Surgery – Blood transferred between different bodies along continuous...
Reexamination Certificate
1998-07-22
2001-06-05
Kennedy, Sharon (Department: 3763)
Surgery
Blood transferred between different bodies along continuous...
Reexamination Certificate
active
06241699
ABSTRACT:
FIELD OF THE INVENTION
The present invention is generally related to cardiac catheter systems including venous perfusion and arterial perfusion cardiac catheters for providing cardiopulmonary bypass support and isolation of a heart during heart surgery, and more particularly to a system and method facilitating intracardiac surgery including valvular repair and/or replacement on a beating heart.
BACKGROUND OF THE INVENTION
Use of catheters to administer fluids to and draw fluids out of the body has been a standard practice in medical procedures for years. Multiple catheters may be used to connect an extracorporeal circuit to the body during open-heart procedures. The various catheters are simultaneously or sequentially used to provide different functions, for instance, one catheter for delivering a cardioplegia solution to arrest the heart, with another catheter being inserted into the heart to infuse oxygenated blood to the ascending aorta.
One of the developing technologies in medicine at this time is least invasive cardiac surgery. Currently, the two popular methods of least invasive surgery is either on a beating heart, or on a stable heart. The beating heart surgery is typically limited to anterior epicardial revascularization. Specifically, this surgery includes procedures including anastomosis of the left internal mammary artery (LNIA) to the left anterior descending (LAD) artery.
Left ventricular decompression (LVD) and right ventricular decompression (RVD) are popularly used as assist devices, wherein a pump is used to drain the blood from the left ventricle or the right ventricle and delivered into the aorta or pulmonary artery, respectively, so that the myocardium is rested and can recover over a period of time. Assist devices are popularly used as bridges to heart transplants. In some cases, assist devices are used post-operatively to help the myocardium to recover from the shock of myocardial infarction in combination with the stress of open-heart surgery.
The present invention is directed to a catheter system and method for facilitating intracardiac surgery including valvular repair and/or replacement on a beating heart. It is desirable to keep a heart beating where possible to reduce trauma to the heart. There is a desire for procedures including, repair and/or replacement of the mitrial valve located between the left atrium and the left ventricle, and the aortic valve located at the aortic base of the heart. There is also a desire to provide a procedure to repair the tricuspid valve and the pulmonic valve in the right side of the heart.
SUMMARY OF THE INVENTION
The present invention achieves technical advantages as a catheter system and method facilitating intracardiac surgery on a beating heart. The present invention comprises a catheter system and method for obtaining a left ventricular isolation to drain the left ventricle and facilitate valvular or posterior epicardial surgery on a beating heart including replacement of the mitrial valve and the aortic valve. The present invention also comprises a catheter system and method for obtaining a right ventricular isolation to drain the right atrium and facilitate intracardiac or posterior epicardial surgery on a beating heart, such as to repair the tricuspid valve and the pulmonic valve.
According to a first embodiment of the present invention, a left ventricular isolation is obtained by draining oxygenated blood from the left ventricle of the heart, or draining directly from the pulmonary veins, using a catheter and a pump. The pump directs the drained oxygenated blood to the ascending aorta to provide artrial return. The left ventricle is accessed in one of several ways including a) through the apex of the heart, b) via the pulmonary vein and the mitrial valve, c) via the left atrial apendage and through the mitrial valve, and d) through the aorta and through the aortic valve.
According to a second embodiment of the present invention a right ventricular isolation is obtained by draining the systemic blood from the superior vena cava and the inferior vena cava to provide a bloodless right side of the heart. The drained blood is returned by a pump directly to the pulmonary artery to complete the extracorporeal circuit.
Myocardial infusion is provided while performing the left ventricular isolation and the right ventricular isolation by perfusing the blood vessels of the beating heart in antegrade or retrograde flow. In antegrade flow, a portion of the arterial return blood is infused into the coronaries at the aortic base of the aorta. In retrograde flow, a portion of the arterial return blood is infused into the coronary sinus. In both the antegrade and retrograde flow of myocardial infusion, the perfusion pressures and flow rates are carefully maintained to adequately perfuse the heart to meet the oxygen demand of the myocardium. The pressure and flow rate of the myocardial infusion is carefully controlled to avoid damage to the coronary sinus.
The catheter system of the present invention includes several embodiments for effectively providing a bloodless portion of the heart to facilitate intracardiac surgery on a beating heart. To facilitate repair or replacement of the mitrial valve or aortic valve, for example, several embodiments are provided for draining the left ventricle of the heart. To facilitate repair or replacement of the pulmonic valve and the tricuspid valve on a beating heart, several embodiments are provided to drain the right atrium of the heart.
REFERENCES:
patent: Re. 35352 (1996-10-01), Peters
patent: Re. 35459 (1997-02-01), Jonkman
patent: 2701559 (1955-02-01), Cooper
patent: 3640282 (1972-02-01), Kamen et al.
patent: 4129129 (1978-12-01), Amrine
patent: 4285341 (1981-08-01), Pollack
patent: 4328056 (1982-05-01), Snooks
patent: 4413989 (1983-11-01), Schjeldahl et al.
patent: 4417576 (1983-11-01), Baran
patent: 4531936 (1985-07-01), Gordon
patent: 4592340 (1986-06-01), Boyles
patent: 4596552 (1986-06-01), DeVries
patent: 4601706 (1986-07-01), Aillon
patent: 4610662 (1986-09-01), Weikl et al.
patent: 4648384 (1987-03-01), Schmukler
patent: 4676778 (1987-06-01), Nelson, Jr.
patent: 4689041 (1987-08-01), Corday et al.
patent: 4741328 (1988-05-01), Gabbay
patent: 4781682 (1988-11-01), Patel
patent: 4927412 (1990-05-01), Menasche
patent: 4943277 (1990-07-01), Bolling
patent: 4988515 (1991-01-01), Buckberg
patent: 5011469 (1991-04-01), Buckberg et al.
patent: 5013296 (1991-05-01), Buckberg et al.
patent: 5021045 (1991-06-01), Buckberg et al.
patent: 5024668 (1991-06-01), Peters et al.
patent: 5033998 (1991-07-01), Corday et al.
patent: 5090960 (1992-02-01), Don Michael
patent: 5135474 (1992-08-01), Swan et al.
patent: 5135484 (1992-08-01), Wright
patent: 5149330 (1992-09-01), Brightbill
patent: 5151087 (1992-09-01), Jonkman
patent: 5167628 (1992-12-01), Boyles
patent: 5171218 (1992-12-01), Fonger et al.
patent: 5197952 (1993-03-01), Marcadis et al.
patent: 5213576 (1993-05-01), Abiuso et al.
patent: 5221258 (1993-06-01), Shturman
patent: 5290231 (1994-03-01), Marcadis et al.
patent: 5308319 (1994-05-01), Ide et al.
patent: 5308323 (1994-05-01), Sogawa et al.
patent: 5312344 (1994-05-01), Grinfeld et al.
patent: 5324260 (1994-06-01), O'Neill et al.
patent: 5334142 (1994-08-01), Paradis
patent: 5338298 (1994-08-01), McIntyre
patent: 5360403 (1994-11-01), Mische
patent: 5378230 (1995-01-01), Mahurkar
patent: 5395330 (1995-03-01), Marcadis et al.
patent: 5395331 (1995-03-01), O'Neill et al.
patent: 5423745 (1995-06-01), Todd et al.
patent: 5433700 (1995-07-01), Peters
patent: 5437637 (1995-08-01), Lieber et al.
patent: 5443446 (1995-08-01), Shturman
patent: 5443448 (1995-08-01), DeVries
patent: 5451207 (1995-09-01), Yock
patent: 5452733 (1995-09-01), Sterman et al.
patent: 5458574 (1995-10-01), Machold et al.
patent: 5458575 (1995-10-01), Wang
patent: 5478309 (1995-12-01), Sweezer et al.
patent: 5487730 (1996-01-01), Marcadis et al.
patent: 5501667 (1996-03-01), Verduin, Jr.
patent: 5505598 (1996-04-01), Booth et al.
patent: 5533957 (1996-07-01), Aldea
patent: 5558644 (1996-09-01), Boyd et
Davis Albert
Suresh Mitta
Chase Medical Inc.
Haynes and Boone LLP
Kennedy Sharon
Serke Catherine
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