CN107185103B

CN107185103B - Pulmonary valve expanding device

Info

Publication number: CN107185103B
Application number: CN201710561799.5A
Authority: CN
Inventors: 孙琦; 刘锦纷; 孙彦隽; 张海波; 郑景浩; 王伟; 张玉奇
Original assignee: Shanghai Childrens Medical Center Affiliated to Shanghai Jiaotong University School of Medicine
Current assignee: Shanghai Childrens Medical Center Affiliated to Shanghai Jiaotong University School of Medicine
Priority date: 2017-07-11
Filing date: 2017-07-11
Publication date: 2023-03-14
Anticipated expiration: 2037-07-11
Also published as: CN107185103A

Abstract

The invention relates to a pulmonary valve expansion device, which consists of a front end shell, a spring, a fixed disk, an arc expansion plate, a rear end shell and a needle core; the front end shell is a cylinder with a head part with a round corner, a penetrating front end center hole is formed in the front end shell, depth scale marks are arranged on the side surface, a spring positioning groove is arranged at the tail part of the front end shell and connected with a spring, the spring is connected to a fixed disc, and an expansion plate positioning groove is formed in the lower surface of the front end shell; the arc expansion plate is fixedly connected with the fixed disc and the upper surface of the rear end shell; the rear end shell is provided with a through rear end central hole, and the side surface of the rear end shell is provided with a depth scale mark; one side of the needle core is provided with depth scale marks, the other side of the needle core is provided with scale marks of the expansion diameter with the maximum expansion of the expansion plate when the rear-end shell is pushed forwards, and the middle of the needle core is fixedly connected with a circular fixed disk; the needle core penetrates through the central holes at the front end and the rear end. Its advantages are: the pulmonary valve is reliably punctured and quantitatively expanded by one-time delivery, so that the puncture wound of the heart or the blood vessel wall is reduced, and the feeding depth and the expansion degree of the device can be accurately evaluated.

Description

Pulmonary valve expanding device

Technical Field

The invention relates to the technical field of medical instruments, in particular to a pulmonary valve expansion device.

Background

Among patients with congenital heart disease, there is a group of children with occluded or severely narrowed pulmonary valve, who often require urgent treatment during the neonatal period because of severe hypoxia immediately after birth, which is life threatening. However, due to small age and low weight, the trauma of incising or expanding the pulmonary valve under direct vision through the traditional extracorporeal circulation auxiliary operation is large, and the infant patients are often difficult to endure the operation shock, so that the death rate is high. If extracorporeal circulation is not adopted for assistance, the operation is directly performed under the direct vision after the total pulmonary artery is cut, so that serious circulation instability and even life threatening of a child patient are often caused by large instantaneous bleeding amount. The traditional cardiac catheter interventional therapy needs puncture from femoral vein vessel at the root of thigh and sends radio frequency ablation or balloon dilatation device to the position corresponding to pulmonary valve at the top of right ventricular outflow tract for treatment through a catheter. Firstly, the diameter of the catheter delivery device is greatly limited due to the small diameter of femoral vein vessels of children with low age and low weight; in addition, in the implementation process of interventional catheter treatment, for a patient with pulmonary artery occlusion, because no blood flow can enter the pulmonary artery from the right ventricle, the corresponding position of the pulmonary valve cannot be clarified through radiography, blind radiofrequency ablation on the pulmonary artery with membranous occlusion can cause serious risk of cardiac perforation rupture, and certainly, muscular occlusion is less likely to be treated through a traditional interventional treatment means.

The concept of internal and surgical inlay therapy is in force, considering that both traditional surgery and traditional medical intervention have their own obvious drawbacks for treating pulmonary artery occlusion and severe stenosis. The mosaic therapy is a therapy performed by a surgical operation in combination with an interventional method or a sequential surgical operation. The inlay treatment process for the infant with pulmonary artery occlusion or severe stenosis is to open the chest by a cardiac surgeon after anesthesia and directly send an interventional therapy device through the right ventricle or the pulmonary artery to carry out the acupuncture or the expansion of the pulmonary artery. The devices currently used in surgery are common venipuncture needles, guide wires, inflatable balloons. Direct needling, whether from the right ventricle or the pulmonary artery, risks the accidental injury of the heart structure or the pulmonary artery wall by the needle, and the steps of needling, feeding of a guide wire, withdrawing the needle, feeding of an expandable balloon for inflation and expansion are required to be carried out in sequence through a pre-sewn pouch, so that the possibility of re-operation is caused when the device slips due to complicated operation and multiple steps.

The surgery wound is large under the assistance of extracorporeal circulation, and the complications of pulmonary edema, general edema, inflammation medium release and the like of the newborn are easily caused, so that the postoperative recovery is difficult. The pulmonary artery incision and/or dilation is performed on the pulmonary artery under the assistance of non-extracorporeal circulation, so that the instant bleeding volume is large, the circulation instability of a child patient is easily caused, and even the life is directly endangered. Traditional interventional treatment approaches are limited by femoral vein vessel diameter for small-weight newborns, and delivering radiofrequency ablation or balloon dilation devices is difficult. The positioning of the pulmonary valve in the right ventricle presents difficulties, and the blind radiofrequency ablation may cause serious complications of cardiac rupture, which is even more intractable in myogenic pulmonary atresia with long stenoses.

Mosaic therapy is currently a good way to treat neonatal pulmonary occlusion or severe stenosis, but there is currently no specific treatment device. The conventional methods of needling, feeding the guide steel wire, withdrawing the needle and feeding the guide steel wire into the inflatable balloon are used for expansion, so that the operation is complex, and the risk of accidental injury of the needle head or the possibility that the guide steel wire falls off and needs to be operated again still exist. Therefore, it is a urgent need to design an inlay treatment device that can allow a surgeon to safely deliver the implant to a position corresponding to a pulmonary valve and can achieve reliable expansion by one delivery.

Chinese patent documents: CN205515941U discloses a pulmonary valve balloon dilator, which comprises a through pipe, wherein a groove is arranged on the through pipe, a dilating inflating balloon is arranged on the groove, the dilating inflating balloon is connected with an inflating pipe, and the inflating pipe is arranged on the outer wall of the through pipe. Chinese patent documents: CN205759114U discloses a pulmonary stenosis percutaneous sacculus dilatation is with guide pipe under ultrasonic guide, including the expandable sacculus that sets up outside pipe and the pipe, be provided with the inlet channel who communicates the sacculus in the pipe, inlet channel intercommunication sacculus inner chamber, the inlet channel is the cavity pipe, is provided with the seal wire passageway in it, the pipe in be provided with the pressure measurement passageway, be provided with two pressure measurement holes on the pipe, pressure measurement passageway intercommunication pressure measurement hole, the pressure measurement sheetmetal sets up the position at pressure measurement hole place, pressure measurement passageway, seal wire passageway and inlet channel are independent each other, the one end that is provided with the sacculus of pipe is provided with the end sheetmetal. However, no report has been made on a pulmonary valve dilating device of the present invention.

Disclosure of Invention

The invention aims to provide a pulmonary valve expanding device.

In order to realize the purpose, the invention adopts the technical scheme that: a pulmonary valve expansion device is composed of a front end shell, a spring, a fixed disk, an arc expansion plate, a rear end shell and a needle core; the front end shell is a cylinder with a rounded head, a penetrating front end center hole is formed in the front end shell, depth scale marks are arranged on the side face of the front end shell, and a spring positioning groove is formed in the tail of the front end shell; the spring positioning groove is fixedly connected with a spring, and the tail part of the spring is fixedly connected to the spring positioning groove on the fixed disc; a circle of spring positioning grooves are formed around the fixed disc, and expansion plate positioning grooves are formed in the lower surface of the fixed disc; the expansion plate positioning groove is fixedly connected with an arc expansion plate, the arc expansion plate is in an arc plate shape, and the tail part of the arc expansion plate is fixedly connected in the expansion plate positioning groove on the rear-end shell; the rear end shell is a cylinder, an expansion plate positioning groove is formed in the upper surface of the rear end shell, depth scale marks are formed in the side face of the rear end shell, and a rear end central hole penetrates through the rear end shell; the needle core is a cylinder with a needle point-shaped head, the middle of the needle core is fixedly connected with a fixed disc, one side of the side surface of the needle core is provided with a depth scale mark, and the other side of the side surface is provided with an expansion diameter scale mark which pushes the maximum expansion diameter mark of the rear-end shell arc expansion plate forwards and expands the mark; the zero scale at the beginning of the expanded diameter scale mark is flush with the bottom surface of the rear end shell; the needle core penetrates through a front end center hole of the front end shell and a rear end center hole of the rear end shell; the diameters of the front end central hole and the rear end central hole are the same as the diameter of the needle core.

The height of the front end shell is 3mm to 5mm.

The length of the spring is 2mm to 3mm.

The length of the arc expansion plate is 2cm to 3cm.

The length of the pulmonary valve expansion device is 10cm to 15cm; and the needle head of the needle core is covered by the front end shell.

The invention has the advantages that:

1. the pulmonary valve expansion device can complete reliable puncture and quantitative expansion of the pulmonary valve through one-time delivery through a pulmonary artery approach.

2. The front protective needle head design of the invention can effectively reduce the heart or vessel wall puncture injury caused by the puncture of a common needle head in the traditional inlay treatment.

3. The pulmonary valve expansion device is provided with scale marks, so that the depth and the expansion degree of the device can be accurately evaluated.

4. The invention provides a safer and more convenient-to-operate inlay treatment device for treating pulmonary valve occlusion or stenosis and treating children with low age and low weight who need to be operated in the neonatal period.

Drawings

Fig. 1 is a schematic view of a pulmonary valve dilation apparatus.

Fig. 2 is a schematic view of the front end housing of a pulmonary valve dilation apparatus.

Figure 3 is a schematic view of a stationary disk of a pulmonary valve dilation device.

Fig. 4 is a schematic view of the combination of the fixed disk of the pulmonary valve expanding device with the arc-shaped expanding plate and the rear end housing.

Figure 5 is a schematic view of the posterior end housing of a pulmonary valve dilation device.

Fig. 6 is a combination of a needle core and a fixed disk of the pulmonary valve dilating device.

Fig. 7 is a schematic view of a needle core of a pulmonary valve dilation device.

Figure 8 is a schematic view of a pulmonary valve dilation device.

Detailed Description

The invention is further described with reference to the following examples and with reference to the accompanying drawings.

The reference numerals and components referred to in the drawings are as follows:

1. front end shell

11. Front end center hole

12. Spring positioning groove

2. Spring

3. Fixed disk

31. Positioning groove of expansion plate

32. Fixed disk center hole

4. Arc expansion board

5. Rear end shell

51. Rear end center hole

6. Needle core

61. Scale mark for expanding diameter

62. Depth graduation line

Example 1

Referring to fig. 1, fig. 2, fig. 3, fig. 4, fig. 5, fig. 6, fig. 7, and fig. 8, fig. 1 is a schematic diagram of a pulmonary valve dilator of the present embodiment, fig. 2 is a schematic diagram of a front end housing of a pulmonary valve dilator of the present embodiment, fig. 3 is a schematic diagram of a fixing disk of a pulmonary valve dilator of the present embodiment, fig. 4 is a schematic diagram of a combination of a fixing disk of a pulmonary valve dilator of the present embodiment with an arc-shaped dilator plate and a rear end housing, fig. 5 is a schematic diagram of a rear end housing of a pulmonary valve dilator of the present embodiment, fig. 6 is a schematic diagram of a combination of a needle core and a fixing disk of a pulmonary valve dilator of the present embodiment, fig. 7 is a schematic diagram of a needle core of a pulmonary valve dilator of the present embodiment, and fig. 8 is a schematic diagram of a pulmonary valve dilator of the present embodiment.

The pulmonary valve expansion device is composed of a front end shell 1, a spring 2, a fixed disk 3, an arc expansion plate 4, a rear end shell 5 and a needle core 6.

Front end shell 1 be the cylinder of head radius angle, front end shell 1 have the front end centre bore 11 that runs through, front end shell 1 side be equipped with degree of depth scale mark 62, the afterbody of front end shell 1 is equipped with spring positioning groove 12.

The spring positioning groove 12 is fixedly connected with a spring 2, and the tail part of the spring 2 is fixedly connected to the spring positioning groove 12 on the fixed disc 3; a ring of spring positioning grooves 12 are arranged around the fixed disc 3, and expansion plate positioning grooves 31 are arranged on the lower surface.

Expansion plate constant head tank 31 in fixed connection arc expansion plate 4, arc expansion plate 4 be arc platelike, 4 afterbody fixed connection of arc expansion plate in expansion plate constant head tank 31 on rear end shell 5.

The rear end shell 5 be the cylinder, rear end shell 5 upper surface is equipped with expansion plate constant head tank 31, and the side is equipped with degree of depth scale mark 62, rear end shell 5 have the rear end centre bore 51 that runs through.

The needle core 6 is a cylinder with a needle point-shaped head, the middle of the needle core 6 is fixedly connected with the fixed disc 3, one side of the side surface is provided with a depth scale mark 62, and the other side of the side surface is provided with an expansion diameter scale mark 61 which is the maximum when the rear end shell is pushed forwards and the expansion plate is expanded; the zero scale of the beginning of the expanded diameter scale mark 61 is flush with the bottom surface of the rear end shell 5; the stylet 6 penetrates through the front center hole 11 of the front end housing 1 and the rear center hole 51 of the rear end housing 5.

The diameter of the front end central hole 11 and the rear end central hole 51 is the same as the diameter of the needle core 6.

The height of the front end shell 1 is 3mm to 5mm.

The length of the spring 2 is 2mm to 3mm.

The length of the arc expansion plate 4 is 2cm to 3cm.

The length of the pulmonary valve expanding device is 10cm to 15cm.

The needle of the needle core 6 is covered by the front end housing 1.

Example 2

Referring to fig. 1, fig. 2, fig. 3, fig. 4, fig. 5, fig. 6, fig. 7, and fig. 8, fig. 1 is a schematic diagram of a pulmonary valve dilating device according to the present embodiment, fig. 2 is a schematic diagram of a front end housing of a pulmonary valve dilating device according to the present embodiment, fig. 3 is a schematic diagram of a fixing disk of a pulmonary valve dilating device according to the present embodiment, fig. 4 is a schematic diagram of a fixing disk of a pulmonary valve dilating device according to the present embodiment combined with an arc-shaped dilating plate and a rear end housing, fig. 5 is a schematic diagram of a rear end housing of a pulmonary valve dilating device according to the present embodiment, fig. 6 is a schematic diagram of a needle core and a fixing disk of a pulmonary valve dilating device according to the present embodiment combined, fig. 7 is a schematic diagram of a needle core of a pulmonary valve dilating device according to the present embodiment, and fig. 8 is a schematic diagram of a pulmonary valve dilating device according to the present embodiment.

The pulmonary valve expansion device consists of a front end shell 1, a spring 2, a fixed disk 3, an arc expansion plate 4, a rear end shell 5 and a needle core 6.

When in use, the fixed disk 3 is fixed on the needle core 6 and can not move, and the round blunt front end shell 1 is connected and fixed with the needle core 6 through the spring 2 and the fixed disk 3. When the device is pushed, the front end shell 1 touches the pulmonary artery total wall or the pulmonary artery valve and receives a certain resistance, then the needle head of the needle core 6 is exposed to puncture the pulmonary artery total wall or the pulmonary artery valve, and when the needle head of the needle core 6 punctures the pulmonary artery total wall to enter the pulmonary artery total wall or punctures the pulmonary artery valve to enter the right ventricle, the front end shell 1 restores the original position by the elasticity of the spring 2, and then the needle head of the needle core 6 is covered again. The head end of an arc expansion plate 4 behind the spring 2 is fixed with a fixed disc 3 above the needle core 6, the tail end of the arc expansion plate is fixed with a rear end shell 5 of the device, and the arc expansion plate 4 can be expanded to different degrees through the rear end shell 5 of the pushing device under the condition that the needle core 6 is fixed. The front housing 1, the back housing 5 and the hub 6 have depth markings 62 indicating the length of the tip of the device to allow the depth of insertion of the device to be read. The needle core 6 is provided with expansion diameter scale marks 61 for marking the maximum expansion diameter after the arc expansion plate 4 of the shell 5 at the rear end is pushed to be expanded, and the size of the expansion diameter of the device can be read.

The foregoing is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and additions can be made without departing from the principle of the present invention, and these should also be considered as the protection scope of the present invention.

Claims

1. A pulmonary valve expansion device is characterized by comprising a front end shell, a spring, a fixed disk, an arc expansion plate, a rear end shell and a needle core; the front end shell is a cylinder with a head part rounded, the front end shell is provided with a front end central hole which penetrates through the front end shell, the side surface of the front end shell is provided with depth scale marks, and the tail part of the front end shell is provided with a spring positioning groove; the spring positioning groove is fixedly connected with a spring, and the tail part of the spring is fixedly connected to the spring positioning groove on the fixed disc; a circle of spring positioning grooves are formed around the fixed disc, and expansion plate positioning grooves are formed in the lower surface of the fixed disc; the expansion plate positioning groove is fixedly connected with an arc expansion plate, the arc expansion plate is in an arc plate shape, and the tail part of the arc expansion plate is fixedly connected in the expansion plate positioning groove on the rear-end shell; the rear end shell is a cylinder, an expansion plate positioning groove is formed in the upper surface of the rear end shell, depth scale marks are formed in the side face of the rear end shell, and a rear end center hole penetrates through the rear end shell; the needle core is a cylinder with a needle point-shaped head, the middle of the needle core is fixedly connected with a fixed disc, one side of the side surface of the needle core is provided with a depth scale mark, and the other side of the side surface is provided with an expansion diameter scale mark which pushes the maximum expansion diameter mark of the rear-end shell arc expansion plate forwards and expands the mark; the zero scale at the beginning of the expanded diameter scale mark is flush with the bottom surface of the rear end shell; the needle core penetrates through a front end center hole of the front end shell and a rear end center hole of the rear end shell; and the diameters of the front end central hole and the rear end central hole are the same as the diameter of the needle core.

2. The pulmonary valve dilation device of claim 1, wherein the front end housing has a height of 3mm to 5mm.

3. The pulmonary valve dilation device of claim 1, wherein the spring has a length of 2mm to 3mm.

4. The pulmonary valve dilation device of claim 1, wherein the arcuate dilation plate has a length of 2cm to 3cm.

5. The pulmonary valve dilation device according to claim 1, wherein the pulmonary valve dilation device has an overall length of 10cm to 15cm; and the needle head of the needle core is covered by the front end shell.