Cannula system for a biventricular cardiac support system or a cardiopulmonary bypass system

• US 5,688,245 A
• Filed: 05/02/1996
• Issued: 11/18/1997
• Est. Priority Date: 05/02/1996
• Status: Expired due to Fees

• Current Assignee: Thomas M. Runge
• Original Assignee: Thomas M. Runge
• Inventors: Runge, Thomas M.
• Primary Examiner(s): McDermott, Corrine M.
• Assistant Examiner(s): RODRIGUEZ, CRIS LOIREN
• Application Number:
  US08/641,756
• Time in Patent Office: 565 Days
• Field of Search: 600/16-18, 623/3, 604/43, 604/44, 604/45, 604/53, 604/264, 604/93, 604/173, 604/280, 604/49, 604/8, 604/96, 604/105, 604/99, 604/131, 604/151, 604/153
• US Class Current: 604/151
• CPC Class Codes: A61M 1/3659 Cannulae pertaining to extracorporeal circulation
• CPC Class Codes: A61M 1/3666 Cardiac or cardiopulmonary bypass, e.g. heart-lung machines
• CPC Class Codes: A61M 2025/0037 characterized by lumina being arranged side-by-side
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2202/0472 cryo-cardioplegic
• CPC Class Codes: A61M 2210/127 Aorta
• CPC Class Codes: A61M 25/0021 characterised by the form of the tubing A61M25/0054 takes precedence
• CPC Class Codes: A61M 25/007 Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
• CPC Class Codes: A61M 25/10 Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 60/117 for assisting the heart, e.g. transcutaneous or external ventricular assist devices
• CPC Class Codes: A61M 60/562 for making blood flow pulsatile in blood pumps that do not intrinsically create pulsatile flow
• CPC Class Codes: A61M 60/851 Valves
• CPC Class Codes: A61M 60/892 Active valves, i.e. actuated by an external force

Abstract

A cannula system for a biventricular cardiac support system or a cardiopulmonary bypass system wherein a first cannula having a pair of side-by-side lumens is adapted to be positioned within the left atrium and left ventricle and aorta of a patient. Blood from the left atrium and left ventricle drains into one of the lumens in the first cannula and is conveyed to the inlet of a pulsatile flow cardiopulmonary bypass pump from where it is pumped through the other lumen into the aorta of the patient. An inflatable balloon is provided at the distal end of the first cannula for holding the distal end of the cannula in the aorta above the aortic valve. The first cannula includes an axially extending bore communicating with a space in the aorta between the inflated balloon and the aortic valve for conveying cardioplegic solution to the space communicating with the left and right arteries of the patient. A second cannula having a pair of side-by-side lumens is adapted to be positioned within the right atrium and right ventricle and pulmonary artery of the patient. Blood from the right atrium and right ventricle flows into one of the lumens in the second cannula and is conveyed to the pulsatile flow cardiopulmonary bypass pump from where it is pumped through the other lumen into the pulmonary artery of the patient.

Claims

1. In combination, a cannula for use in a biventricular cardiac support system or a cardiopulmonary bypass system and a pulsatile flow cardiopulmonary bypass pump, said pump having an inlet and an outlet and a compression chamber intermediate the inlet and outlet of said pump, said compression chamber including a moveable compression plate, a pair of side-by-side externally valved, compressible conduits extending through said compression chamber and under said compression plate, each conduit having an inlet and an outlet, a passive exterior valve positioned at the pump inlet and outlet, said pair of side-by-side conduits extending through said valves, said compressible conduits having portions extending between the inlet and outlet valves forming sacks, the valve at the pump inlet being positioned downstream from the inlets of said conduits, the valve at the pump outlet being positioned upstream from the outlets of said conduits;

said cannula comprising first cannula means having a pair of side-by-side first and second lumens adapted to communicate with the left atrium, left ventricle, and aorta of a patient, and second cannula means having a pair of side-by-side first and second lumens adapted to communicate with the right atrium, right ventricle, and pulmonary artery of the patient, a first tube connecting said first lumen of the first cannula means to the inlet of one of said compressible conduits, a second tube connecting the second lumen of said first cannula means to the outlet of said one compressible conduit, a third tube connecting the first lumen in said second cannula means to the inlet of the other of said compressible conduits, a fourth tube connecting the second lumen in said second cannula means to the outlet of other of said compressible conduits, whereby when the inlet valve is open and the outlet valve is closed blood flows from the left atrium, left ventricle, right atrium, and right ventricle through the inlets of the side-by-side conduits into the sack portions of the conduits underneath the pump compression plate, to thereby push the compression plate upwardly until at least one of the sacks is filled, whereupon the compression plate descends to compress the sacks, thereby pumping the blood out of the conduits simultaneously while the inlet valve moves to the closed position and the outlet valve moves to the open position, whereby the pumping rate is automatically varied as a function of the filling pressure, to thereby substantially balance the volume of blood passing from the right atrium and right ventricle to the pulmonary artery with the volume of blood passing from the left atrium and left ventricle to the aorta.

2. The combination according to claim 1, wherein said first cannula means comprises an elongated tube having a side wall and a proximate end and a distal end, a transverse, axially extending wall having a distal end and mounted within said tube for dividing the tube into said first lumen and said second lumen, the distal end of the transverse wall merging with the side wall of the tube substantially intermediate the proximate and distal ends of said tube, to thereby terminate and close the distal end of said first lumen, a plurality of aspiration orifices in the side wall of said tube communicating with said first lumen, said first lumen being adapted to be positioned within the left atrium and left ventricle of the patient, the second lumen extending the full length of said tube, a large end orifice at the distal end of said second lumen, a plurality of smaller orifices in the side wall of the tube communicating with said second lumen adjacent the distal end thereof, an inflatable balloon connected to the distal end of said second lumen, said balloon being positioned below and adjacent to said plurality of smaller orifices, a first axially extending inflation bore provided in the side wall of the tube communicating with and adapted to inflate the balloon, the distal end of said second lumen being adapted to be positioned within the ascending thoracic aorta of the patient with the inflated balloon spaced above the aortic valve and adapted to engage the interior wall of the ascending thoracic aorta, and a second axially extending bore provided in the side wall of the tube adapted to convey an oxygenated cardioplegic solution to the exterior of the tube in the space between the aortic valve and the inflated balloon communicating with the left and right coronary arteries of the patient for supplying oxygenated blood to the heart muscle myocardium, the proximate end of said first lumen being connected to said first tube, and the proximate end of said second lumen being connected to said second tube.

3. The combination according to claim 1, wherein said second cannula means comprises an elongated tube having a side wall and a proximate end and a distal end, a transverse, axially extending wall having a distal end and mounted within said tube for dividing the tube into said first lumen and said second lumen, the distal end of the transverse wall merging with the side wall of the tube substantially intermediate the proximate and distal ends of said tube, to thereby terminate and close the distal end of said first and second lumen, a plurality of aspiration orifices in the side wall of said tube communicating with said first lumen, said first lumen being adapted to be positioned within the right atrium and right ventricle of the patient, the second lumen extending the full length of said tube, a large end orifice at the distal end of said second lumen, a plurality of smaller orifices in the side wall of the tube communicating with said second lumen adjacent the distal end thereof, the distal end of said second lumen being adapted to be positioned within the pulmonary artery of the patient, the proximate end of said first lumen being connected to said third tube, and the proximate end of said second lumen being connected to said fourth tube.

4. The combination according to claim 3, wherein an inflatable balloon is connected to the distal end of said second lumen, said balloon being positioned below and adjacent to said plurality of smaller orifices, an axially extending inflation bore provided in the side wall of the tube communicating with the balloon for inflating said balloon, whereby the inflated balloon is adapted to engage the interior wall surface of the pulmonary artery.

5. The combination according to claim 1, wherein the first and second cannula means are provided with corrugated wall portions to facilitate the manipulation of the cannula means and to vary the effective length of the first and second cannula means to fit the patient'"'"'s heart dimensions.

6. The combination according to claim 1, wherein the first cannula means precludes the necessity of insertion of a cannula through the aortic wall, thereby diminishing the propensity to embolic phenomena caused by aortic perforation.

7. The combination according to claim 1, wherein the second cannula means precludes the necessity of insertion of a cannula through the pulmonary artery.

8. The combination according to claim 1, wherein the first cannula means precludes the necessity of perforating the left ventricle wall for venting.

9. The combination according to claim 1, wherein the second cannula means precludes the necessity of perforating the right ventricle wall for venting.