7938 results about "Vein" patented technology

This invention relates to a surgical device and method. More particularly, it relates to a tissue ablation device assembly and method using a circumferential ablation member in combination with a position monitoring assembly in order to position the circumferential ablation member along a circumferential region of tissue at a location where a pulmonary vein extends from a left atrium.

An improved pulse oximeter provides for simultaneous, noninvasive oxygen status and photoplethysmograph measurements at both single and multiple sites. In particular, this multiple-site, multiple-parameter pulse oximeter, or “stereo pulse oximeter” simultaneously measures both arterial and venous oxygen saturation at any specific site and generates a corresponding plethysmograph waveform. A corresponding computation of arterial minus venous oxygen saturation is particularly advantageous for oxygen therapy management. An active pulse-inducing mechanism having a scattering-limited drive generates a consistent pulsatile venous signal utilized for the venous blood measurements. The stereo pulse oximeter also measures arterial oxygen saturation and plethysmograph shape parameters across multiple sites. A corresponding calculation of delta arterial saturation and comparison of plethysmograph shape parameters between multiple sites is particularly advantageous for the detection and management of persistent pulmonary hypertension in neonates (PPHN), a patent ductus arteriosis (PDA), and aortic coarctation.

The tissue-identifying surgical instrument includes a surgical instrument having a handle and an integral probe operatively connected to the handle. The probe senses a tissue of interest to identify the type of tissue, e.g., nerve, muscle, vein or other. The interior of the handle includes a control assembly connected to a power source for operation of the tissue identification function. The control assembly displays and wirelessly transmits tissue identification data to a monitoring workstation to inform the surgeon of the type of tissue contacted by the probe.

Bifurcated delivery assemblies provide bilateral access to first and second branch lumens extending from a main body space or lumen in a patient. One or more interventional devices are combined with the delivery assemblies for delivery s into one or both of the branch lumens. Bilateral renal stenting or embolic protection procedures are performed using the combination delivery / interventional device assemblies. Fluids may also be injected or aspirated from the assemblies. A bifurcated catheter has a first fluid port located on one bifurcation branch, a second fluid port located on a second branch of the bifurcation, and a third fluid port positioned so as to be located within a vena cava when the first and second ports are positioned bilaterally within first and second renal veins.

A catheter introduction apparatus provides an ultrasound assembly for emission of ultrasound energy. In one application the catheter and the ultrasound assembly are introduced percutaneously, and transseptally advanced to the ostium of a pulmonary vein. An anchoring balloon is expanded to center an acoustic lens in the lumen of the pulmonary vein, such that energy is converged circumferentially onto the wall of the pulmonary vein when a transducer is energized. A circumferential ablation lesion is produced in the myocardial sleeve of the pulmonary vein, which effectively blocks electrical propagation between the pulmonary vein and the left atrium.

A catheter introduction apparatus provides an optical assembly for emission of laser light energy. In one application, the catheter and the optical assembly are introduced percutaneously, and transseptally advanced to the ostium of a pulmonary vein. An anchoring balloon is expanded to position a mirror near the ostium of the pulmonary vein, such that light energy is reflected and directed circumferentially around the ostium of the pulmonary vein when a laser light source is energized. A circumferential ablation lesion is thereby produced, which effectively blocks electrical propagation between the pulmonary vein and the left atrium.

A system, method and apparatus for performing a renal replacement therapy is provided. In one embodiment, two small high flux dialyzers are connected in series. A restriction is placed between the two dialyzers in the dialysate flow path. The restriction is variable and adjustable in one preferred embodiment. The restriction builds a positive pressure in the venous dialyzer, causing a high degree of intentional backfiltration. That backfiltration causes a significant flow of dialysate through the high flux venous membrane directly into the patient's blood. That backfiltered solution is subsequently ultrafiltered from the patient from the arterial dialyzer. The diffusion of dialysate into the venous filter and removal of dialysate from the arterial dialyzer causes a convective transport of toxins from the patient. Additionally, the dialysate that does not diffuse directly into the patient but instead flows across the membranes of both dialyzers provides a diffusive clearance of waste products.

Described are devices and methods for treating degenerative, congestive heart disease and related valvular dysfunction. Percutaneous and minimally invasive surgical tensioning structures offer devices that mitigate changes in the ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. These tensioning structures can be implanted within various major coronary blood-carrying conduit structures (arteries, veins and branching vessels), into or through myocardium, or into engagement with other anatomic structures that impact cardiac output to provide tensile support to the heart muscle wall which resists diastolic filling pressure while simultaneously providing a compressive force to the muscle wall to limit, compensate or provide therapeutic treatment for congestive heart failure and / or to reverse the remodeling that produces an enlarged heart.

A prosthetic valve assembly for use in replacing a deficient native valve comprises a replacement valve supported on an expandable valve support. If desired, one or more anchors may be used. The valve support, which entirely supports the valve annulus, valve leaflets, and valve commissure points, is configured to be collapsible for transluminal delivery and expandable to contact the anatomical annulus of the native valve when the assembly is properly positioned. Portions of the valve support may expand to a preset diameter to maintain coaptivity of the replacement valve and to prevent occlusion of the coronary ostia. A radial restraint, comprising a wire, thread or cuff, may be used to ensure expansion does not exceed the preset diameter. The valve support may optionally comprise a drug elution component. The anchor engages the lumen wall when expanded and prevents substantial migration of the valve assembly when positioned in place. The prosthetic valve assembly is compressible about a catheter, and restrained from expanding by an outer sheath. The catheter may be inserted inside a lumen within the body, such as the femoral artery, and delivered to a desired location, such as the heart. A blood pump may be inserted into the catheter to ensure continued blood flow across the implantation site during implantation procedure. When the outer sheath is retracted, the prosthetic valve assembly expands to an expanded position such that the valve and valve support expand at the implantation site and the anchor engages the lumen wall. Insertion of the catheter may optionally be performed over a transseptally delivered guidewire that has been externalized through the arterial vasculature. Such a guidewire provide dual venous and arterial access to the implantation site and allows additional manipulation of the implantation site after arterial implantation of the prosthetic valve. Additional expansion stents may be delivered by venous access to the valve.

Devices, systems and methods are disclosed for the mapping of electrical signals and the ablation of tissue. Embodiments include an ablation catheter that has an array of ablation elements attached to a deployable carrier assembly. The carrier assembly can be transformed from a compact, linear configuration to a helical configuration, such as to map and ablate pulmonary vein ostia.

Apparatus and methods are provided for monitoring cardiac output using bioelectrical impedance techniques in which first and second electrodes are placed in the trachea and / or bronchus in the vicinity of the ascending aorta, while an excitation current is injected into the thorax via first and second current electrodes, so that bioelectrical impedance measurements based on the voltage drop sensed by the first and second electrodes reflect voltage changes induced primarily by blood flow dynamics, rather than respiratory or non-cardiac related physiological effects. Additional sense electrodes may be provided, either internally, or externally, for which bioelectrical impedance values may be obtained. Methods are provided for computing cardiac output from bioelectrical impedance values. Apparatus and methods are also provided so that the measured cardiac output may be used to control administration of intravenous fluids to an organism or to optimize a heart rate controlled by a pacemaker.

Embodiments of the invention provide an ablation apparatus for ablating target tissue adjacent pulmonary veins of a patient. The ablation apparatus can include a tube capable of being advanced around the pulmonary veins to form a loop. The tube can receive or include electrodes to ablate target tissue. Some embodiments provide a loop ablation device, which may include a cannula and two or more electrode rods carrying two or more bipolar electrodes. The electrode rods can be advanced through the distal ends toward the proximal ends of the loop and toward the target tissue. The bipolar electrodes can receive energy to ablate the target tissue. The bipolar electrodes may be surrounded by the liquid within the cannula while ablating the target tissue. The loop ablation device can further include a rotating grasping mechanism coupled to the electrode rods.

A surgical instrument useful in harvesting blood vessels such as veins and arteries and for manipulating and grasping tissue. The instrument has a pair of jaws and a closing tube to open and close the jaws.

A multiple-sided medical device comprises a closed frame of a single piece of wire or other resilient material and having a series of bends and interconnecting sides. The device has both a flat configuration and a second, folded configuration that comprises a self-expanding stent. The stent is pushed from a delivery catheter into the lumen of a duct or vessel. One or more barbs are attached to the frame of the device for anchoring or to connect additional frames. A covering of fabric or other flexible material such as DACRON, PTFE, or collagen, is sutured or attached to the frame to form an occlusion device, a stent graft, or an artificial valve such as for correcting incompetent veins in the lower legs and feet. A partial, triangular-shaped covering over the lumen of the device allows the valve to open with normal blood flow and close to retrograde flow.

A mitral annuloplasty and left ventricle restriction device is designed to be transvenously advanced and deployed within the coronary sinus and in some embodiments other coronary veins The device places tension on adjacent structures, reducing the diameter and / or limiting expansion of the mitral annulus and / or limiting diastolic expansion of the left ventricle. These effects may be beneficial for patients with dilated cardiomyopathy.

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.

A method for ablating tissue with ultrasonic energy is provided. The method including: generating ultrasonic energy from one or more ultrasonic transducers; and focusing the ultrasonic energy in the radial direction by one of: shaping the one or more ultrasonic transducers to focus ultrasonic energy in the radial direction; and arranging one or more lenses proximate the one or more ultrasonic transducers for focusing the ultrasonic energy from the one or more ultrasonic transducers in a radial direction.

Disclosed is an expandable transluminal sheath, for introduction into the body while in a first, low cross-sectional area configuration, and subsequent expansion of at least a part of the distal end of the sheath to a second, enlarged cross-sectional configuration. The sheath is configured for use in the vascular system. The access route is through the inferior vena cava to the right atrium, where a trans-septal puncture, followed by advancement of the catheter is completed. The distal end of the sheath is maintained in the first, low cross-sectional configuration during advancement through the atrial septum into the left atrium. The distal end of the sheath is expanded using a radial dilator. In one application, the sheath is utilized to provide access for a diagnostic or therapeutic procedure such as electrophysiological mapping of the heart, radio-frequency ablation of left atrial tissue, placement of atrial implants, valve repair, or the like.

An ablation catheter comprises a catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis; and an ablation element assembly comprising ablation elements connected to the catheter body, each ablation element to be energized to produce an ablation zone. The ablation elements are distributed in a staggered configuration such that the ablation zones of the ablation elements span one or more open arc segments around the longitudinal axis, but the ablation zones of all ablation elements projected longitudinally onto any lateral plane which is perpendicular to the longitudinal axis span a substantially closed loop around the longitudinal axis. Since the ablation zones do not form a closed loop, the risk of renal artery / vein stenosis is reduced or eliminated. Since the ablation zones of all ablation elements projected longitudinally onto any lateral plane span a substantially closed loop, substantially complete renal denervation is achieved.

Organs and other tissue structures are isolated and perfused with a therapeutic agent. Isolation is effected by endovascularly positioning catheters having occlusion balloons within the arteries or other blood vessels which supply blood to the organ. Similarly, blood flow from the organ back to the patient's circulatory system is blocked by endovascularly positioning one or more catheters carrying occlusion members within the veins or other blood vessels leading from the organ. The therapeutic agent may then be perfused through the organ in either an antegrade or retrograde fashion using the endovascularly positioned catheters while maintaining isolation.

The invention relates to leadless cardiac pacemakers (LBS), and elements and methods by which they affix to the heart. The invention relates particularly to a secondary fixation of leadless pacemakers which also include a primary fixation. Secondary fixation elements for LBS's may either actively engage an attachment site, or more passively engage structures within a heart chamber. Active secondary fixation elements include a tether extending from the LBS to an anchor at another site. Such sites may be either intracardial or extracardial, as on a vein through which the LBS was conveyed to the heart, the internal or external surface thereof. Passive secondary fixation elements entangle within intraventricular structure such as trabeculae carneae, thereby contributing to fixation of the LBS at the implant site.

Devices and methods provide for ablation of cardiac tissue for treating cardiac arrhythmias such as atrial fibrillation. Although the devices and methods are often be used to ablate epicardial tissue in the vicinity of at least one pulmonary vein, various embodiments may be used to ablate other cardiac tissues in other locations on a heart. Devices generally include at least one tissue contacting member for contacting epicardial tissue and securing the ablation device to the epicardial tissue, and at least one ablation member for ablating the tissue. Various embodiments include features, such as suction apertures, which enable the device to attach to the epicardial surface with sufficient strength to allow the tissue to be stabilized via the device. For example, some embodiments may be used to stabilize a beating heart to enable a beating heart ablation procedure. Many of the devices may be introduced into a patient via minimally invasive introducer devices and the like. Although devices and methods of the invention may be used to ablate epicardial tissue to treat atrial fibrillation, they may also be used in veterinary or research contexts, to treat various heart conditions other than atrial fibrillation and / or to ablate cardiac tissue other than the epicardium.

A surgical device including: a first shaft having a first projection radially offset from an axial direction of the first shaft, the first projection having a first clamping surface; a second shaft slidably disposed relative to the first shaft, the second shaft having a second projection radially offset from the axial direction, the second projection having a second clamping surface; a dissector for dissecting tissue from a blood vessel to be harvested; a first actuator for sliding the second projection relative to the first projection to capture a side branch of the vessel between the first and second clamping surfaces; at least one electrode for applying cauterizing energy to cauterize the captured side branch; a cutting blade movably disposed on one of the first or second projections; and a second actuator for moving the cutting blade to sever the side branch captured between the first and second projections.

Method and apparatus for monitoring the sleep state condition of an individual by using an external probe applied to a peripheral body location, such as the individual's finger or toe, for detecting changes in the peripheral vascular bed volume of the individual. A predetermined pressure field is applied to the distal end of the peripheral body location, including its distal-most extremity, to prevent the occurrence of venous pooling within and distal to the peripheral body location. The probe produces an output corresponding to changes in the peripheral arterial bed volume at the peripheral body location, which output provides an indication of the sleep state condition of the individual. Such information is useful in diagnosing and / or in treating, a number of sleep disorders as well as other conditions, such as impotence, diabetes, and various disorders in children.

An electro-stimulation device includes a pair of electrodes for connection to at least one location in the body that affects or regulates the heartbeat. The electro-stimulation device both electrically arrests the heartbeat and stimulates the heartbeat. A pair of electrodes are provided for connection to at least one location in the body that affects or regulates the heartbeat. The pair of electrodes may be connected to an intravenous catheter for transvenous stimulation of the appropriate nerve. A first switch is connected between a power supply and the electrodes for selectively supplying current from the power supply to the electrodes to augment any natural stimuli to the heart and thereby stop the heart from beating. A second switch is connected between the power supply and the electrodes for selectively supplying current from the power supply to the electrodes to provide an artificial stimulus to initiate heartbeating. In another aspect, the invention is directed to a method for arresting the beat of a heart in a living body comprising the steps of connecting the pair of electrodes to at least one location in the body that affects or regulates the heartbeat and supplying an electrical current to the electrodes of sufficient amplitude and duration to arrest the heartbeat. The device may also serve to still the lungs by input to a respirator or by stimulation of the phrenic nerve during surgical procedures.

Devices, systems and methods are disclosed for the mapping of electrical signals and the ablation of tissue. Embodiments include an ablation catheter that has an array of ablation elements attached to a deployable carrier assembly. The carrier assembly can be transformed from a compact, linear configuration to a helical configuration, such as to map and ablate pulmonary vein ostia.

Apparatus is provided including an implantable sensor, adapted to sense an electrical parameter of a heart of a subject, and a first control unit, adapted to apply pulses to the heart responsively to the sensed parameter, the pulses selected from the list consisting of: pacing pulses and anti-arrhythmic energy. The apparatus further includes an electrode device, adapted to be coupled to a site of the subject selected from the list consisting of: a vagus nerve of the subject, an epicardial fat pad of the subject, a pulmonary vein of the subject, a carotid artery of the subject, a carotid sinus of the subject, a coronary sinus of the subject, a vena cava vein of the subject, a right ventricle of the subject, and a jugular vein of the subject; and a second control unit, adapted to drive the electrode device to apply to the site a current that increases parasympathetic tone of the subject and affects a heart rate of the subject. The first and second control units are not under common control. At least one of the control units is adapted to coordinate an aspect of its operation with an aspect of operation of the other control unit. Other embodiments are also described.