Coaxial Transseptal ECMO Catheters for Low-Trauma Aortic Return
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Solution Overview
Problem
Conventional ECMO procedures using large bore cannulas are associated with complications such as critical limb ischemia, leading to higher mortality rates, necessitating an improved catheter-based cardiopulmonary bypass technology.
Innovation Solution
The use of catheter-based systems involving multiple coaxial catheters, including a first inner catheter advanced through a transseptal puncture and a second inner catheter surrounding it, with a balloon for centering at the mitral valve, to facilitate blood removal and oxygenation, minimizing tissue damage.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If large bore cannulas are used for conventional ECMO, then high flow removal of deoxygenated venous blood is achieved, but critical limb ischemia and tissue damage occur leading to higher mortality
Solution Approach 1:
The catheter system is divided into multiple coaxial components including an inner catheter with distal opening for blood withdrawal, a middle section with porous wall for oxygenation, and an outer catheter for blood return. This segmentation allows each section to perform its specific function with optimized dimensions, avoiding the need for a single large bore cannula that causes tissue damage.
Solution Approach 2:
The patent employs a nested catheter configuration where the inner catheter is positioned within the middle catheter, which is in turn positioned within the outer catheter. This nested structure enables multiple functions (blood withdrawal, oxygenation, and return) to be performed through concentric catheters of progressively larger sizes, minimizing the overall footprint and reducing vascular trauma compared to parallel large-bore cannulas.
2Reliability
If catheter-based systems are used to reduce vascular trauma, then procedural safety is improved, but device complexity increases due to multiple coaxial catheters
Solution Approach 1:
The patent combines multiple catheter functions into a single integrated coaxial assembly. The inner catheter, middle catheter with porous wall, and outer catheter are configured to work together as one unit, allowing blood withdrawal, oxygenation, and return to be performed through a single access site. This merging reduces the number of separate insertion procedures and simplifies the overall procedural complexity despite the sophisticated internal structure.
Solution Approach 2:
The coaxial catheter system performs multiple functions simultaneously: the inner catheter withdraws deoxygenated blood, the middle porous catheter section oxygenates the blood, and the outer catheter returns oxygenated blood to circulation. This multi-functionality within a single device structure eliminates the need for separate cannulas for each function, reducing procedural complexity and improving safety.
Data Source
AI summary
A method and system for performing transseptal extracorporeal membrane oxygenation is disclosed. The method may include puncturing a septum between the right atrium and the left atrium and advancing a catheter system through the puncture and into the aorta. A first portion of the catheter system can remove blood from the patient, in some examples near the inferior vena cava. A second portion can return oxygenated blood to the patient, through the transseptal puncture and into the aorta.