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WO2016174379A1 - Valvules phoniques et ensembles tubes de trachéotomie - Google Patents

Valvules phoniques et ensembles tubes de trachéotomie Download PDF

Info

Publication number
WO2016174379A1
WO2016174379A1 PCT/GB2016/000075 GB2016000075W WO2016174379A1 WO 2016174379 A1 WO2016174379 A1 WO 2016174379A1 GB 2016000075 W GB2016000075 W GB 2016000075W WO 2016174379 A1 WO2016174379 A1 WO 2016174379A1
Authority
WO
WIPO (PCT)
Prior art keywords
speaking valve
tracheostomy tube
flow
speaking
valve
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/GB2016/000075
Other languages
English (en)
Inventor
Timothy Bateman
Stephen James Field
Andrew Thomas Jeffrey
Christopher John WOOSNAM
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Smiths Medical International Ltd
Original Assignee
Smiths Medical International Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Smiths Medical International Ltd filed Critical Smiths Medical International Ltd
Publication of WO2016174379A1 publication Critical patent/WO2016174379A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
    • A61M16/0468—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters with valves at the proximal end limiting exhalation, e.g. during speaking or coughing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0427—Special features for tracheal tubes not otherwise provided for with removable and re-insertable liner tubes, e.g. for cleaning
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0434—Cuffs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0475—Tracheal tubes having openings in the tube
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2206/00—Characteristics of a physical parameter; associated device therefor
    • A61M2206/10—Flow characteristics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2207/00—Methods of manufacture, assembly or production
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2209/00—Ancillary equipment
    • A61M2209/10—Equipment for cleaning
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F15—FLUID-PRESSURE ACTUATORS; HYDRAULICS OR PNEUMATICS IN GENERAL
    • F15D—FLUID DYNAMICS, i.e. METHODS OR MEANS FOR INFLUENCING THE FLOW OF GASES OR LIQUIDS
    • F15D1/00—Influencing flow of fluids
    • F15D1/02—Influencing flow of fluids in pipes or conduits

Definitions

  • This invention relates to speaking valves of the kind for tracheostomy tubes.
  • Tracheostomy tubes are used to ventilate patients during and after surgery. As the patient begins to recover, it is preferable for him to be gradually weaned off breathing through the tube before it is completely removed. Also, in order to enable the patient to speak it is necessary to allow at least a part of the air exhaled by the patient to flow up past the tracheostomy tube to the vocal folds instead of out through the machine end of the tube. Both these ends can be achieved by deflating or partially deflating the sealing cuff on the tube.
  • a fenestrated tracheostomy tube can be used having one or more small openings in its side wall, so that a part of the patient's breathing passes through these openings and via his nose or mouth, instead of through the machine end of the tracheostomy tube.
  • An inner cannula is commonly used with tracheostomy tubes, being removably inserted in the outer, tracheostomy tube so that it can be removed and replaced periodically to ensure that the passage through the assembly does not become blocked by secretions. This avoids the need to remove the outer tube frequently.
  • the inner cannula can also be used to block the openings in a fenestrated when speech is not required but must be removed from the tube when the patient wants to speak.
  • the speaking valve includes a one-way valve that enables air to be inhaled by the patient through the valve but prevents or limits flow out through the valve so that air instead flows to the larynx via the fenestrations or around the outside of a tube with a deflated cuff.
  • the speaking valve includes a movable valve element such as a flexible flap, which is moved towards or away from a flow path through the valve, thereby preventing or enabling flow through the valve.
  • Examples of speaking valves are described in, for example, US4325366, GB2164424, GB2214089, GB2313317, EP78685, EP214243, EP18461, DE2505123 and DE3503874.
  • Tracheostomy tubes with speaking valves are used by conscious patients who may have to use such a tube permanently or long-term.
  • Conventional speaking valves project from the machine end fitting of the tracheostomy tube so present a problem in that they tend to increase the profile of the tube and make it more conspicuous, which can be embarrassing for the patient.
  • Another problem arises because conventional speaking valves may interfere with clothing around the neck region, which may cause uncomfortable pressure to be exerted on the tube itself.
  • a speaking valve of the above-specified kind characterised in that the speaking valve includes a tube arranged to extend along at least a part of the bore of a tracheostomy tube, and that the tube has a flow passage extending along it shaped to enable gas flow preferentially in one direction, into the patient, and to restrict gas flow in the opposite direction, out of the patient.
  • the flow passage preferably includes a series of loops the opposite ends of which are inclined towards the patient end of the flow passage.
  • the flow passage is preferably provided by a Tesla valvular conduit.
  • the interior of the speaking valve may include deformable portions that allow a cleaning tool to be passed along the flow passage inside of the valve.
  • the speaking valve may be split longitudinally to enable it to be opened for cleaning.
  • the speaking valve may be made by injection moulding or by casting on a core of a material that is subsequently removed by melting or dissolving.
  • tracheostomy tube assembly including a tracheostomy tube and a speaking valve according to the above one aspect of the present invention extending along a part at least of the bore of the tube.
  • the tube may have at least one fenestration in its wall positioned to allow air to flow to the vocal folds, the patient end of the speaking valve terminating on the machine side of the fenestration so that it does not block flow out through the fenestration.
  • tracheostomy tube assembly including a tracheostomy tube and a speaking valve, the length of the speaking valve being contained entirely within the bore of the tracheostomy tube.
  • a tracheostomy tube assembly according to the above further aspect of the present invention, the speaking valve being of a kind according to the above one aspect of the present invention.
  • Figure 1 is a perspective view of the tracheostomy tube assembly and speaking valve
  • Figure 2 is a cross sectional, side elevation view of the speaking valve showing flow into the patient.
  • Figure 3 is an enlarged cross-sectional, side elevation view of the patient end of the speaking valve showing restricted flow out of the patient.
  • the assembly comprises a tracheostomy tube 1 and a speaking valve 2 fitted in and extending along the tube and removable from its machine end 3.
  • the tracheostomy tube 1 includes a curved shaft 10 of a plastics material and having a circular cross-section.
  • the tube extends from a patient end 11 to a neck flange 12 and a machine end fitting or coupling 13 of the conventional 15mm male tapered kind.
  • a sealing member in the form of an inflatable cuff 14 encircles the shaft 10 towards the patient end 11.
  • the interior of the cuff 14 communicates with an inflation line 15 including an inflation indicator in the form of a pilot balloon 16 having a sealing valve 17 at its machine end.
  • the tube 1 does not have fenestrations, speech being enabled by deflating the cuff 14.
  • the tube need not have a sealing cuff.
  • the speaking valve 2 consists of an inner cannula or tube 20 with an enlarged hub 21 at its machine end adapted to locate within the machine end coupling 13 on the tracheostomy tube 1.
  • the hub 21 could protrude slightly from the machine end of the coupling 13 or have a ring-pull arrangement (not shown) to enable the valve to be grasped and pulled out of the tube 1 when necessary.
  • the outside of the tube 20 is smooth, continuous and of circular section.
  • the length of the speaking valve 2 is such that it extends as a close sliding fit along the entire length of the bore 18 of the tracheostomy tube 1 such that the patient end 22 of the valve is located at the patient end 11 of the tracheostomy tube 1.
  • the inside of the speaking valve 2, along the length of the tube 20, is specially shaped to provide a flow passage 23 that allows gas to flow more easily along the passage in one direction than in the opposite direction. More particularly, the flow passage 23 allows a ready flow of inspiratory air or other gas from the machine end 21 to the patient end 22, that is, into the patient and substantially (but not entirely) blocks flow in the opposite direction, that is, expiratory flow out of the patient.
  • a "Tesla valvular conduit" is described in US 1329559.
  • the flow path 23 comprises a series of flow regions 24 one after the other (seven such regions are shown in Figure 2).
  • Each flow region 24 has a central, axial passage 25 and two lateral loops 26 and 27 positioned one after the other.
  • the opposite ends of each loop 26 and 27 open into the central passage 25 at an angle that is inclined in the direction of preferential flow, that is, towards the patient end 22 of the valve or cannula 2.
  • the flow of air or other gas during inhalation is illustrated in Figure 2 where the arrows indicate that the gas can flow through the valve 2 relatively freely, along the central passage 25, thereby enabling the patient to inhale freely.
  • the upstream end of the loops 26 and 27 are angled in the downstream direction such that there is little flow into these loops. Any flow there is into the upstream end of the loops 26 and 27 exits the downstream end of the loop in the same direction as the flow along the central passage 25, thereby contributing to the overall flow.
  • FIG 3 illustrates what happens when the patient tries to exhale through the valve 2.
  • the expiratory gas is initially split along two divergent paths, one provided by the central passage 25 and the other by the inclined opening into the first, lower loop 26.
  • the gas flowing along this loop 26 emerges from its opposite, downstream end at an angle directed back towards the patient end of the valve, that is, against the flow along the central passage 25, thereby impeding and reducing the overall flow from right to left out of the patient.
  • the same effect is created at the next loop 27 and at each subsequent loop, thereby producing a progressive drop in pressure along the valve 2, with very little gas emerging from the machine end 21.
  • the valve 2 of the present invention does not need any moving parts so avoids the problem of such moving parts sticking or wearing during use.
  • the length of the speaking valve 2 is contained entirely within the bore of the tracheostomy tube so avoids the problem of any part extending beyond the machine end fitting. This enables the profile of the external part of the tracheostomy assembly with the speaking valve to be very small, thereby avoiding the problem of conspicuous speaking valves or speaking valves that interfere with clothing. Long-term tracheostomy tubes often have a low profile fitting without the conventional 15mm male connector.
  • Speaking valves according to the present invention are particularly suited to use with such tubes.
  • the speaking valve 2 of the present invention is provided as a part of an inner cannula 20 it serves the dual purpose of enabling speech and providing an inner cannula that can be removed and replaced regularly as secretions build up, without the need to replace the outer tracheostomy tube 1.
  • the tracheostomy tube assembly described above uses an unfenestrated tube 1 and relies on the tube being uncuffed or having its cuff 14 deflated so that exhaled air can flow past the tube to the larynx and vocal cords to enable speech. If a speaking valve according to the present invention were to extend along the entire length of a fenestrated tube it can be seen that it would block the openings or fenestrations and thereby prevent exhalation.
  • a speaking valve according to the present invention would be used with a fenestrated tube providing the valve were shorter and its patient end terminated above (on the machine side of) the fenestrations.
  • the shorter length of such a valve would mean that it would have fewer divergent flow loops and would, therefore, make it less effective at blocking exhaled gas flow but it might still be sufficiently effective to enable speech.
  • the particular form of the Tesla flow passageway described above and illustrated is only exemplary since there could be other configurations of flow passageway that would have a similar effect of enabling inspiratory flow but restricting expiratory flow.
  • the loop formations could be deformable to enable a cleaning brush to be passed down the central passage.
  • the inner cannula/speaking valve could be of a clam type split construction with a longitudinal hinge along one side and clips along the opposite open side so that the valve could be opened by folding along the hinge to expose the interior flow passageway and more readily enable cleaning.
  • Speaking valves according to the present invention could be made in various different ways. For example, they could be moulded, such as by injection moulding. Alternatively, they could be cast about a core it the shape of the desired flow passage and the core subsequently removed such as by melting or dissolving. It would also be possible to use 3-D printing techniques to manufacture such valves.

Landscapes

  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Emergency Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne une valvule phonique de tube de trachéotomie (2) ne comportant aucune pièce mobile qui est formée avec un conduit valvulaire de Tesla du type ayant un passage d'écoulement (23) comportant une série de boucles (26) et (27) dont les extrémités opposées sont inclinées vers l'extrémité patient (22) du passage. Ceci permet à l'air de circuler à travers la valvule (2) de préférence depuis l'extrémité machine (21) vers l'extrémité patient (22) afin de permettre au patient de respirer mais limite la circulation dans la direction opposée de telle sorte que la plus grande partie de l'air expiré par le patient est déviée de sorte à circuler vers les cordes vocales. La longueur de la valvule phonique (2) est contenue entièrement dans l'alésage (18) du tube de trachéotomie (1).
PCT/GB2016/000075 2015-04-25 2016-04-08 Valvules phoniques et ensembles tubes de trachéotomie Ceased WO2016174379A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB1507195.4 2015-04-25
GBGB1507195.4A GB201507195D0 (en) 2015-04-25 2015-04-25 Speaking valves and tracheostomy tube assemblies

Publications (1)

Publication Number Publication Date
WO2016174379A1 true WO2016174379A1 (fr) 2016-11-03

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2016/000075 Ceased WO2016174379A1 (fr) 2015-04-25 2016-04-08 Valvules phoniques et ensembles tubes de trachéotomie

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GB (1) GB201507195D0 (fr)
WO (1) WO2016174379A1 (fr)

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108167564A (zh) * 2018-01-24 2018-06-15 西安建筑科技大学 一种限制流体回流装置
CN112254244A (zh) * 2020-10-23 2021-01-22 王婷 一种节能建筑用新风导流装置
CN112283486A (zh) * 2020-10-09 2021-01-29 武晓丹 一种水锤效应消除装置
CN112283411A (zh) * 2020-10-10 2021-01-29 金恩升 一种带有内壁清洗功能的特斯拉阀
CN112303296A (zh) * 2020-10-10 2021-02-02 丁文铃 一种可清理管内杂质的特斯拉阀管
CN112386792A (zh) * 2020-12-18 2021-02-23 李建朝 一种磁场驱动式血泵
CN112972886A (zh) * 2021-02-02 2021-06-18 北京工业大学 一种单滑块容积血泵
CN113331998A (zh) * 2021-06-07 2021-09-03 山东大学齐鲁医院 一种人工心脏瓣膜
CN113952643A (zh) * 2021-11-23 2022-01-21 吉林大学 仿生控温减湿口罩
WO2022096036A1 (fr) * 2021-06-01 2022-05-12 青岛海尔空调器有限总公司 Climatiseur et système d'air neuf
WO2024159818A1 (fr) * 2023-02-02 2024-08-08 米建军 Tuyau unidirectionnel, moteur à combustion interne, et amortisseur
WO2025220051A1 (fr) * 2024-04-15 2025-10-23 Gallelli Vincenzo Tuyau diodique

Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1329559A (en) 1916-02-21 1920-02-03 Tesla Nikola Valvular conduit
US3924637A (en) * 1974-12-23 1975-12-09 Arthur H Swanson Tracheotomy tube
DE2505123A1 (de) 1974-06-20 1976-01-08 Tracoe Medizine Ges Fuer Endotrachealkanuele aus flexiblem kunststoff mit schwenkbarem sprechventil
EP0018461A1 (fr) 1979-05-08 1980-11-12 ITALCAPS S.p.A. Procédé pour la préfermeture avec capsule de récipients qui contiennent des produits qui peuvent déborder et dispositif pour sa réalisation
US4325366A (en) 1980-07-07 1982-04-20 Tabor Carl J Valve and method for use with a tracheotomy tube
EP0078685A1 (fr) 1981-10-29 1983-05-11 Hansa Medical Products Inc. Appareil destiné à être utilisé dans un tracheotomy stoma
DE3503874A1 (de) 1984-02-06 1985-08-08 Aktiebolaget Fixfabriken, Göteborg Luftroehrenventil
GB2164424A (en) 1984-09-11 1986-03-19 Waryam Singh A voice prosthesis device
EP0214243A1 (fr) 1985-03-08 1987-03-18 David A Muir Dispositif de tracheotomie.
GB2214089A (en) 1988-01-22 1989-08-31 Respaid Ab Breathing valve
GB2313317A (en) 1996-05-22 1997-11-26 Smiths Industries Plc Speaking valve assembly and cap therefor
WO2009051884A1 (fr) * 2007-10-15 2009-04-23 Hansa Medical Products, Inc. Valve pour parler
WO2014186584A2 (fr) * 2013-05-15 2014-11-20 Fresca Medical Inc. Valve d'auto-rétroaction pour dispositif contre l'apnée du sommeil

Patent Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1329559A (en) 1916-02-21 1920-02-03 Tesla Nikola Valvular conduit
DE2505123A1 (de) 1974-06-20 1976-01-08 Tracoe Medizine Ges Fuer Endotrachealkanuele aus flexiblem kunststoff mit schwenkbarem sprechventil
US3924637A (en) * 1974-12-23 1975-12-09 Arthur H Swanson Tracheotomy tube
EP0018461A1 (fr) 1979-05-08 1980-11-12 ITALCAPS S.p.A. Procédé pour la préfermeture avec capsule de récipients qui contiennent des produits qui peuvent déborder et dispositif pour sa réalisation
US4325366A (en) 1980-07-07 1982-04-20 Tabor Carl J Valve and method for use with a tracheotomy tube
EP0078685A1 (fr) 1981-10-29 1983-05-11 Hansa Medical Products Inc. Appareil destiné à être utilisé dans un tracheotomy stoma
DE3503874A1 (de) 1984-02-06 1985-08-08 Aktiebolaget Fixfabriken, Göteborg Luftroehrenventil
GB2164424A (en) 1984-09-11 1986-03-19 Waryam Singh A voice prosthesis device
EP0214243A1 (fr) 1985-03-08 1987-03-18 David A Muir Dispositif de tracheotomie.
GB2214089A (en) 1988-01-22 1989-08-31 Respaid Ab Breathing valve
GB2313317A (en) 1996-05-22 1997-11-26 Smiths Industries Plc Speaking valve assembly and cap therefor
WO2009051884A1 (fr) * 2007-10-15 2009-04-23 Hansa Medical Products, Inc. Valve pour parler
WO2014186584A2 (fr) * 2013-05-15 2014-11-20 Fresca Medical Inc. Valve d'auto-rétroaction pour dispositif contre l'apnée du sommeil

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108167564A (zh) * 2018-01-24 2018-06-15 西安建筑科技大学 一种限制流体回流装置
CN112283486A (zh) * 2020-10-09 2021-01-29 武晓丹 一种水锤效应消除装置
CN112283411A (zh) * 2020-10-10 2021-01-29 金恩升 一种带有内壁清洗功能的特斯拉阀
CN112303296A (zh) * 2020-10-10 2021-02-02 丁文铃 一种可清理管内杂质的特斯拉阀管
CN112254244A (zh) * 2020-10-23 2021-01-22 王婷 一种节能建筑用新风导流装置
CN112386792A (zh) * 2020-12-18 2021-02-23 李建朝 一种磁场驱动式血泵
CN112972886A (zh) * 2021-02-02 2021-06-18 北京工业大学 一种单滑块容积血泵
WO2022096036A1 (fr) * 2021-06-01 2022-05-12 青岛海尔空调器有限总公司 Climatiseur et système d'air neuf
CN113331998A (zh) * 2021-06-07 2021-09-03 山东大学齐鲁医院 一种人工心脏瓣膜
CN113331998B (zh) * 2021-06-07 2024-04-26 山东大学齐鲁医院 一种人工心脏瓣膜
CN113952643A (zh) * 2021-11-23 2022-01-21 吉林大学 仿生控温减湿口罩
WO2024159818A1 (fr) * 2023-02-02 2024-08-08 米建军 Tuyau unidirectionnel, moteur à combustion interne, et amortisseur
WO2025220051A1 (fr) * 2024-04-15 2025-10-23 Gallelli Vincenzo Tuyau diodique

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