U.S. patent number 3,791,374 [Application Number 05/169,936] was granted by the patent office on 1974-02-12 for programmer for segmented balloon pump.
This patent grant is currently assigned to The United States of America as represented by the Secretary, Department. Invention is credited to Henry R. Guarino.
United States Patent |
3,791,374 |
Guarino |
February 12, 1974 |
PROGRAMMER FOR SEGMENTED BALLOON PUMP
Abstract
A circuit for programming the inflation and deflation of a five
segmented balloon pump as used in circulatory assist blood pump
systems is disclosed. The rising and falling edges of wave pulses
are used by a volume transducer to create a volume signal
corresponding thereto. Means are provided to produce a plurality of
signals corresponding to the rising edge of the waveform and a
plurality of signals corresponding to the falling edge thereof.
These signals are used to activate the various valves of the
balloon pump and thereby inflate and deflate the segments.
Inventors: |
Guarino; Henry R. (Revere,
MA) |
Assignee: |
The United States of America as
represented by the Secretary, Department (Washington,
DC)
|
Family
ID: |
22617827 |
Appl.
No.: |
05/169,936 |
Filed: |
August 9, 1971 |
Current U.S.
Class: |
600/17; 604/914;
600/18 |
Current CPC
Class: |
A61M
60/50 (20210101); A61M 60/40 (20210101); A61M
60/135 (20210101); A61M 2205/3334 (20130101); A61M
60/268 (20210101) |
Current International
Class: |
A61M
1/10 (20060101); A61m 001/00 () |
Field of
Search: |
;128/1D,344,419P,2.05
;417/282,298 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Kamm; William E.
Attorney, Agent or Firm: Browdy & Neimark
Claims
What is claimed is:
1. A circuit for programming a mult-segment ballon blood pump
having a valve for each balloon segment, comprising
means for sensing the heart rhythm of a patient using the balloon
pump, said sensing means including a volumetric transducer for
producing a volume signal, the waveforms of which are synchronized
with his blood flow;
a first signal channel means for transporting a plurality of first
waveforms;
a second signal channel means for simultaneously transporting a
plurality of second waveforms; said second waveforms being the
inverse of said first waveforms;
a pair of comparators, said pair of comparators including a first
comparator connected to said first signal channel means for
producing a plurality of first trigger pulses phased with the
rising edge of said first waveforms and a second comparator
connected to said second signal channel means for producing a
plurality of second trigger pulses phased with the falling edge of
said second waveforms, there being a pair of comparators for each
balloon segment; and
means connected to said pair of comparators for utilizing the first
and second trigger pulses to active and deactivate the valves of
the balloon pump, said utilizing means including a plurality of
monostable multivibrators and a plurality of pulse valve drivers
connected to said multivibrators, there being a multivibrator and a
pulse valve driver for each pair of comparators.
2. The device of claim 1 wherein said first signal channel means
includes:
a first emitter follower;
a second emitter follower connected to said first emitter follower
and said first comparator;
clamping means connected to said first emitter follower for
grounding said volume signal;
a complimentary emitter follower connected to said second emitter
follower and said first comparator, wherein part of the output of
said second emitter follower goes to said first comparator and part
of said output goes to said complimentary emitter follower;
means connected between said second emitter follower and said
complimentary emitter follower for detecting and holding the peak
of said part of said output of said second emitter follower which
goes to said complimentary emitter follower; and
a potentiometer connected between the output of said complimentary
emitter follower and ground, the moving arm of said potentiometer
being connected to said first comparator for variably phasing said
first trigger pulses.
3. The device of claim 2 wherein there is a complimentary emitter
follower, potentiometer and comparator in the first signal channel
for each segment in the balloon pump.
4. The device of claim 1 wherein the second signal channel means
includes:
a signal inverter for inverting said volume signal;
a first emitter follower connected to said signal inverter;
clamping means connected to said first emitter follower for
grounding said inverted volume signal;
a complimentary emitter follower connected to said first emitter
follower and said second comparator, wherein part of the output of
said first emitter follower goes to said second comparator and part
of said output goes to said complimentary emitter follower;
means connected between said first emitter follower and said
complimentary emitter follower for detecting and holding the peak
of said part of said output of said second emitter follower which
goes to said complimentary emitter follower; and
a potentiometer connected between the output of said complimentary
emitter follower and ground, the moving arm of said potentiometer
being connected to said second comparator for variably phasing said
second trigger pulses.
5. The device of claim 4 wherein there is a complimentary emitter
follower, potentiometer and comparator in the second signal channel
for each segment in the balloon pump.
Description
BACKGROUND OF THE INVENTION
The present invention relates to circuits for operating cardiac
assisting balloon pumps and, more particularly, to a circuit for
programming the inflation and deflation of a plural segmented
balloon pump as used in circulatory assist blood systems.
As is well known, the systemic circulation is maintained by the
action of the left ventricle in pumping blood into the aorta, or
main artery. A back-flow of blood into the left ventricle is
prevented by the aortic valve. During its contraction (systole) the
left ventricle works primarily against the elastic compliance of
the aorta, raising the pressure in the aorta and distending it. As
soon as contraction is complete and the ventricle relaxes, the
aortic valve closes and the elastic contraction of the aorta then
maintains a continuing flow of blood through the capillaries and
other vessels (diastole). In addition to its function as a vessel
for carrying blood to various organs, the aorta thus acts as an
elastic reservoir storing some of the energy supplied to the heart.
In many cases of heart insufficiency, it is found that the aorta
has become relatively stiff and inelastic because of physiological
processes, and thus requires excessive pressures from the heart to
maintain normal circulation.
Heretofore, mechanical assistance to the systemic circulation has
been attempted by veno-arterial pumping, left-heart bypass,
diastolic augmentation, intra-arterial balloon pumping, and
counterpulsation.
Thus, situations are frequently encountered in the treatment of
heart patients where the patient's heart action is simply not
sufficient to supply the patient's bodily needs. Frequently, the
situation is encountered that while the diastolic action of the
heart will bring a volume of blood into the left ventricle of the
heart sufficient to supply the bodily needs, this ventricle will
not fully empty into the aorta. Or, should the ventricle fill the
aorta with arterial blood, the systolic action of the heart is not
thereafter sufficient in itself to completely discharge the blood
content of the aorta into the arterial tree. Blood backs up,
stagnates, and seriously impairs bodily function. Conventionally,
weakness in heart action is termed heart failure.
From the foregoing, it will be understood that any practical
auxiliary blood pump which will assist the natural heart action in
some simple, reliable and predictable manner may be expected to
receive recognition and acceptance within the medical field and, as
well, to subserve a strongly practical function. That the problem
is difficult, however, is apparent simply upon considering that,
despite long-felt and very prominent need for such external
assistance, and despite the substantial thought, study and work
which have been devoted over the years to this overlying problem,
no really entirely satisfactory solution has yet been evolved,
either as a method of long term treatment or as a physical
embodiment of heart-assisting means.
For one reason or another, therefore, the many proposals heretofore
propounded by the medical researchers have fallen short of certain
desirable requirements, thereby failing in complete acceptance
within the healing arts. Either they have proved too difficult,
delicate and/or uncertain to maintain reliable operation, or
partially impractical in fulfilling requirements of either proper
relationship with natural heart action or volumetric response to
desirable standards. Other proposals and/or related equipment have
failed to respond to minimum standards or adjustability to meet
adequately the requirements of the cardiac specialist.
SUMMARY OF THE INVENTION
From the foregoing discussion it will be clear then that the
present invention provides an improvement over prior devices and
will fill a long needed requirement in the field of circulatory
assist blood systems. Intra-arterial or "balloon" type pumps per
se, for use, for example, in the aorta by insertion through the
femoral artery, up the arterial tree and into the aorta, are well
known. However, the operation of the pump is extremely critical
since it must operate periodically in a transient or instantaneous
pulsating manner which must be synchronized with the patient's
heart. Furthermore, the stroke of such a pump must operate under
various types of conditions such as at different pressures relating
to the pressure of the patient. The present invention, then,
fulfills these conditions by providing a circuit when accurately
and reliably operates a balloon pump to meet these special
requirements. A balloon pump disclosed in U.S. Pat. No. 3,504,662,
is divided into separate fluid retaining compartments, and, under
the programmed control of the present invention, these compartments
are adapted to be pneumatically actuated at different rates to
provide, for example, a controlled action and/or actuation of the
middle compartment or compartments prior to or at a more rapid rate
than the end compartments.
An object of the present invention is to provide for improved
cardiac assistance.
Another object of the invention is the provision of a control
system for the operation of balloon type blood pumps.
Another object of the invention is to provide a control system
which will operate an intra-arterial ballon pump with a generally
peristolic action.
Still another object of the invention is the provision of a control
system for operating the segments of a balloon pump at different
rates of inflation.
Yet another object of the invention is the provision of a control
system for a balloon pump wherein expansion of both its ends
portions prior to expansion of its center portion is prevented.
Other objects and many of the attendant advantages of the instant
invention will be readily appreciated as the same becomes better
understood by reference to the following detailed description of an
embodiment when considered in connection with the accompanying
drawings in which like reference numerals designate like parts
throughout the figures thereof, it being understood that this
embodiment is to be intended as merely exemplary and in no way
limitative.
BRIEF DESCRIPTION OF THE DRAWING
FIG. 1 shows a typical balloon type pump having three inflatable
segments;
FIG. 2 shows a block diagram of the control circuit making up the
invention; and
FIG. 3 shows the waveforms produced at various points in the
control circuit.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring briefly to FIG. 1 there is shown a typical balloon pump,
the inflating and deflating of which might be controlled or
programmed by the present invention. Structure-wise these pumps
have a plurality of segments which are individually inflated and
deflated to augment a patient's blood flow. Intra-arterial balloon
pumping techniques are based on the principle that the expansion of
the balloon within the artery displaces the blood from the region
between the balloon and the inner wall of the artery, the
individual sections of the pump functioning in sequence to assist
in moving the blood. Thus the pump may have a central gas release
tube 10 extending from an elongated catheter and running the length
of the device, and an outer flexible membrane 11, the membrane 11
being fastened to tube 10 at points such as 12 and 13 to form a
plurality (in this illustration three, or it may be five) of fluid
retaining compartments 14, 15 and 16.
Each compartment has an opening as 17, 18 and 19 into tube 10 for
the release and admittance of inflating gas pumped into tube 10
through the catheter and the pressure receiving end 53, the
openings 17, 18 and 19 being provided with electrically controlled
valves 17a, 18 a and 19a to control the inflation and deflation of
each particular compartment. The membrane 11 is attached at its
ends 51 and 52 to form the ends of the balloon and the leading end
is closed by a plug 52 which may house a transducer.
In the block diagram of FIG. 2 there is a volume transducer 20
which is utilized to respond to the patient's blood flow, the
output of transducer 20 being applied to an emitter follower 21 and
on to a capacitor-diode combination 22 and 23. A second emitter
follower 24 is connected to capacitor 22 and the output of 24 is
divided into two channels, one of these channels furnishing a
signal to a comparator 25. It should be mentioned at this point
that there are a plurality of comparators, the number matching the
number of segments or compartments in the pump, and for the sake of
simplicity in the drawings, only one is shown in FIG. 2.
The second output from emitter follower 24 is applied to a diode 26
and capacitance 27 before going to complimentary emitter followers
28. Connected between the output of complimentary emitter followers
and ground there are a plurality of potentiometers R.sub.1
-R.sub.5, the number matching the number of comparators 25, the
moving arm 30 of each potentiometer being connected to a comparator
25.
The signal from capacitance 22, besides being applied to emitter
follower 24, is also applied to a volume signal inverter 31. After
inversion the signal passes through a capacitance 32, with a diode
33, before going to an emitter follower 34. The output of follower
34 again divides, one signal path going to comparaton 35, while the
other path goes through diode 36 to complimentary emitter follower
37, and on to a plurality of potentiometers R.sub.6 -R.sub.10.
Sliding arm 38 of each potentiometer forms a second input to
comparator 35.
There are a plurality of monostable multivibrators 40, one for each
signal channel, the output of comparator 25 and diode 41 forming
one input to the multivibrator 40, and the output of comparator 35
and diode 42 forming the other. Outputs from the multivibrators 40
are used to activate the pulse valve drivers 43, these in turn
acting to flex the compartments 14, 15 and 16 of the balloon
pump.
It should be obvious from the above description of the structure of
the invention, when considered along with FIG. 2, that there are a
plurality of signal channels involved, the number depending upon
the number of segments in the balloon pump. Thus, if there are five
segments, then there are five potentiometers in R.sub.1 -R.sub.5
and R.sub.6 -R.sub.10, also five comparators in 25 and 35, five
monostable multivibrators 40, and five pulse valve drivers 43.
Also it should be noted from FIG. 2 that there is a positive signal
channel and a negative signal channel, the positive channel
terminating in comparator 25 while the negative channel terminates
in comparator 35.
In operating the invention the device develops the waveforms shown
in FIG. 3, with the identifying letter of each waveform
corresponding to the same testpoint on FIG. 2. Thus, the volume
signal as generated by volume transducer 20, in response to the
patient's blood flow, is passed on to emitter follower 21 and then
clamped to zero or ground by means of capacitance 22 and diode 23.
This clamped signal is connected to another emitter follower 24
which produces two outputs. One of these outputs is connected to
the base of a transistor operating as a comparator 25 while the
other output feeds a diode 26. From diode 26 the signal is passed
to capacitance 27, where through the charging action of the
capacitance the peak signal is held for several seconds.
Complimentary emitter followers 28 provide a proper buffer to
connect the peak (DC voltage) to potentiometers R.sub.1 through
R.sub.5. The center arm 30 of one of these potentiometers is
connected to the emitter of comparator 25, and by adjusting the
potentiometer the trigger produced at the output of comparator 25
(testpoint E) may be phased anywhere along the leading edge of the
volume signal from transducer 20. There may be five such
potentiometers and five comparators, thus five triggers are
generated that may be phased in any position with respect to one
another. Reference to waveforms A, B, C, D and E in FIG. 3 will
provide a clearer understanding of the above operation.
The comparators used throughout the circuit will respond only to
positive going signals on their respective bases. This being the
case, the volume pulse from transducer 20, and feed off at point B,
is inverted by signal inverter 31 and the signal producing
circuitry is duplicated to match the previous channel. In
accomplishing this, the signal from inverter 31 is clamped to
ground by capacitance 32 and diode 33. From emitter follower the
signal divides to comparator 35, and to diode 36 whence its peak is
held by capacitance 39. Complimentary emitter followers 37 produce
signals on potentiometers R.sub.6 through R.sub.10, and the center
arm 38 on one of these potentiometers produces a second input to
comparator 35. Thus, phasable triggers are produced anywhere along
the rise and fall of volume meter movement and transducer signal
20. Reference to waveforms F, G, H, I and J will display the phase
relationship of the second set of five triggers.
The ten triggers are connected in pairs to five monostable
multivibrators 40 through diodes 42 and each multivibrator produces
two pulses; one in phase with the rise of the transducer signal and
the other in phase with its fall. The five multivibrator outputs
are connected to pulse valve drivers 43 which may be used to
control valves (not shown) for inflating and deflating the balloon
segments 14, 15 and 16. See waveforms K and L of FIG. 3. Thus, the
pulse in phase with the rise in signal inflates the balloon
segment, while the pulse in phase with the fall deflates the
segment. Since the segments operate in sequence, at different
speeds, and synchronized with the patient's heart beat, circulation
of blood through the aorta is boosted.
From the above description of the structure and operation of the
invention it is obvious that there is disclosed a new and novel
means for programming the operation of a balloon blood pump.
Through selective phasing of the generated triggers, segments of
the pump are inflated and deflated at varying speeds to provide a
beneficial and healthful peristolic assistance to blood flowing
through a patient's aorta.
Obviously many modifications and variations of the present
invention are possible in the light of the above teachings. It is
therefore to be understood that within the scope of the appended
claims, the invention may be practiced otherwise than as
specifically described.
* * * * *