. 1h, and Fig. 1i, the expandable material band 161 includes a base arranged around the periphery of the stent and a water-absorbing swellable material fixed on the base.
基底和吸水膨胀材料采用聚合物材料制成,例如,以下材料的一种或多种构成:聚酯、聚对苯二甲酸乙二酯(PET)、聚醚醚酮(PEEK)、聚丙烯(PP)、聚四氟乙烯(PTFE)、聚氨酯(PU)、超高分子量聚乙烯(UHMWPE)、硅酮、聚甲醛、聚苯砜、聚砜、聚偏二氟乙烯、聚酰胺。基底可采用PET等高分子材料,吸水膨胀材料可采用水凝胶等遇水膨胀的材料或多孔发泡材料。在其中一实施例中,参见图1f、图1g、图1h、图1i、图1j所示,吸水膨胀材料呈带状且在支架周向上连续分布,或为间隔布置的多个的块状;环形部120具有网格结构,块状的吸水膨胀材料分别处对应网格结构的镂空区。The substrate and water-swellable material are made of polymeric materials, for example, one or more of the following materials: polyester, polyethylene terephthalate (PET), polyetheretherketone (PEEK), polypropylene ( PP), polytetrafluoroethylene (PTFE), polyurethane (PU), ultra-high molecular weight polyethylene (UHMWPE), silicone, polyoxymethylene, polyphenylsulfone, polysulfone, polyvinylidene fluoride, polyamide. The substrate can use polymer materials such as PET, and the water-swellable material can use water-swellable materials such as hydrogel or porous foam materials. In one of the embodiments, as shown in Fig. 1f, Fig. 1g, Fig. 1h, Fig. 1i, and Fig. 1j, the water-absorbing swelling material is in the shape of a strip and is continuously distributed in the circumferential direction of the stent, or is in the shape of a plurality of blocks arranged at intervals; The annular portion 120 has a grid structure, and the block-shaped water-absorbing swelling material is respectively located in the hollowed-out areas of the grid structure.
吸水膨胀材料为间隔布置的多个块状,块状的吸水膨胀材料相对于支架朝向支架径向外侧凸起。The water-absorbing swellable material is a plurality of blocks arranged at intervals, and the block-shaped water-absorbed swellable material protrudes toward the radially outer side of the stent relative to the stent.
在其中一实施例中,参见图1j所示,防周漏部160包括可膨胀材料带以及内覆膜141的一部分,可膨胀材料带161附着于内覆膜141上。In one embodiment, as shown in FIG. 1 j , the anti-circumferential leakage portion 160 includes a strip of expandable material and a part of the inner membrane 141 , and the strip of expandable material 161 is attached to the inner membrane 141 .
在其中一实施例中,内覆膜141采用可膨胀材料,可膨胀材料带161与内覆膜141为一体结构。In one embodiment, the inner covering film 141 is made of expandable material, and the expandable material band 161 and the inner covering film 141 are integrally structured.
在其中一实施例中,参见图1j所示,可膨胀材料带161连接于内覆膜141的流入侧,且为沿支架周向间隔布置的多个的块状,环形部具有网格结构,块状的吸水膨胀材料分别处对应网格结构的镂空区。In one of the embodiments, as shown in FIG. 1j, the expandable material band 161 is connected to the inflow side of the inner membrane 141, and is in the shape of a plurality of blocks arranged at intervals along the circumferential direction of the stent, and the annular part has a grid structure. The blocks of water-absorbing and swelling materials respectively correspond to the hollowed-out areas of the grid structure.
在其中一实施例中,参见图1f、图1g、图1h、图1i所示,缝合环150上带 有穿线标志170,在支架周向上,穿线标志170与结合柱112的错位布置。也即,在支架周向上,相邻两结合柱112中间位置设置穿线标志170。In one of the embodiments, as shown in Fig. 1f, Fig. 1g, Fig. 1h, and Fig. 1i, the sewing ring 150 has a threading mark 170, and the threading mark 170 and the binding post 112 are arranged in a misalignment in the circumferential direction of the stent. That is, in the circumferential direction of the stent, a threading mark 170 is provided at the middle of two adjacent coupling columns 112 .
在其中一实施例中,参见图2h、图2i所示,图中虚线为血流方向,装载状态下,缝合环150呈沿支架周向延伸的波浪结构:In one of the embodiments, as shown in Fig. 2h and Fig. 2i, the dotted line in the figure is the direction of blood flow. In the loaded state, the sewing ring 150 has a wave structure extending along the circumference of the stent:
相对处在流入侧的部位为波谷;The part on the inflow side is the trough;
相对处在流出侧的部位为波峰。The part on the outflow side is the peak.
支架在装载状态下和释放状态下均具有波浪结构,区别在于波峰和波谷的高度差不同。The bracket has a wave structure both in the loaded state and the released state, the difference lies in the difference in height between the crests and troughs.
在其中一实施例中,参见图2h、图2i所示,缝合环150上带有穿线标志170,穿线标志170处在波谷位置。In one embodiment, as shown in FIG. 2h and FIG. 2i , the sewing ring 150 is provided with a threading mark 170 , and the threading mark 170 is at a trough position.
本申请还提供了一种人工瓣膜的加工方法,包括:The application also provides a method for processing an artificial valve, including:
S100、将各瓣叶与支架径向内侧覆膜的流出侧边缘连接,形成第一预制品;S100. Connect each valve leaflet to the outflow side edge of the radially inner coating of the stent to form a first preform;
S200、利用支架径向外侧覆膜形成第二预制品;S200. Forming a second preform by using a coating film on the radially outer side of the stent;
S300、将所述第一预制品和所述第二预制品分别连接至支架形成所述人工瓣膜。S300. Connect the first preform and the second preform to a bracket respectively to form the artificial valve.
在其中一实施例中,S100,利用支架径向内侧覆膜附着防周漏材料形成防周漏部,或利用支架径向内侧覆膜褶皱形成防周漏部。In one embodiment, in S100, the anti-peripheral leakage part is formed by adhering the anti-circumferential leakage material to the radially inner membrane of the stent, or forming the anti-circumferential leakage part by using the folds of the radially inner membrane of the stent.
在其中一实施例中,S200,利用支架径向外侧覆膜的第一部分包裹缝合材料,形成第二预制品。In one embodiment, S200, wrapping the suture material with the first part of the radially outer membrane of the stent to form a second preform.
在其中一实施例中,S200,利用支架径向外侧覆膜的第二部分包裹防周漏材料,形成第二预制品。In one of the embodiments, S200, using the second part of the radially outer covering film of the stent to wrap the anti-circumferential leakage material to form a second preform.
在其中一实施例中,S200,利用支架径向外侧覆膜的褶皱形成缝合部和/或防周漏部,形成第二预制品。In one embodiment, at S200 , the seam portion and/or the peripheral leakage prevention portion are formed by using the folds of the covering film on the radially outer side of the stent to form a second preform.
在其中一实施例中,人工瓣膜的加工方法,步骤S300包括:In one of the embodiments, the processing method of the artificial valve, step S300 includes:
S310、将第一预制品缝缀连接至支架,且在邻近结合柱112的顶端部位预留有第一非缝合区;S310, stitching and connecting the first preform to the bracket, and reserving a first non-sewing area near the top of the bonding column 112;
S320、将第二预制品缝缀连接至支架,且在邻近结合柱112的顶端部位预留有第二非缝合区;S320, stitching and connecting the second preform to the bracket, and reserving a second non-sewing area near the top of the bonding column 112;
S330、将第一非缝合区和第二非缝合区连同支架一并缝缀彼此固定。S330. Sewing the first non-sewing area and the second non-sewing area together with the support to fix each other.
为了将人工瓣膜递送至体内,本申请还提供了一种输送系统,参见图2a、图2b、图2c、图2f所示,输送系统,包括:In order to deliver the artificial valve into the body, the present application also provides a delivery system, as shown in Figure 2a, Figure 2b, Figure 2c, and Figure 2f, the delivery system includes:
控制手柄210,具有相对的远端和近端;a control handle 210 having opposing distal and proximal ends;
瓣膜卡扣230,自身的外周具有与人工瓣膜相应的适配结构231;The valve buckle 230 has a matching structure 231 corresponding to the artificial valve on its periphery;
套筒220,活动设置在瓣膜卡扣230的外周,套筒220可在包裹和暴露适配结构231这两种状态间切换;The sleeve 220 is movably arranged on the outer periphery of the valve buckle 230, and the sleeve 220 can be switched between wrapping and exposing the fitting structure 231;
两传动件240,内外嵌套配合且最远端分别连接瓣膜卡扣230和套筒220,两传动件240的近端连接至控制手柄210、且至少一者与控制手柄210之间活动配合以适应套筒220的状态切换。Two transmission parts 240 are nested inside and outside, and the farthest ends are respectively connected to the valve buckle 230 and the sleeve 220. The proximal ends of the two transmission parts 240 are connected to the control handle 210, and at least one of them is movably matched with the control handle 210 to Adapt to the state switching of the sleeve 220 .
控制手柄210的近端为靠近操作者的一端,远端为远离操作者的一端。The proximal end of the control handle 210 is the end close to the operator, and the distal end is the end far away from the operator.
输送系统将人工瓣膜收缩至小尺寸状态,并将其输送至目标位置,参见图2g、图2h所示,在手术进行前,将人工瓣膜与瓣膜卡扣230通过适配结构231相连接,通过操作控制手柄210,使套筒220从暴露适配结构231切换至包裹适配结构231,人工瓣膜在径向被压缩而减小尺寸,以适应小切口位置的置入。The delivery system shrinks the artificial valve to a small size and delivers it to the target position, as shown in Fig. 2g and Fig. 2h. Before the operation, the artificial valve is connected with the valve buckle 230 through the fitting structure 231. Operate the control handle 210 to switch the sleeve 220 from the exposed fitting structure 231 to the wrapping fitting structure 231 , and the artificial valve is compressed in the radial direction to reduce its size, so as to adapt to the placement of the small incision.
输送系统中仅套筒220和瓣膜卡扣230与人工瓣膜位置靠近,且遮挡有限,控制手柄210远离人工瓣膜,不容易阻挡术者的视线,便于在输送瓣膜的过程中观察瓣膜的状态。In the delivery system, only the sleeve 220 and the valve buckle 230 are close to the artificial valve, and the occlusion is limited. The control handle 210 is far away from the artificial valve, so it is not easy to block the operator's sight, and it is convenient to observe the state of the valve during the delivery of the valve.
压缩在套管中的人工瓣膜尺寸较小,更容易通过窦管交界,且在输送过程中部会影响术者视野。The prosthetic valve compressed in the sleeve is smaller in size, easier to pass through the sinotubular junction, and will affect the operator's field of view during delivery.
输送系统的工作过程参见图2g~图2m所示,具体如下:The working process of the conveying system is shown in Figure 2g ~ Figure 2m, as follows:
参见图2g所示,套筒220暴露瓣膜卡扣230的适配结构231,人工瓣膜与瓣膜卡扣230的适配结构231相结合;Referring to Fig. 2g, the sleeve 220 exposes the fitting structure 231 of the valve buckle 230, and the artificial valve is combined with the fitting structure 231 of the valve buckle 230;
参见图2h所示,通过控制手柄210操作套筒220包裹适配结构231,人工瓣膜处于压缩状态;As shown in FIG. 2h, the sleeve 220 is operated to wrap the fitting structure 231 through the control handle 210, and the artificial valve is in a compressed state;
参见图2i所示,通过控制手柄210锁定套筒220位置;Referring to Fig. 2i, the position of the sleeve 220 is locked through the control handle 210;
参见图2j所示,术者将缝线穿过原生瓣环,并将缝线穿过压缩状态的人工瓣膜的缝合环150,将压缩后的人工瓣膜沿缝线移动递送至原生瓣环;Referring to Fig. 2j, the operator passes the suture through the original valve annulus, and passes the suture through the suture ring 150 of the artificial valve in the compressed state, and moves the compressed artificial valve along the suture to deliver to the original valve annulus;
参见图2k所示,通过控制手柄210解除套筒220位置的锁定,并操作套筒220由包裹适配结构231的状态切换至暴露适配结构231的状态,人工瓣膜释放,并逐渐由装载状态切换至释放状态;Referring to Fig. 2k, by controlling the handle 210 to unlock the position of the sleeve 220, and operating the sleeve 220 to switch from the state of wrapping the fitting structure 231 to the state of exposing the fitting structure 231, the artificial valve is released and gradually changes from the loading state switch to release state;
参见图2l所示,人工瓣膜完全脱离瓣膜卡扣230,恢复至原始尺寸;As shown in Figure 2l, the artificial valve is completely detached from the valve buckle 230 and returns to its original size;
参见图2m所示,人工瓣膜完全释放后置于原生瓣环处,将原生瓣环与人工瓣膜的缝合环150进行缝合,撤离输送系统。Referring to Fig. 2m, after the artificial valve is fully released, it is placed on the native valve annulus, the original valve annulus and the sewing ring 150 of the artificial valve are sutured, and the delivery system is withdrawn.
为了避免影响术者的视野,套筒220可以采用透明材质。In order to avoid affecting the operator's field of vision, the sleeve 220 can be made of transparent material.
两传动件在轴向上可相对滑动,以实现套筒220包裹和暴露适配结构231两种状态的切换。其中一传动件相对控制手柄210固定,另一传动件可沿轴向移动,可沿轴向移动的传动件可以与套筒220联动,或者与瓣膜卡扣230联动。The two transmission parts can slide relative to each other in the axial direction, so as to realize the switch between the two states of the sleeve 220 wrapping and exposing the matching structure 231 . One of the transmission parts is fixed relative to the control handle 210 , and the other transmission part can move in the axial direction. The transmission part that can move in the axial direction can be linked with the sleeve 220 or with the valve buckle 230 .
在其中一实施例中,参见图2a、图2b、图2c所示,套筒220的远端为扩口结构,扩口结构的开口边缘设有沿周向间隔布置的多个避让槽221。In one embodiment, as shown in FIG. 2a , FIG. 2b , and FIG. 2c , the distal end of the sleeve 220 is a flaring structure, and the opening edge of the flaring structure is provided with a plurality of escape grooves 221 arranged at intervals in the circumferential direction.
参见图2h所示,在人工瓣膜发生压缩时,避让槽221可以容纳缝合环150 的褶皱,减少压缩后人工瓣膜的径向尺寸。Referring to Fig. 2h, when the artificial valve is compressed, the avoidance groove 221 can accommodate the folds of the sewing ring 150, reducing the radial dimension of the compressed artificial valve.
在其中一实施例中,参见图2a、图2f所示,图2f中省略了套筒220结构,展示内部的瓣膜卡扣230结构,瓣膜卡扣230为柱状,适配结构231为设置在瓣膜卡扣230外周的防脱槽和/或防脱柱,避让槽221的周向分布位置与适配结构231相对应。In one of the embodiments, as shown in Fig. 2a and Fig. 2f, the sleeve 220 structure is omitted in Fig. 2f, and the internal valve buckle 230 structure is shown. The valve buckle 230 is columnar, and the fitting structure 231 is arranged on the valve The circumferential distribution positions of the anti-off grooves and/or anti-off posts on the outer periphery of the buckle 230 and the avoidance grooves 221 correspond to the matching structures 231 .
适配结构231为了将人工瓣膜稳定的保持在瓣膜卡扣230上,瓣膜卡扣230与人工瓣膜的适配结构231为互补的结构,例如,人工瓣膜上设置防脱耳,则瓣膜卡扣230上设置与防脱耳形状相应的防脱槽;人工瓣膜上设置防脱槽,则瓣膜卡扣230上设置与防脱槽形状相应的防脱柱。The fitting structure 231 is in order to keep the artificial valve stably on the valve buckle 230. The valve buckle 230 and the fitting structure 231 of the artificial valve are complementary structures. An anti-off groove corresponding to the shape of the anti-off ear is provided on the artificial valve; if an anti-off groove is arranged on the artificial valve, an anti-off post corresponding to the shape of the anti-off groove is arranged on the valve buckle 230 .
避让槽221的周向分布位置与适配结构231相对应,是基于人工瓣膜压缩后的状态考虑,使避让槽221更好的容纳人工瓣膜的褶皱部位。The circumferential distribution position of the escape groove 221 corresponds to the fitting structure 231 , which is based on the compressed state of the artificial valve, so that the avoidance groove 221 can better accommodate the folds of the artificial valve.
控制手柄210包括:Control handle 210 includes:
壳体211,壳体211内为安装室,两传动件中的一者固定至安装室内; Housing 211, the housing 211 is an installation room, and one of the two transmission parts is fixed to the installation room;
移动座212,滑动设置在安装室内,两传动件中的另一者固定至移动座212;The moving seat 212 is slidably arranged in the installation room, and the other of the two transmission parts is fixed to the moving seat 212;
档位调节机构213,配置在移动座212和安装室之间,将移动座212限制于至少两个档位;The gear adjustment mechanism 213 is arranged between the moving base 212 and the installation chamber, and limits the moving base 212 to at least two gear positions;
控制钮214,与移动座212相连、且至少一部分延伸至壳体211的外部。The control button 214 is connected with the moving base 212 and at least a part extends to the outside of the casing 211 .
在其中一实施例中,参见图2d、图2e所示,控制手柄210包括:In one of the embodiments, as shown in Fig. 2d and Fig. 2e, the control handle 210 includes:
壳体211,壳体211内为安装室,其中一传动件固定至安装室内; Housing 211, the housing 211 is an installation room, and one of the transmission parts is fixed in the installation room;
移动座212,滑动设置在安装室内,另一传动件固定至移动座212;The moving seat 212 is slidably arranged in the installation room, and the other transmission part is fixed to the moving seat 212;
档位调节机构213,配置在移动座212和安装室之间,将移动座212限制于至少两个档位;The gear adjustment mechanism 213 is arranged between the moving base 212 and the installation chamber, and limits the moving base 212 to at least two gear positions;
控制钮214,与移动座212相连、且至少一部分延伸至壳体211的外部。The control button 214 is connected with the moving base 212 and at least a part extends to the outside of the casing 211 .
控制钮214与移动座212相连,通过拨动控制钮214可以操作移动座212移动,移动座212移动至档位调节机构213对应的档位处会被限制移动,除非通过控制钮214施加外力克服这种限制。The control button 214 is connected with the movable seat 212, and the movable seat 212 can be operated to move by toggling the control button 214, and the movable seat 212 will be restricted to move when it moves to the gear position corresponding to the gear adjustment mechanism 213, unless an external force is applied through the control button 214 to overcome this limitation.
档位调节机构213具有至少两个档位,至少两个档位分别对应下列位置:The gear adjustment mechanism 213 has at least two gears, and the at least two gears respectively correspond to the following positions:
a)人工瓣膜完全压缩的位置;a) The fully compressed position of the prosthetic valve;
b)人工瓣膜完全释放的位置。b) The position where the prosthetic valve is fully released.
除此之外,还可以设置的档位对应人工瓣膜释放过程中不同状态的位置,例如,针对人工瓣膜中缝合环完全张开的状态设置相应的档位,人工瓣膜的缝合环保持在完全张开的状态时,利用缝线将缝合环和原生瓣环进行缝合,缝合完毕后,将人工瓣膜完全释放,撤回输送系统。In addition, the stalls that can also be set correspond to the positions of different states during the release process of the artificial valve. For example, the corresponding stalls are set for the state where the sewing ring in the artificial valve is fully opened, and the sewing ring of the artificial valve is kept in a fully opened state. In the open state, the suture ring and the original valve ring are sutured. After the suturing is completed, the artificial valve is completely released and withdrawn from the delivery system.
人工瓣膜的完全压缩并非指人工瓣膜可能的最大程度的压缩状态,而是指人工瓣膜在输送系统中所需达到的最终压缩状态。The complete compression of the artificial valve does not refer to the maximum possible compression state of the artificial valve, but refers to the final compression state that the artificial valve needs to achieve in the delivery system.
通过档位调节机构213对移动座212进行限位,可以避免术者在操作过程中,由于误操作造成的瓣膜脱落或者移位,确保手术过程的安全。Limiting the position of the moving seat 212 by the gear adjustment mechanism 213 can prevent the operator from falling off or displacing the valve due to misoperation during the operation, and ensure the safety of the operation process.
档位调节结构包括:The gear adjustment structure includes:
沿壳体211轴向间隔排布的多个卡槽215,多个卡槽215设置于移动座212和壳体211内壁中的一者;A plurality of card slots 215 arranged at intervals along the axial direction of the housing 211, and the plurality of card slots 215 are arranged on one of the moving seat 212 and the inner wall of the housing 211;
弹性卡舌216,设置于移动座212和壳体211内壁中的另一者,弹性卡舌216在移动座212处在不同档位下与相应的卡槽215结合。The elastic tab 216 is disposed on the other one of the moving base 212 and the inner wall of the casing 211 , and the elastic tab 216 is combined with the corresponding slot 215 in different positions of the moving base 212 .
通过弹性卡舌216与卡槽215的配合,将移动座212限定于不同的档位。卡槽215设置于移动座212上时,弹性卡舌216设置于壳体211内壁,或者卡槽215设置于壳体211内壁上时,卡槽215设置于壳体211内壁。Through the cooperation of the elastic tab 216 and the slot 215 , the moving seat 212 is limited to different gear positions. When the locking groove 215 is disposed on the moving seat 212 , the elastic tongue 216 is disposed on the inner wall of the housing 211 , or when the locking groove 215 is disposed on the inner wall of the housing 211 , the locking groove 215 is disposed on the inner wall of the housing 211 .
卡槽的数量即为档位的数量,每个档位对应一个移动座的位置,可以根据 需要设置卡槽的数量。The number of slots is the number of gears, and each gear corresponds to the position of a moving seat, and the number of slots can be set as required.
在其中一实施例中,参见图2d、图2e所示,档位调节结构包括:In one of the embodiments, as shown in Fig. 2d and Fig. 2e, the gear adjustment structure includes:
沿壳体211轴向间隔排布的三个卡槽215,三个卡槽215设置于壳体211的内壁;Three card slots 215 arranged at intervals along the axial direction of the housing 211, and the three card slots 215 are arranged on the inner wall of the housing 211;
弹性卡舌216,设置于移动座212上,弹性卡舌216在移动座212处在不同档位下与相应的卡槽215结合。The elastic tab 216 is arranged on the moving seat 212 , and the elastic tab 216 is combined with the corresponding slot 215 when the moving seat 212 is in different positions.
在其中一实施例中,参见图2d、图2e所示,移动座212并排固定有两根弹性条217,各弹性条217其中的一段彼此相背的外凸形成两个弹性卡舌216,卡槽215为两排,分别对应其中一弹性卡舌216。图2e中其中一排卡槽215被壳体211部分遮挡。In one of the embodiments, as shown in Fig. 2d and Fig. 2e, two elastic strips 217 are fixed side by side on the moving seat 212, and a section of each elastic strip 217 protrudes away from each other to form two elastic tabs 216, The slots 215 are in two rows, respectively corresponding to one of the elastic tabs 216 . In FIG. 2 e , one row of card slots 215 is partially covered by the housing 211 .
两排卡槽215的位置一一对应,每对弹性卡舌216对应的置入对应的卡槽215中。The positions of the two rows of card slots 215 are in one-to-one correspondence, and each pair of elastic tabs 216 is correspondingly inserted into the corresponding card slots 215 .
在其中一实施例中,参见图2d、图2e所示,壳体211的内壁设有引导移动座212的导向结构218。导向结构218为固定在壳体211内壁的滑槽。壳体211上还设有引导控制钮214移动的滑槽。In one embodiment, as shown in FIG. 2d and FIG. 2e , the inner wall of the casing 211 is provided with a guide structure 218 for guiding the moving seat 212 . The guiding structure 218 is a sliding groove fixed on the inner wall of the casing 211 . The casing 211 is also provided with a sliding slot for guiding the movement of the control button 214 .
在其中一实施例中,参见图2d、图2e所示,两传动件均为管件,分别为与瓣膜卡扣230相连的内管241,以及与套筒220相连的外管242,外管242的近端固定于移动座212,内管的近端延伸越过移动座212并固定至壳体211。In one of the embodiments, as shown in Fig. 2d and Fig. 2e, the two transmission parts are tube parts, respectively the inner tube 241 connected with the valve buckle 230, and the outer tube 242 connected with the sleeve 220, the outer tube 242 The proximal end of the inner tube is fixed to the movable base 212 , and the proximal end of the inner tube extends beyond the movable base 212 and is fixed to the housing 211 .
在操作控制手柄210时,内管241相对于控制手柄210保持静止状态,通过改变外管242的位置,实现套筒220在包裹和暴露瓣膜卡扣230的适配结构231这两种状态间切换。When the control handle 210 is operated, the inner tube 241 remains stationary relative to the control handle 210, and by changing the position of the outer tube 242, the sleeve 220 is switched between the two states of wrapping and exposing the fitting structure 231 of the valve buckle 230 .
在其中一实施例中,参见图2d、图2e所示,壳体211上活动嵌装有锁定件219,锁定件219可在干涉和避让移动座212这两种状态间切换。In one embodiment, as shown in FIG. 2d and FIG. 2e , a locking member 219 is movably embedded in the housing 211 , and the locking member 219 can switch between two states of interfering with and avoiding the moving seat 212 .
人工瓣膜处于完全压缩状态时,通过锁定件219干涉移动座212的运动,即将人工瓣膜稳定安装于输送系统内,在移动过程中防止误操作,当需要将人工瓣膜从输送系统上释放时,将锁定件219切换至避让移动座212移动的状态。When the artificial valve is in a fully compressed state, the locking member 219 interferes with the movement of the moving seat 212, that is, the artificial valve is stably installed in the delivery system, and misoperation is prevented during the movement process. When the artificial valve needs to be released from the delivery system, the The locking member 219 is switched to a state of avoiding the movement of the moving seat 212 .
在其中一实施例中,参见图2d所示,移动座212的远端侧设有L形的限位槽250,该限位槽250包括沿壳体211轴向延伸的纵向段以及与纵向段垂直连通的横向段,其中纵向端的端部为开放口;In one of the embodiments, as shown in FIG. 2d, an L-shaped limiting groove 250 is provided on the distal side of the moving seat 212, and the limiting groove 250 includes a longitudinal section extending axially along the housing 211 and a longitudinal section connected to the longitudinal section. Vertically connected transverse sections, where the longitudinal ends are open at the ends;
锁定件219在干涉和避让移动座212这两种状态下、分别处在横向段和纵向段。The locking member 219 is in the transverse section and the longitudinal section respectively under the two states of interfering with and avoiding the moving seat 212 .
人工瓣膜从非压缩状态向完全压缩状态转换的过程中,锁定件219经由开放口进入纵向段内,人工瓣膜达到完全压缩状态时,锁定件219处于纵向段和横向段的交汇处,将锁定件219沿横向段拨动,使锁定件219远离纵向段,由于锁定件219与横向段在移动座212的运动方向上存在干涉,限制了移动座212的移动。During the conversion of the artificial valve from the non-compressed state to the fully compressed state, the locking member 219 enters the longitudinal section through the open opening. 219 is toggled along the transverse section to make the locking piece 219 away from the longitudinal section. Since the locking piece 219 interferes with the transverse section in the moving direction of the moving seat 212, the movement of the moving seat 212 is restricted.
需要释放人工瓣膜时,将锁定件219沿横向段拨动,使锁定件219位于纵向段内,锁定件219可沿纵向段在移动座212运动方向上移动,解除对移动座212的运动限制。When the artificial valve needs to be released, the locking member 219 is moved along the transverse section, so that the locking member 219 is located in the longitudinal section, and the locking member 219 can move along the longitudinal section in the moving direction of the moving seat 212 to release the movement restriction of the moving seat 212.
参见图2b所示,输送系统的长度(也即D1和D2的尺寸之和)为300~400mm。本申请中输送系统输送的人工瓣膜既非介入瓣,也非外科瓣,输送系统的长度也处于二者输送系统之间,输送系统中控制手柄的长度D1为100~150mm,除控制手柄外其余部件的长度D2为150~300mm,套筒端部的尺寸D3为15~20mm,控制手柄的宽度D4为15~30mm。Referring to Fig. 2b, the length of the delivery system (that is, the sum of the dimensions of D1 and D2) is 300-400 mm. The artificial valve delivered by the delivery system in this application is neither an interventional valve nor a surgical valve, and the length of the delivery system is also between the two delivery systems. The length D1 of the control handle in the delivery system is 100-150mm, except for the control handle. The length D2 of the component is 150-300 mm, the dimension D3 of the sleeve end is 15-20 mm, and the width D4 of the control handle is 15-30 mm.
所述输送系统的使用方法,包括如下步骤:The method for using the delivery system comprises the steps of:
控制手柄驱动套筒相对于瓣膜卡扣运动,以暴露瓣膜卡扣;The control handle drives the sleeve to move relative to the valve buckle to expose the valve buckle;
瓣膜卡扣的适配结构与人工瓣膜的支撑部相结合;The fitting structure of the valve buckle is combined with the supporting part of the artificial valve;
控制手柄驱动套筒处于包裹所述适配结构的状态,The control handle driving sleeve is in the state of wrapping the adapter structure,
人工瓣膜的流出侧径向向内聚拢,流入侧呈扩口;The outflow side of the artificial valve is gathered radially inward, and the inflow side is flaring;
控制手柄驱动套筒处于释放所述适配结构的状态,人工瓣膜的流出侧脱离适配结构径向向外扩张,人工瓣膜整体上为直筒结构。The control handle driving sleeve is in the state of releasing the adapting structure, the outflow side of the artificial valve breaks away from the adapting structure and expands radially outward, and the artificial valve has a straight cylindrical structure as a whole.
控制手柄驱动套筒处于包裹所述适配结构的状态时,参见图2h所示,人工瓣膜仅支撑部位于套筒内部,环形部并不完全被套筒收纳,环形部的流入侧仍位于套筒的外部。When the control handle driving sleeve is in the state of wrapping the matching structure, as shown in Figure 2h, only the supporting part of the artificial valve is located inside the sleeve, the annular part is not completely accommodated by the sleeve, and the inflow side of the annular part is still located in the sleeve. outside of the barrel.
以上所述实施例的各技术特征可以进行任意的组合,为使描述简洁,未对上述实施例中的各个技术特征所有可能的组合都进行描述,然而,只要这些技术特征的组合不存在矛盾,都应当认为是本说明书记载的范围。The technical features of the above-mentioned embodiments can be combined arbitrarily. To make the description concise, all possible combinations of the technical features in the above-mentioned embodiments are not described. However, as long as there is no contradiction in the combination of these technical features, should be considered as within the scope of this specification.
以上所述实施例仅表达了本申请的几种实施方式,其描述较为具体和详细,但并不能因此而理解为对发明专利范围的限制。应当指出的是,对于本领域的普通技术人员来说,在不脱离本申请构思的前提下,还可以做出若干变形和改进,这些都属于本申请的保护范围。因此,本申请专利的保护范围应以所附权利要求为准。The above-mentioned embodiments only represent several implementation modes of the present application, and the description thereof is relatively specific and detailed, but it should not be construed as limiting the scope of the patent for the invention. It should be noted that those skilled in the art can make several modifications and improvements without departing from the concept of the present application, and these all belong to the protection scope of the present application. Therefore, the scope of protection of the patent application should be based on the appended claims.
Claims (24)
- 一种人工瓣膜系统,其特征在于,所述人工瓣膜系统包括相互配合的人工瓣膜和输送系统,所述人工瓣膜包括:支架、设置在支架上的瓣叶、附着在所述支架上的覆膜,所述支架内部围成血流通道,支架具有相对的流入侧和流出侧,所述支架包括:An artificial valve system, characterized in that the artificial valve system includes an artificial valve and a delivery system that cooperate with each other, and the artificial valve includes: a stent, a valve leaflet arranged on the stent, and a membrane attached to the stent , the inside of the stent encloses a blood flow channel, the stent has opposite inflow sides and outflow sides, and the stent includes:支撑部,由多个U形框围成且各U形框的开口朝向流出侧,相邻两U形框的侧边彼此邻近形成结合柱,相邻两U形框的侧边交汇至结合柱的顶端;The support part is surrounded by a plurality of U-shaped frames and the opening of each U-shaped frame faces the outflow side, the sides of two adjacent U-shaped frames are adjacent to each other to form a joint column, and the sides of two adjacent U-shaped frames meet at the joint column top of环形部,为在径向上可形变的网格结构,且整体上位于所述支撑部的流入侧;an annular part, which is a radially deformable grid structure, and is located on the inflow side of the support part as a whole;所述输送系统包括:The delivery system includes:控制手柄,具有相对的远端和近端;a control handle having opposing distal and proximal ends;瓣膜卡扣,自身的外周具有与人工瓣膜的支撑部相应的适配结构;The valve buckles, and its periphery has a matching structure corresponding to the supporting part of the artificial valve;套筒,活动设置在所述瓣膜卡扣的外周,所述套筒可在包裹和暴露所述适配结构这两种状态间切换;The sleeve is movably arranged on the outer periphery of the valve buckle, and the sleeve can be switched between wrapping and exposing the fitting structure;所述套筒处于包裹所述适配结构的状态时,所述人工瓣膜处于流出侧径向向内聚拢,流入侧呈扩口的装载状态;When the sleeve is in the state of wrapping the matching structure, the artificial valve is in a loading state where the outflow side is gathered radially inward, and the inflow side is flaring;所述套筒处于暴露所述适配结构的状态时,所述人工瓣膜处于流出侧径向向外扩张,人工瓣膜整体上为直筒结构的释放状态;When the sleeve is in the state of exposing the fitting structure, the artificial valve is in the radially outward expansion of the outflow side, and the artificial valve is in a release state of a straight cylindrical structure as a whole;两传动件,内外嵌套配合且最远端分别连接所述瓣膜卡扣和所述套筒,所述两传动件的近端连接至所述控制手柄、且至少一者与所述控制手柄之间活动配合以适应所述套筒的状态切换。Two transmission parts, nested inside and outside, and the farthest ends are respectively connected to the valve buckle and the sleeve, the proximal ends of the two transmission parts are connected to the control handle, and at least one of them is connected to the control handle. The active cooperation between them is adapted to the state switching of the sleeve.
- 根据权利要求1所述的人工瓣膜系统,其特征在于,所述支架的外周设置有缝合环。The artificial valve system according to claim 1, characterized in that a sewing ring is arranged on the outer periphery of the stent.
- 根据权利要求2所述的人工瓣膜系统,其特征在于,所述支架的外周围 绕有环形的防周漏部,所述防周漏部处在所述缝合环的流入侧。The artificial valve system according to claim 2, wherein an annular anti-peripheral leakage part is surrounded on the periphery of the stent, and the anti-peripheral leakage part is on the inflow side of the sewing ring.
- 根据权利要求3所述的人工瓣膜系统,其特征在于,所述缝合环沿支架周向延伸且具有波浪结构,相对处在流入侧的部位为波谷,相对处在流出侧的部位为波峰,所述波谷与防周漏部相贴靠。The artificial valve system according to claim 3, wherein the sewing ring extends circumferentially along the stent and has a wave structure, the position opposite to the inflow side is a wave trough, and the position opposite to the outflow side is a wave peak, so Said trough and the anti-peripheral leakage part are attached to each other.
- 根据权利要求2所述的人工瓣膜系统,其特征在于,所述缝合环处在所述U形框的流入侧,且与所述U形框之间留有间隔区。The artificial valve system according to claim 2, wherein the sewing ring is on the inflow side of the U-shaped frame, and there is a space between the U-shaped frame and the U-shaped frame.
- 根据权利要求3所述的人工瓣膜系统,其特征在于,所述覆膜包括包覆于所述支架径向外侧的外覆膜,所述防周漏部包括可膨胀材料带以及所述外覆膜的第一部分,且所述第一部分包裹所述可膨胀材料带。The artificial valve system according to claim 3, characterized in that, the covering film includes an outer covering film covering the radially outer side of the stent, and the anti-circumferential leakage part includes an expandable material strip and the outer covering film A first portion of a membrane, and the first portion wraps around the strip of expandable material.
- 根据权利要求6所述的人工瓣膜系统,其特征在于,外覆膜采用PET材料制成。The artificial valve system according to claim 6, wherein the outer covering membrane is made of PET material.
- 根据权利要求7所述的人工瓣膜系统,其特征在于,所述缝合环包括缝合材料带以及所述外覆膜的第二部分,且所述第二部分包裹所述缝合材料带。7. The prosthetic valve system of claim 7, wherein the sewing ring includes a strip of suture material and a second portion of the outer covering, the second portion wrapping around the strip of suture material.
- 根据权利要求7所述的人工瓣膜系统,其特征在于,各瓣叶具有与U形框相连的固定缘以及与其他瓣叶相配合改变血流通道开放程度的游离缘,所述覆膜包括包覆于所述支架径向内侧的内覆膜,所述内覆膜的流出侧对接至所述瓣叶的固定缘,所述内覆膜和所述外覆膜两者交汇连接于所述支架的流入侧。The artificial valve system according to claim 7, wherein each leaflet has a fixed edge connected to the U-shaped frame and a free edge that cooperates with other leaflets to change the opening degree of the blood flow channel, and the covering film includes a covering The inner covering membrane covering the radial inner side of the stent, the outflow side of the inner covering membrane is connected to the fixed edge of the leaflet, the inner covering membrane and the outer covering membrane are converging and connected to the stent the inflow side.
- 根据权利要求9所述的人工瓣膜系统,其特征在于,所述内覆膜与外覆膜为一体膜片,或为分体膜片。The artificial valve system according to claim 9, characterized in that, the inner covering membrane and the outer covering membrane are an integral diaphragm, or are separate diaphragms.
- 根据权利要求8所述的人工瓣膜系统,其特征在于,所述可膨胀材料带以及所述缝合材料带各自独立的被所述外覆膜完全包裹,或被夹持包裹在所述内覆膜和所述外覆膜之间。The artificial valve system according to claim 8, characterized in that, the expandable material band and the suture material band are independently completely wrapped by the outer covering membrane, or clamped and wrapped around the inner covering membrane and between the outer covering film.
- 根据权利要求6所述的人工瓣膜系统,其特征在于,所述可膨胀材料 带为吸水膨胀材料呈带状且在支架周向上连续分布,或为间隔布置的多个的块状;所述环形部具有网格结构,块状的吸水膨胀材料分别处对应网格结构的镂空区。The artificial valve system according to claim 6, characterized in that, the expandable material belt is in the shape of a water-absorbing expandable material and is continuously distributed in the circumferential direction of the stent, or is a plurality of blocks arranged at intervals; The inner part has a grid structure, and the blocky water-absorbing swelling materials are respectively located in the hollowed-out areas of the grid structure.
- 根据权利要求6所述的人工瓣膜系统,其特征在于,所述可膨胀材料带包括绕支架外围布置的基底以及固定于基底上的吸水膨胀材料。The artificial valve system according to claim 6, wherein the expandable material band comprises a base arranged around the periphery of the stent and a water-absorbing swellable material fixed on the base.
- 根据权利要求2所述的人工瓣膜系统,其特征在于,所述缝合环上带有穿线标志,在支架周向上,所述穿线标志与所述结合柱错位布置。The artificial valve system according to claim 2, wherein the sewing ring is provided with a threading mark, and the threading mark is misaligned with the coupling column in the circumferential direction of the stent.
- 根据权利要求4所述的人工瓣膜系统,其特征在于,所述缝合环上带有穿线标志,所述穿线标志处在波谷位置。The artificial valve system according to claim 4, characterized in that there is a threading mark on the sewing ring, and the threading mark is at a trough position.
- 根据权利要求1所述的人工瓣膜系统,其特征在于,所述瓣膜卡扣为柱状,所述适配结构为设置在所述瓣膜卡扣外周的防脱槽和/或防脱柱。The artificial valve system according to claim 1, wherein the valve buckle is columnar, and the fitting structure is an anti-off groove and/or an anti-off post arranged on the outer periphery of the valve buckle.
- 根据权利要求1所述的人工瓣膜系统,其特征在于,所述控制手柄包括:The artificial valve system according to claim 1, wherein the control handle comprises:壳体,所述壳体内为安装室,所述两传动件中的一者固定至安装室内;A housing, the housing is an installation chamber, and one of the two transmission parts is fixed in the installation chamber;移动座,滑动设置在所述安装室内,所述两传动件中的另一者固定至所述移动座;a moving seat, which is slidably arranged in the installation chamber, and the other of the two transmission parts is fixed to the moving seat;档位调节机构,配置在所述移动座和所述安装室之间,将所述移动座限制于至少两个档位;a gear adjustment mechanism, configured between the moving base and the installation chamber, and restricting the moving base to at least two gears;控制钮,与所述移动座相连、且至少一部分延伸至所述壳体的外部。The control button is connected with the moving base, and at least a part extends to the outside of the housing.
- 根据权利要求1所述的人工瓣膜系统,其特征在于,所述套筒的远端为扩口结构,所述扩口结构的开口边缘设有沿周向间隔布置的多个避让槽,所述避让槽的周向分布位置与所述适配结构相对应。The artificial valve system according to claim 1, wherein the distal end of the sleeve is a flaring structure, and the opening edge of the flaring structure is provided with a plurality of escape grooves arranged at intervals in the circumferential direction, the The circumferential distribution positions of the escape grooves correspond to the matching structures.
- 根据权利要求17所述的人工瓣膜系统,其特征在于,所述档位调节结 构包括:The artificial valve system according to claim 17, wherein the gear adjustment structure comprises:沿壳体轴向间隔排布的多个卡槽,所述多个卡槽设置于所述移动座和所述壳体内壁中的一者;A plurality of card slots arranged at intervals along the axial direction of the housing, the plurality of card slots are arranged on one of the moving seat and the inner wall of the housing;弹性卡舌,设置于所述移动座和所述壳体内壁中的另一者,所述弹性卡舌在所述移动座处在不同档位下与相应的卡槽结合。The elastic tab is arranged on the other one of the moving seat and the inner wall of the housing, and the elastic tab is combined with the corresponding slot when the moving seat is in different positions.
- 根据权利要求19所述的人工瓣膜系统,其特征在于,所述移动座并排固定有两根弹性条,各弹性条其中的一段彼此相背的外凸形成两个所述弹性卡舌,所述卡槽为两排,分别对应其中一弹性卡舌。The artificial valve system according to claim 19, wherein two elastic strips are fixed side by side on the moving seat, and a section of each elastic strip protrudes away from each other to form two elastic tabs. There are two rows of card slots, corresponding to one of the elastic tabs respectively.
- 根据权利要求17所述的人工瓣膜系统,其特征在于,所述壳体上活动嵌装有锁定件,所述锁定件可在干涉和避让所述移动座这两种状态间切换。The artificial valve system according to claim 17, characterized in that a locking piece is movably embedded in the casing, and the locking piece can be switched between two states of interfering with and avoiding the moving seat.
- 根据权利要求21所述的人工瓣膜系统,其特征在于,所述移动座的远端侧设有L形的限位槽,该限位槽包括沿壳体轴向延伸的纵向段以及与所述纵向段垂直连通的横向段,其中所述纵向端的端部为开放口;The artificial valve system according to claim 21, characterized in that, the distal side of the moving base is provided with an L-shaped limiting groove, and the limiting groove includes a longitudinal section extending axially along the casing and is connected to the a transverse segment vertically connected to a longitudinal segment, wherein the ends of the longitudinal ends are open;所述锁定件在干涉和避让所述移动座这两种状态下、分别处在所述横向段和所述纵向段。The locking member is respectively located in the transverse section and the longitudinal section under the two states of interfering with and avoiding the moving seat.
- 根据权利要求1所述的人工瓣膜系统,其特征在于,所述输送系统的长度为300~400mm。The artificial valve system according to claim 1, wherein the delivery system has a length of 300-400 mm.
- 根据权利要求1~23任一项所述的输送系统的使用方法,其特征在于,包括如下步骤:The use method of the delivery system according to any one of claims 1-23, characterized in that it comprises the following steps:控制手柄驱动套筒相对于瓣膜卡扣运动,以暴露瓣膜卡扣;The control handle drives the sleeve to move relative to the valve buckle to expose the valve buckle;瓣膜卡扣的适配结构与人工瓣膜的支撑部相结合;The fitting structure of the valve buckle is combined with the supporting part of the artificial valve;控制手柄驱动套筒处于包裹所述适配结构的状态,人工瓣膜的流出侧径向向内聚拢,流入侧呈扩口;The driving sleeve of the control handle is in the state of wrapping the matching structure, the outflow side of the artificial valve is gathered radially inward, and the inflow side is flaring;控制手柄驱动套筒处于释放所述适配结构的状态,人工瓣膜的流出侧脱离适配结构径向向外扩张,人工瓣膜整体上为直筒结构。The control handle driving sleeve is in the state of releasing the adapting structure, the outflow side of the artificial valve breaks away from the adapting structure and expands radially outward, and the artificial valve has a straight cylindrical structure as a whole.
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WO (1) | WO2023125684A1 (en) |
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US20020173842A1 (en) * | 2001-05-17 | 2002-11-21 | Buchanan Eric S. | Prosthetic heart valve with slit stent |
CN104884002A (en) * | 2012-12-31 | 2015-09-02 | 爱德华兹生命科学公司 | Surgical heart valves adapted for post implant expansion |
CN107485465A (en) * | 2011-12-09 | 2017-12-19 | 爱德华兹生命科学公司 | The heart valve prosthesis of commissure support with improvement |
CN107735051A (en) * | 2015-07-02 | 2018-02-23 | 爱德华兹生命科学公司 | The mixing cardiac valves expanded after being suitable for implantation into |
CN107920894A (en) * | 2015-07-02 | 2018-04-17 | 爱德华兹生命科学公司 | The mixing cardiac valves of integration |
CN111281605A (en) * | 2010-10-05 | 2020-06-16 | 爱德华兹生命科学公司 | Artificial heart valve |
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2022
- 2022-12-28 CN CN202280081974.XA patent/CN118338866A/en active Pending
- 2022-12-28 CN CN202211702656.9A patent/CN116459040A/en active Pending
- 2022-12-28 WO PCT/CN2022/142902 patent/WO2023125684A1/en active Application Filing
- 2022-12-28 CN CN202211701291.8A patent/CN116370149A/en active Pending
- 2022-12-28 CN CN202223541909.7U patent/CN219896030U/en active Active
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US20020173842A1 (en) * | 2001-05-17 | 2002-11-21 | Buchanan Eric S. | Prosthetic heart valve with slit stent |
CN111281605A (en) * | 2010-10-05 | 2020-06-16 | 爱德华兹生命科学公司 | Artificial heart valve |
CN107485465A (en) * | 2011-12-09 | 2017-12-19 | 爱德华兹生命科学公司 | The heart valve prosthesis of commissure support with improvement |
CN104884002A (en) * | 2012-12-31 | 2015-09-02 | 爱德华兹生命科学公司 | Surgical heart valves adapted for post implant expansion |
CN107735051A (en) * | 2015-07-02 | 2018-02-23 | 爱德华兹生命科学公司 | The mixing cardiac valves expanded after being suitable for implantation into |
CN107920894A (en) * | 2015-07-02 | 2018-04-17 | 爱德华兹生命科学公司 | The mixing cardiac valves of integration |
Also Published As
Publication number | Publication date |
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CN118338866A (en) | 2024-07-12 |
CN219896030U (en) | 2023-10-27 |
CN116459040A (en) | 2023-07-21 |
CN116370149A (en) | 2023-07-04 |
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