Development of a new thoracoswpic cardiovascular surgicall systems with CCD camera

【导读】非泵送冠状动脉搭桥成为缺血性心脏病的标配，血管内治疗成为当今外周动脉疾病的重要治疗策略。然而，心脏内手术或主动脉手术还没有像这种侵入性较小的手术那样建立起来，因为没有足够的视野来观察充满的血液。目前这些手术仍然离不开心肺机的使用，术后并发症的发生率也很高。一种具有划时代意义的治疗方法，如支架植入术的监护，有几个问题需要解决。在本报告中，我们开发了用于微创心内和主动脉手术的设备。这些基本实验是在猪身上进行的。血管镜的发展对血管镜进行了如下改进；由聚氨酯制成的气球被二氧化碳吹胀。得到了满意的意见。主动脉没有损伤，因为…，更多的肺扩张。该方法未发现血栓形成。设计了导管式订书机。人工血管与主动脉的吻合简便、安全。导管式后扩张装置的研制用金属丝代替球囊制成扩张装置。扩张后未见明显主动脉损伤。人工移植物与主动脉之间的固定增加。心内手术采用超声CCD相机观察心内结构。尝试实验性ASD闭合。超声CCD相机观测简单、清晰。但是，该装置尺寸太大，目前临床上还难以使用。使用新设备的主动脉手术本实验1、2和2开发的设备进行了全面检查。经血管镜观察，支架置入顺利。此外，订书机是有效的。【结论】本系列研究开发了具有吸引力的心血管手术器械。虽然临床试验中还存在一些问题，但技术创新将在未来得到解决。少

[Introduction]Off-pump CABG became standard for ischemic heart diseases, and the endovascular therapy came to be an important treatment strategy for the peripheral arterial diseases today. However, the intracardic operations or the aortic operations have not been established like this less invasive procedures, because the enough view is not gotten with the filled blood. Usage of the heart-lung machine is still indispensable for these operations now, and the incidence of postoperative complications is also high. An epoch-making treatment like as stentgrafting custody is developed, and there are several problems to be.solved. In this report, we developed the devices for less-invasive intracardiac and aortic surgeries. These basic experiments were performed by pigs.1.Development of the angioscopeThe improvement was added to the angioscope as follows; The balloon made of the urethane was inflated by CO_2. The satisfied view was obtained.. No damage in the aorta was caused because of the ba … More lloon expansion. The thrombosis was not detected by this procedure.2.Development of the catheter with staplerThe catheter type stapler was designed. The anastmosis between the artificial graft and the aorta was performed easily and safely.3.Development of catheter type post-dolatation deviceThe dilatation devise was made of metallic wire instead of the balloon. There was no significant aortic damage by the post-dilatation. The fixation between the artificial graft and the aorta was increased.4.Intracardic operationBy ultrasonic CCD camera, the intracardiac structures were observed. Experimental ASD closure was tried. The observation by the ultrasonic CCD camera was easil and clearly. However, the device size is too large, and it is difficult to use this device clinically now.5.Aortic surgery using new devicesThe devices developed by this experiment 1, 2, and 2 was totally examined. Under angioscopic observation, the stentgraft deployment was smoothly. Furthermore, the staplers were effective.[Conclusion]In this series, The attractive devices for cardiovascular surgery were developed. Though there are several problems for clinical trial, the technical innovation will solve in future. Less