TISSUE PROTECTION DEVICE FOR MITRAL VALVE MEMBRANE CERCLAGE PROCEDURE
20200330091 ยท 2020-10-22
Assignee
Inventors
Cpc classification
A61F2/2451
HUMAN NECESSITIES
A61B90/04
HUMAN NECESSITIES
A61B17/0493
HUMAN NECESSITIES
International classification
A61B17/04
HUMAN NECESSITIES
A61B90/00
HUMAN NECESSITIES
Abstract
The present invention relates to a tissue protection device for mitral valve cerclage annuloplasty and, more particularly to a tissue protection device for protecting tissues of the body (heart) during mitral valve cerclage annuloplasty that is performed on a mitral valve cerclage patient with mitral regurgitation. The tissue protection device for mitral valve cerclage annuloplasty of the present invention is a hollow cylindrical tube where cerclage sutures (10a, 10b) are inserted, in which a hole (22) is formed at a predetermined portion of the cylindrical tube so that a coronary sinus cerclage suture (10a) inserted in a coronary sinus comes out of the cylindrical tube, and a lower section from the hole is inserted into the tricuspid valve to protect tissues of the tricuspid valve and the ventricular septum.
Claims
1. A tissue protection device, the tissue protection device comprising: a tube, the tube having a stem section being an upper part, a support section being a middle part connected to the stem section, and a tricuspid valve insert being a lower part being connected to the support section wherein the tricuspid valve insert is configured to traverse a tricuspid valve, the tricuspid valve insert having a distal portion, the tricuspid valve insert having a stopper positioned on the distal portion of the tricuspid valve insert to prevent the distal portion of the tricuspid valve insert from going deep inside a myocardium.
2. The device of claim 1, wherein a hole is formed at the support section.
3. The device of claim 1 further comprising: a first cerclage suture and a second cerclage suture wherein the first cerclage suture and the second cerclage suture are connected to each other and inserted in the tube,
4. The device of claim 1, wherein the support section is more rigid than the tricuspid valve insert.
5. The device of claim 1, wherein the tube is thicker at the support section than the tricuspid valve insert.
6. The device of claim 1, wherein a protrusion is formed at an upper portion of the tricuspid valve insert.
7. The device of claim 1, wherein the stopper is a circular protrusion.
8. The device of claim 1, wherein the tricuspid valve insert becomes narrower at a lower end portion of the tricuspid valve insert.
9. The device of claim 1, wherein the tricuspid valve insert maintains its C-shape between the hole and the stopper without being in contact with a wall of a tricuspid valve.
10. The device of claim 1, wherein the support section is straight.
11. The device of claim 1, wherein the stem section is straight.
Description
DESCRIPTION OF DRAWINGS
[0017]
[0018]
[0019]
BEST MODE
[0020] Hereinafter, the tissue protection device for mitral valve cerclage annuloplasty of the present invention will be described in detail with reference to the accompanying drawings.
[0021]
[0022] A cerclage suture 10, which is a very thin thread having a thickness of about 0.014 and used for mitral cerclage coronary sinus annuloplasty (MVA), was named in the meaning that a piece of string comes out of a body after going around a coronary sinus (CS), a tricuspid valve (TV), and a ventricular septum, and when the cerclage suture comes out of a body, it is divided into two pieces at one end and the other end. That is, a cerclage suture is divided into a coronary sinus cerclage suture 10a and a tricuspid valve cerclage suture 10b in
[0023] A tissue protection device 20 is a hollow cylindrical tube where the cerclage sutures 10a and 10b are inserted. The tissue protection device 20 is a hollow cylindrical tube, that is, it has an empty inside and is manufactured as thick as a 4Fr catheter. The material is a soft and flexible rubber or synthetic resin. Alternatively, a metal spring coated with biological synthetic resin may be used.
[0024] As for each part of the tissue protection device 20, the device is composed of a stem section 23 that is the upper part, a support section 26 that is the middle part, and a tricuspid valve insert 24 that is the lower part. The parts collectively make one hollow thin cylindrical tube.
[0025] The tissue protection device of the present invention has a hole 22 at a predetermined position and the hole 22 is a part through which the coronary sinus cerclage suture 10a inserted in a coronary sinus comes out of the cylindrical tube. The support section 26 is defined to predetermined positions over and under the hole 22, the step section 23 is defined over the support section, and the tricuspid valve insert 24 for protecting a tricuspid valve and a ventricular septum is defined under the support section.
[0026] The coronary sinus cerclage suture 10a and the tricuspid valve cerclage suture 10b are connected to each other. The cerclage suture 10a that is supposed to be inserted into a coronary sinus is not covered with the tube in the coronary sinus, so it may be formed to be more rigid than the tricuspid valve cerclage suture 10b in order to protect the coronary sinus tissues. The coronary sinus cerclage suture 10a is formed thicker than the tricuspid valve cerclage suture 10b and thus damage to the coronary sinus tissues due to the coronary sinus cerclage suture is prevented.
[0027] The support section 26 where the hole 22 for the coronary sinus cerclage suture 10a to come out of the tissue protection device 20 is connected to the stem section 23 and positioned under the stem section 23.
[0028] The support section 26 is formed to be more rigid than the stem section 23 or the tricuspid valve insert 24. This is for more stably supporting the coronary sinus cerclage suture 10a when the coronary sinus cerclage suture 10a comes out of the hole.
[0029]
[0030] As shown in
[0031] The tricuspid valve insert 24 connected to the support section 26 is a part that protects the tricuspid valve and the ventricular septum from the cerclage suture 10b that is inserted in the tricuspid valve.
[0032] A stopper 24a is formed at a lower end portion of the cylindrical tube (that is, a lower end portion of the tricuspid valve insert) to prevent the tissue protection device from going deep inside the myocardium. The stopper 24a may be a circular protrusion, as shown in the figure. Further, as shown in the figure, the lower end portion of the cylindrical tube (that is, the lower end portion of the tricuspid valve insert) may become narrower as it goes to the end in order to cover the cerclage suture 10b in a ventricular septum.
[0033] The distance between an RVOT stopper 24a and the hole 22a is selected in advance such that the tricuspid valve insert 24 is around two times longer than the distance between an RVOT exit and the coronary sinus hole that is measured from a scanning image of a patient obtained in advance. That is, the distance between the hole 22 and the stopper 24a is designed around two times longer than the distance from the stopper to the end. To this end, it may be possible to change the position of the stopper at the tricuspid valve insert 24, but various tissue protection devices having different distances between the hole 22 and the stopper 24a may be provided.
[0034] When the coronary sinus cerclage suture 10a coming out of the tissue protection device 20 is inserted into the coronary sinus, the hole 22 is locked to the edge of a CS inlet. Accordingly, the stopper 24a of the tricuspid valve insert 24 (RVOT exit stopper) and the hole 22 are fixed, so the tricuspid valve insert 24 is curved into a reverse C-shape as long as the length without being in contact with the wall of the tricuspid valve (TV). Accordingly, erosion of the tricuspid valve due to the cerclage suture 10 is prevented and movement of lobes of the mitral valve is less limited.
[0035] On the other hand, a protrusion 27 may be formed on the outer side of the tissue protection device 20, as shown in the figure. The protrusion 27 prevents the tissue protection device from being excessively inserting into the body by locking to a tissue inside the body and supports a side when the tricuspid valve insert 24 is curved in a reverse C-shape.
[0036] The embodiments described above are just examples of the present invention and the scope of the present invention is not limited to the embodiments. The present invention may be changed, replaced, and modified in various ways by those skilled in the art without departing from the scope of the present invention described in claims.
INDUSTRIAL APPLICABILITY
[0037] The present invention can be used for a tissue protection device for mitral valve cerclage annuloplasty and, more particularly to a tissue protection device for protecting tissues of the body (heart) during mitral valve cerclage annuloplasty that is performed on a mitral valve cerclage patient with mitral regurgitation.