Heart valve prosthesis
SUBSTANCE: invention relates to field of medicine and can be applied in cardiosurgery in operations aimed at replacement of natural heart valves. Prosthesis includes ring-shaped body, limited with upper and lower butt-ends, installed in body with possibility of rotation in order to form clearing section and its blocking locking element made in form of convex-concave cusps, and fold movement limiting elements. In each cusp rectangular slot is made. Fold movement limiting elements are made in form of hook-like protrusions, which have rectangular cross-section for interaction with through slots of folds during their closing or opening. Elements limiting cusp motion are supplied with supports for limitation of fold turning, and in upper butt-end of the body turns are made for interaction with folds when opening or closing and formation of limited reverse blood flow in state of fold closed state.
EFFECT: increase of reliability of fold holding during travel.
6 cl, 4 dwg
The technical field
The present invention relates to medicine, in particular for cardiovascular surgery, and is intended to replace a diseased natural heart valves during cardiac operations.
The level of technology
The most popular design of the prosthetic heart valve at the present time remains the case with repeated inside bore leaves. Such prostheses have high reliability and provide satisfactory hemodynamics, improvements reduce acoustic noise, anxiety patients, increase uptime. Standard dentures include the housing has a circular shape. One or more valves are installed in the housing with the possibility of repetition between an open position to direct transmission of blood flow and a closed position for covering the channel and restrict the return flow of blood. In addition, the prosthetic heart valve includes a connecting mechanism for connecting the valve body with the surrounding tissues of the heart. Basically, this mechanism is made in the form of a cuff, which is attached to the tissues of the heart and covers the side surface of the housing of the valve prosthesis. An important problem is the problem of secure retention of the valves in the housing. For this purpose various types of hinges, rancitelli move and rotate the valves.
The prior art solutions that reduce the probability of valve failure due to inadequate fixation of the valves (see, for example, published application U.S. No. 2007193632). In the open here prosthesis sash rotate on an axis fixed in the body and intersecting the flow area at the center. However, in this valve is significantly distorted hemodynamics due to the overlap of the center bore in the open position of the valve.
The number of known structures (see U.S. patent 4274437, RF patent 2066984) ensuring primary zone flow area in the center. With this arrangement, it is obvious that the Central part of the flow through the valve remains weakly perturbed, and distortion introduced shutters, minimum. However, these valves in surgical practice are not applied due to the low reliability and a high probability of falling leaves. As it turned out, the main difficulties rearranges the development of such travel stop valves that would reliably and throughout the service life of valve kept sash and contributed to the smooth operation of the valve.
Thus, the obvious need for a new design of a prosthetic heart valve, the reliability of which could be combined with undistorted hemodynamics of blood flow.
The closest analogue to the present invention is an artificial heart valve(international publication WO 91/07148), containing the annular body and three leaf, placed in it can be rotated between the upper and lower flow of blood restrictors folds and formation of the primary zone flow area in the center, limited all portions of the inner walls of the casing and the lower downstream edges of the shutters.
The present invention is directed to solving the problem of creating an artificial heart valve that eliminates the disadvantages of the known analogues, namely, providing high reliability and durability with the primary zone flow area in the center of the prosthetic heart valve.
Technical result achieved when using the present invention is to improve the reliability of retention of the valves during the move.
The technical result is achieved due to the fact that the prosthetic heart valve including an annular housing, limited upper and lower ends mounted in the housing can be rotated for the formation of a bore and it is closed, the locking element made in the form of a convexo-concave valves and restrictors folds, each fold is made rectangular groove, the restrictors shutters made in the form of hook protrusions that have a rectangular piperacetazine to interact with through the slots of the valves when they are closed and opened, when the sash restrictors fitted with stops to limit rotation of the valves, and in the upper end of the body is made grooves for engagement with the sash during opening and closing and education limited reverse flow of blood in the closed state of the valves.
The technical effect is enhanced due to the fact that the locking element is designed as three folds. The restrictors shutters made in the form of three hook the tabs on the upper end of the body. Grooves are located under each hook protrusion of the stroke limiter.
The casing from the outer side has an annular groove for fastening sewn cuffs. The body and wings are made of pyrocarbon.
The list of drawings.
The invention will be clearer from the description below with reference to the positions of the drawings, where
figures 1 and 2 show the prosthetic heart valve with closed doors, respectively, a front view and a top view,
figure 3 and 4 shows the prosthetic heart valve with open shutters, respectively the front view and top view.
Information confirming the possibility of carrying out the invention
The prosthetic heart valve includes an annular casing 1, made of pyrocarbon and having three convex-concave sash 2, also made of pyrocarbon and with the possibility p. the gate and education primary zone flow area in the center, installed in the housing 1. The annular body 1 is limited to two upper 4 and lower 5 ends (the direction is determined in accordance with the direct blood flow through the valve). Each of the leaf 2 has a rectangular cross-cutting groove 6. Limiters 3 stroke 2 folds made in the form of three hook projections 7, which in cross section are rectangular in shape and interact with through the slots 6 of the respective valves 2 are opened and closed. The stops 3 are located on the top end 4 of the housing 1 and provided with lugs 8 to limit rotation of the valves 2. On the upper 4 end of the body 1, there are three grooves 9 that are essential for interaction with a corresponding shutter opening and closing and education limited reverse flow of blood in the closed state of the valve.
The housing 1 from the outer side has an annular groove (not shown) for fastening sewn cuffs. Grooves 9 are located under each hook protrusion of the stroke limiter.
The prosthetic heart valve operates as follows.
When opening the valve prosthesis under the action of the direct flow of blood is turning the valves 2, they are held securely hook the tabs 7, interacting with rectangular grooves 6 each sash 2. Turn the sash 2 limit stop 8, which interacts with the outer surface the values of the sash 2. This rotation occurs to the position of the equilibrium state. While the blood flows in the forward direction, the Central part of the valve housing 1 of the valve freely without distortion skip the thread. Shutters are arranged almost vertically and do not create resistance to flow. The stops 8 and grooves 9 securely hold the sash in the open position. Perform exterior shutters convexo-concave provides a still further opening of the valve. At the termination of the direct flow of the leaf 2 begins to turn around and return to its original position before touching each other. The outer bottom edge of the valves communicate with the grooves 9, which are made each hook protrusion 7, limited reverse flow of blood that occurs when closing the valve, washes the inner part of the hook protrusions 7 and the upper end face 4.
The declared design of artificial heart valve has the following advantages:
1. Completely eliminates the loss of the valves by performing the restrictors hook with stops.
2. Provides high efficiency orifice valve, almost without resistance to flow in the open position of the valves.
3. Eliminates the formation of stagnant zones due to washing of the layout areas of the limiters is Otok and stops the forward and backward flow of blood.
4. Significantly reduces the factor of thrombosis.
5. Eliminates the instability of the valve when opened by performing external surfaces of the valves convex-concave.
7. Has high reliability and durability, good compatibility with natural fabrics.
1. The prosthetic heart valve including an annular housing, limited upper and lower ends mounted in the housing can be rotated for the formation of a bore and it is closed, the locking element made in the form of a convexo-concave valves and restrictors of the valves, wherein each fold is made rectangular groove, the restrictors shutters made in the form of hook protrusions that have a rectangular cross-section for interaction with end-to-end grooves of the valves when they are closed and opened, the sash restrictors fitted with stops to limit rotation of the valves, and in the upper end of the body is made grooves for interaction with leaves when opening and closing and education limited reverse flow of blood in the closed state of the valves.
2. The prosthesis according to claim 1, characterized in that the locking element is designed as three folds.
3. The prosthesis according to claim 1, characterized in that the restrictors shutters made in the form of three hook protrusions, RA is displaced on the upper end of the body.
4. The prosthesis according to claims 1 and 3, characterized in that the grooves are located under each hook protrusion of the stroke limiter.
5. The prosthesis according to claim 1, characterized in that the housing from the outer side has an annular groove for mounting sew cuffs.
6. The prosthesis according to claim 1, characterized in that the casing and sash made of pyrocarbon.
SUBSTANCE: hemocompatible material comprises solid and unpenetrable synthetic substrate to which biological tissue is adhered by means of composing agent of specified substrate dispersed in the resolvent.
EFFECT: method simplification.
SUBSTANCE: prosthesis consists of framework in form bearing ring with three wire uprights, placed on the circumference, flexible locking elements, soft walls and cup. Bearing ring is made in form of hexagon, each side of which contains clips, consisting of frame and core with front, middle and back locking devices. Wire uprights consist of two side arcs, connected by crosspiece and are rigidly connected with bearing ring in hexagon angles in such way that planes, in which side arcs are located contain sides of bearing ring and form angle 120°.
EFFECT: increase of heart valve prosthesis size after implantation by low invasive method preserving its functional consistency.
3 dwg, 1 ex
SUBSTANCE: invention can be used for adjustment of an internal circle of an anatomic aperture or a lumen, in particular at an annuloplasty of cardiac valves. The device for adjustment of an anatomic aperture or lumen internal circle contains the opened ring bound to an agent of the opened ring circle size adjustment. The agent of the opened ring circle size adjustment is executed in the form of the guide tube located in a ring socket and bridged to the case. The adjusting handle with possibility of rotary and longitudinal moving concerning the case is established in the case. One extremity of the opened ring is fixed on a guide tube, and the second extremity executed extended, is placed in the guide tube with possibility of moving along it and fixed on the adjusting handle.
EFFECT: simplification of an internal circle of anatomic aperture or lumen adjustment process, simplification of the device design and increased reliability.
2 cl, 1 dwg
SUBSTANCE: invention relates to medicine, more specifically to cardiosurgery. Distal and proximal parts are exected, as well as a valved device with corresponding valves, commissural zones, atriums and free edges for their subsequent stitching in compliance with the design size of the circle of the reconstructed output section. A virtual three-dimensional model of the prosthetic device is made and displayed on a plane. All elements are exected. The length of the arc of the elements along the line of attachment is the same. The exected valves and distal part are juxtaposed by the visceral side to each other such that, the centres of the atriums and the base of the valve coincide. The proximal part is attached to the base of the valve and all elements are stitched using continuous twisted suture with formation of commissural rods. Atriums in the distal part of the prosthetic device are formed by joining the proximal part with the smallest and the distal part with the largest radius of curvature, measured on the displays. An extra commissural rod is formed when stitching the edges of the distal part of the prosthetic device.
EFFECT: improved haemodynamic characteristics of the prosthetic device, reduced risk of fatigue wear of biomaterial and thrombosis on the valved device.
2 cl, 8 dwg
FIELD: medicine; cardiology.
SUBSTANCE: said valve comprises a ring box and a number of indented leaves to be attached thereto. The ring box is supplied with an opened conductive element arranged therein or on its surface. Fastening indents for each leaf are interconnected in pairs with the conductive element contacting to the conductive element of the ring box. The method involves fitting the valve with a radiator and recording electromagnetic radiation within radio frequency band therefrom, as well as determining the dysfunction by frequency response deviation from the reference received from a standard valve. The device for valve testing for dysfunction comprises a receiving antenna representing a multi-turn spiral arranged on the external surface of the patient's body at the minimum distance between the valve and the antenna connected to a recording unit.
EFFECT: possibility to examine dysfunction of the valve in service.
3 cl, 1 dwg
FIELD: medicine; cardiosurgery.
SUBSTANCE: fragments aorta and pulmonary artery together with a valve unit are isolated from donor heart in sterile conditions. Then isolated homografts are estimated for adaptability. The fragments of aorta and pulmonary artery together with the valve unit are isolated in a sequence as follows: aorta and pulmonary artery are divided to fibrous rings of aortic and pulmonary valves; it is followed with excision of distal parts of pulmonary artery 2 cm away from artery mouths; left and right coronary arteries are isolated from epicardium and cut off 0.7-1 cm away from mouths; right ventricle of heart and interventricular septum are cut off 2-2.5 cm away from pulmonary valve in parallel to coronary transverse from heart edge to interventricular septum; then pulmonary homograft with muscular flange 2-2.5 cm of right ventricle of heart is isolated from fibrous ring, while aortic homograft with a flange 1.5-2 cm is isolated from fibrous ring of valve, herewith mitral valve anterior leaflet is left without chords to be cut off with shortening muscular flanges of transplants up to 0.5 cm in width and thickness. To test the valve unit for adequacy, homografts are turned inside out to make a visual inspection of valves, sinuses and vascular walls.
EFFECT: method allows standardising tissue preparation for transplantation, reducing number of damages of valve unit, isolated homografts, decreasing defect ratio and reduction cost price of commercial homografts, improving functional reliability of a transplant due to removal of models with border changes of valve tissues observed.
FIELD: medicine; cardiovascular surgery.
SUBSTANCE: heart valve bioprosthesis comprises a flexible bearing frame formed by three axially symmetrical arches joining the rack tops. The commissure tops are formed by shutters connected by sutures and fixed on the bearing frame enclosed in a biocompatible material, e.g. xenopericardium. The enclosure shaped as the top edge frame, while its bottom part is shaped as an edge of fibrous ring of recipient aortic valve and forms an attached cuff. A bioprosthesis is made of valve complexes of mammal hearts or pericardium.
EFFECT: inventions prevent stenotic effect and allow reducing operation time.
2 cl, 3 dwg
FIELD: medicine; cardiovascular surgery.
SUBSTANCE: valve contains a frame with a carrier ring corresponding with the natural shape of fibrous ring of human valve, a rack and an obturative shutter element attached to the frame. The carrier ring of the frame is segmented on perimetre, while the rack supports are V-shaped and interfaced to the ends of the specified segments of the carrier ring. The racks are provided with platforms to fix the tips of papillary muscles. The method consists that the carrier ring is segmented by number of racks. And the racks rest on the V-shaped bottoms to connect to the related segments of the carrier ring. The racks are supplied with platforms to fasten papillary muscles. The fibrous ring is fixed to the carrier ring of the frame all around, and the tips of papillary muscles are additionally reinforced with a biocompatible flap and fastened to rack platforms. The biocompatible material is used to make an attached cuff sutured to fibrous ring.
EFFECT: inventions allow for deformation of fibrous ring within heart cycle in conformity with deformations of fibrous ring of the recipient.
5 cl, 10 dwg, 1 tbl
SUBSTANCE: invention concerns medical equipment and can be used in cardiosurgery for replacement of the damaged natural valves of the heart. The prosthesis contains a ring-shaped case and rotary cusps. The agent of deduction of the cusp in the case is executed in the form of two pairs through grooves forming among themselves two mutually-grasping structures. One pair of grooves is executed on the opposite additional regiments located on an internal surface of the case. The second pair of grooves - on opposite parallel sites of a lateral surface of a cusp. The wall of each groove represents a part of surface circular ring from its internal diameter. On the case surface opposite face prominences are placed. Internal surfaces of these prominences are executed flat and mutually parallel, with the possibility of interaction with opposite parallel sites of a lateral surface of a cusp. The supports for restriction of an angle of opening of cusps are located on internal surfaces of face.
EFFECT: invention is referred on rising of reliability of the valve at the expense of clottage depression on hinges.
3 cl, 7 dwg
SUBSTANCE: invention concerns medical equipment, and can be used for replacement of the damaged natural valves of human heart. The skeleton contains a rigid tubular loose leaf with a ring-shaped basis. The flexible element having flexible legs, bridged to its bases is established on the rigid tubular insert. The rigid tubular insert is supplied departing from circinate base in a direction of an axis of the rigid tubular loose leaf by movement terminators. Each flexible leg contains two flexible beams executed with the possibility of a flexure independent from each other. Flexible beams are supplied by the basic racks bridged to the bases by intersections. Each terminator of movement of flexible legs is executed in the form of two rigid teeth, each of which are supplied by basic surfaces, thus rigid teeth are located on perimeter of the tubular loose leaf with interaction possibility the basic surfaces with basic racks of flexible beams.
EFFECT: invention provides dampening of shock load at valve closing.
2 cl, 3 dwg
FIELD: medical engineering.
SUBSTANCE: device is designed as flexible hose segment of flat cross-section enveloping base member manufactured as circular or oval ring. The opposite end is left free. The valve has an additional member like supporting plate (contour frame or contour loop) rigidly fixed on the base member and embraced with free end of the flexible hose. To achieve better conditions for blood flow to wash working member surface, the member is perforated in zone of its attachment to the base member. To achieve better biocompatibility conditions, valve member is manufactured from natural patient blood vessel.
EFFECT: high operation reliability and reduced hemolysis.
4 cl, 2 dwg
FIELD: medical engineering.
SUBSTANCE: device has two leaflets. The leaflets are mounted on finger member allowing rotation about artery axle and have working ends and shank. The working ends have fitting surfaces restricted with thrusting and holding ribs. A holding rib has internal and external end surface. The external end surface of holding rib of each leaflet has protrusions having centering surfaces manufactured as portions of the same revolution surface having diameter of Dc. Revolution surface axis coincides with the central axis of the holder.
EFFECT: excluded valve displacement relative to fibrous ring; reduced risk of canal dysfunction; improved long-term prosthetic operation results.
3cl, 4 dwg
FIELD: medical engineering.
SUBSTANCE: device has body having external and end face surfaces and envelope box cuff. Locking member is mounted in the device body. The locking member is connected to the device body by means of rotation unit of hinge type. External surface of the device body has ring-shaped protrusion having fitting and supporting surfaces. The envelope box is collapsible and detachable. It has bushing and ring having smooth or threaded connection between them. The device body has two external surface areas free of the cuff adjacent to end face surfaces of the body.
EFFECT: high reliability and long service life.
4 cl, 3 dwg
FIELD: medical engineering.
SUBSTANCE: device has ring-shaped body, fixing members 3 manufactured as protrusions and rotatable cusps mounted in the ring-shaped body. Slots are available on lateral surfaces of body fixing members mainly arranged along central axis of the device body. Protrusions are available on lateral surfaces of slots produced on lateral surfaces of cusp. The protrusions are engageable with slots in device body.
EFFECT: higher thrombus formation resistance.
6 cl, 5 dwg
FIELD: medical engineering.
SUBSTANCE: device has cylindrical body and locking disk member mounted therein with rotation about axis displaced relative to diameter being in parallel to it. Disk member center of gravity is deviated relative to its geometrical center and set so that its rotation axis passes through the center of gravity and the member itself is engageable with opposite device body ends in closed state. The device body has locking disk member stroke stopper manufactured as prominence located between the locking disk member rotation axis and device body diameter arranged in parallel to the rotation axis.
EFFECT: enhanced effectiveness of operation; reduced force magnitude needed for opening the locking member; maximum effective cross-section in open position.
6 cl, 1 dwg
FIELD: medical engineering.
SUBSTANCE: device has connection member manufactured from absorbable material connected to thread on one of its ends. The thread transmits longitudinal pulling force for introducing the connection member into valve ring tissue to set up it therein. The second device embodiment has different needle design. The needle is introduced into endomyocardium of valve ring and brought through a part of the opening perimeter. The needle is brought out and the connection member is introduced into endomyocardium by means of the thread in a way that free end of the connection member is to be at introduction point. The connection member is fixed in the endomyocardium and brought through the ring to the position characterized in that the other end is located in removal point and exits in this way from the endomyocardium. The second end is fixed.
EFFECT: normalized valve ring growth in children.
29 cl, 9 dwg
SUBSTANCE: method involves arranging testee and additional valves in system circulation canal with parameters of working liquid flow having physiological values. The working liquid has blood viscosity. Hemolysis degree is determined from changed elastic stress relaxation time in working liquid samples taken in course of the experiment. Preliminary tests are carried out with several additional valves of different hemolytic properties under working liquid flow parameters being fixed. Total hemolysis degree is measured in various combinations of mounted additional valves in circulation system canal. After having solved a linear equations system, hemolysis degree values as contributions caused by circulation system and additional valves. Hemolysis degree of a valve under test tested in combination with one of additional valves is calculated from a formula ΓN=ΓΣ-Γ0-Γadd, where ΓΣ is the total hemolysis degree, Γ0 is the hemolysis degree contributed by circulation system, Γadd is the hemolysis degree of additional valve used.
EFFECT: high accuracy in determining hemolysis degree.
FIELD: medicine, cardiosurgery.
SUBSTANCE: the method deals with valvular reprosthetics. After dissecting a prosthesis and treating infectious foci with antiseptics it is necessary to implant a carcass xenoprosthesis faced with epoxy-treated xenopericardium. At implanting xenoprosthesis into mitral position it should be fixed in position of fibrous ring by separate P-shaped sutures, one part of which could be upon interlayers. At implanting xenoprosthesis into tricuspid position it should be fixed in position of fibrous ring, moreover, septal valve should be fixed with separate P-shaped sutures, anterior valve - in the middle with a single P-shaped suture, The rest length of xenoprosthesis should be fixed with uninterrupted blanket suture.
EFFECT: decreased chance for prosthetic infectioning.
FIELD: medical engineering.
SUBSTANCE: device has working member manufactured as viscoelastic ring-shaped corrugation having blank wall, tightly embracing a base ring with passage orifice of round or oval shape. Movable part of the working member is represented with one or several cusps belonging to the blank wall of the viscoelastic corrugation. The cusps have thickenings in diametric or radial direction and/or supporting pins transecting the passage opening to prevent them from being drawn by pressure into passage opening of the base ring.
EFFECT: simplified valve design.
7 cl, 10 dwg
FIELD: medical engineering.
SUBSTANCE: device has grooves, bevel or ledge on each cusp closure surface to guide limited reverse blood flow directly to articulated members and casing and cusp surfaces adjacent thereto. The cusps allow forced rotation about casing axis due to limited reverse blood flow tangentially arriving when having the cusps closed, to make blood volume whirl about the central axis of the casing when entering the prosthesis and opening cusps.
EFFECT: high resistance to thrombus formation; prolonged service life; high reliability; reduced load applied to patient heart.
3 cl, 10 dwg