CN110368071A - Three-dimensional atrial septal puncture expander - Google Patents
Three-dimensional atrial septal puncture expander Download PDFInfo
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- CN110368071A CN110368071A CN201810327781.3A CN201810327781A CN110368071A CN 110368071 A CN110368071 A CN 110368071A CN 201810327781 A CN201810327781 A CN 201810327781A CN 110368071 A CN110368071 A CN 110368071A
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- distal end
- atrial septal
- cutting mouth
- septal puncture
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3439—Cannulas with means for changing the inner diameter of the cannula, e.g. expandable
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B2017/0237—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for heart surgery
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- Surgery (AREA)
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- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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- Surgical Instruments (AREA)
Abstract
The invention discloses a kind of three-dimensional atrial septal puncture expander, including tube body, the tube body includes central lumen, proximally and distally, and the distal end of the tube body is warp architecture, and the distal end of the warp architecture is equipped with cutting mouth.Expander of the invention allows the position of needle point is accurate in real time in three dimension system to show, and eliminates the risk that needle point in other three-dimensional piercing methods causes damage to superior vena cava and endocardial tissue.
Description
Technical field
The present invention relates to a kind of three-dimensional atrial septal puncture expanders.
Background technique
The patient of Chinese affected by atrial trembling (atrial fibrillation) is more than 12,000,000, and average annual growth, and radical cure atrial fibrillation is preferred three-dimensional
Radio-frequency ablation procedure under systematic direction.One of the important step for completing the operation is exactly heart atrial septal puncture art.
The atrial septal puncture art of mainstream is still the atrial septal puncture art under radioscopy guidance both at home and abroad at present, this is
Technology under a kind of two-dimensional surface visual angle that developed before over half a century, x-ray can not directly judge fossa ovalis position,
More lack the accurate cues in three-dimensional structure, grasps this technology and need prolonged clinical accumulation, if patient's heart
Then venipuncture difficulty is very big for variation, more influence when patient and the not high X-ray machine clarity of being too obese puncture success rate and
Safety.Atrial septal puncture art under the intracardiac echocardiography guidance that external country, especially U.S. etc. advocates is in radioscopy base
Increase by radical center endo-luminal ultrasound (ICE) conduit on plinth, is on the whole also flat with two dimension although increasing the accuracy of positioning
Based on surface technology, it is difficult to furthermore the good true three-dimension solid space for embodying heart lacks electricity analysis to the judgement of fossa ovalis,
Therefore, it is difficult to accomplish more accurately to position.It is practical due to needing corresponding cardiac ultrasonic to gain knowledge and expensive ultrasound catheter
On substantially increase equipment and technical threshold.
In recent years, as the application of three dimension system is further extensive, a kind of novel three-dimensional atrial septal puncture method is derived,
It is operated under Three Dimensional Interface completely, does not need X-ray and contrast agent.The accuracy and successfully of atrial septal puncture can not only be improved
Rate, safety are also completely more secure.The more crucial step of such piercing method first is that seal wire and Interaurcular septum puncture needle
Visualization.Any good conductor, such as seal wire or puncture needle can be defined as a two pole mapping catheters in three dimension system, and
Buttock line is extremely accordingly connected by two, and conductor is accessed into three-dimensional mapping system.When puncture, it is quiet that seal wire and long sheath are sent into epicoele first
Arteries and veins.Long sheath is sent into superior vena cava using the conduit with magnetic orientation device, interior sheath expansion sheath is then exchanged for and adds seal wire.Wherein
Seal wire remains outside interior sheath expansion sheath, when 1~2mm outside interior sheath expansion sheath is stretched out in the distal end of seal wire, can maintain three
The head end of seal wire is shown in system.Then seal wire is exchanged for Interaurcular septum puncture needle, long expansion sheath is stayed in by puncture needle handle
Outer length judges the relative position of puncture needle and long sheath；The position of Interaurcular septum puncture needle is confirmed with this.
It finally rebuilds atrium dextrum three-dimensional structure and visualizes Interaurcular septum puncture needle using three-dimensional mapping system.When needle point goes out sheath
When 1~2mm, the display of needle can be seen in three-dimensional mapping system and judges position of the needle in heart and blood vessel.It will puncture
4~5 directions are directed toward in the direction of needle handle indicator and long sheath, are pulled down simultaneously, the movement of visible puncture needle in three dimension system.When
Puncture needle slide to label point of puncture when, i.e. atrial septum oval hole site, generally having the sense that falls through can try on, between passing through
Every when generally have breakthrough sense.It can be clearly apparent puncture needle in three dimension system at this time and enter atrium sinistrum 1cm or so.If there is image
Fusion, is clear that puncture needle and left and right atrium and the isostructural three-dimensional relationship of aorta.
The problem of such above-mentioned piercing method is, could be in three dimension system since needle point need to expose interior 1~2mm of sheath always
The position of middle real-time display puncture needle, during operation Interaurcular septum puncture needle slides into oval foramen point of puncture by epicoele passages through which vital energy circulates,
Needle point may cause to damage to superior vena cava and endocardial tissue, be badly in need of a kind of new expander head construction now, reducing
Or it does not need X-ray, need to complete centesis in the case where intracardiac echocardiography guidance, and it is quiet to epicoele to reduce or eliminate needle point
Arteries and veins and endocardial tissue cause to damage.
Therefore, it is necessary to a kind of novel expanders.
Summary of the invention
A kind of three-dimensional atrial septal puncture expander, including tube body, the tube body include central lumen, proximally and distally,
The distal end of the tube body is warp architecture, and the distal end of the warp architecture is equipped with cutting mouth.
According to an embodiment of the present invention, the cutting mouth is inclined cutting mouth.
The distance of distal end end face of the proximal edge of the cutting mouth apart from the warp architecture is 1-3mm, preferably
1mm。
According to an embodiment of the present invention, the cutting mouth is horizontal cutting mouth, is set in the axial direction along the expander
It sets.
The distal end of the cutting mouth switches to the distal end end face of the warp architecture.
The cross section of the cutting mouth is rectangle, ellipse, square or irregular shape.
The cross section of the cutting mouth is to gradually become smaller from the proximal end of cutting mouth to distal cross section product, close to the pipe
The distal end endface of body, and become larger.
In the vertical direction for the bending plane that the cutting mouth is set to the warp architecture.
Preferably, the cutting mouth is set to the outside of the warp architecture bending.
The distal end of the central lumen of the tube body is ladder end face.
It is 8-9mm with a distance from distal end end face of the stepped end identity distance from the warp architecture.
According to the three-dimensional atrial septal puncture expander described in one embodiment of the invention, the distal end of tube body is set
There is cutting mouth, Interaurcular septum puncture needle tip portion is enable to realize electric performance conducting with blood, three dimension system can display real-time needle point
The risk that needle point causes damage to superior vena cava and endocardial tissue is eliminated in position.
Detailed description of the invention
Fig. 1 show the structural schematic diagram of three-dimensional atrial septal puncture expander 10；
Shown in Fig. 2 is the distal structure of three-dimensional atrial septal puncture expander 10 according to an embodiment of the present invention
Schematic diagram；
Shown in Fig. 3 is the cross-sectional view of the line A-A along Fig. 2；
Shown in Fig. 4 is the distal end of the three-dimensional atrial septal puncture expander 100 of another embodiment according to the present invention
Structural schematic diagram；
Shown in fig. 5 is the cross-sectional view of the line B-B along Fig. 4；
Shown in fig. 6 is the enlarged drawing in Fig. 5 at I.
Specific embodiment
Below with reference to the embodiments and with reference to the accompanying drawing the technical scheme of the present invention will be explained in further detail, but this hair
It is bright to be not limited only to the following examples.
Fig. 1 show the structural schematic diagram of three-dimensional atrial septal puncture expander 10；Shown in Fig. 2 is according to the present invention one
The distal structure schematic diagram of the three-dimensional atrial septal puncture expander 10 of kind embodiment；Shown in Fig. 3 is the line A-A along Fig. 2
Cross-sectional view.As shown in Figure 1, Figure 2 and Figure 3, a kind of three-dimensional atrial septal puncture expander 10 includes tube body 15, the tube body 15
Including central lumen, proximally and distally.The proximal end of the tube body 15 can be connect with connector 14, and the connector 14 can be Rule
Connector.The distal end of the tube body 15 is warp architecture 16.The distal end of the warp architecture 16 is equipped with inclined cutting mouth 17, described
The section of cutting mouth 17 can be any suitable shape, such as arc-shaped.The proximal edge of the cutting mouth 17 is apart from described curved
The distance of the distal end end face of bent structure 16 is 1-3mm, preferably 1mm.The cutting mouth 17 is set to the curved of the warp architecture 16
In the vertical direction of shape plane.The cutting mouth 17 can be set to any side of 16 bending of warp architecture, such as outside or
Inside.According to an embodiment of the present invention, the cutting mouth 17 is set to the outside of 16 bending of warp architecture.The cutting mouth
17 distal end can switch to the distal end end face of the warp architecture 16, can not also switch to the distal end of the warp architecture 16
Face, i.e. distal end end face of the distal end of cutting mouth 17 apart from the warp architecture 16 can have a certain distance.
When the needle point of the Interaurcular septum puncture needle is moved to cutting mouth 17, needle point and blood realize electric performance conducting, at this time
The display of Interaurcular septum puncture needle can be seen in three-dimensional mapping system and judges Interaurcular septum puncture needle in heart and blood vessel
Position.When expander superior vena cava slide when, it is described to cut since the distal end end face of the warp architecture 16 directly contacts tissue
It cuts mouth 17 not contact directly with tissue, Interaurcular septum puncture needle needle point can be eliminated, superior vena cava and endocardial tissue are caused to damage
Risk.Even if the distal end of the cutting mouth 17 switches to the distal end end face of the warp architecture 16, due to the atrial septal puncture
When the needle point of needle is moved to cutting mouth 17, only slightly exposing can be realized and be connected with blood, and the cutting mouth 17 not with group
Direct contact is knitted, tissue will not be caused to damage.
Interaurcular septum puncture needle can pass through in the central chamber of the tube body 15.The central lumen of the tube body 15 it is remote
End is ladder end face 19, and the distance of distal end end face of the ladder end face 19 apart from the warp architecture 16 is 8-9mm.Stepped end
Face 19 goes out needle length for limiting Interaurcular septum puncture needle, avoids out the too long bring of needle dangerous.
Expander 10 according to an embodiment of the present invention when in use, will first with the conduit with magnetic orientation device
Long sheath is sent into superior vena cava, is then exchanged for expander 10 and seal wire.Wherein seal wire remains at outside expander 10, when leading
When the head end of silk stretches out 10 1~2mm of outside of expander, the head end of seal wire can be shown in three dimension system, is maintained by three
System confirms that seal wire and expander are located at superior vena cava.Then seal wire is exchanged for Interaurcular septum puncture needle, is cut when needle point slightly exposes
When cutting mouth 17, needle point and blood realize electric performance conducting, can see Interaurcular septum puncture needle in three-dimensional mapping system at this time
It has been shown that, and judge position of the puncture needle in heart and blood vessel.The direction of puncture needle handle indicator and long sheath is coaxial, simultaneously
It pulls down, the movement of visible puncture needle in three dimension system.When the point of puncture that puncture needle slide to three dimension system marks, i.e. atrial septum
Oval hole site generally has the sense that falls through, and can try on, and breakthrough sense and cavity pressure variation are generally had when across interval.
It can be clearly apparent puncture needle in three dimension system at this time and enter atrium sinistrum.If there is visual fusion, be clear that puncture needle and
Left and right atrium and the isostructural three-dimensional relationship of aorta.
Shown in Fig. 4 is the distal end of the three-dimensional atrial septal puncture expander 100 of another embodiment according to the present invention
Structural schematic diagram；Shown in fig. 5 is the cross-sectional view of the line B-B along Fig. 4；Shown in fig. 6 is the enlarged drawing in Fig. 5 at I.It is described to cut
Cutting mouth 170 is horizontal cutting mouth, is set up along the axis of the expander.The cross section of the cutting mouth 170 can be to appoint
What suitable shape is also possible to irregular shape such as rectangle, ellipse, square.According to an embodiment of the present invention, such as
Shown in Fig. 4, Fig. 5 and Fig. 6, the cross section of the cutting mouth 170 is gradually to become from the proximal end of cutting mouth 170 to distal cross section product
It is small, it in the distal end endface close to the tube body 150, and becomes larger, this shape can guarantee the support of 150 distal end of tube body
Power.In the vertical direction for the bending plane that the cutting mouth 170 is set to the warp architecture.The distal end of the cutting mouth 170 can
To switch to the distal end end face of the warp architecture.Remaining structure of the three-dimensional atrial septal puncture expander 100 is the same as Fig. 2 to figure
Shown in 3.
Embodiments of the present invention are not limited to described in above-described embodiment, in feelings without departing from the spirit and scope of the present invention
Under condition, those of ordinary skill in the art can make various changes and improvement to the present invention in form and details, and these are
It has been considered within protection scope of the present invention.
Claims (10)
1. a kind of three-dimensional atrial septal puncture expander, it is characterised in that including tube body, the tube body includes central lumen, distal end
And proximal end, the distal end of the tube body are warp architecture, the distal end of the warp architecture is equipped with cutting mouth.
2. three-dimensional atrial septal puncture expander according to claim 1, it is characterised in that the cutting mouth is that inclination is cut
Cut mouth.
3. three-dimensional atrial septal puncture expander according to claim 2, it is characterised in that the proximal leg of the cutting mouth
The distance of distal end end face of the edge apart from the warp architecture is 1-3mm, preferably 1mm.
4. three-dimensional atrial septal puncture expander according to claim 1, it is characterised in that the cutting mouth is horizontal cutting
Mouth is cut, is set up along the axis of the expander.
5. three-dimensional atrial septal puncture expander according to claim 4, it is characterised in that cut the distal end of the cutting mouth
To the distal end end face of the warp architecture.
6. three-dimensional atrial septal puncture expander according to claim 4 or 5, it is characterised in that described to cut the transversal of mouth
Face is rectangle, ellipse, square or irregular shape.
7. the three-dimensional atrial septal puncture expander according to claim 4 or 5 or 6, it is characterised in that the cutting mouth
Cross section is to gradually become smaller from the proximal end of cutting mouth to distal cross section product, in the distal end endface close to the tube body, and by
Gradual change is big.
8. the three-dimensional atrial septal puncture expander according to any of the above-described claim, it is characterised in that the cutting mouth
In the vertical direction of the bending plane of the warp architecture；Preferably, the cutting mouth is set to the warp architecture bending
Outside.
9. the three-dimensional atrial septal puncture expander according to any of the above-described claim, it is characterised in that the tube body
The distal end of central lumen is ladder end face.
10. three-dimensional atrial septal puncture expander according to claim 9, it is characterised in that the stepped end identity distance is from institute
The distance for stating the distal end end face of warp architecture is 8-9mm.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810327781.3A CN110368071A (en) | 2018-04-12 | 2018-04-12 | Three-dimensional atrial septal puncture expander |
| PCT/CN2018/100751 WO2019196293A1 (en) | 2018-04-12 | 2018-08-16 | Dilator for three-dimensional transseptal puncture |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810327781.3A CN110368071A (en) | 2018-04-12 | 2018-04-12 | Three-dimensional atrial septal puncture expander |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN110368071A true CN110368071A (en) | 2019-10-25 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201810327781.3A Pending CN110368071A (en) | 2018-04-12 | 2018-04-12 | Three-dimensional atrial septal puncture expander |
Country Status (2)
| Country | Link |
|---|---|
| CN (1) | CN110368071A (en) |
| WO (1) | WO2019196293A1 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112438693A (en) * | 2020-12-09 | 2021-03-05 | 武汉佑康科技有限公司 | Combined endoscope with visual expansion function and head end capable of being accurately positioned |
Family Cites Families (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8317810B2 (en) * | 2008-12-29 | 2012-11-27 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Tissue puncture assemblies and methods for puncturing tissue |
| US9289297B2 (en) * | 2013-03-15 | 2016-03-22 | Cardiosolutions, Inc. | Mitral valve spacer and system and method for implanting the same |
| CN105431194A (en) * | 2013-07-29 | 2016-03-23 | 艾姆瑞科医疗***有限公司 | Actively tracked medical devices |
| CN106618749B (en) * | 2015-10-30 | 2019-07-19 | 四川锦江电子科技有限公司 | A kind of positioning conduit and the puncture arrangement for guiding using the positioning conduit |
| CN207101338U (en) * | 2016-08-09 | 2018-03-16 | 上海交通大学医学院附属新华医院 | Three-dimensional atrial septal puncture system |
-
2018
- 2018-04-12 CN CN201810327781.3A patent/CN110368071A/en active Pending
- 2018-08-16 WO PCT/CN2018/100751 patent/WO2019196293A1/en active Application Filing
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112438693A (en) * | 2020-12-09 | 2021-03-05 | 武汉佑康科技有限公司 | Combined endoscope with visual expansion function and head end capable of being accurately positioned |
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| Publication number | Publication date |
|---|---|
| WO2019196293A1 (en) | 2019-10-17 |
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