Multipurpose cardiocirculatory assist cannula and methods of use thereof

• US 4,014,317 A
• Filed: 02/18/1972
• Issued: 03/29/1977
• Est. Priority Date: 02/18/1972
• Status: Expired due to Term

• Current Assignee: United States of America As Represented By The Secretary of The Department of Health Education and Welfare
• Original Assignee: United States of America As Represented By The Secretary of The Department of Health Education and Welfare
• Inventors: Bruno, Anthony M.
• Primary Examiner(s): Truluck, Dalton L.
• Application Number:
  US05/227,399
• Time in Patent Office: 1,866 Days
• Field of Search: 128/1 D, 128/1 R, 128/2.06 E, 128/3.48, 128/404, 128/418, 128/419 P
• US Class Current: 600/18
• CPC Class Codes: A61M 1/3613 Reperfusion, e.g. of the coronary vessels, e.g. retroperfusion
• CPC Class Codes: A61M 1/3659 Cannulae pertaining to extracorporeal circulation
• CPC Class Codes: A61M 2205/054 with electrotherapy
• CPC Class Codes: A61M 2205/33 Controlling, regulating or measuring
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 60/13 by means of a catheter allowing explantation, e.g. catheter pumps temporarily introduced via the vascular system
• CPC Class Codes: A61M 60/148 in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
• CPC Class Codes: A61M 60/174 discharging the blood to the ventricle or arterial system via a cannula internal to the ventricle or arterial system
• CPC Class Codes: A61M 60/274 the inlet and outlet being the same, e.g. para-aortic counter-pulsation blood pumps
• CPC Class Codes: A61M 60/295 Balloon pumps for circulatory assistance
• CPC Class Codes: A61M 60/497 for balloon pumps for circulatory assistance
• CPC Class Codes: A61M 60/515 Regulation using real-time patient data
• CPC Class Codes: A61M 60/843 Balloon aspects, e.g. shapes or materials
• CPC Class Codes: A61M 60/894 Passive valves, i.e. valves actuated by the blood
• CPC Class Codes: A61M 60/896 having flexible or resilient parts, e.g. flap valves
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems

Abstract

A method and device for assisting cardiocirculation includes inserting a cannula in the axillary or subclavian artery, which cannula has associated therewith a blood pump, a balloon pump which responds to EKG signals, and a heart pacer which triggers the EKG and is capable of responding to and reversing ventricular extra systoles, and maneuvering the cannula into the aorta and left ventricle. The device functions by directly unloading surplus blood from the left ventricle of the heart, thereby reducing the work load of the heart so that it may in time recover from a serious if not critical insult.

Claims

1. A multipurpose cardiocirculatory assist device comprising:

a hollow elongated cannula having a diameter sufficiently small for insertion into a human artery leading to the aorta, said cannula having a leading tip at the upstream end and a trailing end at the downstream end thereof, wherein upstream and downstream relate to the direction of blood flow during arterial usage;

electrode means at the leading tip of said cannula for pacing the heart;

blood pump means to pump blood from the left ventricle during cardiac systole and into the aorta during cardiac diastole, including inlet valve means along said cannula and adapted to be disposed within the left ventricle during usage for allowing blood to pass into said blood pump means, and outlet valve means along said cannula downstream from said inlet valve means and adapted to be disposed within the aorta during usage for allowing blood to pass out of said blood pump means; and

supplementary heart pumping assist means comprising balloon pump means including a balloon connected to said cannula disposed downstream from said outlet valve means, said balloon pump means causing inflation of said balloon during cardiac diastole and deflation of said balloon during cardiac systole.

2. A cardiocirculatory assist device in accordance with claim 1, wherein said electrode means, blood pump means and supplementary heart pumping assist means include drive means connected thereto for supplying electrical pacing pulses to said electrode means, for driving said blood pump means, and for supplying gas for inflation and deflation of said balloon pump means.

3. A cardiocirculatory assist device in accordance with claim 2, further including:

a chamber connected between said drive means and said balloon;

elastic diaphragm means connected within said chamber for preventing gas from said drive means from directly entering said balloon;

wherein the balloon side of said diaphragm is airtight and has a present pressure therein whereby inflation of said balloon is dependent on the position of said diaphragm means.

4. A cardiocirculatory assist device in accordance with claim 1, wherein said cannula includes multi-fenestrated areas and said inlet valve means and said outlet valve means each comprise one way valves covering the multi-fenestrated areas of said cannula.

5. A cardiocirculatory assist device in accordance with claim 3, further including:

an outer housing surrounding said cannula between said balloon and the trailing end of said cannula and having a widened portion at the trailing end of said cannula, said chamber being defined by said widened portion of said outer housing, and

a conduit connecting said chamber and said balloon located between said cannula and said outer housing wherein said conduit comprises at least one tube.

6. A cardiocirculatory assist device in accordance with claim 3, further including:

an outer housing surrounding said cannula between said balloon and the trailing end of said cannula and having a widened portion at the trailing end of said cannula, said chamber being defined by said widened portion of said outer housing and;

a conduit connecting said chamber and said balloon located between said cannula and said outer housing wherein said conduit comprises an annular area between said cannula and said outer housing.

7. A cardiocirculatory assist device in accordance with claim 1 wherein said electrode means includes:

an electrode at the leading tip of said cannula;

a cable connected to said housing; and

a lead portion slidably housed in said cable such that said electrode is movable axially and rotatably, independently of said cannula.

8. A cardiocirculatory assist device in accordance with claim 7 wherein said electrode includes securing means connected thereto for securing said electrode in place when in operation.

9. A cardiocirculatory assist device in accordance with claim 2 wherein said drive means further includes electrocardiograph means connected thereto for determining the proper periodicity of operation of said electrode means, blood pump means and supplementary heart pumping assist means.

10. A method of treating cardiocirculatory ailments using the cardiocirculatory assist device of claim 1 comprising the steps of:

inserting the cannula of said cardiocirculatory assist device into an artery which leads to the aorta;

maneuvering the cannula into a position in the aorta siuch that the electrode means and the inlet valve means of the cannula lie within the left ventricle, the outlet valve means lies within the sinus of Valsalva and the balloon is in the transverse arc of the aorta distal to the outflow tract of the carotid artery;

supplying electrical pulses through electrode means to ensure a constant heart beat;

pumping blood through the blood pump means; and

12. A method in accordance with claim 10 further comprising the steps of:

after ventricular function has improved, ceasing the blood pumping action; and

withdrawing the cannula to a position such that the leading end no longer extends through the aortic valve and the balloon is still within the transverse aortic arch distal to the outflow tract of the carotid artery.

14. A method in accordance with claim 12 further comprising the steps of:

after ventricular function has improved, ceasing the blood pumping action; and

withdrawing the catheter to a position such that the tip end no longer extends through the aortic valve and the balloon is still within the transverse aortic arch distal to the outflow tract of the carotid artery.

11. driving said supplementary heart pumping assist means,

13. A method for augmenting the action of an ailing heart having a left ventricle and associated aorta, comprising:

inserting a catheter tip having spaced apart inlet and outlet check valves thereon into the aorta, through the aortic valve and into the left ventricle, said inlet check valve being located adjacent the tip end of the catheter so that blood may be sucked into the catheter from the left ventricle, said outlet check valve being proximally spaced from the tip end of the catheter so as to be located outside the aortic valve permitting blood within the catheter to be pumped directly into the aorta, said catheter further including supplementary heart pumping assist means comprising balloon pump means including a balloon connected to said catheter proximally spaced from said outlet check valve so as to be located in the transverse arc of the aorta distal to the outflow tract of the carotic artery after said inserting step;

sequentially sucking blood from said left ventricle by way of said inlet valve of the catheter during systolic pulsation and on reverse cycle, forcing all of said sucked blood back through the catheter and into said aorta via said outlet valve; and

inflating said balloon during cardiac diastole and deflating said balloon during systolic pulsation.

15. A cardiocirculatory assist device, comprising:

a hollow elongated cannula having a diameter sufficiently small for insertion into a human artery leading to the aorta;

a heart pumping assist means comprising balloon pump means including a balloon connected to said cannula, said balloon pump means causing inflation of said balloon during cardiac diastole and deflation of said balloon during cardiac systole;

said heart pumping assist means further including drive means connected to said cannula for supplying gas for inflation and deflation of said balloon pump means;

a chamber connected between said drive means and said balloon; and

elastic diaphragm means connected within said chamber for preventing gas from said drive means from directly entering said balloon, wherein the balloon side of said diaphragm is airtight and has a preset pressure therein whereby inflation of said balloon is dependent on the position of said diaphragm means.

16. A heart assist device for pumping blood directly from the left ventricle into the aorta past the artic vlve, comprising:

catheter means including an elongated member with an axial bore therein and having a distal end for insertion into the left ventricle, said distal end having a tip portion, said tip portion having therein an opening in fluid communication with said bore, said distal end also being provided with a second set of openings axially spaced from said tip opening, said second set of openings also communicating with said bore;

first check valve means associated with said tip opening and closing same during first predetermined intervals and opening same during second predetermined intervals;

second check valve means associated with said second set of openings and closing said second set of openings during said second predetermined intervals and opening same during said first predetermined intervals; and

supplementary heart pumping assist means comprising balloon pump means including a balloon connected to said catheter means proximally spaced from said second check valve means, said balloon pump means causing inflation of said balloon during cardiac diastole and deflation of said balloon during cardiac systole.

17. A heart assist device for pumping blood directly from the left ventricle into the aorta past the aortic valve comprising catheter means including an elongated member with an axial bore therein and having a distal end for insertion into the left ventricle, said distal end having a tip portion, said tip portion having therein an opening in fluid communication with said bore, said distal end also being provided with a second set of openings axially spaced from said top opening, said second set of openings also communicating with said bore, first check valve means associated with said tip opening and closing same during first predetermined intervals and opening same during second predetermined intervals, second check valve means associated with said second set of openings and closing said second set of openings during said second predetermined intervals and opening same during said first predetermined intervals, and channel means within the wall of said catheter means for introducing electrode means through said catheter means directly into the left ventricle.

18. A method for augmenting the action of an ailing heart having a left ventricle and associated aorta, comprising:

inserting a catheter tip having spaced apart inlet and outlet check valves thereon into the aorta, through the aortic valve and into the left ventricle, said inlet check valve being located adjacent the tip end of the catheter so that blood may be sucked into the catheter from the left ventricle, said outlet check valve being proximally spaced from the tip end of the catheter so as to be located outside the aortic valve permitting blood within the catheter to be pumped directly into the aorta, said catheter further including electrode means at the tip end of the catheter for pacing the heart;

sequentialy sucking blood from said left ventricle by way of said inlet valve of the catheter during systolic pulsation and on reverse cycle, forcing all of said sucked blood back through the catheter and into said aorta via said outlet check valve; and

supplying electrical pulses through said electrode means to ensure a constant heart beat.

19. A heart assist device for pumping blood directly from the left ventricle into the aorta past the aortic valve, comprising:

catheter means including an elongated member with an axial bore therein and having a distal end for insertion into the left ventricle, said distal end having a tip portion, said tip portion having therein an opening in fluid communication with said bore, said distal end also being provided with a second set of openings axially spaced from said tip opening, said second set of opening also communicating with said bore;

first check valve means associated with said tip opening and closing same during first predetermined intervals and opening same during second predetermined intervals;

second check valve means associated with said second set of openings and closing said second set of openings during said second predetermined intervals and opening same during said first predetermined intervals; and

electrode means at the tip portion of said catheter means for pacing the heart.