Method for accessing the pericardial space

• US 5,931,810 A
• Filed: 12/05/1996
• Issued: 08/03/1999
• Est. Priority Date: 12/05/1996
• Status: Expired due to Fees

• Current Assignee: Comedicus, Inc.
• Original Assignee: Comedicus, Inc.
• Inventors: Grabek, James R.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/761,189
• Time in Patent Office: 971 Days
• Field of Search: 606/205, 606/129, 604/51, 604/115, 604/158
• US Class Current: 604/506
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/34 Trocars; Puncturing needles pointed biopsy instruments A61B10/0233; devices for piercing the ear-lobes A44C7/001; seals or hemostasis valves A61M39/06
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/2926 Details of heads or jaws
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation

Abstract

There is provided an apparatus and a method of using the apparatus for creating a bleb of tissue of the pericardium of the heart, for accessing the pericardial space, intermediate the pericardium and the heart, and withdrawing fluid therefrom or delivering fluid, including drugs, therapeutic agents, or the like, thereto. The apparatus of the present invention includes a shaft with a first distal end and a second proximal end. A bore extends through the shaft from the distal end to the proximal end. The first end includes jaws, that open and close, as at least one of the jaws is movable. The second end includes a handle, at least a portion of the handle in communication with a mechanism in communication with the movable jaw, such that upon movement of at least a portion of the handle, the jaws can be opened and closed continuously. A needle, for puncturing the bleb of tissue grasped within the jaws, is movably mounted within the bore and is in communication with a mechanism for limiting its travel with respect to the bore.

Claims

1. A method for accessing the space between the pericardium and the heart, comprising:

a) providing a pericardial access device including at least two jaws movable relative to each other, and means for accommodating instrumentation extending through said access device;

b) mechanically grasping a portion of the pericardium between said at least two jaws of said access device;

c) mechanically pulling said grasped portion of the pericardium away from the heart to form a bled of pericardium tissue adjacent said jaws;

d) inserting a needle through said instrumentation accommodating means into said bleb, and limiting the travel of the needle to prevent laceration of the heart; and

e) introducing a guidewire, through the needle into said bleb and into said pericardial space.

2. The method of claim 1, additionally comprising, introducing an instrument through said instrumentation accommodating means in said access device over said guidewire and into the pericardial space.

3. The method of claim 2, wherein said instrument is a catheter.

4. The method of claim 1, wherein said bleb is formed without suction.

5. A method for accessing the pericardial space, the method comprising a step of:

grasping an exterior surface of an unopened pericardium surrounding a patient'"'"'s heart between at least two grasping surfaces of a grasping instrument to create a bleb of pericardium;

penetrating the bleb of pericardium with a piercing instrument which passes between the grasping surfaces to access the pericardial space.

6. A method according to claim 5 wherein the grasping surfaces of the grasping instrument provide a passage through which the piercing instrument can freely pass to penetrate the bleb of pericardium.

7. A method according to claim 5 wherein the grasping surfaces of the grasping instrument include teeth.

8. A method according to claim 5 wherein the grasping instrument includes a shaft having a bore therethrough, the bore providing for passage of the piercing instrument through the shaft of the grasping instrument and into the bleb of pericardium.

9. A method according to claim 8 wherein the shaft has a first end and a second end, the first end including a handle for operating the grasping surfaces of the grasping instrument.