Non-invasive aortic impingement and core and cerebral temperature manipulation method

• US 5,531,776 A
• Filed: 06/27/1994
• Issued: 07/02/1996
• Est. Priority Date: 09/24/1993
• Status: Expired due to Fees

• Current Assignee: Ohio State University
• Original Assignee: Ohio State University
• Inventors: Ward, Kevin R., Dzwonczyk, Roger R., Brown, Charles G.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): SCHAETZLE, KENNEDY
• Application Number:
  US08/266,201
• Time in Patent Office: 736 Days
• Field of Search: 607/96, 607/104, 607/105, 607/106, 607/113-124, 607/133, 128/672, 128/668, 128/673, 128/677, 128/736, 128/897, 128/898, 128/DIG. 27, 606/20, 606/21, 606/27, 600/16-18
• US Class Current: 607/105
• CPC Class Codes: A61N 1/0517 Esophageal electrodes

Abstract

A method of non-invasively occluding the descending thoracic aorta to a desired extent in order to enhance cerebral and myocardial perfusion or the like, and/or of manipulating core and cerebral temperature of a patient, wherein a device is extended into the patient'"'"'s esophagus and manipulated to selectively displace a wall of the esophagus toward the descending thoracic aorta to thereby at least partially occlude the latter, and/or to exchange heat between a device positioned in the patient'"'"'s esophagus and a proximately located thoracic vessel in order to increase or decrease the temperature of blood flowing in such vessel.

Claims

1. A non-invasive method of at least partially occluding the descending thoracic aorta and manipulating core and cerebral temperature of a portion of a patient, including:

positioning in the patient'"'"'s esophagus a device adapted to extend in said esophagus and selectively displacing with said device a wall of said esophagus posterior-laterally in the direction of said descending thoracic aorta; and

exchanging heat between said device and blood flowing through a thoracic vessel in order to increase or decrease the temperature of said blood flowing through said thoracic vessel.

2. The method of claim 1 including displacing said wall sufficiently to cause substantially complete occlusion of said descending aorta.

3. The method of claim 1 wherein said exchanging heat includes circulating a fluid through said device, said fluid having a temperature that is different from the temperature of said blood flowing through said thoracic vessel and exchanging heat between said fluid and said blood flowing through said thoracic vessel.

4. The method of claim 1 wherein said exchanging heat includes pumping heat through said device between said blood flowing through said thoracic vessel and tissue surrounding another portion of said esophagus.

5. The method of claim 1 including displacing said wall of said esophagus in synchronism with the patient'"'"'s ventricular contraction in order to counter-pulse the descending thoracic aorta during ventricular diastole.

6. The method of claim 1 wherein said thoracic vessel includes one of the patient'"'"'s descending thoracic aorta, carotid artery, aortic arch, and heart.

7. A non-invasive method of enhancing cerebral and myocardial perfusion in a patient, including:

positioning a device having an elongated tubular member in a portion of the patient'"'"'s esophagus juxtaposed with the patient'"'"'s descending thoracic aorta; and

displacing with said tubular member a wall of said portion of the esophagus posteriorly-laterally in the direction of said descending thoracic aorta in order to at least partially occlude said descending aorta and thereby increase central and intracranial arterial pressure without increasing central and intracranial venous pressure.

8. The method of claim 7 including substantially completely occluding said descending thoracic aorta.

9. The method of claim 7 including displacing said portion in synchronism with the patient'"'"'s ventricular contractions in order to counter-pulse the descending thoracic aorta during ventricular diastole.

10. The method of claim 7 wherein said tubular member includes a selectively moveable portion at one end thereof that is adapted to displacing said wall in said direction.

11. The method of claim 10 wherein said device further includes a radial positioning member on an opposite end of said tubular member, and further including manipulating said positioning member in order to radially position said moveable portion to displace in said direction.

12. The method of claim 7 further including monitoring said patient in order to determine the amount of occlusion of the patient'"'"'s aorta.

13. The method of claim 12 wherein said monitoring includes determining changes in the patient'"'"'s blood pressure.

14. The method of claim 12 wherein said monitoring includes determining changes in the metabolic state of the patient'"'"'s myocardium.

15. The method of claim 7 including exchanging heat between said tubular member and blood flowing through said descending thoracic aorta across walls of said esophagus and said aorta in order to manipulate the patient'"'"'s cerebral and core temperature.

16. A non-invasive method of treating shock in a patient, including:

positioning a device having an elongated tubular member in a portion of the patient'"'"'s esophagus juxtaposed with the patient'"'"'s descending thoracic aorta; and

displacing with said tubular member a wall of said portion of the esophagus posteriorly-laterally in the direction of said descending thoracic aorta in order to at least partially occlude said descending thoracic aorta in order to increase central and intracranial arterial pressure and to reduce or stop blood flow in said descending thoracic aorta beyond the point of occlusion.

17. The method of claim 16 including substantially completely occluding said descending aorta.

18. The method of claim 16 including displacing said portion in synchronism with the patient'"'"'s ventricular contractions in order to counter-pulse the aorta during ventricular diastole.

19. The method of claim 16 wherein said elongated member includes a selectively moveable portion at one end thereof that is adapted to displacing said wall in said direction.

20. The method of claim 19 wherein said device further includes a radial positioning member on an opposite end of said tubular member, and further including manipulating said positioning member in order to radially position said moveable portion to displace in said direction.

21. The method of claim 16 further including monitoring said patient in order to determine the amount of occlusion of the patient'"'"'s aorta.

22. The method of claim 21 wherein said monitoring includes determining changes in the patient'"'"'s blood pressure.

23. The method of claim 21 wherein said monitoring includes determining changes in the metabolic state of the patient'"'"'s myocardium.

24. The method of claim 16 including exchanging heat between said device and blood flowing through a thoracic vessel across walls of said esophagus and said thoracic vessel in order to manipulate the patient'"'"'s core and cerebral temperature.

25. The method of claim 24 wherein said thoracic vessel includes one of the patient'"'"'s descending thoracic aorta, carotid artery, aortic arch, and heart.

26. A non-invasive method of manipulating core and cerebral temperature of a patient, including:

positioning in the patient'"'"'s esophagus a device having a heat transfer surface in a manner that said heat transfer surface is at the juxtaposition with a vessel through which blood is flowing; and

exchanging heat between said heat transfer surface and blood flowing through said vessel across said wall of said tube and a wall of said vessel.

27. The method of claim 26 wherein said vessel is one of the patient'"'"'s descending thoracic aorta, carotid artery, aortic arch and heart.

28. The method of claim 27 wherein said vessel is the patient'"'"'s descending thoracic aorta.

29. The method of claim 26 including circulating a fluid between said heat transfer surface and at least one of a heat source and a heat sink, in order to modify the temperature of said heat transfer surface to a temperature that is different from the temperature of said blood flowing through said vessel and exchanging heat between said blood and said at least one of a heat source and a heat sink.

30. The method of claim 26 wherein said exchanging heat includes transferring heat between said heat transfer surface and another heat transfer surface on said device away from said vessel.

31. The method of claim 26 wherein said device includes an elongated body with said heat transfer surface at one end thereof and a radial positioning member on an opposite end thereof, and further including manipulating said positioning member in order to radially position said heat transfer surface with respect to said vessel.

32. The method of claim 26 further including at least partially occluding said vessel with said device by displacing the patient'"'"'s esophagus in the direction of said vessel.