The present application relates to a medical device, and more particularly relates to a left atrial appendage occluder.
At the present, an occluder may be put into a left atrial appendage through a catheter intervention method to prevent a left atrial appendage thrombus caused by atrial fibrillation and avoid apoplexy caused by a fact that the thrombus goes up to a brain, or prevent systematic embolization caused by a fact that the thrombus reaches other portions of a body through a blood circulation system of a human body. Such left atrial appendage occluders substantially include an integrated occluder and a split type occluder according to its structure. For example, the split type occluder generally includes a fixing component and a sealing component which are connected with each other; the fixing component is disposed in a cavity of the left atrial appendage to fix the whole occluder; and the sealing component seals an opening portion of the left atrial appendage to block flowing of blood flow into the cavity of the left atrial appendage.
For the split type occluder of this type, a connection restriction is set between its fixing component and sealing component, which means that one component would be pulled by the other component, and the two components may not deform independently completely. For example, after being fixed in the cavity of the left atrial appendage, the fixing component would pull the sealing component during adaption to the cavity structure of the left atrial appendage and in the activity process of the left atrial appendage; during pulling, a phenomenon that the sealing component cannot be fully fitted to the opening portion of the left atrial appendage is possibly caused, and a blood flow leaking channel would be formed between a left atrium and the left atrial appendage, so that an optimal sealing effect may not be achieved, and afterwards, the thrombus in the left atrial appendage flows out of the left atrial appendage, which leads to the apoplexy.
In view of the above-mentioned problems, it is necessary to provide a left atrial appendage occluder with a good sealing effect and a high adaptability.
A technical scheme adopted to solve the technical problems is as follows: a left atrial appendage occluder is provided, including a sealing plate, a fixing plate located on one side of the sealing plate, and a connection member for connecting the sealing plate with the fixing plate, and the connection member is of a filament woven structure.
A radial deformability of the sealing plate is greater than that of the fixing plate and/or an axial deformability of the sealing plate is greater than that of the fixing plate.
According to the left atrial appendage occluder provided by the embodiment of the present application, under the action of same radial force, a radial length variation of the sealing plate is more than that of the fixing plate; or under the action of the same radial force, a radial length change rate of the sealing plate is more than that of the fixing plate; or under the action of same axial force, a displacement of the sealing plate along the axial force direction is more than that of the fixing plate along the axial force direction.
According to the left atrial appendage occluder provided by the embodiment of the present application, the connection member is of an elastic filament woven structure.
According to the left atrial appendage occluder provided by the embodiment of the present application, the connection member is of a disk shape or a barrel shape in a naturally unfolded state.
According to the left atrial appendage occluder provided by the embodiment of the present application, the peripheral surface of the connection member has an annular recess.
According to the left atrial appendage occluder provided by the embodiment of the present application, a recess is formed near a joint on at least one of end surfaces of the connection member connected with the sealing plate and connected with the fixing plate.
According to the left atrial appendage occluder provided by the embodiment of the present application, in the naturally unfolded state, the maximum radial length of the connection member is shorter than that of the fixing plate.
According to the left atrial appendage occluder provided by the embodiment of the present application, in the naturally unfolded state, at least one portion of the connection member extends out of a space encircled by the fixing plate.
According to the left atrial appendage occluder provided by the embodiment of the present application, the connection member includes a first fixed connection member, a second fixed connection member and a woven body formed by weaving filaments; the first end of the woven body is collected and fixed by the first fixed connection member; and the second end of the woven body is collected and fixed through the second fixed connection member.
According to the left atrial appendage occluder provided by the embodiment of the present application, the sealing plate is of a filament woven structure; one end of the sealing plate is connected with one side of the connection member; the fixing plate includes a plurality of supporting members; one end of each supporting member radiates and extends from the other side of the connection member; and the multiple supporting members cooperatively form an umbrella-shaped structure.
In the left atrial appendage occluder of the present application, the fixing plate and the sealing plate are connected through the connection member of the filament woven structure, so that a distance between the fixing plate and the sealing plate and an angle formed thereby are both adjustable to adapt to a left atrial appendage having a large bending angle (such as a chicken-wing shape) or requiring the fixing plate to remain at an increased distance to the sealing plate (such as a conical shape), thereby reducing a risk of failed occlusion of the left atrial appendage. In addition, as the distance between the fixing plate and the sealing plate is adjustable, the fixing plate may be located at a deep portion of the left atrial appendage to improve the fixing stability of the occluder and reduce a risk of device embolization.
In addition, the filament woven structure featuring elastic extension and retraction may achieve a buffer effect on an interaction force between the fixing plate and the sealing plate, thereby lowering the probability of poor fitting of the sealing plate to an opening portion of the left atrial appendage and reducing long-term leakage; and injury caused by puncture of a cavity wall of the left atrial appendage by the fixing plate may be lowered by alleviating stress on the fixing plate, thereby reducing a risk of hydropericardium.
In addition, the sealing plate is configured to have a larger deformation amount or deformation rate than the fixing plate. Therefore, in a pulling process, the sealing plate deforms more easily to better get close to and be better fitted to the opening portion of the left atrial appendage. Moreover, as the elastic and flexible connection member is arranged, a sealing effect of the sealing plate may be further improved. In addition, as the sealing plate deforms more easily, wear to a tissue at the opening portion of the left atrial appendage may be further correspondingly reduced, and the possibility of occurrence of inflammation, hydropericardium and even pericardial tamponade may be also reduced.
For the purpose of making the description of a structure of a left atrial appendage occluder clearer, the present application defines terms “distal end” and “proximal end”. The above-mentioned terms are commonly used terms in the field of interventional medical devices. To be more specific, the “distal end” represents an end far away from an operator in a surgical process, and the “proximal end” represents an end close to the operator in the surgical process.
The connection member 21, which is disposed between the fixing plate 12 and the sealing plate 11 and is of the filament woven structure, has a relatively high bending flexibility; under the action of the fixing plate 12 and the sealing plate 11, the connection member 21 may elastically extend and retract or bend to compensate an included angle and a distance between the fixing plate 12 and the sealing plate 11; therefore, when a cavity of the left atrial appendage 02 has a relatively large bending angle, for example, when the cavity of the left atrial appendage 02 is of a chicken wing shape as shown in
For example, the sealing plate 11 is of a filament woven structure formed by multiple weaving filaments which may be made of a shape memory material (such as a nickel-titanium alloy); one end of the sealing plate 11 is adjacent to the connection member 21, for example, the end of the sealing plate 11 and the connection member may be fixedly connected to each other in a welding or riveting way; the other end of the sealing plate 11 is detachably connected with a deliverer in a delivery process of the left atrial appendage occluder 100, and the detachable connection may be threaded connection. For example, with reference to
The fixing plate 12 includes multiple supporting members 13; one end of each supporting member 13 is connected with the connection member 21, and may be fixedly connected with the connection member 21 in a welding or riveting manner; the other end of each supporting member 13 radiates and extends from the other side of the connection member; the multiple supporting members 13 cooperatively form an umbrella-shaped structure; and each supporting member 13 includes a suspended supporting section 130. The fixing plate 12 may be manufactured by using a cutting mode. For example, the fixing plate 12 may be integrally cut from a metal tube; the metal tube may be made of a shape memory material, such as the nickel-titanium alloy. In some embodiments, anchor burrs 131 may be further formed on the suspended supporting sections 130; and the anchor burrs 131 are inserted into a cavity wall 03 of the left atrial appendage 02 to fixedly connect the fixing plate with the cavity wall 03. When the left atrial appendage occluder 100 implanted into a human body is released and unfolded, the fixing plate 12 is put into a cavity of the left atrial appendage 02 and is fixedly fitted with the cavity wall 03 of the left atrial appendage 02; and the sealing plate 11 covers an opening of the left atrial appendage 02.
Further, with reference to
With reference to
The woven body 213 woven by the filaments may elastically extend and retract or bend under the action of an external force. For example,
It can be seen from the above-mentioned description that under the action of the external force, such as the pulling action of the sealing plate 11 and/or the fixing plate 12, the connection member 21 may change a distance between the first fixed connection member 211 and the second fixed connection member 212, and may further change an angle between the first fixed connection member 211 and the second fixed connection member 212, thereby correspondingly and adaptively adjusting a length and/or an angle between the sealing plate 11 and the fixing plate 12. Therefore, the left atrial appendage occluder 100 provided by the present application may meet implantation requirements of the left atrial appendages 02 of different shapes such as the chicken-wing shape and a conical shape. In addition, under the pulling action of the sealing plate 11 and/or the fixing plate 12, with the filament woven structure, the connection member 21 may buffer the influence of the pulling force on the sealing plate 11 and the fixing plate 12 by right of its high elastic extension, retraction and bending performance.
The woven body 213 is formed by weaving 1 to 168 metal wires, preferably 12 to 144 metal wires, such as the nickel-titanium metal wires, and the diameter of each metal wire is 0.01 to 0.5 mm. The diameters and the number of the metal wires may be reasonably matched, and the metal wires are sized through thermal treatment. Further, the surfaces of the metal wires may be coated with bioceramic films, so that the flexible connection member 21 has proper hardness while keeping certain elasticity.
With reference to
With reference to
With reference to
With reference to
According to any specific implementation embodiment of the present application, for example the left atrial appendage occluder 100 or 101 or 102, the deformability of the sealing plate 11 is greater than that of the fixing plate 12. The deformability of a certain component or structure refers to a size of a deformation amount of the component or structure under the action of an external force. In the present application, the deformability herein may be expressed by a radial length (such as diameter) variation of the component or structure under the action of a radial force. Further, the radial deformability of the sealing plate 11 of the left atrial appendage occluder is greater than that of the fixing plate 12 and/or the axial deformability of the sealing plate 11 is greater than that of the fixing plate 12. To be more specific, under the action of the same radial force, the radial length variation of the sealing plate 11 is more than that of the fixing plate 12; or under the action of the same radial force, the radial length change rate of the sealing plate 11 is more than that of the fixing plate 12; or under the action of the same axial force, the displacement of the sealing plate 11 along an axial force direction is more than that of the fixing plate along the axial force direction.
Radial length changes of the fixing plate and the sealing plate under the action of the same radial force may be respectively tested by adopting a flat plate method. For example, with reference to
With reference to
It should be understood that although
With reference to
During test of the left atrial appendage occluder by adoption of the flat plate method, in order to avoid deformation of the elastic connection member 21 to adapt to radial compression of the fixing plate or the sealing plate in a flat plate radial compression process, with reference to
After the left atrial appendage occluder is implanted into a human body, such a case of improper selection of an implantation position may be possibly caused, for example, the fixing plate extends too deep into the cavity of the left atrial appendage, which possibly leads to a fact that the naturally unfolded axial length of the occluder is shorter than a relative distance between the fixing plate and the sealing plate after the implantation, thus leading to mutual pulling action between the fixing plate and the sealing plate; or after being implanted, the occluder would move together with the heart, but different movement amplitudes or directions at all portions may also lead to the mutual pulling action between the fixing plate and the sealing plate. Generally, the fixing plate and the sealing plate pull each other through the connection member.
When the fixing plate is pulled by the sealing plate, and the fixing plate is fixed in the cavity of the left atrial appendage through a radial supporting force surrounding a circumferential region of the central axial line 140, the fixing plate is mainly closely fitted to the circumferential region of the cavity of the left atrial appendage to resist this pulling acting force. Therefore, axial pulling for the fixing plate would lead to radial deformation of the fixing plate; large enough pulling action would possibly lead to separation of the fixing plate from the cavity wall of the left atrial appendage, and then the left atrial appendage occluder would fall off, which causes an implantation failure. When pulled by the fixing plate, the sealing plate with a disk surface structure is connected with the connection member through the disk surface, so that the axial pulling for the sealing plate would also lead to radial deformation of the sealing plate.
Therefore, when the fixing plate and the sealing plate pull each other, one plate which easily deforms in the radial direction is pulled by the other plate, for example, under the same radial acting force, as the radial length variation of the fixing plate according to the embodiment of the present application is smaller than that of the sealing plate, or the radial length change rate of the fixing plate according to the embodiment of the present application is smaller than that of the sealing plate, in the mutual pulling process, the fixing plate would pull the sealing plate in a leading manner to make the sealing plate deform towards the fixing plate direction (or towards the distal end). Such deformation enables the sealing plate to be fitted to a left atrial wall at an opening of the left atrial appendage more closely than the naturally unfolded state, which enhances a sealing effect of the sealing plate on the opening of the left atrial appendage and avoids formation of a clearance space between the sealing plate and the left atrial wall, thereby preventing apoplexy or systematic embolization caused by blood flow flowing into the cavity of the left atrial appendage through the clearance space and a thrombus flowing into a left atrium through the clearance space. In addition, the fixing plate leads the pulling and is not easily pulled to be separated from the cavity wall of the left atrial appendage by the sealing plate, so that the occluder is better fixed in the left atrial appendage and is prevented from falling off from the left atrial appendage.
The above-mentioned flat plate test method is only an example test method, but not intended to limit the present application, and a person of ordinary skill in the art can adopt any proper method for conducting the test equivalent to the flat plate test method. For example, the radial acting force is uniformly applied to the circumferential direction of a component to be tested for testing. Specifically, with reference to
In addition, under a condition that one portion of the component to be tested (the fixing plate or the sealing plate) is restricted, the axial deformability of the component is expressed by testing an axial displacement (along the direction of the central axial line 140) of the component under the action of the same axial force. In a first axial deformability test method, the above-mentioned restriction is equidimensional restriction, that is to say, in the restriction process, the component to be tested does not elastically deform or deforms a little, which may be ignored basically; and in addition, the axial acting force is applied to a position, where no elastic deformation occurs, on the component to be tested. For example, the same axial acting force is applied to one end portion, which is connected with the connection member, of the component to be tested to test the axial displacement of the component to express its own deformability, and the axial displacement of the component here is the axial displacement of the force application portion. The left atrial appendage occluder meets the condition that the axial displacement of the fixing plate is smaller than that of the sealing plate. During testing, the fixing plate and the sealing plate are independently tested, for example, the single fixing plate or the single sealing plate is tested at each time, so that the influence of the connection member 21 may be ignored.
With reference to
With reference to
It can be seen from the above that after the left atrial appendage occluder is implanted into the human body, under the condition that one portion of the sealing plate is clamped, for example, under the condition that the distal end fixing member 111 of the sealing plate 11 is clamped, the tested axial displacement under the action of the axial pulling force F1 represents the axial deformability of the sealing plate 11 pulled by the fixing plate 12 under the restricting action of a tissue wall of the opening portion of the left atrial appendage after the occluder is implanted into the cavity of the left atrial appendage. Under the same axial pulling force, larger ΔO2 indicates easier pulling deformation of the sealing plate 11.
It is tested that under the action of the same axial force, the axial displacement ΔO1 of the fixing plate is smaller than that ΔO2 of the sealing plate. It should be understood that when the fixing plate and the sealing plate pull each other, one plate which has a larger axial displacement is pulled by the other plate, for example, under the same axial acting force, as the axial displacement of the fixing plate according to the embodiment of the present application is smaller than that of the sealing plate, in the mutual pulling process, the fixing plate would pull the sealing plate in a leading manner to make the sealing plate deform towards the fixing plate direction (or towards the distal end). Such deformation enables the sealing plate to be fitted to the left atrial wall at the opening of the left atrial appendage more closely than the naturally unfolded state, which enhances a sealing effect of the sealing plate on the opening of the left atrial appendage and avoids formation of a clearance space between the sealing plate and the left atrial wall, thereby preventing blood flow from flowing into the cavity of the left atrial appendage through the clearance space and preventing a thrombus from flowing into a left atrium through the clearance space. In addition, the fixing plate leads the pulling and is not easily pulled to be separated from the cavity wall of the left atrial appendage by the sealing plate, so that the occluder is better fixed in the left atrial appendage and is prevented from falling off from the left atrial appendage.
A second axial deformability test method may be further adopted. With reference to
It can be seen from the above that after the left atrial appendage occluder is implanted into a human body, under the condition that one portion of the fixing plate 12 is clamped, for example, under the condition that the maximum contour of the fixing plate 12 is clamped, the tested axial displacement under the action of an axial pulling force represents the deformability of the fixing plate 12 pulled by the sealing plate 11 under the restricting action of the cavity of the left atrial appendage after the occluder is implanted into the cavity of the left atrial appendage. Under the same axial pulling force, larger ΔO3 indicates easier pulling deformation of the fixing plate 12.
With reference to
It can be seen from the above that after the left atrial appendage occluder is implanted into the human body, under the condition that one portion of the sealing plate is pressed by the cavity wall of the left atrium at the opening portion of the left atrial appendage, wherein at least the maximum radial edge, which faces to the fixing plate, of the sealing plate is pressed, so that in the test process of the sealing plate, under conditions that the annular fixing member presses against the maximum radial edge, which faces to the fixing plate, of the sealing plate and the maximum radial edge is kept not moving along the direction of the central axial line 140, the tested axial displacement of the sealing plate under the action of the axial pulling force represents the deformability of the sealing plate pulled by the fixing plate at the opening of the left atrial appendage after the occluder is implanted into the human body. Under the same axial pulling force, larger ΔO4 indicates easier pulling deformation of the sealing plate.
It is tested that under the action of the same axial force (F2), the axial displacement ΔO3 of the fixing plate is smaller than that ΔO4 of the sealing plate. It should be understood that when the fixing plate and the sealing plate pull each other, one plate which has a larger axial displacement is pulled by the other plate, for example, under the same axial acting force, as the axial displacement of the fixing plate according to the embodiment of the present application is smaller than that of the sealing plate, in the mutual pulling process, the fixing plate would pull the sealing plate in a leading manner to make the sealing plate deform towards the fixing plate direction (or towards the distal end). Such deformation enables the sealing plate to be fitted to the left atrial wall at the opening portion of the left atrial appendage more closely than the naturally unfolded state, which enhances a sealing effect of the sealing plate on the opening of the left atrial appendage and avoids formation of a clearance space between the sealing plate and the left atrial wall, thereby preventing blood flow from flowing into the cavity of the left atrial appendage through the clearance space and preventing a thrombus from flowing into a left atrium through the clearance space. In addition, the fixing plate leads the pulling, and is not easily pulled to be separated from the cavity wall of the left atrial appendage by the sealing plate, so that the occluder is better fixed in the left atrial appendage and is prevented from falling off from the left atrial appendage.
In the left atrial appendage occluder of the present application, the connection member is of the filament woven structure, and has high elastic extension, retraction and bending performance. It has a deformation space under a pulling force and/or a compressing force, and may provide an angle and/or length adjustment function to adapt to implantation of left atrial appendages in more shapes and sizes, and the implantation stability of the left atrial appendage occluder is improved. In addition, the mutual pulling action between the fixing plate and the sealing plate during operation and after operation may be buffered through the elastic extension, retraction and bending performance of the connection member when transmitted to the connection member, thereby reducing influence on the fixing plate and the sealing plate due to the pulling action, for example, avoiding leakage as much as possible caused by non-fitting of coverage of the sealing plate due to the fact that the sealing plate is pulled into the cavity of the left atrial appendage and avoiding injury as much as possible to the cavity wall of the left atrial appendage due to pulling of the fixing plate, which reduces a risk of hydropericardium.
All the technical features of the above embodiments may be randomly combined. In order to simplify the description, not all possible combinations of the respective technical features in the embodiments are described. However, the combinations of these technical features shall fall within the scope described in the description in case of no contradictions.
The above embodiments only express a few of implementation modes of the present application, and their descriptions are relatively specific and detailed, but shall not be regarded as limitations to the scope of the patent for the present application. It should be noted that persons of ordinary skill in the art can further make a plurality of deformations and improvements without departing from the idea of the present application, and these deformations and improvements shall all fall within the protection scope of the present application. Therefore, the scope of protection of the present application shall be based on attached claims.
Number | Date | Country | Kind |
---|---|---|---|
2015 1 0714210 | Oct 2015 | CN | national |
Filing Document | Filing Date | Country | Kind |
---|---|---|---|
PCT/CN2016/092753 | 8/1/2016 | WO | 00 |
Publishing Document | Publishing Date | Country | Kind |
---|---|---|---|
WO2017/071353 | 5/4/2017 | WO | A |
Number | Name | Date | Kind |
---|---|---|---|
5725552 | Kotula | Mar 1998 | A |
6652555 | VanTassel | Nov 2003 | B1 |
8828051 | Javois | Sep 2014 | B2 |
20070265656 | Amplatz | Nov 2007 | A1 |
20080200945 | Amplatz | Aug 2008 | A1 |
20130218193 | Erzberger et al. | Aug 2013 | A1 |
Number | Date | Country |
---|---|---|
101304693 | Nov 2008 | CN |
103598902 | Feb 2014 | CN |
103705274 | Apr 2014 | CN |
103889339 | Jun 2014 | CN |
203634235 | Jun 2014 | CN |
204181678 | Mar 2015 | CN |
Entry |
---|
International Search Report with Written Opinion dated Nov. 2, 2016 of corresponding International application No. PCT/CN2016/092753; 13 pgs. |
Number | Date | Country | |
---|---|---|---|
20180271538 A1 | Sep 2018 | US |