Catheter system and method for providing cardiopulmonary bypass pump support during heart surgery

• US 5,478,309 A
• Filed: 05/27/1994
• Issued: 12/26/1995
• Est. Priority Date: 05/27/1994
• Status: Expired due to Term

• Current Assignee: Edwards Lifesciences LLC (Edwards Lifesciences Corporation), Endosurgical Development Corp.
• Original Assignee: William P. Sweezer Jr
• Inventors: Sweezer, William P., Coleman, Ronald L., Jimison, James
• Primary Examiner(s): Green, Randall L.
• Assistant Examiner(s): RUHL, DENNIS WILLIAM
• Application Number:
  US08/250,721
• Time in Patent Office: 578 Days
• Field of Search: 604/4-6, 604/95, 604/96, 604/101, 604/102, 604/280, 128/656-658, 600/16-18
• US Class Current: 604/6.14
• CPC Class Codes: A61M 1/3659 Cannulae pertaining to extracorporeal circulation
• CPC Class Codes: A61M 2025/0031 characterized by lumina for withdrawing or delivering, i.e. used for extracorporeal circuit treatment
• CPC Class Codes: A61M 2025/0036 with more than four lumina
• CPC Class Codes: A61M 2025/0037 characterized by lumina being arranged side-by-side
• CPC Class Codes: A61M 2025/0039 characterized by lumina being arranged coaxially
• CPC Class Codes: A61M 2025/004 characterized by lumina being arranged circumferentially
• CPC Class Codes: A61M 2025/1015 having two or more independently movable balloons where the distance between the balloons can be adjusted, e.g. two balloon catheters concentric to each other forming an adjustable multiple balloon catheter system
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2210/125 Heart
• CPC Class Codes: A61M 25/0068 Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
• CPC Class Codes: A61M 25/007 Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool
• CPC Class Codes: A61M 25/1011 Multiple balloon catheters
• CPC Class Codes: A61M 60/113 in other functional devices, e.g. dialysers or heart-lung machines
• CPC Class Codes: A61M 60/117 for assisting the heart, e.g. transcutaneous or external ventricular assist devices
• CPC Class Codes: A61M 60/279 Peristaltic pumps, e.g. roller 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 60/833 Occluders for preventing backflow
• CPC Class Codes: A61M 60/857 Implantable blood tubes

Abstract

A catheter system and method for achieving total cardiopulmonary bypass during heart surgery. A venous perfusion catheter is inserted peripherally into a preselected vein where it is advanced and positioned at the atrio-caval junction. The venous perfusion catheter has first and second balloons which when inflated respectively occlude the inferior and superior vena cava thereby precluding blood flow into the right atrium. An arterial perfusion catheter is inserted peripherally into a preselected arterial vessel and advanced within the vessel and positioned in the ascending aorta cephalid of the junction of the coronary arteries with the aortic root. A second flexible arterial cannula is mounted in sliding relationship with the first flexible cannula and carries an inflatable balloon adjacent its distal end to provide for occlusion of the ascending aorta. A first flexible cannula has a first lumen and an arterial venting orifice communicating with the first lumen defining a single flow path for the passage of cardioplegia solution to arrest the heart or for the evacuation of blood from the aortic root. A third lumen extends axially through the first flexible arterial cannula and communicates with a multiplicity of openings in the distal tip of the cannula defining a flow path for suctioning blood from the left ventricle. The second flexible cannula of the arterial perfusion catheter has a first cavity extending axially therethrough that communicates with an opening at its distal tip to permit the passage of blood delivered by the cardiopulmonary bypass pump into arterial circulation.

Claims

1. A catheter system for bypassing a heart of a patient during heart surgery, wherein the heart has an aorta, an aortic root, a superior vena cava, an inferior vena cava, and a left ventricle, the catheter system comprising:

(a) a cardiopulmonary bypass pump having an outlet port for the delivery of oxygen-rich blood to arterial circulation and an inlet port for receiving blood from venous circulation;

(b) an arterial perfusion catheter comprising a first flexible arterial cannula member having an axis of elongation, a distal end and a proximate end, and further having a first lumen extending at least in part axially therethrough and having a first proximate port communicating with said first lumen, an arterial venting orifice contained adjacent said distal end communicating with said first lumen and defining a single flow path for the passage of cardioplegia solution or for the evacuation of fluid from the aortic root said heart, said first flexible arterial cannula member having a second lumen extending at least in part axially therethrough and an inflation port communicating with said second lumen and an inlet port communicating with said second lumen and said inflation port;

an expandable member carried by said first flexible arterial cannula member adjacent said distal end and spaced in an axially proximal direction from said arterial venting orifice where said expandable member radially and sealingly encloses and communicates with said inflation port; and

a second flexible arterial cannula member having a second axis of elongation and a distal and proximate end, said second flexible arterial cannula member having an axially extending first cavity therethrough and a first opening adjacent said distal end of said second flexible arterial cannula member communicating with said first cavity to permit the passage of blood into the aorta of said patient where said second flexible arterial cannula member has a second axially extending cavity therethrough adapted for receiving said first flexible arterial cannula member to permit relative slideable movement between said first flexible Arterial cannula member and said second flexible arterial cannula member; and

means associated with said second flexible arterial cannula member for connecting said second flexible arterial cannula member to said outlet port of said cardiopulmonary bypass pump; and

(c) normally closed valve means communicating with said first lumen for selectively permitting the flow of cardioplegic solution within said single flow path or for selectively evacuating fluid from said aortic root through said single flow path;

(d) a venous catheter comprising a flexible venous member having an axis of elongation, a distal end and a proximate end and an axially extending venous cavity therethrough, and having a first venous lumen extending at least in part axially therethrough and a first venous inflation port communicating with said first venous lumen, said flexible venous member further having a second venous lumen extending at least in part axially therethrough and a second venous inflation port communicating with said second venous lumen;

a first expandable venous member carried by said flexible venous member adjacent said distal end of said flexible venous member for occluding the superior vena cava of said patient, where said flexible venous member has a first venous return port spaced intermediate said distal end of said flexible venous member and said first expandable venous member and communicating with said venous cavity for receiving blood from the superior vena cava of said patient, and where said first expandable venous member radially and sealingly encloses and communicates with said first venous inflation port;

a second expandable venous member carried by said flexible venous member proximately of said first expandable venous member for occluding the inferior vena cava of said patient, said flexible venous member having a second venous return port spaced proximately and adjacent said second expandable venous member and communicating with said venous cavity for receiving blood from the inferior vena cava of said patient, and where said second expandable venous member radially and sealingly encloses and communicates with said second venous inflation port; and

means associated with said flexible venous member for connecting said flexible venous member to said cardiopulmonary bypass pump so as to permit said venous cavity to be in fluid communication with said cardiopulmonary bypass pump.

2. The catheter system for bypassing the heart during heart surgery recited in claim 1 wherein said first flexible arterial cannula member further comprises a plurality of radially and oppositely spaced steering lumens extending at least in part axially therethrough and a plurality of steering cables having first and second ends where each said first end is fixed to said first flexible arterial cannula member adjacent said distal end of said first flexible arterial cannula member, and where each one of said plurality of steering cables extends respectively through one of said plurality of steering lumens, and steering means connected to said plurality of steering cables adjacent said second ends of said plurality of steering cables for selectively increasing and decreasing the tension in said plurality of steering cables so as to omnidirectionally permit said distal end of said first flexible arterial cannula member to articulate.

3. The catheter system for bypassing the heart during heart surgery recited in claim 2 further comprising sensor means responsive to ultrasound waves carried by said first flexible arterial cannula member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible arterial cannula member.

4. The catheter system for bypassing the heart during surgery recited in claim 3 wherein said flexible venous member further comprises a plurality of radially and oppositely spaced venous steering lumens extending at least in part axially therethrough and a plurality of venous steering cables having respectively a first end and a second end where each said first end is fixed to said flexible venous member adjacent said distal end of said flexible venous member and where each one of said plurality of venous steering cables extends respectively through one of said venous steering lumens, and venous steering means connected to said plurality of venous steering cables adjacent said second ends of said venous steering cables for selectively increasing and decreasing the tension in said venous steering cables so as to omnidirectionally permit said distal end of said flexible venous member to articulate.

5. The catheter system for bypassing the heart during surgery recited in claim 4 further comprising venous sensor means responsive to ultrasound waves carried by said flexible venous member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said flexible venous member.

6. The catheter system recited in claim 1 wherein said first flexible arterial cannula member further comprises a third lumen extending at least in part axially therethrough, said first flexible arterial cannula member having a decompression port located proximally of said expandable member and communicating with said third lumen, said first flexible arterial cannula member further having a second opening located adjacent said distal end of said first flexible arterial cannula member communicating with both said third lumen and said decompression port defining a flow path for blood suctioned from the left ventricle of said heart, where said second opening is spaced sufficiently axially and distally from said arterial venting orifice to permit said second opening to communicate with said left ventricle of said heart while said arterial venting orifice communicates with said aortic root of said heart.

7. The catheter system for bypassing the heart during heart surgery recited in claim 6 wherein said first flexible arterial cannula member further comprises a plurality of radially and oppositely spaced steering lumens extending at least in part axially therethrough and a plurality of steering cables having first and second ends where each said first end is respectively fixed to said first flexible arterial cannula member adjacent said distal end of said first flexible arterial cannula member, and where each one of said plurality of steering cables extends respectively through one of said plurality of steering lumens, and steering means connected to said plurality of steering cables adjacent each said second end for selectively increasing and decreasing the tension in said plurality of steering cables so as to omnidirectionally permit said distal end of said first flexible arterial cannula member to articulate.

8. The catheter system for bypassing the heart during heart surgery recited in claim 7 further comprising sensor means responsive to ultrasound waves carried by said first flexible arterial cannula member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible arterial cannula member.

9. The catheter system for bypassing the heart during heart surgery recited in claim 8 wherein said flexible venous member further comprises a plurality of radially and oppositely spaced venous steering lumens extending at least in part axially therethrough and a plurality of venous steering cables having a first end and a second end where each said first end is fixed to said flexible venous member adjacent said distal end of said flexible venous member and where each one of said plurality of venous steering cables extends respectively through one of said plurality of venous steering lumens, and venous steering means connected to said plurality of venous steering cables adjacent each said second end of said plurality of venous steering cables for selectively increasing and decreasing the tension in said plurality of venous steering cables so as to omnidirectionally permit said distal end of said flexible venous member to articulate.

10. The catheter system for bypassing the heart during heart surgery recited in claim 9 further comprising venous sensor means responsive to ultrasound waves carried by said flexible venous member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said flexible venous member.

11. A catheter system for bypassing a heart of a patient during heart surgery, wherein the heart has an aorta, an aortic root, a superior vena cava, an inferior vena cava, and a left ventricle, the catheter system comprising:

(a) a cardiopulmonary bypass pump having an outlet port for the delivery of oxygen-rich blood to arterial circulation and an inlet port for receiving blood from venous circulation;

(b) an arterial perfusion catheter comprising a first flexible arterial cannula member having an axis of elongation, a distal end and a proximate end, and a first lumen extending at least in part axially therethrough and having a first proximate port communicating with said first lumen and an arterial venting orifice contained adjacent said distal end communicating with said first lumen and defining a single flow path for the passage of cardioplegia solution or for the evacuation of fluid from the aortic root of said heart, said first flexible arterial cannula member having a second lumen extending at least in part axially therethrough and an inflation port communicating with said second lumen and an inlet port communicating with said second lumen and said inflation port;

an expandable member carried by said first flexible arterial cannula member adjacent said distal end and spaced in an axially proximal direction from said arterial venting orifice where said expandable member radially and sealingly encloses and communicates with said inflation port; and

a second flexible arterial cannula member having a second axis of elongation and a distal and proximate end, said second flexible arterial cannula member having an axially extending first cavity therethrough and a first opening adjacent said distal end of said second flexible arterial cannula member communicating with said first cavity to permit the passage of blood into the aorta of said patient where said second flexible arterial cannula member has a second axially extending cavity therethrough adapted for receiving said first flexible arterial cannula member to permit relative slideable movement between said first flexible arterial cannula member and said second flexible arterial cannula member; and

means associated with said second flexible arterial cannula member for connecting said second flexible arterial cannula member to said outlet port of said cardiopulmonary bypass pump; and

(c) normally closed valve means communicating with said first lumen for selectively permitting the flow of cardioplegic solution within said single flow path or for selectively evacuating fluid from the aortic root of said heart through said single flow path;

(d) a venous catheter comprising a first flexible venous cannula having an axis of elongation, a distal end and a proximal end and an axially extending cavity therethrough, and having a first venous lumen extending at least in part axially therethrough and a first venous inflation port communicating with said first lumen;

a first expandable venous member carried by said first flexible venous cannula adjacent said distal end of said first flexible venous cannula for occluding the superior vena cava of said patient, where said first flexible venous cannula has an orifice spaced distally of said first expandable venous member communicating with said cavity for receiving blood from the superior vena cava of said patient, and where said first expandable venous member radially and sealingly encloses and communicates with said first venous inflation port;

a second flexible venous cannula having a second axis of elongation and a distal end and proximal end, said second flexible venous cannula having a second axially extending cavity therethrough and a first opening adjacent said distal end of said second flexible venous cannula communicating with said second cavity, where said second cavity is adapted for receiving said first flexible venous cannula to permit relative slideable movement between said first flexible venous cannula and said second flexible venous cannula, said second flexible venous cannula having a second venous lumen extending at least in part axially therethrough and a second venous inflation port communicating with said second venous lumen;

a second expandable venous member carried by said second flexible venous cannula adjacent said distal end of said second flexible venous cannula for occluding the inferior vena cava of said patient, where said second flexible venous cannula has a venous return port spaced proximally and adjacent said second expandable venous member, said second flexible venous cannula having a third cavity extending at least in part axially therethrough for receiving blood from the inferior vena cava of said patient and where said venous return port communicates with said third cavity; and

connecting means associated with said first flexible venous cannula and said second flexible venous cannula for connecting said first cavity and said third cavity to said inlet port of said cardiopulmonary bypass pump.

12. The catheter system for bypassing the heart during heart surgery recited in claim 11 wherein said first flexible arterial cannula member further comprises a plurality of radially and oppositely spaced steering lumens extending at least in part axially therethrough and a plurality of steering cables having first and second ends where each said first end is fixed to said first flexible arterial cannula member adjacent said distal end of said first flexible arterial cannula member, and where each one of said steering cables extends respectively through one of said steering lumens, and steering means connected to said steering cables adjacent said second ends of said steering cables for selectively increasing and decreasing the tension in said steering cables so as to omnidirectionally permit said distal end of said first flexible arterial cannula member to articulate.

13. The catheter system for bypassing the heart during heart surgery recited in claim 12 further comprising sensor means responsive to ultrasound waves carried by said first flexible arterial cannula member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible arterial cannula member.

14. The catheter system for bypassing the heart during surgery recited in claim 13 wherein said first flexible venous cannula further comprises a plurality of radially and oppositely spaced venous steering lumens extending at least in part axially therethrough and a plurality of venous steering cables having first and second ends where each said first end is fixed to said first flexible venous cannula adjacent said distal end of said first flexible venous cannula and where each one of said venous steering cables extends respectively through one of said venous steering lumens, and venous steering means connected to said venous steering cables adjacent said second ends of said venous steering cables for selectively increasing and decreasing the tension in said venous steering cables so as to omnidirectionally permit said distal end of said first flexible venous cannula to articulate.

15. The catheter system for bypassing the heart during surgery recited in claim 14 further comprising venous sensor means responsive to ultrasound waves carried by said first flexible venous cannula for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible venous cannula.

16. The catheter system recited in claim 11 wherein said first flexible arterial cannula member further comprises a third lumen extending at least in part axially therethrough, said first flexible arterial cannula member having a decompression port located proximally of said expandable member and communicating with said third lumen, said first flexible arterial cannula member further having a second opening located adjacent said distal end of said first flexible cannula communicating with both said third lumen and said decompression port defining a flow path for blood suctioned from the left ventricle of said heart, where said second opening is spaced sufficiently axially and distally from said arterial venting orifice to permit said second opening to communicate with the left ventricle of said heart while said arterial venting orifice communicates with said aortic root.

17. The catheter system for bypassing the heart during heart surgery recited in claim 16 wherein said first flexible arterial cannula member further comprises a plurality of radially and oppositely spaced steering lumens extending at least in part axially therethrough and a plurality of steering cables having first and second ends where each said first end is fixed to said first flexible arterial cannula member adjacent said distal end of said first flexible arterial cannula member, and where each one of said steering cables extends respectively through one of said steering lumens, and steering means connected to said steering cables adjacent said second ends of said steering cables for selectively increasing and decreasing the tension in said steering cables so as to omnidirectionally permit said distal end of said first flexible arterial cannula member to articulate.

18. The catheter system for bypassing the heart during heart surgery recited in claim 17 further comprising sensor means responsive to ultrasound waves carried by said first flexible arterial cannula member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible arterial cannula member.

19. The catheter system for bypassing the heart during heart surgery recited in claim 18 wherein said flexible venous cannula further comprises a plurality of radially and oppositely spaced venous steering lumens extending at least in part axially therethrough and a plurality of venous steering cables having a first end and a second end where said first end is fixed to said first flexible venous cannula adjacent said distal end of said first flexible venous cannula and where each one of said venous steering cables extends respectively through one of said venous steering lumens, and venous steering means connected to said venous steering cables adjacent said second ends of said steering cables for selectively increasing and decreasing the tension in said venous steering cables so as to omnidirectionally permit said distal end of said first flexible venous cannula to articulate.

20. The catheter system for bypassing the heart during heart surgery recited in claim 19 further comprising venous sensor means responsive to ultrasound waves carried by said first flexible venous cannula for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible venous cannula.

21. A catheter system for bypassing a heart of a patient during heart surgery, wherein the heart has an aorta, an aortic root, a superior vena cava, an inferior vena cava, and a left ventricle, the catheter system comprising:

(a) a cardiopulmonary bypass pump having an outlet port for the delivery of oxygen-rich blood to arterial circulation and an inlet port for receiving blood from venous circulation;

(b) an arterial perfusion catheter comprising a first flexible arterial cannula member having an axis of elongation, a distal end and a proximal end, and a first lumen extending at least in part axially therethrough and having a first proximate port communicating with said first lumen and an arterial venting orifice contained adjacent said distal end communicating with said first lumen and defining a single flow path for the passage of cardioplegia solution or for the evacuation of fluid from the aortic root of said heart, said first flexible arterial cannula member further having a third lumen and a decompression port communicating with said third lumen and a second opening communicating with said third lumen and said decompression port defining a flow path for blood suctioned from the left ventricle of said heart where said second opening is spaced sufficiently axially and distally from said arterial venting orifice to permit said second opening to communicate with the left ventricle of said heart while said arterial venting orifice communicates with the aortic root of said heart;

a second flexible arterial cannula member having a second axis of elongation and a distal and proximal end, said second flexible arterial cannula member having an axially extending first cavity therethrough and a first opening adjacent said distal end of said second flexible arterial cannula member communicating with said first cavity to permit the passage of blood into the aorta of said patient where said second flexible arterial cannula member has a second axially extending cavity therethrough adapted for receiving said first flexible arterial cannula member to permit relative slideable movement between said first flexible arterial cannula member and said second flexible arterial cannula member, said second flexible arterial cannula member having an inlet port and an inflation lumen extending at least in part axially therethrough communicating with said inlet port and an inflation port communicating with both said inflation lumen and said inlet port;

an expandable member carried by said second flexible arterial cannula member adjacent said distal end of said second flexible arterial cannula member where said expandable member radially and sealingly encloses said inflation port; and

means associated with said second flexible arterial cannula member for connecting said second flexible arterial cannula member to said outlet port of said cardiopulmonary bypass pump;

(c) normally closed valve means communicating with said first lumen for selectively permitting the flow of cardioplegia solution within said single flow path or for selectively evacuating fluid from said aortic root through said single flow path; and

(d) a venous catheter comprising a flexible venous member having an axis of elongation, a distal end and a proximate end and an axially extending venous cavity therethrough, and having a first venous lumen extending at least in part axially therethrough and a first venous inflation port communicating with said first venous lumen, said flexible venous member further having a second venous lumen extending at least in part axially therethrough and a second venous inflation port communicating with said second venous lumen;

a first expandable venous member carried by said flexible venous member adjacent said distal end of said flexible venous member for occluding the superior vena cava of said patient, where said flexible venous member has a first venous return port spaced intermediate said distal end of said flexible venous member and said first expandable venous member and communicating with said venous cavity for receiving blood from said superior vena cava, and where said first expandable venous member radially and sealingly encloses and communicates with said first venous inflation port;

a second expandable venous member carried by said flexible venous member proximately of said first expandable venous member for occluding the inferior vena cava of said patient, said flexible venous member having a second venous return port spaced proximately and adjacent said second expandable venous member and communicating with said venous cavity for receiving blood from said inferior vena cava, and where said second expandable venous member radially and sealingly encloses and communicates with said second venous inflation port; and

means associated with said flexible venous member for connecting said flexible venous member to said cardiopulmonary bypass pump so as to permit said venous cavity to be in fluid communication with said cardiopulmonary bypass pump.

22. The catheter system for bypassing the heart during heart surgery recited in claim 21 wherein said first flexible arterial cannula member further comprises a plurality of radially and oppositely spaced steering lumens extending at least in part axially therethrough and a plurality of steering cables having first and second ends where each said first end is respectively fixed to said first flexible arterial cannula member adjacent said distal end of said first flexible arterial cannula member, and where each one of said steering cables extends respectively through one of said steering lumens, and steering means connected to said steering cables adjacent said second ends 0f said steering cables for selectively increasing and decreasing the tension in said steering cables so as to omnidirectionally permit said distal end of said first flexible arterial cannula member to articulate.

23. The catheter system for bypassing the heart during heart surgery recited in claim 22 further comprising sensor means responsive to ultrasound waves carried by said first flexible arterial cannula member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible arterial cannula member.

24. The catheter system for bypassing the heart during heart surgery recited in claim 23 wherein said flexible venous member further comprises a plurality of radially and oppositely spaced venous steering lumens extending at least in part axially therethrough and a plurality of venous steering cables having a first end and a second end where said first end is fixed to said flexible venous member adjacent said distal end of said flexible venous member and where each one of said venous steering cables extends respectively through one of said venous steering lumens, and venous steering means connected to said venous steering cables adjacent said second ends of said venous steering cables for selectively increasing and decreasing the tension in said venous steering cables so as to omnidirectionally permit said distal end of said flexible venous member to articulate.

25. The catheter system for bypassing the heart during surgery recited in claim 24 further comprising venous sensor means responsive to ultrasound waves carried by said flexible venous member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said flexible venous member.

26. A catheter system for bypassing a heart of a patient during heart surgery, wherein the heart has an aorta, an aortic root, a superior vena cava, an inferior vena cava, and a left ventricle, the catheter system comprising:

(a) a cardiopulmonary bypass pump having an outlet port for the delivery of oxygen-rich blood to arterial circulation and an inlet port for receiving blood from venous circulation;

(b) an arterial perfusion catheter comprising a first flexible arterial cannula member having an axis of elongation, a distal end and a proximal end, and a first lumen extending at least in part axially therethrough and having a first proximate port communicating with said first lumen and an arterial venting orifice contained adjacent said distal end of said first flexible arterial cannula member communicating with said first lumen and defining a single flow path for the passage of cardioplegia solution or for the evacuation of fluid from the aortic root of said patient, said first flexible arterial cannula member further having a third lumen and a decompression port communicating with said third lumen and a second opening communicating with said third lumen and said decompression port defining a flow path for blood suctioned from the left ventricle of said heart where said second opening is spaced sufficiently axially and distally from said arterial venting orifice to permit said second opening to communicate with the left ventricle of said heart while said arterial venting orifice communicates with said aortic root;

a second flexible arterial cannula member having a second axis of elongation and a distal and proximal end, said second flexible arterial cannula member having an axially extending first cavity therethrough and a first opening adjacent said distal end of said second flexible arterial cannula member communicating with said first cavity to permit the passage of blood into the aorta of said patient where said second flexible arterial cannula member has a second axially extending cavity therethrough adapted for receiving said first flexible arterial cannula member to permit relative slideable movement between said first flexible arterial cannula member and said second flexible arterial cannula member, said second flexible arterial cannula member having an inlet port and an inflation lumen extending at least in part axially therethrough communicating with said inlet port and an inflation port communicating with both said inflation lumen and said inlet port;

an expandable member carried by said second flexible arterial cannula member adjacent said distal end of said second flexible arterial cannula member where said expandable member radially and sealingly encloses said inflation port; and

means associated with said second flexible arterial cannula member for connecting said second flexible arterial cannula member to said outlet port of said cardiopulmonary bypass pump; and

(c) normally closed valve means communicating with said first lumen for selectively permitting the flow of cardioplegia solution within said single flow path or for selectively evacuating fluid from said aortic root through said single flow path;

(d) a venous catheter comprising a first flexible venous cannula having an axis of elongation, a distal end and a proximal end and an axially extending cavity therethrough, and having a first venous lumen extending at least in part axially therethrough and a first venous inflation port communicating with said first lumen;

a first expandable venous member carried by said first flexible venous cannula adjacent said distal end of said first flexible venous cannula for occluding the superior vena cava of said patient, where said first flexible venous cannula has an orifice spaced distally of said first expandable venous member communicating with said cavity for receiving blood from the superior vena cava of said patient, and where said first expandable venous member radially and sealingly encloses and communicates with said first venous inflation port;

a second flexible venous cannula having a second axis of elongation and a distal end and proximal end, said second flexible venous cannula having a second axially extending cavity therethrough and a first opening adjacent said distal end of said second flexible venous cannula communicating with said second cavity, where said second cavity is adapted for receiving said first flexible venous cannula to permit relative slideable movement between said first flexible venous cannula and said second flexible venous cannula, said second flexible venous cannula having a second venous lumen extending at least in part axially therethrough and a second venous inflation port communicating with said second venous lumen;

a second expandable venous member carried by said second flexible venous cannula adjacent said distal end of said second flexible venous cannula for occluding the inferior vena cava of said patient, where said second flexible venous cannula a venous return port spaced proximally and adjacent said second expandable venous member, said second flexible venous cannula having a third cavity extending at least in part axially therethrough for receiving blood from said inferior vena cava and where said venous return port communicates with said third cavity; and

connecting means associated with said first flexible venous cannula and said second flexible venous cannula for connecting said first cavity and said third cavity to said inlet port of said cardiopulmonary bypass pump.

27. The catheter system for bypassing the heart during heart surgery recited in claim 26 wherein said first flexible arterial cannula member further comprises a plurality of radially and oppositely spaced steering lumens extending at least in part axially therethrough and a plurality of steering cables having first and second ends where each said first end is fixed to said first flexible arterial cannula member adjacent said distal end of said first flexible arterial cannula member, and where each one of said steering cables extends means connected to said steering cables adjacent said second ends of said steering cables for selectively increasing and decreasing the tension in said steering cables so as to omnidirectionally permit said distal end of said first flexible arterial cannula member to articulate.

28. The catheter system for bypassing the heart during heart surgery recited in claim 27 further comprising sensor means responsive to ultrasound waves carried by said first flexible arterial cannula member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible arterial cannula member.

29. The catheter system for bypassing the heart during surgery recited in claim 28 wherein said first flexible venous cannula further comprises a plurality of radially and oppositely spaced venous steering lumens extending at least in part axially therethrough and a plurality of venous steering cables having first and second ends where each said first end is fixed to said first flexible venous cannula adjacent said distal end of said first flexible venous cannula and where each one of said venous steering cables extends respectively through one of said venous steering lumens, and venous steering means connected to said venous steering cables adjacent said second ends of said venous steering cables for selectively increasing and decreasing the tension in said venous steering cables so as to omnidirectionally permit said distal end of said first flexible venous cannula to articulate.

30. The catheter system for bypassing the heart during surgery recited in claim 29 further comprising venous sensor means responsive to ultrasound waves carried by said first flexible venous cannula for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible venous cannula.

31. An arterial catheter device for occluding an aorta of a heart that has an aortic root and a left ventricle, for delivering cardioplegia solution, for providing aortic root venting, for providing left ventricle decompression, and for delivering oxygen-rich blood from a cardiopulmonary bypass pump during heart surgery of a patient comprising:

(a) a first flexible arterial cannula member having an axis of elongation, a distal end and a proximal end, and a first lumen extending at least in part axially therethrough and having a first proximate port communicating with said first lumen and an arterial venting orifice communicating with said first lumen defining a single flow path for the passage of cardioplegia solution or for the evacuation of fluid from said aortic root, said first flexible arterial cannula member having a second lumen extending at least in part axially therethrough and an inflation port communicating with said second lumen, said first flexible arterial cannula member further having an inlet port in communication with said second lumen and said inflation port;

(b) an expandable member carried by said first flexible arterial cannula member adjacent said distal end of said first flexible arterial cannula member and spaced in an axially proximate direction from said arterial venting orifice where said expandable member radially and sealingly encloses and communicates with said inflation port;

(c) a second flexible arterial cannula member having a second axis of elongation and a distal and proximate end said second flexible arterial cannula member further having an axially extending first cavity therethrough and a first opening adjacent said distal end of said second flexible arterial cannula member communicating with said first cavity to permit the passage of blood into said aorta where said second flexible cannula member has a second axially extending cavity therethrough adapted for receiving said first flexible arterial cannula member to permit relative slideable movement between said first flexible arterial cannula member and said second flexible arterial cannula member;

(d) means associated with said second flexible arterial cannula member for connecting said second flexible arterial cannula member to said cardiopulmonary bypass pump.

32. The catheter device recited in claim 31 further comprising sensor means responsive to ultrasound waves carried by said first flexible cannula member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible arterial cannula member.

33. The catheter device recited in claim 31 wherein said first flexible arterial cannula member further comprises a third lumen extending at least in part axially therethrough, said first flexible arterial cannula member having a decompression port located proximally of said expandable member and communicating with said third lumen, said first flexible arterial cannula member further having a second opening located adjacent said distal end of said first flexible arterial cannula member communicating with both said third lumen and said decompression port defining a flow path for blood suctioned from said left ventricle, where said second opening is spaced sufficiently axially and distally from said arterial venting orifice so as to permit said second opening to communicate with said left ventricle while said arterial venting orifice is in communication with said aortic root.

34. The catheter device recited in claim 33 further comprising sensor means responsive to ultrasound waves carried by said first flexible arterial cannula member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible arterial cannula member.

35. The catheter device recited in claim 33 where said first flexible arterial cannula member further includes a region of flexion located adjacent to and proximately of said expandable member where said region of flexion has less flexural rigidity than said first flexible arterial cannula member so as to permit enhanced elastic bending of said first flexible arterial cannula member within said region of flexion.

36. The catheter device recited in claim 34 where said first flexible arterial cannula member further includes a region of flexion located adjacent to and proximately of said expandable member where said region of flexion has less flexural rigidity than said first flexible arterial cannula member so as to permit enhanced elastic bending of said first flexible arterial cannula member within said region of flexion.

37. The catheter device for occluding the aorta recited in claim 33 wherein said first cannula further includes a plurality of radially and oppositely spaced steering lumens extending at least in part axially therethrough and a plurality of steering cables having a first and second end where said first end is fixed to said first flexible arterial cannula member adjacent said distal end of said first flexible arterial cannula member and where each one of said steering cables extends respectively through one of said steering lumens, and steering means connected to said steering cables at said second ends of said steering cables for selectively increasing and decreasing the tension in said steering cables so as to omnidirectionally permit said distal end of said first flexible arterial cannula member to articulate.

38. An arterial catheter device for occluding an aorta of a heart that has an aortic root and a left ventricle, for delivering cardioplegia solution, for providing aortic root venting, for providing left ventricle decompression, and for delivering oxygen-rich blood from the cardiopulmonary bypass pump during heart surgery of a patient comprising:

(a) a first flexible cannula member having an axis of elongation, a distal end and a proximate end, and a first lumen extending at least in part axially therethrough and having a first proximate port communicating with said first lumen and an arterial venting orifice contained adjacent said distal end communicating with said first lumen defining a single flow path for the passage of cardioplegia solution or for the evacuation of fluid from said aortic root, said first flexible arterial cannula member further having a third lumen and a decompression port communicating with said third lumen and located proximately of said arterial venting orifice and a second opening communicating with said third lumen defining a single flow path for blood suctioned from said left ventricle where said second opening is spaced sufficiently axially and distally from said arterial venting orifice so as to permit said second opening to communicate with said left ventricle while said arterial venting orifice is in communication with said aortic root;

(b) a second flexible arterial cannula member having a second axis of elongation and a distal and proximate end, said second flexible arterial cannula member having an axially extending first cavity therethrough and a first opening adjacent said distal end of said second flexible arterial cannula member communicating with said first cavity to permit the passage of blood into said aorta where said second flexible arterial cannula member has a second axially extending cavity therethrough adapted for receiving said first flexible arterial cannula member to permit relative slideable movement between said first flexible arterial cannula member and said second flexible arterial cannula member, said second flexible arterial cannula member having an inlet port and an inflation lumen extending at least in part axially therethrough communicating with said inlet port and further having an inflation port communicating with both said inflation lumen and said inlet port;

(c) an expandable member carried by said second flexible arterial cannula member adjacent said distal end of said second flexible arterial cannula member where said expandable member radially and sealingly encloses said inflation port; and

(d) means associated with said second flexible arterial cannula member for connecting said second flexible arterial cannula member to said cardiopulmonary bypass pump.

39. The catheter device recited in claim 38 further comprising sensor means responsive to ultrasound waves carried by said first flexible arterial cannula member for generating an electrical signal to be transformed into visual indicia of location of said distal end of said first flexible arterial cannula member.

40. The catheter device for occluding the aorta recited in claim 38 wherein said first flexible arterial cannula member further includes a plurality of radially and oppositely spaced steering lumens extending at least in part axially therethrough and a plurality of steering cables having a first and second end where each said first end is fixed to said first flexible arterial cannula member adjacent said distal end of said first flexible arterial cannula member and where each one of said steering cables extends respectively through one of said steering lumens, and steering means connected to said steering cables at said second ends of said steering cables for selectively increasing and decreasing the tension in said steering cables so as to omnidirectionally permit said distal end of said first flexible arterial cannula member to articulate.

41. The catheter device recited in claim 38 where said second flexible arterial cannula member further includes a region of flexion located adjacent to and proximately of said expandable member where said region of flexion has less flexural rigidity than said second flexible arterial cannula member so as to permit enhanced elastic bending of said second flexible arterial cannula member within said region of flexion.

42. A venous catheter device for occluding a superior vena cava and an inferior vena cava of a heart of a patient and for delivering blood to a cardiopulmonary bypass pump during heart surgery comprising:

(a) a flexible venous cannula having an axis of elongation, a distal end and a proximate end and an axially extending cavity therethrough, and having a first lumen extending at least in part axially therethrough and a first venous inflation port communicating with said first lumen, said flexible venous cannula further having a second lumen extending at least in part axially therethrough and a second venous inflation port communicating with said second lumen;

(b) a first expandable venous member carried by said flexible venous cannula adjacent said distal end of said flexible venous cannula for occluding said superior vena cava, where said flexible venous cannula has a first venous return port spaced intermediate said distal end of said flexible venous cannula and said first expandable venous member and communicating with said cavity for receiving blood from said superior vena cava, and where said first expandable venous member radially and sealingly encloses and communicates with said first venous inflation port;

(c) a second expandable venous member carried by said flexible venous cannula proximately of said first expandable venous member for occluding said inferior vena cava, said flexible venous cannula having a second venous return port spaced proximately and adjacent said second expandable venous member and communicating with said cavity for receiving blood from said inferior vena cava, and where said second expandable venous member radially and sealingly encloses and communicates with said second venous inflation port;

(d) means associated with said flexible venous cannula for connecting said flexible venous cannula to said cardiopulmonary bypass pump.

43. The venous catheter device recited in claim 42 wherein said flexible venous cannula further comprises a plurality of radially and oppositely spaced steering lumens extending at least in part axially therethrough and a plurality of steering cables having a first and second end where each said first end is fixed to said flexible venous cannula adjacent said distal end of said flexible venous cannula and where each one of said steering cables extends respectively through one of said steering lumens, and steering means connected to said steering cables adjacent said second ends for selectively increasing and decreasing the tension in said steering cables so as to omnidirectionally permit said distal end of said flexible venous cannula to articulate.

44. The venous catheter device recited in claim 43 further comprising sensor means responsive to ultrasound waves carried by said flexible venous cannula for generating an electrical signal to be transformed into visual indicia of location of said flexible venous cannula within said patient.

45. A venous catheter device for occluding a superior vena cava and an inferior vena cava of a heart of a patient and for delivering blood to a cardiopulmonary bypass pump during heart surgery comprising:

(a) a first flexible venous cannula having an axis of elongation, a distal end and a proximate end and an axially extending cavity therethrough, and having a first lumen extending at least in part axially therethrough and a first venous inflation port communicating with said first lumen;

(b) a first expandable venous member carried by said first flexible venous cannula adjacent said distal end of said first flexible venous cannula for occluding said superior vena cava, where said first flexible venous cannula has an orifice spaced distally of said first expandable venous member communicating with said cavity for receiving blood from said superior vena cava, and where said first expandable venous member radially and sealingly encloses and communicates with said first venous inflation port;

(c) a second flexible venous cannula having a second axis of elongation and a distal end and proximate end, said second flexible venous cannula having a second axially extending cavity therethrough and a first opening adjacent said distal end of said second flexible venous cannula communicating with said second cavity, where said second cavity is adapted for receiving said first flexible venous cannula to permit relative slideable movement between said first flexible venous cannula and said second flexible venous cannula, said second flexible venous cannula having a second lumen extending at least in part axially therethrough and a second venous inflation port communicating with said second lumen;

(d) a second expandable venous member carried by said second flexible venous cannula adjacent said distal end of said second flexible venous cannula for occluding said inferior vena cava, where said second flexible venous cannula has a venous return port spaced proximately and adjacent said second expandable venous member, said second flexible venous cannula further having a third cavity extending at least in part axially therethrough for receiving blood from said inferior vena cava and where said venous return port communicates with said third cavity;

(e) connecting means associated with said first flexible venous cannula and said second flexible venous cannula for connecting said first cavity and said third cavity to said cardiopulmonary bypass pump.

46. The venous catheter device recited in claim 45 wherein said first flexible venous cannula further comprises a plurality of radially and oppositely spaced steering lumens extending at least in part axially therethrough and a plurality of steering cables having a first end and second end where each said first end of said plurality of steering cables is fixed to said first flexible venous cannula adjacent said distal end of said first flexible venous cannula, and where each one of said steering cables extends respectively through one of said steering lumens, and steering means connected to said steering cables adjacent said second ends of said plurality of steering cables for selectively increasing and decreasing the tension in said steering cables so as to omnidirectionally permit said distal end of said first flexible venous cannula to articulate.

47. The venous catheter device recited in claim 46 further comprising sensor means responsive to ultrasound waves carried by said first flexible venous cannula for generating an electrical signal to be transformed into visual indicia of location of said first flexible venous cannula within the body of said patient.

48. A method for providing a heart of a patient providing a patient with cardiopulmonary bypass pump support during heart surgery wherein the heart has a right atrium, an inferior vena cava, a superior vena cava, an ascending aorta, a left ventricle, and an aorta with an aortic arch, an aortic valve, and an aortic root, the method comprising the steps of:

(a) inserting an arterial perfusion catheter having a proximal and distal end into a preselected arterial vessel of sufficient radial dimensions to permit the passage of said arterial perfusion catheter within said arterial vessel and into the ascending aorta of said patient distal of the aortic root of said heart where said arterial perfusion catheter carries an expandable member proximally of said distal end of said arterial perfusion catheter for occluding the aorta of said patient so as to occlude blood flow from the left ventricle of said heart and isolate the arterial side of said heart from arterial circulation, said arterial perfusion catheter having a first lumen therein for providing fluid to expand said expandable member;

said arterial perfusion catheter further having a second lumen for delivering a cardioplegia solution into the aortic root of said heart distally of said expandable member or for providing aortic root venting of said heart, said arterial perfusion catheter further having a third lumen to deliver blood into arterial circulation;

(b) advancing said arterial perfusion catheter within said arterial vessel and positioning said expandable member in the ascending aorta of said patient cephalid of the junction of the coronary arteries with the aortic root of said heart;

(c) inserting a venous catheter having a proximal and distal end into a preselected vein of said patient having sufficient radial dimensions to permit passage of said venous catheter within said vein of said patient and into communication with the entrance of the superior and inferior vena cava of said patient into the right atrium of said heart where said venous catheter carries a first expandable member adjacent the distal end of said venous catheter for occluding the superior vena cava of said patient and a second expandable member carried by said venous catheter and located proximally of said first expandable member for occluding the inferior vena cava of said patient so as to preclude blood flow into the right atrium of said heart;

said venous catheter having a first conduit communicating with both said first expandable member and said second expandable member for providing fluid to said first and second expandable members for expanding said first and second expandable members; and

a second conduit for receiving blood from the superior and inferior vena cava of said patient for delivering said blood to said cardiopulmonary bypass pump;

(d) advancing said venous catheter within said vein and positioning said first and second expandable members in the superior vena cava and inferior vena cava of said patient respectively so as to preclude blood flow into the right atrium of said heart upon sufficient expansion of said first expandable member and said second expandable member;

(e) connecting said arterial perfusion catheter to said cardiopulmonary bypass pump such that said third lumen of said arterial perfusion catheter is in communication with said cardiopulmonary bypass pump and connecting said venous catheter to said cardiopulmonary bypass pump such that said second conduit is in communication with said cardiopulmonary bypass pump;

(f) after steps a, b, c, d and e, the step of activating said cardiopulmonary bypass pump;

(g) after step f, the step of expanding said expandable member of said arterial perfusion catheter sufficiently to occlude the passage of blood from the aortic root of said heart into systemic arterial circulation;

(h) after step g, the step of infusing said cardioplegia solution into said aortic root of said heart to arrest said heart; and

(i) expanding said first expandable member and said second expandable member sufficiently to preclude blood flow from the inferior and superior vena cava respectively of said patient into the right atrium of said heart thereby completing isolation of said heart and establishing total cardiopulmonary bypass support.

49. The method for providing cardiopulmonary bypass pump support during heart surgery recited in claim 48 wherein said arterial perfusion catheter further comprises a fourth lumen communicating with an opening adjacent said distal end of said arterial perfusion catheter where said distal end of said arterial perfusion catheter is sufficiently spaced distally from said expandable member to permit said distal end of said arterial perfusion catheter to extend across the aortic valve of said heart and into the left ventricle of said heart such that blood contained within the left ventricle of said heart may be suctioned through said opening and into said fourth lumen, and further comprising, after step f, the step of suctioning blood from the left ventricle of said heart into said fourth lumen.

50. The method for providing cardiopulmonary bypass pump support during heart surgery recited in claim 48 wherein said expandable member carried by said arterial perfusion catheter is delineated by ultrasound sensors, further comprising the step of positioning said expandable member ultrasonically.

51. The method for providing cardiopulmonary bypass support during heart surgery recited in claim 48 wherein said expandable member carried by said arterial perfusion catheter is delineated by radiopaque markers, further comprising the step of positioning said expandable member fluoroscopically.

52. The method for providing cardiopulmonary bypass pump support during heart surgery recited in claim 49 wherein said expandable member carried by said arterial perfusion catheter and said opening of said fourth lumen are delineated by ultrasound sensors, further comprising the step of positioning said expandable member and said opening of said fourth lumen ultrasonically.

53. The method for providing cardiopulmonary bypass pump support during heart surgery recited in claim 49 wherein said expandable member is positioned by monitoring characteristic pressure wave forms transported by said fourth lumen to a display monitor.

54. The method for providing cardiopulmonary bypass support during heart surgery recited in claim 48 wherein said first expandable member and said second expandable member are delineated by ultrasound sensors, further comprising the step of positioning said first expandable member and said second expandable member ultrasonically.

55. The method for providing cardiopulmonary bypass pump support during heart surgery recited in claim 49 wherein said first expandable member and said second expandable member are delineated by ultrasound sensors further comprising the step of positioning said first expandable member and said second expandable member ultrasonically.

56. The method for providing cardiopulmonary bypass pump support during heart surgery recited in claim 48 further comprising the step of inserting a guide wire having a proximal and distal end into said preselected arterial vessel and advancing said guide wire through said preselected arterial vessel and into the aortic arch of the patient and thereafter advancing said arterial catheter along said guide wire as recited in step (b).

57. The method recited in claim 56 further comprising the step of advancing said distal end of said guide wire into the left ventricle of the patient.

58. A method for providing a heart of a patient with cardiopulmonary bypass pump support during heart surgery wherein the heart has a right atrium, an inferior vena cava, a superior vena cava, an ascending aorta, a left ventricle, and an aorta with an aortic root, the method comprising the steps of:

(a) inserting an arterial perfusion catheter having a proximal and distal end into the aorta of said patient where said arterial perfusion catheter has a first conduit communicating with said cardiopulmonary bypass pump for the delivery of blood to arterial circulation, said arterial perfusion catheter having an expandable member positioned adjacent said distal end of said arterial perfusion catheter in the ascending aorta of said patient for occluding, upon expansion of said expandable member, the flow of blood from the left ventricle of said heart cephalid of the aortic root of said heart;

said arterial perfusion catheter having a first lumen therein for providing fluid to said expandable member to expand said expandable member;

said arterial perfusion catheter further having a second lumen for delivering a cardioplegia solution into the aortic root of said heart distally of said expandable member and to provide for venting of the aortic root of said heart;

(b) advancing said distal end of said arterial perfusion catheter through the aortic valve of said heart and into the left ventricle of said heart and positioning said expandable member in the ascending aorta of said patient cephalid of a junction of the coronary arteries of said heart with the aortic root of said heart where said arterial perfusion catheter has an opening adjacent said distal end of said arterial perfusion catheter and a fourth lumen communicating with said opening where said distal end of said arterial perfusion catheter is sufficiently removed distally from said expandable member to permit said distal end to extend across the aortic valve of said heart and into the left ventricle of said heart such that blood contained within the left ventricle of said heart may be suctioned through said opening and into said fourth lumen;

(c) inserting a venous catheter having a distal and proximal end into a preselected venous structure of said patient having sufficient radial dimensions to permit the passage of said venous catheter within said venous structure and into communication with the superior and inferior vena cava junctions of said patient with the right atrium of said heart where said venous catheter carries a first expandable member adjacent said distal end of said venous catheter for occluding the superior vena cava of said patient and a second expandable member carried by said venous catheter and located proximally of said first expandable member for occluding the inferior vena cava of said patient so as to preclude blood flow into the right atrium of said heart;

said venous catheter having a first conduit communicating with said first expandable member and said second expandable member for providing fluid to said first and second expandable members for expansion and a second conduit for receiving blood from the superior and inferior vena cava of said patient for delivering the blood to said cardiopulmonary bypass pump;

(d) advancing said venous catheter within said venous structure and positioning said first and second expandable members in the superior vena cava and inferior vena cava of said patient respectively so as to preclude blood flow into the right atrium of said heart upon sufficient expansion of said first and second expandable members;

(e) connecting said arterial perfusion catheter to said cardiopulmonary bypass pump such that said third lumen of said arterial perfusion catheter is in communication with said cardiopulmonary bypass pump and connecting said venous catheter to said cardiopulmonary bypass pump such that said second conduit is in communication with said cardiopulmonary bypass pump;

(f) after steps a, b, c, d and e, the step of activating said cardiopulmonary bypass pump;

(g) after step f, the step of suctioning blood from the left ventricle of said heart into said fourth lumen;

(h) after step g, expanding said expandable member sufficiently to occlude the passage of blood from the left ventricle of said heart into the ascending aorta of said heart thereby isolating the heart of said patient;

(i) after step h, infusing said cardioplegia solution into the aortic root of said heart to arrest said heart and thereafter venting the aortic root of said heart;

(j) expanding said first and second expandable members sufficiently to preclude blood flow from the inferior and superior vena cava of said patient respectively into the right atrium of said heart.

59. The method for providing cardiopulmonary bypass pump support during heart surgery recited in claim 58 wherein the insertion of said arterial perfusion catheter into the aorta of said patient is performed thorascopically.

60. The method for providing cardiopulmonary bypass pump support during heart surgery recited in claim 58 further comprising, before steps a through j, the step of performing a thoracotomy or sternotomy and exposing the aorta of said patient.

61. A method for providing a heart of a patient with cardiopulmonary bypass pump support during heart surgery wherein the heart has a right atrium, an inferior vena cava, a superior vena cava, an ascending aorta, a left ventricle, and an aorta with an aortic root, the method comprising the steps of:

(a) inserting a first arterial catheter having a distal and proximal end into a pre-selected first arterial vessel of said patient where said arterial vessel is of sufficient radial dimension to permit the passage of said first arterial catheter within said first arterial vessel and into the ascending aorta of said patient distally of the aortic root of said heart, where said first arterial catheter carries an expandable member proximally of said distal end of said first arterial catheter for occluding the aorta of said patient such that blood flow from the left ventricle of said heart may be occluded by sufficient expansion of said expandable member, said first arterial catheter further having a first lumen therein for providing fluid to expand said expandable member;

said first arterial catheter further having a second lumen defining a single flow path for delivering cardioplegia solution to the aortic root of said heart distally of said expandable member or for providing venting of said aortic root;

(b) advancing said first arterial catheter within said first arterial vessel and positioning said expandable member in the ascending aorta of said patient cephalid of the coronary arteries of said heart;

(c) inserting a second arterial catheter into a preselected second arterial vessel of said patient of sufficient radial dimensions to permit the passage of said second arterial catheter within said second arterial vessel of said patient, said second arterial catheter having an opening for delivering blood from said cardiopulmonary bypass pump into arterial circulation;

(d) advancing said second arterial catheter within said second pre-selected arterial vessel of said patient and positioning said opening to deliver blood into arterial circulation;

(e) inserting a venous catheter having a distal and proximate end into a pre-selected vein of said patient, said vein having sufficient radial dimensions to permit passage of said venous catheter within said vein and into communication with an entrance of the superior and inferior vena cava of said patient adjacent the right atrium of said heart, where said venous catheter carries a first expandable member adjacent said distal end of said venous catheter for occluding the superior vena cava of said patient and a second expandable member located proximally of said first expandable member for occluding the inferior vena cava of said patient;

said venous catheter having a first conduit communicating with said first expandable member and said second expandable member for providing fluid to said first and second expandable members for expanding said first and second expandable members and a second conduit for receiving blood from said superior and inferior vena cava for delivering said blood to said cardiopulmonary bypass pump;

(f) advancing said venous catheter within said vein of said patient and positioning said first and second expandable members in the superior vena cava and inferior vena cava of said patient respectively such that upon sufficient expansion of said first expandable member and said second expandable member blood flow into the right atrium of said heart is precluded;

(g) connecting said second arterial catheter to said cardiopulmonary bypass pump and connecting said venous catheter to said cardiopulmonary bypass pump;

(h) after steps (a), (b), (c), (d), (e), (f), (g), the step of activating said cardiopulmonary bypass pump;

(i) after step (h), the step of expanding said expandable member carried by said first arterial catheter sufficiently to occlude the passage of blood from the aortic root of said heart into arterial circulation;

(j) after step (i), the step of infusing cardioplegia solution into said aortic root of said heart to arrest said heart; and

(k) expanding said first expandable member and said second expandable member sufficiently to preclude blood flow from said inferior and superior vena cava of said patient respectively into the right atrium of said heart thereby completing isolation of said heart and establishing total cardiopulmonary bypass.

62. The method for providing cardiopulmonary bypass pump support during heart surgery recited in claim 61 wherein said first arterial catheter has a fourth lumen and an opening adjacent said distal end of said first arterial catheter where said fourth lumen communicates with said opening and where said distal end of said first arterial catheter is sufficiently removed distally from said expandable member to permit said distal end of said first arterial catheter to extend across the aortic valve of said heart and into the left ventricle of said heart such that blood contained within said left ventricle may be suctioned through said opening and into said fourth lumen, and further comprising after step (h) the step of suctioning blood from said left ventricle into said fourth lumen.

63. The method for providing cardiopulmonary bypass pump support during heart surgery recited in claim 62 further comprising the step of inserting a guidewire having a distal tip into said first arterial vessel of said patient and advancing said guidewire within said first arterial vessel into the aortic arch of said patient and thereafter advancing said first arterial catheter along said guidewire as recited in step (b).

64. The method recited in claim 63 further comprising the step of advancing said distal tip of said guidewire said the left ventricle.

65. The method for providing a patient with cardiopulmonary bypass pump support during heart surgery comprising the steps of:

(a) inserting an arterial perfusion catheter having a distal end and a proximate end into a pre-selected arterial vessel of said patient of sufficient radial dimensions to permit the passage of said arterial perfusion catheter within said arterial vessel and into the ascending aorta of said heart distally of the aortic root of said heart where said arterial perfusion catheter carries an expandable member proximally of said distal end of said arterial perfusion catheter for occluding the aorta of said patient, said arterial perfusion catheter having a first lumen therein for providing fluid to expand said expandable member;

said arterial perfusion catheter further having a second lumen defining a single flow path for delivering a cardioplegia solution into the aortic root of said heart distally of said expandable member or for venting said aortic root, said arterial perfusion catheter having a third lumen for delivering blood into arterial circulation;

(b) advancing said arterial perfusion catheter within said arterial vessel and positioning said expandable member in the ascending aorta of said heart cephalid of the junction of the coronary arteries of said heart with said aortic root;

(c) inserting a first venous catheter having a distal and proximal end into a pre-selected vein of said patient having sufficient radial dimensions to permit passage of said first venous catheter within said vein and into communication with the superior vena cava of said patient, where said first venous catheter carries a first expandable member adjacent said distal end of said first venous catheter for occluding said superior vena cava adjacent the entrance of said superior vena cava into the right atrium of said heart;

said first venous catheter having a first conduit communicating with said first expandable member for providing fluid to said first expandable member to expand said expandable member and a second conduit for receiving blood from said superior vena cava and for delivering the blood to said cardiopulmonary bypass pump;

(d) inserting a second venous catheter having a distal and proximal end into a second pre-selected vein of said patient having sufficient radial dimensions to permit passage of said second venous catheter within said second vein and into communication with the inferior vena cava of said patient where said second venous catheter carries a second expandable member adjacent said distal end of said second venous catheter for occluding said inferior vena cava adjacent the entrance of said inferior vena cava to the right atrium of said heart;

said second venous catheter having a second conduit communicating with said second expandable member for providing fluid to said second expandable member for expanding said second expandable member and a second venous conduit for receiving blood from said inferior vena cava and delivering the blood to said cardiopulmonary bypass pump;

(e) advancing said first venous catheter within said first vein of said patient and positioning said first expandable member in said superior vena cava cephalid of the atrio-caval junction to preclude blood flow from said superior vena cava of said patient into the right atrium of said heart upon sufficient expansion of said first expandable member;

(f) advancing said second venous catheter within said second vein and positioning said second expandable member in said inferior vena cava to preclude blood flow from said inferior vena cava into the right atrium of said heart upon sufficient expansion of said second expandable member;

(g) after steps (a), (b), (c), (d), (e) and (f), the step of activating said cardiopulmonary bypass pump;

(h) after step (g), the step of expanding said expandable member carried by said arterial perfusion catheter sufficiently to occlude the passage of blood from said aortic root into systemic arterial circulation;

(i) after step (h), the step of infusing said cardioplegia solution into said aortic root to arrest said heart; and

(j) expanding said first expandable member sufficiently to preclude blood flow from said superior vena cava into the right atrium of said heart and expanding said second expandable member sufficiently to preclude blood flow from said superior vena cava into the right atrium of said heart thereby completing isolation of said heart and establishing total cardiopulmonary bypass support.