Retroperfusion and retroinfusion control apparatus, system and method

• US 5,011,468 A
• Filed: 04/16/1990
• Issued: 04/30/1991
• Est. Priority Date: 05/29/1987
• Status: Expired due to Term

• Current Assignee: Zoll Circulation Incorporated (Asahi Kasei Corporation)
• Original Assignee: Retroperfusion Systems, Inc.
• Inventors: Kardos, Thomas J., Tarczy-Hornoch, Zoltan, Lundquist, Ingemar H.
• Primary Examiner(s): Cohen, Lee S.
• Assistant Examiner(s): SCHAETZLE, KENNEDY
• Application Number:
  US07/511,930
• Time in Patent Office: 379 Days
• Field of Search: 600/16-18, 604/96-99, 604/101, 417/478
• 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 1/3621 Extra-corporeal blood circuits single-needle circuits A61M1/30
• CPC Class Codes: A61M 1/36224 with sensing means or components thereof
• CPC Class Codes: A61M 1/36225 with blood pumping means or components thereof
• CPC Class Codes: A61M 1/36226 Constructional details of cassettes, e.g. specific details on material or shape
• CPC Class Codes: A61M 1/362261 at least one cassette surface or portion thereof being flexible, e.g. the cassette having a rigid base portion with preformed channels and being covered with a foil
• CPC Class Codes: A61M 1/362262 Details of incorporated reservoirs
• CPC Class Codes: A61M 1/362265 Details of valves
• CPC Class Codes: A61M 1/362266 Means for adding solutions or substances to the blood
• CPC Class Codes: A61M 1/3643 Priming, rinsing before or after use
• CPC Class Codes: A61M 1/3644 Mode of operation
• CPC Class Codes: A61M 1/3652 using gas, e.g. air
• CPC Class Codes: A61M 2025/0002 with a pressure sensor at the distal end
• CPC Class Codes: A61M 2025/102 driven by a solenoid-activated pump
• CPC Class Codes: A61M 2025/1022 driven by a rotary motor-activated pump
• CPC Class Codes: A61M 2205/12 with interchangeable cassettes forming partially or totally the fluid circuit
• CPC Class Codes: A61M 2205/128 with incorporated valves
• CPC Class Codes: A61M 2205/14 Detection of the presence or absence of a tube, a connector or a container in an apparatus
• CPC Class Codes: A61M 2205/33 Controlling, regulating or measuring
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• 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 2230/04 : Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 60/113 : in other functional devices, e.g. dialysers or heart-lung machines
• CPC Class Codes: A61M 60/152 : branching on and drawing blood from a blood vessel
• 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 60/31 : for enhancement of in vivo organ perfusion, e.g. retroperfusion
• CPC Class Codes: A61M 60/427 : the force acting on the blood contacting member being hydraulic or pneumatic
• CPC Class Codes: A61M 60/515 : Regulation using real-time patient data
• CPC Class Codes: A61M 60/531 : using blood pressure data, e.g. from blood pressure sensors
• CPC Class Codes: A61M 60/538 : Regulation using real-time blood pump operational parameter data, e.g. motor current
• CPC Class Codes: A61M 60/554 : of blood pressure
• CPC Class Codes: A61M 60/585 : User interfaces
• CPC Class Codes: A61M 60/847 : arranged in a cassette
• CPC Class Codes: A61M 60/849 : Disposable parts
• CPC Class Codes: A61M 60/851 : Valves
• CPC Class Codes: A61M 60/853 : the valve being formed by a flexible tube element which is clamped for restricting the flow
• CPC Class Codes: A61M 60/892 : Active valves, i.e. actuated by an external force
• CPC Class Codes: A61M 60/894 : Passive valves, i.e. valves actuated by the blood

Abstract

Disposable pump cassette for a liquid comprising a substantially rigid housing providing a chamber and having upper and lower portions. A flexible substantially cylindrical bladder is vertically disposed in the chamber and has an inlet adapted to receive the liquid and an outlet. The bladder has upper and lower wall portions. The lower wall portion is of a thinner cross section then the upper wall portion. An inlet valve is disposed in the inlet of the bladder and is mounted in the lower portion of the housing. An outlet valve is disposed in the outlet of the bladder and is mounted in the upper portion of the housing. The inlet and outlet valves are disposed in the liquid and provide unidirectional flow of the liquid through the bladder. A substantially incompressible driving liquid is disposed in the chamber and surrounds the bladder. A housing extension is mounted on said housing and is in communication with the driving liquid disposed in the chamber. A movable piston is slidably mounted in the housing extension. A drive is provided for reciprocating the piston for causing displacement of the driving liquid in the chamber to compress and decompress the bladder to cause the liquid to flow through the bladder progressively from the lower portion to the upper portion of the bladder.

Claims

1. In a control apparatus for supplying arterial blood of a patient to the venous side of a patient'"'"'s organ, the apparatus comprising a balloon catheter having a distal extremity and an inflatable balloon carried by the distal extremity, the catheter having a balloon inflation lumen in communication with the balloon and a blood flow lumen extending through the balloon, a blood pump having an inlet adapted to be connected to an arterial blood vessel of the patient and having an outlet adapted to be connected to a venous blood vessel of the patient, motorized means for operating the blood pump in synchronism with the operation of the heart and gas pressure generation means connected to the balloon inflation lumen for inflating and deflating the balloon out of synchronism with the motorized means for operating the blood pump.

2. Apparatus as in claim 1 wherein the pump is in the form of a pump cassette having a chamber therein, a flexible bladder disposed in the chamber, a captive driving liquid in the chamber and surrounding the bladder, a movable piston carried by the cassette and in communication with the liquid in the chamber, means for causing reciprocatory motion of the piston to cause pressurization and depressurization of the liquid in the chamber, and inlet and outlet valve means for providing unidirectional flow of blood out of and into said bladder as said liquid in the chamber is pressurized and depressurized.

3. In a control apparatus for supplying arterial blood of a patient to the venous side of a patient'"'"'s brain, the patient'"'"'s brain having first and second drainage paths, the apparatus comprising a first balloon catheter having a distal extremity and an inflatable balloon carried by the distal extremity and adapted to be disposed in the first drainage path, a second balloon catheter having a distal extremity and an inflatable balloon carried by the distal extremity and adapted to be disposed in the second drainage path, the first and second balloon catheters each having a balloon inflation lumen in communication with the balloon, the second balloon catheter being adapted to be disposed in a drainage path from the brain, gas pressure generation means, means connecting the gas pressure generation means to the balloon inflation lumen of the first balloon catheter and to the balloon inflation lumen of the second balloon catheter for inflating and deflating the first and second balloon catheters, at least one of the first and second balloon catheters having a blood flow lumen extending through the balloon, a blood pump having an inlet adapted to be connected to an arterial blood vessel of the patient and having an outlet connected to the blood flow lumen to supply arterial blood to a venous blood vessel in the brain of the patient.

4. In a method for supplying arterial blood into a venous region of an organ of a patient by the use of a catheter having a distal extremity and an inflatable balloon carried by the distal extremity, the catheter having a balloon inflation lumen in communication with the balloon and a blood flow lumen extending through the balloon, the method comprising placing the balloon in a venous vessel of the patient'"'"'s organ, supplying arterial blood from the patient under pressure through the blood flow lumen of the catheter at predetermined periods of time into a venous region of the patient'"'"'s organ and inflating the balloon with a gas out of synchronism with the flow of blood in the blood flow lumen.

5. A method as in claim 4 wherein the blood is introduced into the balloon catheter in accordance with the R wave of the patient, and wherein gas is introduced into the balloon of the balloon catheter independently of the R-wave.

6. A method as in claim 4 wherein the balloon is introduced into the first balloon catheter in accordance with the R wave of the patient and the gas is introduced into the balloon of the first balloon catheter for a period of time corresponding to a multiple of cycles of the R-wave.

7. In a method for supplying arterial blood into a venous region of the brain of a patient by the use of a first balloon catheter having a distal extremity and an inflatable balloon carried by the distal extremity, the first balloon catheter also having a balloon inflation lumen in communication with the balloon and a blood flow lumen extending through the balloon, and a second balloon catheter having a distal extremity and an inflatable balloon carried by the distal extremity, the second balloon catheter having a balloon inflation lumen in communication with the balloon of the second catheter, the method comprising placing the balloons of the first and second balloon catheters in first and second venous drainage paths of the patient'"'"'s brain, synchronously inflating and deflating the balloons of the first and second balloon catheters for occluding venous flow simultaneously in said first and second venous drainage paths of the patient'"'"'s brain and supplying arterial blood from the patient under positive pressure through the blood flow lumen of the first balloon catheter at predetermined periods of time into a venous region of the patient'"'"'s brain.

8. A method as in claim 7 wherein the balloons of the first and second balloon catheters are inflated by the same gas.

9. A disposable pump cassette for a liquid comprising a substantially rigid housing providing a chamber and having upper and lower portions, a flexible substantially cylindrical bladder vertically disposed in the chamber and having an inlet adapted to receive the liquid and an outlet, said bladder having upper and lower wall portions, said lower wall portion being of thinner cross section than the upper wall portion, inlet valve means disposed in the inlet of the bladder and mounted in the lower portion of the housing, outlet valve means disposed in the outlet of the bladder and mounted in the upper portion of the housing, said inlet and outlet valve means being disposed in the liquid and providing unidirectional flow of the liquid through the bladder, a substantially incompressible driving liquid disposed in the chamber and surrounding the bladder, a housing extension mounted on said housing and being in communication with the driving liquid disposed in said chamber and a movable piston slidably mounted in said housing extension and means for causing reciprocation of said piston for causing displacement of the driving liquid in the chamber to compress and decompress the bladder to cause said liquid to flow through the bladder progressively from the lower portion to the upper portion of the bladder.

10. A cassette as in claim 9 in which the liquid to be pumped by the pump cassette is blood and wherein the driving liquid is a saline solution.

11. A cassette as in claim 9, together with a reservoir mounted on said housing and having an outlet and connecting means connecting the outlet of the reservoir to the inlet of the bladder.

12. In a disposable pump cassette for pumping blood, a housing providing a chamber, a flexible bladder disposed in the chamber and having an inlet adapted to receive the blood and an outlet, inlet valve means disposed in the inlet of the bladder, outlet valve means disposed in the outlet of the bladder, said inlet and outlet valves being disposed in the blood and providing unidirectional flow of the blood through the bladder, a saline solution serving as a substantially incompressible driving liquid disposed in the chamber and surrounding the bladder, a housing extension mounted on said housing and being in communication with the driving liquid disposed in said chamber, a movable piston slidably mounted in said housing extension and means for causing reciprocation of said piston for causing displacement of the driving liquid in the chamber to compress and decompress the bladder to cause said blood to flow through the bladder, blood level detector means mounted on said housing and having an outlet and connecting means connecting the outlet of the blood level detector means to the inlet of the bladder.