U.S. patent number 3,592,184 [Application Number 04/885,507] was granted by the patent office on 1971-07-13 for heart assist method and catheter.
Invention is credited to Erwin J. Klink, David H. Watkins.
United States Patent |
3,592,184 |
Watkins , et al. |
July 13, 1971 |
HEART ASSIST METHOD AND CATHETER
Abstract
Method and device for augmenting the action of an ailing heart
having an incompetent aortic valve, wherein blood is sucked up from
the aorta, while blocking flow to the arterial tree, and then, upon
reverse, a major portion of the blood is forced into the arterial
tree and a minor portion forced into the coronary arteries of the
heart itself.
Inventors: |
Watkins; David H. (Des Moines,
IA), Klink; Erwin J. (Albuquerque, NM) |
Family
ID: |
25387053 |
Appl.
No.: |
04/885,507 |
Filed: |
December 16, 1969 |
Current U.S.
Class: |
604/192;
604/6.16; 600/18; 604/247; 604/28 |
Current CPC
Class: |
A61M
25/04 (20130101); A61M 25/0125 (20130101); A61M
25/0075 (20130101) |
Current International
Class: |
A61M
25/04 (20060101); A61M 25/02 (20060101); A61M
25/00 (20060101); A61M 25/01 (20060101); A61m
001/03 (); A61b 019/00 () |
Field of
Search: |
;128/1R,214,348,241,245,344 ;3/1 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Truluck; Dalton L.
Claims
We claim:
1. Method for augmenting the action of an ailing heart having
associated aorta and arterial tree supplied thereby and coronary
arteries supplying the heart itself wherein an open ended catheter
is inserted into the aortic, or left subclavian artery, to a point
adjacent the aortic valve, comprising in sequential operation
sucking blood from said aorta through said catheter during systolic
heart pulsation, while blocking backflow from the said arterial
tree; and on reverse cycle forcing the major portion of the said
blood back through said catheter into the arterial tree while
forcing a minor portion into the said coronary arteries during
diastolic period.
2. Method according to claim 1 wherein about two-thirds of the
blood on reverse cycle is supplied the arterial tree and about
one-third is supplied the coronary arteries of the heart
itself.
3. Heart assist device comprising catheter means including an
elongated member with a bore extending therethrough and having a
distal end with opening therein and a second opening back from said
first-mentioned opening; expandible and imperforate membrane valve
means flaring out circumferentially and extending radially
extending about said catheter means from a point between said two
openings; valve means engaging said catheter closing said second
opening upon a suction being established in said catheter; and
valve means within said catheter largely closing said
first-mentioned opening upon a pressure being established in said
catheter.
4. Device according to claim 3 wherein said catheter engaging valve
means is in the form of an expandible sleeve positioned externally
of said catheter and secured thereto; and said valve means within
the catheter is in the form of an expandible sleeve positioned
internally of said catheter and secured thereto.
5. Device according to claim 3 wherein said catheter engaging valve
means and said valve means within said catheter comprise a single
reciprocable chamber closely fitting within said catheter and
having a first port therein adapted to register with the said
opening in the distal end of the catheter upon the suction cycle of
operation, the walls of the chamber closing off said further
opening in said catheter; and a second port therein for but
partially registering with and largely closing off said distal end
opening upon application of pressure during the succeeding cycle of
operation.
Description
As a matter of introduction, our invention relates to method and
apparatus for augmenting the action of the ailing heart of a
patient.
Among the objects of our invention is the provision of a method and
a device for safely, effectively and reliably moving blood from the
incompetent aortic valve of a failing heart and then discharging
the same into the arterial tree while supplying a minor portion of
the blood to the coronary arteries of the heart itself.
Other objects in part will be apparent and in part particularly
pointed to in the description which follows.
Our invention may be considered to reside in the combination of
elements, features of construction and arrangement of parts and in
the several operational steps and the relation of each of the same
to one or more of the others, all as described herein and set out
in the claims at the end of this specification.
CROSS-REFERENCE TO RELATED APPLICATION
The present application for patent is generally related to our
application of May 27, 1969, Ser. No. 828,151 entitled Heart Assist
Method and Apparatus.
BACKGROUND OF THE INVENTION
In order to gain a better understanding of certain features of our
invention, it is to be noted at this point that situations occur
wherein the heart action of the patient is wholly insufficient to
supply the bodily needs. In certain of these instances the patient
has an incompetent aortic valve. And blood pumped out of the left
ventricle of the heart partially flows back into the left
ventricle, this as a result of the inability of the aortic valve to
prevent the back flow. As a result, there is a loss of pressure,
and a loss of blood supplied the arterial tree. Moreover, in many
instances there is insufficient blood supplied the coronary
arteries of the heart itself.
Although many efforts have been made in the past to overcome the
deficiencies of an ailing heart, and indeed to take account of an
incompetent aortic valve, for one reason or another these have not
been entirely satisfactory. In some instances prior systems and
apparatus have been too complicated. In others they have been
either too costly or not sufficiently reliable for most use.
An object of the present invention, therefore, is to provide a
system, as well as a method and device, for overcoming the
deficiencies of the prior art and assure effective movement of
blood from an incompetent aortic valve of the heart and discharge a
major portion of the same into the arterial tree while at the same
time supplying a minor portion to the coronary arteries.
SUMMARY OF THE INVENTION
Directing attention to the practice of our invention, we provide a
method and device of novel construction. A catheter is introduced
into the aorta, or into the left subclavian artery, by means of an
arterialotomy incision. The proximate end of the catheter of course
protrudes from the artery and is provided with a plastic tube
connecting to a reciprocating pump and apparatus of the character
more generally shown and described in our copending application for
patent identified above. The distal end of the catheter is directed
toward the heart. It is this end of the catheter which is provided
with one hole or port. Back from this first opening there is
provided a further hole or port. An expandible membrane is located
circumferentially and radially extending about the catheter at a
position between the two holes or ports referred to.
BRIEF DESCRIPTION OF THE DRAWINGS
In the accompanying drawings in which we disclose two preferred
embodiments of our invention:
FIG. 1 is the catheter of our invention on a somewhat enlarged
scale;
FIG. 2 is a sectional view of the catheter of FIG. 1 as installed
in the aorta of a patient at a position adjacent to the aortic
valve;
FIG. 3 is a detached view of a portion of the catheter of FIG. 1 on
enlarged scale in order to best illustrate certain features of the
invention; and
FIG. 4 is a similar sectional view on an enlarged scale of an
alternate embodiment of the catheter of our invention.
Like reference characters denote like parts throughout the several
views of the drawings.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Turning now to a preferred embodiment of our invention, attention
is directed to FIGS. 1, 2 and 3 of the drawings. It is seen that
our catheter essentially comprises a hollow shaft portion 50 with
proximate end 50a received and secured in tube 29 leading to a
suitable blood pump (not shown). The distal end of the catheter is
provided with a suitable port or opening 54 just back from tip 50b
(see FIG. The the distal end, moreover, is provided with a further
port 55 back from port 54. Surrounding the catheter at a point
between the ports 54 and 55 there is an expansible imperforate
membrane 52 serving as valve means exteriorly of said catheter.
This is suitably secured to catheter 50 and flares outwardly and
circumferentially about the same. The outer circumferential
extremity of the flaring membrane is secured to catheter shaft 50
by suitable radial filaments 51.
During the cyclic operation of the blood pump associated with our
device, and connecting to the catheter by way of tube 29 as
indicated above, with the suction stroke of the pump the blood
coming from the aortic valve enters port 54. In this action a
membrane valve means 56 secured to the inner walls of the catheter
adjacent the distal end thereof collapses inwardly. Such action
permits the free flow of blood into the catheter and to the pump.
During this action any loss of blood through the second port 55 is
prevented by virtue of the collapse of the exteriorly mounted
membrane valve means 57 (see FIG. 3) against the outer wall of the
catheter. And any inflow of blood from the arterial tree toward the
distal end of the catheter and into port 54 is prevented by the
expansion of circumferential membrane 52. Membrane 52 also serves
to prevent any collapse of the walls of the aorta under the reduced
pressure conditions obtaining during this cycle in the pump.
With a reverse of pump action, that is, the discharge stroke, blood
flows back into the catheter by way of tube 29 and out through port
55 into the aorta. During this action the exteriorly positioned
membrane 57 is expanded outwardly under the pressure of the blood
and allows an unimpeded flow into the arterial tree.
It will be noted that port 54 adjacent to the distal end of the
catheter is not completely closed by the interiorly positioned
membrane 56. The construction is such that there is provided a
portion 54a that amounts roughly to some one-third the area of the
entire port 54. As a result, a substantial portion of the blood
coming from the pump with the discharge stroke passes into the
aorta near its distal end, this by way of port 54a, and effectively
supplies the coronary arteries of the heart itself. While provision
is made for sufficient blood to flow into the coronary arteries,
there is no undue reverse filling of the incompetent left
ventricle.
A modified catheter construction is shown in FIG. 4 of the
drawings. In this the distal end of the catheter is provided with a
reciprocable sleeve 58, with valve means comprising closed end 60
and port 59. A lug 61 provided on sleeve 58 rides back and forth in
slot 50'a provided in the catheter wall. With the pressure stroke
of the pump, movement of sleeve 58 to the left, as seen in FIG. 4,
is arrested by lug 61 striking one end of slot 50'a, and with the
suction stroke the reverse movement is arrested by the lug striking
the other end of the slot.
During the suction stroke of the pump, sleeve 58 is drawn to the
right. With this movement the walls of sleeve 58 effectively close
port 55' of the catheter. And concurrently with this action, port
59 of sleeve 58 is brought into register with port 54' of the
catheter. Blood from the aorta then is sucked into catheter 50' by
way of registered ports 54' and 59. Any flow of blood from the
arterial tree under the back pressure of the tree and the suction
conditions maintaining in the area of the aorta is prevented by the
outward expansion of membrane valve 52'.
With the reverse stroke of the pump during the discharge cycle of
the same, the reciprocable sleeve 58 is forced outwardly or to the
left, as seen in the drawing, under the pressure conditions then
maintaining. This provides free access of the blood to port 55' and
thence to the arterial tree. Under the pressure action port 59 is
brought forward from register with port 54' and extends somewhat
beyond the end portion 50'b of the catheter, this providing an
opening of the port equal to about one-third of that of port 59
itself. We conveniently refer to this portion of the opening as
59a. While the major portion of the blood exits through port 55',
and thence to the arterial tree, a minor portion exits through port
59a to supply the coronary arteries. The amount of this minor
portion, however, and the conditions of pressure associated
therewith are not sufficient to discharge blood back into the
incompetent left ventricle.
It will be seen that in the method and apparatus of our invention
the content of the left ventricle of the heart is exhausted with a
suction stroke. Yet, even with an incompetent aortic valve, any
backflow of blood under the pressure conditions obtaining with a
succeeding discharge stroke, there is no undue reverse filling as
encountered with normal operation of a defective heart with
incompetent valve.
Thus, it will be seen that we provide in our invention a method and
apparatus in which the various objects hereinbefore set forth are
successfully had. The method and apparatus is simple, direct and
reliable.
Since many embodiments may be made of our invention, and since many
changes may be made in the embodiments hereinbefore set forth, it
should be understood that all matter described herein, or shown in
the accompanying drawings, is to be interpreted as illustrative,
and not by way of limitation.
* * * * *