U.S. patent number 3,568,659 [Application Number 04/762,017] was granted by the patent office on 1971-03-09 for disposable percutaneous intracardiac pump and method of pumping blood.
Invention is credited to James N. Karnegis.
United States Patent |
3,568,659 |
Karnegis |
March 9, 1971 |
DISPOSABLE PERCUTANEOUS INTRACARDIAC PUMP AND METHOD OF PUMPING
BLOOD
Abstract
A heart pump is provided including a catheter and catheter tube
having at its extremity a series of longitudinally extending ribs
extending in angularly spaced relation about the catheter. The ribs
are enclosed within a resilient tube which is expanded and
contracted by said ribs to more or less fill the left ventricle of
the heart. The ribs are flexed from a position generally parallel
to the catheter axis to an outwardly bowed position by a flexible
member extending into said catheter and through said catheter
tube.
Inventors: |
Karnegis; James N.
(Minneapolis, MN) |
Family
ID: |
25063903 |
Appl.
No.: |
04/762,017 |
Filed: |
September 24, 1968 |
Current U.S.
Class: |
600/18; 604/914;
604/105 |
Current CPC
Class: |
A61M
25/04 (20130101); A61M 60/135 (20210101); A61M
60/40 (20210101); A61M 2205/32 (20130101); A61M
60/17 (20210101); A61M 60/122 (20210101); A61M
60/857 (20210101) |
Current International
Class: |
A61M
25/04 (20060101); A61M 25/02 (20060101); A61M
1/10 (20060101); A61b 019/00 (); A61b 005/02 () |
Field of
Search: |
;128/1,242--246,348--351,341--345,328,356,303,2,2.05 (D)/ ;128/2.05
(E)/ ;128/2.05 (V)/ |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Frinks; Ronald L.
Claims
I claim:
1. A heart pump including:
a catheter having a tip end;
a series of resilient flexible ribs in angularly spaced relation
about said catheter and extending parallel to the axis thereof;
means securing an end of each of said ribs to said catheter
adjoining the tip end thereof;
a ring slidably supported on said catheter and to which the other
ends of said ribs are anchored;
a reciprocating member slidably supported within the catheter;
said catheter having longitudinally extending slot means therein
inwardly of said ring;
means extending through said slot means connecting said ring with
said reciprocating member; and
a flexible resilient tube encircling said ribs and anchored to said
catheter beyond the ends of said ribs.
2. The structure of claim 1 and in which said reciprocating member
is hollow.
3. The structure of claim 2 and including a guide wire slidably
supported within said reciprocating member and extendable through
said tip end of said catheter.
4. A method of pumping blood from the heart by use of a catheter
having on its extremity an expandable and contractable member
including the steps of:
inserting the catheter through the aorta and into the left
ventricle of the heart;
mechanically expanding the member to force blood through the aorta;
and
contracting the member to draw blood into the left ventricle.
5. The method of claim 4 and in which the expandable and
contractable member is actuated by a flexible member extending into
said catheter, and including the step of reciprocating said
flexible member.
Description
This invention relates to an improvement in disposable percutaneous
introcardiac pump, and deals particularly with a means of expanding
and contracting the left ventricle of the heart chamber to promote
the flow of blood through the blood stream of the body.
The heart is a pump whose job is to circulate oxygenated blood to
all parts of the body. There are times, as for example, when the
patient suffers a myocardial infarction, that the heart is weakened
to such a degree that it can no longer adequately pump blood to
maintain life. Since this weakened state may at times by transient,
tremendous effort has been, and is being, expended in the search
for a method to temporary mechanically support the heart.
A variety of methods have been attempted. Some previous devices
have been used which in effect encircle the ventricle and by
intermittently squeezing the heart, aid in expelling blood into
circulation. Another method is to place sausage shaped balloons in
the aorta, and by alternately inflating the balloon from the
proximal to the distal end, create a "milking action" in the aorta
which helps propel blood in a forward direction.
The object of the present invention lies in the provision of
somewhat different device which does not require an operation of
the opening of the chest. The only anesthesia needed would be a
skin wheal of local anesthetic The device could be involved with
fluoroscopy even in the patient's room. It is anticipated that the
device may be produced very inexpensively and thus be
disposable.
A feature of the present invention resides in the provision of a
device which is mounted upon the end of a catheter which may be
percutaneously inserted into a systemic artery under local
anesthesia. By means of a spring guide wire, the aortic valve is
crossed in the retrograde direction, and the end of the catheter is
lodged in the cavity of the left ventricle of the heart. This may
be readily accomplished using fluoroscopy.
The end of the catheter which lies within the left ventricle is
covered by a plastic tube or plastic bag which is sealed relative
to the catheter at both ends. The surface of the catheter, inwardly
of the plastic tube, is provided with a series of angularly spaced
resilient wires each of which is anchored at one end to the body of
the catheter. Means are provided extending through the hollow
catheter to move the other end of each of these wires toward the
anchored end. This causes the wires to bow outwardly, expanding the
encircling plastic tubing and materially increasing the volume
thereof. As the tube is expanded, the blood is forced from the left
ventricle in the proper direction to enter the circulatory
system.
A feature of the present invention resides in the provision of a
catheter of the type described which includes a series of angularly
spaced wires or resilient filaments extending longitudinally
thereof, and which are preferably anchored at the distal end of the
catheter. The proximal end of the wires are connected to a wire or
similar means extending through the catheter tube to a point
externally of the body. The proximal end of the wires are held from
expansion by suitable means, such as by a ring encircling the
catheter. When the ring anchored to the proximal end of the wires
is moved toward the distal end of the catheter, the wires are
caused to bow outwardly, expanding the encircling the resilient
tube or bag.
A feature of the present invention resides in the provision of a
device which may be extended into the left ventricle and which may
be expanded and contracted at virtually any desired interval. As
the device is expanded, blood flows from the left ventricle through
the aorta in the usual manner. As the device is collapsed, the
blood is drawn into the left ventricle from the left atrium in the
usual manner. Accordingly, the flow of blood is natural and follows
the natural path.
A further feature of the present invention resides in the provision
of a device which lends itself to inflation and deflation at
shorter intervals than would otherwise be obtained. For example, if
the usual type of balloon were inserted into the heart, it would be
necessary to inflate and deflate the balloon at short intervals.
Such inflation and deflation would be impractical due to the
necessary movement of fluid of one type or another to expand or
contract the balloon. The present device may be inflated and
deflated by movement of a wire extending through the catheter and
accordingly the present device is much more flexible in its time
cycle.
A further feature of the present invention resides in the device
which may, if desired, by controlled or triggered by the
electrocardiogram. There is a wave form in the electrocardiogram
called the "QRS complex." This electrical wave precedes the
mechanical contraction of the ventricle. The present device may be
coupled or connected electrically in such a way as to trigger the
action of the device as desired in relation to the QRS wave. Thus
the device may be triggered at the peak of the wave or after any
time interval had elapsed as desired. These and other objects and
novel features of the present invention will be more clearly and
fully set forth in the following specification and claims.
In the drawings forming a part of the specification:
FIG. 1 is a sectional view through the tip of a catheter, showing
the device in its collapsed form.
FIG. 2 is a view similar to FIG. 1, showing the device in its
expanded form.
FIG. 3 is a cross-sectional view, the position of the section being
indicated by the line 3-3 of FIG. 1.
FIG. 4 is a diagrammatic view of a portion of the circulatory
system of a human showing the relative general position of the
femoral artery, the aorta, the heart, and the left ventricle, and
the left atrium.
FIG. 5 is a enlarged detail showing a portion of the art.
The introcardiac pump is indicated in general by the letter A in
FIGS. 1, 2, and 3 of the drawings. The numeral 10 indicates the
catheter which is of a size capable of being inserted into a
systemic artery such as the femoral artery. The catheter 10
comprises an elongated tube having a plurality of angularly spaced
resilient wires or other such elements 11 extending parallel to the
axis of the tube and normally extending longitudinally thereof
parallel to the axis. The term wire has been used for the purpose
of description, but any filaments which are resilient and which act
in the manner of resilient wires can be used in place thereof.
In the particular arrangement illustrated, the wires 11 are shown
as including inturned ends 12 which extend into the catheter tube
10 and are thus anchored thereto. The other ends of the wires 11
are secured to a ring 13 which encircles the catheter tube and
which is slidable relative thereto. A tube 14 extends through the
catheter and the associated catheter tube, and extends beyond the
end of the catheter tube so that it may be moved axially of the
tube. For the purpose of illustration, pins such as 15 are attached
to the tube 14 and project radially therefrom, and are terminally
connected to the ring 13. The purpose of this arrangement is to
permit the ring 13 to be moved axially of the catheter tube 10 by
movement of the tube 14.
As indicated in FIGS. 1 and 2 of the drawings, the catheter tube 10
is longitudinally slotted as indicated at 16 to permit the pins 15
and ring 13 to move longitudinally of the axis of the catheter tube
within certain predetermined limits. FIG. 1 of the drawings shows
the pump in its deflated or relaxed position. FIG. 2 of the
drawings shows the same pump in its expanded or inflated position.
As will be obvious from these drawings, as the ring 13 moves toward
the right in the FIGS. indicated, the wires 11 will be flexed from
their straight position generally parallel to the axis of the
catheter tube to an outwardly bowed position as indicated in FIG.
2. This can be controlled completely from the end of the catheter
tube which is external of the human body.
An elongated sheathing or tube 17 of resilient plastic or similar
material encircles the portion of the catheter tube end which
includes the wires 11. The sheathing 17 is normally secured to the
catheter tube beyond the end of the wires 11. The sheathing 17 is
preferably anchored to the end of the catheter 10 by any suitable
means such as by adhesive or by a binding ring. The tube 17 is also
secured and sealed to the catheter tube 10 in the area 20 which is
beyond the ends of the slots 16. As a result, the portion of the
catheter tube which bears the various wires 11 is completely
enclosed by the sheathing.
A guide wire 18 may extend through the tube 14 and may serve to
guide the catheter tube 10 into the artery. The guide wire may
serve also to guide the tip of the catheter across the aortic valve
and into the left ventricle. The guide wire 18 may then be removed,
leaving the tube 14 open. This may be of advantage for using the
lumen for measurement of pressure generated within the left
ventricle, or for injection of liquids or dye or radiopaque
material through the lumen and into the circulatory system.
FIG. 4 of the drawings indicates diagrammatically portions of a
human body. A systemic artery, such as the femoral artery 21 is
connected to the aorta 22 which leads to the aortic valve 23
leading to the left ventricle 24 of the heart. As is indicated in
FIG. 5 of the drawings, the left atrium 25 of the heart is
connected by suitable passages 26 leading from the lungs. When the
left ventricle 24 of the heart 27 is expanded blood is drawn into
the left ventricle from the lungs through the passages 26.
Similarily, when the left ventricle of the heart 24 is collapsed,
blood is forced through the aortic valve to the aorta and through
the blood system.
In order to function, the heart is enclosed in a relatively
inelastic layer 29 which is known as the paracardium. This permits
the expansion and contraction of the left ventricle within natural
limits and maintains the proper size left ventricle chamber.
The operation of the device is generally as follows. The catheter
preferably through the use of the guide wire 18, is inserted into a
systemic artery percutaneously. This is normally done under a local
anesthesia. By means of the spring guide wire 18, the catheter is
moved past the aortic valve in a retrograde direction, and the end
of the catheter is positioned in the cavity of the left ventricle.
This is normally accomplished through the use of fluoroscopy.
Once the expandable and contractable end of the catheter is within
the left ventricle chamber, the resilient covering of the catheter
tip is expanded and contracted at regular intervals. Each time the
catheter tip is expanded, blood is forced from the left ventricle
through the aorta and into the artery system. Each time the
catheter tip is contracted, blood is drawn into the left ventricle
from the left atrium and the lungs. As a result, blood may be
circulated through the body much in the same manner as it would if
the heart pump were functioning properly.
If it is desired, the tube 14 may be moved or reciprocated within
the catheter tube by suitable mechanical means. This mechanical
means may be timed to move the lumen in proper timed relation to
the QRS wave on the electrocardiagram. Each time this wave is
experienced in the electrocardiagram, means may be provided for
reciprocating the tube 14 within the catheter tube. If preferred,
the tube may be moved at a predetermined time interval after the
QRS wave is experienced. As a result, the blood may be pumped
through the body much in the same manner as it would be by the
heart, and may be used to supplement the action of the heart.
In the foregoing description the member 14 has been described as a
tube which slides within the catheter tube. As an alternative, the
tube 14 may be a wire mesh material which expands and decreases in
length as the mesh is rotated within the catheter tube. In other
words means other than reciprocatory movement of the tube 14 may be
employed for flexing the wires 11.
In accordance with the Pat. Statutes, I have described the
principles of construction and operation of my improvement in
disposable percutaneous intracardiac pump, and while I have
endeavored to set forth the best embodiment thereof, I desire to
have it understood that changes may be made within the scope of the
following claims without departing from the spirit of my
invention.
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