Steerable catheter and method for locating coronary sinus

• US 6,591,144 B2
• Filed: 10/23/2001
• Issued: 07/08/2003
• Est. Priority Date: 10/23/2001
• Status: Expired due to Term

• Current Assignee: Administrators Of The Tulane Educational Fund (ADMINISTRATORS|DAVID H. COY)
• Original Assignee: Administrators Of The Tulane Educational Fund (ADMINISTRATORS|DAVID H. COY)
• Inventors: Pigott, John D.
• Primary Examiner(s): Evanisko, George R.
• Assistant Examiner(s): KHAN, OMAR A
• Application Number:
  US10/044,587
• Publication Number:
  US 20030078645A1
• Time in Patent Office: 623 Days
• Field of Search: 607/119-132, 600/322-340, 600/372-377
• US Class Current: 607/119
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 5/14539 for measuring pH
• CPC Class Codes: A61B 5/1459 invasive, e.g. introduced into the body by a catheter A61B5/1464 takes precedence
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

A steerable catheter includes an elongate cannula having a proximal end and a distal end. A blood characteristic sensor, such as an oxygen sensor, is connected to the cannula and disposed to sense percent oxygen saturation of blood at the distal end of the cannula. The blood oxygen sensor generates a signal indicative of percent oxygen saturation. An oximetry display is responsive to the signal and capable of displaying sensed percent oxygen saturation in a form understandable by an operator. A steering mechanism is operably connected to the cannula and is selectively operable by an operator to deflect the distal end of the cannula. A method of locating the coronary sinus of a heart involves endovascularly introducing a catheter into the right atrium, sensing percent oxygen saturation at the distal end of the catheter, and steering the catheter toward a region of lowest percent oxygen saturation.

Claims

1. A method of locating the coronary sinus of a heart, comprising the steps of:

endovascularly introducing a catheter into a right atrium of the heart;

sensing a characteristic of blood at the distal end of the catheter;

qualitatively correlating the sensed characteristic of the blood at the distal end of the catheter with a characteristic of blood of the coronary sinus; and

steering the catheter toward a region in which the sensed characteristic is qualitatively correlated with the blood of the coronary sinus.

2. The method of claim 1, wherein the catheter is oxymetric and the step of sensing a characteristic comprises sensing percent oxygen saturation.

3. The method of claim 2, wherein the step of steering the catheter comprises qualitatively correlating the lowest percent oxygen saturation.

4. The method of claim 1, and further including the step of:

introducing the distal end of the catheter into the coronary sinus.

5. The method of claim 4, and further including the step of:

introducing a sheath over the catheter into the coronary sinus and withdrawing the catheter from the coronary sinus.

6. The method of claim 5, and further including the step of introducing a pacing lead through the sheath and into the coronary sinus.

7. The method of claim 6, and further including the step of introducing the pacing lead through the coronary sinus and into a vein associated with the left ventricle of the heart.

8. The method of claim 1 further including introducing a pacing electrode through a passageway in the catheter into the coronary sinus.

9. The method of claim 1, wherein the step of sensing a characteristic comprises sensing pH.

10. The method of claim 1, further comprising placing a pacing lead proximate to or through the coronary sinus of the heart, wherein placing a pacing lead comprises introducing the catheter into the right atrium of the heart and steering the catheter while concurrently monitoring at the distal end of the catheter the characteristic of blood indicative of blood in the coronary sinus to introduce the distal end of the catheter into the coronary sinus, and introducing a pacing lead into the coronary sinus.

11. The method of claim 10, wherein monitoring a characteristic of blood comprises sensing percent oxygen saturation.

12. The method of claim 10, wherein the step of sensing a characteristic of blood comprises sensing pH.

13. The method of claim 10, wherein the step of sensing a characteristic of blood comprises sensing percent CO₂ saturation.

14. The method of claim 10 wherein the pacing lead is fixed to the heart proximate to the coronary sinus.

15. The method of claim 10 wherein the catheter is introduced through the coronary sinus and into a great vein.

16. The method of claim 10 wherein the pacing lead is fixed in a great vein.

17. The method of claim 10 wherein the pacing lead is fixed in a coronary vein extending from a great vein.

18. The method of claim 10 further including advancing a hollow sheath over the catheter after the distal end of the catheter is introduced into the coronary sinus, removing the catheter and introducing the pacing lead through the hollow sheath.

19. The method of claim 1, wherein the catheter includes a hollow cannula and the pacing lead is introduced through the hollow cannula.

20. The method of claim 1, wherein the catheter includes a hollow cannula and a steering guide disposed therein, the steering guide being withdrawn from the hollow cannula and replaced by a pacing lead after the distal end of the catheter is introduced into the coronary sinus.

21. A method of locating the coronary sinus of the heart, comprising the steps of:

introducing a percent oxygen saturation sensor into a right atrium of the heart;

sensing the percent oxygen saturation with the oxygen saturation sensor; and

steering the percent oxygen saturation sensor toward lowest percent oxygen saturation until the lowest percent oxygen saturation is located.

22. A method of locating the coronary sinus of a heart, comprising the steps of:

introducing a catheter having a distal end into a right atrium of the heart, the catheter further including a blood characteristic sensor for sensing the blood characteristic at the distal end;

sensing a characteristic of blood with the blood characteristic sensor; and

steering the catheter to the coronary sinus based on the sensed characteristic of blood.

23. The method of claim 22, wherein the blood characteristic sensor is a percentage oxygen saturation sensor and the step of sensing a characteristic comprises sensing percent oxygen saturation.

24. The method of claim 23, wherein the oxygen saturation sensor comprises a optical fiber assembly.

25. The method of claim 22, wherein the blood characteristic sensor is a pH sensor and the step of sensing a characteristic comprises sensing blood acidity level.

26. The method of claim 22, wherein the blood characteristic sensor is a percentage CO₂ saturation sensor and the step of sensing a characteristic comprises sensing percent CO₂ saturation.

27. The method of claim 22 further including introducing a pacing electrode through a passageway in the catheter into the coronary sinus.

28. The method of claim 27, and further including the step of introducing a sheath over the catheter into the coronary sinus and withdrawing the catheter from the coronary sinus.

29. The method of claim 28, and further including the step of introducing the pacing lead through the coronary sinus and into a vein associated with a left ventricle of the heart.

30. The method of claim 22 including further introducing a pacing electrode through a passageway in the catheter into the coronary sinus.