INTRODUCTORY ASSEMBLY AND METHOD FOR INSERTING INTRACARDIAC INSTRUMENTS

• US 20150025312A1
• Filed: 02/06/2014
• Published: 01/22/2015
• Est. Priority Date: 08/09/2011
• Status: Abandoned Application

• Current Assignee: Corquest Medical, Inc. (Celyad Oncology SA)
• Original Assignee: Didier De Canniere
• Inventors: de Canniere, Didier
• Application Number:
  US14/174,212
• Publication Number:
  US 20150025312A1
• Time in Patent Office: Days
• US Class Current: 600/104
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00606 Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
• CPC Class Codes: A61B 2017/00615 Implements with an occluder on one side of the opening and holding means therefor on the other
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61B 2017/00659 located only on one side of the opening
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation

Abstract

An introduction assembly and method for the insertion of medical instruments through a thoracic passage into a selected one of either the left or right atrium of the heart. Catheters or other instruments dedicated to performing required cardiac maneuvers are passed through an introductory sheath having a distal end disposed within the targeted atrium. Upon completion of the required cardiac maneuvers the instruments are removed from the atrium and a closure assembly is passed through the introductory sheath into a closing relation to an entry site, formed in the pericardium and corresponding atrium wall, to facilitate healing thereof. The introductory assembly and method facilitates the concurrent, operative disposition of a plurality of catheters or other instruments into the interior of the selected atrium through different thoracic passages and entry sites thereby allowing synergistic interaction between the multiple catheters in the performance of the required cardiac maneuvers.

Claims

1. An introduction assembly structured to facilitate insertion of instrumentation through the wall of the heart and into the interior thereof, said introduction assembly comprising:

an elongated sheath dimensioned for operative placement relative to the heart along a thoracic passage,

said sheath including open distal and proximal ends and a predetermined configuration along at least a portion of its length,

said predetermined configuration structured to facilitate orientation of said open distal end into said operative placement;

said operative placement comprising a substantially flush, confronting relation of said open distal end to an exterior of the heart wall adjacent an entry site,

said sheath having a predetermined interior transverse dimensions sufficient to facilitate passage of the instrumentation there through into the heart, and

at least a portion of the length of said sheath formed of a rigid material, said rigid material having sufficient rigidity to facilitate manipulation of said sheath and disposition of said open distal end into said operative placement.

2. An introduction assembly as recited in claim 1 wherein said predetermined configuration comprises a curved configuration extending along a portion of the length of said sheath.

3. An introduction assembly as recited in claim 2 wherein said curved configuration is formed along a portion of the length of said sheath extending from said open distal end outwardly therefrom towards and in spaced relation to said open proximal end.

4. An introduction assembly as recited in claim 3 wherein said sheath is formed from a rigid material along at least a majority of its length.

5. An introduction assembly as recited in claim 3 wherein said sheath is formed of a rigid material along substantially its entire length.

6. An introduction assembly as recited in claim 1 wherein said sheath has a sufficient length for concurrent positioning of said open distal end in said operative placement and said open proximal end in an accessible location exteriorly of the thoracic cavity.

7. An introduction assembly as recited in claim 1 wherein said predetermined interior transverse dimension is greater than 7.3 mm.

8. An introduction assembly as recited in claim 7 wherein said predetermined interior transverse dimension of said sheath extends along the length of said sheath between said open proximal and distal ends.

9. An introduction assembly as recited in claim 1 further comprising a stabilizer assembly removably disposable within said sheath and including a stabilizer structure positionable through said open distal end into retaining relation to the entry site in the heart wall.

10. An introduction assembly as recited in claim 9 further comprising said stabilizer assembly including a central lumen having a predetermined transverse dimension sufficient to facilitate the passage there through of the instrumentation within the heart.

12. An introduction assembly as recited in claim 9 wherein said stabilizer structure extends through the entry site and comprises a retaining assembly disposed in a retaining orientation concurrently on an exterior and an interior of the heart wall.

13. An introduction assembly as recited in claim 12 wherein said retaining assembly comprises a central channel and two retaining members each disposed on different interior and exterior ends of said channel in said retaining orientation.

14. An introduction assembly as recited in claim 13 wherein each of said retaining members is inflatable into said retaining orientation;

said retaining orientation comprising corresponding ones of said retaining members disposed in confronting relation with interior and exterior surfaces of the heart wall.

15. An introduction assembly as recited in claim 9 further comprising a dilator movably disposable within said stabilizer assembly and including a dilating tip dimensioned and configured to facilitate passage thereof into and expansion of the entry site.

16. An introduction assembly as recited in claim 15 wherein said dilating tip comprises a substantially pointed, partially conical configuration.

17. An introduction assembly as recited in claim 15 wherein said stabilizer structure is disposable relative to said dilator into said retaining relation with the entry site upon said expansion of the entry site.

18. An introduction assembly as recited in claim 15 further comprising a penetrating needle including a hollow interior, said needle movable through said sheath into penetrating relation with the heart wall at the entry site.

19. An introduction assembly as recited in claim 18 further comprising a guide wire dimensioned to pass through said hollow interior and into the heart interior concurrent to disposition of said penetrating needle through the entry site.

20. An introduction assembly as recited in claim 19 wherein said dilator is movably positioned on said guide wire into the heart through the entry site.

21. An introduction assembly as recited in claim 20 wherein said guide wire is removable from the within the heart through an interior of said dilator, concurrent to disposition of said dilator within the heart.

22. An introduction assembly as recited in claim 19 wherein said penetrating needle is movably disposed in telescoping relation on said guide wire and removal from the within the heart over said guide wire.

23. An introduction assembly as recited in claim 1 further comprising a camera mounted on said sheath and movable there with along the thoracic passage;

said camera disposed of to define a field of vision of the entry site into the heart, when said open distal end is in said operative placement.

24. An introduction assembly as recited in claim 1 further comprising a buffer member connected to said sheath adjacent said open distal end, said buffer member disposed at and structured to restrict frictional confrontation of said open distal end with the exterior of the heart wall.

11. An introduction assembly as recited in 10 wherein said predetermined transverse dimension of said lumen is greater than 7.3 mm.

25. An introduction assembly structured to facilitate insertion of instrumentation into the heart through a wall thereof, said introduction assembly comprising:

an elongated sheath including an open distal end and a predetermined configuration extending along at least a portion of the length of said sheath,

said predetermined configuration disposed and structured to establish a substantially flush relation of said open distal end with an exterior of the heart wall, when said sheath is in said operative placement,

a stabilizer assembly movably disposable within said sheath and including a stabilizing structure positionable through said open distal end into a retaining orientation within an entry site in the heart wall,

said stabilizer assembly including a central lumen having a predetermined transverse dimension sufficient to facilitate the passage there through of instrumentation within the heart,

a dilator movably disposable within said stabilizer assembly and including a dilating tip dimensioned and configured to facilitate passage into and expansion of the entry site, and

said stabilizer structure disposable relative to said dilator into said retaining relation with the entry site upon the expansion of said entry site.

26. An introduction assembly as recited in claim 25 further comprising said stabilizer assembly and said stabilizer structure each including a central lumen having a predetermined transverse dimension sufficient to facilitate the passage there through of the instrumentation within the heart, said predetermined transverse dimension of said lumen is generally between 7.3 mm and 1.5 cm.

27. An introduction assembly as recited in claim 25 wherein said stabilizer structure extends through the entry site and comprises a retaining assembly and two retaining members, each of said two retaining members disposed on different interior and exterior ends of said stabilizing structure.

28. An introduction assembly as recited in claim 27 wherein each of said retaining members is independently inflatable into said retaining orientation;

said retaining orientation comprising corresponding ones of said retaining members disposed in confronting relation with interior and exterior surfaces of the heart wall.

29. An introduction assembly as recited in claim 27 wherein said stabilizer structure is disposable relative to said dilator into said retaining orientation within the entry site upon said expansion of the entry site.