Surgery – Truss – Pad
Patent
1994-03-08
1995-05-02
Jaworski, Harris
Surgery
Truss
Pad
600 18, 607122, A61B 800, A61M 2902
Patent
active
054110270
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND OF THE INVENTION
Adequate blood circulation is of vital importance to man and to all warm blooded animals. Death or loss of vital body functions occurs several minutes after acute circulatory arrest. There can be a number of causes for this, the most common of which are ventricular fibrillation and asystole, that is to say, conditions in which the heart muscle's periodic contractions stop. These conditions can be primary, that is, they can occur without any apparent reason. Other acute conditions such as blood clots in the pulmonary arteries or in the coronary arteries can secondarily produce the same circulatory effects.
All types of circulatory arrest are treatable in principle, but results are poor. A maximum of 50% of those who suffer such an arrest in the presence of a witness attain normal circulation again after treatment. The others die immediately, as a consequence of their disease, or too long a wait for effective treatment, or inadequate treatment. Of those patients who first regain spontaneous circulation, a large number later die. Circulatory arrest is consequently very difficult to treat, partly due to the short period of time available before damage occurs due to lack of oxygen. Today this treatment most often consists of a combination of different measures such as artificial respiration, compressions of the thorax, administration of cardiac stimulating medication, and short-duration electrical stimulation of the cardiac muscle, so-called defibrillation, by which ventricular fibrillation can often be stopped. By means of external cardiac compressions ("cardiac massage") some degree of blood circulation (5-10% of normal blood flow in vital organs) can be sustained, which along with artificial respiration provides a prolongation of the time period existing before irreversible damage occurs, from 3-4 minutes to a maximum of about 20 minutes. During this time it is in principle possible to go over to more effective forms of treatment. Use of the heart-lung machine, for example, is in the testing stage in certain places in the world. It has been demonstrated that the perfusion pressure of the blood and thereby the blood flow and the amount of oxygen delivered are in direct proportion to the chances of restoring normal circulation and other vital functions following a circulatory arrest. The present invention consists of an apparatus and method for more effective treatment of circulatory arrest, and the invention described here improves treatment of circulatory arrest in a substantially simpler, safer and less expensive but nevertheless much more effective way.
SUMMARY OF THE INVENTION
The invention makes it possible to attain central circulation by means of a retrograde balloon catheter within a very short period of time (one to two minutes), which initially results in a higher perfusion pressure in the vital organs and makes it possible to selectively inject pharmacological agents into the chambers of the heart, the coronary arteries, etc., and also makes it possible to defibrillate more effectively. The method consists of puncturing the skin over an artery, a suitable one being, for example, the femeral artery at the level of the groin, and using a special ultrasonic probe to localize this artery and insert a cannula. After exchanging the cannula for a larger access line by using the so-called Seldinger technique, a catheter is then inserted in the retrograde direction via the aorta up toward the heart. When the tip of the catheter has come up to the aortic arch, one or two catheter-encircling balloons are inflated, by means of which a tightening of the vessel walls is attained. The different subeffects which can be obtained using the specially adapted balloon catheter together constitue the total effect of treatment, which is radically better than that of previously existing techniques. A comparison between the simplicity of these measures, their cost, the absence of serious treatment risks and all the effects of treatment attained are surprisingly favorable for the present inve
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Hok Bertil
Wiklund Lars
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