An anastomosis assisting device for proximal aorta in coronary artery bypass grafting

Abstract

An auxiliary device for proximal aortic anastomosis in coronary artery bypass grafting (CABG) includes a puncture needle, a puncture cannula, a cutting cannula, and a ring compressor. The puncture cannula is fitted over the puncture needle, with a bulging ball at its tip and an annular groove at its tail end. The ring compressor is fitted over the puncture cannula and can slide axially; its tip has a notched compression ring with an inner diameter smaller than the outer diameter of the bulging ball. During puncture, after the aorta is penetrated, the ring compressor is pressed down, and the compression ring and bulging ball work together to clamp the puncture site, achieving a bloodless procedure. The cutting cannula is then pressed down, and the aortic wall within the compression ring is removed. The graft vessel is then anastomosed to the aorta, with the suture passing through the compression ring. After suturing, the ring compressor is rotated, and the suture exits through the notch. The entire device is then withdrawn, and the suture is tightened and knotted to complete the anastomosis. This invention avoids aortic clamping, eliminates the risk of plaque dislodgement, requires only a single port for anastomosis, and is simple to operate with reliable hemostasis.

Description

Technical Field

[0001] This invention relates to the field of human daily necessities, and more particularly to medical devices, specifically a proximal anastomosis assist device in coronary artery bypass grafting. Background Technology

[0002] Coronary atherosclerotic heart disease (CAD) is one of the major diseases threatening human health. Coronary artery bypass grafting (CABG) is one of the main surgical treatments for severe CAD. In this procedure, surgeons harvest the patient's own great saphenous vein or internal mammary artery as a graft, anastomosing one end (proximal) to the ascending aorta and the other end (distal) to the distal end of the coronary artery lesion to restore blood supply to the myocardium.

[0003] Traditional proximal anastomosis procedures generally rely on partial occlusion clamps. The surgical steps are as follows: First, a portion of the lateral wall of the ascending aorta is clamped with a partial occlusion clamp to isolate the clamped area from the high-pressure blood flow of the aorta; then, a hole is punctured in the isolated aortic wall with a scalpel, and a circular anastomosis with a diameter of about 4-5 mm is created using a punch; finally, the bypass graft is manually sutured to the anastomosis, and the partial occlusion clamp is released after suturing to restore blood flow.

[0004] However, this traditional approach carries significant clinical risks. In patients with severe atherosclerosis or calcification of the ascending aorta (especially common in the elderly, those with diabetes, or those with high cholesterol), the clamping force of the side-wall clamp can easily cause plaque fragmentation and detachment from the aortic wall. Detached plaques can travel through the bloodstream to the brain, potentially causing disabling or fatal strokes; if the aortic intima is damaged, it can even induce type A aortic dissection, endangering the patient's life. Therefore, avoiding extensive clamping in patients with unhealthy aortic walls has always been a challenge in cardiac surgery.

[0005] To address the aforementioned issues, several proximal anastomosis assistance devices that do not require side wall clamps have emerged in recent years, including:

[0006] 1. Enclose II proximal anastomosis assist device (Novare Surgical Systems, Inc., USA)

[0007] This device operates on the principle of "balloon occlusion" or "umbrella structure." During use, two holes must be pre-punctured in the aortic wall: one serves as the working channel for device insertion, and the other accommodates the device's fixation / occlusion element. While this device avoids the use of side-wall clamps, its two-hole operation increases additional trauma to the aortic wall. Furthermore, the relative positions of the two holes are limited by the device's structure, making it difficult to freely choose the optimal anastomosis location based on the patient's aortic morphology (such as width and curvature) and plaque distribution, resulting in poor adaptability.

[0008] 2. Heartstring proximal anastomosis assist device (Guidant Corporation CardiacSurgery, USA)

[0009] This device involves inserting an umbrella-shaped occluder after puncture to seal the blood flow around the puncture site, allowing for perforation at any location on the aorta. However, this device has the following drawbacks: blood gushes out from the puncture site after puncture, resulting in significant bleeding in the surgical field, requiring continuous use of carbon dioxide gas to blow away blood and maintain a clear view; the insertion and removal of the occluder are relatively complex procedures with a long learning curve; and the device is a single-use medical device, making it expensive and increasing the financial burden on patients.

[0010] In summary, existing proximal anastomosis assist devices for coronary artery bypass grafting (CABG) have the following technical problems: traditional side-wall clamping methods pose a risk of clamping injury to the diseased aorta; the Enclose II device has limited drilling positions; and the Heartstring device results in significant intraoperative bleeding, complex operation, and high cost. Therefore, providing a proximal anastomosis assist device that is easy to operate, minimally invasive, allows for flexible drilling positions, and is cost-effective has become a pressing technical problem for those skilled in the art. Summary of the Invention

[0011] To address the shortcomings of existing technologies, this invention provides an auxiliary device for proximal aortic anastomosis during coronary artery bypass grafting. This device overcomes the deficiencies of existing technologies, completely avoids aortic clamping operations, eliminates the risk of plaque detachment, and allows anastomosis to be completed with only a single port. It is easy to operate, provides reliable hemostasis, and is inexpensive.

[0012] To achieve the above objectives, the present invention provides the following technical solution:

[0013] An auxiliary device for proximal aortic anastomosis during coronary artery bypass grafting includes a puncture needle, a puncture cannula, an annular compressor, and a cutting cannula. The puncture cannula is a hollow tubular structure, fitted over the puncture needle. A bulging ball is fixedly disposed on the outer periphery of the proximal end of the puncture cannula, and an annular groove is formed on the tail end face of the bulging ball. The annular groove is coaxially arranged with the puncture cannula. The maximum outer diameter of the bulging ball is larger than the outer diameter of the puncture cannula, for entering and limiting its position within the aortic lumen.

[0014] The annular compressor includes a compression ring, which is a ring-shaped structure with a notch in the circumferential direction. The compression ring is coaxially sleeved on the outside of the puncture cannula and slides along the axial direction of the puncture cannula. The compression ring is located at the head end of the annular compressor, and the inner diameter of the compression ring is smaller than the outer diameter of the bulging ball, so that when the annular compressor slides to the puncture point, the compression ring can press the aortic wall around the puncture point tightly against the bulging ball. The cutting cannula is a hollow tubular structure, located on the outside of the puncture cannula and slides along the axial direction of the puncture cannula. A moving control component is rotatably connected to the side of the tail end of the cutting cannula. The moving control component is used to control the position of the cutting cannula sliding along the axial direction of the puncture cannula. The head end of the cutting cannula is provided with an annular blade, which matches the inner diameter of the compression ring and is movably engaged with an annular groove.

[0015] Preferably, a Luer male connector is fixedly provided at the tail of the puncture needle, and a Luer female connector is fixedly provided at the tail of the puncture cannula. The Luer male connector and the Luer female connector are detachably connected and used to fix the relative position of the puncture needle and the puncture cannula during puncture.

[0016] Preferably, the tail end of the puncture cannula is provided with a plurality of limiting teeth along the axial direction; the annular compressor includes a rod parallel to the axial direction of the puncture cannula, a compression ring is fixedly connected to the head end of the rod, and a compressor sleeve is fixedly connected to the tail end of the rod. The compressor sleeve is coaxially sleeved outside the puncture cannula. One end of the first support is fixedly installed on the outer wall of the compressor sleeve, and the other end of the first support is connected to the middle of the first limiting spring. One end of the first limiting spring is provided with a first locking tooth, which meshes with the limiting tooth. One end of the first limiting spring is fixedly connected to one end of a compression spring, and the other end of the compression spring is fixedly connected to the outer wall of the compressor sleeve. The compression spring always applies an elastic force to the first limiting spring, causing the first locking tooth to swing in the direction of the limiting tooth.

[0017] Preferably, the moving control component includes a hollow slotted seat, which is integrally fixed to the outer wall of the tail end of the cutting sleeve. A gear is rotatably connected in the middle of the hollow slotted seat, and the gear meshes with a limiting tooth. The central shaft of the gear passes through the outside of the hollow slotted seat and is connected to a gear knob. One end of a second support column is fixedly installed on the outer wall of the hollow slotted seat. The other end of the second support column is connected to the middle of a second limiting spring. One end of the second limiting spring is provided with a second locking tooth, which meshes with the limiting tooth. One end of the second limiting spring is fixedly connected to one end of a spring, and the other end of the spring is fixedly connected to the outer wall of the hollow slotted seat. The spring always applies an elastic force to the second limiting spring, causing the second locking tooth to swing in the direction of the limiting tooth.

[0018] Preferably, the puncture cannula is a slender hollow rod-shaped structure, and the bulging ball is an elliptical enlarged structure.

[0019] Preferably, the puncture needle, puncture cannula, cutting cannula, and annular compressor are coaxially nested from the inside out, and the puncture needle, annular compressor, and cutting cannula can move relative to the puncture cannula along the axis.

[0020] Preferably, the distal end face of the compression ring is flat or slightly curved, so as to fit evenly against the outer wall of the aorta during compression.

[0021] This invention provides an auxiliary device for proximal aortic anastomosis during coronary artery bypass grafting. It has the following beneficial effects:

[0022] The use of a ring-shaped compressor in conjunction with the bulging ball of the puncture cannula replaces traditional side-wall clamps, effectively avoiding clamping of the aortic wall. The puncture needle creates only a tiny puncture hole, and the ring-shaped compressor applies gentle pressure only to the puncture site, without clamping or deforming the overall aortic structure. This significantly reduces the risk of plaque dislodgement and aortic dissection, allowing patients who would otherwise be unable to tolerate traditional surgery due to aortic wall disease to safely undergo coronary artery bypass grafting. Furthermore, hemostasis is achieved through purely mechanical compression, eliminating the need for carbon dioxide purging and completely avoiding the potential risk of gas embolism, further enhancing the safety of the procedure.

[0023] The synergistic action of the elliptical bulge and the flat-end compression ring creates an "inner top, outer pressure" mechanical seal structure, achieving 360-degree uniform pressure on the puncture point. This ensures a clear and bloodless surgical field, creating ideal conditions for precise suturing. The compression ring itself acts as a stable suturing platform, providing uniform support for the needle, making the needle insertion depth controllable and the alignment precise, significantly improving the quality of the anastomosis.

[0024] By employing a coaxial nested structure design, the entire procedure can be completed with just a tiny puncture in the aortic wall, avoiding the additional trauma caused by double-hole punctures or extensive tissue dissection in existing technologies. The notch design on the sidewall of the compression ring, combined with the smooth end face, allows for smooth suture withdrawal after suturing, avoiding the problems of suture snagging and anastomosis pulling when traditional devices are withdrawn. Attached Figure Description

[0025] To more clearly illustrate the technical solutions in this invention or the prior art, the accompanying drawings used in the description of the prior art will be briefly introduced below.

[0026] Figure 1 This is a schematic diagram of the overall structure of the present invention;

[0027] Figure 2 This is a schematic diagram of the cross-sectional structure of the present invention;

[0028] Figure 3 This is a schematic diagram of the puncture needle in this invention;

[0029] Figure 4 This is a schematic diagram of the puncture cannula in this invention;

[0030] Figure 5 This is a schematic diagram of the annular compressor in this invention;

[0031] Figure 6 This is a schematic diagram of the cutting sleeve structure in this invention;

[0032] In the diagram: 1. Puncture needle; 11. Luer male connector; 2. Puncture cannula; 21. Bulgarian ball; 22. Limiting tooth; 23. Luer female connector; 24. Annular groove; 3. Annular compressor; 31. Compression ring; 32. Compressor cannula; 33. First support; 34. First limiting spring; 35. First locking tooth; 36. Compression spring; 4. Cutting cannula; 41. Hollow slot seat; 42. Gear; 43. Gear knob; 44. Second support; 45. Second limiting spring; 46. Second locking tooth; 47. Spring. Detailed Implementation

[0033] To make the objectives, technical solutions, and advantages of the present invention clearer, the technical solutions of the present invention will be clearly and completely described below with reference to the accompanying drawings.

[0034] Example 1, as Figures 1 to 5As shown, an auxiliary device for proximal aortic anastomosis in coronary artery bypass grafting according to the present invention includes a puncture needle 1, a puncture cannula 2, a ring compressor 3, and a cutting cannula 4. The puncture needle 1, puncture cannula 2, cutting cannula 4, and ring compressor 3 are coaxially nested from the inside out. The puncture needle 1, ring compressor 3, and cutting cannula 4 can move relative to the puncture cannula 2 along the axis. The puncture needle 1 is a rigid, thin needle with a sharp bevel at its tip for penetrating the aortic wall. The puncture cannula 2 is a hollow, slender tubular structure with an inner diameter slightly larger than the outer diameter of the puncture needle 1, allowing the tip of the puncture needle 1 to pass axially through the inner lumen of the puncture cannula 2. A bulging ball 21 is fixedly provided on the outer periphery of the tip end of the puncture cannula 2. The maximum outer diameter of the bulging ball 21 is larger than the outer diameter of the main body of the puncture cannula 2, which is used to enter the aortic lumen and limit its position. An annular groove 24 is provided on the end face of the tail end of the bulging ball. The annular groove 24 is coaxially arranged with the puncture cannula 2.

[0035] The annular compressor 3 is fitted over the outside of the puncture cannula 2 and can slide freely along the axial direction of the puncture cannula 2. The head end of the annular compressor 3 is integrally provided with a compression ring 31, which is a ring structure with a notch in the circumferential direction. A notch for suture removal is opened on the side wall of the compression ring 31. The inner diameter of the compression ring 31 is smaller than the outer diameter of the bulging ball 21, so that when the annular compressor 3 slides to the puncture point, the compression ring 31 can press the aortic wall around the puncture point tightly against the bulging ball 21.

[0036] The cutting cannula 4 is a hollow tubular structure. It is fitted over the puncture cannula 2 and slides along the axial direction of the puncture cannula 2. A movement control element is rotatably connected to the tail end of the cutting cannula 4. This element controls the position of the cutting cannula 4 as it slides along the axial direction of the puncture cannula 2. The head end of the cutting cannula 4 has an annular blade that matches the inner diameter of the compression ring 31. The annular blade also engages with the annular groove 24. This allows the annular blade to slide along the axial direction of the puncture cannula 2 and precisely embed into the annular groove 24, achieving annular cutting of the aortic wall.

[0037] Working principle:

[0038] Before use, insert the puncture needle 1 into the puncture cannula 2 and tighten it to form the puncture assembly, such as... Figure 1 As shown, at this time, the annular compressor 3 and the cutting cannula 4 are located at the proximal end of the puncture cannula 2 and are in a ready-to-go state.

[0039] At this point, the operator can hold the puncture assembly and, at the selected anastomosis location (completely avoiding plaque areas on the aortic wall), align the bulge 21 with the predetermined puncture point on the ascending aorta, applying axial thrust to allow the puncture needle 1 to penetrate the aortic wall and vertically insert into the ascending aorta. The puncture depth is determined by ensuring the bulge 21 is completely inside the aortic lumen. Because the maximum outer diameter of the bulge 21 is larger than the puncture hole, a slight pull back of the device will create resistance, indicating that the bulge 21 has adhered to the inner wall of the aorta, achieving initial positioning and preventing accidental dislodgement of the device.

[0040] After confirming the puncture is in place, the operator can use their thumb to push the ring compressor 3 distally (towards the aorta). The ring compressor 3 slides distally along the puncture cannula 2, with its compression ring 31 gradually approaching the outer wall of the aorta. When the compression ring 31 contacts the outer wall of the aorta and continues to press down, because the inner diameter of the compression ring 31 is smaller than the outer diameter of the bulge 21, the aortic wall can be tightly clamped between the bulge 21 (located inside the lumen) and the compression ring 31 (located outside the lumen), forming a ring-shaped mechanical compression, thereby effectively sealing the puncture site and achieving complete hemostasis. At this time, there is no blood leakage in the surgical field, providing a stable platform for delicate incision and suturing operations. Furthermore, the smooth surface of the bulge 21 and the uniform force-bearing surface of the compression ring 31 avoid shearing or tearing damage to the aortic wall, making it particularly suitable for fragile or calcified aortic tissue. At this point, the position of the ring compressor 3 can be locked to prevent axial displacement during subsequent suturing.

[0041] Under the stable pressure of the compression ring 31, the aortic wall tissue within the ring opening is pushed up from the inside by the bulging ball 21, forming a clearly defined "island". At this time, the cutting cannula 4 can be moved towards its tip by the movable control component, so that the annular blade at the tip of the cutting cannula 4 can accurately cut into the base of the "island". Through the cooperation of the annular blade and the annular groove 24, a full-thickness annular cut of the aortic wall is completed. The cut tissue ring is intact, with neat edges, no burrs or tears, providing an ideal wound geometry for subsequent anastomosis. Furthermore, during the cutting process, because the annular blade matches the inner diameter of the compression ring 31, the cutting range is limited to the inner circle of the compression ring 31, thereby ensuring the accuracy of the anastomosis size and effectively avoiding the risk of accidentally cutting adjacent healthy tissue or vascular structures. Finally, a circular anastomosis matching the diameter of the bypass vessel is formed. During this process, because the bulging ball 21 provides support from the inside, the posterior wall of the aorta is not easily damaged during the resection.

[0042] Next, the cutting cannula 4 is retracted to its tail position using the movement control device. At this point, the bulging ball 21 still maintains intraluminal support, preventing aortic wall collapse. This exposes a regular circular anastomosis formed by the bulging ball 21. The prepared bypass vessel (such as the great saphenous vein) is then anastomosed end-to-side to this anastomosis. During suturing, the surgeon's suture needle must pass through the bypass vessel wall, the aortic wall, and also pass below the compression ring 31, meaning the suture sutures the compression ring 31 together with the aortic wall within the anastomosis. During suturing, as the suture needle passes through the aortic wall, the compression ring 31 provides a reaction force from the outside, making needle insertion more stable and the depth more controllable. Furthermore, because the suture sutures the compression ring 31 together with the aortic wall within the anastomosis, the compression ring 31 remains relatively fixed to the sutured tissue throughout the suturing process, avoiding suturing deviations caused by tissue movement. This makes the suturing operation more stable and precise, especially beneficial for high-quality suturing on calcified or fragile aortic walls.

[0043] Once all the sutures for the bypass graft anastomosis are completed (without tightening or knotting), the device needs to be removed. First, the surgeon can release the locking of the ring compressor 3. Then, while maintaining pressure, the ring compressor 3 is slightly slid proximally (away from the aorta) to slightly separate the compression ring 31 from the aortic wall, eliminating friction between them. Next, the ring compressor 3 is rotated. As the compression ring 31 rotates, all the sutures that were originally encircling it will slide out one by one from the notches on the side wall of the compression ring 31, freeing themselves from its restraint. This effectively avoids suture entanglement with the device, ensuring the device can be withdrawn without resistance and protecting the newly completed suture.

[0044] After all sutures have been withdrawn from the notch of the compression ring 31, there is no longer any physical connection between the entire device (puncture needle 1, puncture cannula 2, and ring compressor 3) and the sutures. The surgeon can then pull out the entire device, leaving only the sutures surrounding the anastomosis at the puncture site on the aortic wall. Finally, the surgeon tightens the sutures and ties a knot, causing the puncture site formed by the bulge 21 to close naturally under the tightening of the sutures, thus completing the anastomosis between the bypass graft and the aorta.

[0045] In Example 2, as a further preferred embodiment of Example 1, a Luer male connector 11 is fixedly provided at the tail of the puncture needle 1. This Luer male connector 11 is a standard conical male connector with internal threads or a bayonet structure. A Luer female connector 23 is fixedly provided at the tail of the puncture cannula 2. This Luer female connector 23 is a standard conical female connector with external threads or a groove. The Luer male connector 11 and the Luer female connector 23 are detachably connected by rotational locking to form a puncture assembly, used to fix the relative position of the puncture needle and the puncture cannula during puncture.

[0046] Therefore, before starting the puncture procedure, the operator can insert the puncture needle 1 into the puncture cannula 2 and then lock it by rotating the Luer male connector 11 and the Luer female connector 23. At this time, the puncture needle 1 and the puncture cannula 2 become a mechanically rigid whole. This ensures that the puncture needle 1 and the puncture cannula 2 are axially fixed and do not slide relative to each other during the puncture, thus ensuring the straightness of the puncture path and the accuracy of repeatability. After the Luer connector is locked, the axial resistance experienced by the puncture needle 1 is directly transmitted to the Luer female connector 23 through the Luer male connector 11, and then to the puncture cannula 2. At this time, the puncture needle 1 and the puncture cannula 2 share the tissue resistance and maintain a fixed relative position, ensuring that the bulging ball 21 can accurately and controllably enter the aortic lumen to the predetermined depth. After the bulging ball 21 has entered the aortic lumen and the device has been positioned, the operator can rotate it in the opposite direction to unlock the Luer male connector 11 and the Luer female connector 23. At this point, the puncture needle 1 and the puncture cannula 2 return to a relatively free state, allowing the puncture needle 1 to withdraw independently after completing the puncture positioning, or allowing the puncture needle 1 to slide along the axial direction of the puncture cannula 2, thereby achieving axial decoupling between the puncture needle 1 and the puncture cannula 2.

[0047] In Example 3, as a further preferred embodiment of Example 1, the outer wall of the puncture cannula 2 is provided with multiple limiting teeth 22 along the axial direction at its tail end. Each limiting tooth 22 has a unidirectional inclined surface (a gentle slope near the tail end and a steep slope or vertical surface near the head end), forming a unidirectional locking groove. The annular compressor 3 includes a slender rod-shaped structure, with a compression ring 31 fixedly disposed at the head end of the rod-shaped structure. A compressor sleeve 32 is fixedly connected to the tail end of the rod-shaped structure. In this embodiment, the annular compressor 3 and the compressor sleeve 32 can be integrally structured or fixed by laser welding. The compressor sleeve 32 is a hollow tubular structure and is coaxially sleeved outside the puncture cannula 2. The compressor sleeve 32 is located outside the body, allowing the surgeon to apply force with their thumb. When the surgeon pushes the compressor sleeve 32, the thrust is directly transmitted through the body of the annular compressor 3 to the compression ring 31 at the head end, realizing the axial movement and downward pressure of the compression ring 31. The outer wall of the compressor sleeve 32 is provided with an anti-rebound locking mechanism, which includes a first limiting spring 34, a first support 33, and a compression spring 36. The first support 33 is fixedly connected to the outer wall of the compressor sleeve 32, serving as the swing fulcrum of the first limiting spring 34. The first limiting spring 34 has a lever-type structure, with its middle part rotatably connected to the first support 33 via a pin, forming a swing mechanism similar to a seesaw. The first limiting spring 34 is a rigid or semi-rigid sheet-like component. One end of the first limiting spring 34 (facing the tail end) is provided with a first locking tooth 35, and the other end of the first limiting spring 34 (facing the head end) is a pressing part. One end of the compression spring 36 is fixedly connected to the pressing part of the first limiting spring 34, and the other end is fixedly connected to the outer wall of the compressor sleeve 32. The compression spring 36 is always in a compressed state, continuously applying an outward pushing force to the pressing part of the first limiting spring 34, thereby causing the first locking tooth 35 to maintain an elastic force that swings inward (i.e. towards the limiting tooth 22).

[0048] Before the annular compressor 3 is pressed down, the first locking tooth 35 of the first limiting spring 34 is pressed tightly against the outer wall of the puncture cannula 2 under the elastic force of the compression spring 36. When the operator pushes the compressor cannula 32 of the annular compressor 3 distally (towards the aorta), the compressor cannula 32 moves the entire anti-rebound locking mechanism distally. The thrust is transmitted through the main body of the annular compressor 3 to the compression ring 31 at the tip, causing the compression ring 31 to slide distally along the puncture cannula 2. At this time, when the first locking tooth 35 encounters the gentle slope of the limiting tooth 22, the slope of the limiting tooth 22 pushes the first locking tooth 35 outward. This action overcomes the elastic force of the compression spring 36, causing the end of the first locking tooth 35 of the first limiting spring 34 to swing outward around the first support 33 (the first locking tooth 35 is raised, and the tail end is pressed down). Once the first locking tooth 35 passes the tip of the limiting tooth 22, the elastic force of the compression spring 36 immediately takes effect, pushing the tail end of the first limiting spring 34 outward, causing the first locking tooth 35 to quickly swing back and engage in the groove of the next limiting tooth 22. This process is repeated to achieve unidirectional step-like displacement of the annular compressor 3 along the axial direction of the puncture sleeve 2, with each step displacement precisely limited by the tooth pitch of the adjacent limiting teeth 22. When the external force is removed or an attempt is made to pull back in the opposite direction, the end face of the first locking tooth 35 will abut against the steep vertical surface of the limiting tooth 22, preventing it from sliding back in the opposite direction, thus effectively locking the current compression depth.

[0049] Therefore, when the annular compressor 3 is pressed down to the predetermined position (compression ring 31 is tightly against the aortic wall), the surgeon can release their hand directly. At this time, the compression spring 36 continues to apply elastic force, causing the first locking tooth 35 to firmly engage in the groove of the corresponding limiting tooth 22. Because the steep slope of the limiting tooth 22 and the end face of the first locking tooth 35 form a mechanical interference, any force attempting to retract the annular compressor 3 proximally will be effectively blocked by this engaging structure. Thus, the annular compressor 3 is automatically locked in the current position, maintaining stable compression on the aortic wall without the surgeon needing to continuously hold or apply force.

[0050] When the surgery is complete and the device needs to be withdrawn, the surgeon can press the tail end (pressing part) of the first limiting spring 34 with their finger. This causes the first limiting spring 34 to overcome the elastic force of the compression spring 36, causing the first locking tooth 35 to lift outward, thereby disengaging the first locking tooth 35 from the limiting tooth 22. At this time, the one-way locking is released, and the surgeon can smoothly withdraw the annular compressor 3 along the puncture cannula 2 proximally until it is completely detached from the aortic wall, facilitating subsequent suture removal and device withdrawal. During withdrawal, the first locking tooth 35 remains in an elevated position under continuous pressure from the pressing part, avoiding interference with the limiting tooth 22 and ensuring smooth and unobstructed retraction.

[0051] In embodiment four, as a further preferred embodiment three, the moving control component includes a hollow slotted seat 41, which is integrally fixed on the outer wall of the tail end of the cutting sleeve 4. A gear 42 is rotatably connected in the middle of the hollow slotted seat 41, and the gear 42 meshes with the limiting tooth 22. The central shaft of the gear 42 passes through the outside of the hollow slotted seat 41 and is connected to a gear knob 43. One end of a second support column 44 is fixedly installed on the outer wall of the hollow slotted seat 41. The other end of the second support column 44 is connected to the middle of the second limiting spring 45. One end of the second limiting spring 45 is provided with a second locking tooth 46, which meshes with the limiting tooth 22. One end of the second limiting spring 45 is fixedly connected to one end of a spring 47, and the other end of the spring 47 is fixedly connected to the outer wall of the hollow slotted seat 41. The spring 47 always applies an elastic force to the second limiting spring 45, causing the second locking tooth 46 to swing towards the limiting tooth 22.

[0052] Therefore, when the cutting sleeve 4 moves axially towards the tip, rotating the gear knob 43 drives the gear 42 to rotate forward. This, through the meshing of the gear 42 and the limiting tooth 22, drives the cutting sleeve 4 to move synchronously along the axial direction of the puncture sleeve 2. At this time, the second locking tooth 46 slides tightly against the inclined surface of the limiting tooth 22 under the action of the spring 47. When the cutting sleeve 4 is pressed down to the predetermined depth, the second locking tooth 46 automatically engages in the groove of the adjacent limiting tooth 22 under the action of the spring 47, achieving precise positioning and self-locking of the cutting sleeve 4. When it is necessary to retract the cutting sleeve 4, the operator can press the tail end (pressing part) of the second limiting spring 45 with their finger. This causes the second limiting spring 45 to overcome the elastic force of the spring 47, causing the second locking tooth 46 to lift outward, thereby releasing the engagement between the second locking tooth 46 and the limiting tooth 22. At this time, the one-way locking is released, and the operator can smoothly withdraw the cutting cannula 4 along the puncture cannula 2 proximally until it is completely detached from the aortic wall, so that the subsequent sutures can be removed and the device can be withdrawn.

[0053] In Example 5, as a further preferred embodiment of Example 1, the puncture cannula 2 is a slender, hollow rod-shaped structure, and the bulging ball 21 is an elliptical, enlarged structure, with the long axis of the bulging ball 21 aligned with the axial direction of the puncture cannula 2. This combination of the slender rod-shaped body and the elliptical bulging ball ensures that the resistance change is gradual as the puncture cannula 2 penetrates the aortic wall, allowing the operator to obtain a uniform and controllable puncture feel, avoiding the risks of "forward rushing" or "excessive penetration" caused by sudden changes in resistance. Furthermore, the slender rod-shaped structure exposes most of the length of the puncture cannula 2 outside the aorta, allowing the operator to clearly observe changes in puncture depth. This enables precise control of the puncture depth, ensuring that the bulging ball 21 enters the lumen just right without going too deep, thus avoiding damage to the posterior wall of the aorta. As the elliptical bulging ball 21 passes through the puncture hole, it gradually enters along its long axis, dispersing the expansion process of the puncture hole over time, avoiding the risk of tissue tearing caused by the instantaneous expansion of the spherical structure. Furthermore, when the bulge 21 contacts the intima during blood flow impact or device micro-movement, its elliptical surface evenly distributes the contact force, preventing intimal damage or plaque detachment caused by excessive local pressure. The elliptical bulge 21 also provides a stable support platform within the aortic lumen, forming an "inner-top, outer-pressure" clamping structure with the external compression ring 31. Compared to a sphere, the elliptical shape offers a larger contact area and tighter fit with the aortic wall, resulting in a more reliable hemostatic seal. Additionally, aortic wall thickness varies among patients (normal thickness is approximately 2-3 mm; it may be thicker in hypertensive patients and thinner in elderly patients). The long axis of the elliptical bulge provides a greater tolerance range for adjustment of the compression ring 31; even with slight deviations in the compression ring 31's downward position, the elliptical contour of the bulge ensures effective engagement with the compression ring.

[0054] In Example Six, as a further preferred embodiment of Example One, the distal end face of the compression ring 31 (i.e., the side of the compression ring 31 facing the aortic wall) is flat or slightly curved, designed to uniformly conform to the outer wall of the aorta during compression. By forming surface contact with the outer wall of the aorta through the flat or slightly curved end face, the compressive force is evenly distributed across the annular contact band, avoiding localized stress concentration or insufficient compression, and ensuring a 360-degree seal around the puncture point. Furthermore, compared to sharp edges or small-curvature spherical surfaces, the flat or slightly curved end face can form a wider sealing contact band, thereby significantly enhancing the hemostatic effect. Additionally, if the distal end face of the compression ring 31 has a sharp edge (such as a right-angled sharp edge), the sharp edge may cut into the aortic adventitia when pressure is applied, causing tissue cutting damage. The flat or slightly curved end face used in this embodiment has no sharp edges, forming smooth contact with the tissue during compression, avoiding the cutting effect and protecting the integrity of the aortic adventitia. Furthermore, the flat or slightly curved end face forms a large area of ​​tight contact with the outer wall of the aorta, and the static friction between them is significantly greater than that of point contact or line contact. Even under the impact of blood flow pulses, the compression ring is not easily displaced, ensuring the continuity of hemostasis.

[0055] The above embodiments are only used to illustrate the technical solutions of the present invention, and are not intended to limit it. Although the present invention has been described in detail with reference to the foregoing embodiments, those skilled in the art should understand that modifications can still be made to the technical solutions described in the foregoing embodiments, or equivalent substitutions can be made to some of the technical features. Such modifications or substitutions do not cause the essence of the corresponding technical solutions to deviate from the spirit and scope of the technical solutions of the embodiments of the present invention.

Claims

1. A device for assisting proximal aortic anastomosis during coronary artery bypass grafting, characterized in that: It includes a puncture needle (1), a puncture cannula (2), an annular compressor (3), and a cutting cannula (4); the puncture cannula (2) is a hollow tubular structure, and the puncture cannula (2) is sleeved on the outside of the puncture needle (1). A bulging ball (21) is fixedly provided on the outer periphery of the head end of the puncture cannula (2), and an annular groove (24) is opened on the tail end face of the bulging ball. The annular groove (24) is coaxially arranged with the puncture cannula (2); the maximum outer diameter of the bulging ball (21) is larger than the outer diameter of the puncture cannula (2), and it is used to enter the aortic lumen and limit its position. The annular compressor (3) includes a compression ring (31), which is a ring structure with a notch in the circumferential direction. The compression ring (31) is coaxially sleeved on the outside of the puncture cannula (2) and slides along the axial direction of the puncture cannula (2). The compression ring (31) is located at the head end of the annular compressor (3). The inner diameter of the compression ring (31) is smaller than the outer diameter of the bulging bulb (21), so that when the annular compressor (3) slides to the puncture point, the compression ring (31) can press the aortic wall around the puncture point tightly against the bulging bulb. (21) Above; the cutting sleeve (4) is a hollow tubular structure. The cutting sleeve (4) is located outside the puncture sleeve (2) and is slidably arranged along the axial direction of the puncture sleeve (2). A moving control component is rotatably connected to the side of the tail end of the cutting sleeve (4). The moving control component is used to control the position of the cutting sleeve (4) sliding along the axial direction of the puncture sleeve (2). The head end of the cutting sleeve (4) is provided with an annular blade. The annular blade matches the inner diameter of the compression ring (31). The annular blade is movably engaged with the annular groove (24).

2. The proximal aortic anastomosis assistance device for coronary artery bypass grafting according to claim 1, characterized in that: The puncture needle (1) is fixedly provided with a Luer male connector (11) at the tail end, and the puncture cannula (2) is fixedly provided with a Luer female connector (23) at the tail end. The Luer male connector (11) and the Luer female connector (23) are detachably connected and used to fix the relative position of the puncture needle and the puncture cannula during puncture.

3. The proximal aortic anastomosis assistance device for coronary artery bypass grafting according to claim 1, characterized in that: The puncture cannula (2) has multiple limiting teeth (22) axially arranged at its tail end; the annular compressor (3) includes a rod parallel to the axial direction of the puncture cannula (2), a compression ring (31) is fixedly connected to the head end of the rod, and a compressor sleeve (32) is fixedly connected to the tail end of the rod. The compressor sleeve (32) is coaxially sleeved outside the puncture cannula (2), and one end of a first support column (33) is fixedly installed on the outer wall of the compressor sleeve (32). The other end of the first support column (33) is connected to the first The middle part of the limiting spring (34) is connected. One end of the first limiting spring (34) is provided with a first locking tooth (35). The first locking tooth (35) meshes with the limiting tooth (22). The other end of the first limiting spring (34) is fixedly connected to one end of a compression spring (36). The other end of the compression spring (36) is fixedly connected to the outer wall of the compressor sleeve (32). The compression spring (36) always applies an elastic force to the first limiting spring (34) to make the first locking tooth (35) swing towards the limiting tooth (22).

4. The proximal aortic anastomosis assistance device for coronary artery bypass grafting according to claim 3, characterized in that: The moving control component includes a hollow slotted seat (41), which is integrally fixed on the outer wall of the tail end of the cutting sleeve (4). A gear (42) is rotatably connected in the middle of the hollow slotted seat (41). The gear (42) meshes with a limiting tooth (22). The central shaft of the gear (42) extends out of the outside of the hollow slotted seat (41) and is connected to a gear knob (43). One end of a second support column (44) is fixedly installed on the outer wall of the hollow slotted seat (41), and the other end of the second support column (37) is fixedly installed on the outer wall of the hollow slotted seat (41). The second limiting spring (45) is connected to the middle part of the second limiting spring (45). One end of the second limiting spring (45) is provided with a second locking tooth (46). The second locking tooth (46) meshes with the limiting tooth (22). The other end of the second limiting spring (45) is fixedly connected to one end of a spring (47). The other end of the spring (47) is fixedly connected to the outer wall of the hollow slot seat (41). The spring (47) always applies an elastic force to the second limiting spring (45) to make the second locking tooth (46) swing towards the limiting tooth (22).

5. The proximal aortic anastomosis assistance device for coronary artery bypass grafting according to claim 1, characterized in that: The puncture cannula (2) is a slender hollow rod-shaped structure, and the bulging ball (21) is an elliptical bulging structure.

6. The proximal aortic anastomosis assistance device for coronary artery bypass grafting according to claim 1, characterized in that: The puncture needle (1), puncture cannula (2), cutting cannula (4) and annular compressor (3) are coaxially nested from the inside to the outside. The puncture needle (1), annular compressor (3) and cutting cannula (4) can move relative to the puncture cannula (2) along the axis.

7. The proximal aortic anastomosis assistance device for coronary artery bypass grafting according to claim 1, characterized in that: The distal end face of the compression ring (31) is flat or slightly curved, which is used to fit evenly against the outer wall of the aorta during compression.

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