CN113893067A - Sleeve locking type conveying device for heart valve repair instrument - Google Patents
Sleeve locking type conveying device for heart valve repair instrument Download PDFInfo
- Publication number
- CN113893067A CN113893067A CN202111293145.1A CN202111293145A CN113893067A CN 113893067 A CN113893067 A CN 113893067A CN 202111293145 A CN202111293145 A CN 202111293145A CN 113893067 A CN113893067 A CN 113893067A
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- Prior art keywords
- sleeve
- limiting
- locking
- heart valve
- valve repair
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- 210000003709 heart valve Anatomy 0.000 title claims abstract description 46
- 230000008439 repair process Effects 0.000 title claims abstract description 45
- 230000000670 limiting effect Effects 0.000 claims description 166
- 238000007789 sealing Methods 0.000 claims description 4
- 230000015572 biosynthetic process Effects 0.000 claims description 2
- 230000002441 reversible effect Effects 0.000 claims description 2
- 230000002093 peripheral effect Effects 0.000 description 4
- 210000005240 left ventricle Anatomy 0.000 description 3
- 238000011160 research Methods 0.000 description 3
- 206010067660 Heart valve incompetence Diseases 0.000 description 2
- 206010067171 Regurgitation Diseases 0.000 description 2
- 230000032683 aging Effects 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 238000013461 design Methods 0.000 description 2
- 238000001514 detection method Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000003780 insertion Methods 0.000 description 2
- 230000037431 insertion Effects 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 230000036961 partial effect Effects 0.000 description 2
- 230000000149 penetrating effect Effects 0.000 description 2
- 230000000452 restraining effect Effects 0.000 description 2
- 208000010496 Heart Arrest Diseases 0.000 description 1
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 238000011835 investigation Methods 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 230000002829 reductive effect Effects 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 238000009958 sewing Methods 0.000 description 1
- 230000035882 stress Effects 0.000 description 1
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Classifications
-
- 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
- A61F2/2427—Devices for manipulating or deploying heart valves during implantation
- A61F2/243—Deployment by mechanical expansion
-
- 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
- A61F2/2427—Devices for manipulating or deploying heart valves during implantation
- A61F2/2436—Deployment by retracting a sheath
-
- 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
- A61F2/2427—Devices for manipulating or deploying heart valves during implantation
- A61F2/2439—Expansion controlled by filaments
-
- 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
- A61F2/2466—Delivery devices therefor
Landscapes
- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Transplantation (AREA)
- Biomedical Technology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Mechanical Engineering (AREA)
- Prostheses (AREA)
Abstract
The invention belongs to the technical field of medical instruments, and particularly relates to a conveying device. A sleeve locking type conveying device for a heart valve repair instrument comprises a shell, a mandrel and an outer tube; the mandrel part is positioned in the shell, and the distal end of the mandrel penetrates through the distal end of the shell and is detachably connected with the inner clip of the heart valve repair instrument; the outer tube is sleeved outside the mandrel, and the distal end of the outer tube penetrates through the distal end of the shell and is detachably connected with the sleeve of the heart valve repair instrument; the sleeve locking structure is arranged on the shell; the sleeve locking structure includes: and the locking assembly adjusts the relative positions of the outer pipe and the sleeve, and when the locking assembly adjusts the circumferential relative position of the outer pipe to a preset position, the sleeve can be separated from the outer pipe. The visible part of the invention is mainly divided into a shell and an outer tube, the two parts are both structures with certain hardness, the heart valve repair instrument can be conveyed and clamped by one person, and the operation is simpler and more convenient.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a conveying device.
Background
As China enters the population aging society, more and more heart valve regurgitation patients are present, and according to an investigation and research aiming at people of nearly 3 ten thousand and over 35 years old, the regurgitation detection rate of male and female heart valves in natural people of China is higher and is 18.4%, and the regurgitation detection rate also tends to increase along with the aging. The heart valve regurgitation phenomenon can be effectively reduced in the source heart valve repair operation, compared with the traditional thoracotomy operation, the transapical heart valve repair operation does not need thoracotomy, only needs a 3-4cm wound at the rib, and does not need cardiac arrest and extracorporeal blood circulation, so that the wound caused to a patient is smaller, the patient can get out of bed on the same day after the general operation, and the patient can be discharged out of hospital by one worship.
In the heart valve repair through the apex of the heart, many researches are still conducted on repair instruments, and the research focuses generally on how to improve the clamping force of an inner clamp and an outer clamp so as to prevent the valve leaflets from escaping, how to reduce the stress damage of the repair instruments to the valve leaflets during use, and the like. Some conveying devices are long in structure, and doctors need to stand at a higher position during operation, so that the operation is inconvenient.
Disclosure of Invention
The invention aims to solve the technical problem that the existing conveying device matched with a heart valve repair instrument is inconvenient to operate due to complex or long structure, and aims to provide a sleeve locking type conveying device for the heart valve repair instrument.
A sleeve locking type conveying device for a heart valve repair instrument comprises a shell, a mandrel and an outer tube;
the mandrel part is positioned in the shell, and the distal end of the mandrel penetrates through the distal end of the shell and is detachably connected with an inner clamp of the heart valve repair device;
the outer tube is sleeved outside the mandrel, and the distal end of the outer tube penetrates through the distal end of the shell and is detachably connected with a sleeve of the heart valve repair instrument;
the sleeve locking structure is arranged on the shell;
the sleeve locking structure includes:
and the locking assembly adjusts the relative positions of the outer pipe and the sleeve, and when the locking assembly adjusts the circumferential relative position of the outer pipe to a preset position, the sleeve can be separated from the outer pipe.
The conveying device further comprises:
and the inner pipe is positioned between the mandrel and the outer pipe, and the far end of the inner pipe is matched with the far end of the outer pipe to be detachably connected with the sleeve.
The far end of the inner pipe is provided with a sleeve circumferential limiting piece;
the far end of the outer pipe is provided with a sleeve axial limiting piece;
when the sleeve circumferential limiting piece and the sleeve axial limiting piece are coaxial, the sleeve is separated from the inner pipe and the outer pipe.
The end face of the far end of the inner pipe is provided with at least one first clamping piece along the axial direction, the first clamping piece is a sleeve circumferential limiting piece, and preferably, the first clamping piece is an inner pipe groove or an inner pipe circumferential protrusion;
and a second clamping piece is arranged on the inner wall of the far end of the outer pipe, and the second clamping piece is the sleeve axial limiting piece.
An axial limiting groove for preventing the outer pipe and the inner pipe from moving axially is further arranged in the shell.
The locking assembly comprises:
the locking handle is provided with a handle end and a locking ring which are mutually connected, the handle end extends out of the shell, the locking ring is positioned in the shell, a plurality of limiting jacks are axially arranged on one side surface of the locking ring, an outer pipe connecting part is arranged on the other side surface of the locking ring, and the outer pipe connecting part is fixedly connected with the near end of the outer pipe;
the locking limiting part can limit the circumferential rotation of the locking ring and can move in the shell along the axial direction, and a plug pin head is arranged at the end part of the locking limiting part and can be inserted into any one limiting jack so as to limit the relative position of the outer pipe and the sleeve;
when the circumferential relative position of the outer pipe needs to be adjusted, the locking limiting piece is moved, the bolt head is far away from a corresponding limiting jack, the locking ring is rotated through the handle end, the circumferential position of the outer pipe is adjusted to a preset position, the locking limiting piece is moved in the reverse direction, and the bolt head is connected with another limiting jack in an inserting mode.
A guide strip is arranged in the shell;
the locking limiting part adopts a bolt with the bolt head, a guide groove is axially arranged on the bolt, and the guide groove is in sliding connection with the guide strip.
The shell is also internally provided with a bolt limiting part for limiting the axial moving distance of the bolt;
the bolt is provided with a plurality of bolt limiting grooves, and the bolt limiting grooves are connected with the bolt limiting parts in a clamping mode.
A handle limiting plate is further arranged in the shell and is positioned on the side edge of the locking ring or the peripheral surface of the locking ring;
and a locking limiting strip is arranged on the side surface of one side of the locking ring, and when the locking ring rotates, the end surface of the locking limiting strip can abut against the handle limiting plate, so that the circumferential motion amplitude of the locking ring is limited.
The near ends of the inner pipe and the outer pipe are provided with emptying valves;
a sealing gasket is arranged between the inner tube and the mandrel, and another sealing gasket is arranged between the inner tube and the outer tube. So as to avoid air entering the body or blood flowing out from the gap between the mandrel and the inner tube or between the inner tube and the outer tube.
The casing has the cavity of terminal surface open-ended for near-end terminal surface and distal end terminal surface, the casing preferably includes first casing and second casing, first casing with the connection formation can be dismantled to the second casing the cavity.
The positive progress effects of the invention are as follows: the sleeve locking type conveying device for the heart valve repair instrument has the following remarkable advantages that:
1. the visible part is mainly divided into a shell and an outer tube, the two parts are both structures with certain hardness, the heart valve repair instrument can be conveyed and clamped by one person, and the operation is simpler and more convenient;
2. on one hand, the core pipe and the inner pipe with insufficient hardness are hidden by the design of the shell, and form a rigid whole with the outer pipe, so that the operation is convenient; on the other hand, a plurality of limiting plates, limiting grooves, accommodating cavities and the like are further arranged in the device, so that the axial and circumferential motion amplitude of each part is limited, and the stability of the product is better.
Drawings
FIG. 1 is a schematic view of an overall structure of the present invention;
FIG. 2 is a schematic view of a portion of the interior of the housing of the present invention;
FIG. 3 is a partial schematic structural view of the present invention;
FIG. 4 is a schematic view of one construction of the gear assembly of the present invention;
FIG. 5 is a schematic view of the relative positions of the outer tube, inner tube and mandrel of the present invention;
FIG. 6(a) is a partially enlarged schematic view of FIG. 5;
FIG. 6(b) is another enlarged partial schematic view of FIG. 5;
FIG. 7 is a schematic view of the structure of the axial limiting structure and the axial conveying structure of the present invention;
FIG. 8 is an enlarged view of a portion of FIG. 7;
FIG. 9 is a schematic structural view of another axial limiting structure of the present invention;
FIG. 10 is another schematic view of the structure of FIG. 9;
FIG. 11 is a schematic view of another axial stop arrangement in accordance with the present invention in combination with an axial transport arrangement;
FIG. 12 is a schematic view of an axial stop arrangement of FIG. 11;
FIG. 13 is a schematic view of a portion of the structure of FIG. 12;
FIG. 14 is a cross-sectional view of FIG. 13;
FIG. 15 is a schematic view of a spacing sleeve according to the present invention;
FIG. 16 is a cross-sectional view of FIG. 15;
FIGS. 17(a) to 17(d) are schematic views showing a structure of the closure handle of the present invention;
FIGS. 18(a) to 18(c) are schematic views showing another structure of the locking handle of the present invention;
FIG. 19 is a schematic view of a locking limiter according to the present invention.
Detailed Description
In order to make the technical means, the creation characteristics, the achievement purposes and the effects of the invention easy to understand, the invention is further described with the specific drawings.
Referring to fig. 1 to 19, a sleeve-locking delivery device for a heart valve repair apparatus includes a housing 100, an inner clip delivery structure 200, a mandrel 210, a sleeve-locking structure 300, an inner tube 310, and an outer tube 320.
The housing 100 is a hollow cavity with end openings at the proximal end face and the distal end face, and the housing 100 preferably includes a first housing 110 and a second housing 120, and the first housing 110 and the second housing 120 are detachably connected to form the hollow cavity. The casing 100 is provided with a plurality of limiting plates, limiting grooves or accommodating cavities, so as to limit the axial movement distance and the circumferential movement amplitude of each component of the inner clamping conveying structure 200, the mandrel 210, the sleeve locking structure 300, the inner tube 310 and the outer tube 320, specifically:
the housing 100 is provided therein with a gear receiving cavity 130, a gear assembly support plate 140, an axial direction limiting groove, a meshing cylindrical portion limiting plate 150, a guide bar 160, a bolt limiting portion, a handle limiting plate, and the like. The gear receiving cavity 130 is used to receive the gear 221, the gear assembly support plate 140 is located in the gear receiving cavity 130, and the gear assembly support plate 140 is used to support the gear 221. The axial restraint slots may prevent axial movement of the outer tube 320 and the inner tube 310. The meshing cylinder limiting plate 150 is located on the side of the distal end of the gear accommodating cavity 130, and a meshing cylinder limiting hole is formed in the meshing cylinder limiting plate 150 and is used for being penetrated by the distal end of the spindle 210 and limiting the meshing cylinder 230, so that the meshing cylinder limiting plate 150 limits the axial movement distance of the meshing cylinder 230. The guide bar 160 is slidably coupled to the guide slot 336 of the latch to limit the direction of movement of the latch. The bolt limiting part is used for limiting the axial moving distance of the bolt. The handle limiting plate is located on the side of the locking ring 332 or the periphery of the locking ring 332, and the handle limiting plate is used for limiting the circumferential movement amplitude of the locking ring 332.
Referring to fig. 1-3, the internal clamp delivery structure 200 includes an axial delivery structure 220, an engagement cylinder portion 230, an axial stop structure 250, and a release structure. The inner clip delivery structure 200 is used to deliver a mandrel 210.
Portions of the mandrel 210 are located within the housing 100, and the distal end of the mandrel 210 passes through the distal end of the housing 100 and is removably coupled to the inner clip of the heart valve repair device. The mandrel 210 may move the inner clamp of the heart valve repair device in an axial direction.
The proximal end of the stem 210 is sleeved with an engaging cylinder 230, and a rack is provided on the outer circumferential surface of the engaging cylinder 230. The outer circumferential surface of the engaging cylindrical portion 230 is also cut in the axial direction so that the engaging cylindrical portion 230 forms a non-cylindrical portion of a non-cylindrical structure. The tangent plane on the engaging cylindrical portion 230 is a flat plane. The distal end of the stem 210 passes through the engaging stud portion limiting hole, and the engaging stud portion limiting plate 150 limits the engaging stud portion 230, so that the engaging stud portion limiting plate 150 limits the axial movement distance of the engaging stud portion 230.
The axial conveying structure 220 drives the mandrel 210 to move axially, and further drives the inner clamp of the heart valve repair apparatus to move axially. Referring to fig. 4, the axial transport structure 220 preferably employs a gear assembly including a gear 221, a gear handle 222, a gear shaft 223, and a gear positioning pin. The gear 221 is preferably located above the rack, and the gear 221 may be in meshed engagement with the rack or may be remote from the rack. The gear handle 222 is located outside the housing 100, the gear handle 222 is fixed with the gear 221 through a gear shaft 223 penetrating through the housing 100, the axial direction of the gear shaft 223 is intersected with the axial direction of the spindle 210, and the gear handle 222 drives the gear 221 to rotate, so as to drive the spindle 210 to move along the axial direction. The gear shaft 223 is provided with a plurality of gear positioning rings 224 or gear positioning holes matched with the gear positioning pins along the axial direction of the gear shaft 223, and as shown in fig. 4, two gear positioning rings 224 are arranged on the gear shaft 223. The gear shaft 223 passes through the gear receiving cavity 130 and the gear 221 assembly support plate 140 from one side of the housing 100 in order and then faces the opposite side of the housing 100. The gear positioning pin is fixed in the gear receiving cavity 130, and faces the gear shaft 223. The gear positioning rings 224 or the gear positioning holes can be respectively matched with the gear positioning pins in a positioning way.
In an initial state, at least one of the gear positioning rings 224 or the gear positioning holes is matched and positioned with the gear positioning pin, the gear 221 is far away from the rack, when the spindle 210 needs to be moved axially, the gear shaft 223 is pushed into the housing 100 or pushed out of the housing 100 through the gear handle 222, at least another one of the gear positioning rings 224 or the gear positioning holes is matched and positioned with the gear positioning pin, the gear 221 is meshed with the gear 221, and at the moment, the spindle 210 is driven to move axially through rotating the gear handle 222. So that the invention realizes the engagement or separation of the gear and the rack by pushing the gear handle.
Referring to fig. 7 and 8, the axial stopper structure 250 includes an axial stopper hole 251, an axial stopper portion 252, at least two axial stopper rings 253, a stopper guide plate 254, and an elastic stopper ball 255.
An axial restraint hole 251 is provided in the spindle 210 or the engagement cylinder 230. One end of the axial limiting portion 252 extends out of the casing 100, and the other end of the axial limiting portion 252 is located in the casing 100 and can extend into or out of the axial limiting hole 251. The axial limiting portion 252 may be a positioning post, a positioning rod, or a pin.
At least two axial limiting rings 253 are arranged on the axial limiting part 252 along the periphery. A limiting guide plate 254 is arranged in the housing 100, a guide groove 2541 is dug on the limiting guide plate 254, the guide groove 2541 is positioned above the axial limiting hole 251, an elastic limiting ball 255 which is matched with the axial limiting ring 253 for limiting is further arranged on the limiting guide plate 254, and the elastic limiting ball 255 is positioned below the guide groove 2541. The gear handle drives the gear to rotate, and then drives the mandrel 210 to move to a preset position along the axial direction, the axial limiting portion 252 is pressed to extend into the axial limiting hole 251, one axial limiting ring 253 is clamped and positioned with the elastic limiting ball 255 to prevent the mandrel 210 from moving along the axial direction, when the mandrel 210 needs to move along the axial direction, the axial limiting portion 252 is pulled out to extend out of the axial limiting hole 251 to release the mandrel 210, the other axial limiting ring 253 is clamped and limited with the elastic limiting ball 255, the gear is driven to rotate through the gear handle again, and then the mandrel 210 is driven to move along the axial direction.
Referring to fig. 9 and 10, the axial restraint structure 250 may also include an axial restraint hole 251, an axial restraint portion 252, a restraint bracket 256, a restraint baffle 257, and a resilient member 258.
An axial restraint hole 251 is provided in the spindle 210 or the engagement cylinder 230. One end of the axial limiting portion 252 extends out of the casing 100, and the other end of the axial limiting portion 252 is located in the casing 100 and can extend into or out of the axial limiting hole 251. The axial limiting portion 252 may be a positioning post, a positioning rod, or a pin. The outer peripheral surface of the axial limiting portion 252 is provided with a limiting flange, and the limiting flange is located outside the housing 100. So as to limit the maximum distance that the axial restraining portion 252 extends into the axial restraining hole 251.
The limiting support 256 is arranged in the casing 100, a limiting through hole 2561 is formed in the limiting support 256, the limiting through hole 2561 is penetrated by the axial limiting portion 252, and a limiting support plate 2562 is arranged on at least one edge of the limiting support 256. The limit supporting plate 2562 is preferably an L-shaped supporting plate, and the limit baffle 257 is located on the transverse section of the limit supporting plate 2562. So that the axial stopper 252 is pulled out and reversely rotated to limit the rotation amplitude thereof when the mandrel 210 needs to be released. The opposite side of the limit support plate 2562 may be provided with a vertical auxiliary limit plate 2563, the auxiliary limit plate 2563 being located at one side of the vertical section away from the limit support plate 2562. So that the axial limiting portion 252 limits the positioning of the spindle 210 to only one direction of rotation.
Two limiting baffle plates 257 are symmetrically arranged on the outer peripheral surface of the axial limiting portion 252, one of the limiting baffle plates 257 is arranged on the transverse section of the limiting support plate 2562, an elastic element 258 is sleeved on the axial limiting portion 252, the elastic element 258 is limited between the limiting baffle plates 257 and the inner wall of the shell 100, and the elastic element 258 is preferably a spring.
Under the supporting and limiting of the limiting baffle 257 by the limiting support plate 2562, the elastic element 258 is in a compressed state, the axial limiting portion 252 extends out of the axial limiting hole 251, when the mandrel 210 needs to be prevented from moving towards the near end along the axial direction, the axial limiting portion 252 is rotated, the limiting baffle 257 is far away from the limiting support plate 2562, the elastic element 258 resets to push the axial limiting portion 252 downwards, and the axial limiting portion 252 extends into the axial limiting hole 251. When the mandrel 210 needs to move in the axial direction, the axial restraint portion 252 is pulled out and reversed so that the restraint flapper 257 returns to the lateral section of the restraint support plate 2562 to release the mandrel 210.
Referring to fig. 11 to 16, the axial limiting structure 250 may also adopt the following structure:
the axial limiting structure 250 includes an axial limiting hole 261, a limiting sleeve 262, a limiting button 263, a limiting rod 264, a first elastic element 265 and a second elastic element 266.
An axial stop hole 261 is provided in the spindle 210 or the engagement cylinder 230.
The limiting sleeve 262 is fixed in the casing 100, the limiting sleeve 262 is a hollow cylindrical structure with open upper and lower end faces, two symmetrical slide bar guide grooves 2621 are arranged on the inner wall of the limiting sleeve 262, each slide bar guide groove 2621 comprises a first vertical guide groove a1, a second transverse guide groove a2, a third oblique guide groove a3 and a fourth curved guide groove a4 which are connected in sequence, and the third oblique guide groove a3 is located below the second transverse guide groove a 2.
The upper portion of the limit button 263 extends out of the housing 100, the lower portion of the limit button 263 is a hollow structure with an open bottom surface, the bottom of the limit button 263 is provided with a ratchet 2631, the outer peripheral surface of the lower portion of the limit button 263 is provided with two sliding rods 2632, and one sliding rod 2632 is correspondingly arranged in one sliding rod guide groove 2621 and can slide along the sliding rod guide groove 2621. A stopper flange 2633 is provided on an upper outer circumferential surface of the stopper button 263, and the stopper flange 2633 is located outside the housing 100. So as to limit the maximum distance that the axial stopper portion 252 extends into the axial stopper hole 261.
The limiting rod 264 is of an integral T-shaped structure, the bottom of the limiting rod 264 can extend into or out of the axial limiting hole 261, the periphery of the top of the limiting rod 264 is provided with a movable ratchet 2641 matched with the ratchet 2631, the middle of the top of the limiting rod is provided with a limiting cylinder 2642 protruding upwards, the limiting cylinder 2642 is inserted into the bottom surface of the limiting button 263, and the limiting cylinder 2642 limits the first elastic element 265 in the hollow structure of the limiting button 263. The first elastic member 265 is preferably a spring.
The second elastic element 266 is sleeved on the lower part of the limiting rod 264. The second resilient element 266 is preferably a spring.
When the gear handle drives the gear to rotate, and further drives the mandrel 210 to move axially to a preset position, the limit button 263 is pressed, the two sliding rods 2632 slide downwards along the first vertical guide groove a1 to the second horizontal guide groove a2 in the corresponding sliding rod guide grooves 2621, the limit button 263 is released, under the limitation of the first elastic element 265, the two sliding rods 2632 are located in the second horizontal guide groove a2, at this time, the bottom of the limit rod 264 extends into the axial limit hole 261 to prevent the mandrel 210 from moving axially, when the mandrel 210 needs to move axially, the limit button 263 is pressed and rotated, the two sliding rods 2632 return along the second horizontal guide groove a2 to the third horizontal guide groove a3 in the corresponding sliding rod guide grooves 2621, the limit button 263 is released, under the reset of the second elastic element 266, the two sliding rods 2632 return along the fourth curved guide groove a4, the bottom of the limit rod 264 extends out of the axial limit hole 261 to release the mandrel 210, the gear handle drives the gear to rotate again, and then the mandrel 210 is driven to move along the axial direction.
Referring to fig. 2 and 6, a release mechanism is used to release the inner clamp at the distal end of the mandrel 210. The release structure includes a release rotating member 241 and an inner clip connecting portion 242. The proximal end of the releasing rotating member 241 extends out of the proximal end of the housing 100, the distal end of the releasing rotating member 241 is connected to the proximal end of the engaging cylinder 230 in a sleeved manner, due to the arrangement of the upper tangent plane of the engaging cylinder 230, when the releasing rotating member 241 rotates, the engaging cylinder 230 rotates along with the rotating, and further the mandrel 210 connected with the engaging cylinder 230 is driven to rotate together, when the engaging cylinder 230 moves along the axial direction, the releasing rotating member 241 cannot be driven to move axially, and the releasing rotating member 241 can also serve as a proximal end limiting portion of the engaging cylinder 230, so as to limit the moving distance of the engaging cylinder 230 towards the proximal end. The inner clip connecting portion 242 is disposed at the distal end of the mandrel 210 for threaded or snap-fit connection with the inner clip. As shown in fig. 6, the inner clamp connection 242 is an external thread provided at the distal end of the mandrel 210. When the release rotating member 241 is rotated, the core shaft 210 is driven to rotate, and the inner clamp connecting portion 242 is driven to rotate to separate the inner clamp.
Referring to fig. 1-3, the sleeve locking structure 300 includes a locking assembly 330, an evacuation valve 340, and a gasket.
The inner tube 310 is an optional structure of the present invention, the inner tube 310 is sleeved outside the mandrel 210, and the proximal end of the mandrel 210 extends out of the inner tube 310, and the engaging column 230 is sleeved on the extending portion of the mandrel 210. The distal end of the inner tube 310 is adapted to mate with the distal end of the outer tube 320 and then removably attach to the sleeve of the heart valve repair device. The far end of the inner tube 310 is provided with a sleeve circumferential limiting part, the far end face of the inner tube 310 is provided with at least one first clamping part along the axial direction, the first clamping part is the sleeve circumferential limiting part, and the first clamping part is an inner tube groove 311 or an inner tube circumferential protrusion 312. As shown in fig. 6(a), the distal end surface of the inner tube 310 is axially dug with at least one inner tube groove 311, and the inner tube groove 311 is a sleeve circumferential stopper. As shown in fig. 6(b), at least one inner tube circumferential protrusion 312 is axially provided on the outer wall of the distal end face of the inner tube 310. In practical use, at least one sleeve groove is dug on the proximal end part of the sleeve towards the distal end, and the inner pipe 310 is inserted into the inner pipe groove 311 through the sleeve groove to limit the circumferential movement of the sleeve.
The outer tube 320 is disposed outside the inner tube 310, and the distal end of the inner tube 310 does not extend beyond the distal end of the outer tube 320 during the use of the present invention. The distal end of the outer tube 320 passes through the distal end of the housing 100, i.e., the distal end of the outer tube 320 extends out of the housing 100, and the distal end of the outer tube 320 is detachably connected to the sleeve of the heart valve repair device. Preferably, the distal end of the outer tube 320 is provided with a sleeve axial limiting member, as shown in fig. 6, the inner wall of the distal end of the outer tube 320 is provided with a second locking member 321, and the second locking member 321 is a sleeve axial limiting member. The sleeve bulge is arranged on the outer circumferential surface of the sleeve, at least one clamping groove for penetrating through the clamping piece 321 is formed in the sleeve bulge, and in practical use, the sleeve bulge of the sleeve is limited to the proximal end side of the clamping piece 321, so that the outer tube 320 limits axial movement of the sleeve.
The locking assembly 330 is used for adjusting the circumferential relative position of the outer tube 320 and the sleeve, and when the locking assembly 330 adjusts the circumferential relative position of the outer tube 320 to a preset position, the sleeve is disengaged from the outer tube 320. The predetermined position is preferably when the sleeve circumferential limiter and the sleeve axial limiter are coaxial, and the sleeve is separated from the inner tube 310 and the outer tube 320.
Referring to fig. 3, 17-19, the locking assembly 330 includes a locking handle and a locking stop.
The locking handle has a handle end 331 and a locking ring 332 connected to each other. The handle end 331 extends out of the casing 100, the locking ring 332 is located in the casing 100, a plurality of limiting insertion holes 333 are axially arranged on one side surface of the locking ring 332, an outer tube connecting part 334 is arranged on the other side surface of the locking ring 332, and the outer tube connecting part 334 is fixedly connected with the proximal end of the outer tube 320. The locking limiting strip 3321 is provided on one side surface of the locking ring 332, the locking limiting strip 3321 is an arc strip or a plurality of protrusions, the shape of the locking limiting strip 3321 is not limited as long as the locking limiting strip can be matched with the handle limiting plate, as shown in fig. 17(a) to 17(d), the locking limiting strip 3321 provided on one side surface of the locking ring 332 is an arc strip, and the arc strip can be provided on any side surface of the locking ring 332. As shown in fig. 18(a) to 18(c), the locking stopper 3321 provided on one side surface of the locking ring 332 is a plurality of protrusions, and the protrusions may be provided on either side surface of the locking ring 332. When the locking ring 332 rotates, the end surface of the locking limit bar 3321 can abut against the handle limit plate, so that the circumferential movement amplitude of the locking ring 332 is limited.
The locking limiting piece can limit the locking ring 332 to rotate circumferentially, the locking limiting piece can move axially in the housing 100, the end of the locking limiting piece is provided with a pin head 335, and the pin head 335 can be inserted into any one limiting insertion hole 333 to limit the relative position of the outer pipe 320 and the sleeve. When the circumferential relative position of the outer tube 320 needs to be adjusted, the locking limiting piece is moved, the bolt head 335 is far away from the corresponding limiting jack 333, the locking ring 332 is rotated through the handle end 331, the circumferential position of the outer tube 320 is adjusted to the preset position, the locking limiting piece is moved reversely, the bolt head 335 is inserted into the other limiting jack 333, and the circumferential rotation of the locking ring 332 is limited at the moment. Referring to fig. 19, the locking position limiter is preferably a pin having a pin head 335 with a guide slot 336 axially disposed therein, the guide slot 336 slidably engaging the guide bar 160. A plurality of bolt limiting grooves 337 are arranged on the bolt, and the bolt limiting grooves 337 are connected with the bolt limiting parts in a clamping manner. A latch handle 338 may also be provided on the latch to facilitate moving the latch in an axial direction. The design can limit the movement direction and the movement distance of the bolt.
The proximal ends of the inner tube 310 and the outer tube 320 are each provided with an evacuation valve 340. A seal is provided between the inner tube 310 and the mandrel 210, and another seal is provided between the inner tube 310 and the outer tube 320. To avoid air entering the body or blood flowing out of the gap between the mandrel 210 and the inner tube 310 or the inner tube 310 and the outer tube 320.
Before the heart valve repair device is matched with the heart valve repair device for use, the inner clamp connecting part 242 at the distal end of the mandrel 210 is detachably connected with an inner clamp of the heart valve repair device, and a sleeve of the heart valve repair device is inserted into the inner tube 310 and is positioned on the outer tube 320. When in use, the process is as follows:
1. cutting 4-6 cm between the fourth and fifth ribs of the left chest of the patient, exposing the apex of the heart, and sewing the purse-string at the apex of the heart. Then a puncture needle is used for puncturing the left ventricle in the center of the purse string, a guide wire is fed along the middle hole of the puncture needle, and the puncture needle is pulled out;
2. the catheter sheath and the dilator are fed along the guide wire, the components are not included in the invention, the catheter sheath is used for providing a passage for the conveying device, the dilator is used for expanding the hole on the apex of the heart, the conveying device can conveniently enter the left ventricle through the apex of the heart, and after the dilator expands the hole on the apex of the heart, the work of the guide wire and the dilator is finished, and the guide wire and the dilator exit to the outside of the body.
3. After the gas in the conveying device is emptied by normal saline and the like, the conveying device is conveyed along a catheter sheath, the conveying device penetrates through the apex of the heart and enters the left ventricle, the gear handle 222 of the gear assembly is pushed inwards to the bottom, the gear 221 is in contact engagement with the rack, the gear handle 222 is rotated, the far end of the mandrel 210 is taken out of the inner tube 310 and the outer tube 320, the mandrel 310 pushes the inner clamp of the heart valve repair device, the inner clamp drives the outer clamp to leave the sleeve, the inner clamp spans the heart valve and is called as a cross valve, the outer clamp supports valve blades of the heart valve, when appropriate, the mandrel 210, the inner clamp and the outer clamp are driven to move towards the near end direction by reversely rotating the gear handle 222, and the inner clamp and the outer clamp are retracted into the sleeve after the valve blades are captured by the inner clamp, and the valve blades are clamped.
4. After confirming that the pinch is intact, the heart valve repair device is ready to be released. The gear handle 222 is pulled outwards to separate the gear 221 from the rack, so as to prevent the spindle 210 from moving axially by rotating the gear handle 222 inadvertently. The release rotating member 241 is rotated counterclockwise to drive the mandrel 210 to rotate in the same direction, and the inner clamp connecting portion 242 at the distal end of the mandrel 210 is gradually separated from the inner clamp of the heart valve repair apparatus. After the inner clamp is disengaged, the latch head 335 is moved, the locking ring 332 is rotated via the handle end 331, the latch head 335 is moved to insert the locking ring 332, and the delivery device and sheath are withdrawn, completing the procedure.
The foregoing shows and describes the general principles, essential features, and advantages of the invention. It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, which are described in the specification and illustrated only to illustrate the principle of the present invention, but that various changes and modifications may be made therein without departing from the spirit and scope of the present invention, which fall within the scope of the invention as claimed. The scope of the invention is defined by the appended claims and equivalents thereof.
Claims (11)
1. A sleeve locking type conveying device for a heart valve repair instrument comprises a shell, a mandrel and an outer tube;
the heart valve repair instrument is characterized in that the mandrel part is positioned in the shell, and the distal end of the mandrel penetrates through the distal end of the shell and is detachably connected with an inner clamp of the heart valve repair instrument;
the outer tube is sleeved outside the mandrel, and the distal end of the outer tube penetrates through the distal end of the shell and is detachably connected with a sleeve of the heart valve repair instrument;
the sleeve locking structure is arranged on the shell;
the sleeve locking structure includes:
and the locking assembly adjusts the relative positions of the outer pipe and the sleeve, and when the locking assembly adjusts the circumferential relative position of the outer pipe to a preset position, the sleeve can be separated from the outer pipe.
2. The sleeve-locked delivery device for a heart valve repair instrument of claim 1, further comprising:
and the inner pipe is positioned between the mandrel and the outer pipe, and the far end of the inner pipe is matched with the far end of the outer pipe to be detachably connected with the sleeve.
3. The sleeve-locked delivery device for a heart valve repair apparatus of claim 2, wherein the distal end of the inner tube is provided with a sleeve circumferential stop;
the far end of the outer pipe is provided with a sleeve axial limiting piece;
when the sleeve circumferential limiting piece and the sleeve axial limiting piece are coaxial, the sleeve is separated from the inner pipe and the outer pipe.
4. The sleeve locking delivery device for the heart valve repair instrument according to claim 3, wherein the distal end face of the inner tube is provided with at least one first detent member along the axial direction, the first detent member is the sleeve circumferential limit member, preferably, the first detent member is an inner tube groove or an inner tube circumferential protrusion;
and a second clamping piece is arranged on the inner wall of the far end of the outer pipe, and the second clamping piece is the sleeve axial limiting piece.
5. The sleeve-locking delivery device for a heart valve repair apparatus of claim 2, wherein an axial limiting groove for preventing the outer tube and the inner tube from moving axially is further provided in the housing.
6. The sleeve-latching delivery apparatus for a heart valve repair device of any of claims 1 to 5, wherein the latching assembly comprises:
the locking handle is provided with a handle end and a locking ring which are mutually connected, the handle end extends out of the shell, the locking ring is positioned in the shell, a plurality of limiting jacks are axially arranged on one side surface of the locking ring, an outer pipe connecting part is arranged on the other side surface of the locking ring, and the outer pipe connecting part is fixedly connected with the near end of the outer pipe;
the locking limiting part can limit the circumferential rotation of the locking ring and can move in the shell along the axial direction, and a plug pin head is arranged at the end part of the locking limiting part and can be inserted into any one limiting jack so as to limit the relative position of the outer pipe and the sleeve;
when the circumferential relative position of the outer pipe needs to be adjusted, the locking limiting piece is moved, the bolt head is far away from a corresponding limiting jack, the locking ring is rotated through the handle end, the circumferential position of the outer pipe is adjusted to a preset position, the locking limiting piece is moved in the reverse direction, and the bolt head is connected with another limiting jack in an inserting mode.
7. The sleeve-locking delivery device for a heart valve repair instrument of claim 6, wherein a guide strip is disposed within the housing;
the locking limiting part adopts a bolt with the bolt head, a guide groove is axially arranged on the bolt, and the guide groove is in sliding connection with the guide strip.
8. The sleeve-locking delivery device for a heart valve repair apparatus of claim 6, wherein a pin-limiting portion is further disposed in the housing for limiting an axial movement distance of the pin;
the bolt is provided with a plurality of bolt limiting grooves, and the bolt limiting grooves are connected with the bolt limiting parts in a clamping mode.
9. The sleeve-locking delivery device for heart valve repair instruments according to claim 6, wherein a handle-limiting plate is further disposed in the housing and located at a side of the locking ring or on a circumferential surface of the locking ring;
and a locking limiting strip is arranged on one side surface of the locking ring, and when the locking ring rotates, the end surface of the locking limiting strip can abut against the handle limiting plate, so that the circumferential motion amplitude of the locking ring is limited.
10. The sleeve-locked delivery device for a heart valve repair apparatus of claim 2, wherein the proximal ends of the inner tube and the outer tube are each provided with a drain valve;
a sealing gasket is arranged between the inner tube and the mandrel, and another sealing gasket is arranged between the inner tube and the outer tube.
11. The sleeve-locked delivery device for a heart valve repair apparatus of claim 1, wherein the housing is a hollow cavity having end openings at a proximal end face and a distal end face;
the casing includes first casing and second casing, first casing with the connection formation can be dismantled to the second casing the cavity.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111293145.1A CN113893067A (en) | 2021-11-03 | 2021-11-03 | Sleeve locking type conveying device for heart valve repair instrument |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111293145.1A CN113893067A (en) | 2021-11-03 | 2021-11-03 | Sleeve locking type conveying device for heart valve repair instrument |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN113893067A true CN113893067A (en) | 2022-01-07 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202111293145.1A Pending CN113893067A (en) | 2021-11-03 | 2021-11-03 | Sleeve locking type conveying device for heart valve repair instrument |
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| CN (1) | CN113893067A (en) |
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| CN216754727U (en) * | 2021-11-03 | 2022-06-17 | 科凯(南通)生命科学有限公司 | Sleeve locking structure for heart valve repair instrument |
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| EP0654246A1 (en) * | 1993-11-18 | 1995-05-24 | DELMA ELEKTRO-UND MEDIZINISCHE APPARATEBAU GESELLSCHAFT mbH | Medical instrument with a central working rod and with a handle |
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