Reduce the valve bracket of reduction length and the valve replacement device with the valve bracket
Technical field
The present invention relates to technical field of medical instruments, and in particular to the valve bracket of a kind of reduction reduction length and with this
The valve replacement device of valve bracket.
Background technology
Tetralogy of Fallot is most common Children with Cyanotic Congenital Heart Disease in survival baby, and the incidence of disease accounts for all kinds of congenital hearts
The 10~15% of popular name for.
Tetralogy of Fallot is made up of following four deformity:(1) pulmonary stenosis, it is common with infundibular stenosis, it is secondly leakage
Pan and valve merge narrow, and stenosis can increase and aggravate with the age;(2) ventricular septal defect, affiliated high-order film portion defect;
(3) aortic overriding, aortic overriding is on Ventricular, as sustainer is developed, and the right side can gradually be aggravated across phenomenon, about
25% patient is dextroaortic arch;(4) right ventricle is plump, is that right ventricle load increase causes after pulmonary stenosis.The above four
Plant maximum on the pathologic, physiologic influence of infant with pulmonary stenosis in deformity.
In tetralogy of Fallot surgical operation, doctor is repairing pulmonary artery, pulmonary valve or during right ventricle infundibular stenosis,
Sticking patch is implanted into generally by correspondence position, to solve asking for main pulmonary artery, pulmonary artery stenosis or pulmonary stenosis
Topic.But this surgical operation is a kind of palliative treatment, pulmonary valve missing is frequently can lead to, when infant grows to adult, still
It need to be treated continuing with pulmonary valve missing.
Pulmonary valve after being grown up for infant lacks problem, can be solved using secondary thoracotomy operation implantation valve,
Interventional method can be used, implantable artificial cusps of pulmonary valve is solved.Surgical operation is compared using interventional method, can be substantially reduced
The operation wound of patient, another therapy approach is provided for that can not bear the patient of surgical operation.
Infant passes through first time sticking patch Post operation, and sustainer is soft, enlarged-diameter, therefore, and the artificial lung of required implantation is moved
The length and diameter dimension of arteries and veins valve are all larger.Pulmonary valve membrane support of the prior art implantation human body before, be with
The state of compression is placed in sheath, after being transported to by sheath in human body, and pulmonary valve membrane support is discharged in sheath, release
Pulmonary valve membrane support afterwards returns to nature, plays a part of supporting prostheses valve.
Existing lung arterial support is for the ease of compression, and agent structure is network, for example, application publication number is CN
103431931A Chinese invention patent document discloses a kind of lung arterial support, includes the support rack of tubulose, and connection
At the axial two ends of support rack and inflow segment and outflow section in enlarging are radially expanded, the neighbouring outflow section position of the support rack
With around circumferentially distributed some first module lattice, first module lattice use rhombus.
When the main part of pulmonary valve membrane support uses diamond structure, either length direction or diametric(al),
Change in size before and after compression is larger, and the implantation path of cusps of pulmonary valve passes sequentially through vein, atrium dextrum, right ventricle, main lung
Artery, the flexibility in the implantation path is larger, if the length after pulmonary valve compression is long, will have a strong impact on apparatus and conveyed
Compliance in journey, increase conveying difficulty.
The content of the invention
The invention provides a kind of valve bracket for reducing reduction length, the length before and after valve bracket compression can be reduced
Change, improves the bending compliance of valve bracket, valve is smoothly reached implantation position in human body, it is ensured that surgical procedure
Be smoothed out, reduce it is postoperative occur vascular complication risk.
A kind of valve bracket for reducing reduction length, includes the support rack of tubulose, wherein one section of the support rack
For changeover portion, the ratio between the axial length before and after changeover portion compression is equal to 1.
It is typically by heart valve bracket pressure when heart valve bracket of the prior art sends into human body by induction system
Be placed on the apparatus loading station of induction system after contracting, and be placed with the apparatus loading station of valve bracket be in whole sheath most
Hard part, in order that the length of the most tough parts is minimum, to meet the demand by the larger implantation path of flexibility,
The length after heart valve bracket is compressed is needed to reduce.
Support rack in the present invention, which refers to remove in valve bracket, is used for the part for strutting blood vessel outside positioning element, lead to
It is often tubulose, blood flows in inner tubular portion, the prosthetic valve phase separation with inner tubular portion.Support rack is not limited to isometrical
Can diametrically there be expansion the tubular of extension, the end of support rack or shrink.
In order to reduce the length after support rack compression, the present invention sets one section of changeover portion, changeover portion on support rack
Holding shaft upward length is constant after before compression, compared with prior art in network, can reduce before and after compression in axial direction
On length change.
Preferably, the axial length of the changeover portion is at least the 25% of support rack total length.Only in changeover portion
When the ratio between axial length and support rack total length reach more than 25%, the effect of changeover portion can be shown, that is, be based on
The presence of changeover portion, enables the length of the support rack after compression to be reduced to the requirement for meeting bending compliance, makes supporting network
Frame can successfully reach inside of human body and be expected position, it is ensured that operation is smoothed out.
Although changeover portion can reduce the upward length change of support rack compression antero posterior axis, the length of changeover portion
Also not the longer the better, because, although the length change before and after network compression in the axial direction is than larger, network
Structure ensure that support rack has enough intensity, prolonged blood can be born and washed away, and the knot of network
Structure enables support rack to be compressed, so as to be placed in sheath.
It is therefore preferred that the axial length of the changeover portion is the 40~90% of support rack total length.It is further excellent
Choosing, the axial length of the changeover portion is the 50~80% of support rack total length.
As simplest embodiment, the changeover portion is made up of some straight-bars axially extending along valve bracket, respectively
Straight-bar is circumferentially uniformly arranged.
Straight-bar is along the axially extending of valve bracket, and the length of straight-bar is the axial length of changeover portion, circumferentially uniform arrangement,
It can ensure to support the integrally-built symmetry of rack, when being subjected to blood flow for a long time in the blood vessel and washing away, uniform force is not susceptible to
Tilt, so as to be damaged to vascular wall.
Preferably, the axial two ends of support rack are connected with inflow segment and outflow section, the two ends of the changeover portion with
Connect or be directly connected to by grid section between inflow segment, outflow section.
When changeover portion is connected by grid section with inflow segment or outflow section, changeover portion and grid section collectively form institute of the present invention
The support rack stated.
Described inflow segment and outflow Duan Juncheng enlargings, make valve bracket be implanted into after human body, be difficult motion with heart and
There is displacement.
When being discharged in human body, inflow segment and outflow section in valve bracket are likely to be first to discharge end, are in and first release
Put the inflow segment or outflow section at end, referred to as flared section.Flared section is connected with all end nodes of respective side on support rack.
All end nodes are connected with flared section, it is to avoid isolated summit occur at the position of the non-end of valve bracket,
Eliminate valve bracket to be compressed into after sheath, the phenomenon of spine occur.
The outward flange of the flared section is surrounded by the support bar of some bendings, corresponding with support bar position on support rack
End node be connected with support bar.The end node intersects on support bar or is connected to support bar by connecing to draw bar and cross
On.
All end nodes are directly connected to or draws bar by connecing and is connected on support bar, that is, supports and orphan is not present on rack
The vertical end node existed, each end node has been at least connected with three linear edges, when whole valve bracket compresses, end node
Spine will not be deformed into.
The two ends of every support bar connect an end node of support rack respectively, the middle part edge support rack of support bar
It is axially extending, and support bar is bent outwardly to form enlarging adjacent to the position of end node.Described connect draws bar by corresponding to end node extremely
The extension path of support bar is gradually away from support rack.
Connect and draw bar also with appropriate bending, and the curved shape of degree of crook and support bar is adaptable, connects and draws bar and branch
Stay is located on same smooth surface.
Preferably, the angle of extension path two end point connecting line and valve bracket axis is 0~70 degree.Extension path and valve
When membrane support axis angle is 0 degree, connect draw bar length it is most short, still, draw bar and support bar is respectively provided with bending knot due to connecing
Structure, therefore, connect draw the extension path of bar generally will not be parallel with the axis of valve bracket.Connect and draw the remittance of bar needs to support bar
On, in order to coordinate the shape of support bar, connect and draw the extension path of bar and be not easy to that there is very big angle with the axis of valve bracket.
Preferably, the angle of extension path two end point connecting line and valve bracket axis is 20~60 degree.Further preferably, prolong
The angle for stretching path two end point connecting line and valve bracket axis is 30~45 degree.
Connect and draw bar and be connected with closest support bar, connect that to draw bar and the angle of support bar intersection area be acute angle.Using
This structure is easy to maintain original mechanical property.
Per four adjacent end nodes as one group, in one group of end node, the two ends of the support bar respectively with distance
Two farthest end nodes are connected, and two end nodes positioned at middle part draw the support that bar is connected to respective side by a piece-root grafting respectively
On bar, and two piece-root graftings are drawn bar and mutually disjointed, and the position that bar intersects with support bar is drawn per piece-root grafting and is located substantially on flared section axial direction
Middle part.
In order to farthest retain existing valve bracket structure, it is easier to make for the processing of valve bracket, preferably
Ground, the grid section is network, and each straight-bar termination of changeover portion is connected with corresponding rhombus summit.
Each straight-bar termination is connected with corresponding rhombus summit, first, the symmetrical structure based on network, it is easier to control
Each straight-bar is circumferentially evenly distributed, processing is more easy to progress, and secondly, the end points of exposure is less on valve bracket, it is not easy to puncture
Sheath or blood vessel, finally, the stress of valve bracket are more simple, are easy to the structure design of valve bracket (for example to select
Suitable axially and radially length) simultaneously, it is also beneficial to valve bracket holding position in the blood of flowing stable.
Preferably, each straight-bar termination of changeover portion is connected to rhombus summit of the network towards changeover portion.
The two ends of straight-bar are connected with a rhombus summit respectively, two adjacent straight-bars and the rhombus that is connected with straight-bar
Corresponding edge constitutes hexagonal structure, and each interior angle of the hexagon is obtuse angle.Can farthest it be subtracted using this structure
The summit quantity of small rhombus exposure, makes the safety in utilization of valve bracket more preferable.
Heretofore described network, is not proper rhombus, and each side of rhombus can slightly be bent,
It is each to be formed close to circular structure, reduce stress concentration point during stress.
Present invention also offers a kind of valve replacement device, including described valve bracket, and it is fixed on the support
Prosthetic valve inside rack.
The equal overlay film of support rack and inflow segment of the valve bracket, prosthetic valve can sew the inwall in valve bracket,
Installation fixation can also be carried out using existing other method.
The present invention reduces the valve bracket of reduction length, can reduce the length change before and after valve bracket compression, improve
The bending compliance of valve bracket, while ensureing the good compression performance of valve bracket holding and intensity, enables valve to exist
Implantation position is smoothly reached in human body, the postoperative risk for occurring vascular complication is reduced.
Brief description of the drawings
Fig. 1 is the schematic diagram of the first embodiment of the lung arterial support for reducing reduction length;
Fig. 2 is the stereogram of the first embodiment of the lung arterial support for reducing reduction length;
Fig. 3 is the schematic diagram (rear half side omission) of second of embodiment of the lung arterial support for reducing reduction length;
Fig. 4 is the schematic diagram for the aortic stents for reducing reduction length.
In figure:1st, section is flowed out;2nd, grid section;3rd, changeover portion;4th, end node;5th, inflow segment;6th, support bar;7th, straight-bar;8、
Connect and draw bar;9th, grid section;10th, inflow segment;11st, changeover portion;12nd, straight-bar;13rd, grid section;14th, grid section;15th, section is flowed out.
Embodiment
Embodiment 1
Below in conjunction with the accompanying drawings, by taking lung arterial support as an example, further explaination is done to the present invention.
As shown in Figure 1 and Figure 2, reduce the lung arterial support of reduction length, including support rack and be connected to support
The inflow segment 5 and outflow section 1 at rack axial direction two ends, wherein one section of support rack is changeover portion 3.
One end of changeover portion 3 13 is connected by grid section with inflow segment 5, the other end of changeover portion 3 by grid section 2 and
It is connected with outflow section 1, grid section 2, grid section 13 and changeover portion 3 collectively form support rack.Grid section 2 is by continuous rhombus
Composition, grid section 13 is made up of continuous half rhombus, and inflow segment 5 compares changeover portion 3, diametrically expands outwardly to form enlarging,
The side of rhombus and the straight line of non-critical, but be slightly bent outwardly, inflow segment 5, grid section 2 and grid section 13 are upward in circumference
Rhombus or half rhombus number are identical.
Changeover portion 3 is made up of some straight-bars 7 axially extending along lung arterial support, the circumferentially uniform arrangement, mistake of each straight-bar 7
It is the 70% of support rack total length to cross the axial length of section 3.
Each termination of straight-bar 7 of changeover portion 3 is connected with corresponding rhombus summit, and each termination of straight-bar 7 of changeover portion 3 is connected to rhombus net
Lattice are towards the rhombus summit of changeover portion 3.As seen from Figure 1, the side of each straight-bar 7 of changeover portion 3 and adjacent rhombus constitutes six
Side shape, each interior angle of hexagon is obtuse angle.
Embodiment 2
In addition to having the structure of identical changeover portion 3 with embodiment 1, this embodiment eliminates isolate to deposit in lung arterial support
End node.
As shown in figure 3, inflow segment 5 and outflow section 1 are radially expanded in enlarging, and when being discharged in human body, lung arterial support
Outflow section 1 first to discharge end, outflow section 1 is with supporting all end nodes 4 of respective side on rack to be connected.Lung is eliminated in Fig. 3
Arterial bracket it is rear half side, only show the preceding half side of lung arterial support.
The outward flange of outflow section 1 is surrounded by the support bar 6 of some bendings, per four adjacent end nodes 4 as one group,
In one group of end node 4, draw bar 8 with a piece-root grafting of support bar 6 and two, the two ends of support bar 6 respectively with lie farthest away two
Individual end node 4 is connected, and two end nodes 4 positioned at middle part draw the support bar 6 that bar 8 is connected to respective side by a piece-root grafting respectively
On, this two piece-root grafting is drawn bar 8 and mutually disjointed, and is located substantially at per the position that piece-root grafting draws bar 8 with support bar 6 intersects on outflow section 1 axial direction
Middle part.
Connect and draw bar 8 by the extension path of correspondence end node 4 to support bar 6 gradually away from support rack, connect and draw bar 8 and support
The angle of the intersection area of bar 6 is acute angle.
Embodiment 3
Below in conjunction with the accompanying drawings, by taking aortic stents as an example, further explaination is done to the present invention.
As shown in figure 4, reducing the aortic stents of reduction length, including support rack and be connected to support rack axial direction
The outflow section 15 and inflow segment 10 at two ends, wherein one section of support rack is changeover portion 11.
One end of changeover portion is connected by grid section 9 with outflow section 15, and the other end of changeover portion 11 passes through grid section 14
It is connected with outflow section 10, grid section 14, grid section 9 and changeover portion 11 collectively form support rack.Grid section 14, grid section
9 are made up of continuous half rhombus, and inflow segment 10 diametrically expands outwardly to form enlarging compared to changeover portion 11, and the side of rhombus is not
Strict straight line, but be slightly bent outwardly.
Changeover portion 11 is made up of some straight-bars 12 axially extending along aortic stents, and each straight-bar 12 is circumferentially uniform to be arranged
Cloth, the axial length of changeover portion 11 is the 80% of support rack total length.
Each two ends of straight-bar 12 of changeover portion 11 are connected with half rhombus summit of corresponding grid section 14, grid section 9, by Fig. 4
As can be seen that the side of each straight-bar 12 of changeover portion 11 and half adjacent rhombus constitutes hexagon, each interior angle of hexagon is blunt
Angle.
Length after valve bracket compression can be greatly reduced using technical scheme, it is assumed that a support rack
Changeover portion axial direction diamond-shaped element has n, than the axial increment before compression is X after the compression of each diamond-shaped element, then supporting network
Length increase change value is n*X after frame compression;Contrast can be obtained, if changeover portion diamond-plaid is changed into straight line, the two of changeover portion
Remaining each half of diamond-plaid respectively is then supported rack compression anterior-posterior length change to turn to 1*X, before and after straight line portion compression axially by end
Length change amount is ' zero '.It is illustrated below:In current most common self-inflated lung arterial support, support rack is all by water chestnut
Shape grid is constituted, and by taking most common 30# valves as an example, circumference is to 12 networks, the straight section length of secure valve is distributed with
There are 4 diamond-plaids on 30mm, axial direction, when valve bracket is compressed, diamond-plaid is changed into straight line, and straight section length change is about
43.04mm;After the technical scheme provided using the present invention, in remaining each half of the diamond-plaid of two ends difference of changeover portion 3, after compression
Straight section length is about 33.26mm, reduces 9.78mm reduction length, and effect is notable.
In addition, metal material used in valve bracket can (be usually memorial alloy, the present invention is adopted by the present invention
With Ultimum Ti) the nearly half of consumption reduction, the diameter after valve bracket compression can have both been reduced, bending can have been improved again suitable
Ying Xing, makes further being lifted by performance for valve.
The valve replacement device that the present invention is provided, including foregoing valve bracket, and be fixed on inside support rack
Prosthetic valve.Valve bracket is entered behind human body precalculated position by induction system, and valve bracket discharges and expanded in sheath, valve
Fixed prosthetic valve substitutes original valve in human body inside membrane support, realizes the function of making blood unidirectionally pass through.