The disclosure relates to a technical field of medical instruments, and in particular to a valve clip delivery device.
A mitral valve is a one-way valve located between a left atrium and a left ventricle of a heart. The mitral valve which is normal and healthy can control flow of blood from the left atrium to the left ventricle, and further avoid flow of blood from the left ventricle to the left atrium. The mitral valve includes a pair of leaflets, which are referred to as an anterior leaflet and a posterior leaflet. Under normal circumstances, during the systole of the left ventricle, edges of the anterior leaflet and the posterior leaflet are completely aligned, so as to prevent blood from flowing from the left ventricle to the left atrium. When the leaflets, chordae tendineae or annulus of the mitral valve is diseased, for example, such as partial rupture of the chordae tendineae and poor alignment of the anterior leaflet and the posterior leaflet of the mitral valve, the mitral valve cannot be fully closed during the systole of the left ventricle, such that blood flows back from the left ventricle to the left atrium, resulting in a series of pathological and physiological changes, which are referred to as “mitral regurgitation”.
Edge-to-edge repair of the mitral valve is an effective method for treating mitral regurgitation. Specifically, the edges of the anterior leaflet and the posterior leaflet of the mitral valve that cannot be normally aligned are fixed together by means of suturing or clamping, so as to reduce a leaflet gap, such that a double orifice structure is formed at a valve orifice of the mitral valve, so as to reduce a total area of the valve orifice of the mitral valve and reduce or eliminate regurgitation. A traditional edge-to-edge repair surgery for a mitral valve is operated under direct vision conditions, and usually requires thoracotomy and establishment of extracorporeal blood circulation, resulting in a high risk. With advancement of a technology, various minimally invasive surgeries and interventional surgeries have been developed. These surgeries only require a small operating window on a body of a patient, and thus a valve clip is delivered to the diseased mitral valve by utilizing a delivery device. The valve clip clamps and fixes part of edges of two leaflets together, and the double orifice structure is formed at the valve orifice of the mitral valve, thereby reducing regurgitation. However, an existing valve clip delivery device typically allows a valve clip to be actuated at any position and at any moment, posing a risk that the valve clip is accidentally opened, thereby disrupting a surgical process.
The technical problem to be solved by the disclosure is to provide a valve clip delivery device, which can avoid a risk of accidental opening of a valve clip.
In order to achieve the above objective, some embodiments of the disclosure use the following technical solution:
Some embodiments of the disclosure provide a valve clip delivery device configured to deliver and control a valve clip. The valve clip includes at least two clamping members which are relatively opened and closed, and the valve clip is provided with a self-locking mechanism. The valve clip delivery device includes a handle and a catheter, wherein the handle includes a housing, a clamping control assembly and a locking control assembly, wherein a proximal end of the catheter is fixedly connected with a distal end of the housing, the clamping control assembly and the locking control assembly are both disposed on the housing, the locking control assembly is connected with the self-locking mechanism and is configured to control the valve clip to be switched between an unlocked state and a self-locking state, and the clamping control assembly is configured to control the at least two clamping members to be opened or closed when the valve clip is in the unlocked state.
According to the valve clip delivery device provided by the disclosure, since the locking control assembly is arranged, it can be ensured that the valve clip is delivered in place in the self-locking state. Only after the valve clip is controlled to be switched to the unlocked state by means of the locking control assembly, the at least two clamping members of the valve clip can be opened to clamp leaflets such that the valve clip can be prevented from being accidentally opened in a delivery process, thereby being conducive to smooth operation of a valve edge-to-edge repair surgery.
In order to make the objectives, technical solutions, and advantages of the disclosure clearer, the disclosure will be further described in detail below referring to the accompanying drawings.
It should be understood that expressions such as “include”, “comprise”, “may include” and “may comprise” that can be used in the disclosure indicate existence of disclosed functions, operations, or constituent elements, and do not limit one or more additional functions, operations, or constituent elements. In the present disclosure, terms such as “including”. “comprising” and/or “having” can be interpreted as indicating a specific characteristic, number, operation, constituent element, assembly or combination thereof, but cannot be interpreted as excluding the existence or addition possibility of one or more other characteristics, number, operation, constituent element, assembly or combination thereof.
In addition, in the disclosure, the expression “and/or” includes any and all combinations of words listed in association. For example, the expression “A and/or B” can include A, B, or both A and B.
In the disclosure, expressions including ordinal numbers such as “first” and “second” can modify various elements. However, these elements are not limited by the above expression. For example, the above expression does not limit the order and/or importance of the elements. The above expression is only configured to distinguish one element from other elements. Similarly, without departing from the scope of the present disclosure, a first element can be referred to as a second element. Similarly, the second information can also be referred to as the first element.
When an assembly is referred to as “connecting” or “being connected with” other assemblies, it should be understood that the assembly not only directly connects or is connected with other assemblies, but another assembly can further exist between the assembly and other assemblies. On the other hand, when the assembly is referred to as “directly connecting” or “being directly connected with” other assemblies, it should be understood that there are no assemblies between the assemblies.
In the technical field of interventional medical instruments, a direction close to an operator is generally defined as a proximal end, and a direction away from the operator is defined as a distal end. The direction of a central axis of rotation of objects such as cylinders and tubes is defined as an axial direction. A circumferential direction refers to a direction (perpendicular to an axis and further perpendicular to a sectional radius) around the axis of a type of objects such as cylinders or tubes.
Referring to
Referring to
Referring to
The valve clip 20 has an unlocked state and a self-locking state. The valve clip 20 can be switched between the unlocked state and the self-locking state. When the resilient piece 275 biases the locking piece 273, the through hole of the locking piece 273 is abutted against the shaft body 213 of the base 21, the shaft body 213 can not move in its axial direction relative to the locking piece 273, and the valve clip 20 is in the self-locking state. When the locking piece 273 is subjected to an external force to overcome a bias of the resilient piece 275, the locking piece 273 returns to a desired position, such that the inner wall of the through hole for the shaft body 213 to pass therethrough on the locking piece 273 is no longer abutted against the shaft body 213 of the base 21. The shaft body 213 can move in its axial direction relative to the locking piece 273, and the valve clip 20 is switched from the self-locking state to the unlocked state. In this case, the valve clip delivery device 40 can control the shaft body 213 to move in the axial direction, such that the two clamping members 25 can be driven to be opened radially or closed.
Referring to
Referring to
Understandably, in some embodiments of the present disclosure, more than two clamping members 25 can be arranged, and more than two driving arms 23 can be arranged, just ensure that the valve clip 20 can clamp or release the leaflets, and the valve clip 20 can be in the self-locking state or the unlocked state.
Referring to
Referring to
Referring to
Referring to
The locking control assembly 423 in the valve clip system 100 according to present disclosure can ensure that the valve clip 20 is delivered in place in the self-locking state. Only after the valve clip 20 is controlled to be switched to the unlocked state by means of the locking control assembly 423, the clamping member 25 of the valve clip 29 can be opened to clamp the leaflets such that the valve clip 20 can be prevented from being accidentally opened in a delivery process, thereby being conducive to smooth operation of a valve edge-to-edge repair surgery, and ensuring safety of the surgery. In addition, the valve clip 20 can only be released after the valve clip being opened and then closed to clamp the leaflets. Therefore, the risk of accidental disengagement of the valve clip 20 is actually reduced by means of arrangement of the locking control assembly 423.
In some embodiments, the locking control wire 4231 passes through the first control rod 4232 along an axial direction of the first control rod 4232 and exposes a proximal end of the first control rod 4232. Referring to
Referring to
Each of the two first connecting sections 4234 passes through the corresponding one of the two first sub-cavities 442 to connect with the first control rod 4232 to make the locking control wire 4231 be U-shaped, such that the two first connecting sections 4234 of the locking control wire 4231 can be prevented from being intertwined with each other, and the locking control wire 4231 can be withdrawn more smoothly and easily, thereby avoiding the risks of wire tearing and breakage, and improving the safety. Understandably, the connecting member 277 can be omitted, and the locking control wire 4231 is directly movably connected with the locking piece 273.
Since the locking control wire 4231 needs to react immediately when the first control rod 4232 is moved towards the proximal end of the housing 422, it is required for the locking control wire 4231 to have low ductility and high tensile breaking stress. In some embodiments of the disclosure, the locking control wire 4231 should have the tensile breaking stress greater than or equal to 25 Mpa. The locking control wire 4231 can be made of at least one of ultra-high molecular weight polyethylene, nickel-titanium alloy, and stainless steel. In some embodiments of the disclosure, the locking control wire 4231 can be made of at least one of an ultra-high molecular weight polyethylene suture, a nickel-titanium wire, a stainless steel wire, a high molecular weight polymer wire, etc. In some embodiments of the disclosure, the locking control wire 4231 is made of the ultra-high molecular weight polyethylene suture.
Referring to
Referring to
In some embodiments of the disclosure, the first guide portion 4230 is a guide protrusion, the second guide portion 4237 is a guide groove disposed on an inner wall of the first sleeve 4235, and a limiting groove 4238 communicating with the guide groove is further disposed at a proximal end of the first sleeve 4235. The limiting groove 4238 extends in a circumferential direction of the first sleeve 4235 and is provided with a limiting step 4239, and the limiting groove 4238 is substantially an arc-shaped groove. When the guide protrusion of the first control rod 4232 is abutted against a bottom surface of the limiting groove 4238, the first control rod 4232 cannot move towards the distal end of the housing 422. An initial end surface of the limiting groove 4238 is flush with a wall surface of the second guide portion 4237, and the limiting step 4239 is disposed between a terminational end surface 4270 of the limiting groove 4238 and the other wall surface of the second guide portion 4237. The limiting step 4239 is configured to limit the first guide portion 4230 in the limiting groove 4238, so as to prevent the first guide portion 4230 from detaching from the limiting groove 4238. When the first guide portion 4230 is disposed in the limiting groove 4238 and abutted against the limiting step 4239, the valve clip 20 is kept in the unlocked state.
Referring to
The free ends of the two first connecting sections 4234 of the locking control wire 4231 away from the first folded section 4233 can be wound around the proximal end of the first control rod 4232, and the first fixing member 4236 is screwed on the proximal end of the first control rod 4232, so as to press and fix the free ends of the two first connecting sections 4234 of the locking control wire 4231 away from the first folded section 4233. Under the condition that the first fixing member 4236 is screwed tightly, the locking control wire 4231 can pull the locking piece 273 back to a horizontal position by pulling the first control rod 4232 back towards the proximal end of the housing 422, thereby unlocking the shaft body 213. Correspondingly, the locking control wire 4231 is loosened by pushing the first control rod 4232 towards the distal end of the housing 422, and the locking piece 273 is inclined under the action of the resilient piece 275, such that the valve clip 20 is in the self-locking state. Under the condition that the first fixing member 4236 is removed, the locking control wire 4231 can be removed from a patient body by pulling the free end of one of the two first connecting sections 4234 of the locking control wire 4231, so as not to obstruct subsequent disengagement of the valve clip 20.
The valve clip 20 can be switched to the self-locking state or the unlocked state by operating the first control rod 4232 to drive the locking control wire 4231. Referring to
It can be understand that one of the first guide portion 4230 and the second guide portion 4237 is a guide groove extending in an axial direction of the first control rod 4232, the other one of the first guide portion 4230 and the second guide portion 4237 is a guide protrusion, and the guide protrusion is slidably disposed in the guide groove. Understandably, the first sleeve 4235 can be omitted, and the second guide portion can be directly disposed on the housing 422.
Understandably, the first fixing member 4236 is not limited to a nut, and can also be a cover. The first fixing member 4236 can be omitted, and a connection method by which the portion of the locking control wire 4231 exposed from the proximal end of the first control rod 4232 connects the first control rod 4232 is not limited. For example, the portion of the locking control wire 4231 exposed from the proximal end of the first control rod 4232 is directly wound around the first control rod 4232. Alternatively, the portion of the locking control wire 4231 exposed from the proximal end of the first control rod 4232 is directly fixed to the first control rod 4232 by means of bonding, etc. After the first control rod 4232 is pulled back towards the proximal end, the locking control wire 4231 is cut off, and then one strand of the locking control wire 4232 is pulled out. So the locking control wire 4232 can also be removed from the patient body, so as not to obstruct disengagement of the valve clip 20.
It should be noted that control of a distance of linear motion of the first control rod 4232 relative to the housing 422 should not only consider an optimal unlocking force value that the locking control wire 4231 can generate for the valve clip 20, but also consider loss of the locking control wire 4231 in the first sub-cavity 442 of the catheter 44 and an effect of extensibility of the locking control wire 4231. With the optimal unlocking force value is 6N as an example, the distance of linear motion of the first control rod 4232 relative to the housing 422 is set to [9, 13] mm. Thus, the valve clip 20 can be unlocked by pulling the first control rod 4232 backwards towards the proximal end, such that the situation that the valve clip 20 and the locking control wire 4231 are damaged due to an excessive pulling force is avoided. The valve clip 20 can be self-locked by pushing the first control rod 4231 forwards towards the distal end, such that it is ensured that a stacking amount of the locking control wire 4231 is not too large to cause the locking control wire 4231 to hang the valve clip 20. Understandably, the stroke of linear motion of the first control rod 4162 relative to the housing 422 is not limited in the disclosure.
Understandably, the structure and arrangement of the self-locking mechanism 27 of the valve clip 20 and the structure and arrangement of the locking control assembly 423 are not limited in the disclosure.
Referring to
In some embodiments of present disclosure, referring to
The clamping control assembly 424 further includes a constant-force gear 4244 and a knob 4245 driving the constant-force gear 4244 to rotate. The constant-force gear 4244 is in threaded connection with the transmission member 4242. The constant-force gear 4244 rotates to drive the transmission member 4242 to move in the axial direction of the housing 4221. That is, rotation of the constant-force gear 4244 is converted into axial motion of the transmission member 4242 relative to the housing 422, so as to control opening and closing of the two clamping members 25.
In some embodiments, an outer wall of the transmission member 4242 includes a screw section 4246, an inner wall of the constant-force gear 4244 is provided with a transmission thread 4247, and the screw section 4246 is matched to the transmission thread 4247 disposed in the constant-force gear 4244.
The knob 4245 is sleeved on the constant-force gear 4244. When the knob 4245 rotates towards a positive direction and a driving force of the knob 4245 to the constant-force gear 4244 is less than a preset force value, the knob 4245 drives the constant-force gear 4244 to synchronously rotate towards the positive direction, such that the transmission member 4242 moves towards one end of the housing 4221 in the axial direction relative to the housing 422. For example, the knob 4245 drives the constant-force gear 4244 to rotate towards the positive direction, and the transmission member 4242 and the mandrel 4241 move towards the proximal end in the axial direction, so as to drive the two clamping members 25 of the valve clip 20 to be relatively closed. The greater a distance of motion of the transmission member 4242 towards the proximal end is, the tighter a degree of closing of the two clamping members 25 is.
When the knob 4245 rotates towards the positive direction and the driving force of the knob 4245 to the constant-force gear 4244 is greater than or equal to the preset force value, the knob 4245 independently rotates relative to the constant-force gear 4244. For example, after the valve is clamped by the two clamping members 25, if the knob 4245 continues being rotated, the knob 4245 independently rotates in a sliding manner relative to the constant-force gear 4244, thereby preventing the clamping members 25 from excessively clamping the leaflets to damage the leaflets. Even if a driving force of the knob 4245 to the constant-force gear 4244 is excessively large, once the driving force exceeds the preset force value, an acting force applied to the mandrel 4241 can not be increased, such that the mandrel 4241 is prevented from being broken or damaged due to an excessive pulling force.
When the knob 4245 rotates towards an opposite direction of the positive direction, the knob 4245 drives the constant-force gear 4244 to synchronously rotate in the opposite direction of the positive direction, such that the transmission member 4242 slides towards an opposite end in the axial direction relative to the housing 422. For example, the knob 4245 drives the constant-force gear 4244 to rotate in the opposite direction of the positive direction, and the transmission member 4242 and the mandrel 4241 move towards the distal end in the axial direction, so as to drive the two clamping members 25 of the valve clip 20 to be relatively opened. The greater a distance of motion of the transmission member 4242 towards the distal end is, the greater a relative opening angle of the two clamping members 25 is.
The constant-force gear 4244 includes a gear body 4248 and a plurality of toothed arms 4249 protruding from an outer wall of the gear body 4248 and disposed at intervals in a circumferential direction of the gear body 4248, and an inner wall of the knob 4245 is provided with a plurality of stop portions 4250 matching the plurality of toothed arms 4249 in the circumferential direction of the gear body 4248; and the preset force value is a value of an acting force applied to the constant-force gear 4244 by the knob 4245 when each toothed arm 4249 of the plurality of toothed arms 4249 relatively slides through each corresponding stop portion 4250 of the plurality of stop portions 4250.
One end of the toothed arm 4249 is fixedly connected with the outer wall of the gear body 4248, and the other end of the toothed arm 4249 is a free end. At least part of the outer wall of the toothed arm 4249 extends in the circumferential direction of the gear body 4248.
Referring to
The preset force value can be controlled by configuring a maximum outer diameter of the constant-force gear 4244, a thickness of the toothed arm 4249, a material of the constant-force gear 4244, etc. In some embodiments, 8 toothed arms 4249 are disposed in the circumferential direction of the gear body 4248, the preset force value is about 50 N, the material of the constant-force gear 4244 is preferably polycarbonate (PC) having high hardness and toughness, the maximum outer diameter value is configured as 35 mm-40 mm, and the thickness value of the toothed arm 4249 is configured as 1.5 mm-2.0 mm. When a linear pulling force value applied to the mandrel 4241 is greater than a certain force value, the knob 4245 and the constant-force gear 4244 slide relatively. Even if the driving force of the knob 4245 to the constant-force gear 4244 is excessively large, once the driving force exceeds the preset force value, the mandrel 4241 stops moving in the axial direction, and an acting force applied to the mandrel 4241 is not increased.
A free end of the toothed arm 4249 includes a first sliding guide surface 4254 and a first sliding stop surface 4256 disposed opposite the first sliding guide surface 4254. Referring to
In some embodiments, the first sliding guide surface 4254 is inclined relative to the first sliding stop surface 4256, the first sliding stop surface 4256 substantially extends in a radial direction of the gear body 4248. The second sliding guide surface 4258 is inclined relative to the first sliding stop surface 4259, and the second sliding stop surface 4259 substantially extends in a radial direction of the knob 4245. Contact between the first sliding guide surface 4254 and the second sliding guide surface 4258 is inclined surface contact, and the second sliding guide surface 4258 presses the first sliding guide surface 4254 towards the gap 4252, such that relative sliding between the first sliding guide surface 4254 and the second sliding guide surface 4258 is easy. Contact between the first sliding stop surface 4256 and the second sliding stop surface 4259 is substantially straight surface contact, and the second sliding stop surface 4259 pushes the first sliding stop surface 4256 towards a direction away from the gap 4252. Therefore, relative sliding between the first sliding stop surface 4256 and the second sliding stop surface 4259 is difficult. Understandably, in some embodiments, different degrees of roughness of surfaces are configured, such that relative sliding between the first sliding guide surface 4254 and the second sliding guide surface 4258 can be easy, and relative sliding between the first sliding stop surface 4256 and the second sliding stop surface 4259 can be difficult. For example, the degree of roughness of the first sliding guide surface 4254 can be less than that of the first sliding stop surface 4256, and the degree of roughness of the second sliding guide surface 4258 can be less than the degree of roughness of the second sliding stop surface 4259.
Referring to
Referring to
Referring to
Referring to
Each of the two second connecting sections 4284 passes through the corresponding one of the four second sub-cavities 444 to connect with the second control rod 4282 to make the locking control wire 4231 be U-shaped, such that the two second connecting sections 4284 of the grasping wire 4281 can be prevented from being intertwined with each other, and the grasping wire 4281 can be withdrawn more smoothly and easily, thereby avoiding the risks of wire tearing and breakage, and improving safety.
A stroke of the second control rod 4282 should be not less than 2πR×θ/360. R is a length of each of the two grasping members 28, θ is an absolute value of a difference value between a first angle and a second angle, the first angle is an angle between each of the two grasping members 28 and a central axis (a central axis of the shaft body 213) of the valve clip 20 when the two grasping members 28 are relatively close to each other, and the second angle is a maximum angle between one of the two grasping members 28 and the central axis of the valve clip 20 after the two grasping members 28 are opened radially. The first angle between each of the two grasping members 28 and the central axis of the valve clip 20 can be 0 degree when the two grasping members 28 are relatively close (or before released) to each other. After the two grasping members 28 are opened radially (or after released), the second angle between one of the two grasping members 28 and the central axis of the valve clip 20 can be less than 90 degrees, equal to 90 degrees, or greater than 90 degrees.
In consideration of loss of the grasping wire 4281 in the second sub-cavity 444, an effective advancing stroke of the second control rod 4282 is preferably configured as 2×(2πR×θ/360). For example, before the two grasping members 28 are relatively close to each other, a circumference of an arc caused by a movement of a free end of each of the two grasping members 28 is 13 mm, and an effective stroke of the second control rod 4282 is preferably 25±2 mm. On one hand, when the two grasping members 28 are tightened, the grasping wire 4281 can not be broken or damaged. On the other hand, when the two grasping members 28 are released, the grasping wire 4281 can not be stacked too much.
Referring to
In some embodiments, the third guide portion 4280 is a guide protrusion, and the fourth guide portion 4287 is a guide groove provided in an inner wall of the second sleeve 4285. A limiting groove 4288 in communication with the guide groove is further provided at a proximal end of the second sleeve 4285, the limiting groove 4288 extends in a circumferential direction of the second sleeve 4285 and is provided with a limiting step 4289, and the limiting groove 4288 is substantially an arc-shaped groove. When the guide protrusion of the second control rod 4282 is abutted against a bottom surface of the limiting groove 4288, the second control rod 4282 can not move towards the distal end relative to the second sleeve 4285. An initial end surface of the limiting groove 4288 is flush with a wall surface of the fourth guide portion 4287, and the limiting step 4289 is disposed between a terminational end surface 4290 of the limiting groove 4288 and the other wall surface of the fourth guide portion 4287. The limiting step 4289 is configured to limit the third guide portion 4280 in the limiting groove 4288, so as to prevent the third guide portion 4280 from detaching from the limiting groove 4288. When the third guide portion 4280 disposed in the limiting groove 4288 and abuts against the limiting step 4289, the grasping wire 4281 is in a straightened state, and the grasping wire 4281 pulls the grasping member 28.
Understandably, one of the third guide portion 4280 and the fourth guide portion 4287 is a guide groove extending in an axial direction of the second control rod 4282, the other one of the third guide portion 4280 and the fourth guide portion 4287 is a guide protrusion, and the guide protrusion is slidably disposed in the guide groove. A position of the limiting groove 4288 is not limited. Understandably, the second sleeve 4285 can be omitted, and the second control rod 4282 can move in the axial direction of the housing 422.
The second fixing member 4286 is fixed to a proximal end of the second control rod 4282, and a portion of the grasping wire 4281 exposed from the second control rod 4282 is fixed to the proximal end of the second control rod 4282 by means of the second fixing member 4286. In some embodiments, the second fixing member 4286 is a nut, and the second fixing member 4286 is in threaded connection with the proximal end of the second control rod 4282. The portion of the grasping wire 4281 exposed from the second control rod 4282 is fixedly clamped between an inner wall of the second fixing member 4286 and an outer wall of the proximal end of the second control rod 4282.
The free ends of the two second connecting sections 4284 of the grasping wire 4281 away from the second folded section 4283 can be wound around the proximal end of the second control rod 4282, and the second fixing member 4286 is screwed on the second control rod 4282 to press and fix the free ends of the two second connecting sections 4284 of the grasping wire 4281 away from the folded section 4283. Under the condition that the second fixing member 4286 is screwed tightly, the grasping wire 4281 can pull the grasping member 28 by pulling the second control rod 4282 back towards the proximal end, such that a leaflet accommodation space is formed between the grasping member 28 and the clamping member 25. Correspondingly, the grasping wire 4281 is loosened by pushing the second control rod 4282 towards the distal end, and under the elastic action of the grasping member 28, one end of the grasping member 28 connected with the grasping wire 4281 abuts against the clamping member 25, so as to capture the leaflet. Under the condition that the second fixing member 4286 is removed, the grasping wire 4281 can be removed from the patient body by pulling the free end of one of the two second connecting sections 4284 of the grasping wire 4281, so as not to obstruct subsequent disengagement of the valve clip 20.
The grasping wire 4281 can be made at least one of a nickel-titanium wire, stainless steel wire, a high molecular polymer suture. In some embodiments, the grasping wire is made of a nickel-titanium wire having high strength, so as to reduce the risk of wire breakage.
Understandably, a second fixing member 4236 is not limited to a nut, and can also be a cover. The second fixing member 4286 can be omitted, and a connection mode between a portion of the grasping wire 4281 exposed from the proximal end of the second control rod 4282 and the second control rod 4282 is not limited. In some embodiments, the portion of the grasping wire 4281 exposed from the proximal end of the second control rod 4282 is directly wound around the second control rod 4282. In some embodiments, the portion of the grasping wire 4281 exposed from the proximal end of the second control rod 4282 is directly fixed to the second control rod 4282 by means of bonding, etc. After the second control rod 4282 is pulled back towards the proximal end, the grasping wire 4281 is cut off, and then one strand of the grasping wire 4281 is pulled out. Moreover, the grasping wire 4281 can also be removed from a patient body, so as not to obstruct disengagement of the valve clip 20.
By operating the second control rod 4232, motion of the grasping member 28 can be controlled, so as to cooperate with the clamping member 25 to clamp or loose a leaflet. The two grasping control assemblies 428 can be simultaneously controlled. In some embodiments, referring to
Referring to
Referring to
In some embodiments, a distal end of the mandrel 4241 is in threaded connection with a proximal end of the shaft body 213. At least one first rotation stopping surface 4332 is disposed at a distal end of the core rod 4322, and a second rotation stopping surface 4334 is disposed on an inner wall of the one-way gear 4324 corresponding to the first rotation stopping surface 4332. The first rotation stopping surface 4332 matches the second rotation stopping surface 4334 to prevent relative rotation between the one-way gear 4324 and the core rod 4322.
The transmission member 4242 is provided with a hole 401 along an axial direction, and the core rod 4322 is disposed in the hole 401. A connecting hole 403 in communication with the hole 401 is provided on an outer wall of the transmission member 4342. The safety switch 4326 is disposed in the connecting hole 403.
The disengagement control assembly 432 has a first state and a second state. When the disengagement control assembly 432 is in the first state, the safety switch 4326 is abutted against the core rod 4322, and the core rod 4322 and the transmission member 4242 are connected into a whole; and when the disengagement control assembly 432 is in the second state, the safety switch 4326 is separated from the core rod 4322, and the core rod 4322 is driven to unidirectionally rotates relative to the transmission member 4242, thereby driving the distal end of the mandrel 4241 to be disengaged from the valve clip 20.
The disengagement control assembly 432 further includes an elastic member 4328. The elastic member 4328 extends along the axial direction and is held between the core rod 4322 and the transmission member 4242. In some embodiments, the elastic member 4328 is sleeved on the core rod 4322 and accommodated in the hole 401.
The disengagement control assembly 432 further includes a release knob 4329. The release knob 4329 is fixed to the proximal end of the core rod 4322 to rotate the core rod 4322 conveniently.
When the disengagement control assembly 432 needs to be switched from the first state to the second state, the safety switch 4326 is pulled up towards a direction away from the mandrel 4241 (for example, a direction indicated by an arrow 313 in
When the disengagement control assembly 432 needs to be switched from the second state to the first state, the safety switch 4326 is pressed down, such that the safety switch 4326 is abutted against the core rod 4322 to form a whole, and the transmission member 4242 axially moves to drive the mandrel 4241 and the core rod 4322 to move synchronously.
Since the disengagement control assembly 432 is provided with the safety switch 4326, connection between the mandrel 4241 and the valve clip 20 may be released only after the safety switch 4326 is pulled up (that is, when the disengagement control assembly 432 is in the second state), which prevents misoperation and unexpected disengagement of the valve clip 20, and improves safety of surgery. The one-way gear 4324 only allows the core rod 4322 to drive the mandrel 4241 to rotate towards a direction of releasing threaded connection, such that the mandrel 4341 can be disengaged efficiently.
As shown in
A working process of a valve clip system 100 is briefly described below. The valve clip 20 is delivered transcatheterly by the valve clip delivery device 40 to a vicinity of a mitral valve of a patient.
In an initial state, the first control rod 4232 is pushed forwards (towards a distal end) to keep the valve clip 20 in a self-locking state, and the two second control rods 4282 are pulled back towards a proximal end and limited, such that the two grasping members 28 are in a relatively close state. The safety switch 4326 is abutted against the core rod 4322, and the transmission member 4242 is integrated with the core rod 4322. An operator adjusts a bending degree of the sheath 64 by means of the adjustable handle 62, and the catheter 44 disposed in the sheath 64 conforms to the sheath 64 to deliver the valve clip 20 to a predetermined position near the mitral valve of the patient.
The first control rod 4232 is driven to move towards the proximal end, and the valve clip 20 is switched from the self-locking state to the unlocked state. That is, self-locking of the valve clip 20 is removed by means of the locking control assembly 423. The first guide portion 4230 is accommodated in the limiting groove 4238 and is abutted against a limiting step 4239 to keep the valve clip 20 in the unlocked state.
Then, the clamping members 25 of the valve clip 20 are controlled to be opened by means of the clamping control assembly 424. For example, the knob 4245 of the clamping control assembly 424 is rotated in the opposite direction (for example, a direction indicated by an arrow 303 in
Then, each of the two grasping members 28 is controlled by means of the grasping control assembly 428 to capture the leaflet between the clamping member 25 and the grasping member 28. For example, referring to
Next, the two clamping members 25 are controlled by means of the clamping control assembly 424 to be closed, so as to clamp the anterior leaflet and the posterior leaflet of the mitral valve together. For example, the knob 4245 of the clamping control assembly 424 is rotated towards a positive direction (e.g., a direction indicated by an arrow 305 in
Once the leaflets of the mitral valve are aligned edge to edge, the first fixing member 4236 is removed and the locking control wire 4231 is withdrawn from a body, the second fixing member 4286 is removed, and the grasping wire 4281 is withdrawn from the body.
The operator pulls up the safety switch 4326 (for example, a direction indicated by an arrow 313 in
Understandably, the valve clip system 100 of the disclosure may also implement edge-to-edge repair of a tricuspid valve in a transcatheter manner.
What are described above are merely preferred embodiments of the disclosure, and are not intended to limit the disclosure in any form. Although the disclosure has been disclosed in the above preferred embodiments, the disclosure is not limited to the preferred embodiments. Any person skilled in the art can make many possible changes and modifications to the technical solution of the disclosure by utilizing the method and technical content disclosed above or modify the technical solution of the disclosure to equivalent embodiments without departing from the scope of the technical solution of the disclosure. Hence, any simple alteration, equivalent change and modification which are made to the above-mentioned embodiments in accordance with the technical essence of the disclosure without departing from the content of the technical solution of the disclosure all fall within the scope of protection of the technical solution of the disclosure.
Number | Date | Country | Kind |
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202011445523.9 | Dec 2020 | CN | national |
202022998734.7 | Dec 2020 | CN | national |
The present disclosure is a national stage application of International Patent Application No. PCT/CN2021/125369, which is filed on Oct. 21, 2021, and claims priority to Chinese Patent Application No. 2020114455239 (entitled “valve clip delivery device”) and 2020229987347 (entitled “valve clip delivery device”), and filed on Dec. 11, 2020, the contents of which are hereby incorporated by reference in its entirety.
Number | Date | Country | |
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Parent | PCT/CN2021/125369 | Oct 2021 | US |
Child | 18208273 | US |