Method and apparatus for estimating tissue damage

• US 4,887,608 A
• Filed: 01/10/1989
• Issued: 12/19/1989
• Est. Priority Date: 01/31/1986
• Status: Expired due to Term

• Current Assignee: Werner Mohl
• Original Assignee: Boston Scientific Corporation
• Inventors: Mohl, Werner, Tolkoff, Marc J.
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US07/295,750
• Time in Patent Office: 343 Days
• Field of Search: 600/16-17, 128/668, 128/673, 128/686
• US Class Current: 600/486
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61M 1/3613 Reperfusion, e.g. of the coronary vessels, e.g. retroperfusion
• CPC Class Codes: A61M 2025/0003 having an additional lumen transmitting fluid pressure to the outside for measurement
• CPC Class Codes: A61M 2025/102 driven by a solenoid-activated pump
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2205/3355 Controlling downstream pump pressure
• CPC Class Codes: A61M 25/10 Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 60/143 inside the coronary sinus, e.g. for pressure-controlled intermittent coronary sinus occlusion
• CPC Class Codes: A61M 60/295 Balloon pumps for circulatory assistance
• CPC Class Codes: A61M 60/427 the force acting on the blood contacting member being hydraulic or pneumatic
• CPC Class Codes: A61M 60/531 using blood pressure data, e.g. from blood pressure sensors
• CPC Class Codes: A61M 60/554 of blood pressure
• CPC Class Codes: A61M 60/857 Implantable blood tubes

Abstract

The coronary sinus is intermittently occluded by use of means for occluding the sinus, a pressure transducer for sensing the fluid pressure within the sinus and providing corresponding fluid pressure signals, and a controller responsive to the transducer and arranged to provide trigger signals to the occluding means to trigger an occlusion and to interrupt the occlusion, the system being characterized in that the controller is arranged to estimate a plateau level of the fluid pressure during each occlusion and for providing a trigger signal to interrupt each occlusion on the basis of the estimate. The duration of the interruption before the next occlusion is controlled in response to the volume flow in the sinus during the interruption. Pharmacological agents are injected into the sinus during the occlusion, for retroprofusion to the heart tissue. An analysis of heart function is obtained by analyzing the local pressure maxima in successive heartbeats during occlusion. Initiation of the next occlusion is times based on fluid pressure signals taken from the sinus during occlusion. The degree of tissue at risk of infarction (pr the amount of infarcted tissue) is estimated based on the fluid pressure signals.

Claims

1. Apparatus for analyzing the degree of tissue damage in a heart subjected to inadequate arterial blood flow comprising

means for intermittently occluding the coronary sinus of said heart,

a pressure transducer for sensing the pressure within said sinus and providing corresponding fluid pressure signals, and

means for estimating the amount of said tissue at risk of infarction on the basis of said fluid pressure signals.

2. The apparatus of claim 1 wherein said means for estimating bases said estimation on parameters derived from local maxima and local minima of said fluid pressure signals.

3. Apparatus for analyzing the degree of tissue damage in a heart subjected to inadequate arterial blood flow comprising

means for intermittently occluding the coronary sinus of said heart,

a pressure transducer for sensing the pressure within said sinus and providing corresponding fluid pressure signals, and

means for estimating the amount of infarcted said tissue on the basis of said fluid pressure signals.

4. The apparatus of claim 3 wherein said means for estimating bases said estimation on parameters derived from local maxima and local minima of said fluid pressure signals.

5. A method of analyzing the degree of tissue damage in a heart subjected to inadequate arterial blood flow comprising

intermittently occluding the coronary sinus of said heart, sensing the pressure within said sinus and providing corresponding fluid pressure signals, and

estimating the amount of tissue at risk of infarction based on fluid pressure signals.

6. A method of analyzing the degree of tissue damage in a heart subjected to inadequate arterial blood flow comprising

intermittently occluding the coronary sinus of said heart,

sensing the pressure within the sinus and providing corresponding fluid pressure signals, and

estimating the amount of infarcted tissue on the basis of the fluid pressure signals.