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CN2388920Y - Multi-function apparatus for cardiac valve replacement operation - Google Patents

Multi-function apparatus for cardiac valve replacement operation Download PDF

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Publication number
CN2388920Y
CN2388920Y CN 99234462 CN99234462U CN2388920Y CN 2388920 Y CN2388920 Y CN 2388920Y CN 99234462 CN99234462 CN 99234462 CN 99234462 U CN99234462 U CN 99234462U CN 2388920 Y CN2388920 Y CN 2388920Y
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wide
valve replacement
diameter
fixed
lever arm
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CN 99234462
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郑国强
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Abstract

The utility model discloses a multi-function apparatus for cardiac valve replacement operation, which is a surgical instrument mainly used for aortic valve replacement operation, bicuspid valve replacement operation, tricuspid valve replacement operation, multi-cardiac valve replacement operation in cardiac operation under direct vision. The utility model is characterized in that the multi-function apparatus for cardiac valve replacement operation is composed of a gear rack plate, a fixed arm, a movable arm, a driving wheel, a rocking handle, four movable baffles, two suture fixing springs and six plate type draw hooks, wherein, a breast bone is unhinged by the baffles in four points, which causes the breast bone not easy to break off and break up. The spring interval is 0.2-0.3 mm, and each valve suture can be fixed in an optimum position. The plate type draw hooks with different sizes causes the operating field of heart notching operations to be exposed sufficiently in favor of operators to operate.

Description

Cardiac valve replacement operation multi-functional apparatus
This utility model relates to a kind of operating theater instruments, is that a kind of breastbone of OH valve replacement surgery retracts, the operation on heart otch retracts, the fixed three function apparatuses of valve suture specifically.Be mainly used in the aortic valve replacement of OH; Mitral valve replacement; Replacement of tricuspid valve; The multiple valve replacement art.Chest medisection, the vertical shape breastbone of riving retracts the breast bone; Cut heart, the operative incision tractive is opened; Insert mechanical valve prosthesis or biovalve, with the fixed three function operating theater instruments of suture of seam valve.Thus, the innovation for cardiac valve replacement operation multi-functional apparatus has very big practical value.
Valvular displacement developmental stage is: nineteen sixty, Harken replaces art with mechanical prosthetic valve row aorta lobe; 1961, StarrShi replaced Bicuspid valve with the ball cage type mechanical prosthetic valve; 1962, RossShi then transplanted successfully with aortic valve of the same race; Changhai hospital of China nineteen sixty-five The 2nd Army Medical College is used for mechanical prosthetic valve clinical; The Fuwai Hospital was used for bioprosthetic valve clinical in 1976.
Over 30 years, the operative incision method of prosthetic valve replacement sees " department of cardiac surgery technology collection of illustrative plates " book of professor Guo Jiaqiang of Fuwai Hospital, Beijing chief editor, nineteen ninety-five December publication 2-7 page or leaf.Seam valve method sees Fuwai Hospital, Beijing, " department of cardiac surgery guide " book of Zhu Xiaodong academician, professor Xue Ganxin chief editor, and nineteen ninety publishes, 369~419 pages.
Prosthetic valve replacement extensively adopts chest median incision and the stringer breastbone of riving over 30 years.The patient generally all gets dorsal position.Skin incision is from sternal notch upper limb 10~20mm, terminate in the going up of xiphoid-process and umbilicus line, in 1/3 place.Should be exactly at the breastbone median line breastbone of riving, to a side, after strutting otch, will be high on one side low on one side as askew, heart is also askew appear extreme difference, and narrow one side breastbone to fracture very easily on one side, and is when art is used fixation with steel wire eventually, also extremely insecure.The two blade retractors used of the general rib of Cai Yonging always, two blades should be supported on the middle and lower part of sternal body.If the length of otch is moderate, strut the back otch and be Long Circle, the operating field space is big, is convenient to operation; On the contrary, too short as otch, two blades of retractor certainly will can not be placed on too low position, and after firmly strutting, otch is a short horizontal ellipse, and trunks of branchial plexus also is extruded between clavicle and rib cage and injured easily, thus, the two blade retractors of using with general rib in prosthetic valve replacement are unscientific, cause that easily breastbone fractures, trunks of branchial plexus is injured, simultaneously two blades height are at 40~50mm, damage the histoorgan below the breastbone easily.
Over 30 years, the seam lobe method of aortic valve replacement has three kinds: 1. single needle interrupted suture; 2/0 suture passes lobe ring and artificial lobe sutural margin, and artificial lobe is placed on the operating field, and 7-8 single line put in per 1/3 week footpath (attachment margin that is equivalent to a lobe leaf), and mosquito forceps cuts off suture needle on the folder.With the tension of three groups of lines and push artificial lobe and go into the lobe bed, the knotting back checks that artificial lobe opens and closes that function is good, coronary ostium is not obstructed, and the end of a thread stump is not long in case block the blade of mechanical prosthetic valve, can sew up aortic orifice.2. it is similar to single needle interruption stitch to be interrupted " 8 " word sewing method, but each 1/3 periphery is only with 4-5 " 8 " word, mosquito forceps on the folder.3. be interrupted mattress suture: the 2-0 double needle stitched the lobe ring earlier, passed artificial lobe sutural margin then.4-5 of seam was interrupted cotton-padded mattress formula suture between each had a common boundary, and with mosquito forceps the end of a thread clipped together, and was three groups altogether.
Over 30 years, the seam lobe method of mitral valve replacement has two kinds: 1. continous suture: this method is simple, toe-in is few, saves time, and is applicable to that mitral orifice appears good case.With the general Lip river of 2-0 synthetic fibre line,, be stitched to 12 knottings respectively from both sides since 6.2. interrupted suture: be applicable to secondary changing valve, appear poor case.From left room face inserting needle, mattress suture 12-15 pin divides two groups to press from both sides with mosquito forceps with 7 * 17 double end noinvasive polyester threads.
Over 30 years, the seam lobe method of Tricuspid Valve Replacement: the septal leaflet position will be adopted and is interrupted cotton-padded mattress formula shimming sewing method, is sewn on the basilar part of lobe leaf, can't be sewn on the lobe ring, in case III ° of atrioventricular block, all the other positions can adopt interruption or continuation method to be sewn on the lobe ring.Suture divides two groups or three groups to press from both sides with mosquito forceps.
Over 30 years, the seam valve method of aortic valve replacement, mitral valve replacement, replacement of tricuspid valve, single needle interrupted suture wherein, be interrupted the suture fixing means that " 8 " word is sewed up, is interrupted mattress suture, weak point, 7-8 single lug is together, make several sutures tangle up that intersects, be difficult to during knotting separately prolong the aorta clamping time, cause death easily; 7-8 single lug together, the degree of tightness of drawing is inhomogeneous, tension cuts or tears aorta wall easily, causes the postoperative aorta hemorrhage; 7-8 single lug beaten this root line easily during knotting and is in the same place together with other single line, the suture spacing increases, also easy postoperative hemorrhage; Suture is not tight, and perivalvular leakage can take place.When inserting valve, suture is clipped together, and indivedual suture tensions cause excessive tractive atrioventricular ring easily, cause the postoperative massive hemorrhage easily; Single lug trimming together after 7-8 knotting causes stump different in size easily, forms that indivedual suture stumps are long to embed artificial lobe mouth, and rough sledding such as acute lobe is malfunctioning take place.
The purpose of this utility model is for fear of home and abroad the deficiencies in the prior art part, and provide a kind of chest median incision, the stringer breastbone of riving, 4 retract breastbone, multiple spot retracts cardiac incision, the valve suture is fixed, and various heart valve replacement surgeries are suitable for, cardiac valve replacement operation multi-functional apparatus easy to use.
This utility model is formed (seeing accompanying drawing) to (5), (6) 4 of movable plate washers, (7) 6 on screw, (8) 2 of suture retainer springs, (9) 6 of board-like drag hooks by rack-plate (1), fixed arm (2), lever arm (3), thumb wheel (4), rocking handle.
Detailed content of the present utility model is the long 270mm of rack-plate (1), wide 20mm, thick 5mm.Space width is that 4mm, the facewidth are that 4mm, tooth depth are 6mm, and the tooth bar top is circular-arc.Tooth bar (1) one end stretches into the slot of fixed arm (2) the wide 20mm in side, high 5mm, and welds with argon arc; The long 210mm of fixed arm (2), thick 20mm, thick 5mm have two on the wide face The shape hole, long 32mm, middle wide 6mm, two head breadth 8mm slide the screw of fixing movable plate washer (6) in the above, and three diameter 5mm screwed holes are arranged on the wide face, the screw of fixing spring (7) usefulness, an end side surface have the slot of wide 20mm, high 5mm to be connected with tooth bar (1) one end; The long 220mm of lever arm (3), lever arm is a sliding shoe near the long 40mm of tooth bar end, wide 40mm, thick 12mm, residue 180mm is wide 20mm, thick 5mm, has two above
Figure Y9923446200062
The shape hole, long 32mm, middle wide 6mm, two head breadth 8mm, the screw of fixing movable plate washer (6) is slided in the above, three diameter 5mm screwed holes are arranged on the wide face of this end, midfeather 60mm, the screw of fixing spring (7) is used, it is the circular hole of 14mm that diameter is arranged on the face of sliding shoe, thumb wheel (4) is inserted in this hole, and there is the slot of long 20mm, high 5mm the center, side, is inserted in rack-plate (1) and goes up slip; Thumb wheel (4) is combined integrated by wheel disc, washer, three of dial axises, highly is 35mm, and the spacing of wheel disc and washer is 5mm, 2 of dial axises, the diameter of axle is that the height of 3.5mm, axle is 5mm, and diaxon centre-to-centre spacing is 8.5mm, and the wheel disc height is 21mm, for cylindrical, top body diameter is 10mm, and there is the circular hole of 2mm the side, below the round platform diameter be 14mm, middle round platform diameter 17mm, washer diameter 14mm, thick 4mm.Distance herein, size, structure are crucial, and not so retractor leads not open; Rocking handle is (5) long 110mm, and the wide end of handle is that 15mm, thick 6mm, narrow end are 9mm, thick 8mm, connects thumb wheel (4) end and is the U-shaped fork, width is 16mm, the long 20mm of fork, pitch thick 3mm on one side, pitch high 8mm, and the circular hole of the 2mm of the top cylindrical sides of dial axis (4), fix with the connecting rod of diameter 2mm; Movable plate washer (6) has 4, for
Figure Y9923446200071
Shape, lower part adopt the sheet material once-forming of 3mm, high 36mm, wide 30mm, above the length of fall home be 20mm, below the length of fall home be 13mm.Above part be the high 10mm of diameter 5mm screw with cover, be fixed on lever arm (3) and fixed arm (2)
Figure Y9923446200072
The part of fall home adopts and penetrates welding in the shape hole and above the plate washer, can only
Figure Y9923446200073
Move in the shape hole, plate washer (6) can not take off; 6 in screw (7) a cover, covers thick 3mm at long 20mm, diameter 6mm, the long 5mm of threaded section, and there is a groove centre, change the vertebra usefulness of tightening up a screw, have that 4mm is wide, diameter is the 4mm ring recess under the lid, fix board-like drag hook (9) herein, the partial fixing suture retainer spring (8) below the ring recess; The long 130mm of suture retainer spring (8), overall diameter 7mm, interior diameter 5mm, gap are 0.2~0.3mm, adopt the 1.0mm1Cr18Ni9Ti filament winding to become.Fixed arm (2) and lever arm (3) are gone up each one; 6 in board-like drag hook (9) one covers, width are 12,14,16,18,20,22mm, length 230mm, thickness 1.5mm, and the degree of depth of hook is 20,23,26,30,35 respectively, 40mm, the front is a recessed crack circular arc.There are three on each board-like drag hook
Figure Y9923446200074
Shape fixing hole (10), spacing be 30mm, go up circular diameter 7mm, circular diameter 4mm down, and this hole is that board-like drag hook (9) is fixed on the diameter 4mm ring recess of screw (7) the cardiac incision tissue pulling.Thumb wheel (4) is inserted in wide circular hole of going up diameter 14mm of sliding shoe of lever arm (3), and lever arm (3) is inserted on the rack-plate (1) again, and rotation crank is (5), and lever arm (3) can be gone up at rack-plate (1) and slide freely.
Suture retainer spring (8) is selected the 1.0mm1Cr18Ni9Ti silk for use, and all the other all select rare metal titanium material for use.
Compared to existing technology, this utility model has following advantage:
1. design science is reasonable, and 4 contacts of movable plate washer patient breastbone part has disperseed to have avoided breastbone to fracture, split, damage the trunks of branchial plexus nerve to retracting the pressure that breastbone bears.Obviously be better than 2 retractors that retract breastbone.
2. the spring gap of two long 130mm, 0.2~0.3mm is fixed seam aortic valve, Bicuspid valve, all optional optimum position of tricuspid every suture, obviously is better than suture is divided into two groups or three groups of methods with the mosquito forceps folder.
3. the board-like drag hook of 6 different sizes has three on each board-like drag hook
Figure Y9923446200081
The shape hole can adapt to large and small different otch on the heart, and with wild expose very abundant of art, board-like drag hook plasticity is very strong, and flexible different angles are fixed on the retractor, avoid the patient with pulling.
4. movable plate washer is at fixed arm and lever arm
Figure Y9923446200082
Arbitrarily move on the shape, adapt to different weight, all ages and classes, dissimilar operation, multi-use.
5. spring is selected the 1cr18Ni9Ti material for use, good springiness, other select the titanium material for use, have excellent decay resistance, prolonged application needn't be worried to get rusty, and reduces pollution factor.
6. the height of movable plate washer is that 36mm, width are 30mm, and size is suitable, and at present the plate washer height of the retractor of usefulness is 40~50mm, damages the histoorgan below the breastbone easily.
7. various sterilization methods such as adaptive radiation sterilization, heat sterilization, chemosterilization.
Description of drawings: figure is the sketch map of cardiac valve replacement operation multi-functional apparatus
1-rack-plate, 2-fixed arm
3-lever arm, 4-thumb wheel
5-rocking handle is 6-movable plate washer
7-screw, 8-suture retainer spring
9-board-like drag hook 10-
Figure Y9923446200083
The shape fixing hole
The best way of implementing:
1. rare metal titanium material is a difficult to machine material.The one, keep cutter sharp, correctly select cutter material for use; The 2nd, choose reasonable cutting three elements; The 3rd, fully use cutting agent to reduce the friction of cutter bits.
2. the processing of thumb wheel is adopted the method for machining, welding secondary operations.Thumb wheel is one of important component part of retractor, and is combined integrated by wheel disc, dial axis, 3 of washers, and the spacing that guarantees diaxon centre-to-centre spacing and washer and wheel disc is a key.After processing for the first time, adopt the dividing head location, hole, and then connect with pulsed argon arc welding.
3. rack-plate is to guarantee that thumb wheel rotates continuously, and the sliding shoe slip key freely on the lever arm adopts the electric spark cutting forming for this reason.
4. because material surface has a hard oxide and a carbide lamella, its solder technology is complicated stricter than rustless steel and aluminium alloy welding, adopts argon tungsten-arc welding, conscientiously clear up weldment, welding wire surface impurity, with the low source of welding current, fast speed of welding, in case produce defectives such as pore and crackle.

Claims (7)

  1. One kind by rack-plate (1), fixed arm (2), lever arm (3), thumb wheel (4), rocking handle (5), (6) 4 of movable plate washers, screw (7), (8) 2 of suture retainer springs, (9) 6 cardiac valve replacements of forming operations of board-like drag hook multi-functional apparatus.It is characterized in that rack-plate (1) one end stretches into the slot of fixed arm (2) the wide 20mm in side, high 5mm, welds with argon arc; Fixed arm (2) and wide of lever arm (3) all have two
    Figure Y9923446200021
    The shape hole.Sideboard (6) 4 high 36mm, wide 30mm are separately fixed at In the shape hole, on wide of fixed arm (2) and the lever arm (3) three screws (7) are arranged respectively, 2 of suture retainer springs are separately fixed on the screw (7); (9) 6 of board-like drag hooks are the ring recess place of 4mm, wide 4mm according to the operation needs with several screw (7) diameters that just are fixed on fixed arm (2) and lever arm (3) wide.Lever arm (3) one end sliding shoe sides have the slot of long 20mm, high 5mm to be inserted on the rack-plate (1), the circular hole that diameter 14mm is arranged on wide of sliding shoe, thumb wheel (4) is inserted in this hole, body diameter 10mm above the thumb wheel (4), there is the circular hole of 2mm the side, with rocking handle the connecting rod of the U-shaped of (5) fork with diameter 2mm is connected.Rotation crank is (5), and lever arm (3) can be gone up at rack-plate (1) and slide freely.
  2. 2. cardiac valve replacement according to claim 1 operation multi-functional apparatus is characterized in that there are two respectively on fixed arm (2) and lever arm (3) wide The shape hole, long 32mm, middle wide 6mm, two head breadth 8mm are that sideboard (6) moves usefulness in the above.
  3. 3. cardiac valve replacement operation multi-functional apparatus according to claim 1, it is characterized in that on fixed arm (2) and lever arm (3) wide the long 20mm of three screws (7), diameter 6mm being arranged respectively, the long 5mm of threaded section, cover thick 3mm, there is a groove centre, change the vertebra usefulness of tightening up a screw, lid has down that 4mm is wide, diameter is the 4mm ring recess, fixes board-like drag hook (9) herein, tight following cylinder anchor suture retainer spring (8).
  4. 4. cardiac valve replacement according to claim 1 operation multi-functional apparatus is characterized in that movable plate washer (6) has 4, is " ㄋ " shape, high 36mm, wide 30mm, above fall home length be 20mm, below fall home length be 13mm.Upper part is diameter 5mm, the high 10mm of screw with cover.
  5. 5. heart valve replacement operation multi-functional apparatus according to claim 1, it is characterized in that (9) 6 of board-like drag hooks, width is 12,14,16,18,20,22mm, length 230mm, thickness 1.5mm, the degree of depth of hook is 20,23,26,30,35 respectively, 40mm, the front is a recessed crack circular arc, has three on the board-like drag hook The shape hole, last circular diameter 7mm, following circular diameter 4mm, hole and pitch of holes are 30mm, this hole is that the ring recess that (9) 6 of board-like drag hooks are fixed on the screw (7) is used.
  6. 6. cardiac valve replacement operation multi-functional apparatus according to claim 1 is characterized in that (8) 2 of suture retainer springs, and long 130mm, overall diameter 7mm, interior diameter 5mm, gap are 0.2~0.3mm, adopt the 1.0mm1Cr18Ni9Ti filament winding to become.The screw (7) of fixed arm (2) and lever arm (3) is gone up each and is fixed one.
  7. 7. cardiac valve replacement operation multi-functional apparatus according to claim 1 is characterized in that rack-plate (1), fixed arm (2), lever arm (3), thumb wheel (4), rocking handle are to select for use rare metal titanium material to manufacture to (5), (6) 4 of sideboards, screw (7), (9) 6 of board-like drag hooks.
CN 99234462 1999-03-22 1999-03-22 Multi-function apparatus for cardiac valve replacement operation Expired - Fee Related CN2388920Y (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN 99234462 CN2388920Y (en) 1999-03-22 1999-03-22 Multi-function apparatus for cardiac valve replacement operation

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN 99234462 CN2388920Y (en) 1999-03-22 1999-03-22 Multi-function apparatus for cardiac valve replacement operation

Publications (1)

Publication Number Publication Date
CN2388920Y true CN2388920Y (en) 2000-07-26

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Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101365389B (en) * 2005-10-14 2011-07-06 科力士公司 Apparatus and method for forming a hole in a hollow organ
CN102429691A (en) * 2011-09-16 2012-05-02 刘鸿箫 Suture fixer prohibited for secondary use
CN102647947A (en) * 2009-10-23 2012-08-22 碧维-韦斯泰科国际(美国)股份有限公司 Speculum
CN109464170A (en) * 2018-12-18 2019-03-15 山东省千佛山医院 A left atrial appendage retractor and an auxiliary component for mitral valve surgery
CN114668435A (en) * 2022-03-28 2022-06-28 首都医科大学附属北京安贞医院 Atrial stretch auxiliary device and atrial retractor
CN116763368A (en) * 2023-04-27 2023-09-19 浙江大学医学院附属儿童医院 Surgical spreader for infants

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101365389B (en) * 2005-10-14 2011-07-06 科力士公司 Apparatus and method for forming a hole in a hollow organ
CN102647947A (en) * 2009-10-23 2012-08-22 碧维-韦斯泰科国际(美国)股份有限公司 Speculum
CN102429691A (en) * 2011-09-16 2012-05-02 刘鸿箫 Suture fixer prohibited for secondary use
CN102429691B (en) * 2011-09-16 2013-02-27 刘鸿箫 Suture fixer prohibited for secondary use
CN109464170A (en) * 2018-12-18 2019-03-15 山东省千佛山医院 A left atrial appendage retractor and an auxiliary component for mitral valve surgery
CN114668435A (en) * 2022-03-28 2022-06-28 首都医科大学附属北京安贞医院 Atrial stretch auxiliary device and atrial retractor
CN116763368A (en) * 2023-04-27 2023-09-19 浙江大学医学院附属儿童医院 Surgical spreader for infants

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