Expandable Cardiac Access Catheter

• US 20180263658A1
• Filed: 03/16/2017
• Published: 09/20/2018
• Est. Priority Date: 03/16/2017
• Status: Active Grant

• Current Assignee: William Joseph Drasler
• Original Assignee: William Joseph Drasler
• Inventors: Drasler, William Joseph
• Granted Patent: US 10,595,842 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/1205 Introduction devices
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation
• CPC Class Codes: A61F 2/2466 Delivery devices therefor

Abstract

An access catheter provides access for a large bore stiff therapeutic catheter across the atrial septum from above via the superior vena cava. The access catheter has an expandable member that direct a delivery tube outwards in a radial direction to place a delivery tube opening into direct contact with the fossa ovalis. The braided expandable member allows blood flow to pass when it is expanded; the expandable member provides support against the opposite wall of the right atrium. A hollow dilator tube enters the delivery tube to form a tenting shape to the fossa and a guidewire is passed across the fossa ovalis. Standard procedure allows delivery of the therapeutic catheter over the guidewire.

Claims

1. An access catheter for crossing the wall of a tubular member of the body comprising;

A. an elongated outer shaft having an outer shaft distal end, said outer shaft extending to a proximal region of said access catheter,

B. an elongated inner shaft that extends within a lumen of said outer shaft, said inner shaft extending distally beyond said outer shaft distal end to an inner shaft distal end, said inner shaft extending proximally to said proximal region of said access catheter,

C. an expandable structure positioned along a distal region of said access catheter, said expandable member being attached to said outer shaft distal end at a first end of said expandable structure, and attached to said inner shaft distal end at a second end of said expandable structure,

D. said expandable structure having an unexpanded configuration with a first diameter located midway between said first end and said second end of said expandable structure with said inner shaft positioned in a distal position relative to said outer shaft, said expandable structure having an expanded configuration with a second diameter larger than said first diameter, said second diameter being least three times larger than a diameter of said outer shaft, said second diameter having said inner shaft in a proximal position with respect to said outer shaft,

D. a delivery tube that extends from said proximal region of said access catheter to said distal region of said access catheter, said delivery tube having a distal end that is attached to an attachment site located along a perimeter of said expandable structure, said attachment site being substantially midway between said first end and said second end of said expandable structure, said delivery tube having a delivery tube lumen that extends from said proximal region of said access catheter to said distal end of said delivery tube, said distal end of said delivery tube having a distal delivery opening that is directed radially outward away from a central axis of said access catheter with said expanded structure in said expanded configuration.

2. the access catheter of claim 1 wherein said expandable structure has an open surface that allows blood flow to pass freely through an outer surface of said expandable structure from said first end of said expandable structure to said second end of said expandable structure while said expandable structure is in contact along a perimeter of said expandable structure with a perimeter of the tubular member.

3. The access catheter of claim 1 wherein said expandable structure is a braided expandable structure comprised of a braided tube.

4. The access catheter of claim 1 wherein said expandable structure is a formed from a slit tubing, said slit tubing having upper legs and lower legs, said upper legs and said lower legs having hinge regions located between said upper legs and said lower legs.

5. The access catheter of claim 1 wherein said expandable structure is a formed from upper legs and lower legs, said upper legs and said lower legs having middle hinges located between said upper legs and said lower legs, said upper legs being attached to said outer shaft by upper hinges and said lower legs being attached to said inner shaft by lower hinges.

6. The access catheter of claim 1 wherein a portion of said delivery tube extends in the interior of said expandable structure.

7. The access catheter of claim 1 wherein a portion of said delivery tube extends along the outer surface of said expandable structure.

8. The access catheter of claim 1 wherein said expansion structure has said expanded configuration is its equilibrium configuration.

9. The access catheter of claim 1 wherein said expansion structure has said unexpanded configuration is its equilibrium configuration.

10. The access catheter of claim 1 further comprising a dilator tube, said dilator tube configured to extend within a lumen of said delivery tube, said dilator tube having a beveled distal end, said dilator tube extending out of the distal delivery opening in a radial direction.

11. The access catheter of claim 9 wherein said dilator tube provides passage for a crossing catheter, said dilator tube directing said crossing catheter in a radial direction, said crossing catheter comprising a needle or a guidewire.

12. An access catheter for crossing the wall of a tubular member of the body comprising;

A. an elongated outer shaft having an outer shaft distal end, said outer shaft extending to a proximal region of said access catheter,

B. an elongated inner shaft that extends within a lumen of said outer shaft, said inner shaft extending distally beyond said outer shaft distal end to an inner shaft distal end, said inner shaft extending from said inner distal shaft distal end to said proximal region of said access catheter,

C. an expandable structure positioned along a distal region of said access catheter, said expandable member being attached to said outer shaft distal end at a first end of said expandable structure, and said expandable member being attached to said inner shaft distal end at a second end of said expandable structure,

D. said expandable structure having an expanded configuration with an expanded diameter that is at least three times larger than a diameter of said outer shaft, said expanded large diameter being generated from movement of said inner shaft in a proximal direction with respect to said outer shaft,

E. a delivery tube that extends from said proximal region of said access catheter to a distal end of said delivery tube, said distal end of said delivery tube being attached to a said expandable structure at an attachment site located substantially midway between said first end and said second end of said expandable structure, said delivery tube having a distal delivery opening that is directed radially outward away from a central axis of said access catheter in an expanded configuration.

13. The method of use for an access catheter for crossing the atrial septum from the right atrium into the left atrium for placing a therapeutic device across the mitral annulus comprising the steps,

A. providing an access catheter having an expandable structure attached at a distal end of said access catheter, said expandable structure having a first diameter in a nonexpanded configuration,

B. positioning said expandable structure such that a central region located midway between a distal end and a proximal end of said expandable structure is able to be located within a right atrium, said expandable structure having a delivery tube attached to an attachment site located along a perimeter of said central region, said delivery tube having a distal delivery opening, said distal delivery opening being directed outward in a radial direction,

C. activating said expandable structure to expand said expandable structure to a second diameter larger than said first diameter thereby able to place said distal delivery opening into contact with an atrial septum and able to place an opposite side of said expandable member located 180 degrees around said perimeter of said central region opposed to a wall of the right atrium.

14. The method of claim 13 further comprising the step of delivering a dilator tube within a delivery lumen of said delivery tube and radially out of said distal delivery opening in a radial direction into contact with the atrial septum causing deflection of the atrial septum.

15. The method of claim 14 further comprising the steps of delivering a crossing catheter within a dilator lumen of said dilator tube and advancing said crossing catheter across the atrial septum.

16. The method of claim 15 further comprising the steps of advancing a guidewire within said lumen of said dilator tube and across the atrial septum.

17. The method of claim 16 further comprising the steps of removing said dilator tube, removing said crossing catheter, and removing said access catheter from the body and leaving said guidewire across the atrial septum.

18. The method of claim 13 wherein said access catheter is deliverable to the right atrium via the inferior vena cava, said access catheter able to provide direct contact of said distal delivery opening with the fossa ovalis or the atrial septum when said expandable member is expanded to said second diameter.