U.S. patent number 3,720,200 [Application Number 05/193,370] was granted by the patent office on 1973-03-13 for intra-arterial blood pump.
This patent grant is currently assigned to Avco Corporation. Invention is credited to John D. Laird.
United States Patent |
3,720,200 |
Laird |
March 13, 1973 |
INTRA-ARTERIAL BLOOD PUMP
Abstract
The disclosure illustrates an intra-aortic circulatory assist
balloon pump, expanding and contracting in synchronism with a
patient's heart rhythm to assist systemic circulation. The balloon
pump comprises an elongated elastic membrane having a number of
compartments supplied with pressure for expansion from an exterior
source via a central tube and orifices between compartments. A
second tube connects one of the end compartments and extends to an
exterior flexible capacitance device that preferentially expands
relative to the end compartment, thereby preventing "bubble
blowing."
Inventors: |
Laird; John D. (Rotterdam,
NL) |
Assignee: |
Avco Corporation (Cincinnati,
OH)
|
Family
ID: |
22713366 |
Appl.
No.: |
05/193,370 |
Filed: |
October 28, 1971 |
Current U.S.
Class: |
600/18;
604/914 |
Current CPC
Class: |
A61M
60/135 (20210101); A61M 60/40 (20210101); A61M
60/274 (20210101) |
Current International
Class: |
A61M
1/10 (20060101); A61b 019/00 (); A61b 005/02 ();
A61m 001/00 () |
Field of
Search: |
;128/1D,2,2.5D,2.5E,2.5V,243,344,349R,349BV ;119/14.49,14.47 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Medbery; Aldrich F.
Claims
Having thus described the invention, what is claimed as novel and
desired to be secured by Letters Patent of the United States
is:
1. An intra-aortic circulatory assist balloon pump positionable in
a patient's aorta for inflation and deflation by an exterior
pressurizing means in synchronism with the patient's heart rhythm,
said balloon pump comprising:
an elastic elongated generally tubular closed end membrane having
an outside diameter approximating the inner diameter of the
aorta:
a plurality of transverse flexible webs dividing said membrane into
a pair of end compartments and a plurality of middle compartments,
said webs having orifices of predetermined areas;
means for forming a first passageway extending from the interior of
said elastic membrane and adapted to be coupled to said exterior
pressurizing means, said passageway means having an opening into a
middle compartment in said membrane;
means for forming a second passageway having a first end connecting
with at least one of the end compartments of said membrane and a
second end extending outside of said patient; and
a capacitance device connected to the second end portion of said
second passageway means, said capacitance device being
preferentially expandable relative to said end compartment during
pressurization of said membrane thereby minimizing early inflation
of said end compartment relative to said middle compartments.
2. Apparatus as in claim 1 wherein said capacitance device
comprises an elastic membrane connected to the second end portion
of said second passageway means.
3. Apparatus as in claim 1 wherein said second passageway means
connects with the end compartment of said membrane adjacent to the
patient's heart.
4. Apparatus as in claim 1 further comprising a first check valve
connecting said first passageway means to another middle
compartment of said membrane, said first check valve permitting
fluid to pass only from said chamber to said first passageway
means, thereby assisting the deflation of said membrane.
5. Apparatus as in claim 4 further comprising a second check valve
connecting said second tube to said first tube, said second check
valve only permitting flow from said second tube to said first tube
whereby the deflation of said membrane is assisted.
6. Apparatus as in claim 5 wherein said first and second elongated
tubes are coaxial with one another, said second tube being
positioned through the interior of said tube.
7. Apparatus as in claim 1 wherein said first tube connects with a
middle compartment adjacent the end of said membrane remote from
said heart whereby inflation of said membrane expels blood toward
the heart.
Description
The present invention relates to circulatory assist devices and
more particularly to intra-arterial blood pumps.
In recent years the balloon pump has been used to aid a patient's
systemic circulation when physiological processes result in a
relatively inelastic aorta. Briefly, the balloon pump comprises an
elongated elastic membrane inserted into the aorta of a patient and
inflated and deflated in synchronism with the heart rhythm through
a tube connected to a pressure control device. The membrane is
deflated as the left ventricle of the heart contracts (systole) to
discharge blood into the aorta. After contraction the aortic valve
closes to prevent backflow into the heart and the membrane expands
to force blood out of the aorta and through the arteries to the
various organs of the body. While this type of pump is highly
advantageous by reason of its simplicity, it poses a particular
problem known as the "bubble blowing" effect. It has been found
that during inflation of the membrane the blood near the center of
the membrane requires a greater interior pressure for expulsion
than the blood at the ends. With a uniform inflation pressure, both
ends of the membrane preferentially expand and occlude the aorta,
thus trapping blood between the ends of the membrane. This greatly
reduces the pumping efficiency and can give rise to additional
problems of clotting, etc.
There have been a number of balloon pump configurations designed to
alleviate the ballooning effect. An excellent example may be found
in the patient to R. T. Jones, U.S. Pat. No. 3,504,662, entitled
"Intra-Arterial Blood Pump," and of common assignment with the
present invention.
It is an object of the present invention to provide an intra-aorta
balloon pump which efficiently aids in the systemic circulation and
minimizes the tendency for occluding the aorta.
The above ends are achieved by an intra-arterial balloon pump
having a plurality of compartments in a flexible membrane. Adjacent
compartments are interconnected by orifices. A first tube extends
from an exterior pressurizing and depressurizing source to one of
the middle compartments of the membrane. A second tube connects
with at lest one of the end compartments of the membrane and
extends to a remote flexible capacitance device designed to
preferentially inflate relative to the end compartment thereby
eliminating the bubble-blowing effect.
The above and other related objects and features of the present
invention will be apparent from a reading of the description of the
disclosure shown in the accompanying drawing and the novelty
thereof pointed out in the appended claims.
In the drawing:
FIG. 1 shows an intra-arterial pump embodying the present
invention, along with pressurizing and depressurizing apparatus
with which it is used;
FIG. 2 shows the intra-arterial pump of FIG. 1 in a partially
inflated condition.
Referring particularly to FIG. 1 there is shown a patient's heart,
generally indicated by reference character 10, and an aorta 12
extending from the hart to the circulatory system. A circulatory
assist balloon-type pump, generally indicated by reference
character 14, is positioned in the aorta 12. The pump 14 comprises
an elastic elongated generally tubular closed end membrane 16
having an inflated outside diameter approximating the inner
diameter of the aorta. The membrane 16 is divided into a plurality
of compartments 15, 17, 19, 21 and 23 by annular flexible webs
18.
A central flexible tube 20 extends into membrane 16 and has an
opening 22 for entry and discharge or fluid into one of the middle
compartments of the membrane 16, herein shown as compartment 17. A
check valve 26, shown in schematic form, permits one-way flow from
another middle compartment 21 into tube 20. The webs 18 have
orifices 28 of predetermined size to interconnect in series the
chambers within membrane 16. The membrane 16 may be formed from a
plastic material inert to body fluids, such as polyvinyl chloride,
polyurethane latex, silicon rubber, a polysiloxane-polyurethane
block copolymer, as disclosed in U.S. Pat. No. 3,562,352, or other
materials. The tube 20 may also be formed from similar inert
materials.
A pressure control system 30, located outside of the patient's
body, pressurizes and depressurizes the membrane 16 with a gas,
such as nitrogen, helium or carbon dioxide, in synchronism with the
patient's heart rhythm as sensed by electrocardiogram electrodes.
The apparatus shown in U. S. Pat. No. 3,266,487 is particularly
suitable for this purpose.
A second elongated flexible tube 32, as shown herein, extends
through the center of tube 20 and opens into at least one of the
end compartments. As herein show, tube 32 connects with compartment
23. The remote end of tube 32 extends outside the aorta of the
patient and connects with a flexible capacitance device 36,
illustrated as an elastic membrane. The flexibility of the elastic
membrane 36 is selected so that it preferentially expands relative
to end compartment 23, as later described. A check valve 38 in tube
32 provides one-way flow from tube 32 to tube 20.
In operation, the pressure control device 30 deflates membrane 16
as the patient's left ventricle (not shown) of his heart 10 pumps
blood into the aorta 12. The deflation of the membrane 16 greatly
eases the effort required of the left ventricle because it does not
have to contract against the pressure in the system. When the left
ventricle has ceased contracting, the aortic valve closes to
prevent backflow of blood into the heart and the membrane 16 is
inflated by pressure control system 30 to push the blood out of the
aorta and through the circulatory system. During pressurization of
the membrane 16 gas enters through opening 22 into compartment 17.
From there it flows to compartment 15 and in series relation from
compartment 19 toward end compartment 23. This sequentially
pressurizes the compartments, thus causing the compartments away
from the heart 10 to inflate first, as shown in FIG. 2.
As noted above, the end compartment 23 has a tendency to blow up
relative to the middle compartments because of the lower interior
pressure required to expel blood from the region around compartment
23. The membrane outside the patient's body preferentially expands
relative to end compartment 23, as shown in FIG. 2, to lower its
interior pressure during inflation, thus preventing this early
expansion. When the compartment are fully inflated they have a
uniform pressure and the membrane 16 and capacitance device 36
assume the shapes shown in FIG. 1. It will be apparent to those
skilled in the art that the flexibility of the membrane 36 can be
precisely tailored to the conditions existing in the aorta to lower
the pressure in compartment 23 during the transient inflation a
sufficient amount to prevent the bubble effect.
During inflation of membrane 16 the pressure in tube 20 is higher
than the pressure in tube 23 thereby opposing any flow of gas from
tube 32 to tube 20. During deflation, however, the pressure in tube
20 is rapidly lowered by pressure control system 30 and the gas is
discharged into tube 20 through opening 22, check valve 26 and
check valve 38. The provision of the check vales greatly assists
deflation of the membrane 16 and achieves a more uniform
contraction.
The balloon pump arrangement described above blocks the lower
portion of the aorta and pumps blood primarily to the carotid,
coronary and subclavian arteries, generally designated by reference
character 48. The reason for this is that in some cases it is felt
that the blood in the aorta should be pumped to the arteries
feeding the brain and the upper extremities rather than downward
through the circulatory system. The end compartment 15 then expands
preferentially relative to the rest of the compartments and the
middle compartments inflate in sequence thereby providing a
peristaltic action while the exterior member 36 prevents bubble
blowing of the end compartment 23.
The above balloon-type pump provides a highly simplified and
effective way of minimizing the bubble effect experienced by this
type of intra-arterial pumps. The flexibility of the exterior
elastic membrane 36 may be conveniently controlled as to its
flexibility to precisely vary the rate at which it expands relative
to the end compartment 34. While the arrangement shown illustrates
a pump which preferentially supplies blood to the patient's brain
and upper region extremities, it should be understood that a pump
may be designed to pump blood in both directions by connecting the
flexible membrane to both compartments and inflating the membrane
through the center compartment 19.
While the preferred embodiment of the present invention has been
illustrated, it should be apparent to those skilled in the art that
other modifications may be utilized without departing from the
spirit and scope thereof.
* * * * *