Expandable trans-septal sheath
First Claim
1. An expandable endovascular access sheath for providing minimally invasive access to a left atrium, comprising:
- an axially elongate sheath tube with a proximal end, a distal end, and a central through lumen, the sheath having a distal region which is expandable in circumference in response to outward pressure applied therein;
a hub coupled to the proximal end of the sheath tube, the hub configured to facilitate the passage of instrumentation;
an obturator that extend through the central lumen and which is configured to occlude the central lumen of the sheath during insertion, the obturator comprising an obturator hub that is releasably couples to the hub of the sheath; and
a guidewire lumen within the obturator;
wherein. the obturator is a balloon dilator capable of expanding the distal region of the sheath from a collapsed configuration to an expanded configuration.
3 Assignments
0 Petitions
Accused Products
Abstract
Disclosed is an expandable transluminal sheath, for introduction into the body while in a first, low cross-sectional area configuration, and subsequent expansion of at least a part of the distal end of the sheath to a second, enlarged cross-sectional configuration. The sheath is configured for use in the vascular system. The access route is through the inferior vena cava to the right atrium, where a trans-septal puncture, followed by advancement of the catheter is completed. The distal end of the sheath is maintained in the first, low cross-sectional configuration during advancement through the atrial septum into the left atrium. The distal end of the sheath is expanded using a radial dilator. In one application, the sheath is utilized to provide access for a diagnostic or therapeutic procedure such as electrophysiological mapping of the heart, radio-frequency ablation of left atrial tissue, placement of atrial implants, valve repair, or the like.
467 Citations
22 Claims
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1. An expandable endovascular access sheath for providing minimally invasive access to a left atrium, comprising:
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an axially elongate sheath tube with a proximal end, a distal end, and a central through lumen, the sheath having a distal region which is expandable in circumference in response to outward pressure applied therein;
a hub coupled to the proximal end of the sheath tube, the hub configured to facilitate the passage of instrumentation;
an obturator that extend through the central lumen and which is configured to occlude the central lumen of the sheath during insertion, the obturator comprising an obturator hub that is releasably couples to the hub of the sheath; and
a guidewire lumen within the obturator;
wherein. the obturator is a balloon dilator capable of expanding the distal region of the sheath from a collapsed configuration to an expanded configuration. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A method of instrumenting a left atrium of a patient comprising the steps of:
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routing a guidewire into the right atrium from a peripheral vein, inserting a sheath with a collapsed distal region and a pre-inserted dilator into the patient over the guidewire;
advancing the sheath to a treatment or diagnostic site within the right atrium of the heart;
performing a trans-septal puncture between the right and left atrium and advancing the collapsed distal region through the puncture into the left atrium;
dilating the distal region of the sheath so that the distal region of the sheath is expanded;
collapsing the dilator;
removing the dilator from the sheath, inserting instrumentation through the lumen of the sheath into the left atrium, performing therapy or diagnosis with the instrumentation, and removing the sheath from the patient. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17)
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18. A sheath adapted for insertion into the right or left atrium of the heart comprising:
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a diametrically collapsed distal end;
means for tracking the sheath over an already placed guidewire to a target treatment site in the right or left atrium of the heart, means for articulating the distal end of the sheath,, means for dilating at least a portion of the distal end of the sheath, and means for removal of the sheath from the patient. - View Dependent Claims (19, 20, 21, 22)
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Specification