Cutter for cardiac muscles in cardiac chamber

Abstract

The invention discloses a cutter for cardiac muscles in a cardiac chamber, and belongs to the technical field of minimally invasive cardiac operation instruments. The cutter for the cardiac muscles inthe cardiac chamber comprises an outer-layer protecting sleeve and an inner-layer knife barrel, wherein a cutting window is formed in a side wall of the upper portion of the outer-layer protecting sleeve; a downward hook is arranged at the upper edge of the cutting window; an axial chute is formed in a side wall of the outer-layer protecting sleeve; the inner-layer knife barrel is mounted in theouter-layer protecting sleeve; an annular blade with an upward cutting edge is arranged at the upper end of the inner-layer knife barrel; and a hollow operation handle is arranged on a side wall of the inner-layer knife barrel and extends out from the chute. Operation can be implemented without extracorporeal circulation, the operation time is shortened remarkably, traditional median sternal incision operation wound is relieved, and complications related to extracorporeal circulation are avoided. More importantly, a cutting range and a cutting effect can be monitored and evaluated in real timein the operation under the heart beating state, the operation effect is greatly improved, complications such as perforation of a ventricular septum and insufficient cutting range are avoided, and theoperation effect of the patients is improved remarkably.

Description

technical field [0001] The invention belongs to the technical field of minimally invasive heart surgery instruments, and in particular relates to an intracardiac myocardial cutter. Background technique [0002] Hypertrophic obstructive cardiomyopathy is a disease with abnormal myocardial morphology. The incidence rate in the population is about 0.02% to 0.2%, that is, one person in about 500 people suffers from this disease. The cause of the disease may be related to gene mutation, abnormal myocardial calcium dynamics and catecholamines. related to increased secretion of substances. The pathological manifestations of the disease are asymmetric ventricular septal hypertrophy, the hypertrophic myocardium protrudes toward the left ventricle, which reduces the volume of the left ventricle, the pressure gradient of the left ventricular outflow tract increases significantly, and the mitral valve moves forward during systole (SAM sign) and further aggravates it. Left ventricular o...

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Problems solved by technology

However, this method still has great limitations: ①It may lead to myocardial infarction in non-target areas, causing abnormal myocardial movement and exacerbating the condition; ②High incidence of complications such as atrioventricular block and ventricular arrhythmia due to myocardial scar formation (about 10 %); ③ Due to the variation of the first septal branch, about 5% to 8% of patients are not suitable for alcohol ablation; ④ The short-term and long-term curative effects are inferior to open ventricular septal myectomy; ⑤ Unable to treat the mitral valve papillary muscle Malformation and concurrent valve structural abnormalities

[0004] Nevertheless, traditional ventricular septal myectomy still faces many challenges and problems: ①Because the heart is resected in a stopped state, the thickness and texture of the heart are different from those in a beating state, and the extent of resection is difficult to evaluate before operation , and completely depend on the experience of the surgeon, so only a very small number of experienced heart centers can perform the operation well, and it is difficult to popularize; ②The resection effect cannot be evaluated in real time after resection, and if the resection is too wide, it may lead to ventricular septal perforation and conduction bundle damage, and incomplete resection will lead to poor surgical efficacy; ③ Median thoracotomy, surgical trauma caused by open heart surgery and cardiopulmonary bypass, myocardial injury and systemic inflammatory response

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