Devices, systems, and methods for accessing the epicardial surface of the heart
First Claim
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1. A system for use with a vacuum source for placing a lead into a tissue of a heart, comprising:
- an engagement catheter comprising a proximal end, a distal end, and first and second lumens extending between the proximal end and the distal end;
a delivery catheter comprising an elongated tube having a wall and a first lumen, wherein the delivery catheter is configured such that the delivery catheter is capable of at least partial insertion into the second lumen of the engagement catheter;
a lead having a tip at a distal end, the lead configured for at least partial insertion into the first lumen of the delivery catheter; and
a vacuum port located at the proximal end of the engagement catheter, the vacuum port being operatively connected to the first lumen of the engagement catheter and capable of operative connection to a vacuum source;
wherein the first lumen of the engagement catheter includes a suction port located at or near the distal end of the engagement catheter, the suction port being configured to removably attach to a targeted tissue on an interior of a wall of a heart after the engagement catheter has been advanced through a blood vessel into the heart, such that the suction port is capable of forming a reversible seal with the targeted tissue when the vacuum source is operatively attached to the vacuum port.
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Abstract
Devices, systems, and methods for accessing the internal and external tissues of the heart are disclosed. At least some of the embodiments disclosed herein provide access to the external surface of the heart through the pericardial space for localized delivery of leads to the heart tissue. In addition, various disclosed embodiments provide devices, systems, and methods for closing a hole in cardiac tissue.
55 Citations
25 Claims
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1. A system for use with a vacuum source for placing a lead into a tissue of a heart, comprising:
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an engagement catheter comprising a proximal end, a distal end, and first and second lumens extending between the proximal end and the distal end; a delivery catheter comprising an elongated tube having a wall and a first lumen, wherein the delivery catheter is configured such that the delivery catheter is capable of at least partial insertion into the second lumen of the engagement catheter; a lead having a tip at a distal end, the lead configured for at least partial insertion into the first lumen of the delivery catheter; and a vacuum port located at the proximal end of the engagement catheter, the vacuum port being operatively connected to the first lumen of the engagement catheter and capable of operative connection to a vacuum source; wherein the first lumen of the engagement catheter includes a suction port located at or near the distal end of the engagement catheter, the suction port being configured to removably attach to a targeted tissue on an interior of a wall of a heart after the engagement catheter has been advanced through a blood vessel into the heart, such that the suction port is capable of forming a reversible seal with the targeted tissue when the vacuum source is operatively attached to the vacuum port. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 25)
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12. A method of placing a lead in a tissue of a heart, the method comprising:
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extending into a blood vessel an elongated tube having a proximal end, a distal end, and a first lumen, such that the distal end of the tube is in contact with a targeted tissue on an interior of a wall of a heart; aspirating the targeted tissue such that the wall of the heart is retracted away from a pericardial sac surrounding the heart to enlarge a pericardial space between the pericardial sac and the wall of the heart; accessing the pericardial space through the targeted tissue; inserting into the first lumen of the elongated tube and over an elongated guide wire a delivery catheter comprising a first lumen, wherein the first lumen of the delivery catheter has a bend at or near the distal end of the delivery catheter to facilitate delivery of a lead into a tissue of the heart when at least part of the delivery catheter is positioned within the pericardial space and an outlet at or near the distal end of the delivery catheter; advancing at least the distal end of the delivery catheter through the targeted tissue into the pericardial space; directing the delivery catheter such that the outlet of the first lumen of the delivery catheter is adjacent to the tissue of the heart; and extending a lead through the first lumen of the delivery catheter into the tissue of the heart. - View Dependent Claims (13, 14, 15, 16, 17)
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18. A method of injecting a substance into a cardiac tissue from the pericardial space surrounding the external surface of a heart, the method comprising:
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extending into a blood vessel an elongated tube having a proximal end, a distal end, and a first lumen, such that the distal end of the tube is in contact with a targeted tissue on an interior of a wall of a heart; aspirating the targeted tissue such that the wall of the heart is retracted away from a pericardial sac surrounding the heart to enlarge a pericardial space between the pericardial sac and the wall of the heart; accessing the pericardial space through the targeted tissue; inserting at least the distal end of an elongated guide wire into the pericardial space; inserting into the first lumen of the elongated tube and over the elongated guide wire a delivery catheter comprising a first lumen, wherein the first lumen of the delivery catheter has a bend at or near the distal end of the delivery catheter to facilitate injection of a substance into a cardiac tissue when at least part of the delivery catheter is positioned within the pericardial space and an outlet at or near the distal end of the delivery catheter; advancing at least the distal end of the delivery catheter through the targeted tissue into the pericardial space; directing the delivery catheter such that the outlet of the first lumen of the delivery catheter is adjacent to the external surface of the heart; extending a needle through the first lumen of the delivery catheter into the cardiac tissue; and injecting the substance into the cardiac tissue. - View Dependent Claims (19, 20, 21, 22, 23, 24)
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Specification