Method for intraluminally inducing cardioplegic arrest and catheter for use therein

• US RE35,352 E
• Filed: 01/19/1996
• Issued: 10/15/1996
• Est. Priority Date: 12/03/1992
• Status: Expired due to Term

• Current Assignee: Edwards Lifesciences LLC (Edwards Lifesciences Corporation)
• Original Assignee: Heartport, Inc. (Johnson & Johnson)
• Inventors: Peters, William S.
• Primary Examiner(s): YASKO JR, JOHN D
• Application Number:
  US08/588,791
• Time in Patent Office: 270 Days
• Field of Search: 604/4, 604/5, 604/28, 604/49, 604/51-53, 604/96-103, 604/113, 606/21, 606/192, 606/194, 600/18, 128/898
• US Class Current: 604/6.14
• CPC Class Codes: A61B 2018/00232 having an irregular shape
• CPC Class Codes: A61B 2018/00261 arranged in a line
• CPC Class Codes: A61M 2025/028 having a mainly rigid support structure
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2202/047 cardioplegic
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2205/3355 Controlling downstream pump pressure
• CPC Class Codes: A61M 2210/127 Aorta
• CPC Class Codes: A61M 25/0023 by the form of the lumen, e.g. cross-section, variable diameter
• CPC Class Codes: A61M 25/0026 Multi-lumen catheters with stationary elements catheter assemblies comprising a catheter in combination with a guide tube, sheath or sleeve A61M2025/0681; catheters comprising telescoping coaxial elements A61M2025/0175
• CPC Class Codes: A61M 25/0032 characterized by at least one unconventionally shaped lumen, e.g. polygons, ellipsoids, wedges or shapes comprising concave and convex parts

Abstract

A process for inducing cardioplegic arrest of a heart in situ in a patient'"'"'s body, comprising maintaining the patient'"'"'s systemic circulation by peripheral cardiopulmonary by-pass, occluding the ascending aorta through a percutaneously placed arterial balloon catheter, venting the left side of the heart, and introducing a cardioplegic agent into the coronary circulation. This procedure readies the heart for a variety of surgical procedures that can be performed percutaneously through lumina in the catheter. An aortic catheter for use in the process is also described.

Claims

1. A method for inducing cardioplegic arrest of a heart in situ in a patient'"'"'s body, comprising the steps of:

(a) maintaining systemic circulation with peripheral cardiopulmonary by-pass;

(b) occluding at least one of the patient'"'"'s vena cavae with an inflatable cuff on a distal portion of at least one percutaneously placed venous catheter to isolate a fight atrium of the heart from at least a portion of the patient'"'"'s venous system;

(c) occluding the ascending aorta through a percutaneously placed arterial balloon catheter;

(d) introducing a cardioplegic agent into the coronary circulation; and

(e) venting the heart through a percutaneously placed catheter.

2. A method as claimed in claim 1 in which the ascending aorta is occluded by an arterial balloon catheter percutaneously placed through one of the fernoral arteries.

3. A method as claimed in claim 2 wherein the cardioplegic agent is introduced through a lumen in the arterial balloon catheter.

4. A method as claimed in claim 1 further comprising introducing a fluid into the right atrium through a lumen in a percutaneous venous catheter which opens between the two cuffs.

5. A method as claimed in claim 1 in which the percutaneous venous catheter is introduced into the heart through a femoral vein.

6. A method as claimed in claim 1 in which the systemic circulation is maintained through a cardiopulmonary by-pass that includes an oxygenated blood return catheter introduced into one of the femoral arteries.

7. A method as claimed in claim 1 wherein the vena cavae arc occluded with two inflatable cuffs, each inflatable cuff being on a separate percutaneously placed venous catheter.

8. A method as claimed in claim 1 wherein the vena cavae are occluded with two inflatable cuffs both disposed on a single percutaneously placed venous catheter.

9. A method as claimed in claim 1 further comprising withdrawing venous blood from at least one vena cava through a lumen in at least one of the percutaneously placed venous catheters and directing the venous blood to the cardiopulmonary by-pass.

10. A method as claimed in claim 4 wherein the fluid comprises saline.

11. A method as claimed in claim 1 wherein oxygenated blood is returned from the cardiopulmonary bypass to the patient'"'"'s arterial system through a lumen in the arterial balloon catheter.

12. A method as claimed in claim 1 wherein the heart is vented by withdrawing fluid through a lumen in the arterial balloon catheter.

13. A method as claimed in claim 1 further comprising introducing an instrument through a lumen in the arterial balloon catheter into the patient'"'"'s heart.

14. A method as claimed in claim 13 wherein the instrument comprises a scope, the method further comprising visualizing the heart with the scope.

15. A method as claimed in claim 13 wherein the instrument comprises a cannula having a lumen, the method further comprising venting fluids from the heart through the lumen in the cannula.

16. A method for inducing cardioplegic arrest of a heart in situ in a patient'"'"'s body, comprising the steps of:

(a) positioning a percutaneously placed venous catheter in at least a portion of both of the patient'"'"'s vena cavae and in a right atrium of the heart;

(b) occluding a superior vena cavae with a first inflatable cuff on a distal portion of the percutaneously placed venous catheter and occluding an inferior vena cavae with a second inflatable cuff on a distal portion of the percutaneously placed venous catheter to isolate the heart from at least a portion of the patient'"'"'s venous system;

(c) withdrawing blood from the venous system through a lumen in the venous catheter;

(d) oxygenating the blood withdrawn from the venous system;

(e) returning the oxygenated blood to the patient'"'"'s arterial system;

(f) occluding the ascending aorta through a percutaneously placed arterial balloon catheter,

(g) introducing a cardioplegic agent into the coronary circulation; and

(h) venting the heart through a percutaneously placed catheter.

17. A method for inducing cardioplegic arrest of a heart in situ in a patient'"'"'s body, comprising the steps of:

(a) maintaining systemic circulation with peripheral cardiopulmonary bypass;

(b) isolating a fight atrium of the patient'"'"'s heart from the patient'"'"'s venous system with at least one percultaneously placed venous catheter;

(c) isolating a coronary vasculature from the patient'"'"'s arterial system with a percutaneously placed arterial balloon catheter;

,

(d) introducing a cardioplegic agent into the coronary vasculature; and

(e) venting fluid from the heart through a percutaneously placed catheter.