Guiding catheter and method of use

• US 4,651,751 A
• Filed: 10/05/1984
• Issued: 03/24/1987
• Est. Priority Date: 10/14/1982
• Status: Expired due to Term

• Current Assignee: Edwards Lifesciences Corporation
• Original Assignee: American Hospital Supply Corp. (Baxter International Inc.)
• Inventors: Rold, Michael D., Elson, Edward E., Lieber, Clement, Swendson, David L.
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US06/658,111
• Time in Patent Office: 900 Days
• Field of Search: 604/96, 604/280, 604/281, 604/282, 128/772, 128/784, 128/786, 128/419 P
• US Class Current: 607/122
• CPC Class Codes: A61M 2025/0063 having means, e.g. stylets, mandrils, rods or wires to reinforce or adjust temporarily the stiffness, column strength or pushability of catheters which are already inserted into the human body
• 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 25/0054 with regions for increasing flexibility
• CPC Class Codes: A61M 25/0105 Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems

Abstract

A guiding catheter adapted to be passed through the right side of the heart into the pulmonary artery and comprising a catheter body having at least first and second lumens extending longitudinally in the catheter body and a port extending from the first lumen to the exterior of the catheter body. The port is between the ends of the catheter and is in the right heart when the catheter is in use. An elongated stiffening element is locked within the second lumen and extends from a location on the proximal side of the port to a location on the distal side of the port. The stiffening element is flexible, but it is sufficiently stiff to cause the catheter to be gently curved along the stiffening element without forming a kink when the catheter is in use. The first lumen is adapted to have an inner catheter passed through it and out of the port into the right heart.

Claims

1. A guiding catheter adapted to be passed through the right side of the heart into the pulmonary artery, said guiding catheter comprising:

an elongated catheter body having proximal and distal ends, at least one lumen extending longitudinally in the body and a port extending from the lumen to the exterior of the catheter body, said port being in the right ventricle when the catheter extends through the right ventricle into the pulmonary artery for passing an inner catheter from said lumen through said port into the right ventricle; and

an elongated stiffening element permanently fixed within the catheter body and extending from a location on the proximal side of said port to a location on the distal side of the port, said stiffening element being curved, flexible and sufficiently stiff to cause the catheter to form a gentle curve without forming a kink when the catheter extends through the right ventricle to the pulmonary artery.

2. A guiding catheter as defined in claim 1 wherein said stiffening element extends no farther proximally than the superior vena cava when the guiding catheter extends through the right heart to the pulmonary artery and no farther distally than the right ventricle when the guiding catheter extends through the right heart to the pulmonary artery.

3. A guiding catheter as defined in claim 1 wherein said elongated stiffening element terminates in the right atrium and the right ventricle when the catheter extends through the right heart to the pulmonary artery.

4. A guiding catheter as defined in claim 1 including means for at least partially closing said one lumen adjacent said port without closing said port to facilitate the passage of the inner catheter through the port into the right heart and said closing means includes a radiopaque plug.

5. A guiding catheter as defined in claim 4 wherein said closing means includes a sloping surface facing proximally in said one lumen to facilitate the passage of the inner catheter through the port into the right heart.

6. A guiding catheter as defined in claim 1 wherein said stiffening element has a central section of substantially constant stiffness and end portions of lesser stiffness than said central section.

7. A guiding catheter as defined in claim 1 wherein said catheter body has a second lumen therein and said stiffening element is preformed into a curve and bonded in said second lumen so that the stiffening element is held against rotation in the second lumen.

8. A guiding catheter as defined in claim 7 wherein said stiffening element in an unstressed condition forms a generally circular arc which extends for over 180 degrees.

9. A guiding catheter as defined in claim 1 wherein said stiffening element extends farther distally of said port than proximally of said port.

10. A guiding catheter as defined in claim 1 wherein the center of said port is generally on the outside of said curve.

11. A guiding catheter as defined in claim 1 wherein a radial line through the center of the port as viewed in a radial plane forms an angle of no more than about 30 degrees with a radial reference line which bisects the portion of the curve which faces outside.

12. A guiding catheter adapted to be passed through the right side of the heart into the pulmonary artery, said guiding catheter comprising:

an elongated catheter body having proximal and distal ends, at least one lumen extending longitudinally in the body and a port extending from the lumen to the exterior of the catheter body, said port being in the right ventricle when the catheter extends through the right heart into the pulmonary artery for passing an inner catheter from said lumen through said port into the right ventricle;

an elongated stiffening element permanently fixed within the catheter body and held against rotation in the catheter body, said stiffening element extending from a location on the proximal side of said port to a location on the distal side of said port and being flexible, a region of said catheter body and stiffening element being curved and said port being on said curved region, said stiffening element resisting torsional displacement of the port.

13. A guiding catheter as defined in claim 12 wherein said stiffening element extends farther distally of said port than proximally of said port.

14. A guiding catheter as defined in claim 12 wherein the center of said port is generally on the outside of said curve.

15. A guiding catheter as defined in claim 14 wherein a radial line through the center of the port as viewed in a radial plane forms an angle of no more than about 30 degrees with a radial reference line which bisects the portion of the curve which faces outside.

16. A guiding catheter as defined in claim 12 including a balloon on said catheter body distally of the port, said catheter body having balloon inflation lumen means communicating with the balloon for use in inflating the balloon and said first location being distally of said proximal end and said second location being proximally of said balloon.

17. A guiding catheter as defined in claim 16 wherein said catheter body has an injectate port located proximally of said first location.

18. A guiding catheter as defined in claim 16 wherein said stiffening element extends farther distally of said port than proximally of said port.

19. A guiding catheter as defined in claim 12 wherein said locations are spaced substantially from said ends of the catheter body.

20. A guiding catheter adapted to be passed through the right side of the heart into the pulmonary artery, said guiding catheter comprising:

an elongated catheter body having proximal and distal ends, at least one lumen extending longitudinally in the body and a port extending from the lumen to the exterior of the catheter body, said port being in the right ventricle when the catheter extends through the right heart into the pulmonary artery for passing an inner catheter from said lumen through said port into the right ventricle;

an elongated stiffening element permanently fixed within the catheter body and extending from a first location on the proximal side of said port to a second location on the distal side of said port, said stiffening element being flexible;

a balloon on said catheter body distally of the port, said catheter body having balloon inflation lumen means communicating with the balloon for use in inflating the balloon; and

said first location being distally of said proximal end and said second location being proximally of said balloon whereby the stiffening element is shorter than the catheter body.

21. A guiding catheter as defined in claim 20 including a thermistor carried by the catheter body intermediate said second location and said balloon.

22. A guiding catheter as defined in claim 20 wherein said catheter body has an injectate port located proximally of said first location.

23. A guiding catheter as defined in claim 22 wherein said catheter body has a stiffener lumen and said stiffener element is in said stiffener lumen and said injectate port leads from the stiffener lumen.

24. A guiding catheter as defined in claim 20 wherein said stiffening element extends farther distally of said port than proximally of said port.

25. A catheter system for pacing the heart comprising:

a guiding catheter which can be passed through the right ventricle and into the pulmonary artery, said guiding catheter having proximal and distal ends, at least one lumen extending longitudinally in the guiding catheter and a port extending from the lumen to the exterior of the guiding catheter, said port being exposed in the right ventricle when the guiding catheter extends through the right ventricle into the pulmonary artery;

an elongated stiffening element permanently fixed within the catheter and extending from a location on the proximal side of said port to a location on the distal side of said port, said stiffening element being curved, flexible and sufficiently stiff to cause the guiding catheter to be gently curved without forming a kink when the guiding catheter extends through the right ventricle to the pulmonary artery;

a cardiac pacing catheter including at least one electrode; and

said pacing catheter extending through said lumen and passing through said port.

26. A catheter system as defined in claim 25 wherein said stiffening element extends no farther proximally than the right atrium when the guiding catheter extends through the right heart into the pulmonary artery and no farther distally than the right ventricle when the guiding catheter extends through the right heart into the pulmonary artery.

27. A method of pacing the heart comprising:

providing a guiding catheter having proximal and distal ends, at least one lumen extending longitudinally in the guiding catheter, a port extending from the lumen to the exterior of the guiding catheter, and an elongated flexible stiffening element permanently fixed within the guiding catheter and extending from a location on the proximal side of said port to a location on the distal side of said port;

positioning the guiding catheter in a patient with the port being in the right ventricle, the distal end in the pulmonary artery and with the guiding catheter being formed into a curve without forming a kink in extending through the right ventricle to the pulmonary artery;

advancing a cardiac pacing catheter through the lumen out of the port and into contact with a wall of the heart; and

pacing the heart with the pacing catheter.