Instrument of patterning cusp for cardiac valve reconstruction and component thereof

Abstract

In a case of repairing an aortic valve, etc. by forming a valve cusp with a biomembrane or the like, the shape and the size of a valve cusp can be determined easily. An instrument including a valve cusp sizer 2 for measuring the sizer of the valve cusp and a template 3 for scribing lines for the shape of a valve cusp conforming to the measured size of the valve cusp, in which the valve cusp sizer 2 has a plurality of differently-sized sizer blocks (G 1 to G 8 ) attached to each of the top ends of grip members 21 respectively and each sizer block has an arcuate surface 24 formed by cutting each of differently-sized circular cylinders 22 at an angle conforming to the central angle for the commissure portions and, the template 3 is formed with a scribing portion 31 including a substantially semi-circular valve cusp base forming portion 33 having a diameter as a sum of a nominal diameter (D 1 to D 8 ) defined for the diameter of a circular cylinder constituting the arcuate surface of a sizer block (G 1 to G 8 ) whose arcuate surface 24 conforms at both ends thereof to both of the commissure portions and an allowance for stitching margin (W), and a coaptation zone forming portion 34 in contiguous with the valve cusp base forming portion.

1 . An instrument of patterning a valve cusp used for aortic valve reconstruction by stitching a valve cusp patterned from an artificial membrane or a biomembrane to a portion of a tricuspid cardiac valve such as an aortic valve from which an abnormal cusp has been excised, the instrument including;
 a valve cusp sizer for measuring the size of a valve cusp conforming to the size of a cardiac valve, and   a template for scribing lines of the shape of the valve cusp on the artificial membrane or the biomembrane conforming to the measured size of the valve cusp, in which   the valve cusp sizer has a plurality of differently-sized sizer blocks for measuring the length of a valve annulus extending from one commissure portion of a valve cusp to a valve annulus to the other commissure portion of the valve cusp to the valve annulus of an excised valve cusp, where each of the seizer blocks is attached to each of the top ends of grip members respectively and each of the sizer blocks has an arcuate surface formed by cutting each of differently-sized circular cylinders at an angle conforming to the central angle for the commissure portions and,   the template is formed with a scribing portion including a substantially semi-circular valve cusp base forming portion having a diameter as a sum of a nominal diameter defined for a diameter of a circular cylinder constituting the arcuate surface of a sizer block whose arcuate surface conform at both ends thereof to both of the commissure portions of the excised valve cusp when the cusp sizer is inserted to a valve annulus from which the valve cusp has been excised and an allowance for stitching margins, and a coaptation zone forming portion in contiguous with the valve cusp base forming portion.   
     
     
         2 . A valve cusp sizer for measuring the size of a valve cusp conforming to the size of a cardiac valve in a cardiac valve reconstruction of reconstructing a cardiac valve by stitching a valve cusp which is formed by pattering an artificial membrane or a biomembrane, to a portion of a tricuspid cardiac valve, for example, of an aortic valve from which an abnormal valve cusp has been excised in which
 each of a plurality of differently-sized sizer blocks for measuring the length of a valve annulus extending from one commissure portion of a valve cusp to a valve annulus to the other commissure portion of the valve cusp to the valve annulus of an excised valve cusp is attached to the top end of each of grip members, and   an arcuate surface formed by cutting a circular cylinder of different radius at an angle conforming to the central angle for the commissure portion is formed to each of the sizer blocks.   
     
     
         3 . A valve cusp sizer according to  claim 2 , wherein
 contact probe portions for positioning both ends of the arcuate surface of the sizer block to the commissure portions are formed in parallel with the central axis of the arcuate surface.   
     
     
         4 . A valve cusp sizer according to  claim 2 , wherein
 the upper surface of the sizer block is formed being curved as a concave shape such that the central point for the valve cusp base between commissure portions can be observed when both ends of the arcuate surface of the sizer block are abutted against both of the commissure portions of the valve annulus from which the valve cusp has been excised.   
     
     
         5 . A valve cusp sizer according to  claim 3 , wherein
 the upper surface of the sizer block is formed being curved as a concave shape such that the central point for the valve cusp base between commissure portions can be observed when both ends of the arcuate surface of the sizer block are abutted against both of the commissure portions of the valve annulus from which the valve cusp has been excised.   
     
     
         6 . A valve cusp sizer according to  claim 4 , wherein
 an index as a center marker is attached to the upper surface of the sizer block at a position corresponding to the central point of the valve cusp base between commissure portions.   
     
     
         7 . A valve cusp sizer according to  claim 5 , wherein
 an index as a center marker is attached to the upper surface of the sizer block to a position corresponding to the central point of the valve cusp base between the commissure portions.   
     
     
         8 . A valve cusp sizer according to  claim 2 , wherein
 the grip member is attached to the center of the circular cylinder that forms the sizer block and inclined relative to the central axis thereof at a predetermined angle on the side opposite to the arcuate surface.   
     
     
         9 . A template for scribing lines of a valve cusp shape on an artificial membrane or a biomembrane conforming to shape of a valve cusp, in which
 a valve cusp sizer for measuring the size of the valve cusp has a plurality of differently-sized sizer blocks for measuring the length of a valve annulus extending from one commissure portion of a cusp to a valve annulus to the other commissure portion of the cusp to the valve annulus of an excised valve cusp, where each of the seizer blocks is attached to each of the top ends of grip members respectively and each of the sizer blocks is formed with an arcuate surface formed by cutting each of differently-sized circular cylinders at an angle conforming to the central angle for the commissure portions and,   the template is formed with a scribing portion including a substantially semi-circular valve cusp base forming portion having a diameter as a sum of a nominal diameter that is defined for a diameter of a circular cylinder constituting the arcuate surface of a sizer block and stitching margins, and a coaptation zone forming portion in contiguous with the valve cusp base forming portion.   
     
     
         10 . A template according to  claim 9 , wherein
 the coaptation zone forming portion is formed into a rectangular shape in which both end edges thereof are extended from both ends of the valve cusp base forming portion for a length conforming to the height of the coaptation.   
     
     
         11 . A template according to  claim 9 , wherein
 both ends edges of the coaptation zone forming portion are extended for a length conforming to the height of the coaptation zone while being widened gradually from both ends thereof and the free margin portion at the top end is formed into an angled shape.