Inflatable cannula and method of using same

Details Inflatable cannula and method of using same Inflatable cannula and method of using same

1998-08-07

2001-01-02

Kennedy, Sharon (Department: 3763)

Surgery

Means for introducing or removing material from body for...

Treating material introduced into or removed from body...

C604S096010, C604S506000

Utility Patent

active

06168586

ABSTRACT:

FIELD OF THE INVENTION
This invention relates generally to a cannula or catheter that can be introduced to a small port and be inflated to accommodate a large flow of fluids, or can serve as a conduit or port to apply other medical therapy, such as surgical instruments, dilatation catheters, atherectomy devices, filters, aspirators, and pressure monitors.
BACKGROUND OF THE INVENTION
Minimally invasive surgical procedures which use an endoscopic approach have been widely used in many surgical specialties, including cardiothoracic surgery. New surgical techniques and instruments have been developed especially to assist in minimally invasive coronary bypass grafting. This procedure is often performed using the port access approach where a minimal access incision is made in the intercostal space rather than the traditional midsternotomy approach, therefore minimizing trauma to the chest wall. After the incision is made, various instruments can be inserted through the incision and various tissue layers to reach the heart and great vessels. This peripherally-based system achieves aortic occlusion, cardioplegia delivery, and left ventricular decompression; thus, coronary revascularization and various cardiac procedures can be effectively performed.
Traditionally, flexible catheters or cannulas are fixed in their lumen and outside diameter size. In order to provide a large lumen for oxygenated blood flow during cardiopulmonary bypass (CPB), a traditional catheter or cannula is required to have a large diameter, therefore making insertion and tissue penetration difficult through a small port. A rigid trocar provides adequate luminal dimension; however, it is also limited in its ability to expand and provide easy access. Therefore, a need exists for a fluid delivery catheter or cannula having a flexible wall and a capability of achieving a minimal profile for entry through a small port, and having an ability to thereafter expand to accommodate a larger luminal diameter for delivery of fluid and instruments.
SUMMARY OF THE INVENTION
The present invention is particularly useful in minimally invasive coronary artery bypass grafting (CABG) since this procedure is generally performed through a small incision. In one embodiment, the invention provides a cannula comprising an elongate tube having a proximal end, a distal end, an intermediate flexible region, and a lumen. A balloon occluder is mounted at the distal end of the cannula. An elongated cylindrical balloon is disposed circumferentially about the flexible intermediate region of the tube. Each balloon occluder and the cylindrical balloon has its own inflation port. In another embodiment, the cannula has an additional lumen extending distally from the proximal end to a port proximal to the balloon occluder for delivering cardioplegic solution. In other embodiments, the cannula will further include one or more helical threads disposed about the distal end of the tube proximal to the balloon occluder and distal to the cylindrical balloon.
The present invention provides an expandable lumen cannula which assists in minimally invasive aortic cannulation. The expandable lumen cannula is inserted through a port access, advancing the distal end into the ascending aorta. The balloon occluder is then inflated followed by inflation of the cylindrical balloon, thereby increasing the diameter of the cannula lumen. Oxygenated blood then can be infused through the lumen of the cannula into the aorta distal to the balloon occluder. In alternative methods, the expanded lumen of the cannula can be used to insert medical devices for the performance of a surgical procedure within the aorta, carotid arteries, or any other internal body structure accessible by cannulation.
It will be understood that there are many advantages to using an inflatable cannula as disclosed herein. For example, the inflatable cannula of the invention can be used (1) to provide easy introduction of the cannula through a small port, (2) to provide an expanding tube that serves to gently move nearby organs and tissues out of the path during surgery, (3) to provide a conduit or port to apply other medical therapies, e.g., surgical instruments, dilatation catheters, atherectomy devices, filters, aspirators, pressure monitors, etc., (4) to provide an inflatable lumen which can accommodate large flow of fluid, e.g., oxygenated blood, into the aorta or other internal body structure, (5) to provide better contact and therefore stabilization between the cannula and the arterial wall by having cannula threads at the point of contact with the vessel wall, (
6
) to provide interruption of arterial flow through inflating the balloon occluder, thus minimizing damage to the arterial wall and reducing the risk of emboli dislodgment as compared to traditional clamping.


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