DE19917901C2 - Catheter set for preserving the heart and internal organs for transplants - Google Patents

Description

The invention relates to a catheter set for preserving internal organs by means of perfusion, the catheter set comprising:

• a) with a first catheter arrangement
  • a first catheter containing a first blocking balloon,
  • a second catheter that contains a second block balloon,
  • - A third catheter containing a first irrigation line with a first open end;
• b) with a second catheter arrangement
  • a fourth catheter containing a third blocking balloon,
  • a fifth catheter, which holds a second irrigation line with a second open end,
  the lengths of the first, second, third, fourth and fifth catheters are such that
  • - When the first catheter arrangement is positioned in the vena cava leading to the heart, the first blocking balloon and the second blocking balloon, viewed in the direction of flow of the blood, are located upstream of the confluence of the venous coronary arteries opening into the vena cava, and the first open end in this positioning between the first and second blocking balloon is arranged, and
  • - When the second catheter arrangement is positioned in the aorta originating from the heart, the third blocking balloon is located in the pars ascendens aortae of the heart downstream of the confluence of the arterial coronary arteries originating from the pars ascendens aortae, with the second open end in this positioning upstream of the third blocking balloon is arranged.

A catheter set of the type mentioned above is from the DE-A1-197 25 959 known.

It is known that in certain serious diseases, internal org to transplant, e.g. the heart, liver, spleen, the pancreas, kidneys or parts of the intestine. The number However, the organ transplant goes back because of the organ willingness to donate decreases. Even if the more number of people's brain death as final Viewed at the time of death, acceptance among the population decreasing. As a result, fewer and fewer donor organs are available Available so that patients on organ transplantation have to wait longer and longer waiting times. At For many patients, the waiting time becomes so long that they run out of time no longer experience the point of a transplant.

According to the current state of medical science Certain internal organs from brain-dead patients are explained animals and available for a subsequent transplant posed. For this purpose, the relevant internal organ is circled stable running conditions in the donor cardioplegic, explan animals and then stored cold. During this cold Ischemia will transport the organ from the donor to the recipient animals. However, the transport time must not be of a certain duration exceed, because otherwise the quality with increasing Duration of ischemia decreases.  

According to the current conditions, it is still possible lost valuable time for a transplant if over the A potential donor's willingness to donate no clarity stands, especially because the donor has no organ has a donor ID card with him, which allows organ removal or because it is not possible with the rear a short-term agreement on an organization to achieve removal.

From the journal "Transplantation Proceedings", Vol. 27 , No. 5 (October), 1995, pages 2909 to 2912, a catheter set for the perfusion in situ of kidneys of such donors is known whose heart no longer beats. The known catheter set comprises two blocking balloons with a corresponding supply line and a flushing line, which comprises a pressure measuring arrangement at least approximately at the location of its open end.

The well-known catheter set is via an access in the last artery introduced into this. He is with his two bloc kung balloons positioned so that the section of the aorta, from the arteries used to supply the kidneys hen, is isolated. Under control of the pressure sensor is now a flushing liquid is supplied through the flushing line. To Ab conduction of the irrigation fluid, the femoral vein is opened and a drainage catheter is placed over an appropriate access.

A comparable arrangement is also known from US-A-5 505 701 known.

DE-A1-43 24 637 describes a method and a kit for Organ transplant known. Thereby for transplants in  Abdominal cavity, such as B. kidney or liver, each an arterial and a venous catheter placed under x-ray control and when the patient dies, caudal and cranial of the or gane lying blocking balloons electrically blocked and on Circulation via appropriate lines using an oxygenera tors manufactured and preferred by pumps from the organs me until the transplant. Use this for this The catheter set thus includes both arterial and venous area two blocking balloons each. The venous Ka theter is introduced via the femoral vein and in the vena cava inferior placed and blocked with the balloons. The arte The radial catheter is inserted into the femoral artery down to the aorta dominalis introduced. This is done under X-ray control. The circuit already mentioned is maintained via roller pumps received, using blood or blood substitutes.

Various types of catheter arrangements are described in WO 96/30073. These catheter assemblies are used to assist in cardiac surgery that maintain extracorporeal blood circulation. In these applications, it is imperative that the extremities and the head are also supplied with blood. Only the heart should be cardioplegied in this case. In embodiments of the known catheter arrangements ( Fig. 2, Fig. 17) is the blocking balloon seen in the aortic arch before at the aortic root. In practice it can happen that these balloons slip and block at least one head artery going upwards. This carries the risk of patient harm. It must be considered anatomically that the outgoing arteries for the extremities also supply the brain via a branch, so that brain damage can also occur if the arm arteries are blocked unintentionally. In one exemplary embodiment from the known catheter set ( FIG. 16), the blocking balloons are located in the vena cava on both sides of the access to the heart and, as already mentioned, another blocking balloon is located in the aortic arch. However, the upper vena cava is connected to the lower vena cava via a line, so that the venous circulation works despite the blockage of the heart. An additional protection of other internal organs is neither provided nor possible with the known catheter sets.

In US 5,695,457 other types of catheter sets are described. In the case of exemplary embodiments ( FIG. 8) it is a matter of individually blocking the ostia, ie the outlets of the coronary arteries, from the aortic arch by means of two catheters with blocking balloons and introducing a perfusion solution via the blocking balloon. This will keep the heart steady and surgery can be performed on a heart valve. The venous outlet for the perfusate is provided by a heart-lung machine.

Here too there is a protection of further internal organization Neither intended nor possible.

In the catheter set according to the aforementioned DE-A1-197 25 959 becomes a perfusion cycle exclusively for the coronary heart vessels set up under pressure control. For protection tion of other internal organs is this well-known catheter set not suitable.  

The invention is based on the object, a Ka to continue training the tester set of the type mentioned at the beginning the one that holds a multitude with one and the same catheter set organs can be preserved at the same time.

This object is achieved according to the invention in a catheter set of the type mentioned at the outset in that the catheter set further comprises:

• a) with a third catheter arrangement
  • a sixth catheter containing a fourth blocking balloon; and
  • a seventh catheter which contains a third irrigation line with a third open end,
  the length of the sixth and seventh catheters is such that when the third catheter arrangement is positioned below the pars descendens aor tae, the fourth blocking balloon is located downstream of the opening of the arterial supply vessels of the liver, spleen, pancreas, kidneys and intestine and
  that the first and second catheters are sized so that when the first catheter assembly is positioned in the vena cava, the first and second blocking balloons enclose an area between them that extends from a point in the superior vena cava to a point in the Inferior vena cava extends upstream of the junction of the venous supply vessels of the liver, spleen, pancreas, kidneys and intestine.

The object on which the invention is based is achieved in this way completely solved.

It is the first time with the catheter set according to the invention possible to practically all internal human organs preserve, so that the advantages of Kathe mentioned at the beginning Tersets according to DE-A1-197 25 959 also for other internal organs can be achieved.

In a preferred development of the Ka tester sets include the fourth catheter and the fifth catheter a fifth blocking balloon, its position is measured relative to the fourth and fifth catheters so that in positioning the second catheter assembly in the aorta is located in the area of a femoral artery and the sixth and seventh catheters are dimensioned that when positioning the third catheter assembly in the other femoral artery the third open end current located down the branch point of the femoral arteries.

This measure has the advantage of two independent circuits arise, namely a cycle for conservation of the heart and on the other hand a cycle for the mentioned Or gane in the abdomen. In principle, these cycles can be separated be acted upon by one another.  

In an alternative embodiment, however, the fifth catheter with the second irrigation line on the second open end facing away from the third blocking balloon with a fourth open end.

This measure has the advantage of being significantly less Effort on catheters is required, however there is one Dependence of the circuit for the preservation of the heart of the circuit or circuits for preservation the internal organs of the abdomen.

Embodiments of the invention are particularly preferred in which the second blocking balloon and / or the fourth blocking balloon and / or the fifth blocking balloon each part of one are lockable lock.

This measure has the advantage that the functions of the lock and the blocking balloon are structurally combined with one another. This has been the case with the application of this embodiment of the invention inventive catheter sets significant practical importance because the lock from home in its position on or in the body is financed, while on the other hand it is not necessary the position of separate blocking balloons within it mentioned blood vessels to be determined separately. So there is no egg ne separate x-ray control when positioning this Blocking balloons when the aforementioned structural association ge is chosen.

Finally, an embodiment of the Ka according to the invention tester sets particularly preferred where the third blocking balloon is dimensioned so that it is in the actuated state within  of the pars ascendens aortae the outgoing head arteries blocked.

This measure has the advantage that when the third Blocking balloons blocked the blood circulation in the head area so that, among other things, the face color of the person not changed.

It is understood that the above and the following standing features to be explained not only in each specified combination, but also in other combinations or can be used alone, without the scope of to leave the present invention.

An embodiment of the invention is in the drawing shown and is described in more detail in the following description explained. Show it:

Figure 1 is a schematic representation of an embodiment example of a catheter set according to the invention. and

Fig. 2 is a schematic representation of the circulation in the internal organs of a human being, in which the catheter set according to the invention has been used.

The catheter set according to the invention is intended to be internal organs of a Preserve already dead patients in the corpse, whereby this conservation with little effort via catheter locks  can be accomplished from the outside, these locks often fig in patients who were previously intensively cared for or treated with accidents already lying anyway. The body itself needs in this meadow moment not further impaired, especially not opened to become. In this way it is e.g. B. possible that the relatives can still take leave of the deceased in peace.

More details on the background of the application of the he inventive catheter sets can be found in the already mentioned DE-A1-197 25 959, to which reference is made in full.

In Fig. 1, a catheter set according to the Invention is designated 10 in total. The catheter set 10 comprises a first, ve nous catheter assembly 12 , a second, arterial catheter assembly 14 and a third, also arterial catheter assembly 16th

The first, venous catheter assembly 12 includes a lockable lock 20 which can be blocked by means of a blocking balloon 22 who can. The lock 20 thus has two functions, namely firstly to allow access from the outside to a patient's vessel and at the same time to block the relevant vessel at the location of the lock, ie to prevent blood flow there.

A tube 24 formed as a catheter serves to actuate the blocking balloon 22 . The tube 24 is externally connected to a connector 26 he most , via which a pressure medium for expanding the blocking balloon 22 can be passed in a manner known per se.

The lock 20 is also seen with a first flushing line 28 , which has a first open end 29 . The first flushing line 28 is connected to the outside with a hose 30 which is also designed as a catheter. The hose 30 leads to a second connector 32 .

Finally, a tube 34, which is also designed as a catheter, leads from the lock 20 to a blocking balloon 36 . The hose 34 is accessible from the outside via a third connection piece 38 .

In Fig. 1 above, the length of the tube 34 is denoted by l ₁ and the length of the first flushing line 28 by l ₂ , both rela tive to the position of the lock 20 on the patient indicated by dash-dotted lines.

The second arterial catheter arrangement 14 comprises a blockable sheath 40 . The lock 40 is similar in its execution as the lock 20th It contains a blocking balloon 42 which can be actuated from the outside via a hose 44 and a fourth connecting piece 46 . A blocking element 50 of elongated design contains a blocking balloon 52 of likewise elongated shape. A hose 54 leads from the blocking balloon 52 through the lock 40 to a fifth connecting piece 56 . A further hose line 58 leads through the blocking element 50 through to a second flushing line 60 which has a second open end 61 . The hose line 58 is guided outwards through the lock 40 to a sixth connector 62 . Finally, the two-th catheter assembly 14 also includes a pressure sensor 64 , which is preferably located in the vicinity of the second open end 61 of the second flush line 60 . The pressure sensor or pressure measuring device 64 is connected to a cable 66 which leads through the blocking element 50 and the lock 40 to a seventh connection piece 68 . If the pressure is measured by hydraulic means, this will be taken at the seventh connector 68 . If the pressure sensor 64 contains a transducer, the signal is passed electrically to the seventh connector 68 , which in this case is designed as an electrical connector.

In Fig. 1, the length of the second flush line 60 with l ₃ be distinguished. The distance between the outer and the inner end of the blocking element 50 from the dash-dotted reference position on the lock 40 is marked with l ₄ and l ₅ be.

The third, arterial catheter arrangement 16 comprises a blockable lock 70 with a blocking balloon 72 , the implementation in turn being similar to that of the locks 20 and 40 .

To actuate the blocking balloon 72 , a hose 74 is seen before, which leads to an eighth connector 76 to the outside. A third flushing line 78 has a third, open end 79 and is connected via a hose 80 to the outside with a ninth connection piece 82 .

The lengths of the third flushing line 78 and the position of the front end of the third lock 70 are denoted in FIG. 1 by l ₆ and l ₇ , respectively.

If in the course of the previous description there was talk of a hose, a catheter or a cable leading through a lock 20 , 40 , 70 or the blocking element 50 , then it is to be regarded as equivalent to the fact that the elements mentioned next to the side the locks 20 , 40 , 70 and blocking element 50 are guided. In any case, the respective vessel is blocked when the corresponding blocking balloons 22 , 42 , 72 and 52 are actuated.

In Fig. 2, the blood circulation for internal organs of a person is shown in an extremely schematic manner, the three catheter assemblies 12 , 14 , 16 were introduced in certain vessels in certain positions at certain positions to be described.

The blood circulation 86 initially comprises a heart 88 . The direction of flow of the blood with the heart 88 working is indicated in Fig. 2 with arrows 89 a (venous) and 89b (arterial). With regard to these arrows 89 a, 89 b, the terms “upstream” and “downstream” are to be understood, which are used in the context of the present documents.

With 90 in Fig. 2 inside the heart 88 the Herzkranzge vessels are indicated. On the venous side there is an opening 91 at the heart 88 in which the veins, namely the superior vena cava 92 and the inferior vena cava 94 are connected to the heart 88 . The vena cava inferior 94 merges caudally into the vena femoralis dexter 96 and the vena femoralis sinister 98.

On the arterial side, the artery aortae 100 leads away from the heart 88 , from which the head arteries initially depart, namely the arteria subclavia dextra 104 and the arteria carotis communis dextra 106 downstream of the truncus brachiocephalicus 102 Arteria carotis communis sinistra 108 and the artery subclavia sinistra 110 from. The artery aortae 100 then merges in the caudal direction into the descending aorta pars 112 and from there into the abdominal aortae 114. Further caudally, the pars abdominal aortae 114 is divided into the arteria femoralis dextra 116 and the arteria femoralis sinistra 118.

The celiac trunk 120 is located at about half the height of the descending aorta pars 112. The hepatic artery propria 122, which serves to supply the liver 124 , goes off first. The vena portae hepatis 126 leads from the liver 124 to the vena cava inferior 94.

In a corresponding manner, the arteria splenica 128 leads from the trunk celiac 120 to the spleen 130, and the splenic vein 132 then extends from the spleen 130 to the inferior vena cava 94.

In the same way, the pancreas 134 with arterial and venous connection lies between the celiac trunk 120 and the inferior vena cava 94.

Downstream of the celiac trunk 120, the renal artery 136 extends from the pars descen dens aortae 112, which leads to the kidneys 138 , from which the renal vein 140 leads to the inferior vena cava 94 (shown only once in FIG. 2).

Finally, further downstream from the pars descendens aortae 112 is the arteria mesenterica 142, which serves for the arterial supply to the intestine 144 . From there the vena mesenterica 146 leads to the vena cava inferior 94.

The three catheter arrangements 12 , 14 and 16 are now inserted into the blood circuit 86 outlined above as follows:

The first, venous catheter arrangement 12 is inserted into the vena cava 94, 92 through the lockable lock 20 . The lock 20 is preferably inserted in the area of the inguinal vein, ie into the inferior vena cava 94 above the branching point of the femoral vein 96, 98. Alternatively, two blocking balloons could also be inserted into the femoral veins 96, 98 and a corresponding sluice inserted into one of the femoral veins 96 , 98 .

Since the lock 20 , as mentioned, is designed to be blockable, there is a separate localization of the associated blocking balloon 22 by means of x-ray control or similar measures, since the blocking balloon 22 is structurally combined with the first lock 20 , as described.

Through the lock 20 , the catheter or tube 34 is now advanced with the blocking balloon 36 to such an extent that it is located beyond the mouth 91 in the heart 88 . For this purpose, the length l ₁ must be dimensioned according to the size of the patient. Alternatively, both lock 20 and catheter 34 can be positioned over the right jugular vein.

The first flushing line 28 is dimensioned extremely short with l ₂ and be found with its first open end 29 in the immediate vicinity of the lock 20 or even on the lock itself.

The second arterial catheter assembly 14 is inserted through the sheath 40 . The sluice 40 is placed on a femoral artery, in the example of FIG. 2 on the arteria femoralis sinistra 118. The second catheter arrangement 14 is now advanced so far through the pars descendens aortae 112 and the arcus aor tae 100 that the blocking element 50 is itself extends between l ₄ and l ₅ across all three branches of the head arteries 102 , 108 , 110 . The length l _{3 of} the second flushing line 60 is dimensioned such that the second open end 61 with the pressure sensor 64 extends into the transition from the artery aortae 100 into the pars ascendens aortae.

The third arterial catheter assembly 16 is inserted through the sheath 70 . The lock 70 is inserted into the other femoral artery, that is, in the example of FIG. 2, into the femoral artery dextra 116. The lengths l ₆ and l ₇ are dimensioned such that the third flushing line 78 protrudes straight out of the lock 70 or branches off from it.

The action of the catheter set 10 in the blood circulation 86 is now as follows:

Once the three catheter assemblies 12 , 14 and 16 have been advanced or inserted through the locks 20 , 40 and 70 in the manner described above, the lock balloons 22 , 42 and 72 associated with the locks 20 , 40 and 70 are introduced by introducing a pressure medium the connecting pieces 26 , 46 and 76 or the tubes 24 , 44 and 74 are widened, so that the three corresponding vessels, namely the inferior vena cava 94 and the two femoral arteries 116 and 118 are blocked. At the same time is brought into the first catheter assembly 12 in accordance with the way the blocking balloon 36 in its blocking position and in the second catheter assembly 14, the Blockie approximately element 50th The area of the blood circulation 86 between the blocking balloons 22 , 36 , 42 , 52 and 72 is therefore completely blocked to the outside.

Via the sixth connector 62 of the second catheter arrangement 14 , a perfusion solution for the preservation circuit of the coronary arteries 90 is now introduced and via the ninth connection piece 82 of the third catheter arrangement 16 perfusion solution for the preservation circuit of the abdominal organs 124 , 130 , 134 , 138 and 144 . As soon as the perfusion solution has flushed through the blocked area of the blood circuit 86 , a closed circuit is produced. For this purpose, the second connection piece 32 is connected to a recirculation pump 150 , the output of which is brought into connection with the connection pieces 62 and 82 via a controlled pressure distributor 152 . The signal output of the pressure sensor 64 at the seventh connector 68 is connected to a control input of the pressure distributor 152 via a signal line indicated by a double arrow.

The throughput of the recirculation pump 150 is in the range of 1 liter per minute.

If one now considers the preservation of the abdominal organs 124 , 130 , 134 , 138 and 144 , an arrow 154 indicates that the preservation solution flows out of the third irrigation line 78 at the third open end 79 for this branch of preservation and then as indicated by arrows 156 , distributed to the supply artery 122 , 128 , 136 , 142 of the abdominal organs 124 , 130 , 134 , 138 , 144 . From there, the preservation solution flows through the corresponding veins 126 , 132 , 140 , 146 in part (arrow 158 ) into the vena cava inferior 94.

In a corresponding manner in the area of preservation circuit enters run of the heart at the second open end 61 of the second Spüllei tung preservative solution 60 (arrow 160). This preservation solution then also flows into the inferior vena cava 94, so that the entire preservation solution of both circuits merges there and is discharged together through the first open end 29 of the first flushing line 28 (arrow 162 ).

The preservation solution passes from the first flushing line 28 into the recirculation pump 150 and from there into the controlled pressure distributor 152 . There are expediently set two different outlet pressures for the two circuits. The output pressure for the preservation circuit of the heart 88 is preferably set accordingly by means of the pressure sensor 64 , in order not to cause undesired bloating of the heart 88 or of its coronary arteries ( 90 ).

The structure according to FIG. 2 can also be simplified by introducing the preservation solution as a whole on the inflow side into a vessel, namely the pars descendens aortae 112 (arrangement similar to that of the lock 20 in the area of the inferior vena cava 94). Then the separate circuit for the preservation of the coronary arteries 90 would be produced by allowing the second flushing line 60 to end on the right side of the blocking element 50 in FIG. 2, a fixed pressure ratio between the heart 88 then being established by suitable dimensioning of the lumens on the one hand and abdominal organs 124 , 130 , 134 , 138 , 144 on the other hand could adjust.

Claims (7)

1. catheter set for preserving internal organs ( 88 , 124 , 130 , 134 , 138 , 144 ) by means of perfusion, the catheter set ( 10 ) comprising:

• a) with a first (venous) catheter arrangement ( 12 )

• a first catheter ( 34 ) containing a first blocking balloon ( 36 ),
• a second catheter ( 24 ) containing a second blocking balloon ( 22 ),
• - a third catheter ( 30 ) containing a first irrigation line ( 28 ) with a first open end ( 29 );
  • a) with a second (arterial) catheter arrangement ( 14 )
• a fourth catheter ( 54 ) containing a third blocking balloon ( 52 ),
• a fifth catheter ( 58 ), which contains a second irrigation line ( 60 ) with a second open end ( 61 ),

wherein the lengths (l ₁ , l ₂ , l ₃ , l ₄ ) of the first ( 34 ), second ( 24 ), third ( 30 ), fourth ( 54 ) and fifth ( 58 ) catheters are such that

• - When the first catheter arrangement ( 12 ) is positioned in the vena cava ( 92 , 94 ) leading to the heart ( 88 ), the first blocking balloon ( 36 ) and the second blocking balloon ( 22 ), in the direction of flow ( 89 a, 89 b) Seen blood, upstream of the mouth ( 91 ) of the venous coronary arteries opening into the vena cava (superior 92, inferior 94) and the first open end ( 29 ) is positioned between the first ( 36 ) and the second ( 22 ) blocking balloon in this position is and
• - When the second catheter arrangement ( 14 ) is positioned in the aorta ( 112 , 114 , 116 , 118 ) leaving the heart ( 88 ), the third blocking balloon ( 52 ) is located in the pars ascendens aortae ( 112 ) of the heart ( 88 ) downstream of the Confluence of the arterial coronary arteries originating from the pars ascendens aortae ( 112 ), the second open end ( 61 ) being arranged upstream of the third blocking balloon ( 52 ) in this position,

characterized in that the catheter set ( 10 ) further comprises:

• a) with a third (arterial) catheter arrangement ( 16 )

• - a sixth catheter ( 74 ) containing a fourth blocking balloon ( 72 ); and
• a seventh catheter ( 80 ) which contains a third irrigation line ( 78 ) with a third open end ( 79 ),

wherein the length (l ₆ , l ₇ ) of the sixth ( 74 ) and the seventh ( 80 ) catheter is dimensioned such that when the third catheter arrangement ( 16 ) is positioned below the pars descendens aortae ( 112 ), the fourth blocking balloon ( 72 ) downstream of the confluence of the arterial supply vessels ( 122 , 128 , 136 , 142 ) of the liver ( 124 ), spleen ( 130 ), pancreas ( 134 ), kidneys ( 138 ) and intestine ( 144 ) and
that the first ( 34 ) and the second ( 24 ) catheters are so measured that the first ( 36 ) and the second ( 22 ) block balloon when positioning the first catheter arrangement ( 12 ) in the vena cava ( 92 , 94 ) enclose an area between them from a point in the superior vena cava ( 92 ) to a point in the inferior vena cava ( 94 ) upstream of the junction of the venous supply vessels ( 126 , 132 , 140 , 146 ) of the liver ( 124 ), spleen ( 130 ), pancreas ( 134 ), kidneys ( 138 ) and intestine ( 144 ) are sufficient. 2. Catheter set according to claim 1, characterized in that the fourth catheter ( 54 ) and the fifth catheter ( 58 ) are provided with a fifth blocking balloon ( 42 ) that its position relative to the fourth ( 54 ) and fifth ( 58 ) catheters so is dimensioned so that it is in the positioning of the second catheter arrangement ( 14 ) in the aorta ( 112 , 114 , 116 , 118 ) in the area of the one artery femora lis ( 118 ) and that the sixth ( 74 ) and the seventh ( 80 ) catheters are dimensioned such that when the third catheter arrangement ( 16 ) is positioned in the other femoral artery ( 116 ), the third open end ( 79 ) is located downstream of the branching point of the femoral arteries ( 116 , 118 ). 3. Catheter set according to claim 1, characterized in that the fifth catheter ( 58 ) with the second flushing line ( 60 ) on the side facing away from the second open end ( 61 ) of the third blocking balloon ( 52 ) ends with a fourth open end. 4. Catheter set according to one or more of claims 1 to 3, characterized in that the second blocking balloon ( 22 ) is part of a first blockable lock ( 20 ). 5. Catheter set according to one or more of claims 1 to 4, characterized in that the fourth blocking balloon ( 72 ) is part of a second blockable lock ( 70 ). 6. Catheter set according to one or more of claims 2, 4 or 5, characterized in that the fifth blocking balloon ( 42 ) is part of a third blockable lock ( 40 ). 7. Catheter set according to one or more of claims 1 to 6, characterized in that the third blocking balloon ( 52 ) is dimensioned such that, in the actuated state within the pars ascendens aortae ( 112 ), the head arteries ( 102 , 104 , 106 , 108 , 110 ) blocked.