Methods and apparatus for pericardial access

• US 6,423,051 B1
• Filed: 09/16/1999
• Issued: 07/23/2002
• Est. Priority Date: 09/16/1999
• Status: Expired due to Term

• Current Assignee: SentreHeart, LLC (Atricure, Inc.)
• Original Assignee: Aaron V. Kaplan
• Inventors: Manoukian, Nubar S., Bajor, Jordan T., Kaplan, Aaron V.
• Primary Examiner(s): MENDEZ, MANUEL A
• Application Number:
  US09/397,392
• Time in Patent Office: 1,041 Days
• Field of Search: 604/500, 604/506, 604/507, 604/508, 604/510, 604/511, 604/174
• US Class Current: 604/506
• 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 2017/3484 Anchoring means, e.g. spreading-out umbrella-like structure
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61M 2025/0233 specifically adapted for attaching to a body wall by means which are on both sides of the wall, e.g. for attaching to an abdominal wall
• CPC Class Codes: A61M 2025/0286 anchored in the skin by suture or other skin penetrating devices
• CPC Class Codes: A61M 2210/122 Pericardium
• CPC Class Codes: A61M 25/0606 "Over-the-needle" catheter assemblies, e.g. I.V. catheters
• CPC Class Codes: A61M 25/065 Guide needles
• CPC Class Codes: A61M 25/0662 Guide tubes

Abstract

An access tube is used for accessing an anatomic space, such as a pericardial space between the parietal and visceral pericardia. The access tube is advanced against the parietal pericardium and an anchor structure thereon embedded into the parietal pericardium. The access tube can then be used to separate the parietal and visceral pericardia and enlarge the pericardial space. After such enlargement, a needle or other access device can be introduced through the access tube into the pericardial space to provide access for a wide variety of purposes, including aspiration, infusion, and guidewire placement.

Claims

1. A method for accessing an anatomic space having a wall with an outer surface, said method comprising:

embedding a distal end of an access tube into the outer surface

drawing the access tube proximally to raise the wall over the anatomic space and to enlarge the anatomic space; and

introducing an access device through the access tube, penetrating the wall and into the anatomic space while the access tube stabilizes the wall.

2. A method as in claim 1, wherein embedding comprises engaging an anchor structure at the distal end of the access tube against the outer surface and deploying the anchor structure into said surface.

3. A method as in claim 2, wherein the anchor structure comprises one or more penetrating points.

4. A method as in claim 3, wherein the penetrating points are deployed by rotating the access tube about its central axis to cause the penetrating points to penetrate into and capture the wall.

5. A method as in claim 1, wherein introducing comprising positioning a needle in the access tube and passing the needle through the wall and into the anatomic space.

6. A method as in claim 5, further comprising positioning a guidewire through the needle after said needle has been passed into the anatomic space.

7. A method for accessing the pericardial space between the visceral and parietal pericardium, said method comprising:

percutaneously positioning a distal end of an access tube over the parietal pericardium;

embedding the distal end of the access tube into the parietal pericardium but not into the visceral pericardium;

proximally drawing on the access tube to separate the parietal pericardium from the visceral pericardium to enlarge the pericardial space therebetween; and

penetrating an access device through the access tube and parietal pericardium and into the pericardial space.

8. A method as in claim 7, wherein percutaneously positioning the distal end of the access tube comprises passing the access tube deep to the xiphoid process.

9. A method as in claim 7, wherein penetrating comprises positioning a needle in the access tube and passing the needle into the pericardial space.

10. A method as in claim 9, further comprising positioning a guidewire through the needle after said needle has been passed into the pericardial space.

11. A method as in claim 7 wherein embedding comprises engaging an anchor structure at the distal end of the access tube against the parietal pericardium and deploying the anchor structure into said parietal pericardium.

12. A method as in claim 11, wherein the anchor structure comprises one or more penetrating points.

13. A method as in claim 12, wherein the penetrating points are deployed by rotating the access tube about the long axis to cause the penetrating points to penetrate into and capture the parietal pericardium.

14. A method as in claim 7, further comprising drawing the access tube to separate the parietal pericardium over the pericardial space.