Percutaneous transseptal left atrial cannulation system
First Claim
1. A cannulation system for draining blood from the left atrium of the heart through a blood vessel comprising, as an assembly to be inserted through the blood vessel:
- a catheter having a distal end and a proximal end, said distal end including an orifice and the catheter width being reduced near the orifice;
a guide wire;
a needle;
said guide wire and said needle located axially in the catheter such that either the guide wire or the needle can alternately be extended through the orifice at the catheter distal end; and
a cannula, having a distal end and a proximal end, surrounding the catheter, said cannula having a hole located at the extreme distal end of the cannula such that the hole of the cannula slides over the exterior of the catheter, the needle having a stiffness sufficient to serve as an obturator such that the catheter and cannula can be passed over the needle and through the atrial septum, but flexible enough to pass through a blood vessel.
3 Assignments
0 Petitions
Accused Products
Abstract
A transseptal left atrial cannulation system which provides drainage of left atrial blood without the need for thoracotomy. A guide wire and a long needle assembly are inserted into a catheter. A cannula rides over the exterior of this catheter. The guide wire may be advanced past the needle assembly and through a catheter through the distal end of the catheter to assist in directing the system to the right atrium. The cannulation system is inserted in a femoral vein located in the groin. Both the guide wire and needle assembly are long enough to allow a substantial length to extend out of the body at the groin for manipulation even when the distal ends of the guide wire and needle assembly are positioned in the heart. When the catheter distal end is positioned adjacent the septum in the right atrium, the guide wire is withdrawn from the catheter orifice and the needle assembly moves past the guide wire and through the catheter orifice to a position adjacent to the septum. The needle pierces the septum and the catheter moves over the needle assembly to further dilate the septal hole. The cannula attached to the catheter also moves through the septal hole, further dilating it, and resting with the holes in the left atrium. The guide wire, the needle assembly, and the catheter are withdrawn from the cannula. Oxygenated blood from the left atrium drains through the cannula to the extracorporeal pump and back to the body through an arterial cannula.
630 Citations
42 Claims
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1. A cannulation system for draining blood from the left atrium of the heart through a blood vessel comprising, as an assembly to be inserted through the blood vessel:
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a catheter having a distal end and a proximal end, said distal end including an orifice and the catheter width being reduced near the orifice; a guide wire; a needle; said guide wire and said needle located axially in the catheter such that either the guide wire or the needle can alternately be extended through the orifice at the catheter distal end; and a cannula, having a distal end and a proximal end, surrounding the catheter, said cannula having a hole located at the extreme distal end of the cannula such that the hole of the cannula slides over the exterior of the catheter, the needle having a stiffness sufficient to serve as an obturator such that the catheter and cannula can be passed over the needle and through the atrial septum, but flexible enough to pass through a blood vessel. - View Dependent Claims (2)
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3. A cannulation system for accessing blood in the left atrium through a blood vessel comprising, as an assembly to be inserted through the blood vessel:
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a catheter having a distal end and a proximal end and an axial cavity, said distal end including an orifice and the catheter width being reduced near the orifice; a guide wire; a needle; said guide wire and said needle located axially in the catheter such that either the guide wire or the needle can alternately be extended through the orifice at the catheter distal end; and a cannula, having a distal end and a proximal end, surrounding the catheter, said cannula having a hole located at the extreme distal end of the cannula such that the hole of the cannula slides over the exterior of the catheter. - View Dependent Claims (4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28)
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29. A cannula peel-away sheath assembly comprising:
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a cannula including a plurality of holes located on the side of the cannula parallel to the longitudinal axis of the cannula; and a peel-away sheath assembly including a thin-walled tube with a tapered end which causes the sheath to be retained in fixed position on the cannula as the cannula is moved through subcutaneous tissue to cover the plurality of holes on the side of the cannula, such that the sheath assembly prevents the cannula holes from accumulating fat particle debris when passing through subcutaneous fat prior to reaching a blood vessel; and said tube is scored such that the sheath assembly can be pulled back and peeled away after the cannula is within the blood vessel. - View Dependent Claims (30)
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31. A cannulation system for draining blood from the left atrium of the heart through a blood vessel as an assembly to be inserted through the blood vessel:
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a catheter having a distal end and a proximal end, said distal end including an orifice and the catheter width being reduced near the orifice; a guide wire; a needle; said guide wire and said needle located axially in the catheter such that either the guide wire or the needle can alternately be extended through the orifice at the catheter distal end; a cannula, having a distal end and a proximal end, surrounding the catheter, said cannula having a hole located at the extreme distal end of the cannula such that the hole of the cannula rides over the exterior of the catheter; said needle is sufficiently stiff to direct the catheter and then the cannula over the needle; a peel-away sheath assembly including a thin-walled tube with a tapered end which causes the sheath to be retained in fixed portion on the cannula as the cannula is moved through subcutaneous tissue to cover the plurality of holes on the side of the cannula; said thin-walled tube being scored such that it can be pulled back from the cannula and peeled away; the guide wire has a curved flexible end such that the guide wire can guide the cannulation system in a blood vessel and the guide wire can be advanced from the catheter orifice to assess the distance from the catheter orifice to a body part; and a needle with a narrowed distal end such that a predetermined length of needle can extend out of the catheter orifice but a thicker needle width is stopped at the orifice. - View Dependent Claims (32, 33)
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34. A percutaneous transseptal left atrial cannulation system for draining oxygenated blood from the left atrium of the heart through a venous cannula and returning the blood to the body through an arterial cannula after passing through an extra-corporeal pump, said venous cannulation system comprising:
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a catheter having a distal end and a proximal end, said distal end including an orifice and the catheter width being reduced near the orifice; a guide wire; a needle; said guide wire and said needle being located axially in the catheter such that either the guide wire or the needle can be alternately advanced through the orifice at the catheter distal end, said needle having a distal end which may be curved; and a cannula having a distal end and a proximal end, said cannula distal end including a plurality of holes located on the side of the cannula parallel to the longitudinal axis of the cannula and an end hole located at the extreme distal of the cannula;
said end hole of the cannula rides over the exterior of the catheter;
said needle is sufficiently stiff to serve as an obturator to direct the catheter and then the cannula over the needle;such that said venous cannulation system is adapted to enter the femoral vein, pass up the inferior vena cava, enter the right atrium, position the needle assembly distal end at the septum, pierce the septum to form a hole in the septum and to position the needle assembly distal end in the left atrium, move the catheter over the needle assembly to further dilate the septal hole, move the cannula into the left atrium to further dilate the septal hole, and remove the needle, the guide wire, and the catheter from the cannula to permit flow of oxygenated blood from the left atrium to the extra-corporeal pump and through the arterial cannula back to the body.
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35. A method of percutaneous transseptal left atrial ventricular assist for extracting oxygenated flood from the left atrium of the heart by a venous cannulation system and returning the blood to the body by an arterial cannula after passing through an extra-corporeal pump comprising the steps of:
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(a) inserting the venous cannulation system into the femoral vein, said venous cannulation system including a guide wire and a needle located in a catheter with a distal end orifice and a cannula riding over the exterior of the catheter; (b) advancing the guide wire through the catheter orifice and moving the catheter over the guide wire through the inferior vena cava to the septum in the right atrium of the heart; (c) withdrawing the guide wire into the catheter and extending the needle distal end to the septum; (d) piercing the septum with the needle to form a hole; (e) moving the catheter over the needle assembly to further dilate the septal hole; (f) moving the cannula into the left atrium to further dilate the septal hole; (g) withdrawing the guide wire, the needle, and the catheter from the cannula; and (h) draining oxygenated blood from the left atrium through the venous cannula to the extra-corporeal pump and back to the body through the arterial cannula. - View Dependent Claims (36, 37, 38, 39, 40, 41)
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42. A method of inserting a cannula into a blood vessel, said cannula including a plurality of holes located on the side of the cannula parallel to the longitudinal axis of the cannula, comprising the steps of:
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(a) attaching a peel-away sheath assembly to the cannula to cover the cannula holes, said peel-away sheath assembly including a thin-walled tube, said tube is scored; (b) inserting the cannula peel-away sheath assembly into a blood vessel by passing through a subcutaneous layer of fat such that said sheath assembly prevents the cannula holes from accumulating fat particle debris; and (c) pulling back and peeling away the sheath assembly after the cannula is within the blood vessel.
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Specification