Device for use in right ventricular placement and method for using same
First Claim
1. A device for use in rapid, atraumatic placement of medical devices in a right ventricle of a patient comprising:
- an introducer sheath used as a passage for transvenous placement of a medical device in a patient'"'"'s heart, the introducer sheath being of sufficient length to allow a proximal end thereof to be located outwardly from an opening in the skin of the patient over the cephalic vein when a distal end of said introducer sheath is at an apex of the right ventricle, said introducer sheath having a gradient of stiffness which decreases toward the distal end so as to be sufficiently soft and flexible distally to pass atraumatically through a tricuspid valve and have sufficient strength proximally to allow the introducer sheath to be pushed along the length thereof through a tortuous venous path to the apex of the right ventricle;
said introducer sheath having an inside diameter of sufficient size to slidably receive a balloon-tipped catheter or pacing lead therethrough.
1 Assignment
0 Petitions
Accused Products
Abstract
A device and method for rapid, atraumatic placement of medical devices in the right ventricle of a patient. The device includes an introducer sheath used as a passage for intravenous placement of a medical device in a patient'"'"'s heart. The introducer sheath is of sufficient length to allow a proximal end thereof to be located outwardly from an incision in the skin of a patient over the cephalic vein when a distal end of the introducer sheath is at the apex of the right ventricle. The introducer sheath is of sufficient flexibility to pass through the tricuspid valve and through the narrow passage between the clavicle and first rib, and is of sufficient strength to allow the introducer sheath to be pushed along its length thereof through the tortuous path from the incision over the cephalic vein to the apex of the right ventricle. The introducer sheath has an inside diameter of sufficient size to slidably receive a balloon-tipped catheter, a guidewire, a pacing lead, or the like therein.
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Citations
74 Claims
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1. A device for use in rapid, atraumatic placement of medical devices in a right ventricle of a patient comprising:
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an introducer sheath used as a passage for transvenous placement of a medical device in a patient'"'"'s heart, the introducer sheath being of sufficient length to allow a proximal end thereof to be located outwardly from an opening in the skin of the patient over the cephalic vein when a distal end of said introducer sheath is at an apex of the right ventricle, said introducer sheath having a gradient of stiffness which decreases toward the distal end so as to be sufficiently soft and flexible distally to pass atraumatically through a tricuspid valve and have sufficient strength proximally to allow the introducer sheath to be pushed along the length thereof through a tortuous venous path to the apex of the right ventricle; said introducer sheath having an inside diameter of sufficient size to slidably receive a balloon-tipped catheter or pacing lead therethrough. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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20. A device for use in rapid, atraumatic placement of medical devices in a right ventricle of a patient comprising:
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an introducer sheath used as a passage for transvenous placement of a medical device in a patient'"'"'s heart, said introducer sheath being of sufficient length to allow a proximal end thereof to be located outwardly from an opening in the skin of the patient over the cephalic vein when a soft and flexible distal end of said introducer sheath is at an apex of the right ventricle, said introducer sheath having sufficient flexibility to pass atraumatically through a tricuspid valve and having sufficient strength to allow the introducer sheath to be pushed along the length thereof through a tortuous venous path to the apex of the right ventricle; said introducer sheath having a gradient of stiffness which decreases toward the distal end along at least a portion of its length and an inside diameter of sufficient size to pass a removable flexible guidewire therethrough. - View Dependent Claims (21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39)
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40. A kit for rapid, atraumatic right ventricular placement of medical devices comprising:
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a guide member; a dilator having a tapered distal end and a central bore of sufficient size for passing the guide member therethrough; and an introducer sheath used as a passage for transvenous placement of a medical device in a patient'"'"'s heart, said introducer sheath being of sufficient length to allow a proximal end thereof to be located outwardly from an opening in the skin of the patient over the cephalic vein when a distal end is at an apex of the right ventricle, said introducer sheath having a gradient of stiffness which decreases toward the distal end so as to be sufficiently soft and flexible distally to pass atraumatically through a tricuspid valve and have sufficient strength proximally to allow the introducer sheath to be pushed along the length thereof through a tortuous venous path to the apex of the right ventricle, and having an inside diameter configured for a close fit of said dilator therein; said dilator having a length greater than the length of the introducer sheath. - View Dependent Claims (41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58)
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59. A method for rapid, atraumatic right ventricular placement of medical devices across a tricuspid valve to an apex of a right ventricle in the heart of a patient comprising:
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providing a guide member and a hollow needle having an inside diameter sufficient to pass said guide member therethrough; providing an introducer sheath used for transvenous placement of a medical device in a patient'"'"'s heart, said introducer sheath being of sufficient length to allow a proximal end thereof to be located outwardly from an opening in the skin of the patient over the cephalic vein when a distal end is at an apex of the right ventricle, said introducer sheath having a gradient of stiffness which decreases toward the distal end so as to be sufficiently soft and flexible distally to pass atraumatically through a tricuspid valve and have sufficient strength proximally to allow the introducer sheath to be pushed along the length thereof through a tortuous venous path to the apex of the right ventricle, and having an inside diameter of sufficient size to pass said guide member therethrough; inserting said needle into a vein of the patient; passing said guide member through said needle into the vein and into a superior vena cava; removing said needle; advancing said guide member across the tricuspid valve to a vicinity of the apex of the right ventricle; and advancing the introducer sheath over said guide member across the tricuspid valve into the vicinity of the apex of the right ventricle. - View Dependent Claims (60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73)
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74. A method for rapid, atraumatic right ventricular placement of medical devices across a tricuspid valve to an apex of a right ventricle in the heart of a patient comprising:
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providing a balloon-tipped catheter and a hollow needle having an inside diameter sufficient to pass said balloon-tipped catheter therethrough; providing an introducer sheath used for transvenous placement of a medical device in a patient'"'"'s heart, said introducer sheath being of sufficient length to allow a proximal end thereof to be located outwardly from an opening in the skin of the patient over the cephalic vein when a distal end is at an apex of the right ventricle, said introducer sheath having a gradient of stiffness which decreases toward the distal end so as to be sufficiently soft and flexible distally to pass atraumatically through a tricuspid valve and have sufficient strength proximally to allow the introducer sheath to be pushed along the length thereof through a tortuous venous path to the apex of the right ventricle, and having an inside diameter of sufficient size to pass said balloon-tipped catheter therethrough; inserting said needle into a vein of the patient; passing said balloon-tipped catheter through said needle into the vein and into a superior vena cava; removing said needle; advancing said balloon-tipped catheter in said introducer sheath until a distal end of said balloon-tipped catheter exits the distal end of said introducer sheath in proximity to the tricuspid valve; inflating a balloon on the distal end of said balloon-tipped catheter; advancing said balloon-tipped catheter across the tricuspid valve to a vicinity of the apex of the right ventricle; advancing said introducer sheath over said balloon-tipped catheter across the tricuspid valve into a position adjacent the inflated balloon; deflating said balloon; and withdrawing the balloon-tipped catheter.
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Specification