Slidable cannula and method of use

• US 6,129,713 A
• Filed: 08/11/1998
• Issued: 10/10/2000
• Est. Priority Date: 08/11/1998
• Status: Expired due to Term

• Current Assignee: Edwards Lifesciences Corporation
• Original Assignee: Embolx, Inc.
• Inventors: Tsugita, Ross S., Mangosong, Lorraine
• Primary Examiner(s): Coggins, Wynn Wood
• Assistant Examiner(s): Sirmons, Kevin C.
• Application Number:
  US09/132,354
• Time in Patent Office: 791 Days
• Field of Search: 604/508, 604/509, 604/510, 604/122, 604/158, 604/281, 604/530-532, 604/264, 606/159, 606/167, 606/170
• US Class Current: 604/264
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/22067 Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61M 1/3653 Interfaces between patient blood circulation and extra-corporal blood circuit
• 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 2025/0096 being laterally outward extensions or tools, e.g. hooks or fibres
• CPC Class Codes: A61M 25/0041 pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/0662 Guide tubes

Abstract

A cannula system having an internally slidable elongate tubular member frictionally anchored within a trocar, and optionally including a flange which acts as a positive stop against the trocar, that can be deployed for various treatments, including aortic cannulation during cardiopulmonary bypass, for example during CABG surgery. The tubular member has a proximal end, a lumen, and a flexible distal end which carries a preformed angled configuration relative to its proximal region and is bendable to a substantially linear configuration. The rigid trocar maintains the cannula in a substantially linear configuration. When the cannula is advanced through the lumen beyond the distal end of the trocar, the tubular member regains its angled configuration. Methods for using the devices herein are also disclosed.

Claims

1. A slidable cannula for delivering fluid to body tissue, comprising:

an elongate tubular member having a proximal end, a distal end, and a lumen therebetween, the distal end having a preformed angled configuration relative to a proximal region, the angled region being bendable to a substantially linear configuration;

a substantially rigid trocar having a proximal end, a distal end and a lumen therebetween, the lumen shaped to receive the elongate tubular member in its linear configuration; and

a balloon occluder mounted on the distal end of the trocar, the balloon occluder communicating with the proximal end of the trocar,

wherein the tubular member is slidable through the lumen of the trocar, and wherein the tubular member regains its angled configuration when advanced distally beyond the distal end of the trocar.

2. The cannula of claim 1, further comprising a balloon occluder mounted on the distal end of the elongate tubular member.

3. The cannula of claim 2, wherein the lumen of the elongate tubular communicates with a cardioplegia port at the distal end of the elongate tubular member.

4. The cannula of claim 3, wherein the cardioplegia port is proximal the balloon occluder.

5. The cannula of claim 2, wherein the elongate tubular member includes a second lumen extending distally from the proximal end and communicating with the balloon occluder.

6. The cannula of claim 1, wherein the lumen of the elongate tubular member communicates with an infusion port at the distal end of the elongate tubular member.

7. The cannula of claim 6, wherein the trocar further comprises a second lumen communicating with a port at the distal end of the trocar.

8. The cannula of claim 6, wherein the proximal end of the trocar lumen is adapted for attachment to a cardiopulmonary bypass machine.

9. The cannula of claim 6, wherein the trocar further comprises a hemostatic valve at the proximal end of the lumen.

10. The cannula of claim 1, wherein the proximal end of the elongate tubular member is adapted for attachment to a cardiopulmonary bypass machine.

11. The cannula of claim 1, wherein the elongate tubular member carries a retractable surgical blade and a lockout mechanism at its distal end.

12. The cannula of claim 1, wherein the elongate tubular member carries a balloon-protecting sleeve at its distal end.

13. The cannula of claim 12, wherein the cardioplegia port is proximal the balloon occluder.

14. The cannula of claim 1, wherein the angled configuration of the distal end is substantially L-shaped.

15. The cannula of claim 1, wherein the trocar further comprises a suture flange.

16. The cannula of claim 1, further comprising a filter mounted on the distal end of the trocar.

17. The cannula of claim 1, wherein the trocar includes a cardioplegia lumen extending distally from the proximal end and communicating with a cardioplegia port.

18. The cannula of claim 1, wherein the trocar carries a retractable surgical blade at its distal end.

19. The cannula of claim 1, wherein the trocar carries a thin sheath diffuser at its distal end.

27. The method of claim 18, wherein the method further comprises the step of inflating the balloon occluder.

20. A method for cannulating a body tissue, comprising the steps of:

providing a slidable cannula comprising an elongate member having a proximal end, a distal end, and a lumen therebetween, the distal end having a preformed angled configuration relative to the proximal region, the slidable cannula further comprising a trocar having a proximal end, a distal end, and a lumen shaped to receive the elongate tubular member and a balloon occluder mounted on the distal end of the trocar, the balloon occluder communicating with the proximal end of the trocar;

inserting the elongate tubular member into the lumen of the trocar, the trocar maintaining the tubular member in a substantially linear configuration; and

advancing the distal end of the tubular member beyond the distal end of the trocar, wherein the distal end of the tubular member regains its preformed angle configuration.

21. The method of claim 20, wherein the step of inserting the elongate tubular member into the lumen of the trocar is performed before the step of inserting the trocar into a vessel.

22. The method of claim 20, wherein the body tissue is an atrium.

23. The method of claim 20, wherein the body tissue is an artery.

24. The method of claim 23, wherein the artery is an aorta.

25. The method of claim 24, further comprising the step of making an incision in the aorta using the trocar.

26. The method of claim 24, further comprising the step of making an incision in the aorta using the cannula.

28. The method of claim 20, wherein the slidable cannula further includes a cardioplegia lumen communicating with a cardioplegia port, and wherein the method further comprises the step of delivering cardioplegia solution through the cardioplegia port.

29. The method of claim 20, further comprising the step of connecting the proximal end of the cannula to a cardiopulmonary bypass machine.

30. The method of claim 20, further comprising the step of connecting the proximal end of the trocar to a cardiopulmonary bypass machine.

31. The method of claim 20, further comprising the step of performing cardiopulmonary bypass.

32. The method of claim 20, further comprising the step of performing a coronary artery bypass graft procedure.

33. A slideable cannula for delivering fluid to body tissue, comprising:

an elongate tubular member having a proximal end, a distal end, and a lumen therebetween, the distal end having a preformed angled configuration relative to a proximal region, the angled region being bendable to a substantially linear configuration;

a substantially rigid trocar having a proximal end, a distal end, a first lumen therebetween and communicating with a first port on the distal end of the trocar, and a second lumen extending distally from the proximal end and communicating with a second port on the distal end of the trocar, the second port adapted for cardioplegia infusion, the first lumen shaped to receive the elongate tubular member in its linear configuration, and the first port shaped to pass the elongate tubular member beyond the distal end of the trocar; and

a balloon occluder mounted on the distal end of the trocar, the balloon occluder communicating with the proximal end of the trocar,

wherein the tubular member is slideable through the lumen of the trocar, and wherein the tubular member regains its angled configuration when advanced distally beyond the distal end of the trocar.

34. The cannula of claim 33, wherein the proximal end of the trocar is adapted for attachment to a Y-connector.

35. The cannula of claim 34, wherein the Y-connector comprises an access port and a cannula port.

36. The cannula of claim 35, wherein the access port is adapted to receive a filter.

37. The cannula of claim 35, wherein the access port is adapted to receive a pressure monitor.

38. The cannula of claim 35, wherein the access port is adapted to receive a camera.

39. The cannula of claim 35, wherein the access port is adapted to receive a light source.

40. The cannula of claim 35, wherein the access port is adapted to receive an assisting pump.

41. The cannula of claim 35, wherein the access port is adapted to receive an aspirator.

42. The cannula of claim 35, wherein the access port is adapted to receive a CPB cannula.

43. The cannula of claim 35, wherein the access port is adapted to receive an introducer.

44. The cannula of claim 35, wherein the access port is adapted to receive a balloon occluder.

45. The cannula of claim 33, wherein the second lumen is a cardioplegia lumen.

46. The cannula of claim 33, further comprising a balloon occluder mounted on the distal end of the elongate tubular member.

47. The cannula of claim 46, wherein the elongate tubular member further includes an inflation lumen extending distally from the proximal end and communicating with the balloon occluder.

48. The cannula of claim 33, wherein the lumen of the elongate tubular member communicates with an infusion port at the distal end of the elongate tubular member.

49. The cannula of claim 48, wherein the proximal end of the first lumen of the trocar is adapted for attachment to a cardiopulmonary bypass machine.

50. The cannula of claim 48, wherein the trocar further comprises a hemostatic valve at the proximal end of the first lumen.

51. The cannula of claim 33, wherein the proximal end of the elongate tubular member is adapted for attachment to a cardiopulmonary bypass machine.

52. The cannula of claim 33, wherein the elongate tubular member carries a retractable surgical blade and a lockout mechanism at its distal end.

53. The cannula of claim 33, wherein the elongate tubular member further comprises a balloon mounted at the distal end, and wherein the elongate tubular member carries a balloon-protecting sleeve at its distal end.

54. The cannula of claim 53, wherein the cardioplegia port is proximal the balloon occluder.

55. The cannula of claim 33, wherein the angled configuration of the distal end is substantially L-shaped.

56. The cannula of claim 33, wherein the trocar further comprises a suture flange.

57. The cannula of claim 33, further comprising a filter mounted on the distal end of the trocar.

58. The cannula of claim 33, wherein the trocar includes an inflation lumen extending distally from the proximal end and communicating with the balloon occluder.

59. The cannula of claim 33, wherein the trocar carries a retractable surgical blade at its distal end.

60. The cannula of claim 33, wherein the trocar carries a thin sheath diffuser at its distal end.

61. The cannula of claim 33, wherein the proximal end of the trocar is adapted for attachment to a Y-connector.

62. The cannula of claim 61, wherein the Y-connector comprises an access port and a cannula port.

63. The cannula of claim 62, wherein the access port is adapted to receive a filter.

64. The cannula of claim 62, wherein the access port is adapted to receive a pressure monitor.

65. The cannula of claim 62, wherein the access port is adapted to receive a camera.

66. The cannula of claim 62, wherein the access port is adapted to receive a light source.

67. The cannula of claim 62, wherein the access port is adapted to receive an assisting pump.

68. The cannula of claim 62, wherein the access port is adapted to receive an aspirator.

69. The cannula of claim 62, wherein the access port is adapted to receive a CPB cannula.

70. The cannula of claim 62, wherein the access port is adapted to receive an introducer.

71. The cannula of claim 62, wherein the access port is adapted to receive a balloon occluder.

72. A method for cannulating a body tissue, comprising the steps of:

providing a slidable cannula comprising an elongate member having a proximal end, a distal end, and a lumen therebetween, the distal end having a preformed angled configuration relative to the proximal region, the slidable cannula further comprising a trocar having a proximal end, a distal end, a first lumen therebetween, and a second lumen, the first lumen shaped to receive the elongate tubular member, the second lumen extending distally from the proximal end and communicating with a cardioplegia port, the trocar further comprising a balloon occluder mounted on the distal end of the trocar, the balloon occluder communicating with the proximal end of the trocar;

inserting the elongate tubular member into the first lumen of the trocar, the trocar maintaining the tubular member in a substantially linear configuration; and

advancing the distal end of the tubular member beyond the distal end of the trocar, wherein the distal end of the tubular member regains its preformed angle configuration.

73. The method of claim 72, wherein the step of inserting the elongate tubular member into the first lumen of the trocar is performed before the step of inserting the trocar into a vessel.

74. The method of claim 72, wherein the body tissue is an atrium.

75. The method of claim 72, wherein the body tissue is an artery.

76. The method of claim 75, wherein the artery is an aorta.

77. The method of claim 76, further comprising the step of making an incision in the aorta using the trocar.

78. The method of claim 76, further comprising the step of making an incision in the aorta using the cannula.

79. The method of claim 72, wherein the slidable cannula further comprises a balloon occluder, and wherein the method further comprises the step of inflating the balloon occluder.

80. The method of claim 72, wherein the method further comprises the step of delivering cardioplegia solution through the cardioplegia port.

81. The method of claim 72, further comprising the step of connecting the proximal end of the cannula to a cardiopulmonary bypass machine.

82. The method of claim 72, further comprising the step of connecting the proximal end of the trocar to a cardiopulmonary bypass machine.

83. The method of claim 72, further comprising the step of performing cardiopulmonary bypass.

84. The method of claim 72, further comprising the step of performing a coronary artery bypass graft procedure.