CN109984869A - Heart valve prosthesis conveying device - Google Patents

Abstract

The invention discloses a medical device delivery device, comprising a hollow outer sheath conduit and a first braking unit connected with the outer sheath conduit, the first braking unit comprising a hollow tubular first rotating member, and a first braking unit accommodated in a A fixing piece in the inner cavity of the first rotating piece, the fixing piece is connected with the outer sheath catheter; the inner wall of the first rotating piece is provided with a helical guide around the axial direction of the first rotating piece A receiving groove is formed on the side wall of the fixing member; the medical device conveying device further includes a rolling member sandwiched between the guiding groove and the receiving groove, and the first rotating member drives the rotation of the first rotating member. The rolling member rolls in the guide groove, and simultaneously drives the fixed member and the outer sheath catheter to move axially relative to the first rotating member. The first braking unit of the medical device delivery device of the present invention converts the circumferential rotation of itself into the axial movement of the outer sheath catheter, so that the implantation of the medical device is more convenient and labor-saving.

Description

Heart valve prosthesis delivery device

technical field

The invention relates to the field of interventional medical devices, in particular to a heart valve prosthesis delivery device.

Background technique

The human heart is divided into four chambers, each with its own "outlet", and a total of four valves (the mitral, aortic, pulmonary, and tricuspid valves) that ensure the Blood flows in a designated direction in the cardiovascular system. The mitral valve is located between the left atrium and the left ventricle. The normal mitral valve ensures that the blood circulation flows from the left atrium to the left ventricle and through a certain blood flow. In addition, when the left ventricle contracts, the two flexible leaflets of the mitral valve close, preventing the backflow of blood from the left ventricle of the heart to the left atrium. Various heart diseases or degenerative diseases can cause mitral valve dysfunction, causing the mitral valve to become abnormally narrowed or dilated, or to allow blood to flow back from the left ventricle into the left atrium. The loss of mitral valve function can affect the normal work of the heart, causing people to gradually become debilitating or life-threatening.

Various treatments exist for dysfunction of the mitral valve, such as traditional valve replacement surgery, which is considered an "open heart" surgery. In short, the operation requires surgery to open the chest, start cardiopulmonary bypass with a heart-lung machine, open the heart, and remove and replace the patient's mitral valve. Surgery carries a high risk of death. Currently, there is growing interest in the treatment of mitral valve dysfunction by interventional means, and less invasive transcatheter techniques have been developed for delivering a replacement mitral valve. In such techniques, a self-expanding prosthetic valve is typically mounted on the tip of a flexible catheter in a crimped state and advanced through the patient's blood vessel or body until the prosthetic valve reaches the implantation site. The prosthetic valve is then expanded to its functional size at the site of the defective native mitral valve.

Although transcatheter interventional technology to replace the natural mitral valve is an effective method for the treatment of insufficiency, the volume of the prosthetic valve is often large, and it is difficult to deliver it in the delivery device; if the size of the delivery catheter is increased, the patient's heart will be affected. Damage will increase accordingly. In addition, the replacement process of the existing systems and methods is complicated to control, and it is easy to damage the heart tissue, resulting in poor treatment effect. Accordingly, it would be desirable to provide improved devices and methods for treating valvular insufficiency, such as mitral valve insufficiency, a need for a suitable prosthetic valve delivery device, delivery of the prosthetic valve to a target location and release, requiring the delivery of The operation is simple, the release force of the prosthetic valve is small, and the operation of the doctor is convenient.

SUMMARY OF THE INVENTION

The present invention provides a medical device delivery device, comprising a hollow outer sheath conduit and a first braking unit connected with the outer sheath conduit, the first braking unit comprising a hollow tubular first rotating member, and a first braking unit accommodated in a A fixing piece in the inner cavity of the first rotating piece, the fixing piece is connected with the outer sheath catheter; the inner wall of the first rotating piece is provided with a helical guide around the axial direction of the first rotating piece A receiving groove is formed on the side wall of the fixing member; the medical device conveying device further includes a rolling member sandwiched between the guiding groove and the receiving groove, and the first rotating member drives the rotation of the first rotating member. The rolling member rolls in the guide groove, and simultaneously drives the fixed member and the outer sheath catheter to move axially relative to the first rotating member.

In an embodiment, the first braking unit further includes a guide member, the guide member is arranged between the first rotating body and the fixed member, the guide member has an inner cavity and a side wall, so An axial limit opening communicated with the inner cavity of the guide member is provided on the side wall, and the limit opening defines a path for the axial movement of the fixing member.

In one embodiment, the delivery device further includes a handle housing, the first rotating member is partially disposed in the handle housing, and the handle housing defines the relative relation of the first rotating member to the handle housing. Only circumferential rotation occurs.

In one embodiment, the rolling element is a spherical structure.

In one embodiment, the number of the rolling elements is at least one.

In one embodiment, the helix angle of the guide groove ranges from 15 to 45 degrees.

In one embodiment, the fixing member includes a first joint body, the first joint body is connected with the outer sheath catheter, and the rolling member is provided on the side wall of the first joint body and the first rotating member. between the inner walls of the piece.

In one embodiment, the fixing member further includes an adjusting member and a first sealing ring disposed at the distal end of the adjusting member, the adjusting member is provided with an external thread, and the proximal end of the first joint body is also provided with an external thread. The proximal end opening of the adjusting piece and the first sealing ring is accommodated, and the proximal end opening of the first joint body is provided with an internal thread matched with the external thread on the adjusting piece.

In one embodiment, the delivery device further includes a connecting conduit extending through the outer sheath conduit.

In one embodiment, the distal end of the connecting conduit is provided with a threaded structure, and the connecting conduit is connected with the medical device through the threaded structure.

The medical device delivery device of the present invention has at least the following beneficial effects: the control of the catheter assembly is realized by the braking assembly, especially the first braking unit converts its circumferential rotation into the axial movement of the sheath catheter, so that the medical device The implantation is more convenient and labor-saving.

Description of drawings

1 is a schematic structural diagram of a medical device delivery device according to an embodiment of the present invention;

2 is a schematic cross-sectional structural diagram of a medical device delivery device according to an embodiment of the present invention;

3 is a schematic diagram of a partially disassembled structure of a medical device delivery device according to an embodiment of the present invention;

4 is a schematic structural diagram of a first rotating member of a medical device delivery device according to an embodiment of the present invention; FIG. 5 is a cross-sectional structural schematic diagram of the first rotating member shown in FIG. 4 ;

6 is a schematic structural diagram of a guide member of a medical device delivery device according to an embodiment of the present invention;

7a is a schematic cross-sectional structural diagram of a first braking unit of a medical device delivery device according to an embodiment of the present invention;

Fig. 7b is an enlarged view of a part of the structure of Fig. 7a;

8 is a schematic structural diagram of the second braking unit and the third braking unit of the medical device delivery device according to the embodiment of the present invention;

9 is a schematic cross-sectional structure diagram of the structure shown in FIG. 8;

10a to 10g are schematic diagrams illustrating the operation process of implanting a prosthetic heart valve using the delivery device of the present invention.

Detailed ways

In order to better understand the technical solutions and beneficial effects of the present invention, the present invention will be further described in detail below with reference to specific embodiments. In the field of interventional medicine, the end close to the device operator is defined as the "proximal end", and the end farther from the device operator is defined as the "distal end"; the direction parallel to the line connecting the proximal center and the distal center of the device is defined as the "axis" The direction perpendicular to the "axial" is "radial", and the direction around the "axial" is "circumferential". The "connection" can be the direct connection of two objects, or the connection through other objects.

The medical device delivery device of the present invention can be used for delivery of various medical devices, such as filters, occluders or artificial heart valves. Hereinafter, the delivery device of the present invention will be described in detail by taking delivery of an artificial heart valve as an example.

Referring to FIGS. 1 to 3 , the medical device delivery device 01 of the present invention includes a brake assembly 10 and a hollow conduit assembly 20 . The proximal end of the catheter assembly 20 is connected to the distal end of the braking unit 10 , and the braking assembly 10 can brake the catheter assembly 20 .

The braking assembly 10 includes a first braking unit 11 , a second braking unit 12 and a third braking unit 13 axially arranged in sequence from the distal end to the proximal end. The catheter assembly 20 includes an outer sheath catheter 21 , a push rod catheter 22 and a connecting catheter 23 that are coaxially arranged. Each of the sheath conduit 21 , the push rod conduit 22 and the connecting conduit 23 is a hollow structure and has openings at both ends. The push rod catheter 22 penetrates the outer sheath catheter 21 , the connecting catheter 23 penetrates the push rod catheter 22 , and the inner cavity of the connecting catheter 23 can be passed through by the guide wire. There are gaps between the push rod conduit 22 and the connecting conduit 23 and between the push rod conduit 22 and the outer sheath conduit 21 to facilitate relative movement between the conduits. The proximal end of the outer sheath catheter 21 is connected to the first braking unit 11 , and the first braking unit 11 brakes the outer sheath catheter 21 to generate axial movement. The second braking unit 12 is connected with the proximal end of the connecting conduit 23 to brake the connecting conduit 23 to generate circumferential rotation. The third braking unit 13 abuts against the proximal end face of the connecting conduit 23 to brake the connecting conduit 23 to generate axial movement. At the same time, the distal end of the connecting catheter 23 is also provided with a threaded structure (not marked in the figure), through which the connecting catheter 23 can be connected or disengaged with the artificial heart valve.

The outer sheath catheter 21 provides sufficient support for the delivery of the artificial heart valve, and its material can be a single-layer polymer material, metal or a composite material of polymer material and metal, such as PEEK, PC, POM, titanium or PTFE+stainless steel+PEBAX/nylon composite material, etc. The push rod catheter 22 is used to provide an axial support force for the proximal end of the artificial heart valve loaded on the delivery device 01 and an axial thrust force when the heart valve is released. The material can be a single-layer polymer material, such as PE. , PC, PEBAX or nylon, etc. The connecting catheter 23 is used to connect the artificial heart valve, and the material can be polymer material or metal, such as PEEK, stainless steel, nickel titanium or titanium and so on.

The distal end of the outer sheath catheter 21 is further provided with a developing ring 211, and the developing ring 211 can be imaged under an imaging device to indicate the delivery position of the delivery device 01 in the body. The material of the developing ring 211 may be platinum, tantalum or tungsten and other metal materials with good developing properties.

The delivery device 01 also includes a handle housing 50 . The handle housing 50 includes a detachable distal handle housing 51 and a proximal handle housing 52 . The distal handle housing 51 includes a distal first half-shell 511 and a distal second half-shell 512 . The distal first half-shell 511 and the distal second half-shell 512 can be assembled into a distal handle housing 51 through snap connection, or can be assembled into a distal handle through screw and nut connection, bonding or welding, etc. housing 51 . The proximal handle housing 52 includes a proximal first half-shell 521 and a proximal second half-shell 522 . The proximal first half-shell 521 and the proximal second half-shell 522 can be assembled into the proximal handle housing 52 through snap connection, or can be assembled into the proximal handle through screw and nut connection, bonding or welding, etc. housing 52 . The handle housing 50 is used for accommodating and fixing, accommodating, assembling and fixing the brake assembly 10 . The first braking unit 11 , the second braking unit 12 and the third braking unit 13 are axially arranged in the handle housing 50 . The first braking unit 11 and the second braking unit 12 are both arranged in the middle of the handle housing 50 , and the third braking unit 13 is close to the proximal end of the handle housing 50 . The handle housing 50 is also provided with a first valve 31 and a second valve 32, and both the first valve 31 and the second valve 32 are preferably Luer connectors. After the first valve 31 is connected with the syringe, the inner cavity of the push rod catheter 22 can be flushed, and the flushing fluid flowing out from the distal end of the push rod catheter 22 can locally flush the distal end of the sheath catheter 21. After the second valve 32 is connected with the syringe The lumen of the connecting catheter 23 can be flushed.

Referring to FIGS. 4 to 7 at the same time, the first braking unit 11 includes a first rotating member 111 , a guiding member 112 and a fixing member 113 . The first rotating member 111 is a tubular structure with a hollow lumen and an inner wall, and includes a proximal rotating portion 111a and a distal rotating portion 111b that are connected and rotatable at the same time. The proximal rotating part 111a is arranged between the distal handle housing 51 and the proximal handle housing 52, and the distal rotating part 111b is arranged in the distal handle housing 51, that is, the operator can operate the proximal rotating part 111a rotate, thereby driving the distal rotating part 111b to rotate. A guide groove 111c is also provided on the inner wall of the first rotating member 111 . The guide groove 111c is helical, and is arranged to rotate around the axial direction of the first rotating member 111. The helical angle can range from 15° to 45°, and is preferably 18° in this embodiment. The guide member 112 is arranged in the inner cavity of the first rotating member 111 and has an inner cavity and a side wall 112a. The side wall 112a is also provided with an axial limit opening 112b which communicates with the inner cavity of the guide member 112 . The proximal end of the guide member 112 can be fixed in the handle housing 50 to ensure that when the first braking unit 11 brakes the sheath catheter 21 , the guide member 112 has no axial movement relative to the first rotating member 111 . The fixing member 113 is partially disposed in the inner cavity of the guide member 112 and can move axially relative to the guide member 112 . The fixing member 113 includes a first joint body 113a. The proximal end of the first joint body 113a is clamped in the limiting opening 112b, so as to ensure that the fixing member 113 only moves in the axial direction relative to the guide member 112 and does not rotate in the circumferential direction. The distal end of the first joint body 113a is provided with a distal opening that can receive the proximal end of the sheath catheter 21 . It can be understood that, in other embodiments, the first joint body and the proximal end of the outer sheath catheter may also be connected by other means such as snap connection, bonding or welding.

Further, the fixing member 113 further includes an adjusting member 113b and a first sealing ring 40a disposed at the distal end of the adjusting member 113b. The proximal end of the first joint body 113a is also provided with a proximal end opening for accommodating the adjusting member 113b and the first sealing ring 40a, the proximal end opening of the first joint body 113a communicates with the distal opening, and the push rod catheter 22 passes through the first joint The proximal end opening and the distal end opening of the main body 113a penetrate through the interior of the first joint main body 113a. The adjusting member 113b is provided with an external thread, and the proximal opening of the first joint body 113a is provided with an internal thread matching with the external thread on the adjusting member 113b. When assembling the catheter assembly 20 and the braking assembly 10 of the delivery device 01 , the first sealing ring 40 a can be deformed by adjusting the adjusting member 113 b to seal the gap between the sheath catheter 21 and the push rod catheter 22 .

The outer side of the proximal end of the first joint main body 113a is further provided with a hemispherical receiving groove 113c, and a rolling element 114 is arranged in the receiving groove 113c. The rolling element 114 is specifically disposed between the first joint main body 113 a and the guide groove 111 c on the inner wall of the first rotating element 111 . The rolling element 114 is spherical, and the diameter matches the width of the guide groove 111c, so that the rolling element 114 is restricted from rolling in the guide groove 113c but will not fall off from the receiving groove 113c. The number of rolling elements 114 is at least one, preferably two in this embodiment and symmetrically arranged, while the number of guide grooves 111c is not less than the number of rolling elements 114, and the number of guide grooves 111c in this embodiment is also two. It can be understood that, in other embodiments, the receiving groove may also be a quarter spherical groove, a third spherical groove, a fifth spherical groove, or the like. The quarter spherical groove refers to the groove corresponding to the quarter diameter obtained by cutting the spherical structure in the direction perpendicular to the diameter at the quarter diameter of the hollow spherical structure. . The definition methods of one-third spherical groove, one-fifth spherical groove and quarter spherical groove are similar, and will not be repeated here.

When the first rotating member 111 is manually rotated, the rolling member 114 will be driven to roll. Since the first rotating member 111 is restricted by the handle housing to rotate in the circumferential direction, and the guide member 112 restricts the fixed member 113 to only move axially. Therefore, the rolling of the rolling element 114 will drive the fixing element 113 to move axially, thereby driving the axial movement of the sheath catheter 21 connected to the fixing element 113 . The circumferential rotation of the first rotating member 111 is converted into the axial movement of the outer sheath catheter 21 through the guide member 112, so that the force of the outer sheath catheter moving in the axial direction is greatly reduced, and the overall axial dimension of the delivery device 01 is shortened at the same time .

In other embodiments, the guide member may also be omitted, for example, by arranging a limit bar in the handle housing to ensure that the fixing member does not rotate in the circumferential direction relative to the handle housing.

Referring to FIG. 8 and FIG. 9 simultaneously, the second braking unit 12 includes a second rotating member 122 and a connecting member 121 connected with the connecting conduit 23 . The second rotating member 122 has a stepped axial through hole 125 , and a distal end thereof is provided with an opening capable of accommodating the connecting conduit 23 . The axial through hole 125 includes a distal end portion 125a with a larger bore and a proximal end portion 125b with a smaller bore. Preferably, in this embodiment, the cross section of the distal end portion 125a is rectangular. The connecting member 121 is located at the distal end portion 125a of the axial through hole 125, and the shape of the connecting portion 121 and the distal end portion 125a match, so that the connecting member 121 can only move axially relative to the second rotating member 122, but cannot rotate in the circumferential direction . In this embodiment, the cross section of the connecting portion 121 is also rectangular. The proximal end of the connecting catheter 23 is received in the through hole of the second rotating member 122 through the connecting member 121 . Referring to FIG. 1 again, the outer portion of the second rotating member 122 is exposed outside the handle housing, and the operator can operate and rotate the second rotating member 122 to drive the connecting conduit 23 to rotate in the circumferential direction. It can be understood that, in other embodiments, the cross-sectional shape of the distal portion 125a may also be a triangle, a rhombus, a pentagon, an ellipse, etc., as long as the connecting member 121 matches the shape of the distal portion 125a, so that the connecting member 121 The relative second rotating member 122 can only move in the axial direction, but cannot rotate in the circumferential direction.

A second joint body 33 for accommodating the proximal end of the push rod catheter 22 is also coaxially disposed near the distal end of the second rotating member 122 . The fixing of the push rod conduit is realized by fixing the second joint body 33 to the inner wall of the handle housing. The second joint main body 33 is also provided with an opening communicating with the first valve 31 , which is used for flushing the inside of the conveying device 01 .

The third braking unit 13 is disposed at the proximal end of the conveying device 01 , and specifically includes a third rotating member 131 , an adjusting tube 132 screwed to the third rotating member 131 , and a pushing conduit 24 . The third rotating member 131 is disposed at the proximal end of the handle housing 50 and has a hollow inner cavity and an inner wall, and the inner wall is provided with an inner thread. The adjusting tube 132 is inserted through the inner cavity of the third rotating member 131 and is provided with an external thread matching with the internal thread on the inner wall of the third rotating member 131 . An axial through hole is provided inside the regulating pipe 132 , and the axial through hole communicates with the second valve 32 . Push the proximal end of the catheter 24 to pass from the distal end of the adjustment tube 132 into the axial through hole of the adjustment tube 132, and be fixed in the adjustment tube 132; into and can abut against the proximal end face of the connector 121 . By rotating the third rotating member 131, the adjusting tube 132 can be driven to move towards the distal end. Since the pushing conduit 24 is fixed relative to the adjusting tube 132, the pushing conduit 24 moves with the adjusting tube 132 towards the distal end, and the distal end of the pushing conduit 24 is pushed against the distal end. Connect the proximal end of the connecting member 121, and continue to rotate the third rotating member 131 in the same direction, then the pushing catheter 24 that continues to move to the distal end can push the connecting catheter 23 to move distally, so that the distal end of the connecting catheter 23 is removed from the push rod catheter. The distal end face of 22 protrudes. It should be noted that the third braking unit 13 of the present invention can only brake the connecting catheter 23 to move to the distal end, but cannot brake the connecting catheter 23 to move to the proximal end, but the third braking unit 13 retracts to push the distal end of the catheter 24 When not in contact with the connecting piece 121, the connecting catheter 23 can move toward the proximal end under the action of an external force.

Preferably, the second braking unit 12 and the second joint body 33 are also provided with a second sealing ring 40c and a third sealing ring 40b, which can play a sealing and locking role, respectively, and can lock the pushing conduit 24 and the connecting conduit respectively. twenty three.

In other embodiments, the pushing catheter can also be omitted, for example, the proximal end section of the connecting catheter abuts the step of the adjusting tube with the stepped hole, as long as the second adjusting member can drive the connecting catheter to move axially without affecting the connecting catheter can rotate in the circumferential direction.

In conclusion, the usage method of the conveying device 01 of the present invention will be described in detail below. In the initial state, the positional relationship of each conduit in the conduit assembly 20 of the delivery device 01 of the present invention is as follows: the distal end face of the connecting conduit 23 protrudes from the distal end face of the push rod conduit 22, and the distal end face of the push rod conduit 22 is located outside. In the lumen of the sheath catheter 21 , the distal end of the pushing catheter 24 is not in contact with the connector 121 . When the artificial heart valve is implanted using the delivery device 01 of the present invention, the artificial heart valve needs to be loaded on the delivery device 01 first. Specifically, firstly, the first rotating member 111 is rotated, and the outer sheath catheter 21 is braked to move toward the proximal end, so that the distal end of the push rod catheter 22 is exposed from the distal end of the outer sheath catheter 21 . Then, the artificial heart valve is connected to the connecting catheter 23 through screw connection. Finally, the first rotating member 111 is rotated again to move the outer sheath catheter 21 to the distal end, and the connecting catheter 23 and the artificial heart valve are received into the lumen of the outer sheath catheter 21 together. At this time, the force of the outer sheath catheter 21 on the artificial heart valve is indirectly transmitted to the connecting catheter 23, so that the connecting catheter 23 moves axially toward the proximal end relative to the push rod catheter 22, and the moving connecting catheter 23 pushes the connector 121 and pushes the catheter. The distal end faces of 24 abut against each other, and the distal end of the connecting catheter 23 is retracted into the lumen of the push rod catheter 22 again, thereby completing the loading of the artificial heart valve.

After the prosthetic heart valve is delivered to a proper position by the delivery device 01, the prosthetic heart valve needs to be released. Specifically, firstly, the first rotating member 111 is rotated to stop the outer sheath catheter 21 from moving toward the proximal end, and the binding force of the outer sheath catheter 21 to the artificial heart valve is cancelled, so that the artificial heart valve is expanded. Then, the second rotating member 122 is rotated to drive the connecting catheter 23 to rotate in the circumferential direction to release the artificial heart valve. Thus, the release of the artificial heart valve is completed. It can be understood that, if necessary, before rotating the second rotating member 122 to release the artificial heart valve, the third rotating member 131 can be rotated so that the distal end of the connecting catheter 23 slightly protrudes from the distal end face of the push rod catheter 22, thus releasing the artificial heart valve. It is more convenient when the heart valve is used.

When the release position of the artificial heart valve is not good or the artificial heart valve needs to be reconnected to the connecting catheter when the valve is loaded outside the body, the third rotating member 131 can be rotated, and the connecting catheter 23 can be pushed to the distal end by the pushing catheter 24, and the connecting catheter 23 is set. The distal end of the threaded structure emerges from the distal end of the push rod catheter 22 . The third rotating member 131 is rotated again to partially withdraw the pushing catheter 24 , that is, the distal end of the pushing catheter 24 is no longer in contact with the connecting member 121 . The artificial heart valve is then connected to the connecting catheter 23 . Therefore, it can be understood that, in other embodiments, the third braking unit may be omitted if the prosthetic heart valve does not need to be released and recovered repeatedly.

Further, in other embodiments, the distal end of the push rod catheter can also be set into a tapered structure, and the taper angle of the tapered structure is toward the distal end. Such a design can re-connect the artificial heart valve to the connecting catheter through the cooperation of the braking component when the artificial heart valve is released but the position is not ideal, and the artificial heart valve can be re-released after adjusting the position. At this time, the tapered structure at the distal end of the push rod catheter mainly plays the role of puncturing, so that there is no need to re-puncture, the position of the artificial heart valve can be adjusted in time, and the operation time when the position of the heart valve is not released is greatly saved.

Specifically, the method of using the delivery device 01 of the present invention will be described by taking the artificial heart valve implanted into the human heart as an example. Please refer to FIG. 10a to FIG. 10g at the same time, which simultaneously show the basic anatomical structure of the human heart, including the left atrium LA, the left ventricle LV, the left atrium RA and the right ventricle RV. Before using the delivery device 01 of the present invention, a micro-incision is first made in the fifth or sixth intercostal space of the left anterior chest, the pericardium is longitudinally opened through the incision and sutured to expose the apex, and then the apex purse 310 is sutured near the apex. As shown in Figure 10a. Next, the apex of the heart is punctured using the puncture target and a soft guide wire 320 is inserted forward into the left ventricle of the heart, as shown in Figure 10b. Then, the puncture needle is withdrawn, and the pre-shaped short sheath tube 330 at the distal end and the dilator tube 340 with the balloon 341 at the distal end are fed along the guide wire 320, wherein the guide wire 320 is located in the dilator tube 340, and the dilator tube 340 is located in the short sheath tube 330, as shown in FIG. 10c, in addition, the distal end of the short sheath tube 330 or the dilator tube 340 or the distal end of both may be provided with a developing ring 350. Then, the balloon 341 is expanded and filled (as shown in FIG. 10d ). The expanded shape is spherical or elliptical, and the maximum outer diameter is between 8-15 mm, so as to avoid the interference of the chordae tendineae on the approach during the subsequent operation. Immediately thereafter, with the aid of DSA and ultrasound, the guide wire 320 is passed through the mitral valve to the left atrium, establishing an extracorporeal track to the left atrium. Then, the guide wire 320 located in the left atrium is retained, the short sheath tube 330 and the dilator tube 340 are withdrawn, and then the apical dilation device 360 is inserted along the guide wire 320, and the apical puncture point is gradually expanded through the apical dilation tube 361, and the apical dilation outer catheter 362 into the left ventricle, as shown in Figure 10e. Next, the apical dilation catheter 361 is withdrawn, and the apical dilation outer catheter 362 remains in the heart. The catheter assembly 20 of the delivery device 01 is delivered to the heart along the guide wire 320, and the distal end of the sheath catheter 21 is passed through the mitral valve, so that the developing ring 211 of the sheath catheter 21 is parallel to the mitral valve and on the same level. When the position is confirmed to be correct, rotate the first rotating member 111 to retract the sheath catheter 21 towards the proximal end, thereby removing part of the radial restraint on the distal end of the prosthetic heart valve, and the proximal part of the prosthetic heart valve is still in the retraction of the catheter 22 inside the lumen, as shown in Figure 10f. Continue to rotate the first rotating member 111 in the same direction, as the outer sheath catheter 21 is further withdrawn, the artificial heart valve self-expands radially outwards, when the artificial heart valve as a whole exposes the outer sheath catheter 21, rotate the third rotating member 131 , expose the distal end of the connecting catheter 23 to the distal end of the push rod catheter 22, as shown in Figure 10g. At this time, the second rotating member 122 is rotated, so that the connecting catheter 23 is also rotated, so that the threaded connection between the connecting catheter 23 and the artificial heart valve is released, and the final release of the artificial heart valve is completed.

When loading the prosthetic heart valve, the delivery device 01 first inserts the tether extending from the proximal end of the prosthetic valve into the connecting catheter 23, and then the proximal end of the tether protrudes from the proximal end of the connecting catheter 23, and then rotates a third rotation. The rotating member 131 pushes the catheter 24 to move to the distal end in the axial direction, and pushes the connecting member 121, so that the distal end of the connecting catheter 23 exposes the distal end of the push rod catheter 22, and the distal thread of the connecting catheter 23 is threaded with the artificial heart valve. assembled. After the assembly is completed, the third rotating member 131 is rotated back to the original position, so that the pushing catheter 24 is withdrawn and away from the connecting member 121 . At this time, the first rotating member 111 is rotated to move the outer sheath catheter 21 to the distal end, and the artificial heart valve will gradually be received into the outer sheath catheter 21 . At this time, the force of the outer sheath catheter 21 on the artificial heart valve is indirectly transmitted to the connecting catheter 23, so that the connecting catheter 23 moves axially toward the proximal end relative to the push rod catheter 22, and the moving connecting catheter 23 pushes the connecting piece 121 and the pushing catheter. The distal end faces of 24 abut against each other, and the distal end of the connecting catheter 23 is retracted into the lumen of the push rod catheter 22 again, thereby completing the loading of the artificial heart valve.

The above embodiments are only preferred embodiments of the present invention, and all optional modes cannot be listed one by one, so the above embodiments cannot be considered to limit the present invention. Meanwhile, those skilled in the art can simply modify and replace the corresponding partial structures or connection modes according to actual needs, and the protection scope of the present invention is subject to the claims.

Claims (10)

1. a kind of medical instrument conveying device, which is characterized in that be connected including hollow epitheca conduit and with the epitheca conduit First brake unit, first brake unit include the first revolving part of hollow tubular, and are contained in first rotation The interior intracavitary fixing piece of part, the fixing piece are connected with the epitheca conduit；The first revolving part inner wall is equipped with around described The side wall of the spiral guide groove of the axial direction of first revolving part, the fixing piece is equipped with accommodating grooves；The medical instrument Conveying device further includes the rolling member being located between the guide groove and accommodating grooves, and first revolving part drives when rotating The rolling member rolls in the guide groove, while driving the fixing piece and the epitheca conduit relative to first rotation Part is axially moved.

2. medical instrument conveying device according to claim 1, which is characterized in that first brake unit further includes leading To part, the guide part is set between first rotary body and the fixing piece, and the guide part has inner cavity and side wall, institute It states side wall and is equipped with the axial limiting opening communicated with the inner cavity of the guide part, the limit opening limits the fixing piece axis To mobile path.

3. medical instrument conveying device according to claim 1, which is characterized in that the conveying device further includes handle case Body, first rotary portion are set in the handle housing, the handle housing limit first revolving part relative to The handle housing only circumferentially rotates.

4. medical instrument conveying device according to claim 1, which is characterized in that the rolling member is spherical structure.

5. medical instrument conveying device according to claim 1, which is characterized in that the quantity of the rolling member is at least 1 It is a.

6. medical instrument conveying device according to claim 5, which is characterized in that the helix angle range of the guide groove It is 15~45 degree.

7. medical instrument conveying device according to claim 1, which is characterized in that the fixing piece includes the first connector master Body, first adapter body are connected with the epitheca conduit, and the rolling member is set to the first adapter body side wall and institute Between the inner wall for stating the first revolving part.

8. medical instrument conveying device according to claim 7, which is characterized in that the fixing piece further include regulating part and The first sealing ring set on the regulating part distal end, the regulating part are equipped with external screw thread, and first adapter body proximal end is also Proximal openings equipped with receiving regulating part and the first sealing ring, are equipped in the proximal openings of first adapter body and the tune Save the internal screw thread of external screw thread cooperation on part.

9. medical instrument conveying device according to any one of claim 1 to 8, which is characterized in that the conveying device It further include connecting conduit, the connecting conduit runs through the epitheca conduit.

10. medical instrument conveying device according to claim 9, which is characterized in that the connecting conduit distal end is equipped with spiral shell Line structure, the connecting conduit are connect by the helicitic texture with medical instrument.