Development of a new thoracoswpic cardiovascular surgicall systems with CCD camera

[导言]非体外循环冠状动脉旁路移植术已成为缺血性心脏病的标准治疗手段，血管内治疗成为当今外周动脉疾病的重要治疗策略。然而，心内手术或主动脉手术还没有像这样的微创手术，因为充血不能获得足够的视野。目前心肺机的使用仍然是这些手术不可缺少的，术后并发症的发生率也很高。支架植入术是一种划时代的治疗方法，但仍有几个问题需要解决。在这份报告中，我们开发了用于微创心内和主动脉手术的设备。1.血管内窥镜的研制对血管内窥镜进行了如下改进：将氨基甲酸酯制成的气囊用CO_2充气，获得了满意的效果。由于ba…，没有对主动脉造成损害。更缓慢的扩张。本方法未发现血栓形成。2.带吻合器导管的研制设计了导管式吻合器。3.导管式后扩张器的研制该扩张器是用金属丝代替球囊制成的。扩张后未见明显的主动脉损伤。增加人工血管与主动脉之间的固定。4.在心内手术中，利用超声摄像机观察心内结构。尝试实验性房间隔缺损闭合。利用超声摄像机进行观察，操作简单、清晰。然而，该装置的尺寸太大，目前很难在临床上使用。5.使用新装置进行主动脉手术本实验1、2和2开发的装置进行了全面的检查。在血管内窥镜下，支架置入顺利。[结论]在本系列研究中，研制出了极具吸引力的心血管外科器械。虽然临床试验还存在一些问题，但技术创新将在未来得到解决。较少

[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