Methods and devices for occluding the ascending aorta and maintaining circulation oxygenated blood in the patient when the patient's heart is arrested

• US 6,902,556 B2
• Filed: 06/05/2002
• Issued: 06/07/2005
• Est. Priority Date: 01/23/1998
• Status: Expired due to Term

• Current Assignee: Edwards Lifesciences LLC (Edwards Lifesciences Corporation)
• Original Assignee: Heartport, Inc. (Johnson & Johnson)
• Inventors: Komtebedde, Jan, Taylor, David M., Grimes, Kevin V., Garrison, Michi E., Gifford, Hanson S. III, Sharkawy, A. Adam, Sterman, Wesley D., Ray, Pinaki, Rosenman, Daniel C.
• Primary Examiner(s): KENNEDY, SHARON E
• Application Number:
  US10/162,799
• Publication Number:
  US 20020151870A1
• Time in Patent Office: 1,098 Days
• Field of Search: 604/96.01, 604/103.06, 604/103.08, 604/4.01, 604/6.16, 604/916, 604/500, 604/104, 604/101.04, 604/264, 606/192, 606/194
• US Class Current: 604/500
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2025/1084 having features for increasing the shape stability, the reproducibility or for limiting expansion, e.g. containments, wrapped around fibres, yarns or strands
• CPC Class Codes: A61M 2210/127 Aorta
• CPC Class Codes: A61M 25/10 Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 25/1002 characterised by balloon shape A61M25/1006, A61M25/1009 take precedence

Abstract

A method and device for occluding a patient'"'"'s ascending aorta, maintaining circulation of oxygenated blood in the patient and delivering cardioplegic fluid to arrest the patient'"'"'s heart. An aortic occlusion catheter has an occluding member for occluding the ascending aorta. The aortic occlusion catheter passes through a cannula. Delivery of oxygenated blood is accomplished through either the cannula of the aortic occlusion catheter. In another aspect of the invention, an arterial cannula having a curved or angled distal portion. An introducer straightens the distal portion for introduction into the patient. In still another aspect of the invention, an open-mesh stabilizer is used to stabilize a discoid occluding member.

Claims

1. A method of cannulating a patient'"'"'s ascending aorta comprising the steps of:

providing an arterial cannula and an introducer, the arterial cannula having a blood flow lumen and a distal end;

introducing the arterial cannula into the ascending aorta through a side wall of the ascending aorta, the introducer being positioned in the blood flow lumen, the arterial cannula having a first shape during the introducing step;

withdrawing the introducer from the blood flow lumen after the introducing step, the arterial cannula having a second shape after the introducer has been withdrawn from the blood flow lumen;

coupling the blood flow lumen to a source of oxygenated blood; and

perfusing the oxygenated blood into the patient through the blood flow lumen.

2. The method of claim 1, further comprising the steps of:

providing a catheter having a distal end, the catheter being slidably received by the arterial cannula; and

moving the distal end of the catheter into the patient.

3. The method of claim 1, wherein:

the providing step is carried out with the catheter having a balloon.

4. The method of claim 1, wherein the introducing step comprises positioning the introducer within the blood flow lumen such that the distal end of the introducer extends beyond the distal end of the arterial cannula.

5. The method of claim 1, wherein the introducer comprises a cutting element carried at a distal end of the introducer.

6. The method of claim 5, wherein the cutting element has a retracted position, where the cutting element is not exposed, and an extended position, where the cutting element is exposed.

7. The method of claim 6, wherein the introducing step comprises positioning the cutting element beyond the distal end of the arterial cannula in the extended position.

8. The method of claim 1, wherein, when the arterial cannula is in the second shape, the distal end of the arterial cannula is substantially L-shaped.

9. The method of claim 1, wherein, when the arterial cannula is in the second shape, the distal end of the arterial cannula is curved.

10. The method of claim 1, wherein, when the arterial cannula is in the second shape, the distal end of the arterial cannula is oriented to deliver blood in an upstream direction, toward the heart.

11. The method of claim 1, wherein, when the arterial cannula is in the second shape, the distal end of the arterial cannula is oriented to deliver blood in a downstream direction, away from the heart.

12. The method of claim 3, comprising the step of positioning the balloon upstream from the location where the arterial cannula entered the aorta.

13. The method of claim 3, comprising the step of positioning the balloon downstream from the location where the arterial cannula entered the aorta.

14. A method of cannulating a patient'"'"'s ascending aorta comprising the steps of:

providing an arterial cannula and an introducer, the arterial cannula having a blood flow lumen and a distal end;

introducing the arterial cannula into the ascending aorta through a side wall of the ascending aorta, the introducer being positioned at least partially within the arterial cannula, the arterial cannula having a first shape during the introducing step;

withdrawing the introducer from the arterial cannula after the introducing step, the arterial cannula having a second shape after the introducer has been withdrawn from the arterial cannula;

coupling the blood flow lumen to a source of oxygenated blood; and

perfusing the oxygenated blood into the patient through the blood flow lumen.

15. A method of cannulating a patient'"'"'s ascending aorta comprising the steps of:

providing an arterial cannula having a blood flow lumen and a distal end, and a introducer comprising a cutting element at a distal end thereof, the cutting element having a retracted position, where the cutting element is not exposed, and an extended position, where the cutting element is exposed;

positioning the introducer within the arterial cannula such that the cutting element is in the extended position, and the arterial cannula assumes a first shape;

introducing the arterial cannula into the ascending aorta, while the arterial cannula is in the first shape;

withdrawing the introducer from the arterial cannula after the introducing step, the arterial cannula assuming a second shape after the introducer has been withdrawn from the arterial cannula;

coupling the blood flow lumen to a source of oxygenated blood; and

perfusing the oxygenated blood into the patient through the blood flow lumen.

16. The method of claim 15, wherein the introducing step comprises positioning the cutting element beyond the distal end of the arterial cannula in the extended position.

17. The method of claim 15, wherein the positioning step comprises positioning the introducer within the blood flow lumen of the arterial cannula.

18. The method of claim 15, wherein, when the arterial cannula is in the second shape, the distal end of the arterial cannula is substantially L-shaped.

19. The method of claim 15, wherein, when the arterial cannula is in the second shape, the distal end of the arterial cannula is curved.

20. The method of claim 15, wherein, when the arterial cannula is in the second shape, the distal end of the arterial cannula is oriented to deliver blood in an upstream direction, toward the heart.

21. The method of claim 15, wherein, when the arterial cannula is in the second shape, the distal end of the arterial cannula is oriented to deliver blood in a downstream direction, away from the heart.

22. The method of claim 15, wherein the providing step comprises providing a catheter having a distal end, the catheter being slidably received by the arterial cannula, and positioning the distal end of the catheter into the patient.

23. The method of claim 22, wherein the catheter has a balloon attached thereto for occluding the aorta.

24. The method of claim 22, wherein the catheter has a balloon attached thereto and comprising the step of positioning the balloon upstream from the location where the arterial cannula entered the aorta.

25. The method of claim 23, wherein the catheter has a balloon attached thereto and comprising the step of positioning the balloon downstream from the location where the arterial cannula entered the aorta.