公开(公告)号：US06387324B1

公开(公告)日：2002-05-14

申请号：US09409952

申请日：1999-09-30

申请人： William R. Patterson ,  Stephen E. Myrick ,  Vincent Divino, Jr. ,  Jeffrey L. Creech ,  Mark S. Buhr

发明人： William R. Patterson ,  Stephen E. Myrick ,  Vincent Divino, Jr. ,  Jeffrey L. Creech ,  Mark S. Buhr

IPC分类号： A61M114

CPC分类号： A61M1/1698 ,  A61M1/3613 ,  A61M2202/0476 ,  B01F3/04758 ,  Y10S128/03 ,  Y10S261/28

摘要： An apparatus and method for blood oxygenation is provided, advantageously comprising an extracorporeal circuit for the preparation and delivery of hyperoxic or hyperbaric blood. In one embodiment, an apparatus for gas-supersaturating fluids, e.g., physiologic saline, includes a chamber having a first inlet to receive the fluid; a second inlet to receive a gas, e.g., oxygen, from a gas supply that maintains pressure within the chamber at a predetermined level, advantageously about 600 p.s.i.; and an outlet advantageously coupled to a capillary assembly. An atomizer nozzle coupled to the first inlet advantageously creates within the chamber fine droplets of fluid into which gas diffuses to create the gas-supersaturated fluid, which collects within the chamber below the atomizer nozzle for removal via the outlet. The removed gas-supersaturated fluid mixes with blood provided by a blood pump, the mixing occurring within a liquid-to-liquid oxygenation assembly including a pressurizable chamber having inlets for the gas-supersaturated fluid and blood, the inlets advantageously arranged to create a vortical or cyclonic fluid flow within the chamber to promote mixing. The mixed fluid exits the chamber via an outlet for delivery to a patient (e.g., sub-selective delivery) or other site via a catheter, infusion guidewire, or other interventional fluid delivery device, the mixed fluid advantageously comprising blood having increased oxygen levels, i.e., oxygenated blood. Alternately, the blood may be provided by the pump to a high pressure hollow fiber or other type membrane oxygenator within which oxygen, advantageously provided at a pressure greater than atmospheric, diffuses across the membrane(s) and into the blood to form oxygenated blood, again for delivery to a patient or other site. Advantageously, the oxygenated blood is delivered at a target pO2 greater than about 760 mm Hg and is delivered from the liquid-to-liquid oxygenation assembly or membrane oxygenator via a fluid conduit having an approximate pressure drop greater than the target pO2.

公开(公告)号：US06355010B1

公开(公告)日：2002-03-12

申请号：US09282771

申请日：1999-03-31

申请人： Denise R. Barbut

发明人： Denise R. Barbut

IPC分类号： A61M500

CPC分类号： A61M1/3653 ,  A61M1/3613 ,  A61M1/3659 ,  A61M1/369 ,  A61M2205/3606

摘要： Cooled and oxygenated blood is shunted from the heart or proximal aorta into the open ends of intercostal arteries severed during thoracoabdominal aortic surgery to prevent or minimize the effects of spinal ischemia. This cooled perfusion can be accomplished with a variety of perfusion assembly. For instance, a single vessel perfusion assembly can be employed to shunt the oxygenated blood from the heart or aorta to the lumen of a single intercostal artery. Cooled perfusion can also be performed with a branched multiple vessel perfusion assembly, which includes a branched conduit comprising a common portion and branch portions. The arterial perfusion assembly further comprises an inflow cannula formed at the end of the common portion and a plurality of outflow cannulae formed at the respective ends of the branch portions. The inflow cannula is configured to be inserted through the wall of the aorta, and the outflow cannulae are configured to be inserted within the open ends of the severed intercostal arteries. In operation, oxygenated blood flows from the aorta into the inflow cannula, through the blood flow conduit, out of the outflow cannulae, and into the lumens of the intercostal arteries. Cooled perfusion can also be performed with a chambered multiple vessel perfusion assembly, which includes a conduit with an inflow cannula formed at one end and a perfusion chamber formed at the other end. The perfusion chamber comprises a plurality of vessel engaging outlets through which the open ends of the severed intercostal arteries can be disposed. In operation, oxygenated blood flows from the aorta, through the blood flow conduit, into the perfusion chamber, and into the lumens of the intercostal arteries.

摘要翻译： 冷冻和含氧血液从心脏或近端主动脉分流到胸廓主动脉手术切断的肋间动脉的开放端，以预防或最小化脊髓缺血的影响。 这种冷却灌注可以用各种灌注组件完成。 例如，可以使用单个血管灌注组件将来自心脏或主动脉的氧合血液分流到单个肋间动脉的内腔。 冷灌注也可以用分支多血管灌注组件进行，其包括共同部分和分支部分的分支导管。 动脉灌注组件还包括形成在公共部分的端部处的流入套管和形成在分支部分的相应端部处的多个流出套管。 流入套管构造成插入通过主动脉的壁，并且流出套管构造成插入在切断的肋间动脉的开放端内。 在手术中，氧合血液从主动脉流入流入套管，通过血流导管，流出出口套管，并进入肋间动脉的内腔。 冷灌注也可以用腔室多血管灌注组件进行，其包括在一端形成有流入套管的导管和在另一端形成的灌注腔。 灌注室包括多个容器接合出口，可以设置切断的肋间动脉的开放端。 在手术中，氧合血液从主动脉通过血流导管流入灌注腔，并流入肋间动脉的内腔。

公开(公告)号：US20010016729A1

公开(公告)日：2001-08-23

申请号：US09778433

申请日：2001-02-07

发明人： Vincent Divino JR. ,  Paul J. Zalesky ,  William R. Patterson

IPC分类号： A61M025/00

CPC分类号： A61M1/1698 ,  A61M1/3613 ,  A61M2202/0476 ,  B01F3/04758

摘要： An apparatus and method for blood oxygenation is provided, advantageously comprising an extracorporeal circuit for the preparation and delivery of hyperoxic or hyperbaric blood. In one embodiment, an apparatus for gas-supersaturating fluids, e.g., physiologic saline, includes a chamber having a first inlet to receive the fluid; a second inlet to receive a gas, e.g., oxygen, from a gas supply that maintains pressure within the chamber at a predetermined level, advantageously about 600 p.s.i.; and an outlet advantageously coupled to a capillary assembly. An atomizer nozzle coupled to the first inlet advantageously creates within the chamber fine droplets of fluid into which gas diffuses to create the gas-supersaturated fluid, which collects within the chamber below the atomizer nozzle for removal via the outlet. The removed gas-supersaturated fluid mixes with blood provided by a blood pump, the mixing occurring within a liquid-to-liquid oxygenation assembly including a pressurizable chamber having inlets for the gas-supersaturated fluid and blood, the inlets advantageously arranged to create a vortical or cyclonic fluid flow within the chamber to promote mixing. The mixed fluid exits the chamber via an outlet for delivery to a patient (e.g., sub-selective delivery) or other site via a catheter, infusion guidewire, or other interventional fluid delivery device, the mixed fluid advantageously comprising blood having increased oxygen levels, i.e., oxygenated blood. Alternately, the blood may be provided by the pump to a high pressure hollow fiber or other type membrane oxygenator within which oxygen, advantageously provided at a pressure greater than atmospheric, diffuses across the membrane(s) and into the blood to form oxygenated blood, again for delivery to a patient or other site. Advantageously, the oxygenated blood is delivered at a target pO2 greater than about 760 mm Hg and is delivered from the liquid-to-liquid oxygenation assembly or membrane oxygenator via a fluid conduit having an approximate pressure drop greater than the target pO2.

公开(公告)号：US6161547A

公开(公告)日：2000-12-19

申请号：US232438

申请日：1999-01-15

申请人： Denise Barbut

发明人： Denise Barbut

IPC分类号： A61B17/22 ,  A61F2/958 ,  A61M1/36 ,  A61M37/00

CPC分类号： A61M25/1011 ,  A61B17/3207 ,  A61M1/3613 ,  A61M1/3621 ,  A61M1/369

摘要： The invention provides a medical device having first and second elongate tubular members. Each member comprises a manometer at a distal end and a lumen communicating with a port at the distal end. An expandable occlusive member is optionally mounted on either or both tubular members proximal to the distal port. A proximal end of each tubular member is adapted for attachment to an oxygenator and/or a pump for aspirating blood from an artery or a symptomatic carotid artery through the first tubular member and perfusing the blood into the contralateral carotid artery through the second tubular member, thereby providing a means of augmenting the collateral vasculature and maintaining perfusion distal to the offending lesion. The flow rate of blood can be controlled by inflating or deflating the balloon occluder. The device may employ a neuroprotective agent, hypothermic perfusion, and an atherectomy device or an extracorporeal pumping mechanism to remove a vascular occlusion and reestablish cerebral perfusion. Methods of using the devices in treating patients with acute stroke or occlusive cerebrovascular disease are also disclosed.

公开(公告)号：US06139517A

公开(公告)日：2000-10-31

申请号：US212580

申请日：1998-12-14

申请人： John A. Macoviak ,  Wilfred J. Samson ,  James J. Leary ,  Brady D. Esch

发明人： John A. Macoviak ,  Wilfred J. Samson ,  James J. Leary ,  Brady D. Esch

IPC分类号： A61F2/958 ,  A61M1/36 ,  A61M29/02 ,  A61M5/00 ,  A61M29/00

CPC分类号： A61M25/1002 ,  A61M1/3613 ,  A61M1/3653 ,  A61M2025/1052 ,  A61M2025/1097 ,  A61M2210/12 ,  A61M2210/127 ,  A61M25/1011

摘要： A perfusion shunt apparatus and methods are described for isolating and selectively perfusing a segment of a patient's cardiovascular system and for directing circulatory flow around the isolated segment. An aortic perfusion shunt apparatus is configured for deployment within a patient's aortic arch and methods are described for isolating the aortic arch vessels from the aortic lumen, for selectively perfusing the arch vessels with a fluid and for directing blood flow within the aortic lumen through a shunt past the isolated arch vessels. The perfusion shunt apparatus may be mounted on a catheter or cannula for percutaneous introduction or for direct insertion into a circulatory vessel, such as the aorta. The perfusion shunt apparatus has application for protecting a patient from embolic stroke or hypoperfusion during cardiopulmonary bypass or cardiac surgery and also for selectively perfusing the cerebrovascular circulation with oxygenated blood or with neuroprotective fluids in the presence of risk factors, such as head trauma or cardiac insufficiency. The perfusion shunt apparatus will also find application for selective perfusion of other organ systems within the body.

摘要翻译： 描述了灌注分流装置和方法，用于分离和选择性地灌注患者的心血管系统的一部分并用于引导围绕隔离的部分的循环流动。 主动脉瓣灌注分流装置构造成用于部署在患者的主动脉弓内，并且描述了用于将主动脉弓血管与主动脉腔隔离的方法，用于选择性地用流体灌注弓形血管并通过分流器引导主动脉腔内的血流 经过孤立的拱形船只。 灌注分流装置可以安装在用于经皮引入的导管或套管上，或者用于直接插入诸如主动脉的循环血管。 灌注分流装置具有用于在心肺转流或心脏手术期间保护患者免于栓塞性中风或灌注不足的问题，并且还可以在存在诸如头部创伤或心脏功能不全的风险因素的情况下用氧合血液或与神经保护液体选择性灌注脑血管循环 。 灌注分流装置还可以应用于在体内选择性灌注其他器官系统。

公开(公告)号：US6083215A

公开(公告)日：2000-07-04

申请号：US503387

申请日：1995-07-17

申请人： James J. Milavetz

发明人： James J. Milavetz

IPC分类号： A61M1/36 ,  A61M25/00 ,  A61M25/04 ,  A61M31/00

CPC分类号： A61M1/3621 ,  A61M1/3613 ,  A61M2210/125 ,  A61M25/0032 ,  A61M25/04

摘要： A multi-lumen catheter and method for providing antegrade perfusion to an ischemic region of the myocardium of a patient induced by a coronary or vascular deficiency, including a restriction or obstruction in the vessel such as an athesclerotic lesion or stenosis, embolism, thrombosis, vessel spasm, aneurysm, or the like. The distal tip of the catheter is introduced by a conventional percutaneous transluminal procedure via the femoral or brachial artery and advanced through the vascular system to a position closely proximate to the ischemic region. A volume of oxygenated blood is withdrawn into a lumen of the catheter from a position remote to the deficiency, circulated through a pump assembly and filter, and expelled from the distal tip of the catheter to increase the supply of oxygenated blood reaching the ischemic region. The catheter may be advanced directly to or past the deficiency within the same arterial vessel, or the volume of oxygenated blood may be supplied to the ischemic region via a collateral arterial pathway. An inflatable balloon may be used to anchor the distal tip of the catheter in a selected position and to block retrograde perfusion, and a pressure transducer may monitor pressure levels within the vessel and be used to responsively control the pressure at which the oxygenated blood is expelled.

摘要翻译： 一种多腔导管和方法，用于向由冠状动脉或血管缺陷引起的患者的心肌缺血区域提供顺行灌注，包括在血管中的限制性或阻塞性物质，例如不良损伤或狭窄，栓塞，血栓形成，血管 痉挛，动脉瘤等。 通过常规经皮腔内手术通过股动脉或肱动脉引入导管的远端，并通过血管系统前进至紧邻缺血区的位置。 氧合血液的体积从远离缺陷的位置引导到导管的内腔中，循环通过泵组件和过滤器，并从导管的远端排出，以增加到达缺血区域的含氧血液的供应。 导管可以直接前进或通过同一动脉血管内的缺陷，或者氧合血液的体积可经由侧支动脉途径供应至缺血区域。 可以使用可充气球囊将导管的远侧末端锚定在选定位置并阻止逆行灌注，并且压力传感器可以监测血管内的压力水平并用于响应地控制含氧血液被排出的压力 。

公开(公告)号：US5533957A

公开(公告)日：1996-07-09

申请号：US444049

申请日：1995-05-18

申请人： Gabriel S. Aldea

发明人： Gabriel S. Aldea

IPC分类号： A61M1/36 ,  A61N1/362

CPC分类号： A61M1/36 ,  A61M1/3613 ,  A61M2202/0476

摘要： A catheter for retroperfusion of myocardium has an infusion tip, such that when retroperfusing myocardium, the tip extends within the coronary sinus to a depth in a range of about 2 to 4 inches (5 to 10 cm) from the coronary sinus ostium. The catheter also comprises a tube defining at least three channels. The channels include an infusion channel, which has a first infusion end coupled to an infusion port located in the infusion tip and a second infusion end coupled to an outlet orifice of a pump; a withdrawal channel, which has a first withdrawal end coupled to a withdrawal port located in the superior vena cava and a second withdrawal end coupled to an inlet orifice of the pump; and a pressure monitoring channel for monitoring pressure at pressure port at the infusion tip having a first end coupled to the pressure port and a second monitoring end coupled to a pressure sensor. The catheter also has a microprocessor for controlling the pump and measuring a rate of retroperfusate flow, whereby autologous venous blood entering the withdrawal port is continuously discharged at the infusion port at a flow rate in a range of about 5 to 50 mil./min. and at a pressure less than about 15 mm Hg. The tube and tip are made from biocompatible, non-thrombogenic material. Further, the catheter has remotely identifiable markers spaced along the tube, and a marker is located at said infusion tip. The invention also is a method for coronary sinus retroperfusion. The method includes the steps of inserting the catheter through the patient's jugular vein; guiding the catheter's infusion tip into the coronary sinus, such that when retroperfusing myocardium, the tip extends within the coronary sinus to a depth in a range of about 2 to 4 inches (5 to 10 cm) from the coronary sinus ostium; and providing a non-synchronized retroperfusate flow of autologous venous blood at a rate in a range of about 5 to 50 mil./min. and at a pressure less than about 15 mm Hg.

公开(公告)号：US5407424A

公开(公告)日：1995-04-18

申请号：US22048

申请日：1993-02-24

申请人： Daniel M. LaFontaine ,  Thomas J. Holman ,  Daniel O. Adams

发明人： Daniel M. LaFontaine ,  Thomas J. Holman ,  Daniel O. Adams

IPC分类号： A61M1/00 ,  A61M1/36 ,  A61M37/00

CPC分类号： A61M1/0005 ,  A61M1/3613 ,  A61M1/0062

摘要： A double acting piston blood pump having distal and proximal manifolds that are connected by a cylinder having a piston reciprocating therein and dividing the cylinder into a proximal and distal chambers. The manifolds have chambers that are in fluid communication with the distal and proximal chambers of the cylinder and one way valves for controlling fluid flow from and to the cylinder chambers.

摘要翻译： 具有远端和近端歧管的双作用活塞血泵，其通过具有往复运动的活塞的气缸连接并将气缸分成近端和远端腔室。 歧管具有与气缸的远端和近端腔室流体连通的腔室，以及用于控制流体流向气缸室的单向阀。

公开(公告)号：US5358481A

公开(公告)日：1994-10-25

申请号：US71692

申请日：1993-06-03

申请人： Robert J. Todd ,  Kevin G. Marcus

发明人： Robert J. Todd ,  Kevin G. Marcus

IPC分类号： A61M1/36 ,  A61M37/00

CPC分类号： A61M1/367 ,  A61M1/3613 ,  A61M1/3664 ,  A61M2039/082 ,  A61M2205/366

摘要： Methods and apparatus are disclosed for variably controlling the ratio of blood to cardioplegia solution to be administered to a patient. A presently preferred embodiment of the apparatus of the invention comprises a multilumen tubing member having a blood supply lumen and three cardioplegia supply lumens, each having approximately the same tubing wall thickness, but having different inside diameters so that causing flow through different combinations of the cardioplegia lumens will result in different ratios of blood to cardioplegia. The four tubes comprising the multilumen tubing member are advantageously connected by web members, thereby facilitating use with a roller pump and minimizing the tangle of tubes.

摘要翻译： 公开了用于可变地控制待给予患者的血液与麻痹液的比例的方法和装置。 本发明的装置的目前优选的实施例包括具有供血腔和三个心麻痹供应腔的多腔管构件，每个具有大致相同的管壁厚度，但具有不同的内径，使得通过不同的心麻痹组合 流明会导致血液与心脏停搏的不同比例。 包括多腔管构件的四个管有利地通过腹板构件连接，从而便于使用辊泵并使管的缠结最小化。

公开(公告)号：US5011469A

公开(公告)日：1991-04-30

申请号：US237969

申请日：1988-08-29

申请人： Gerald D. Buckberg ,  James V. Maloney, Jr. ,  Kenneth A. Jones ,  Weldon D. West

发明人： Gerald D. Buckberg ,  James V. Maloney, Jr. ,  Kenneth A. Jones ,  Weldon D. West

IPC分类号： A61M1/02 ,  A61M1/10 ,  A61M1/14 ,  A61M1/36 ,  A61M25/00

CPC分类号： A61M1/3621 ,  A61M1/3613 ,  A61M1/3643 ,  A61M1/3664 ,  A61M2025/0003 ,  A61M2205/3344 ,  A61M2205/3351 ,  A61M2205/3355 ,  A61M2205/366

摘要： A method and apparatus to arrest or reverse heart damage from myocardial infarction by using a peripheral, femoral-femoral full bypass along with the venting of the left ventricle wherein the rate at which blood is drawn from the femoral vein and the rate at which the left ventricle is vented are related in a predetermined manner. The damaged area is treated with a cardioplegic solution; the blockage causing the heart attack is then removed by a thrombolytic solution or by angioplasty, while blood is prevented from entering the ventricle and from reactivating the heart from its at-rest condition. Normal blood flow is then restored, and the various catheters and bypass mechanisms removed. The system is also useful for peripheral cardiopulmonary bypass systems not involving the application of a cardioplegic solution. The catheters are specially designed for their function.