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Cardioplegia catheter system
| Details |
Inventors: St. Goar, Frederick G.; Peters, William S.; Evard, Philip C.; Boyd, Stephen W.; Adams, Craig L.; Mueller, Jr., Richard L.; Stevens, John H.;
Assignee: Heartport, Inc. (Redwood City, CA)
Primary Examiner: Bockelman; Mark
Assistant Examiner: Smith; Chalin
Attorney, Agent or Firm: Townsend and Townsend and Crew LLP
A catheter system is provided for accessing the coronary ostia transluminally from a peripheral arterial access site, such as the femoral artery, and for inducing cardioplegic arrest by direct infusion of cardioplegic solution into the coronary arteries. In a first embodiment, the catheter system is in the form of a single perfusion catheter with multiple distal branches for engaging the coronary ostia. In a second embodiment, multiple perfusion catheters are delivered to the coronary ostia through a single arterial cannula. In a third embodiment, multiple perfusion catheters are delivered to the coronary ostia through a single guiding catheter. In a fourth embodiment, multiple catheters are delivered to the coronary ostia through a single guiding catheter which has distal exit ports that are arranged to direct the perfusion catheters into the coronary ostia. In each embodiment, the catheters are equipped with an occlusion means at the distal end of the catheter for closing the coronary ostia and isolating the coronary arteries from the systemic blood flow. The occlusion means can take the form of an inflatable occlusion balloon cuff, a tapered occlusion device or an O-ring encircling the distal end of the catheter. An optional ventricular venting catheter can be included in the system for venting blood and fluids from the left ventricle of the heart. The catheter system is combined with a femoral-to-femoral cardiopulmonary bypass system to provide a system for cardioplegic arrest and total cardiopulmonary support during minimally invasive cardiac surgical procedures. |
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DETAILED DESCRIPTION The present invention provides methods, systems and devices for inducing cardioplegic arrest and for isolating the coronary arteries from the systemic circulation to maintain cardioplegic arrest during cardiac surgery.
The devices take the form of one or more arterial catheters for introducing cardioplegic solution by direct antegrade perfusion into the coronary arteries and for occluding the coronary ostia so that blood from the systemic circulation cannot enter the coronary arteries.
The catheters, when combined with a cardiopulmonary bypass system, create a total cardiopulmonary bypass and myocardial protection system.
When a minimally invasive cardiopulmonary bypass system, such as a femoral-to-femoral cardiopulmonary bypass system, is used, total cardiopulmonary support is achieved without the need for grossly invasive surgical access to the heart.
In a first preferred embodiment, the invention provides a single arterial catheter for introduction through a peripheral artery access by arterial cutdown or by the Seldinger technique.
The single catheter has at least two distal branches which are adapted for selective intubation and occlusion of each of the coronary ostia.
Since there is considerable variability in the normal coronary anatomy of humans, the single catheter can be made in a number of different versions.
To accommodate most patients, the single catheter is made with two distal perfusion branches, one each for the right and left coronary ostia.
A second variation with three distal perfusion branches can be made for the occasional patient who has three significant coronary ostia, such as when the left anterior descending coronary artery and the circumflex artery originate separately from the aortic root.
For the rare cases in which a patient has all of the coronary arteries arising from a single coronary ostium, a single-ended catheter from one of the embodiments described below can be used.
Preferably, the length and diameter of the catheter are such that they allow the catheter to be introduced via the femoral artery
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