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CN-110368071-B - Dilator for three-dimensional atrial septum puncture

CN110368071BCN 110368071 BCN110368071 BCN 110368071BCN-110368071-B

Abstract

The invention discloses a three-dimensional atrial septum puncture dilator which comprises a tube body, wherein the tube body comprises a central cavity, a distal end and a proximal end, the distal end of the tube body is of a bending structure, and a cutting opening is formed in the distal end of the bending structure. The dilator provided by the invention can accurately display the position of the needle point in real time in a three-dimensional system, and eliminates the risk of damage of the needle point to the superior vena cava and endocardial tissues in other three-dimensional puncture methods.

Inventors

  • YU RONGHUI

Assignees

  • 武汉律动医疗科技有限公司

Dates

Publication Date
20260505
Application Date
20180412

Claims (6)

  1. 1. The expander for three-dimensional atrial septum puncture is characterized by comprising a tube body, wherein the tube body comprises a central cavity, a distal end and a proximal end; The far end of the tube body is of a bending structure; the distal end of the bending structure is provided with a cutting opening; the cutting port is an inclined cutting port; The inclined cutting opening is an arc-shaped curve along the axial vertical tangential plane of the tube body and is not in direct contact with tissues; The distance between the proximal edge of the cutting opening and the distal end face of the bending structure is 1-3mm; The far end of the central cavity of the pipe body is a stepped end face, the stepped end face is an isosceles trapezoid, the side close to the cutting opening is shorter, the side close to the joint is longer, and the joint of the two sides has no step transition; the distance between the step end face and the far end face of the bending structure is 8-9mm; when the needle tip of the atrial septum puncture needle moves to the cutting port, the needle tip is electrically connected with blood.
  2. 2. The dilator for three-dimensional atrial septum penetration according to claim 1, wherein the cutting port is a horizontal cutting port, and is disposed along an axial direction of the dilator.
  3. 3. The three-dimensional atrial septum penetrating dilator of claim 2 wherein the distal end of the cutting port is cut into the distal end face of the curved structure.
  4. 4. A three-dimensional atrial septum penetration dilator according to claim 2 or 3 wherein the cross section of the cutting port is rectangular, elliptical, square or irregularly shaped.
  5. 5. The dilator for three-dimensional atrial septum penetration of claim 4 wherein the cross-section of the cutting port is tapered from the proximal end to the distal end of the cutting port and is tapered toward the distal end face of the tube.
  6. 6. The dilator for three dimensional atrial septum penetration of claim 5 wherein the cutting port is disposed in a direction perpendicular to a curved plane of the curved structure.

Description

Dilator for three-dimensional atrial septum puncture Technical Field The invention relates to a dilator for three-dimensional atrial septum puncture. Background Radical treatment of atrial fibrillation radio frequency ablation under the guidance of a three-dimensional system is preferred. One of the important steps in accomplishing this operation is atrial septum puncture. At present, the mainstream room septum puncture operation at home and abroad is still room septum puncture operation under the guidance of X-ray perspective, which is a technology developed in the past for more than half century under the two-dimensional plane view angle, X-rays cannot directly judge the position of the fossa ovalis, and the accurate prompt on the three-dimensional structure is lacking, so that the technology needs long-time clinical accumulation, if the heart of a patient is mutated, the puncture difficulty is extremely high, and the puncture success rate and the safety are more influenced when the definition of an excessively obese patient and an X-ray machine is not high. The atrial septal puncture under the guidance of intracardiac ultrasound is to add an intracardiac ultrasound (ICE) catheter on the basis of X-ray fluoroscopy, and although the positioning accuracy is improved, the two-dimensional plane technology is mainly used as a whole, so that the real three-dimensional space of the heart is difficult to well embody, and in addition, the judgment of the oval fossa lacks electrical analysis, so that the more accurate positioning is difficult to achieve. The equipment and technical threshold are in fact greatly improved by the need for corresponding cardiac ultrasound knowledge and expensive ultrasound catheters. In recent years, as the application of three-dimensional systems is becoming more and more widespread, a novel three-dimensional atrial septum penetration method is derived, which is completely operated under a three-dimensional interface, and no X-rays or contrast agents are needed. Not only can the accuracy and success rate of the atrial septum puncture be improved, but also the safety is completely ensured. One of the key steps in this penetration method is the visualization of the guidewire and the septal needle. Any good conductor, such as a guidewire or a puncture needle, can be defined as a two-dimensional mapping catheter in a three-dimensional system and connected to the three-dimensional mapping system by a two-dimensional corresponding connection tail. During puncture, the guidewire and long sheath are first delivered into the superior vena cava. The long sheath is delivered into the superior vena cava using a catheter with a magnetic positioning device and then exchanged for an inner sheath expanding sheath plus guidewire. Wherein the guide wire is always kept outside the inner sheath expansion sheath, and when the distal end of the guide wire extends out of the inner sheath expansion sheath for 1-2 mm, the head end of the guide wire can be displayed in the three-dimensional system. And then exchanging the guide wire with the atrial septum puncture needle, judging the relative position of the puncture needle and the long sheath through the length of the puncture needle handle left outside the long dilating sheath, and confirming the position of the atrial septum puncture needle. Finally reconstructing the three-dimensional structure of the right atrium and visualizing the atrial septum puncture needle by using a three-dimensional mapping system. When the needle tip is out of the sheath for 1-2 mm, the display of the needle can be seen on the three-dimensional mapping system, and the positions of the needle in the heart and the blood vessel can be judged. The direction of the puncture needle handle indicator and the long sheath are directed to the direction of 4-5 points, and simultaneously the puncture needle is pulled down, so that the movement of the puncture needle is visible in a three-dimensional system. When the puncture needle slides to the marked puncture point, namely the position of the interatrial foramen ovale, the puncture needle generally has a falling sense, can be used for test, and generally has a breakthrough sense when passing through the interatrial septum. At this time, the puncture needle can be clearly seen to enter the left atrium by about 1cm in the three-dimensional system. If the images are fused, the three-dimensional space relation between the puncture needle and the structures such as the left atrium, the right atrium and the aorta can be clearly seen. The problem of the puncture method is that the needle tip is required to be always exposed out of the inner sheath for 1-2 mm, so that the position of the puncture needle can be displayed in real time in a three-dimensional system, when the operation room septum puncture needle slides from the upper cavity meridian to the puncture point of the oval hole, the needle tip can damage the upper cavity vein and endocardial