Methods and devices for maintaining cardiopulmonary bypass and arresting a patient's heart

• US 20020176797A1
• Filed: 07/11/2002
• Published: 11/28/2002
• Est. Priority Date: 01/24/1997
• Status: Active Grant

• Current Assignee: Edwards Lifesciences LLC (Edwards Lifesciences Corporation)
• Original Assignee: Heartport, Inc. (Johnson & Johnson)
• Inventors: Roberts, Craig P., Fan, Sylvia W., Toomasian, John M.
• Granted Patent: US 6,974,434 B2
• Time in Patent Office: Days
• US Class Current: 422/44
• CPC Class Codes: A61M 1/3613 Reperfusion, e.g. of the coronary vessels, e.g. retroperfusion
• CPC Class Codes: A61M 1/3667 with assisted venous return
• CPC Class Codes: A61M 2025/0004 having two or more concentrically arranged tubes for forming a concentric catheter system
• CPC Class Codes: A61M 2025/0031 characterized by lumina for withdrawing or delivering, i.e. used for extracorporeal circuit treatment
• CPC Class Codes: A61M 2202/047 cardioplegic
• CPC Class Codes: A61M 2205/12 with interchangeable cassettes forming partially or totally the fluid circuit
• CPC Class Codes: A61M 2210/125 Heart
• CPC Class Codes: A61M 25/0021 characterised by the form of the tubing A61M25/0054 takes precedence
• CPC Class Codes: A61M 25/0032 characterized by at least one unconventionally shaped lumen, e.g. polygons, ellipsoids, wedges or shapes comprising concave and convex parts
• CPC Class Codes: A61M 25/007 Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
• CPC Class Codes: Y10S 128/03 Heart-lung

Abstract

An endovascular system for arresting a patient'"'"'s heart and maintaining the patient on cardiopulmonary bypass. A venous cannula, venting catheter and an aortic occlusion device are all coupled together so that the blood drawn into each of these catheters may be fed to a pump. A manifold has valves which control flows through the venous cannula, venting catheter and aortic occlusion device. A blood storage element is also provided so that the amount of blood in the perfusion circuit may be varied if necessary. The blood storage element is preferably positioned in parallel with the pump so that the pump may be used to add and remove blood to and from the blood storage element.

Claims

1. A method of withdrawing blood from a patient for use with a cardiopulmonary bypass system, comprising the steps of:

providing a venous cannula and a venting catheter, the venous cannula having a lumen and at least one opening in fluid communication with the lumen, the venting catheter also having a venting lumen with at least one opening in fluid communication with the venting lumen;

inserting the venous cannula into a vein of a patient;

passing the venting catheter through the patient'"'"'s tricuspid and pulmonary valves;

coupling the venous catheter and the venous cannula to a pump; and

withdrawing blood from the patient through the lumen of the venous cannula and the venting lumen of the venting catheter using the pump.

2. The method of claim 1, further comprising the step of:

inserting an arterial cannula into an artery of the patient, the arterial cannula having a lumen;

coupling the lumen of the arterial cannula to an outlet of the pump; and

returning the blood to the patient through the lumen of the arterial cannula using the pump.

3. The method of claim 2, further comprising the step of:

fluidly coupling a blood storage element to the outlet of the pump; and

selectively changing a volume of blood in the blood storage element.

4. The method of claim 1, wherein:

the providing step is carried out with the pump being a centrifugal pump.

5. The method of claim 1, further comprising:

inserting an aortic occlusion device into the patient;

passing the aortic occlusion device through the patient so that an occluding member on the aortic occlusion device is positioned in the ascending aorta;

expanding the occluding member so that the ascending aorta is occluded;

delivering cardioplegic fluid through a lumen in the aortic occlusion device;

coupling the lumen of the aortic occlusion device to the pump; and

venting blood from the patient through the lumen in the aortic occlusion device using the pump.

6. A method of withdrawing and returning blood to a patient supported by a cardiopulmonary bypass system, comprising the steps of:

passing a first lumen and a second lumen through an opening in a patient'"'"'s artery, the first lumen having an occluding member mounted thereto, the occluding member being movable between a collapsed condition and an expanded condition;

inserting a venous cannula into a vein of the patient;

coupling the venous cannula to a venous line;

withdrawing blood from the patient through the venous cannula and the venous line;

returning the blood to the patient through an arterial line coupled to the second lumen;

positioning the occluding member in the patient'"'"'s ascending aorta;

expanding the occluding member to occlude the patient'"'"'s ascending aorta delivering cardioplegic fluid through the first lumen to thereby arrest the patient'"'"'s heart;

providing a blood storage element having an inlet and an outlet;

fluidly coupling the inlet of the blood storage element to the arterial line; and

selectively changing a volume of blood in the blood storage element.

7. The method of claim 6, further comprising the step of:

providing a venting catheter;

passing the venting catheter through the patient'"'"'s tricuspid and pulmonary valves; and

withdrawing blood from the patient using the venting catheter.

8. The method of claim 6, further comprising the steps of:

coupling the outlet of the blood storage element to the venous line.

9. The method of claim 8, wherein:

the withdrawing step is carried out with the venous cannula being coupled to a pump.

10. The method of claim 6, wherein:

the providing step is carried out with the first lumen and second lumen being carried by a single device.

11. The method of claim 6, wherein:

the passing step is carried out with the first lumen being slidable relative to the second lumen.

13. The endovascular bypass system of claim 12, further comprising:

a pump having an inlet and an outlet; and

an exit line which receives blood passing through the first and second valves, the exit line being fluidly coupled to the pump inlet.

14. The endovascular bypass system of claim 12, further comprising:

an arterial cannula having a lumen for returning oxygenated blood to the patient;

an arterial line extending from the pump outlet to the lumen of the arterial cannula; and

a blood storage device having an inlet line and an outlet line, the inlet line being coupled to the arterial line.

15. The endovascular bypass system of claim 14, wherein:

the outlet line of the blood storage element is coupled to the manifold; and

the manifold having a third valve and a third valve controller for controlling the third valve, the third valve being positioned to regulate blood flow through the outlet line of the blood storage element.

16. The endovascular bypass system of claim 12, further comprising:

a bridge line extending between the arterial line and the second conduit.

18. The method of claim 17, wherein:

the blood returning step is carried out with the aortic occlusion device passing through the arterial cannula.

19. The method of claim 17, wherein:

the arterial cannula and aortic occlusion device are integrally formed.

20. The method of claim 17, further comprising:

fluidly coupling the venous cannula and the arterial cannula with a bridge.

12. An endovascular bypass system, comprising:

an aortic occlusion device having a lumen and an occluding member, the occluding member being sized and configured to occlude a patient'"'"'s ascending aorta;

a venous cannula having a lumen for withdrawing blood from the patient;

a manifold having first and second valves and first and second valve controls for controlling the first and second valves;

a vent line extending between the lumen of the aortic occlusion device to the manifold; and

a venous line extending from the venous cannula to the manifold;

the first and second valves being positioned to regulate flows through the first and second lines, respectively.

17. A method of arresting a patient'"'"'s heart and maintaining bypass support, comprising the steps of:

inserting a venous cannula into a vein of a patient;

coupling the venous cannula to an inlet of a pump, the pump having an outlet;

withdrawing blood from the patient through the venous cannula using the pump;

fluidly coupling the outlet of the pump to an arterial cannula through an arterial line;

returning blood to the patient through the arterial cannula;

inserting an aortic occlusion device through an artery of the patient, the aortic occlusion device having an occluding member;

expanding the occluding member in the patient'"'"'s ascending aorta thereby occluding the ascending aorta;

delivering cardioplegic fluid to the ascending aorta through a lumen in the aortic occlusion device; and

coupling the lumen of the aortic occlusion device to the pump intake.