Tendon chord cutting catheter
The minimally invasive cutting technique using chordae tendineae cutting catheters has solved the problems of large trauma, complex operation, and high mortality in large animal models, achieving minimally invasive and simple chordae tendineae cutting, which is suitable for constructing valvular regurgitation models.
Patent Information
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- FUWAI HOSPITAL CHINESE ACAD OF MEDICAL SCI & PEKING UNION MEDICAL COLLEGE
- Filing Date
- 2026-06-22
- Publication Date
- 2026-07-24
AI Technical Summary
Existing technologies for constructing animal models of valvular regurgitation and heart failure suffer from problems such as large trauma, complex operation, and high intraoperative mortality, especially the difficulty in achieving minimally invasive cutting techniques for large animal models.
The chordae tendineae cutting catheter, which includes a cutting section, a connecting section, and an operating section, is used to enter the ventricle through peripheral blood vessels. The cutting groove and cutting components are used to achieve minimally invasive cutting of the chordae tendineae, reducing trauma and intraoperative mortality.
It achieves minimally invasive and simple chordae tendineae cutting, reduces intraoperative mortality, minimizes the impact on research operations, and is suitable for valve regurgitation construction in large animal models.
Smart Images
Figure CN122440355A_ABST
Abstract
Description
Technical Field
[0001] This invention relates to the field of medical device technology, and in particular to a chordae tendineae cutting catheter. Background Technology
[0002] Valvular regurgitation is a significant cause of heart failure, with mitral and tricuspid regurgitation directly leading to ventricular volume overload, subsequently causing myocardial remodeling and deterioration of cardiac function. Research on the pathogenesis, interventional devices, and treatment strategies of valvular regurgitation and heart failure urgently requires stable, standardized, and minimally invasive animal models as validation vehicles. Large animal models (such as pigs and dogs), in particular, are crucial experimental subjects for the development and clinical transformation of cardiovascular interventional devices due to their anatomical structure and physiological function being similar to humans.
[0003] Currently, animal models used for valvular regurgitation and heart failure research mainly include pressure overload, ischemia / infarction, volume overload, drug-induced, rapid pacing, and gene-edited heart failure models. Drug-induced and gene-edited heart failure models are only suitable for small animals such as mice and rats, and cannot meet the needs of large animal experiments. Pressure overload, ischemia / infarction, and traditional volume overload heart failure models require open-chest surgery, which is highly invasive, causes severe postoperative inflammation, and results in low animal survival rates. Furthermore, pleural adhesions and tissue damage can severely interfere with subsequent secondary surgeries, interventional procedures, and pathophysiological index detection, limiting the application of these models in iterative testing of interventional devices. Rapid pacing heart failure models have long preparation cycles, high dependence on pacing devices, poor stability of regurgitation degree and heart failure phenotype, and difficulty in controlling model consistency, making it impossible to accurately simulate the disease progression from mild to moderate valvular regurgitation to severe heart failure.
[0004] In constructing models of valvular regurgitation, current techniques mostly rely on open-chest surgery to cut the chordae tendineae and suture the valve leaflets. While this can induce regurgitation, it involves significant surgical trauma, complex procedures, and a high intraoperative mortality rate, and it cannot achieve minimally invasive surgery. Therefore, there is an urgent need to design a minimally invasive, simple technique that can reduce intraoperative mortality. Summary of the Invention
[0005] The purpose of this invention is to provide a chordae tendineae cutting catheter to solve the problems existing in the prior art, which is less invasive, simple to operate, and can reduce intraoperative mortality.
[0006] To achieve the above objectives, the present invention provides the following solution: This invention provides a chordae tendineae cutting conduit, comprising a cutting section, a connecting section, and an operating section. The end of the cutting section has a smooth, outwardly convex, blunt-rounded structure, and a cutting groove is provided on the side wall near the end of the cutting section to hook the chordae tendineae. A cutting component is provided at the opening of the cutting groove. One end of the connecting section is connected to the beginning end of the cutting section, enabling the cutting section to be driven into the area to be cut through the delivery conduit and move axially along the connecting section to complete the cutting of the chordae tendineae. The operating section is located outside the object being operated on and is connected to the end of the connecting section away from the cutting section, for operating the connecting section and / or the cutting section.
[0007] In one embodiment, the cutting part is hollow inside, the cutting assembly is movably disposed inside the cutting part, and the cutting edge of the cutting assembly is located at the opening area of the cutting groove.
[0008] In one embodiment, the cutting groove has a hook-shaped structure along the axial section of the cutting part, and the sidewall of the cutting groove near the end of the cutting part has a smooth arc-shaped structure, while the sidewall of the cutting groove near the beginning of the cutting part has an inclined linear structure.
[0009] In one embodiment, the cutting assembly includes a cutting blade, one end of which has a smooth hook-shaped structure, and the cutting edge of the cutting blade is located inside the hook-shaped structure; one end of an elastic element is fixedly connected to the cutting blade, and the other end is fixedly connected to the inner wall of the cutting part; one end of a traction guide wire is fixedly connected to the cutting blade, and the other end passes through the interior of the cutting part and the interior of the connecting part in sequence, and is connected to the operating part.
[0010] In one embodiment, the connecting part is a tubular structure, and a flexible bending structure is provided at one end of the connecting part near the cutting part. The flexible bending structure can bend in the opposite direction to the unbent state when passing through the delivery conduit, so that the connecting part can pass along the delivery conduit. After passing through the delivery conduit, the flexible bending structure can return to the initial bending state.
[0011] In one embodiment, the initial bending angle of the flexible bending structure is 90°.
[0012] In one embodiment, the operating part includes a handle and a pull ring, the handle being fixedly connected to the end of the connecting part away from the cutting part, and the pull ring being fixedly connected to the end of the guide wire away from the cutting blade.
[0013] In one embodiment, one end of the cutting blade is a smooth hook-shaped structure, and the other end is provided with a columnar connecting seat. The connecting seat is movably inserted into the cutting part, abuts against one end of the elastic member, and is fixedly connected to one end of the traction guide wire.
[0014] In one embodiment, the cutting part is made of an alloy material, the connecting part is made of a polyurethane-based material, and the operating part is made of a polypropylene-based material.
[0015] The present invention also provides a method for chordae tendineae cutting, comprising the following steps: A pathway is established via peripheral vascular puncture, and the delivery catheter is advanced through the pathway to the left or right ventricle, ensuring that the tip of the delivery catheter is positioned subvalvular. The cutting part and the connecting part are delivered to the left or right ventricle via the delivery catheter. The end of the connecting part near the cutting part extends out of the delivery catheter and automatically returns to a 90° bent state. Rotating the handle of the operating unit causes the cutting component to hook onto the chordae tendineae. Pulling the pull ring of the operating unit controls the cutting component to cut the chordae tendineae. Then, ultrasound is used to determine the valve regurgitation status, and the cutting action is repeated to achieve the desired effect. After the procedure, the cutting and connecting parts were removed, and then the delivery catheter was removed to apply pressure for hemostasis.
[0016] The present invention achieves the following technical effects compared to the prior art: Both the cutting part and the connecting part of this invention can pass through the delivery catheter. The delivery catheter enters the corresponding ventricle through peripheral blood vessels. The cutting part connected to the connecting part can be delivered to the area to be cut under the valve through the delivery catheter. After the cutting part hooks the chordae tendineae, the operating part drives the cutting part to move axially to realize the cutting process of the chordae tendineae. The operating path is established through peripheral blood vessels, which reduces trauma and avoids affecting the research operation after modeling. The chordae tendineae cutting process does not require opening the chest cavity, resulting in less trauma, simple operation, and reduced intraoperative mortality. Attached Figure Description
[0017] To more clearly illustrate the technical solutions in the embodiments of the present invention or the prior art, the drawings used in the embodiments will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort.
[0018] Figure 1 This is a schematic diagram of the cutting section structure of the chordae tendineae cutting conduit in one or more embodiments of the present invention; Figure 2 for Figure 1 Another perspective illustration; Figure 3 This is a schematic diagram of the operating part of the chordae tendineae cutting catheter in one or more embodiments of the present invention; Figure 4 This is a schematic diagram of the overall structure of the chordae tendineae cutting catheter in one or more embodiments of the present invention.
[0019] In the figure: 1-cutting part, 101-cutting groove, 102-elastic element, 103-cutting assembly, 2-connecting part, 3-operating part, 301-handle, 302-pull ring. Detailed Implementation
[0020] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.
[0021] The purpose of this invention is to provide a chordae tendineae cutting catheter and method to solve the problems existing in the prior art, which is less invasive, simple to operate, and can reduce intraoperative mortality.
[0022] To make the above-mentioned objects, features and advantages of the present invention more apparent and understandable, the present invention will be further described in detail below with reference to the accompanying drawings and specific embodiments.
[0023] In constructing models of valvular regurgitation, existing techniques mostly rely on open-chest surgery to cut the chordae tendineae and suture the valve leaflets. While this can induce regurgitation, it involves significant surgical trauma, complex procedures, and a high intraoperative mortality rate. To address this issue, this invention provides a chordae tendineae cutting catheter, referencing... Figures 1-4 As shown, the device includes a cutting section 1, a connecting section 2, and an operating section 3. The end of the cutting section 1 is a smooth, outwardly convex, blunt rounded structure, and a cutting groove 101 that can hook the tendon chord is provided on the side wall near the end of the cutting section 1. A cutting component 103 is provided at the opening of the cutting groove 101. One end of the connecting section 2 is connected to the beginning end of the cutting section 1, which can drive the cutting section 1 into the area to be cut through the delivery conduit and move along the axial direction of the connecting section 2 to complete the cutting of the tendon chord. The operating section 3 is located outside the object being operated on and is connected to the end of the connecting section 2 away from the cutting section 1. It is used to operate the connecting section 2 and / or the cutting section 1. The object being operated on in this embodiment is an experimental animal. Both the cutting part 1 and the connecting part 2 of the present invention can pass through the delivery catheter. The delivery catheter enters the corresponding ventricle through peripheral blood vessels. The cutting part 1, which is connected to the connecting part 2, can be delivered to the area to be cut under the valve through the delivery catheter. After the cutting part 1 enters the area to be cut, the operating part 3 drives the connecting part 2 to rotate, and the connecting part 2 drives the cutting part 1 to rotate, so that the opening end of the cutting groove 101 is opposite to the chordae tendineae. Then, after the cutting component 103 hooks the chordae tendineae, the operating part 3 drives the cutting part 1 to move axially to realize the cutting process of the chordae tendineae. The operation path is established through peripheral blood vessels, which reduces trauma and avoids affecting the research operation after modeling. It is less traumatic, simple to operate, and can reduce the intraoperative mortality rate.
[0024] In one embodiment, the cutting section 1 is hollow inside and is a cylindrical structure made of alloy material. The end of the cutting section 1 is a smooth, outwardly convex, blunt rounded structure used to close the end of the cutting section 1. The smooth, blunt rounded structure makes passage smoother and can avoid damage to the endocardium. In this embodiment, the cutting groove 101 has a hook-shaped structure along the axial section of the cutting section 1. That is, the cutting groove 101 is formed by radially extending and excavating along the side wall of the cutting section 1. The opening end of the cutting groove 101 is located on one side of the plane containing the axis of the cutting section 1, and the inner side wall of the cutting groove 101 is located on the other side of the plane containing the axis of the cutting section 1, thereby forming a sufficiently large cutting operation space. In this embodiment, the sidewall of the cutting groove 101 near the end of the cutting section 1 is a smooth arc-shaped structure, and the sidewall of the cutting groove 101 near the beginning of the cutting section 1 is an inclined linear structure. The sidewall between the arc-shaped sidewall and the linear sidewall is the inner sidewall of the cutting groove 101. The arc-shaped structure facilitates the hooking of tendineae, and the inclined linear sidewall, together with the cavity of the cutting section 1 at this position, can provide a larger cutting space. The cutting assembly 103 is movably disposed in the cutting section 1, and the cutting blade of the cutting assembly 103 is also a hook-shaped structure. It is located at the opening area of the cutting groove 101 and can hook tendineae through the opening end of the cutting groove 101. Then, the operating part 3 drives the cutting assembly 103 to move along the axial direction of the cutting section 1 to realize the cutting action of the hooked tendineae.
[0025] To improve cutting convenience, in one embodiment, the cutting assembly 103 includes a cutting blade, an elastic element 102, and a guide wire. One end of the cutting blade has a smooth hook-shaped structure, and the cutting edge of the cutting blade is located inside the hook-shaped structure. After the hook-shaped structure of the cutting blade hooks the tendon chord, the cutting edge directly abuts against the tendon chord. At this time, the cutting blade is driven to move along the axial direction of the cutting section 1, which can realize the cutting of the tendon chord. The inclined linear structure sidewall of the cutting groove 101, together with the cavity of the cutting section 1 at this position, can provide a large cutting space. This cutting space is located on an inclined virtual slope, used to abut and position the tendon chord before cutting. The inclined linear structure sidewall at one end of the cutting groove 101 can increase the opening of the cutting groove 101, making it easier to place the tendon chord before cutting. The tendon chord is secured at the opening to hook and position the tendon chord before cutting. One end of the elastic element 102 is fixedly connected to the cutting blade, and the other end is fixedly connected to the inner wall of the cutting section 1. In this embodiment, the elastic element 102 is a return spring. One end of the traction guide wire is fixedly connected to the cutting blade, and the other end passes through the inside of the cutting section 1 and the inside of the connecting section 2 in sequence, and is connected to the operating part 3. The operator holds the operating part 3 and pulls the traction guide wire. The traction guide wire can drive the cutting blade to move along the axial direction of the cutting section 1, thereby cutting the tendon chord hooked by the cutting blade. During the cutting process, when the cutting blade moves along the axial direction of the cutting section 1, it will squeeze the return spring. When the cutting is completed, the operating part 3 is released, and under the elastic force of the return spring, the cutting blade moves in the opposite direction to complete the reset. After resetting, the cutting blade is located in the cavity of the arc-shaped sidewall of the cutting groove 101. At this time, the cutting edge is hidden in the cavity of the cutting part 1, that is, the arc of the cutting edge is located inside the arc of the arc-shaped sidewall of the cutting groove 101. The cutting edge is located in the cavity of the cutting part 1. The opening of the cutting groove 101 is located between the cutting edge and the connecting part 2, which can play a protective role for the cutting blade. Since the cutting edge of the cutting blade in the initial state will not enter the opening area of the cutting groove 101, damage to the tissue can be avoided during the movement of the cutting blade with the cutting part 1.
[0026] To avoid hindering the cutting process and to ensure a more secure connection, in one embodiment, one end of the cutting blade has a smooth hook-shaped structure, while the other end has a columnar connecting seat. The connecting seat is movably inserted into the cutting section 1, abutting against one end of the elastic member 102, and fixedly connected to one end of the guide wire. The connection between the connecting seat, the elastic member 102, and the guide wire prevents the cutting edge portion of the cutting blade from being blocked by these components. Furthermore, the cylindrical structure of the connecting seat provides guidance during the cutting blade's movement. In this embodiment, an annular groove is formed at the end of the connecting seat furthest from the cutting edge. This groove is used to engage one end of the return spring. An annular protrusion is fixedly provided on the inner wall of the cutting section 1 to secure the other end of the return spring.
[0027] In one embodiment, the connecting part 2 is a tubular structure made of polyurethane-based material, which has a certain degree of conformability. The end of the connecting part 2 near the cutting part 1 has a flexible bending structure. The initial bending angle of the flexible bending structure is 90°, so that the cutting part 1 connected to its end is angled, facilitating hooking of the tendineae. When the flexible bending structure passes through the delivery conduit, it can bend in the opposite direction to a de-bending state, that is, the bending angle bends in the opposite direction to near 0°, similar to a straight pipe structure, allowing the connecting part 2 to pass smoothly along the delivery conduit. After exiting the delivery conduit, the flexible bending structure can return to its initial bending state. This principle is a mature technology; for example, shape memory alloy can be filled into the sidewall of the connecting part 2 to achieve this function, or an elastic material can be used to prefabricate the flexible bending structure of the connecting part 2 to a 90° bend, so that it can maintain this bending angle when no external force is applied.
[0028] In one embodiment, the operating part 3 includes a handle 301 and a pull ring 302 made of polypropylene. The end of the handle 301 has a crescent-shaped arc structure for the operator to grip. The front end of the handle 301 is fixedly connected to the connecting part 2 by a connecting block. The connecting block at the front end of the handle 301 has a slot or groove for engaging the pull ring 302, allowing the operator to pull the pull ring 302 with their fingers. The pull ring 302 can reciprocate along the slot or groove, thereby guiding the pull ring 302 and the guide wire. The handle 301 and the connecting part 2 are connected by a connecting block. The end of the connecting part 2 away from the cutting part 1 is fixedly connected. The operator can drive the connecting part 2 and the cutting part 1 to rotate synchronously through the handle 301, thereby adjusting the angle of the cutting groove 101. By pulling the handle 301, the axial position of the connecting part 2 and the cutting part 1 can be adjusted. In conjunction with the angle adjustment process, the tendon chord can be hooked. The pull ring 302 is fixedly connected to the end of the guide wire away from the cutting blade. After the cutting groove 101 hooks the tendon chord, the guide wire is pulled, and the cutting edge of the cutting blade moves along the axis of the cutting part 1 to realize the cutting process of the hooked tendon chord.
[0029] The present invention also provides a method for chordae tendineae cutting, comprising the following steps: A peripheral vascular access is established, and the delivery catheter is advanced to the left or right ventricle through the access. The tip of the delivery catheter is positioned subvalvular, a position that can be determined using ultrasound or fluoroscopy. The cutting part 1 and the connecting part 2 are advanced to the left or right ventricle through the delivery catheter. The end of the connecting part 2 near the cutting part 1 extends out of the delivery catheter and automatically returns to a 90° bend. The handle 301 of the operating part 3 is rotated to hook the cutting component 103 onto the chordae tendineae. This process can be determined by touch or ultrasound to confirm whether the chordae tendineae are hooked. The pull ring 302 of the operating part 3 is pulled to control the cutting component 103 to cut the chordae tendineae. The valvular regurgitation is then assessed by ultrasound, and the cutting action is repeated to achieve the desired effect. After the procedure, the cutting part 1 and the connecting part 2 are removed, and then the delivery catheter is withdrawn to apply pressure for hemostasis.
[0030] Using the method described above, in constructing a tricuspid regurgitation / right heart failure model, a sheath is placed via the venous system, and an MPA catheter (multifunctional angiography catheter) is delivered to the right ventricle. The cutting part 1 and connecting part 2 of this invention are introduced into the delivery catheter to sever the tricuspid chordae tendineae, causing tricuspid regurgitation and achieving the goal of right heart failure. In constructing a mitral regurgitation / left heart failure model, a sheath is placed via the arterial system, and an EBU catheter (strong support guiding catheter) is delivered to the left ventricle. The cutting part 1 and connecting part 2 of this invention are introduced into the delivery catheter to sever the mitral chordae tendineae, causing mitral regurgitation and achieving the goal of right heart failure. This method eliminates the need to open the thoracic cavity to induce mitral or tricuspid regurgitation, achieving both mild and severe regurgitation effects. It has virtually no impact on subsequent research procedures.
[0031] Specific examples have been used to illustrate the principles and implementation methods of this invention. The descriptions of the above embodiments are only for the purpose of helping to understand the method and core ideas of this invention. Furthermore, those skilled in the art will recognize that, based on the ideas of this invention, there will be changes in the specific implementation methods and application scope. Therefore, the content of this specification should not be construed as a limitation of this invention.
Claims
1. A chordae tendineae cutting catheter, characterized in that: include: The cutting part has a smooth, outwardly convex, blunt rounded structure at its end, and the side wall of the cutting part near the end is provided with a cutting groove that can hook the tendon cord. The opening of the cutting groove is provided with a cutting component. The connecting part, one end of which is connected to the first end of the cutting part, can drive the cutting part into the area to be cut through the delivery conduit and move along the axial direction of the connecting part to complete the cutting of the tendineae. as well as An operating part is located outside the object being operated on and is connected to the end of the connecting part away from the cutting part, for operating the connecting part and / or the cutting part.
2. The chordae tendineae cutting conduit according to claim 1, characterized in that: The cutting section is hollow inside, the cutting assembly is movably disposed inside the cutting section, and the cutting edge of the cutting assembly is located at the opening area of the cutting groove.
3. The chordae tendineae cutting conduit according to claim 1, characterized in that: The cutting groove has a hook-shaped cross-section along the axial direction of the cutting part, and the sidewall of the cutting groove near the end of the cutting part has a smooth arc-shaped structure, while the sidewall of the cutting groove near the beginning of the cutting part has an inclined linear structure.
4. The chordae tendineae cutting conduit according to claim 2, characterized in that: The cutting assembly includes: A cutting blade, one end of which has a smooth hook-shaped structure, and the cutting edge of the cutting blade is located inside the hook-shaped structure of the cutting blade; An elastic element, one end of which is fixedly connected to the cutting blade, and the other end of which is fixedly connected to the inner wall of the cutting section; and A guide wire is used, one end of which is fixedly connected to the cutting blade, and the other end passes through the inside of the cutting part and the inside of the connecting part in sequence, and is connected to the operating part.
5. The chordae tendineae cutting conduit according to claim 1, characterized in that: The connecting part is a tubular structure, and a flexible bending structure is provided at one end of the connecting part near the cutting part. When the flexible bending structure passes through the delivery conduit, it can bend in the opposite direction to the unbent state so that the connecting part can pass along the delivery conduit. After the flexible bending structure passes through the delivery conduit, it can return to the initial bending state.
6. The chordae tendineae cutting conduit according to claim 5, characterized in that: The initial bending angle of the flexible bending structure is 90°.
7. The chordae tendineae cutting conduit according to claim 4, characterized in that: The operating part includes a handle and a pull ring. The handle is fixedly connected to the end of the connecting part away from the cutting part, and the pull ring is fixedly connected to the end of the guide wire away from the cutting blade.
8. The chordae tendineae cutting conduit according to claim 4, characterized in that: One end of the cutting blade has a smooth hook-shaped structure, and the other end has a column-shaped connecting seat. The connecting seat is movably inserted into the cutting part. The connecting seat abuts against one end of the elastic member, and the connecting seat is fixedly connected to one end of the traction guide wire.
9. The chordae tendineae cutting conduit according to claim 1, characterized in that: The cutting part is made of alloy material, the connecting part is made of polyurethane material, and the operating part is made of polypropylene material.