CN212630962U - Prosthetic valve and valve delivery system - Google Patents
Prosthetic valve and valve delivery system Download PDFInfo
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- CN212630962U CN212630962U CN202021804134.6U CN202021804134U CN212630962U CN 212630962 U CN212630962 U CN 212630962U CN 202021804134 U CN202021804134 U CN 202021804134U CN 212630962 U CN212630962 U CN 212630962U
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Abstract
The utility model discloses a prosthetic valve and a valve conveying system, the prosthetic valve comprises a top support, a middle support and a bottom support, the top support, the middle support and the bottom support are connected in sequence, at least three locking supports are arranged on the top support along the circumferential direction, the top end of each locking support is provided with a locking end, and the middle support is provided with at least three membrane leaf fixing parts; under the unlocking state of each locking end, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 1, under the locking state of each locking end, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 2, and the phi 2 is greater than or equal to 74% of the phi 1. The utility model discloses can realize the nearly full height of valve under the lock-out condition and release in advance, the doctor can be in advance abundant judgement implant back valve's behavior to follow-up adjustment direction to the implantation strategy of better definite.
Description
Technical Field
The utility model belongs to the field of medical equipment, concretely relates to artificial valve and valve conveying system.
Background
Aortic valve disease is a common heart valve disease, and its incidence rate gradually increases with age.
At present, the pathological valve of a patient is usually replaced by a prosthetic heart valve through a surgical method, but the method is not suitable for patients who are partially aged and have the problems of disease combination and the like. Aiming at the patients, the artificial heart valve replacement can be carried out by adopting a minimally invasive transcatheter aortic valve implantation mode, and the transcatheter aortic valve implantation mode does not need to open the chest and has the advantages of small wound, quick recovery and the like, so that the artificial heart valve replacement is more and more widely paid attention and paid attention.
Since the advent of transcatheter aortic valve implantation, valve delivery devices with various functions have been proposed by manufacturers, one important criterion being recyclability. Before the valve is finally released, the valve is usually partially released, and the implantation position of the transcatheter aortic valve is determined whether to be proper or not by evaluating the hydrodynamic index of the partially released (pre-released) valve. Retrievability means that the transcatheter aortic valve device can be retrieved.
The full-height pre-release of the valve is beneficial to the doctor to fully judge the working condition of the valve after implantation in advance, thereby better determining the subsequent adjustment direction of the implantation strategy.
However, the existing valves cannot realize full-height pre-release, the valve needs to be locked and restrained by a sheath tube during release, and the sheath tube of the device cannot allow the valve to retreat within the full-height range during pre-release, so that the valve cannot be completely released, namely completely recoverable, and a doctor cannot fully judge the working condition of the implanted valve in advance.
Disclosure of Invention
An object of the utility model is to provide a prosthetic valve and valve conveying system, the utility model discloses can realize the full height of being close of valve under the lock-out condition and release in advance, the doctor can be abundant judgement in advance implants the operational aspect of back valve to follow-up adjustment direction to the implantation strategy of better definite.
The technical scheme is as follows:
the utility model provides a prosthetic valve, which comprises a top bracket, a middle bracket and a bottom bracket, wherein the top bracket, the middle bracket and the bottom bracket are sequentially connected, at least three locking brackets are arranged on the top bracket along the circumferential direction, the top end of each locking bracket is provided with a locking end, and the middle bracket is provided with at least three membrane leaf fixing parts; under the unlocking state of each locking end, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 1, under the locking state of each locking end, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 2, and the phi 2 is greater than or equal to 74% of the phi 1.
In one embodiment, the middle support is provided with an anchoring frame which is protruded in the circumferential direction and faces the direction of the bottom support.
In one embodiment, the anchor frame includes a fixed section that protrudes outward in a circumferential direction relative to the middle bracket and a free section that is bent inward in the circumferential direction relative to the fixed section.
In one embodiment, the anchor frame has two fixed sections and two free sections, the upper ends of the two fixed sections are connected to the middle support, and the ends of the two free sections are butted.
In one embodiment, the ends of the two free sections are butted to form a tip, with perforations provided in the tip.
In one embodiment, a protective sleeve and/or a developing positioning member is provided on the perforation.
In one embodiment, Φ 2 is 74% to 120% of Φ 1.
In one embodiment, the structural rigidity of the top bracket is less than the structural rigidity of the middle bracket.
In one embodiment, the middle bracket comprises three suture rods, the suture rods are the membrane leaf fixing parts, the locking brackets are three, and the structural rigidity of the locking end of each locking bracket is 5% to 50% of the structural rigidity of the suture rod.
In one embodiment, the middle bracket comprises three suture rods, the suture rods are the membrane leaf fixing parts, the locking brackets are six, and the structural rigidity of the locking end of each locking bracket is 3-45% of that of the suture rods.
In one embodiment, a plurality of membrane leaf fixing holes are formed in the membrane leaf fixing part.
In one embodiment, the circumferential diameter of the bottom bracket gradually increases towards the bottom to form a trumpet shape.
In one embodiment, the bottom bracket is provided with a circumferential skirt.
The utility model also provides a prosthetic valve, which comprises a top bracket, a middle bracket and a bottom bracket, wherein the top bracket, the middle bracket and the bottom bracket are sequentially connected, at least three locking brackets are arranged on the top bracket along the circumferential direction, the top ends of the locking brackets are provided with locking ends, and the middle bracket is provided with a membrane leaf fixing part; the structural rigidity of the top bracket is less than the structural rigidity of the middle bracket.
In one embodiment, the middle bracket comprises three suture rods, the suture rods are the membrane leaf fixing parts, the locking brackets are three, and the structural rigidity of the locking end of each locking bracket is 5% to 50% of the structural rigidity of the suture rod.
In one embodiment, the middle bracket comprises three suture rods, the suture rods are the membrane leaf fixing parts, the locking brackets are six, and the structural rigidity of the locking end of each locking bracket is 3-45% of that of the suture rods.
In one embodiment, the middle bracket further comprises a suture rod and a connecting rod, and the locking bracket, the suture rod, the connecting rod and the bottom bracket are sequentially connected to form an integrated structure; the maximum cross-sectional area of the locking stent is 20-50% of the minimum cross-sectional area of the suture rod, and the cross-sectional area is perpendicular to the central axis of the valve body.
The utility model also provides a prosthetic valve, which comprises a top bracket, a middle bracket and a bottom bracket, wherein the top bracket, the middle bracket and the bottom bracket are sequentially connected, at least three locking brackets are arranged on the top bracket along the circumferential direction, the top ends of the locking brackets are provided with locking ends, and the middle bracket is provided with a membrane leaf fixing part;
the middle support also comprises a sewing rod and a connecting rod, and the locking support, the sewing rod, the connecting rod and the bottom support are sequentially connected to form an integrated structure; the maximum cross-sectional area of the locking stent is 20-50% of the minimum cross-sectional area of the suture rod, and the cross-sectional area is perpendicular to the central axis of the valve body.
The utility model also provides a valve conveying system, which comprises a prosthetic valve and a conveying device, wherein,
the artificial valve comprises a top bracket, a middle bracket and a bottom bracket, wherein the top bracket, the middle bracket and the bottom bracket are sequentially connected, at least three locking brackets are arranged on the top bracket along the circumferential direction, the top end of each locking bracket is provided with a locking end, and the middle bracket is provided with at least three membrane leaf fixing parts;
the conveying device comprises a first locking piece, a second locking piece and a sheath tube, wherein the first locking piece and the second locking piece are movably arranged relatively, the first locking piece is provided with a first locking part, the second locking piece is provided with a second locking part, a locking part is formed between the first locking part and the second locking part, the inner diameter of the sheath tube is larger than the radial size of the second locking piece, and the sheath tube is movably sleeved outside the first locking piece and the second locking piece;
when the first locking piece and the second locking piece move relatively, the locking piece is in an unlocking or locking state; under the unlocking state of each locking end, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 1, under the locking state of each locking end, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 2, and phi 2 is 74% -120% of phi 1.
The utility model provides a technical scheme has following advantage and effect:
in the unlocked state, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 1, and the valve is in a complete working state at the moment. Under the full-height pre-release state (the valve breaks away from the sheath completely, but the locking end of locking support is still locked together) when putting into prosthetic valve, the diameter of the circumference that the uppermost edge of three membrane leaf fixed part is Φ 2, at this moment, Φ 2 is 74% to 120% scope of Φ 1, can guarantee to guarantee that the valve can reach basic operating condition under the lock state, be used for the doctor to judge the behavior of valve after the implantation in advance, thereby follow-up adjustment direction to the implantation tactics of better certainty, and need not release the prosthetic valve complete unlocking, under the condition that prosthetic valve is not conform to the requirement, can be convenient retrieve prosthetic valve.
Drawings
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the description, serve to explain the principles, principles and effects of the invention.
Unless otherwise specified or defined, the same reference numerals in different figures refer to the same or similar features, and different reference numerals may be used for the same or similar features.
For convenience of illustration, fig. 1 to 19 mainly illustrate the valve locking device, and fig. 20 to 32 mainly illustrate the prosthetic valve; some of the figures illustrate the use of the valve locking device in combination with a prosthetic valve.
FIG. 1 is a block diagram of a valve locking device according to one embodiment of the present invention;
FIG. 2 is a block diagram of a valve delivery device according to one embodiment of the present invention;
FIG. 3 is a block diagram of a valve delivery device according to one embodiment of the present invention, with the valve in a full-height pre-release, but locked position;
FIG. 4 is a schematic view of a valve delivery device according to one embodiment of the present invention, with the valve in a fully retracted position;
fig. 5 is a partial cross-sectional view of a valve locking device according to a first embodiment of the present invention;
FIG. 6 is a partial schematic view of a valve locking device according to a first embodiment of the present invention in a locked state;
fig. 7 is a partial schematic view of a valve locking device according to a first embodiment of the present invention in an unlocked state;
FIG. 8 is a block diagram of a valve locking device according to a second embodiment of the present invention;
fig. 9 is a partial schematic view of a valve locking device according to a second embodiment of the present invention in a locked state;
FIG. 10 is a block diagram of a valve locking device according to a third embodiment of the present invention;
fig. 11 is a partial schematic view of a valve locking device according to a third embodiment of the present invention in a locked state;
FIG. 12 is a block diagram of a valve locking device according to the fourth embodiment of the present invention;
fig. 13 is a partial schematic view of a valve locking device according to the fourth embodiment of the present invention in a locked state;
figure 14 is a block diagram of a valve locking device according to example five of the present invention;
figure 15 is a partial schematic view of a valve locking device according to an embodiment of the present invention in an unlocked, unreleased state;
figure 16 is a block diagram of a valve locking device according to a sixth embodiment of the present invention;
figure 17 is a partial cross-sectional view of a valve locking device according to a sixth embodiment of the present invention in a locked state;
figure 18 is a partial cross-sectional view of a valve locking device according to a sixth embodiment of the present invention in an unlocked state;
figure 19 is a partial schematic view of a valve locking device according to a sixth embodiment of the present invention in an unlocked state;
FIG. 20 is a block diagram of a prosthetic valve according to a seventh embodiment of the present invention;
FIG. 21 is a schematic view of a prosthetic valve holder according to a seventh embodiment of the present invention;
FIG. 22 is an enlarged partial view of the anchor frame;
FIG. 23 is a view showing a structure of a developing spacer mounted on an anchor frame;
FIG. 24 is a side view of the structure shown in FIG. 23;
FIG. 25 is a block diagram of the anchor frame with protective sheathing mounted thereon;
fig. 26 is an enlarged partial view of the locking end of a prosthetic valve according to the seventh embodiment of the present invention;
figure 27 is a side view of a prosthetic valve according to seventh embodiment of the present invention in a locked (full-height pre-release) state;
figure 28 is a side view of a prosthetic valve according to seventh embodiment of the present invention in an unlocked (fully released) state;
FIG. 29 is a first directional view of a structural rigidity test of the locking end of the seventh embodiment;
FIG. 30 is an enlarged partial view of FIG. 29;
FIG. 31 is a second directional view of the locking end tested for structural rigidity according to the seventh embodiment;
FIG. 32 is a first directional view of the locking end tested for structural rigidity according to the seventh embodiment;
FIG. 33 is a partial enlarged view of FIG. 22;
FIG. 34 is a second directional view of the locking end tested for structural rigidity according to the seventh embodiment;
FIG. 35 is an enlarged partial view of the locking end of a prosthetic valve according to the eighth embodiment of the present invention;
figure 36 is an enlarged partial view of a locking end of a prosthetic valve according to the ninth embodiment of the present invention;
description of reference numerals:
10. a first locking member, 11, a locking seat, 111, a locking inclined surface, 12, a guide rod, 121, a rod body, 122, a guide head, 13, a matching rod, 14, a through hole, 15, a clamping convex tooth, 151, a groove, 16, a rear seat body, 17, a placing concave part, 20, a second locking member, 21, an annular body, 22, a clamping body, 221, a clamping convex part, 222, a clamping seam, 30, a locking position, 41, a first operating member, 42, a second operating member, 43, a third operating member, 44, a sheath tube, 50, a prosthetic valve, 60, a top bracket, 61, a locking bracket, 611, a locking end, 6111, a locking hole, 6112, a locking head, 6113, a locking neck, 70, a middle bracket, 71, a sewing rod, 711, a membrane leaf fixing hole, 72, a connecting rod, 73, an anchoring bracket, 731, a fixing section, 732, a free section, 7321, a tip, a 7322, a through hole, 733, an anchoring convex part, 74, a sheath part, 75. Developing positioning piece, 80, bottom bracket, 81, skirt, 91, aorta, 92, autologous valve, 93, membrane leaf, 941, tensile tester clamp, 942, silicone tube, 943, fixing tool, 944 and pull wire.
Detailed Description
In order to facilitate an understanding of the invention, specific embodiments thereof will be described in more detail below with reference to the accompanying drawings.
Unless specifically stated or otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. In combination with the present technical solution's realistic scene, all technical and scientific terms used herein may also have meanings corresponding to the purpose of realizing the technical solution of the present invention.
As used herein, unless otherwise specified or defined, "first" and "second" … are used merely for name differentiation and do not denote any particular quantity or order.
As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items, unless specified or otherwise defined.
It will be understood that when an element is referred to as being "secured to" another element, it can be directly secured to the other element or intervening elements may also be present; when an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present; when an element is referred to as being "mounted on" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "on" another element, it can be directly on the other element or intervening elements may also be present.
As used herein, unless otherwise specified or defined, the terms "comprises," "comprising," and "comprising" are used interchangeably to refer to the term "comprising," and are used interchangeably herein.
It is needless to say that technical contents or technical features which are contrary to the object of the present invention or clearly contradict each other should be excluded.
Example one
As shown in fig. 1 to 7, the valve delivery device includes a sheath 44, a third operating member 43, and a valve locking device.
As shown in fig. 1 and 5, the valve locking device includes a first locking member 10 and a second locking member 20, the first locking member 10 and the second locking member 20 are movably disposed relative to each other, the first locking member 10 has a first locking portion, the second locking member 20 has a second locking portion, and a locking portion 30 is formed between the first locking portion and the second locking portion. The rear end of the first locking member 10 is connected with a first operating member 41, the rear end of the second locking member 20 is connected with a second operating member 42, the second operating member 42 is in a hollow tubular shape, the first operating member 41 is sleeved in the hollow part of the second operating member 42, the first operating member 41 and the second operating member 42 are operated and controlled to control the axial displacement of the first locking member 10 and the second locking member 20, and when the first locking member 10 and the second locking member 20 move relatively, the locking position 30 is in an unlocking or locking state.
The second locking member 20 is annular and includes an annular body 21 and a clamping body 22, the clamping body 22 is fixedly connected to the annular body 21 and is matched with the locking seat 11, the locking position 30 is formed between the clamping body 22 and the locking seat, and a central hole is formed in the middle of the annular body 21.
The first locking member 10 includes a locking seat 11, a guiding rod 12 and a matching rod 13, the guiding rod 12 is connected to the front end of the locking seat 11, the matching rod 13 is connected to the rear end of the locking seat 11, the guiding rod 12 includes a rod body 121 and a guiding head 122, the diameter of the rod body 121 is smaller than the diameter of the locking seat 11 and the diameter of the guiding head 122, and a guiding inclined surface is arranged at the front end of the guiding head 122.
Specifically, the three finger-shaped engagement protrusions 221 are provided on the engagement body 22, the engagement protrusions 221 face the front end, an engagement seam 222 is formed between the engagement protrusions 221, and the locking end 611 of the prosthetic valve 50 is engaged in the engagement seam 222. The lock seat 11 is provided with a lock slope 111, and a lock position 30 is formed between the lock slope 111 and the click protrusion 221. The second locking member 20 is fitted around the engagement rod 13 of the first locking member 10 through the central hole and is axially movable relative to the engagement rod 13 to unlock or lock the locking position 30.
As shown in fig. 2, the third operating element 43 is connected to the rear end of the sheath 44, the sheath 44 and the third operating element 43 are both hollow tubular, and the second operating element 42 is sleeved in the hollow part of the third operating element 43; the inner diameter of the sheath 44 is larger than the radial dimension of the second locking member 20.
Referring to fig. 3, 4, 6 and 7, the first locking member 10 and the second locking member 20 of the valve locking device can move relatively, and the locking position 30 can be unlocked (as shown in fig. 7) or locked (as shown in fig. 6) by adjusting the positions of the first locking member 10 and the second locking member 20; at the time of implantation, the locking end 611 of the prosthetic valve 50 is locked by being snapped into the locking position 30, and by controlling the movement of the sheath, the prosthetic valve can be loaded into the sheath, as shown in fig. 4. After the valve 50 is advanced to the aortic root of the patient, the valve 50 can be pre-released in full height (as shown in fig. 3), but the locking position 30 does not need to be unlocked, the doctor can pre-evaluate the valve 50, including the operation state of the valve 50, the release position of the valve 50, etc., if the valve 50 is evaluated to be in accordance with the requirements, the locking position 30 is unlocked, if the valve is evaluated to be not in accordance with the requirements, the locking position 30 of the valve locking device is not unlocked, the valve is pulled into the sheath tube 44 through the valve locking device, and the valve can be completely recovered (as shown in fig. 4), or can be released again after being adjusted. The diameter of the rod body 121 is smaller than the diameters of the locking seat 11 and the guide head 122, so that in a complete recovery state of the artificial valve 50, a sufficient space can be reserved for the artificial valve 50.
The present embodiment allows for full-height pre-release of the prosthetic valve 50 for a physician to fully evaluate the prosthetic valve 50, and for complete retrieval and implantation.
Example two
As shown in fig. 8 and 9, the locking seat 11 is provided with a locking concave portion corresponding to the locking protrusion 221, and the locking concave portion is engaged with the locking protrusion 221. In this embodiment, the locking seat 11 is provided with the locking protrusion 15, the locking protrusion 15 is provided with a plurality of grooves 151, the locking body 22 is provided with six finger-shaped locking protrusions 221, three of the six locking protrusions 221 are longer, and the other three protrusions are shorter, and when the locking body is locked, the locking protrusion 221 is locked at the locking end 611 of the prosthetic valve 50 through the three long locking protrusions 221, so that the second locking member 20 axially moves, and the finger-shaped locking protrusions 221 are clamped into the grooves 151, so that the locking of the locking end 611 of the prosthetic valve 50 is realized.
EXAMPLE III
As shown in fig. 10 and 11, in the present embodiment, a rear seat 16 is disposed at the rear end of the locking seat 11, and the locking end 611 of the artificial valve 50 is further limited by the rear seat 16, so as to achieve more precise control of the valve position.
Example four
As shown in fig. 12 and 13, in the present embodiment, the locking seat 11 is provided with a snap-fit concave portion corresponding to the snap-fit convex portion 221, and the snap-fit concave portion is engaged with the snap-fit convex portion 221. In this embodiment, a through hole 732214 is formed in the locking seat 11, six finger-shaped clamping protrusions 221 are formed on the clamping body 22, three of the six clamping protrusions 221 are longer, and the other three clamping protrusions are shorter, so that when the valve is locked, the valve is clamped at the locking end 611 of the valve 50 through the three long clamping protrusions 221, the second locking member 20 is moved axially, and the finger-shaped clamping protrusions 221 are clamped in the through hole 732214, so that the locking of the locking end 611 of the valve 50 is realized.
EXAMPLE five
As shown in fig. 14 and 15, in the present embodiment, the locking seat 11 is provided with a placement recess 17, the locking end 611 of the prosthetic valve 50 is clamped in the placement recess 17, and is axially moved by the second locking member 20, and the locking end 611 of the prosthetic valve 50 is limited and locked by the inner wall of the clamping body 22; when the second locking member 20 is moved reversely, the locking end 611 of the prosthetic valve 50 is released from the placement recess 17, and the prosthetic valve 50 is unlocked.
EXAMPLE six
As shown in fig. 16 to 19, in the present embodiment, the locking seat 11 is provided with a locking protrusion 221, as shown in fig. 17, the locking protrusion 221 is engaged with an inner wall of the locking body 22 of the second locking member 20, the locking end 611 of the prosthetic valve 50 is provided with a locking hole 6111, the locking protrusion 221 is locked in the locking hole 6111 and locks the locking end 611, as shown in fig. 18, when the second locking member 20 moves axially relative to the first locking member 10, the locking end 611 is disengaged from the locking protrusion 221 and is unlocked.
EXAMPLE seven
As shown in fig. 20 to 30, the prosthetic valve 50 of the present embodiment includes a top support 60, a middle support 70 and a bottom support 80, the top support 60, the middle support 70 and the bottom support 80 are sequentially connected, at least three locking supports 61 are circumferentially disposed on the top support 60, a locking end 611 is disposed at a top end of each locking support 61, and at least three leaflet fixing portions are disposed on the middle support 70; under the unlocking state of each locking end 611, the artificial valve is in a complete release state, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 1, under the locking state of each locking end 611, the artificial valve is in a full-height pre-release state, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 2, and phi 2 is 74% -120% of phi 1. A comparison is shown in fig. 27 to 30.
In the unlocked state, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 1, and the valve is in a complete working state at the moment. In the locked state (the locking ends 611 of the locking stent 61 are locked together) when the prosthetic valve 50 is implanted, the diameter of the circumference of the uppermost edge of the three leaflet securing portions is Φ 2, where Φ 2 is 74% to 120% of Φ 1. The scope can guarantee to guarantee that the valve can reach basic operating condition under the locking state for the working condition of valve after the doctor judges implantation in advance, thereby follow-up adjustment direction to the implantation strategy of better definite, and need not release the complete unblock of prosthetic valve 50, under the condition that prosthetic valve 50 is unsatisfactory, can be convenient retrieve prosthetic valve 50.
In this embodiment, the design consideration of Φ 2 ranges from 74% to 120% of Φ 1, and the main considerations are as follows:
under the locking state of each locking end 611, the diameter phi 2 of the circumference where the uppermost edge of the three membrane leaf fixing parts is located determines the working condition of the artificial valve during pre-evaluation, and if the diameter phi 2 is too small, the three membrane leaves 93 cannot be smoothly attached, so that reflux is caused; if Φ 2 is too large, the free edges of the three leaflets 93 will not fit together, the valve will not close properly, and regurgitation will also be caused.
When the ventricles relax, the volume of the ventricles increases, and the blood in the aorta tends to flow back to the ventricles. The leaflets 93 are closed to prevent the regurgitation of blood due to the action of the blood flow, and accordingly, the action of the blood on the valve generates a force to deform the suture shaft 71 inward, and the amount of deformation of the suture shaft 71 is one of the factors determining whether the valve is well-fitted when closed, so that the amount of deformation of the suture shaft 71 due to the blood flow must be considered in consideration of the size of Φ 2.
The amount of deformation of the sewing rod 71 is determined by the blood pressure of the patient, the structural rigidity of the sewing rod, and the size of the valve. As a rule of thumb, the amount of deflection of a single suture shaft 71 under the influence of blood flow ranges from about 2% to about 10% of Φ 1. According to the above numerical values, considering the deformation of the three suture rods 71, when Φ 2 of the three membrane leaves 93 fixing parts in the locked state is 120% of Φ 1 in the unlocked state, the membrane leaves 93 still have the possibility of normally working under the action of blood flow, so that 120% of Φ 1 is taken as the upper limit of Φ 2;
on the other hand, due to the good flexibility of the membrane leaves 93, even if the diameter of the circumference where the three membrane leaves 93 are fixed is relatively small, the free edges of the membrane leaves 93 can still be well attached, and according to experience, when the circumference where the uppermost edges of the three membrane leaf fixed parts are located is 70% of the circumference in the unlocked state, the membrane leaves 93 still have the possibility of being well closed. According to the conclusion that the minimum deformation of a single suture rod 71 can reach 2% of phi 1, considering the situation of three suture rods 71, when phi 2 of the fixed part of the three membrane leaves 93 is 74% of phi 1 in the unlocked state, the valve still can be well jointed and normally works by virtue of the compliance of the membrane leaves 93, and therefore 74% of phi 1 is taken as the lower limit of phi 2.
The optimal proportion of the diameter phi 2 of the circumference of the uppermost edge of the three membrane leaf fixing parts to phi 1 is 85-110%, and in the proportion range, the three membrane leaves are well closed in a locking state, so that the valve function after release can be accurately estimated.
The prosthetic valve 50 can be used in conjunction with the valve delivery device or valve locking device described in the previous embodiments, and is shown in particular in fig. 3, 6, 7, 9, 11, and 13.
Further, the middle support 70 is provided with an anchoring frame 73 protruding in the circumferential direction and facing the bottom support 80, the anchoring frame 73 can assist the artificial valve 50 in positioning at the root of the aorta 91, reduce the radial force of the bottom support 80, reduce the influence of the artificial valve 50 on the cardiac electric conduction after implantation, and thus reduce the implantation rate of the post-operation pacemaker.
The middle support 70 comprises a sewing rod 71 and a connecting rod 72, the sewing rod 71 is the membrane leaf fixing part, a plurality of membrane leaf fixing holes 711 are formed in the sewing rod and used for sewing and fixing the membrane leaves 93, the connecting rod 72 is formed by branching the lower end of the sewing rod 71 for a plurality of times, and the lower part of the middle support 70 and the bottom support 80 are both in a grid structure; the anchoring frame 73 includes left and right brackets, each of which has a fixed section 731 and a free section 732, the upper ends of the two fixed sections 731 are connected to the connecting rods 72 at both sides, and the ends of the two free sections 732 are butted. The fixed section 731 protrudes outward in the circumferential direction with respect to the connecting rod 72, the free section 732 bends inward in the circumferential direction with respect to the fixed section 731, and the bent portions of the fixed section 731 and the free section 732 form an anchoring projection 733. The anchoring frame 73 comprises brackets on the left side and the right side, the anchoring structure is reliable in anchoring and good in stability, and the anchoring frame 73 has good compliance characteristics through different bending directions of the fixed section 731 and the free section 732, is convenient to implant and recover and can realize repeated positioning; after the positioning is completed, if the prosthetic valve generates longitudinal displacement, the fixed section 731 can be attached to the inner wall of the aorta 91 and is blocked and limited, and the free section 732 can be attached to the inner wall of the aorta 91 and is blocked and limited by the native valve 92.
The ends of the two free sections 732 are butted to form a tip 7321, the tip 7321 is provided with a perforation 7322, the perforation 7322 can be provided with a protective sleeve 74 according to requirements, the protective sleeve 74 can be sewn by soft tissue material or high molecular material, and the risk that the anchoring frame 73 damages the membrane 93 of the native valve 92 or the artificial valve 50 can be reduced. The developing spacer 75 may be installed in the through hole 7322, and the developing spacer 75 may be made of a material having a high X-ray developing property.
To meet the characteristics of the valve prosthesis 50 in the pre-release state, the top stent 60 may have a smaller structural rigidity than the middle stent 70, and specifically, the following may be used:
1. the top bracket 60 is made of a material having a lower modulus of elasticity relative to the middle bracket 70;
2. the top bracket 60 is lengthened in its entire length to keep the locking end 611 away from the suture shaft, which is a fixed end of the locking end, so that lengthening the entire length of the top bracket 60 makes the locking end less rigid.
3. The top bracket 60 and the middle bracket 70 are processed by the same material, so that the processing cost is reduced and the integral mechanical strength is ensured; the top stent 60, the middle stent 70 and the bottom stent 80 are made of nitinol. In this condition, the cross-sectional area of the rod-shaped material of the top stent 60 is small relative to the cross-sectional area of the rod-shaped material of the middle stent 70, and preferably, the maximum value of the cross-sectional area of the rod-shaped material of the top stent 60 is 33% to 95% of the minimum value of the cross-sectional area within the height range of the middle stent 70, and the cross-sectional area is perpendicular to the central axis of the valve assembly. The structural rigidity of the locking end can be better proportioned to the structural rigidity of the mid-stent suture rod when the maximum cross-sectional area within the range of the top stent height is in the range of 50% to 90% relative to the minimum cross-sectional area within the range of the mid-stent height.
The number of the locking brackets 61 of the top bracket 60 is generally three or six, and when the number of the locking brackets 61 is three, the structural rigidity of the locking end of each locking bracket 61 is 5% to 50% of the structural rigidity of the suture rod of the middle bracket 70. When the number of the locking brackets 61 is six, the locking end structural rigidity of each locking bracket 61 is 3% to 45% of the structural rigidity of the suture rod of the middle bracket 70. When the structural rigidity of the locking end of the locking bracket 61 is 20-40% of that of the suture rod of the middle bracket 70, the diameter phi 2 of the circumference where the uppermost edges of the three membrane leaf fixing parts are located in the locking state accounts for 85-110% of the diameter phi 1 of the circumference where the uppermost edges of the three membrane leaf fixing parts are located in the completely releasing state, and in the proportion range, the three membrane leaves are well closed in the locking state, so that the valve function after releasing can be accurately estimated.
In the bottom direction, the circumferential diameter of the bottom stent 80 gradually increases to form a trumpet shape, and a larger radial compression amount can be generated after the artificial valve 50 is implanted to prevent the artificial valve 50 from shifting during operation, a circumferential skirt 81 is arranged on the bottom stent 80, and the skirt 81 can be made of pericardium materials or high polymer materials.
In this embodiment, the method for testing the structural rigidity of the single locking end 611 is as follows: as shown in fig. 29, 30 and 31, the valve stent is released into the silicone tube 942 at an ambient temperature of 37 ℃, and the inner diameter of the silicone tube 942 is selected to be within the range of the diameter of the aortic valve annulus of the human body to which the prosthetic valve is applied. The silicone tube 942 is fixed to the platform of the universal tensile testing instrument by a fixing tool 943, wherein the inner diameter of the fixing tool 943 is attached to the inner diameter of the silicone tube 942. The locking end 611 of the valve stent is tied using a pull wire 944 and locked with a tensile tester clamp 941, keeping the locking end 611 to be measured centered with the tensile tester clamp 941, i.e. keeping the pull wire 944 in a vertical direction. After the universal tensile tester is initially zeroed, the tensile tester clamp is operated to enable the locking end 611 to be in an undeformed state and the pull wire 944 to be just stretched straight, the position is set as a zero point, the force value and deformation of the universal tensile tester are adjusted to be zero, the force value under the condition of upward stretching by 10mm displacement is tested, and the ratio of the obtained maximum force value to the displacement is taken as the structural rigidity.
The structural rigidity of a single suture rod was tested as described above, and is shown in fig. 32, 33 and 34.
Example eight
In this embodiment, as shown in fig. 35, the locking end 611 of the prosthetic valve 50 has a different structure, and the locking end 611 has a locking head 6112, and the locking head 6112 has a smaller inner dimension to form a locking neck 6113.
Referring to fig. 14 and 15 again, when implanting or recovering, the locking seat 11 of the valve delivery device is provided with a placing recess 17, the locking end 611 of the prosthetic valve 50 is clamped in the placing recess 17, and is axially moved by the second locking member 20, and the locking end 611 of the prosthetic valve 50 is limited and locked by the inner wall of the clamping body 22; when the second locking member 20 is moved reversely, the locking end 611 of the prosthetic valve 50 is released from the placement recess 17, and the prosthetic valve 50 is unlocked.
Example nine
In the present embodiment, as shown in fig. 36, the locking end 611 of the valve prosthesis has a different structure, and the locking end 611 is provided with a locking hole 6111.
Referring to fig. 16 to 19 again, in the present embodiment, the locking seat 11 of the valve delivery device is provided with a clamping protrusion 221, the clamping protrusion 221 is matched with the inner wall of the clamping body 22 of the second locking member 20, the locking end 611 of the prosthetic valve 50 is provided with a locking hole 6111, the clamping protrusion 221 is clamped in the locking hole 6111 and locks the locking end 611, as shown in fig. 18, when the second locking member 20 moves axially relative to the first locking member 10, the locking end 611 is released from the clamping protrusion 221 and unlocked.
The above embodiments are intended to be illustrative, and should not be construed as limiting the scope of the invention, and the technical solutions, objects and effects of the present invention are described in full herein.
The above examples are not intended to be exhaustive list of the present invention, and there may be many other embodiments not listed. Any replacement and improvement made on the basis of not violating the conception of the utility model belong to the protection scope of the utility model.
Claims (19)
1. The artificial valve is characterized by comprising a top support, a middle support and a bottom support, wherein the top support, the middle support and the bottom support are sequentially connected, at least three locking supports are arranged on the top support along the circumferential direction, the top end of each locking support is provided with a locking end, and the middle support is provided with at least three membrane leaf fixing parts; under the unlocking state of each locking end, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 1, under the locking state of each locking end, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 2, and the phi 2 is greater than or equal to 74% of the phi 1.
2. The prosthetic valve of claim 1, wherein an anchoring frame is provided on the middle stent that projects circumferentially and faces in the direction of the bottom stent.
3. The prosthetic valve of claim 2, wherein the anchoring frame includes a fixed segment that protrudes circumferentially outward relative to the middle stent and a free segment that is bent circumferentially inward relative to the fixed segment.
4. The prosthetic valve of claim 3, wherein the anchoring frame has two fixed sections and two free sections, the two fixed sections having upper ends connected to the middle support and the two free sections having ends that abut.
5. The prosthetic valve of claim 4, wherein the ends of the two free segments abut to form a tip, and wherein the tip is provided with a perforation.
6. The prosthetic valve of claim 5, wherein a protective sheath and/or a visualization positioning member is provided on the puncture.
7. The prosthetic valve of claim 1, wherein Φ 2 is 74% to 120% of Φ 1.
8. The prosthetic valve of any one of claims 1-7, wherein the top stent has a structural stiffness that is less than a structural stiffness of the middle stent.
9. The prosthetic valve of claim 8, wherein the middle stent comprises three suture rods, the suture rods being the leaflet securing portions, the locking stents being three, the locking end of each of the locking stents having a structural stiffness that is 5% to 50% of the structural stiffness of the suture rods.
10. The prosthetic valve of claim 8, wherein the middle stent comprises three suture rods, the suture rods being the leaflet securing portions, the locking stents being six, the locking end of each locking stent having a structural stiffness that is 3% to 45% of the structural stiffness of the suture rods.
11. The prosthetic valve of any one of claims 1-7, wherein a plurality of leaflet securing holes are provided in the leaflet securing portion.
12. The prosthetic valve of any one of claims 1-7, wherein the circumferential diameter of the bottom stent gradually increases in a bottom direction to form a trumpet shape.
13. The prosthetic valve of any one of claims 1-7, wherein the bottom stent is provided with a circumferential skirt.
14. The artificial valve is characterized by comprising a top support, a middle support and a bottom support, wherein the top support, the middle support and the bottom support are sequentially connected, at least three locking supports are arranged on the top support along the circumferential direction, the top ends of the locking supports are provided with locking ends, and the middle support is provided with a membrane leaf fixing part; the structural rigidity of the top bracket is less than the structural rigidity of the middle bracket.
15. The prosthetic valve of claim 14, wherein the middle stent comprises three suture rods, the suture rods being the leaflet securing portions, the locking stents being three, the locking end of each of the locking stents having a structural stiffness that is 5% to 50% of the structural stiffness of the suture rods.
16. The prosthetic valve of claim 14, wherein the middle stent comprises three suture rods, the suture rods being the leaflet securing portions, the locking stents being six, the locking end of each locking stent having a structural stiffness that is 3% to 45% of the structural stiffness of the suture rods.
17. The prosthetic valve of claim 14, wherein the middle stent further comprises a suture rod and a connecting rod, and the locking stent, the suture rod, the connecting rod and the bottom stent are sequentially connected to form an integrated structure; the maximum cross-sectional area of the locking stent is 20-50% of the minimum cross-sectional area of the suture rod, and the cross-sectional area is perpendicular to the central axis of the valve body.
18. The artificial valve is characterized by comprising a top support, a middle support and a bottom support, wherein the top support, the middle support and the bottom support are sequentially connected, at least three locking supports are arranged on the top support along the circumferential direction, the top ends of the locking supports are provided with locking ends, and the middle support is provided with a membrane leaf fixing part;
the middle support also comprises a sewing rod and a connecting rod, and the locking support, the sewing rod, the connecting rod and the bottom support are sequentially connected to form an integrated structure; the maximum cross-sectional area of the locking stent is 20-50% of the minimum cross-sectional area of the suture rod, and the cross-sectional area is perpendicular to the central axis of the valve body.
19. The valve delivery system is characterized by comprising a prosthetic valve and a delivery device, wherein,
the artificial valve comprises a top bracket, a middle bracket and a bottom bracket, wherein the top bracket, the middle bracket and the bottom bracket are sequentially connected, at least three locking brackets are arranged on the top bracket along the circumferential direction, the top end of each locking bracket is provided with a locking end, and the middle bracket is provided with at least three membrane leaf fixing parts;
the conveying device comprises a first locking piece, a second locking piece and a sheath tube, wherein the first locking piece and the second locking piece are movably arranged relatively, the first locking piece is provided with a first locking part, the second locking piece is provided with a second locking part, a locking part is formed between the first locking part and the second locking part, the inner diameter of the sheath tube is larger than the radial size of the second locking piece, and the sheath tube is movably sleeved outside the first locking piece and the second locking piece;
when the first locking piece and the second locking piece move relatively, the locking piece is in an unlocking or locking state; under the unlocking state of each locking end, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 1, under the locking state of each locking end, the diameter of the circumference where the uppermost edges of the three membrane leaf fixing parts are located is phi 2, and phi 2 is 74% -120% of phi 1.
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CN114081669A (en) * | 2020-08-25 | 2022-02-25 | 北京市普惠生物医学工程有限公司 | Prosthetic valve and valve delivery system |
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CN114081669A (en) * | 2020-08-25 | 2022-02-25 | 北京市普惠生物医学工程有限公司 | Prosthetic valve and valve delivery system |
WO2022042310A1 (en) * | 2020-08-25 | 2022-03-03 | 北京市普惠生物医学工程有限公司 | Artificial valve and valve delivery system |
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