Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS20020161321 A1
Publication typeApplication
Application numberUS 10/100,155
Publication date31 Oct 2002
Filing date18 Mar 2002
Priority date27 May 1994
Also published asCA2191301A1, CA2191301C, DE69524217D1, DE69524217T2, DE69534312D1, EP0760688A1, EP0760688B1, EP1129737A1, EP1129737B1, US5478309, US5765568, US5800375, US5810757, US6248086, US6293920, US6398752, WO1995032745A1
Publication number100155, 10100155, US 2002/0161321 A1, US 2002/161321 A1, US 20020161321 A1, US 20020161321A1, US 2002161321 A1, US 2002161321A1, US-A1-20020161321, US-A1-2002161321, US2002/0161321A1, US2002/161321A1, US20020161321 A1, US20020161321A1, US2002161321 A1, US2002161321A1
InventorsSweezer William, Ronald Coleman, Walter Larkins
Original AssigneeSweezer, William P., Ronald Coleman, Larkins Walter W.
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Method of occluding a patient's ascending aorta and delivering cardioplegic fluid
US 20020161321 A1
Abstract
An extracorporeal support system including an extracorporeal support apparatus and an arterial circulation support catheter. The arterial circulation support catheter includes a blood lumen with a proximal end coupled to extracorporeal support apparatus and a distal end inserted into the blood circulation. A vent lumen has a distal end that crosses the aortic valve into the left ventricle and provides direct venting of the left ventricle through the vent lumen. An arterial circulation support catheter occluding member is positioned either in an interior or at an exterior of the arterial circulation support catheter. A venous circulation support catheter is provided and includes a blood lumen with a proximal end coupled to the extracorporeal support apparatus and a distal end inserted into the blood circulation. A venous circulation support catheter occluding member is included and positioned in an interior or at an exterior of the venous circulation support catheter. The venous circulation support catheter occluding member occludes the superior vena cava and the inferior vena cava.
Images(11)
Previous page
Next page
Claims(47)
What is claimed is:
1. An extracorporeal support system coupled to a blood circulation, comprising:
an extracorporeal support apparatus;
an arterial circulation support catheter with a proximal end coupled to the extracorporeal support apparatus and a distal end inserted into the blood circulation, the arterial circulation support catheter including a blood lumen and a vent lumen with a distal end that crosses the aortic valve into the left ventricle for direct venting of the left ventricle through the vent lumen;
an arterial circulation support catheter occluding member positioned in an interior or at an exterior of the arterial circulation support catheter;
a venous circulation support catheter with a proximal end coupled to the extracorporeal support apparatus and a distal end inserted into the blood circulation, the venous circulation support catheter including a blood lumen; and
a venous circulation support catheter occluding member to occlude the superior vena cava and the inferior vena cava, the venous circulation support catheter occluding member being positioned in an interior or at an exterior of the venous circulation support catheter.
2. The system of claim 1, wherein the extracorporeal support apparatus includes an outlet port for the delivered of re-oxygenated blood to the blood circulation, and an inlet port for receiving blood from the blood circulation.
3. The system of claim 2, wherein the arterial circulation support catheter proximal end is coupled to the outlet port, and the venous circulation support catheter proximal end is coupled to the inlet port.
2. The system of claim 1, further comprising:
an arterial circulatory support occluding member lumen coupled to the arterial circulatory support occluding member and positioned in the arterial circulation support catheter.
3. The system of claim 1 and 2, wherein the arterial circulatory support occluding member is slideably positioned in the blood lumen or the arterial circulation support occluding member lumen.
4. The system of claim 1, wherein the arterial circulation support catheter occluding member is a clamp.
5. The system of claim 1, further comprising:
a venous circulation support catheter occluding member lumen coupled to the venous circulation support catheter occluding member and positioned in the venous circulation support catheter.
6. The system of claims 1 and 5, wherein the venous circulation support catheter occluding member is slideably positioned in the venous circulation support catheter blood lumen or the venous circulation support catheter occluding member lumen.
7. The system of claim 1, wherein the vent lumen provides infusion capability into the left ventricle.
8. The system of claim 1, wherein the arterial circulation support catheter occluding member is a balloon.
9. The system of claim 1, wherein the arterial circulation support catheter includes two occluding members.
10. The system of claim 1, wherein the arterial circulation support catheter further comprises:
an infusion lumen including a distal end that introduces an infusion medium into the aortic root, wherein the infusion lumen is positioned in the interior or at the exterior of the arterial circulation support catheter.
11. The system of claim 10, wherein the infusion lumen is positioned in the blood lumen.
12. The system of claim 10, wherein the infusion lumen is positioned in the arterial circulation support catheter adjacent to the blood lumen.
13. The system of claim 10, wherein the infusion lumen introduces an infusion medium into the aortic root and vents mediums from the aortic root simultaneously or at alternative times.
14. The system of claim 1, wherein the arterial circulation support catheter further comprises:
an international lumen including a distal end that introduces a diagnostic or therapeutic device into the blood circulation, wherein the interventional lumen is positioned in the interior or at the exterior of the arterial circulation support catheter.
15. The system of claim 14, wherein the interventional lumen is positioned in the blood lumen.
16. The system of claim 14, wherein the infusion lumen is positioned in the arterial circulation support catheter adjacent to the blood lumen.
17. The system of claim 1, wherein the extracorporeal support apparatus includes a device to re-oxygenate blood.
18. The system of claim 17, wherein the extracorporeal support apparatus further includes a temperature control device to cool the heart and assist in stopping the heart from beating, and subsequently heat the heart to assist in initiating the heart to beat.
19. The system of claim 18, wherein the flirter comprising:
a fibrillation and defibrillation apparatus coupled to the heart.
20. The system of claim 1, wherein the arterial circulatory support catheter occluding member is positioned in the ascending aorta.
21. The system of claim 10, wherein the infusion medium is a cardio-active agent.
22. The system of claim 10, wherein the infusion medium is one or more contrast agents.
23. The system of claim 10, wherein the infusion medium is an iontropic agent.
24. The system of claim 1, wherein the venous circulation support catheter occluding member includes two occluding members.
25. The system of claim 24, wherein the two occluding members are balloons.
26. The system of claim 24, wherein the occluding members are adjustably positioned relative to each other.
27. The system of claim 1, wherein the venous circulation support catheter further composes:
an infusion lumen including a distal end that introduces an infusion medium into the venous circulation, wherein the infusion lumen is positioned in the interior or at the exterior of the venous circulation support catheter.
28. The system of claim 27, wherein the infusion lumen is positioned in the blood lumen.
29. The system of claim 27, wherein the infusion lumen is positioned in the venous circulation support catheter adjacent to the blood lumen.
30. The system of claim 27, wherein the infusion lumen introduces an infusion medium into the blood circulation and vents mediums from the blood circulation simultaneously or at alternatively.
31. The system of claim 1, wherein the venous circulation support catheter further comprises:
an interventional lumen including a distal end that introduces a diagnostic or therapeutic device into the blood circulation, wherein the interventional lumen is positioned in the interior or at the exterior of the venous circulation support catheter.
32. The system of claim 25, wherein the interventional lumen is positioned in the blood lumen.
33. The system of claim 25, wherein the interventional lumen is positioned in the venous circulation support catheter adjacent to the blood lumen.
34. The system of claim 30, wherein the infusion medium is a cardio-active agent.
35. The system of claim 30, wherein the infusion medium is one or more contrast agents.
36. The system of claim 30, wherein the infusion medium is an iontropic agent.
37. The system of claim 31, wherein the interventional lumen introduces a therapeutic device.
38. The system of claim 31, wherein the interventional lumen permits balloon valvuloplasty.
39. An extracorporeal support system coupled to a blood circulation, comprising:
an extracorporeal support apparatus;
an arterial circulation support catheter including a blood lumen with a proximal end coupled to the extracorporeal support apparatus and a distal end inserted into the blood circulation;
an arterial circulation support catheter occluding member positioned in an interior or at an exterior of the arterial circulation support catheter;
a vent lumen with a distal end positioned in the left ventricle and provide direct venting of the left ventricle, wherein the vent lumen is positioned in the interior or the exterior of the arterial circulatory support lumen.
a venous circulation support catheter including a blood lumen with a proximal end coupled to the extracorporeal support apparatus and a distal end inserted into the blood circulation; and
a venous circulation support catheter occluding member to occlude the superior vena cava and the inferior vena cava, the venous circulation support catheter occluding member being positioned in an interior or at an exterior of the venous circulation support catheter.
40. The system of claim 39, wherein the distal end of the vent lumen crosses the aortic valve.
41. The system of claim 39, wherein the vent lumen is positioned in the arterial circulation support catheter blood lumen.
42. A method for venting a left ventricle of a heart, comprising:
providing an extracorporeal circulation support system including an extracorporeal support apparatus, a venous circulation support catheter, an arterial circulation support catheter and a vent lumen;
introducing the arterial circulation support catheter into a blood circulation;
introducing the venous circulation support catheter into the blood circulation;
positioning a vent lumen distal end into a left ventricle of the heart; and
venting the left ventricle rough the vent lumen.
43. The method of claim 42, wherein a proximal end of the arterial circulation support catheter is coupled to an outlet port of the extracorporeal support device.
44. The method of claim 43, wherein a proximal end of the venous circulation support catheter is coupled to an inlet port of the extracorporeal support device.
45. The method of claim 42, wherein the left ventricle is directly vented through the vent lumen.
Description
    CROSS-REFERENCE TO RELATED APPLICATION
  • [0001]
    This application is a continuation-in-part of U.S. patent application Ser. No. 08/250,721 entitled “A CATHETER SYSTEM AND METHOD FOR PROVIDING CARDIOPULMONARY BYPASS PUMP SUPPORT DURING SURGERY” by Sweezer et al., filed May 27, 1994 incorporated herein by reference.
  • BACKGROUND OF THE INVENTION
  • [0002]
    1. Field of the Invention
  • [0003]
    This invention relates generally to an extracorporeal circulation support system coupled to the blood circulation, and more particularly to an extracorporeal circulation support apparatus which directly vents the left ventricle.
  • [0004]
    2. Background of the Invention
  • [0005]
    Each year extracorporeal circulation support permits over 500,000 patients worldwide with disabling heart disease to undergo therapeutic cardiac operations. The goals of extracorporeal circulation support for heart surgery are, (i) to provide life-support functions, (ii) a motionless decompressed heart, (iii) a dry bloodless field of view for the surgeon, and (iv) adequate myocardial protection.
  • [0006]
    One method of extracorporeal support includes a basic heart-lung life-support system. Oxygen-poor blood is diverted from the venous circulation of the patient and transported to the heart-lung machine where reoxygenation occurs. carbon dioxide is discarded and heat regulation, warming or cooling, is accomplished. This processed blood is then perfused into the patient's arterial circulation for distribution throughout the entire body to nourish and maintain viability of the vital organs. Although current venous diversion and arterial perfusion methods can be combined with other measures to effectively isolate the heart for cardiac surgery, they are associated with disadvantages and limitations which contribute significantly to patient morbidity, mortality, and health care costs. Another method may involve using a left ventricle assist system to channel blood from the left ventricle into aortic circulation.
  • [0007]
    In order to perform coronary artery bypass, valve operations and other complex delicate surgical procedures on the heart, it is desirable to establish a resting, non-beating, non-distended state. This condition, along with a dry bloodless field, is ideal for safe manipulation and suturing of cardiac structures. It also contributes to decreased metabolic cardiac energy demands while promoting preservation of cellular functions. This non-beating state is accomplished by delivery of various methods including but not limited to delivery of a cardioplegia solution to the coronary circulation
  • [0008]
    There are several methods of controlling distension, decompression or venting, and improved visibility of the heart during heart surgery. These include but are not limited to, (i) insertion of a catheter via the left atrium or a pulmonary vein that is directed across the mitral valve so that its openings at the top are positioned within the left ventricular chamber for venting of blood, (ii) inserting a catheter directly into the apex of the left ventricular muscle with its openings at the tip positioned within the left ventricular chamber for venting of blood, (iii) placement of a catheter in the isolated segment of the ascending aorta for antegrade cardioplegia delivery that can be alternatively switched to a suction so to accomplish aortic root venting (decompression) but not Left ventricular decompression (venting), and (iv) inserting a catheter across the aortic valve into the left ventricle to remove blood from the left ventricle and return it back into the arterial circulation. These methods have several disadvantages including but not limited to requiring major sternotomy or thoracotomy.
  • [0009]
    Major invasive chest incisions are often associated with a higher incidence of morbidity including, but not limited to, intraoperative and post-operative bleeding, resulting in the likelihood of increased blood transfusion requirements, returns to surgery for re-exploration to control hemorrhage, longer healing and recovery times, pulmonary complications (such as lung collapse and pneumonia), catastrophic wound infection (mediastinitis), extensive scarring and adhesions. mechanical wound instability and disruption (dehiscence), chronic incisional pain, peripheral nerve and musculoskeletal dysfunction syndromes.
  • [0010]
    Developing a system with features that avoids surgical maneuvers, instrumentation and devices known to be associated with increased morbidity and mortality, while maintaining the conditions necessary to perform various cardiac interventions, is desirable. Such improvements have the likelihood of resulting in a favorable impact on patient care. quality of life, and health care costs.
  • [0011]
    Although peripherally inserted catheters of the prior art avoid direct cardiac trauma and can be placed without a major invasive chest incision (sternotomy or thoracotomy), they do not establish the condition of total extracorporeal circulation support.
  • [0012]
    It is thus desirable to develop an extracorporeal circulation support system coupled to the blood circulation which directly removes blood from the left ventricle. It is further desirable to provide a method for directly venting the left ventricle.
  • SUMMARY OF THE INVENTION
  • [0013]
    Accordingly, an object of the present invention is to provide an extracorporeal circulation support system that occludes the aorta and directly vents the left ventricle.
  • [0014]
    Another object of the present invention is to provide an extracorporeal circulation support system with a vent lumen that directly vents the left ventricle.
  • [0015]
    A further object of the present invention is to provide an extracorporeal circulation support system coupled to the blood circulation and directly vents the left ventricle.
  • [0016]
    Still another object of the present invention is to provide a method for directly venting the left ventricle.
  • [0017]
    These and other objects of the invention are provided in an extracorporeal support system coupled to the blood circulation. An extracorporeal support apparatus and an arterial circulation support catheter are provided. The arterial circulation support catheter includes a blood lumen with a proximal end coupled to the extracorporeal support apparatus and a distal end inserted into the blood circulation. A vent lumen has a distal end that crosses the aortic valve into the left ventricle and provides direct venting of the left ventricle through the vent lumen. An arterial circulation support catheter occluding member is positioned in an interior or an exterior of the arterial circulation support catheter. A venous circulation support catheter includes a blood lumen with a proximal end coupled to the extracorporeal support apparatus and a distal end inserted into the blood circulation. A venous circulation support catheter occluding member is included and positioned in an interior or at an exterior of the venous circulation support catheter. The venous circulation support catheter occluding member occludes the superior vena cava and the inferior vena cava.
  • [0018]
    In another embodiment, a method for venting the left ventricle of the heart is disclosed. An extracorporeal circulation support system is provided and includes an extracorporeal support apparatus, a venous circulation support catheter, an arterial circulation support catheter and a vent lumen. The arterial circulation support catheter and venous circulation support catheter are introduced into the blood circulation. A vent lumen distal end is positioned in the left ventricle, and the left ventricle is directly vented through the vent lumen.
  • [0019]
    An arterial circulation support catheter occluding member lumen can be coupled to the arterial circulation support catheter occluding member and positioned in the arterial circulation support catheter. The arterial circulation support occluding member can be slideably positioned in the blood lumen or in the arterial circulatory support occluding member lumen. The arterial circulation support catheter occluding member can be one or more clamps or balloons.
  • [0020]
    A venous circulation support catheter occluding member lumen can be coupled to the venous circulation support catheter occluding member and positioned in the venous circulation support catheter. The venous circulation support catheter occluding member can be slideably positioned in the venous circulation support catheter blood lumen or in the venous circulation support catheter occluding member lumen.
  • [0021]
    The arterial circulation support catheter may include an infusion lumen with a distal end that introduces an infusion medium into the aortic root. The infusion lumen may be positioned in the interior of the arterial circulation support catheter, at the exterior of the arterial circulation support catheter, in the blood lumen adjacent to the blood lumen or in the arterial circulation support catheter adjacent to the blood lumen.
  • [0022]
    The venous circulation support catheter may also include an infusion lumen that introduces an infusion medium into the venous circulation. The infusion lumen can be positioned in the interior of the venous circulation support catheter, at the exterior of the venous circulation support catheter, in the blood lumen or in the venous circulation support catheter adjacent to the blood lumen. Inclusion of the infusion lumen permits the introduction of an incision medium into the venous circulation and may also vent mediums from the venous circulation and/or the right heart either simultaneously or at alternate times.
  • [0023]
    An intervention al lumen, for the introduction of a diagnostic or therapeutic device into the blood circulation, may be positioned in an interior or exterior of the arterial circulation support catheter or in the blood lumen.
  • BRIEF DESCRIPTION OF THE FIGURES
  • [0024]
    [0024]FIG. 1 is a schematic drawing illustrating the extracorporeal circulation support system of the present invention used for venting the left ventricle.
  • [0025]
    [0025]FIG. 2 is a schematic drawing of an arterial circulation support catheter inserted into the subclavian artery.
  • [0026]
    [0026]FIG. 3 is a schematic drawing illustrating positioning of the arterial and venous circulation support catheters of the present invention to achieve extracorporeal circulation support.
  • [0027]
    FIGS. 4(a) through 4(d) are cross-sectional views of different arterial circulation support catheters of the present invention.
  • [0028]
    FIGS. 5(a) through 5(c) are cross-sectional views of different venous circulation support catheters of the present invention.
  • [0029]
    [0029]FIG. 6 is a cross-sectional view of an arterial circulation support catheter.
  • [0030]
    [0030]FIG. 7 is a cross-sectional view of a distal end of a venous circulation support catheter.
  • [0031]
    [0031]FIG. 8 is a phantom and part cross-sectional view of an embodiment of, an arterial circulation support catheter of the present invention.
  • [0032]
    [0032]FIG. 9 is a schematic view illustrating an arterial circulation support catheter of the present invention inserted directly in the descending aorta.
  • [0033]
    [0033]FIG. 10 is a schematic view illustrating an arterial circulation support catheter inserted through the femoral artery and a venous circulation support catheter occluding the superior and inferior vena cava.
  • DETAILED DESCRIPTION
  • [0034]
    For purposes of this specification, venting is a method for decompressing or unloading a specific compartment of the circulation system. Typically, venting is the decompression of blood from a heart chamber. The left side of the heart is where oxygenated blood is introduced into the arterial system. The right side of the heart is where deoyxgenated blood is introduced into the pulmonary system. The patient may be a human, an animal or a simulator.
  • [0035]
    Extracorporeal support system of the present invention can be used for a variety of procedures, both in the field of cardiology, as well as elsewhere in a patient. Cardiology applications (with a beating or non-beating heart) include but are not limited to, (i) CABG, (ii) congenital defects of the heart, (iii) valve repair and replacement, (iv) valvoplasty, (v) coronary bypass, (vi) heart venting, (vii) heart isolation and (viii) other procedures that are facilitated with heart venting without blood flowing into the heart chambers. The extracorporeal support system of the present invention is used with primary and reoperative surgical procedures as well as a life support system.
  • [0036]
    An extracorporeal support system, denoted as 10, is inserted in the blood circulation. An extracorporeal support apparatus 12 provides for the delivery of re-oxygenated blood to the blood circulation and in one embodiment includes an outlet port 14 for the delivery of re-oxygenated blood to the arterial circulation, and an inlet port 16 for receiving blood from the venous circulation. Extracorporeal support apparatus 12 can be a heart-lung apparatus, left ventricular assist device, roller pump, centrifugal device and the like. An arterial circulation support catheter 18 and a venous circulation support catheter 20 are provided. In one embodiment, arterial circulation support catheter 18 comprises a first flexible cannula 18′ and a second flexible cannula 18″. A proximal end 22 of arterial circulation support catheter 18 can be coupled to outlet port 14, and a distal end 24 is introduced into the blood circulation including but not limited to the arterial circulation. distal end 24 extends proximally to at least an occluding member coupled to arterial circulatory support catheter 18. A proximal end 26 of venous circulation support catheter 20 may be coupled to inlet port 16, and a distal end 28 is introduced into the blood circulation, including but not limited to the venous circulation.
  • [0037]
    Extracorporeal support apparatus 12 provides oxygenation and heating or cooling for blood and in one embodiment includes a bubble oxygenator 30, which incorporates a heat exchanger and an arterial reservoir, an arterial filter and line pressure monitor 32, and a pump 34 from which oxygenated blood is returned to arterial circulation as shown by arrow C. A method to stop or start the heart may include a fibrillation and defibrillation apparatus coupled to the heart.
  • [0038]
    First flexible cannula 18′may be selectively placed in communication with a pump 33. This pump may also provide for the delivery of a cardioactive agent 37 to the aortic root through one or more orifices 35 contained in distal end 24, or for venting blood from the aortic root Vented blood need not be returned to extracorporeal support apparatus 12. In one method the path of returned blood is shown by arrow D through a cardiotomy reservoir return line to bubble oxygenator 30 and a heat exchanger. The vented blood is thereafter oxygenated and then delivered to a pump 34 where it is returned into arterial circulation as shown by arrow C. In another method the path of blood extracted from the left ventricle is reintroduced into the arterial system distal to an arterial circulation support catheter occluding member.
  • [0039]
    In one embodiment, arterial circulation support catheter 18 may be minimally invasively inserted directly into the aorta This technique may require inserting a thorascope through an intercostal incision. The descending thoracic aorta and distal arch are identified. The thorascope is further utilized to obtain an actual image of the cardiac anatomic structure.
  • [0040]
    Specifically and without limiting the scope of the present invention, the technique described in the preceding paragraph is used to assist the surgeon in fashioning a pair of circular tourniquet purse string sutures at the sight selected for insertion of the catheter into the descending thoracic aorta. After the purse string sutures are fashioned, a side-biting vascular clamp is then applied to occlude and isolate the insertion site from the rest of the aorta. This maneuver prevents bleeding when the catheter is advanced through a hole made in the center of the purse strings. After the catheter is advanced through the hole, the tourniquets are drawn taunt to snugly seal the aortic tissue around the catheter entry site. The side-biting vascular clamp is then removed.
  • [0041]
    In another method to create the arteriotomy, a device is used which can facilitate the introduction and closure of the arteriotomy.
  • [0042]
    Arterial circulation support catheter 20 allows distal end 24 to transverse the aortic valve where distal end 24 has one or more openings for venting the left ventricle. Extracorporeal circulation support can be achieved with venous circulation support catheter 20 remotely inserted into the veins. Preferably, the insertion is in the femoral vein. Venous circulation support catheter 20 is then advanced and positioned at the atrio-caval junction by ultrasound or fluoroscopic techniques. To achieve delivery of blood into arterial circulation, one or more arterial catheters may be inserted peripherally into arterial vessels and then advanced and positioned in the aorta, or directly inserted into the aorta by utilizing purse string sutures and the like.
  • [0043]
    As illustrated in FIG. 2, arterial circulation support catheter 18 is inserted in subclavian artery 36. Arterial circulation support catheter 18 and venous circulatory support catheter 20 may be manipulated with a joy stick, steerable and non-steerable guide wires, and the like. In one embodiment arterial circulation support catheter 18 is steered by a joy stick 38 into aortic arch 40 such that a first opening 42 of arterial circulation support catheter 18 is positioned adjacent to the descending or thoracic aorta 44. This permits the flow of oxygenated blood from extracorporeal support apparatus 12 into the arterial circulation. First flexible cannula 18′ is slideably extendable from second flexible cannula 18″ and has one or more occluding members 46, which can be clamps, balloons, and the like, positioned in an interior or exterior of arterial circulation support catheter 18 adjacent to distal end 24. For purposes of this specification, and without limitation, occluding member 46 shall hereafter be referred to as balloon 46. In one embodiment, distal end 24 is spaced a sufficient fixed distance from balloon 46 to transverse aortic valve 48. In another embodiment distal end 24 is positioned directly adjacent to balloon 46. Because of the slidable relationship of first and second flexible cannulas 18′ and 18″ the distance between balloon 46 and a second balloon (if included) can be varied. This slidable relationship permits arterial circulation support catheter 18 to be used with a greater spectrum of patients.
  • [0044]
    In a further embodiment, distal end 24 is extendable distally relative to balloon 46 to permit distal end 24 to be advanced across aortic valve 48 and into left ventricle 50. Balloon 46 may be positioned-in the ascending aorta by utilizing ultrasound or fluoroscopic imagery. One or more apertures can be formed in distal end 24 to introduce a variety of different cardioactive agents.
  • [0045]
    Referring now to FIG. 3, venous circulation support catheter 20 is inserted peripherally into the femoral vein and advanced with the use of a joy stick, guide wire and the like. In one embodiment, to assist the surgeon in locating distal end 24, and also to position balloon 46 in the aortic arch, a sensor is fixed adjacent to distal end 24. The sensor can be made of an ultrasonic reflective material, coated with a piezoelectric or other material, or may be a radiopaque marker for fluoroscopically imaging distal end 24. One or more sensors are fixed to second flexible cannula 18″ adjacent to proximal and distal ends of balloon 46 respectively.
  • [0046]
    Venous circulation support catheter 20 is then positioned by ultrasound, Doppler, electromagnetic mark, fluoroscopy, and the like such that distal end 28 extends into superior vena cava 54. Superior vena cava 54 is occluded by a first occluding member 56 which is located adjacent to distal end 28 and placed cephalad to atrio-caval junction 58. An optional second occluding member 60 is coupled to venous circulation support catheter 20 and spaced proximally from first occluding member 56 either in a fixed or adjustable relationship. First and second occluding members 56 and 60 can be balloons, clamps, deployment devices including but not limited to umbrellas and the like, positioned both at the interior and exterior of venous circulation support catheter 20, and the like.
  • [0047]
    For purposes of this specification, and without limitation, occluding members 46, 56 and 60 will hereafter be called a balloon. Suitable balloon materials include but are not limited to, silicon rubber, polyuretane, latex nylon, polyamide, polyethylene and the like. First and second flexible cannulas 18′ and 18″ may be made of silicon rubber, polyvinyl chloride, polyurethane, ethylene, nylon and the like. Inflation of balloons 56 and 60, as well as balloon 46 may be achieved through the injection of a saline solution or other biocompatible fluid by a syringe through lumens contained within the respective catheters 18 and 20. Instead of a fluid, a gas including but not limited to CO2 may be used.
  • [0048]
    Second balloon 60 is positioned proximately of atrio-caval junction 58 to occlude inferior vena cava 62. First and second balloons 56 and 60 straddle atrio-cava junction 58 and when inflated isolate the heart from blood flow into the right atrium of the heart. Arrows A illustrate the blood flow from superior vena cava 54 through one or more venous orifices 64 which are located in distal end 28 of venous circulation support catheter 20. Venous orifice 64 communicates with the axially extending blood lumen 66 and provide a flow path to extracorporeal support apparatus 12.
  • [0049]
    Extracorporeal circulation support during heart surgery requires the insertion of venous circulation support catheter 20 through a peripheral vein access site and thereafter positioning distal venous return ports of catheter 20 in superior and inferior vena cava 54 and 62 at atrio-caval junction 58. Venous circulatory support catheter 20 contains one or more balloons 56 and/or 59 that allow the choice of either partial or total heart isolation. Total heart isolation occurs if balloon 56, and/or the combination of balloons 56 and 60, completely occluded both inferior and superior vena cava 62 and 54, thereby preventing blood flow into the right atrium.
  • [0050]
    An insertion site for venous circulation support catheter 20 may be the femoral vein, iliac vein, subclavian vein, axillary vein, or internal jugular vein. Insertion of venous circulation support catheter 20 through a peripheral vein access site avoids, (i) the necessity for a major chest incision to expose the heart and (ii) eliminates the surgical trauma that would occur to the right atrium, superior vena cava 54, and inferior vena cava 62. This procedure eliminates costly surgical instruments, tourniquets and reduces the operative time associated with conventional approaches to extracorporeal circulation support.
  • [0051]
    To provide blood in arterial circulation, arterial circulation support catheter 18 is inserted peripherally into arterial vessels to permit first flexible cannula 18′ to be advanced through the vessel into the ascending aorta. In one embodiment, arterial circulation support catheter 18 carries balloon 46 proximately of distal end 24 for occluding the aorta after balloon 46 is positioned in the ascending aorta cephalad of the junction of the coronary arteries in the aortic root. Arterial circulation support catheter 18 is then connected to extracorporeal support apparatus 12 which is then activated to permit oxygenated blood to be delivered to arterial circulation Cardioactive agents may be infused into the aortic root to arrest the heart. Additionally, contrast agents may also be introduced to visualize coronary structures. Balloons 56 and 60 of venous circulation support catheter 20 are expanded sufficiently to preclude blood flow from inferior and superior vena cava 62 and 54 into the right atrium. Total extracorporeal circulation support is achieved. If the vena cava is not totally occluded by complete inflation of one or both of balloons 56 and 60 the result is partial isolation of the heart.
  • [0052]
    In one embodiment, a pair of venous sensors are carried by venous circulation support catheter 20 and located at the distal and proximal ends of first balloon 56. These sensors may be made of a material that is reflective of ultrasound or coated with a piezoelectric or other material. The piezoelectric material may generate an electric signal for transmission to a catheter system interface. The transmission is then presented on a monitor to assist the surgeon in visualizing the distal and proximal ends of first balloon 56 during its passage through the femoral vein and ultimate positioning in atrio-caval junction 58. Alternatively, the sensors may be radiopaque markers for use in fluoroscopically imaging the location of balloon 56. Other methods of imaging known in the art may also be used.
  • [0053]
    Inferior vena cava 62 is occluded by the inflation of second balloon 60. Blood flowing toward the right atrium after balloon 60 is inflated is precluded from flowing past balloon 60 and enters venous circulation support catheter 20 through venous return ports 68. The blood is then transported directly to extracorporeal support apparatus 12.
  • [0054]
    Arterial circulation support catheter 18 may include one or more different lumens which may provide for the introduction and expulsion of blood to and from the arterial circulation.
  • [0055]
    As illustrated in FIGS. 4(a) to 4(d) , a variety of lumens can be included and positioned in an interior or at an exterior of arterial circulation support catheter. These lumens can include, (i) a vent lumen 72, (ii) a blood lumen 74, (iii) an infusion lumen 76, and an intervention lumen 78. Vent lumen 72 is used to directly vent blood from left ventricle 50, introduce fluids or other devices. An inflation lumen coupled to balloon 46 may also be includes
  • [0056]
    Vent lumen 72 has a distal end that crosses the aortic valve into left ventricle 50. Vent lumen 72 may also be utilized as an infusion lumen and/or introduce devices. Arterial circulation support catheter 18 can be a blood lumen, or alternatively include a separate blood lumen 74 which can be positioned adjacent to vent lumen 72, infusion lumen 76 or intervention lumen 78.
  • [0057]
    Infusion lumen 76 and intervention lumen 78 can be positioned in blood lumen 74. Infusion lumen 76 can introduce a variety of different infusion mediums into the arterial circulation. Suitable infusion mediums include but are not limited to, a cardio-active agent, one or more contrast agents, an iontropic agent, and the like. Infusion lumen 76 may introduce the infusion medium into the aortic root and also be used to vent from the aortic root either simultaneously or at alternate times. Intervention lumen 78 introduces a variety of different diagnostic or therapeutic devices into the arterial circulation.
  • [0058]
    Referring now to FIGS. 5(a) through 5(c), venous circulation support catheter 20 can include a blood lumen 80, an infusion lumen 82, an intervention lumen 84 and a vent lumen 86. The functions of blood lumen 80, infusion lumen 82, intervention lumen 84 and vent lumen 86 are substantially the same as their equivalent lumens associated with arterial circulation support catheter 18. Each of the lumens can be positioned in an interior or at an exterior of venous lumen 20. Venous circulation support catheter 20 can be a blood lumen. Alternatively, a separate blood lumen 80 can be positioned in an interior of venous circulation support catheter 20. Infusion lumen 82 introduces an infusion medium into the venous circulation, and can be positioned adjacent to or in blood lumen 80. Intervention lumen 84 may also be positioned adjacent to or in blood lumen 80. Additionally, an inflation lumen can be coupled to balloon 56 and/or 60.
  • [0059]
    By reference now to FIG. 6, it can be seen that first flexible cannula 18′ may have four steering lumens 92 which extend in part axially through flexible cannula 18′ to permit steering wires 94 to pass through first flexible cannula 18′ in slidable relationship where the distal ends of the steering wires 94 are connected to the distal end of the first flexible cannula 18′. Through the manipulation of joy stick 38 appropriate linkage permits steering wires 94 to be placed in tension relative to each other This permits distal end 24 of arterial circulation support catheter 18 to articulate.
  • [0060]
    A clearance exists between first flexible cannula 18′ and second flexible cannula 18″ to permit flexible cannula 18′ to be advanced through second flexible cannula 18″. Movement in either direction can induce the slidable advancement of first cannula 18′ within second cannula 18″. This arrangement permits the surgeon to position first opening 42 of second flexible cannula 18″ in aortic arch 40 and thereafer to slide first cannula 18′ relative to second cannula 18″ and position occluding member 46 in the aortic root. In one embodiment a first sensor is carried by first flexible cannula 18′ proximally of balloon 46 and a second sensor is positioned at the distal end of balloon 46 where the sensors may be made of material that efficiently reflects ultrasonic waves.
  • [0061]
    Ultrasound waves are detectable by a device such as a transesophageal echo device 96 (FIG. 2) for a clear presentation of the extremities of balloon 46. This provides a more precise positioning of balloon 46 in aortic arch 40 cephalid of the junction of the coronary arteries. Fluoroscopic imaging, Doppler, electromagnetic positioning, and other methods may also be used to positioned the catheters.
  • [0062]
    Other embodiments of arterial circulation support catheter 18 may utilize a reflective material to promote fluoroscopic imaging of balloon 46 extremities to achieve proper positioning in the aortic root. Suitable reflective materials include barium sulfate, bismuth subcarbonate and the like. First and second flexible cannulas 18′ and 18″ may also be in part, (i) impregnated with materials for positioning and visualization, including but not limited to radiopaque materials such as barium sulfate, bismuth subcarbonate or iodine containing molecules, (ii) impregnated with tungsten, (iii) include materials to enhance performance characteristics including but not limited to fillers such as plasticizer or other pigmentation or anti-oxidants, or (iv) coated with blood physiology agents, and other agents and materials to promote visualization of arterial circulation support catheter 18 and balloon 46 within the arterial vessel and aortic wall.
  • [0063]
    Another embodiment of venous catheter 20 is shown in FIG. 7 which permits the spacing between first and second balloons 56 and 60 to be adjustable. Only a single balloon need be used This enhances venous circulation support catheter's 20 universality of use.
  • [0064]
    In this embodiment, venous circulation support catheter 20 is comprised of a first flexible cannula 20′ which is in part slideably contained for slidable axial movement relative to a second flexible cannula 20″. Because of the slideable relationship of the first and second flexible cannulas 20′ and 20″ the distance bet first balloon 56 and second balloon 60 can be varied. This slidable relationship permits venous circulation support catheter 20 to be used with a greater spectrum of patients.
  • [0065]
    Venous circulation support catheter 20 has one or more orifices 64 located in distal end 28 which redirect blood flowing through superior vena cava 54 toward the right atrium where The blood is transported through venous circulation support catheter 20 to extracorporeal support apparatus 12. Blood flowing through inferior vena cava 62 is prevented from reaching the right atrium by the inflation of second balloon 60. Blood flows through second venous return ports 70 into venous circulation support catheter 20 where the blood is transported to extracorporeal support apparatus 12. Distal end 28 of venous circulation support catheter 20 may have an associated distal sensor. The distal sensor may be coated with a piezoelectric material, made of a suitable ultrasound reflective material, or be a radiopaque marker for fluoroscopically imaging the location of distal end 28 of venous circulation support catheter 20. Additionally, one or more steering wires may be included to provide articulation and promote passage of venous circulation support catheter 20 through the venous circulation. Venous circulation support catheter 20 may include one or more different cavities or lumens which provide for the introduction and expulsion of blood to and from the venous circulation.
  • [0066]
    An embodiment illuming total isolation of the heart is shown in FIG. 10, described later on in this specification. Although not shown in the figures, isolation of the heart may be achieved by utilizing two venous circulation support catheters 20 of substantially identical construction. These catheters each have an inflatable balloon 60 at their distal ends 28. One of the catheters 20 is inserted through a peripheral vein the jugular vein for example, distal end 28 is advanced into superior vena cava 54 and positioned to occlude superior vena cava 54 at atrio-caval junction 58. Orifices located proximally of balloon 60 permit blood flowing toward the right atrium to be diverted into a lumen within venous circulation support catheter 20 for transport to extracorporeal support apparatus 12. Similarly, second venous circulation support catheter 20 is inserted through the femoral vein and advanced and positioned in inferior vena cava 62 at atrio-caval junction 58. Balloon 60 is then inflated and blood flow redirected through one or more orifices located proximally of balloon 60 to extracorporeal support apparatus 12.
  • [0067]
    Arterial circulation support catheter 18 of FIG. 8 provides an extended distal end 24 which may pass across aortic valve 48 and into left ventricle 50 to provide direct venting. A cardioactive agent 37 can be delivered into the aortic root, as in the above-described embodiments of arterial circulation support catheter 18, or the same flow path may be used for aspiration of the aortic root. Extended distal end 24 of arterial circulation support catheter 18 is positioned in aortic arch 40 after balloon 46 where first flexible cannula 18′ is extendable from second flexible cannula 18″. One or more flow lumens are included in first flexible cannula 18′ to provide for blood venting from left ventricle 50 to extracorporeal support apparatus 12.
  • [0068]
    A specific embodiment for venting using arterial circulation support catheter circuit 98 is illustrated in FIG. 9. These elements provide for injection of cardioactive agent 37, venting of the aortic root, balloon 46 inflation and deflation, arterial circulation of blood from the bypass pump, and left ventricle 50 decompression. Arterial circulation support catheter 18 may also be inserted into ascending aortic arch 40 after a sternotomy has been performed and the heart exposed.
  • [0069]
    Distal end 24 is positioned in left ventricle 50 where blood may be suctioned through one or more arterial venting orifices 106. Arterial circulation support catheter 18 allows blood in left ventricle 50 to be vented. Simultaneously, blood present in the aortic root may also be vented through one or more venting orifices 102. Cardioactive agent 37 may thereafer be infused through venting orifice 102 through a vent lumen 72, and the solution will flow into the coronary arteries and stop the heart.
  • [0070]
    [0070]FIG. 10 illustrates an embodiment where total isolation of the heart is achieved. Arterial circulation support catheter 18 is advanced through the femoral artery and positioned such that balloon 46 may be inflated to occlude the aorta cephalad of the aortic root. Oxygenated blood is then delivered through blood lumen 74, or alternatively through vent lumen 72, into arterial circulation. Vent lumen 72, blood lumen 74 or infusion lumen 76 delivers cardioactive agent 37 to arrest the heart, provide venting the aortic root and provide extension of distal end 24 into left ventricle 50 across the aortic valve. This permits decompression of left ventricle 50 before the right atrium is isolated by inflation of balloon 56 and/or balloons 56 and 60.
  • [0071]
    Another method for providing extracorporeal circulation support during heart surgery includes using two arterial circulation support catheters 18. Both are advanced into aortic arch 40. Venous circulation support catheter 20 is then positioned to preclude blood flow into the right atrium. Passage of blood from the aortic root into the systemic arterial circulation is occluded. Cardioactive agent 37 is then infused into the aortic root to arrest the heart and the aortic root is then vented. The right atrium and the heart are isolated. Total heart isolation is achieved.
  • [0072]
    The foregoing description of a preferred embodiment of the invention has been presented for purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise forms disclosed. Obviously, many modifications and variations will be apparent to practitioners skilled in this art. It is intended that the scope of the invention be defined by the following claims and their equivalents.
Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US150960 *22 Oct 187319 May 1874 Improvement in machinery for polishing buttons
US280225 *6 Apr 188326 Jun 1883 Missotjei
US299622 *17 Aug 18833 Jun 1884 Refrigerating apparatus
US2029236 *24 Apr 193428 Jan 1936Werner KlophausCombination pen and calendar
US2308484 *16 Jan 193919 Jan 1943Davol Rubber CoCatheter
US3326648 *25 Apr 196320 Jun 1967Philips CorpMethod of providing a black layer on a metal object
US3385300 *10 Aug 196528 May 1968Holter CompanyCervical cannula
US3635223 *2 Dec 196918 Jan 1972Us Catheter & Instr CorpEmbolectomy catheter
US3788328 *29 Apr 197129 Jan 1974Sherwood Medical Ind IncCardiovascular catheter
US4000739 *9 Jul 19754 Jan 1977Cordis CorporationHemostasis cannula
US4019515 *8 Dec 197526 Apr 1977Daniel KornblumEnemata administering device
US4154227 *11 Oct 197715 May 1979Krause Horst EMethod and apparatus for pumping blood within a vessel
US4204328 *14 Nov 197727 May 1980Kutner Barry SVariable diameter aspirating tip
US4248224 *1 Aug 19783 Feb 1981Jones James WDouble venous cannula
US4323071 *19 May 19806 Apr 1982Advanced Catheter Systems, Inc.Vascular guiding catheter assembly and vascular dilating catheter assembly and a combination thereof and methods of making the same
US4327709 *18 Oct 19794 May 1982Datascope Corp.Apparatus and method for the percutaneous introduction of intra-aortic balloons into the human body
US4328056 *9 Jul 19804 May 1982Sherwood Medical Industries Inc.Method of making a cuffed tube
US4439186 *17 Aug 198227 Mar 1984Adolf KuhlDilation device
US4441495 *16 Aug 198210 Apr 1984Becton, Dickinson And CompanyDetachable balloon catheter device and method of use
US4451251 *30 Sep 198229 May 1984Thomas Jefferson UniversityStroke treatment utilizing extravascular circulation of oxygenated synthetic nutrients to treat tissue hypoxic and ischemic disorders
US4493697 *14 Aug 198115 Jan 1985Krause Horst EMethod and apparatus for pumping blood within a vessel
US4496345 *30 Aug 198229 Jan 1985Hasson Harrith MBallooned cannula
US4497325 *15 Jul 19825 Feb 1985Wedel Victor JUltrasound needle, biopsy instrument or catheter guide
US4512762 *23 Nov 198223 Apr 1985The Beth Israel Hospital AssociationMethod of treatment of atherosclerosis and a balloon catheter for same
US4573966 *24 Nov 19824 Mar 1986Schneider Medintag AgMethod and apparatus for removing and/or enlarging constricted areas in vessels conducting body fluids
US4574803 *17 Feb 198111 Mar 1986Karl StorzTissue cutter
US4580568 *1 Oct 19848 Apr 1986Cook, IncorporatedPercutaneous endovascular stent and method for insertion thereof
US4639252 *5 Apr 198527 Jan 1987Research Medical, Inc.Venous return catheter
US4648384 *21 Nov 198410 Mar 1987Schmukler Robert ERetrograde coronary sinus perfusion device and method
US4664125 *30 May 198612 May 1987Pinto John GFlow-occluding method for the diagnosis of heart conditions
US4721109 *8 Apr 198626 Jan 1988Healey Maureen ATemporary anastomotic device
US4722347 *8 Jun 19872 Feb 1988Applied Biometrics, Inc.Apparatus for measuring cardiac output
US4723936 *22 Jul 19869 Feb 1988Versaflex Delivery Systems Inc.Steerable catheter
US4733665 *7 Nov 198529 Mar 1988Expandable Grafts PartnershipExpandable intraluminal graft, and method and apparatus for implanting an expandable intraluminal graft
US4741328 *14 Mar 19853 May 1988Shlomo GabbayMeans for intraaortic assist and method of positioning a catheter therefor
US4794928 *10 Jun 19873 Jan 1989Kletschka Harold DAngioplasty device and method of using the same
US4796629 *3 Jun 198710 Jan 1989Joseph GrayzelStiffened dilation balloon catheter device
US4798588 *27 Mar 198717 Jan 1989Rene AillonCentral venous pressure catheter and method for using
US4804358 *20 Feb 198614 Feb 1989Medicorp Research Laboratories CorporationCoronary perfusion pump
US4804365 *13 Feb 198714 Feb 1989C. R. BardVascular cannulae for transfemoral cardiopulmonary bypass and method of use
US4808165 *3 Sep 198728 Feb 1989Carr Ann MInflation/deflation device for balloon catheter
US4809681 *30 Mar 19877 Mar 1989Aisin Seiki Kabushiki KaishaElectrocardiographic measurement method for controlling an intra-aortic balloon pump
US4811737 *16 Nov 198714 Mar 1989Schneider-Shiley (Usa) Inc.Self-purging balloon catheter
US4821722 *6 Jan 198718 Apr 1989Advanced Cardiovascular Systems, Inc.Self-venting balloon dilatation catheter and method
US4830849 *14 Apr 198816 May 1989Thomas Jefferson UniversityExtravascular circulation of oxygenated synthetic nutrients to treat tissue hypoxic and ischemic disorders
US4890825 *15 Jan 19882 Jan 1990Emf CorporationPaper sheet stacking and jogging apparatus
US4898168 *9 Jan 19896 Feb 1990Smiths Industries Public Limited CompanyInflation indicators for cuffed tubes
US4902272 *17 Jun 198720 Feb 1990Abiomed Cardiovascular, Inc.Intra-arterial cardiac support system
US4902273 *22 Mar 198820 Feb 1990Choy Daniel S JHeart assist device
US4911163 *16 Jun 198727 Mar 1990Ernesto FinaTwo ballooned catheter device for diagnostic and operative use
US4917667 *9 Jan 198917 Apr 1990Retroperfusion Systems, Inc.Retroperfusion balloon catheter and method
US4923450 *30 Jun 19888 May 1990Karo MaedaMedical tubes for placement into the body of a patient
US4927412 *8 Dec 198822 May 1990Retroperfusion Systems, Inc.Coronary sinus catheter
US4985014 *11 Jul 198915 Jan 1991Orejola Wilmo CVentricular venting loop
US4986830 *22 Sep 198922 Jan 1991Schneider (U.S.A.) Inc.Valvuloplasty catheter with balloon which remains stable during inflation
US4990143 *9 Apr 19905 Feb 1991Sheridan Catheter CorporationReinforced medico-surgical tubes
US4994032 *29 Nov 198819 Feb 1991Terumo Kabushiki KaishaBalloon catheter
US4994033 *25 May 198919 Feb 1991Schneider (Usa) Inc.Intravascular drug delivery dilatation catheter
US5007896 *16 Mar 198916 Apr 1991Surgical Systems & Instruments, Inc.Rotary-catheter for atherectomy
US5009636 *6 Dec 198923 Apr 1991The Kendall CompanyDual-lumen catheter apparatus and method
US5011468 *16 Apr 199030 Apr 1991Retroperfusion Systems, Inc.Retroperfusion and retroinfusion control apparatus, system and method
US5011469 *29 Aug 198830 Apr 1991Shiley, Inc.Peripheral cardiopulmonary bypass and coronary reperfusion system
US5011488 *20 Aug 199030 Apr 1991Robert GinsburgThrombus extraction system
US5013296 *21 Sep 19897 May 1991Research Medical, Inc.Antegrade cardioplegia cannula
US5080660 *11 May 199014 Jan 1992Applied Urology, Inc.Electrosurgical electrode
US5089015 *28 Nov 198918 Feb 1992Promedica InternationalMethod for implanting unstented xenografts and allografts
US5106368 *20 Apr 199021 Apr 1992Cook IncorporatedCollapsible lumen catheter for extracorporeal treatment
US5109859 *4 Oct 19895 May 1992Beth Israel Hospital AssociationUltrasound guided laser angioplasty
US5112305 *16 Oct 199012 May 1992Cedars-Sinai Medical CenterCatheter device for intramural delivery of therapeutic agents
US5116305 *23 Oct 199126 May 1992Abiomed, Inc.Curved intra aortic balloon with non-folding inflated balloon membrane
US5176619 *5 May 19895 Jan 1993Jacob SegalowitzHeart-assist balloon pump with segmented ventricular balloon
US5186713 *1 Nov 199016 Feb 1993Baxter International Inc.Extracorporeal blood oxygenation system and method for providing hemoperfusion during transluminal balloon angioplasty procedures
US5197952 *13 Jun 199030 Mar 1993Dlp, Inc.Auto-inflating catheter cuff
US5275622 *13 Jul 19904 Jan 1994Harrison Medical Technologies, Inc.Endovascular grafting apparatus, system and method and devices for use therewith
US5290231 *4 Sep 19921 Mar 1994Dlp, Inc.Auto-inflating catheter cuff
US5295958 *4 Apr 199122 Mar 1994Shturman Cardiology Systems, Inc.Method and apparatus for in vivo heart valve decalcification
US5308320 *28 Dec 19903 May 1994University Of Pittsburgh Of The Commonwealth System Of Higher EducationPortable and modular cardiopulmonary bypass apparatus and associated aortic balloon catheter and associated method
US5312344 *9 Aug 199317 May 1994Grinfeld Roberto RArterial perfusion cannula for extracorporeal circulation and other uses
US5314418 *9 Sep 199324 May 1994Toyo Boseki Kabushiki KaishaCannula
US5380282 *21 Sep 199310 Jan 1995Scimed Life Systems, Inc.Balloon catheter assembly
US5382239 *24 Apr 199217 Jan 1995Becton, Dickinson And CompanyRepositional catheter fixation device
US5383854 *19 Aug 199224 Jan 1995University Of Pittsburgh Of The Commonwealth System Of Higher EducationPortable and modular cardiopulmonary bypass apparatus and associated aortic balloon catheter and associated method
US5385548 *22 Apr 199331 Jan 1995Dlp, Inc.Balloon catheter for retrograde perfusion
US5395330 *4 Sep 19927 Mar 1995Dlp, Inc.Auto-inflating catheter cuff
US5395331 *23 Feb 19937 Mar 1995Minnesota Mining And Manufacturing CompanyRetrograde coronary sinus catheter having a ribbed balloon
US5397306 *23 Nov 199314 Mar 1995Terumo Kabushiki KaishaCatheter
US5397351 *13 May 199114 Mar 1995Pavcnik; DusanProsthetic valve for percutaneous insertion
US5411027 *27 May 19942 May 1995Wiklund; LarsEquipment and method for treating circulatory arrest
US5411552 *14 Jun 19942 May 1995Andersen; Henning R.Valve prothesis for implantation in the body and a catheter for implanting such valve prothesis
US5480424 *1 Nov 19932 Jan 1996Cox; James L.Heart valve replacement using flexible tubes
US5487730 *27 May 199430 Jan 1996Medtronic, Inc.Balloon catheter with balloon surface retention means
US5499996 *14 Mar 199419 Mar 1996Hill; John D.Blood vessel occlusion trocar
US5505698 *29 Oct 19939 Apr 1996Medtronic, Inc.Cardioplegia catheter with elongated cuff
US5509897 *15 Feb 199523 Apr 1996The Curators Of The University Of MissouriMultiple lumen catheter for hemodialysis
US5591129 *15 May 19957 Jan 1997Scimed Life Systems, Inc.Perfusion balloon angioplasty catheter
US5595181 *24 Mar 199421 Jan 1997Hubbard; A. RobertSystem for providing cardiac output and shunt quantitation
US5597377 *6 May 199428 Jan 1997Trustees Of Boston UniversityCoronary sinus reperfusion catheter
US5599329 *23 Feb 19944 Feb 1997Gabbay; ShlomoMulti purpose perfusion cannula
US5868703 *6 Dec 19969 Feb 1999Endoscopic Technologies, Inc.Multichannel catheter
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US811872326 Jan 200721 Feb 2012Thoratec CorporationPump-inflow-cannula, a pump-outflow-cannula and a blood managing system
US8241248 *1 Mar 201014 Aug 2012Cvdevices, LlcDevices and systems for selective auto-retroperfusion of the cerebral venous system
US86087244 Nov 201017 Dec 2013Broncus Medical Inc.Devices for delivering substances through an extra-anatomic opening created in an airway
US870903413 May 201129 Apr 2014Broncus Medical Inc.Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall
US878440016 May 201222 Jul 2014Broncus Medical Inc.Devices for delivering substances through an extra-anatomic opening created in an airway
US89323167 Apr 201413 Jan 2015Broncus Medical Inc.Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall
US9101711 *7 Oct 200711 Aug 2015Chi-Wei TaoIntravascular nano-bubbling oxygenator
US9108000 *4 Dec 201218 Aug 2015Cvdevices, LlcDevices, systems, and methods for auto-retroperfusion of the cerebral venous system
US934553211 May 201224 May 2016Broncus Medical Inc.Methods and devices for ablation of tissue
US942107018 Dec 201423 Aug 2016Broncus Medical Inc.Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall
US948622911 May 20128 Nov 2016Broncus Medical Inc.Methods and devices for excision of tissue
US953312831 Oct 20123 Jan 2017Broncus Medical Inc.Devices for maintaining patency of surgically created channels in tissue
US9724232 *13 Aug 20138 Aug 2017Cvdevices, LlcSystems and methods for selective auto-retroperfusion along with regional mild hypothermia
US9757545 *18 Aug 201512 Sep 2017Cvdevices, LlcDevices, systems, and methods for auto-retroperfusion of the cerebral venous system
US20060269444 *2 Jul 200430 Nov 2006Tomislav MihaljevicCardioscopy
US20070197855 *26 Jan 200723 Aug 2007Levitronix LlcPump-inflow-cannula, a pump-outflow-cannula and a blood managing system
US20090093751 *7 Oct 20079 Apr 2009Chi-Wei TaoIntravascular nano-bubbling oxygenator
US20100222738 *1 Mar 20102 Sep 2010Cvdevices, LlcDevices and systems for selective auto-retroperfusion of the cerebral venous system
US20130096494 *4 Dec 201218 Apr 2013Cvdevices, LlcDevices, systems, and methods for auto-retroperfusion of the cerebral venous system
US20130303832 *16 Apr 201314 Nov 2013Richard WamplerMethods and devices for treating heart failure
US20140052224 *13 Aug 201320 Feb 2014Ghassan S. KassabSystems and methods for selective auto-retroperfusion along with regional mild hypothermia
US20150352338 *18 Aug 201510 Dec 2015Cvdevices, LlcDevices, systems, and methods for auto-retroperfusion of the cerebral venous system
EP1825873A2 *7 Dec 200629 Aug 2007Levitronix LLCA pump-inflow-cannula, a pump-outflow-cannula and a blood managing system
EP1825873A3 *7 Dec 200626 Sep 2007Levitronix LLCA pump-inflow-cannula, a pump-outflow-cannula and a blood managing system
WO2015003183A1 *7 Jul 20148 Jan 2015Emory UniversityMethods for intracardiac surgery and intracardiac delivery of therapies and devices
Classifications
U.S. Classification604/6.14, 604/6.16, 604/4.01
International ClassificationA61M25/00, A61B17/00, A61F2/958, A61M1/10, A61M1/36
Cooperative ClassificationA61M1/1039, A61M1/1018, A61M1/1006, A61M25/0082, A61M25/007, A61M1/3659, A61M25/1011, A61M2210/125, A61M2025/004, A61M2025/0039, A61M1/10, A61M2025/1052, A61M2025/1015, A61M2025/0037, A61M2025/0036, A61M2025/0031, A61M25/0068
European ClassificationA61M25/10D, A61M1/10
Legal Events
DateCodeEventDescription
23 Jul 2003ASAssignment
Owner name: ENDOSURGICAL DEVELOPMENT CORP., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:SWEEZER, WILLIAM P.;LARKINS, WALTER W.;COLEMAN, RONALD;REEL/FRAME:013823/0482
Effective date: 19960607
Owner name: HEARTPORT INC., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:ENDOSURGICAL DEVELOPMENT CORP.;REEL/FRAME:013826/0812
Effective date: 19960924
21 Mar 2008ASAssignment
Owner name: EDWARDS LIFESCIENCES, LLC, CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:HEARTPORT, INC.;REEL/FRAME:020753/0153
Effective date: 20071219