A system for accessing a patient's cardiac anatomy which includes an endovascular aortic partitioning device that separates the coronary arteries and the heart from the rest of the patient's arterial system. The endovascular device for partitioning a patient's ascending aorta comprises a flexible shaft having a distal end, a proximal end, and a first inner lumen therebetween with an opening at the distal end. The shaft may have a preshaped distal portion with a curvature generally corresponding to the curvature of the patient's aortic arch. An expandable means, e.g. a balloon, is disposed near the distal end of the shaft proximal to the opening in the first inner lumen for occluding the ascending aorta so as to block substantially all blood flow therethrough for a plurality of cardiac cycles, while the patient is supported by cardiopulmonary bypass. The endovascular aortic partitioning device may be coupled to an arterial bypass cannula for delivering oxygenated blood to the patient's arterial system. The heart muscle or myocardium is paralyzed by the retrograde delivery of a cardioplegic fluid to the myocardium through patient's coronary sinus and coronary veins, or by antegrade delivery of cardioplegic fluid through a lumen in the endovascular aortic partitioning device to infuse cardioplegic fluid into the coronary arteries. The pulmonary trunk may be vented by withdrawing liquid from the trunk through an inner lumen of an elongated catheter. The cardiac accessing system is particularly suitable for removing the aortic valve and replacing the removed valve with a prosthetic valve.

System for cardiac procedures

A catheter system and method for achieving total cardiopul-monary bypass during heart surgery. The venous perfusion catheter has first and second balloons occluding the inferior and superior vena cava thereby precluding blood flow into the right atrium. An arterial perfusion catheter is inserted advanced and positioned in the ascending aorta cephalid of the junction of the conorary ar-teries with the aortic root. A second flexible arterial cannula is mounted an sliding relationship with the first flexible cannula and carries an inflatable balloon adjacent its distal end to provide for occlusion of the ascending aorta. A first flexible cannula has a first lumen and an arterial venting orifice communicating with the first lumen defining a single flow path for the passage of cardioplegia solution to arrest the heart or for the evacuation of blood from the aortic root. A third lumen extends axially through the first flexible arterial cannula and communicates with a multiplicity of openings in the distal tip for suctioning blood from the left ventricle. The second flexible cannula of the arterial perfusion catheter has a first cavity extending axially therethrough that communicates with an opening at its distal tip to permit the passage of blood delivered by the cardiopulmonary bypass pump into arterial circulation. Both the venous and arterial perfusion catheters have a plurality of ra-dially and oppositely spaced steering lumens and a plurality of steering cables fixed to the distal ends to achieve omnidirectional articulation.

Catheter system and method for providing cardiopulmonary bypass pump support during heart surgery

A retrograde delivery catheter (10) includes at its distal end a balloon (11) configured to occlude the coronary sinus (21) of a patient's heart, and has a length and flexibility which allow the distal end to be positioned in the coronary sinus (21) with the proximal end extending trans-luminal to a peripheral vein such as an internal jugular vein (44) and out of the body through a puncture (24) therein. The delivery catheter (20) has a delivey lumen (128) extending between its proximal and distal ends which is configured to allow a cardioplegia fluid to be delivered at a flow rate of at least 200 ml/min with a pump pressure less than 300 mm Hg, thereby allowing cardioplegia arrest to be maintained using a blood cardioplegia fluid without causing excessive hemolysis. In a method of inducing cardioplegia arrest according to the invention, the patient is placed on cardiopulmonary bypass (18), the coronary arteries (50, 51) are isolated from remainder of the arterial system, and the delivery catheter (10) is positioned trans-luminal in the coronary sinus (21) from a peripheral vein.

Retrograde delivery catheter and method for inducing cardioplegic arrest

Devices, systems and methods by which the real or apparent renovascular perfusion and intrarenal pressure may be selectively and controllably increased. By selectively and controllably increasing renovascular perfusion and interstitial hydrostatic pressure when the heart is unable to pump sufficient blood or when renal perfusion is suboptimal, the present invention reduces or reverses neurohormonal activation and fluid retention, and thereby minimizes their deleterious effects on the heart, vasculature, kidneys and other body systems.

Systems and methods for controlling renovascular perfusion

A venous catheter having a central flexible lumen with a formed fluid passageway therein and a plurality of collapsible lumens mounted around the periphery of the central flexible lumen also having formed fluid passageways therein. The central flexible lumen being formed of material which is capable of retaining its shape with or without fluid flowing therethrough. Each collapsible lumen being formed from material which is normally collapsed in a small cross-sectional area and which is further capable of expanding when fluid is flowing therein to a cross-sectional area much greater than that when collapsed. The catheter being capable of being inserted through the center of an insertion needle in the collapsed state into the vein of a patient.

Venous catheter having collapsible multi-lumens

A dynamically augmenting pump system incorporates a sealed liquid-filled catheter which is inserted into a vessel such as an artery, and the pump system is operated in timed relation with the heart to aid the heart during episodes of impairment or failure of cardiac function by producing higher frequency pulsation or pressure waves within the blood during diastole and during the isometric contraction period of the heart. This frequency of pulsation is adjusted to the dynamic transmission characteristics of a selected circulatory subsystem, such as the coronary vascular system, to assure the transmission of a maximum of pulsatile energy into the subsystem. The catheter provides energy to maintain adequate blood flow through the healthy part of the myocardium and has a passage for injecting successive quantities of medication into the coronary arteries. The pump system also functions to penetrate the ischemic myocardial tissue with arterial blood and medication. The pump system may also be used to provide enhanced perfusion for other parts of the systemic circulatory system, for example, to prevent such detrimental effects as renal failure. Any one or combination of the functions may be used depending on the special medical conditions of the patient.

Horst E. Krause

Papers

Method and apparatus for pumping blood within a vessel