Devices, systems, and methods for accessing cardiac tissue
First Claim
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1. A system for engaging heart tissue, comprising:
- an engagement catheter, comprising;
a proximal end, a distal end, and a first lumen extending between the proximal end and the distal end;
a vacuum port located at or near the proximal end of the engagement catheter, the vacuum port operatively connected to the first lumen of the engagement catheter and capable of operative connection to a vacuum source; and
a suction port located at or near the distal end of the engagement catheter in communication with the first lumen of the engagement catheter, the suction port configured to removably engage a targeted tissue on an interior of a wall of a heart, such that the suction port is capable of forming a reversible seal with the wall of the heart when the vacuum source is operatively attached to the vacuum port; and
a delivery catheter comprising a proximal end, a distal end, and a hollow tube extending between the proximal end and the distal end, the delivery catheter configured such that the hollow tube is capable of insertion through the vacuum port into the first lumen of the engagement catheter while the reversible seal is maintained under vacuum through the first lumen using the suction port;
wherein the engagement catheter is configured for percutaneous intravascular insertion into a patient through a blood vessel of the patient and further configured for advancement to the targeted tissue through the blood vessel;
wherein the suction port is configured to removably attach to the targeted tissue after introduction of a portion of the system into the blood vessel; and
wherein the engagement catheter is configured so that at least a portion of the engagement catheter can be retracted after percutaneous intravascular insertion, while remaining removably attached to the targeted tissue, due to vacuum from the vacuum source through the first lumen of the engagement catheter and suction engagement from the suction port, so to locally increase a distance between the targeted tissue and a pericardium surrounding the heart.
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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 substances to the heart tissue. In addition, various disclosed embodiments provide access to the internal surface of the heart for aspiration and delivery of substances to a targeted region without disturbing or interfering with nearby structures or surfaces.
46 Citations
38 Claims
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1. A system for engaging heart tissue, comprising:
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an engagement catheter, comprising; a proximal end, a distal end, and a first lumen extending between the proximal end and the distal end; a vacuum port located at or near the proximal end of the engagement catheter, the vacuum port operatively connected to the first lumen of the engagement catheter and capable of operative connection to a vacuum source; and a suction port located at or near the distal end of the engagement catheter in communication with the first lumen of the engagement catheter, the suction port configured to removably engage a targeted tissue on an interior of a wall of a heart, such that the suction port is capable of forming a reversible seal with the wall of the heart when the vacuum source is operatively attached to the vacuum port; and a delivery catheter comprising a proximal end, a distal end, and a hollow tube extending between the proximal end and the distal end, the delivery catheter configured such that the hollow tube is capable of insertion through the vacuum port into the first lumen of the engagement catheter while the reversible seal is maintained under vacuum through the first lumen using the suction port; wherein the engagement catheter is configured for percutaneous intravascular insertion into a patient through a blood vessel of the patient and further configured for advancement to the targeted tissue through the blood vessel; wherein the suction port is configured to removably attach to the targeted tissue after introduction of a portion of the system into the blood vessel; and wherein the engagement catheter is configured so that at least a portion of the engagement catheter can be retracted after percutaneous intravascular insertion, while remaining removably attached to the targeted tissue, due to vacuum from the vacuum source through the first lumen of the engagement catheter and suction engagement from the suction port, so to locally increase a distance between the targeted tissue and a pericardium surrounding the heart. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A system, comprising:
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an engagement catheter for engaging heart tissue, comprising; an elongated tube comprising a proximal end, a distal end, and an internal lumen extending between the proximal end and the distal end; a vacuum port in communication with the proximal end of the tube, the vacuum port operatively connected to the internal lumen and capable of operative connection to a vacuum source; and a suction port in communication with the internal lumen at or near the distal end of the tube, the suction port configured to removably engage a targeted tissue on the interior of a wall of a heart, such that the suction port is capable of forming a reversible seal with the wall of the heart when the vacuum source is operatively attached to the vacuum port; wherein the engagement catheter is configured for percutaneous intravascular insertion into a patient through a blood vessel of the patient and further configured for advancement to the targeted tissue through the blood vessel; wherein the suction port is configured to removably attach to the targeted tissue under vacuum applied from the vacuum source after introduction of a portion of the engagement catheter into the blood vessel; and wherein the engagement catheter is configured so that at least a portion of the engagement catheter can be retracted after percutaneous intravascular insertion, while remaining removably attached to the targeted tissue due to vacuum from the vacuum source through the first lumen of the engagement catheter and suction engagement from the suction port, so to locally increase a distance between the targeted tissue and a pericardium surrounding the heart; and a second device; wherein the engagement catheter is configured so that when the engagement catheter is used to form the reversible seal under vacuum through the first lumen using the suction port, the second device can be delivered through the vacuum port into the first lumen of the engagement catheter while maintaining the reversible seal. - View Dependent Claims (18, 19, 20, 21, 22, 23)
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24. A method of accessing a pericardial space surrounding a heart, the method comprising the steps of:
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inserting at least a portion of an engagement catheter into a mammalian body, the engagement catheter comprising; a proximal end, a distal end, and a first lumen extending between the proximal end and the distal end, a vacuum port located at or near the proximal end of the engagement catheter, the vacuum port operatively connected to the first lumen of the engagement catheter and capable of operative connection to a vacuum source, and a suction port located at or near the distal end of the engagement catheter in communication with the first lumen of the engagement catheter, the suction port configured to removably engage a targeted tissue on an interior of a wall of a heart, such that the suction port is capable of forming a reversible seal with the wall of the heart when the vacuum source is operatively attached to the vacuum port, wherein the engagement catheter is configured for percutaneous intravascular insertion into a patient through a blood vessel of the patient and further configured for advancement to the targeted tissue through the blood vessel, wherein the suction port is configured to removably attach to the targeted tissue under vacuum applied from the vacuum source after introduction of the at least a portion of the engagement catheter into the blood vessel, wherein the engagement catheter is configured so that at least a portion of the engagement catheter can be retracted after percutaneous intravascular insertion, while remaining removably attached to the targeted tissue due to vacuum from the vacuum source through the first lumen of the engagement catheter and suction engagement from the suction port, so to locally increase a distance between the targeted tissue and a pericardium surrounding the heart, and wherein the engagement catheter is configured so that when the engagement catheter is used to form the reversible seal under vacuum through the first lumen using the suction port, a second device can be delivered through the vacuum port into the first lumen of the engagement catheter while maintaining the reversible seal; positioning the distal end of the engagement catheter such that the suction port of the engagement catheter is in contact with the targeted tissue on the interior of a wall of the heart; operating the vacuum source so that the suction port removably engages the targeted tissue, forming the reversible seal; retracting at least a portion of the engagement catheter, while remaining removably attached to the targeted tissue under vacuum, so to locally increase the distance between the targeted tissue and the pericardium; and after forming the reversible seal, delivering the second device through the vacuum port into the first lumen of the engagement catheter while maintaining the reversible seal. - View Dependent Claims (25, 26, 27, 28, 29, 30, 31, 32)
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33. A method of engaging heart tissue, the method comprising:
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extending into a blood vessel at least a portion of an engagement catheter, the engagement catheter comprising; an elongated tube comprising a proximal end, a distal end, and an internal lumen extending between the proximal end and the distal end; a vacuum port in communication with the proximal end of the tube, the vacuum port operatively connected to the at least one suction channel and capable of operative connection to a vacuum source; and a suction port in communication with the at least one suction channel at or near the distal end of the tube, the suction port configured to removably engage a targeted tissue on the interior of a wall of a heart, such that the suction port is capable of forming a reversible seal with the wall of the heart when the vacuum source is operatively attached to the vacuum port; wherein the engagement catheter is configured for percutaneous intravascular insertion into a patient through a blood vessel of the patient and further configured for advancement to the targeted tissue through the blood vessel; wherein the suction port is configured to removably attach to the targeted tissue after introduction of the at least a portion of the engagement catheter into the blood vessel; and wherein the engagement catheter is configured so that at least a portion of the engagement catheter can be retracted after percutaneous intravascular insertion, while remaining removably attached to the targeted tissue due to vacuum from the vacuum source through the first lumen of the engagement catheter and suction engagement from the suction port, so to locally increase a distance between the targeted tissue and a pericardium surrounding the heart, and wherein the engagement catheter is configured so that when the engagement catheter is used to form the reversible seal under vacuum through the first lumen using the suction port, a second device can be delivered through the vacuum port into the first lumen of the engagement catheter while maintaining the reversible seal; positioning the distal end of the engagement catheter in contact with a targeted tissue on the interior of a wall of the heart; and aspirating the targeted tissue so to removably engage the targeted tissue under vacuum, forming the reversible seal; retracting at least a portion of the engagement catheter, while remaining removably attached to the targeted tissue under vacuum, so to increase the distance between the targeted tissue and the pericardium; and after forming the reversible seal, delivering the second device through the vacuum port into the first lumen of the engagement catheter while maintaining the reversible seal. - View Dependent Claims (34, 35, 36, 37, 38)
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Specification