CN201814605U - Asymmetric double-plate-type left auricle occluder - Google Patents

Abstract

The utility model relates to an asymmetric double-plate-type left auricle occluder comprising an atrium sinistrum velum piece (1), a waist joint (2) and a left auricle velum surface (3). The atrium sinistrum velum piece (1), the waist joint (2) and the left auricle velum surface (3) are reticulate structures woven by alloy wires; the atrium sinistrum velum piece (1) adopts a disc structure, the disc surface is arc-shaped, the center is inner concaved, a loop (4) is arranged in the center of the disc, and a PTFE (Polytetrafluoroethylene) membrane is sewn inside the disc; the left auricle velum surface (3) takes the shape of a horn; the atrium sinistrum velum piece (1) and the left auricle velum surface (3) are connected through the waist joint (2); and the alloy wire adopts Ni-ti alloy. The occluder can help to treat thrombi caused by atrial fibrillation.

Description

A kind of asymmetric double plate-like left atrial appendage occlusion device

Technical field

This utility model belongs to the medical instruments field for the treatment of atrial fibrillation, particularly relates to a kind of asymmetric double plate-like left atrial appendage occlusion device.

Background technology

Atrial fibrillation is one of modal chronic perpetual arrhythmia clinically, simultaneously, also is to cause that cerebral infarction causes the patient to lose labour force and dead major reason, studies confirm that 15%-20% is caused by atrial fibrillation in all paralytics.Therefore, atrial fibrillation is considered to the independently risk factor of cerebral infarction.Although oral anticoagulant prevention of stroke has had very big progress, nearly about 20% patient has the contraindication of anticoagulant therapy.Warfarin is to be widely used in the thrombosed very effective medicine of prevention atrial fibrillation at present, but its pharmacological action is subjected to the influence of many factors such as medicine, food, adjust relatively difficulty of dosage, often need monitoring International standardization zymogen time than (INR), cause the compliance difference of medication and patient's burden, and monitor improper even may cause mortality hemorrhage, its incidence rate is about 1%-2%.Therefore, for these patients with atrial fibrillation, the non-drug therapy method of seeking a kind of prevention of stroke safely and effectively is even more important.Studies confirm that the thrombosis among the nonvalvular atrial fibrillation patient more than 90% forms at left auricle, the sealing left auricle can prevent the danger of patients with atrial fibrillation thromboembolism.At present the method for sealing left auricle commonly used is exactly a department of cardiac surgery direct-view operation ligaturing left atrial appendage and prick the sealing left auricle through the thoracoscope cover down clinically.Ligaturing left atrial appendage or seal left auricle by thoracoscope when mitral valve operation and coronary artery surgery can reduce the chance of thromboembolism.But opening breast knot pricks left auricle and has 36% patient still to have residual leakage between left room and the left auricle, the effect of prevention thromboembolism is not good enough, and because open chest surgery ligaturing left atrial appendage wound is big, complication is many, be difficult to be accepted, only be used for when chronic atrial fibrillation needs operation on heart routine and carry out simultaneously by patient.The technology that Odell etc. reported through thoracoscope ligation LAA in 1996, this technology wound is little, but mirror direct-view down, and the chambers of the heart is operated outward, step is simple, the safety and the success rate height of operation, operating time is short, but needs anesthesia, postoperative has cicatrix, patient is not easy to accept, and the curative effect of prevention thromboembolism do not improve, and makes clinical popularize and popularization is restricted.

Along with the development of interventional technique, percutaneous left auricle conduit shutoff art abroad, the success from the animal experimental applications to clinical research.The external left atrial appendage occlusion device that uses clinically has following several.First, a kind of left atrial appendage occlusion device (PLAATO) of developing by people such as American Lesh the earliest, PLAATO comprises a stopper and a 14F delivery catheter, but stopper is the memorial alloy Metal Ball cage of self-expanding, surface coverage totally enclosed poly tetrafluoroethylene, with the traffic of blocking-up left auricle and left atrium, the periphery of support has barb to pass thin film to fix to assist support.This stopper is the cage spline structure of metal, inserts fully during shutoff in the left auricle, and the left auricle opening part has the possibility of leaving over residual cavity, in residual cavity, form thrombosis easily, the hidden danger that still has thromboembolism, because the deficiency that exists is gone up in design, this device has stopped producing; Propositions such as Meier in 1,2003 year are used for percutaneous left atrial appendage occlusion art with atrial septal defect plugging device Amplatzer umbrella, have reported that except that 1 example takes place the apparatus thromboembolism, other patients all leave hospital safely in the 16 example operations of finishing.But the Amplatzer umbrella is not to design for the shutoff left auricle, be not easy to be fixed on the left auricle opening, also need the assessment of further clinical trial with the safety of Amplatzer umbrella shutoff, the 3rd, another kind of new left atrial appendage occlusion device Watchman system is present up-to-date left atrial appendage occlusion device, and the nick-eltitanium alloy stent proximal end face covers the polyester film of 160um, far-end is open, and the stopper central rings can make itself and left auricle wall combine closely around fixation hook.But its left atrium Noodles is similar to the parachute spline structure, is positioned at the left auricle opening after the release, causes left auricle opening acute dilatation, may influence the function of adjacent structure, still is in clinic trial at present.

Summary of the invention

Technical problem to be solved in the utility model provides a kind of asymmetric double plate-like left atrial appendage occlusion device, to solve the treatment problem of atrial fibrillation in the prior art.

A kind of asymmetric double plate-like left atrial appendage occlusion device of the present utility model, comprise that left atrium face sheet, waist connect and left auricle face face, the network structure that described left atrium face sheet, waist connect and left auricle face face forms for the establishment of alloy silk, described left atrium face sheet is a disc structure, card is curved, circle centre position is inwardly recessed, for climbing, be sewed with PTFE film (film is sewn in the disc between left atrium face sheet, the waist connection, is 3 layers of PTFE film) in the disc in the middle of the disc; Described left auricle face face is horn-like; Connect by waist between left atrium face sheet, the left auricle face face.

Described alloy silk is a Nitinol.

Beneficial effect

The first, this utility model asymmetric double plate-like left atrial appendage occlusion device can with left atrium face form fit, recline fully, reach complete shutoff, the possibility of residual any residual cavity not avoids forming the risk of thromboembolism in residual cavity; The second, the plugging device waist structure is fixed in the left auricle opening, and its waist size can be avoided left auricle opening acute dilatation than the ratio of left auricle opening 1.1: 1, reduces its influence to adjacent structure; The 3rd, left auricle face face is designed to horn-like opening, compares with original smooth disc, is more suitable for the left auricle chamber in different shape, can fully recline with left atrial appendage; The 4th, novel asymmetric double plate-like left atrial appendage occlusion device is connected with pusher and has adopted nitinol alloy wire to climb, with original rustless steel nut relatively, may reduce the formation of thrombosis.

Description of drawings

Fig. 1 is a side view of the present utility model;

Fig. 2 is the front view of left atrium face sheet of the present utility model;

Fig. 3 is the front view of left auricle face face of the present utility model.

The specific embodiment

Below in conjunction with specific embodiment, further set forth this utility model.Should be understood that these embodiment only to be used to this utility model is described and be not used in the restriction scope of the present utility model.Should be understood that in addition those skilled in the art can make various changes or modifications this utility model after the content of having read this utility model instruction, these equivalent form of values fall within the application's appended claims institute restricted portion equally.

Embodiment 1

As Fig. 1, Fig. 2 and shown in Figure 3, this utility model is divided into three parts, and a part is a left atrium face sheet 1, card is curved, reclines fully with atrial walls, and can cover the left auricle opening fully, the centre is slightly recessed, can reduce the influence of plugging device, climbing that nitinol alloy wire makes arranged in the middle of the disc, can catch with the pincers of the head end of pusher and climb left atrium, push whole device, sew up three layers of PTFE film in the disc, stop the left atrium blood flow to enter left auricle, reach its purpose of shutoff.Another part is a left auricle face face 3, is horn-like opening, fully reclines with left atrial appendage.Be tubulose waist connection 2 in the middle of the both sides cards, make whole device stable be anchored to the left auricle intracavity.Whole plugging device is that full nitinol alloy wire braiding forms, and can take in the delivery sheath of 12-14F, delivers to the left auricle intracavity and discharges.

Implantation process is as follows: routine disinfection groin place skin, and after the local anaesthesia, the puncture femoral vein is sent into J type seal wire, arrives superior vena cava, puts the long sheath of 7F, the fossa ovalis position of interatrial septum, location, the puncture interatrial septum is injected in the successful postheparin 0.8mg/kg sheath pipe that punctures.Send into left room steel wire, arrive left atrium by the interatrial septum, the pigtail conduit is arrived left atrium by left room steel wire, radiography is seen the position of left auricle, measure the left auricle openings of sizes and the degree of depth, left once more room steel wire is delivered to left atrium by the pigtail conduit, withdraws from entering left auricle, send into convergent divergent channel expansion interatrial septum, 14F interatrial septum, withdraw from convergent divergent channel, send into delivery sheath, arrive in the left auricle, to select sizeable left atrial appendage occlusion device to move back delivers in the left auricle, radiography is estimated the shutoff situation, and is complete as shutoff, discharges stopper, withdraw from push rod, sheath tube steel silk, the femoral vein hemostasis by compression.If shutoff is incomplete, can before discharging, stopper be recovered in the sheath pipe, use big slightly left atrial appendage occlusion device instead.Postoperative bed 12 hours, vein give antibiotic prophylaxis and infected 3-5 days.

Claims (2)

1. asymmetric double plate-like left atrial appendage occlusion device, comprise that left atrium face sheet (1), waist connect (2) and left auricle face face (3), it is characterized in that: described left atrium face sheet (1), waist connect (2) and left auricle face face (3) is worked out the network structure that forms for the alloy silk, described left atrium face sheet (1) is a disc structure, card is curved, circle centre position is inwardly recessed, for climbing (4), be sewed with film in the disc in the middle of the disc; Described left auricle face face (3) is horn-like; Connecting (2) by waist between left atrium face sheet (1), the left auricle face face (3) connects.

2. a kind of asymmetric double plate-like left atrial appendage occlusion device according to claim 1, it is characterized in that: described alloy silk is a Nitinol.

Images