Patent EA-000649-B1 (EA)
Title: Microcommisurotomy device with levers
Inventor: AMOR GEORGES
IPC: A61M29/00
Filed: 1997-01-06
Abstract: 1- Microcommissurotomy device with levers (4) comprising: -a proximate end socket (5) affixed rigidly to the distal end of a catheter (1), -an axis (11) axially traversing the proximal end socket and terminating at the distal end (6) of the retractor, and -two articulated parallelograms (7) arranged symmetrically in relation to the axis (11) of the retractor, each parallelogram being constituted of one active arm (20) parallel to the axis of the retractor and two parallel levers (21, 22) articulated at one end (17,18) on said arm, the opening of the retractor being secured by manual control by movement of the distal end (6) of the retractor in relation to its proximal end socket (5) to displace the active arms (20) parallel to the axis of the retractor, the retractor in closed position having a radial bulk or extension essentially equal to that of the catheter (1), characterized in that the levers (21, 22) are articulated at their opposite end (15,16) on the proximal end socket (5) and in that each parallelogram (7) is connected to the distal end (6) of the retractor by a small articulated rod (8, 9). 2. Microcommissurotomy device as in Claim 1, characterized in that the distal lever (22) of each parallelogram (7) in the vicinity of its midpoint presents an articulation point (23) for the small rod (8, 9) articulated at its other end (24) on the distal end (6) of the retractor (4). 3. Microcommissurotomy device as in Claim 2, characterized in that the two points of articulation (23, 24) of the small rod (8, 9) are situated one on either side of the axis (11) of the retractor (4). 4. Microcommissurotomy device as in Claim 3, characterized in that the small rods (8, 9) of the two symmetrical parallelograms (7) of the retractor (4) are intersecting. 5. Microcommissurotomy device as in one of the preceding Claims, characterized in that the proximal lever (21) of each parallelogram (7) carries a plate spring (27) which, when the retractor (4) is in closed position, pulls said proximal lever (21) toward the exterior. 6. Microcommissurotomy device as in one of the preceding Claims, characterized in that the distal end (6) of the retractor (4) is in the form of an ogival head carried by a tube (11) sliding in the proximal end socket (5) of the retractor. 7. Microcommissurotomy device as in Claim 6, characterized in that the tube (11) opens at the distal end (6) of the retractor (4) to constitute a passage for a guide in the form of a metal wire for the guiding of the retractor until it reaches the site of the commissurotomy. 8. Microcommissurotomy device as in Claim 7, characterized in that the guide in the form of metal wire carries a pliable end, which is atraumatic, and, to the right of the connection between the guide and its pliable end, a separate olivary member with the capacity to cooperate with the distal end (6) of the retractor to secure complete opening of the retractor. 9. Microcommissurotomy device as in one of the preceding Claims, characterized in that the axis (11) of the retractor is connected to at least one traction wire (12) and slides in a flexible member (13) within the catheter (1), the forces of traction and compression being transmitted from the proximal end to the distal end of the catheter by virtue of the combination of the traction wire (12) and the flexible member (13) within the catheter (1). 10. Microcommissurotomy device as in one of the preceding Claims, characterized in that when the retractor (4) is in open position, its distal end (6) is located between the active arms (20) of the retractor (4). 11. Microcommissurotomy device as in one of the preceding Claims, characterized in that the active arm (20) and the proximal lever (21) of each parallelogram (7) present a semi-cylindrical mounting (25, 26) on the exterior, so that the retractor (4) is contained entirely within the cylindrical exterior surface formed by the symmetrical mountings of the two parallelograms (7) in closed position. 12. Catheter (1) intended to be mounted between the distal retractor (4) and the proximal manual control of the microcommissurotomy device as in one of the preceding Claims, characterized in that it comprises: -a flexible external member (2) and a pliable exterior sheathing (3) covering the flexible external member, -at least one internal traction wire (12) intended to be connected by the one end to said proximal manual control and by the other end to the sliding distal end (6) of the retractor (4), -a flexible member (13), within the catheter (1), in which flexible member (13) slides the traction wire (12), the forces of traction and compression being transmitted from the proximal end to the distal end of the catheter by virtue of the combination of the traction wire (12) and the internal flexible member (13). 13. Catheter as in Claim 12, characterized in that the flexible members (2,13) are in the form of helical springs. 14. Catheter as in Claim 12 or 13, characterized in that it comprises a plurality of traction wires (12) of uniform length in rectilinear or intersecting helices.