Valve-containing aortic root prosthesis

FIELD: medicine.

SUBSTANCE: invention refers to medical equipment and may be used in cardiac surgery for replacement of an injured aortic root with an aortic valve. A valve-containing aortic root prosthesis comprises a vascular prosthesis 1 with a cuff 3 attached from a proximal side, and a valve 4 inserted in the cuff 3. The prosthesis is provided with a ring plate 5 attached to the cuff 3 along the internal perimetre. The plate 5 is pulled to the vascular prosthesis to approach the cuff 3, and intraoperatively anchored over the cuff 3 to seal a junction of the cuff and coronary tendons.

EFFECT: higher reliability and reduced risk of postoperative complications associated with a leaking junction of the prosthesis and the coronary tendons of the valve prosthesis.

4 cl, 2 dwg

 

The invention relates to medical equipment and can be used in heart surgery to replace a diseased aortic root with aortic valve.

Known roots of the aorta (CA)used in cardiac surgery, taken either in animals - xenograft (KG), or the corpse of a man - homograft (GG). (Ross DN. Homograft replacement of the aortic valve. Lancet 1962; 2:447).

Known frameless bioproces of the aortic valve, made of valve-aortic complex mammal containing tubular body and which feature mullioned locking element adjacent to the end of the tubular body (see U.S. patent No. 4443895, 1984).

Known frameless prosthetic aortic root (see U.S. patent No. 5123919, 1992), containing vascular prosthesis made of synthetic fabric attached to the proximal side of the cuff and mechanical valve mounted in the cuff.

All of these prostheses, successfully performing their function, have a significant drawback. At the time of filing of the prosthesis or cuff of the prosthesis to the fibrous ring, the formation of fistulas, identifying possible only after completion of implantation of the prosthesis and filling the heart with blood. In this case elimination of fistula causing bleeding after implantation of the prosthesis is a complex surgical problem.

The task of the invention is to increase n the reliability of the prosthesis and reduce risk of postoperative bleeding.

Proposed laparostomy prosthesis aortic root, containing the vascular prosthesis can be fixed with the proximal side of the cuff and a valve mounted in the cuff. The prosthesis is provided with an annular plate located between the lip and the vascular prosthesis, external diameter which exceeds the outer diameter of the cuff. The cover plate is made of synthetic fabric with a sealing impregnation or plate xenopericardial. When this plate on the inner perimeter of sewn thread the cuff and the outer perimeter of the stitched thread a purse-string suture and attached to a vascular prosthesis, providing access to the cuff.

Known technical solutions with a combination of symptoms that are similar to the features distinguishing the claimed solution to the prototype, not identified.

Proposed laparostomy prosthesis aortic root provides improved reliability of the prosthesis and reduce risk of postoperative bleeding.

Have cleanstream prosthesis aortic root vascular prosthesis can be fixed with the proximal side of the cuff, and a valve mounted in the cuff, which allows the filing of the prosthesis through the cuff to the fibrous ring of the remote valve and, accordingly, not isecheno part of the aorta. This restores the channel for the passage of blood and the function of the valve for the restoration of g is modynamic cardiovascular system.

The presence of vascular prosthesis ring pads located between the lip and the vascular prosthesis, creates the possibility of filing pads on top hemmed cuffs to nessecery the aortic wall, which provides additional sealing cuff and connection joints.

When performing the outer diameter of the gasket is larger than the outer diameter of the cuff, increases the reliability of the sealing cuff at the outer perimeter.

When performing covers of synthetic sealant impregnated fabric or plate xenopericardial ensures the integrity of the lining. The selection of the material due to the material of the vascular prosthesis. If vascular prosthesis made of syntheticchemical, and the strap is made of synthetic fabric. If vascular prosthesis made of biological material, and molding is performed from the plate xenopericardial.

When you sew the lining on the inner perimeter of the thread to the cuff ensures a tight connection pads with the prosthesis.

When the flashing pads on the outer periphery of the thread of the purse string suture and pulling her to vascular prosthesis, provided access to the cuff at the time of filing her to the fibrous ring that facilitates the surgeon's manipulation of the prosthesis when it is podselenii to the fibrous ring dissected AOP the material of the valve.

The invention is illustrated by drawings, where figure 1 presents the appearance cleanstream prosthesis aortic root before implantation. Figure 2 presents laparostomy prosthesis aortic root in longitudinal section after filing it to the fibrous ring.

Laparostomy prosthesis aortic root contains vascular prosthesis 1 is secured at the proximal side of the cuff 3, and the valve 2 mounted in the cuff 3. For clarity, figure 2 shows a bileaflet mechanical valve. But, without limiting the invention, can be used by any mechanical or biological prosthetic heart valve. The cuff 3 is sewn trim ring 5. Plate 5 made of a synthetic sealant impregnated fabric or plate xenopericardial. Plate 5 on the outer periphery of stitched thread 6 a purse-string suture and attached to the vascular prosthesis 1, providing access to the cuff 3.

Laparostomy prosthesis aortic root, depicted in figure 1 and 2 operates as follows.

Using standard surgical procedures in prosthetic aortic root is removed the affected area of the aortic valve, the sleeve 3 is attached to the fibrous ring 1 prosthetic valve. The surgeon then cuts the thread 6 and jerks her, releasing the edges of the pads 5. Then the surgeon podlivaet edge nakedc the 5 on top of the cuff 3 to nesseceraly the area of the sinus of the aorta, sealing the connection zone of the seal 3 with fibrous ring 1. Next, the surgeon podlivaet to vascular prosthesis 1 of the coronary vessels and podlivaet the distal edge of the vascular prosthesis 1 to nesseceraly section of the aortic arch.

The prosthesis is filled with blood. Thanks sealing impregnation of the walls of the vascular prosthesis 1 and the pads 5 are prevented from bleeding through the wall of the prosthesis and the area of its connection with the fibrous ring I. After removing the clamps and run in the functioning of the heart valve 2 under the action of alternating pressure closes the back, and offers direct blood flow, and vascular prosthesis 1 provides a direct passage of blood flow from the heart into the vascular system.

Proposed laparostomy prosthesis aortic root, while retaining all the advantages of the prototype, provides improved reliability and reduced risk of postoperative complications associated with leakage connection of the prosthesis to the fibrous ring of the dissected aortic valve of the heart.

1. Laparostomy prosthesis aortic root, containing the vascular prosthesis can be fixed with the proximal side of the cuff, and a valve mounted in the cuff, wherein the prosthesis is provided with a circular pad mounted on the inner perimeter of the cuff, with the strap attached to the vascular prosthesis to provide access to cuff them is no possibility of filing during the operation over the cuff for sealing the connection zone of the cuff with the fibrous ring.

2. Laparostomy prosthesis aortic root according to claim 1, characterized in that the cover plate is made of synthetic fabric with a sealing impregnation or plate xenopericardial.

3. Laparostomy prosthesis aortic root according to claim 1, characterized in that the cover plate on the inner perimeter of sewn thread to the cuff.

4. Laparostomy prosthesis aortic root according to claim 1, characterized in that the cover plate on the outer periphery of stitched thread a purse-string suture and attached to a vascular prosthesis, providing access to the cuff.



 

Same patents:

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Spiral stent-graft // 2460495

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Implantable device // 2452432

FIELD: medicine.

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26 cl, 172 dwg

FIELD: medicine.

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29 cl, 16 dwg

FIELD: medicine; medical engineering.

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EFFECT: accelerated operation time; reduced risk of traumatic complications.

2 cl, 2 dwg

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