120 results about "Cardiopulmonary bypass time" patented technology

Methods and systems for endovascular, endocardiac, or endoluminal approaches to a patient's heart to perform surgical procedures that may be performed or used without requiring extracorporeal cardiopulmonary bypass. Furthermore, these procedures can be performed through a relatively small number of small incisions. These procedures may illustratively include heart valve implantation, heart valve repair, resection of a diseased heart valve, replacement of a heart valve, repair of a ventricular aneurysm, repair of an arrhythmia, repair of an aortic dissection, etc. Such minimally invasive procedures are preferably performed transapically (i.e., through the heart muscle at its left or right ventricular apex).

The invention includes a novel method and system to achieve leaflet coaptation in a cardiac valve percutaneously by creation of neochordae to prolapsing valve segments. This technique is especially useful in cases of ruptured chordae, but may be utilized in any segment of prolapsing leaflet. The technique described herein has the additional advantage of being adjustable in the beating heart. This allows tailoring of leaflet coaptation height under various loading conditions using image-guidance, such as echocardiography. This offers an additional distinct advantage over conventional open-surgery placement of artificial chordae. In traditional open surgical valve repair, chord length must be estimated in the arrested heart and may or may not be correct once the patient is weaned from cardiopulmonary bypass. The technique described below also allows for placement of multiple artificial chordae, as dictated by the patient's pathophysiology.

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.

Devices and methods are provided for temporarily inducing cardioplegic arrest in the heart of a patient and for establishing cardiopulmonary bypass in order to facilitate surgical procedures on the heart and its related blood vessels. Specifically, a catheter based system is provided for isolating the heart and coronary blood vessels of a patient from the remainder of the arterial system and for infusing a cardioplegic agent into the patient's coronary arteries to induce cardioplegic arrest in the heart. The system includes an endoaortic partitioning catheter having an expandable balloon at its distal end which is expanded within the ascending aorta to occlude the aortic lumen between the coronary ostia and the brachiocephalic artery. Means for centering the catheter tip within the ascending aorta include specially curved shaft configurations, eccentric or shaped occlusion balloons and a steerable catheter tip, which may be used separately or in combination. The shaft of the catheter may have a coaxial or multilumen construction. The catheter may further include piezoelectric pressure transducers at the distal tip of the catheter and within the occlusion balloon. Means to facilitate nonfluoroscopic placement of the catheter include fiberoptic transillumination of the aorta and a secondary balloon at the distal tip of the catheter for atraumatically contacting the aortic valve. The system further includes a dual purpose arterial bypass cannula and introducer sheath for introducing the catheter into a peripheral artery of the patient.

Apparatus and methods for performing retrograde perfusion, especially during cardiopulmonary bypass operations, including dedicated pediatric scaled apparatus for retrograde perfusion of an adult human organ, organ system, or limb, especially the brain, employing small scale oxygenators and heat exchangers such as are designed for pediatric surgery; also including methods and apparatus for retrograde cerebral perfusion, using nonselective infravalvular cannulation of the superior vena cava, estimating the efficacy of cerebral perfusion by monitoring fluid flow across a valve of an internal jugular vein, modification of inflow pressure and administration of pharmacologic agents, and increasing fluid flow into a brain by occlusion of an inferior vena cava distal to its junction with an azygos vein.

A system for inducing cardioplegic arrest and performing an endovascular procedure within the heart or blood vessels of a patient. An endoaortic partitioning catheter has an inflatable balloon which occludes the ascending aorta when inflated. Cardioplegic fluid may be infused through a lumen of the endoaortic partitioning catheter to stop the heart while the patient's circulatory system is supported on cardiopulmonary bypass. One or more endovascular devices are introduced through an internal lumen of the endoaortic partitioning catheter to perform a diagnostic or therapeutic endovascular procedure within the heart or blood vessels of the patient. Surgical procedures such as coronary artery bypass surgery or heart valve replacement may be performed in conjunction with the endovascular procedure while the heart is stopped. Embodiments of the system are described for performing: fiberoptic angioscopy of structures within the heart and its blood vessels, valvuloplasty for correction of valvular stenosis in the aortic or mitral valve of the heart, angioplasty for therapeutic dilatation of coronary artery stenoses, coronary stenting for dilatation and stenting of coronary artery stenoses, atherectomy or endarterectomy for removal of atheromatous material from within coronary artery stenoses, intravascular ultrasonic imaging for observation of structures and diagnosis of disease conditions within the heart and its associated blood vessels, fiberoptic laser angioplasty for removal of atheromatous material from within coronary artery stenoses, transmyocardial revascularization using a side-firing fiberoptic laser catheter from within the chambers of the heart, and electrophysiological mapping and ablation for diagnosing and treating electrophysiological conditions of the heart.

A pumping system 10 provides a physiological pulsatile flow and includes controller 121, a pump drive head 50 coupled to a motor 12 and a fluid housing 52 having at least one port 60. The port 60 includes a ball valve retainer region 69, a valve seat 73, and an occluder ball 71 disposed in the ball valve retainer region 69. During operation, the motor 12 forces the fluid in and out the fluid housing 52 and causes the occluder ball 71 to move from a first position whereby the fluid cannot pass through the port 60, to a second position whereby the fluid moves annular to and generally around the occluder ball 71. This movement creates a slight flow reversal that “breaks up” any blood clots that may form. The pumping system may be used as part of a cardiopulmonary bypass system, a ventricular assist device (VAD) and / or a heart pump.

A method and apparatus for performing coronary artery bypass surgery establishes a channel leading directly from a chamber of a heart into a coronary artery. The coronary artery bypass procedure may be performed with or without cardiopulmonary bypass.

A cardiopulmonary bypass system utilizing membrane-based reciprocating positive displacement blood pumps (“pod pumps”). In one aspect, the pod pumps are constructed to provide reduced shear forces on the blood being pumped. In another aspect blood flow through the pod pumps can be controlled by a controller using information from pressure sensors in the control chamber of the pod pumps. In another aspect, the pod pumps are included on a disposable unit that can be received and held by a receptacle means on a base unit, the base unit also providing pressurized control fluid to the pod pumps on the disposable unit through the receptacle means.

A method and apparatus for performing coronary artery bypass surgery establishes a channel leading directly from a chamber of a heart into a coronary artery. The coronary artery bypass procedure may be performed with or without cardiopulmonary bypass.

Methods and systems for endovascular, endocardiac, or endoluminal approaches to a patient's heart to perform surgical procedures that may be performed or used without requiring extracorporeal cardiopulmonary bypass. Furthermore, these procedures can be performed through a relatively small number of small incisions. These procedures may illustratively include heart valve implantation, heart valve repair, resection of a diseased heart valve, replacement of a heart valve, repair of a ventricular aneurysm, repair of an arrhythmia, repair of an aortic dissection, etc. Such minimally invasive procedures are preferably performed transapically (i.e., through the heart muscle at its left or right ventricular apex).

A method for closed-chest cardiac surgical intervention relies on viewing the cardiac region through a thoracoscope or other viewing scope and endovascularly partitioning the patient's arterial system at a location within the ascending aorta. The cardiopulmonary bypass and cardioplegia can be induced, and a variety of surgical procedures performed on the stopped heart using percutaneously introduced tools. The method of the present invention will be particularly suitable for forming coronary artery bypass grafts, where an arterial blood source is created using least invasive surgical techniques, and the arterial source is connected to a target location within a coronary artery while the patient is under cardiopulmonary bypass and cardioplegia.

A method and apparatus for performing coronary artery bypass surgery establishes a channel leading directly from a chamber of a heart into a coronary artery. The coronary artery bypass procedure may be performed with or without cardiopulmonary bypass.

The present disclosure is directed to an external cardiac basal annuloplasty system (ECBAS or BACE-System: basal annuloplasty of the cardia externally) and methods for treatment of regurgitation of mitral and tricuspid valves. The BACE-System provides the ability to correct leakage of regurgitation of the valves with or without the use of cardiopulmonary bypass, particularly when the condition is related to dilation of the base of the heart. This ECBAS invention can be applied to the base of the heart epicardially, either to prevent further dilation or to actively reduce the size of the base of the heart.

A method and apparatus for repairing the heart's mitral valve by using anatomic restoration without the need to stop the heart, use a heart-lung machine or making incisions on the heart. The method involves inserting a leaflet clamp through the heart's papillary muscle from which the leaflet has been disconnected, clamping the leaflet's free end and then puncturing the leaflet. One end of a suture is then passed through the hollow portion of the clamp, while the other end of the suture is maintained external to the heart. The clamp is then removed and the suture's two ends are fastened together with a securement ring / locking cap assembly to the heart wall exterior, thereby reconnecting the leaflet to the corresponding papillary muscle. The introduction of the clamp, puncturing of the leaflet, passage of the suture therethrough and removal of the clamp can be conducted a plurality of times before each suture's two ends are fastened to the securement ring / locking cap assembly.

An apparatus and method for connecting a first conduit to the heart without the need for cardiopulmonary bypass. The first conduit may then be attached to a second conduit that has a prosthetic device interposed. The second conduit may be connected to the aorta prior to the first conduit being attached to the heart. The prosthetic device may be a prosthetic valve or a pump, for example. The apparatus of the present invention includes an implantable connector with first conduit component, a retractor expansion component, a coring component, and a pushing component. The retractor expansion component is slide-ably coupled to the coring component. The retractor expansion component serves to seat against and separate the inside apical wall of the left ventricle so that the coring component may cut cleanly through the myocardium to form a tissue plug without leaving any hanging attachments to the inside walls. By remaining seated against the inside wall, the retractor expansion component follows the tissue plug into the coring component. The surgeon applies force and rotary motion to the pushing component sufficient to cut the tissue plug and implant the prosthetic component.

A method for closed-chest cardiac surgical intervention relies on viewing the cardiac region through a thoracoscope or other viewing scope and endovascularly partitioning the patient's arterial system at a location within the ascending aorta. The cardiopulmonary bypass and cardioplegia can be induced, and a variety of surgical procedures performed on the stopped heart using percutaneously introduced tools. The method of the present invention will be particularly suitable for forming coronary artery bypass grafts, where an arterial blood source is created using least invasive surgical techniques, and the arterial source is connected to a target location within a coronary artery while the patient is under cardiopulmonary bypass and cardioplegia

Methods are described for preventing or reducing ischemia and / or systemic inflammatory response in a patient such as perioperative blood loss and / or systemic inflammatory response in a patient subjected to cardiothoracic surgery, e.g., coronary artery bypass grafting and other surgical procedures, especially when such procedures involve extra-corporeal circulation, such as cardiopulmonary bypass.

This invention relates to a venous cannula for use in conjunction with cardiovascular examinations, treatments and surgery. The venous cannula is configured for two-stage drainage of oxygen-depleted venous blood from a central venous location via a peripheral venous insertion site, such as a femoral vein. The venous cannula is optimized for use in a cardiopulmonary bypass system that includes a multichannel arterial perfusion catheter. The cardiopulmonary bypass system is advantageous for use in performing standard open chest or least invasive cardiac surgical procedures.

Methods are described for preventing or reducing ischemia and / or systemic inflammatory response in a patient such as perioperative blood loss and / or systemic inflammatory response in a patient subjected to cardiothoracic surgery, e.g. coronary artery bypass grafting and other surgical procedures, especially when such procedures involve extra-corporeal circulation, such as cardiopulmonary bypass.

A catheter system is provided for accessing the coronary ostia transluminally from a peripheral arterial access site, such as the femoral artery, and for inducing cardioplegic arrest by direct infusion of cardioplegic solution into the coronary arteries. In a first embodiment, the catheter system is in the form of a single perfusion catheter with multiple distal branches for engaging the coronary ostia. In a second embodiment, multiple perfusion catheters are delivered to the coronary ostia through a single arterial cannula. In a third embodiment, multiple perfusion catheters are delivered to the coronary ostia through a single guiding catheter. In a fourth embodiment, multiple catheters are delivered to the coronary ostia through a single guiding catheter which has distal exit ports that are arranged to direct the perfusion catheters into the coronary ostia. In each embodiment, the catheters are equipped with an occlusion means at the distal end of the catheter for closing the coronary ostia and isolating the coronary arteries from the systemic blood flow. The occlusion means can take the form of an inflatable occlusion balloon cuff, a tapered occlusion device or an O-ring encircling the distal end of the catheter. An optional ventricular venting catheter can be included in the system for venting blood and fluids from the left ventricle of the heart. The catheter system is combined with a femoral-to-femoral cardiopulmonary bypass system to provide a system for cardioplegic arrest and total cardiopulmonary support during minimally invasive cardiac surgical procedures.

A method for closed-chest cardiac surgical intervention relies on viewing the cardiac region through a thoracoscope or other viewing scope and endovascularly partitioning the patient's arterial system at a location within the ascending aorta. The cardiopulmonary bypass and cardioplegia can be induced, and a variety of surgical procedures performed on the stopped heart using percutaneously introduced tools. The method of the present invention will be particularly suitable for forming coronary artery bypass grafts, where an arterial blood source is created using least invasive surgical techniques, and the arterial source is connected to a target location within a coronary artery while the patient is under cardiopulmonary bypass and cardioplegia.

The invention provides devices and methods for performing less-invasive surgical procedures within an organ or vessel. In an exemplary embodiment, the invention provides a method of closed-chest surgical intervention within an internal cavity of a patient's heart or great vessel. According to the method, the patient's heart is arrested and cardiopulmonary bypass is established. A scope extending through a percutaneous intercostal penetration in the patient's chest is used to view an internal portion of the patient's chest. An internal penetration is formed in a wall of the heart or great vessel using cutting means introduced through a percutaneous penetration in an intercostal space in the patient's chest. An interventional tool is then introduced, usually through a cannula positioned in a percutaneous intercostal penetration. The interventional tool is inserted through the internal penetration in the heart or great vessel to perform a surgical procedure within the internal cavity under visualization by means of the scope. In a preferred embodiment, a cutting tool is introduced into the patient's left atrium from a right portion of the patient's chest to remove the patient's mitral valve. A replacement valve is then introduced through an intercostal space in the right portion of the chest and through the internal penetration in the heart, and the replacement valve is attached in the mitral valve position.

The invention provides devices and methods for performing less-invasive surgical procedures within an organ or vessel. In an exemplary embodiment, the invention provides a method of closed-chest surgical intervention within an internal cavity of a patient's heart or great vessel. According to the method, the patient's heart is arrested and cardiopulmonary bypass is established. A scope extending through a percutaneous intercostal penetration in the patient's chest is used to view an internal portion of the patient's chest. An internal penetration is formed in a wall of the heart or great vessel using cutting means introduced through a percutaneous penetration in an intercostal space in the patient's chest. An interventional tool is then introduced, usually through a cannula positioned in a percutaneous intercostal penetration. The interventional tool is inserted through the internal penetration in the heart or great vessel to perform a surgical procedure within the internal cavity under visualization by means of the scope. In a preferred embodiment, a cutting tool is introduced into the patient's left atrium from a right portion of the patient's chest to remove the patient's mitral valve. A replacement valve is then introduced through an intercostal space in the right portion of the chest and through the internal penetration in the heart, and the replacement valve is attached in the mitral valve position.

Methods are described for preventing or reducing ischemia and / or systemic inflammatory response in a patient such as perioperative blood loss and / or systemic inflammatory response in a patient subjected to cardiothoracic surgery, e.g. coronary artery bypass grafting and other surgical procedures, especially when such procedures involve extra-corporeal circulation, such as cardiopulmonary bypass.

A method for closed-chest cardiac surgical intervention relies on viewing the cardiac region through a thoracoscope or other viewing scope and endovascularly partitioning the patient's arterial system at a location within the ascending aorta. The cardiopulmonary bypass and cardioplegia can be induced, and a variety of surgical procedures performed on the stopped heart using percutaneously introduced tools. The method of the present invention will be particularly suitable for forming coronary artery bypass grafts, where an arterial blood source is created using least invasive surgical techniques, and the arterial source is connected to a target location within a coronary artery while the patient is under cardiopulmonary bypass and cardioplegia

The present invention discloses the method of inhibiting complement activation mediated by factor B inhibitors, that involves: (a) inhibiting factor B binding to properdin-bound C3b; (b) inhibiting the release of Bb; (c) inhibiting the activation of neutrophils, monocytes, platelets, and endothelium; or (d) inhibiting / reducing the formation of PC3bBb, C3a, C5a, and MAC. The present invention also discloses the novel use of factor B inhibitors in the treatment of various immunological disorders, resulting either primarily from direct immune responses such as rheumatoid arthritis, anaphylactic shock, myasthenia gravis, asthma, Alzheimer's disease, and the like, or secondarily from clinical conditions such as cardiopulmonary bypass inflammation, vascular stenosis and restenosis, burn injury, and the like.

An extracorporeal blood circuit for use with a venous return line and an arterial line coupled to a patient. The extracorporeal blood circuit can include a venous air removal device coupled to the venous return line. The venous air removal device can perform an active air removal function. The extracorporeal blood circuit can include a sensor that determines a blood level in the venous air removal device, a purge line coupled to the venous air removal device, and a controller connected to the sensor. The controller can cause the venous air removal device to perform the active air removal function through the purge line when the blood level is less than a threshold. The extracorporeal blood circuit can further include a pump coupled to the venous air removal device, an oxygenator coupled to the pump, and a blood filter coupled to the oxygenator and the arterial line.