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.

System for cardiac procedures

Devices and methods are provided for temporarily inducing cardioplegic arrest in the heart of a patient and for establishing cardiopulmonary bypass in order to facilitate surgical procedures on the heart and its related blood vessels. Specifically, a catheter based system is provided for isolating the heart and coronary blood vessels of a patient from the remainder of the arterial system and for infusing a cardioplegic agent into the patient's coronary arteries to induce cardioplegic arrest in the heart. The system includes an endoaortic partitioning catheter having an expandable balloon at its distal end which is expanded within the ascending aorta to occlude the aortic lumen between the coronary ostia and the brachiocephalic artery. Means for centering the catheter tip within the ascending aorta include specially curved shaft configurations, eccentric or shaped occlusion balloons and a steerable catheter tip, which may be used separately or in combination. The shaft of the catheter may have a coaxial or multilumen construction. The catheter may further include piezoelectric pressure transducers at the distal tip of the catheter and within the occlusion balloon. Means to facilitate nonfluoroscopic placement of the catheter include fiberoptic transillumination of the aorta and a secondary balloon at the distal tip of the catheter for atraumatically contacting the aortic valve. The system further includes a dual purpose arterial bypass cannula and introducer sheath for introducing the catheter into a peripheral artery of the patient.

Endovascular system for arresting the heart

Pressure is measured on both sides of an occluding member for determining when pressure forces on the occluding member may cause migration of the occluding member. An alarm indicates when the pressure force on the balloon exceed a predetermined threshold. In another aspect of the invention, a pressure monitor determines when a rate of pressure increase with respect to the fluid volume in the balloon reaches a predetermined threshold when inflating the occluding member. A predetermined amount of fluid is then added to the balloon so that the balloon is not under inflated or over inflated.

Methods and apparatus for anchoring an occluding member

A catheter system and method for achieving total cardiopul-monary bypass during heart surgery. The venous perfusion catheter has first and second balloons occluding the inferior and superior vena cava thereby precluding blood flow into the right atrium. An arterial perfusion catheter is inserted advanced and positioned in the ascending aorta cephalid of the junction of the conorary ar-teries with the aortic root. A second flexible arterial cannula is mounted an sliding relationship with the first flexible cannula and carries an inflatable balloon adjacent its distal end to provide for occlusion of the ascending aorta. A first flexible cannula has a first lumen and an arterial venting orifice communicating with the first lumen defining a single flow path for the passage of cardioplegia solution to arrest the heart or for the evacuation of blood from the aortic root. A third lumen extends axially through the first flexible arterial cannula and communicates with a multiplicity of openings in the distal tip for suctioning blood from the left ventricle. The second flexible cannula of the arterial perfusion catheter has a first cavity extending axially therethrough that communicates with an opening at its distal tip to permit the passage of blood delivered by the cardiopulmonary bypass pump into arterial circulation. Both the venous and arterial perfusion catheters have a plurality of ra-dially and oppositely spaced steering lumens and a plurality of steering cables fixed to the distal ends to achieve omnidirectional articulation.

Catheter system and method for providing cardiopulmonary bypass pump support during heart surgery

An extracardiac pumping for supplementing the circulation of blood, including the cardiac output, in a patient without any component thereof being connected to the patient's heart, and methods of using same. One embodiment provides a vascular graft that has a first end that is sized and configured to couple to a non-primary blood vessel and a second end that is fluidly coupled to a pump to conduct blood between the pump and the non-primary blood vessel. An outflow conduit is also provided that has a first end sized and configured to be positioned within the same or different blood vessel, whether primary or non-primary, through the vascular graft. The outflow conduit is fluidly coupled to the pump to conduct blood between the pump and the patient. The vascular graft may be connected to the blood vessel subcutaneously to permit application of the extracardiac pumping system in a minimally-invasive procedure.

Implantable heart assist system and method of applying same

A heart-assist device which includes a flexible catheter carrying at least a ventricular balloon, such balloon corresponding in size and shape to the size and shape of the left ventricle in the heart being assisted, the ventricular balloon being progressively inflated creating a wave-like pushing effect and deflated synchronously and automatically by means of a control console which responds to heart signals from the catheter or elsewhere, the catheter optionally also carrying an aortic inflated and deflated automatically and synchronously (but in opposite phase) with the ventricular balloon by means of the control console to ensure high speed inflation-deflation.

Heart-assist balloon pump with segmented ventricular balloon

A heart-assist device which includes a flexible catheter (10) carrying at least a ventricular balloon (30), such balloon (30) corresponding in size and shape to the size and shape of the left ventricle in the heart being assisted, the ventricular balloon (30) being progressively inflated creating a wave-like pushing effect and deflated synchronously and automatically by means of a control console (62) which responds to heart signals from the catheter (10) or elsewhere, the catheter (10) optionally also carrying an aortic balloon (32) inflated and deflated automatically and synchronously (but in opposite phase) with the ventricular balloon (30) by means of the control console (62), helium optionally being used as the inflating medium to ensure high speed inflation-deflation.

Heart-assist balloon pump

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Heart-assist balloon pump with segmented ventricular balloon

Heart-assist balloon pump