intracardiac cutter

Abstract

An intra-cardiac myocardial resection device, comprising an outer protective sleeve (1) and an inner scalpel sleeve (2). The upper sidewall of the outer protective sleeve (1) is provided with a resection window, and a top edge of the resection window is provided with a downward hook (10); the sidewall of the outer protective sleeve (1) is provided with an axial sliding groove (4). The inner scalpel sleeve (2) is mounted in the outer protective sleeve (1), and the upper end of the inner scalpel sleeve (2) is provided with an annular blade (11) having an upward edge. The sidewall of the inner scalpel sleeve (2) is provided with a hollow operation handle (6), and the hollow operation handle (6) extends out of the sliding groove (4). Surgery can be performed by using such an intra-cardiac myocardial resection device, without extracorporeal circulation, so that the surgical time is significantly shortened, the trauma of a traditional median thoracotomy is reduced, and complications related to extracorporeal circulation are avoided. More importantly, during the surgery, a resection extent and a resection effect can be monitored and evaluated in real time in a heart beating state, complications such as ventricular septal rupture and an insufficient resection extent are avoided, and the surgical treatment effect for such patients is improved.

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...

AI Technical Summary

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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