JP5537939B2 - 循環系に補足的な血流を確立するための装置、方法、及びシステム - Google Patents
循環系に補足的な血流を確立するための装置、方法、及びシステム Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
- A61M1/3656—Monitoring patency or flow at connection sites; Detecting disconnections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
- A61M1/3659—Cannulae pertaining to extracorporeal circulation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/02—Holding devices, e.g. on the body
- A61M25/04—Holding devices, e.g. on the body in the body, e.g. expansible
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/06—Body-piercing guide needles or the like
- A61M25/0662—Guide tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/148—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/80—Constructional details other than related to driving
- A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
- A61M60/861—Connections or anchorings for connecting or anchoring pumps or pumping devices to parts of the patient's body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
- A61B2017/3425—Access ports, e.g. toroid shape introducers for instruments or hands for internal organs, e.g. heart ports
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
- A61B2017/3484—Anchoring means, e.g. spreading-out umbrella-like structure
- A61B2017/3488—Fixation to inner organ or inner body tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/20—Type thereof
Description
本出願は、2006年8月30日出願の米国仮特許出願第60/823,971号明細書、「Devices, Methods and Systems for Establishing Supplemental Blood Flow in the Circulatory System」の優先権の利益を主張するものであり、参照によりその全体が本明細書に明示的に組み込まれる。
12 流入カニューレ、流入カテーテル
12a 遠位端
12b 近位端
14 左心房
14a 左心房の壁
15 心臓
16 上大静脈
18 鎖骨下静脈
20 患者
30 心房中隔
32 入口
34 補足的血流ポンプ
36 流出カテーテル
38 出口
40 腋窩動脈
42 矢印
50 頚静脈
52 出口位置
60 血管切開部
62 デリバリーカテーテル、シース
62a 遠位先端部
64 拡張装置
66 ガイドワイヤー
66a 遠位先端部
70 矢印
80 第1のアンカー要素
82 第2のアンカー要素
90 矢印
92 開口
96 縫合糸
98 切断具
100 循環支援システム
102 流入カニューレ
102a 遠位端部分
104 血液ポンプ
106 流出カニューレ
110 アクセス位置
112 解剖刀
120 切開部
122 遠位アンカー要素
124 近位アンカー要素
130、132 巾着縫合糸
140 心臓組織
150 ステンレス鋼またはニチノールコイル
d1 先端寸法
d2 遠位のアンカー要素122と近位のアンカー要素124との間の距離
t1、t2 長手方向軸に沿った厚さ
Claims (14)
- 患者の心臓の内腔と離れた位置との間に血流導管を設ける装置であって、
外面と近位端部分及び遠位端部分とを有するカニューレであって、前記遠位端部分が、カニューレ中を通る血流を可能にするように、前記カニューレの管腔と連絡する開口部を含み、前記遠位端部分及び開口部が前記心臓の内腔に挿入されるように構成された、カニューレと、
前記カニューレの外面から外側に延びる最大幅寸法をそれぞれ有する第1及び第2のアンカー要素と、
を備え、
前記第1のアンカー要素が、前記第2のアンカー要素より遠位に配置され、前記第1のアンカー要素と前記第2のアンカー要素との間に組織収容空間を画定し、前記第1のアンカー要素の最大幅寸法が、前記第2のアンカー要素の最大幅寸法より大きく、それにより、前記第1のアンカー要素が、前記心臓の内腔の内側に配置されるように構成され、前記第2のアンカー要素が、前記心臓の内腔の外側に配置されるように構成され、心臓組織が、前記第1のアンカー要素と前記第2のアンカー要素との間の前記組織収容空間中に保持され、
前記第1または第2のアンカー要素の少なくとも1つが、環状でディスク形の要素を備え、
前記カニューレがさらに、前記遠位端部分を心臓の内腔に案内するために、患者の静脈系に挿入されるように構成された血流カテーテルを備え、
前記第1及び第2のアンカー要素が、静脈系を介して導入する間の第1のコンパクトな状態と、心臓組織の両側に配置するための第2の拡張状態との間を動くことが可能であることを特徴とする装置。 - 前記第1または第2のアンカー要素の少なくとも1つが、柔軟な弾性材料から形成されることを特徴とする請求項1に記載の装置。
- 前記第1及び第2のアンカー要素が、第2の拡張状態に自動拡張可能であることを特徴とする請求項1に記載の装置。
- 前記第1及び第2のアンカー要素が、組織の成長を可能にするように形成されることを特徴とする請求項1に記載の装置。
- 患者の心臓の内腔と離れた位置との間に血流導管を設けるカテーテルシステムであって、
デリバリーカテーテルと、
前記デリバリーカテーテルを介して患者の静脈系に案内されるように構成された血液流入カテーテルであって、外面と近位端部分及び遠位端部分とを有し、前記遠位端部分が、開口部を有し、前記心臓の内腔に挿入されるように構成され、カテーテル中を通る血流を可能にするように、血液流入カテーテルの管腔と連絡する、血液流入カテーテルと、
遠位端部分上で運ばれ、前記血液流入カテーテルの外面から外側に延びる幅寸法をそれぞれ有する、第1及び第2のアンカー要素と
を備え、
前記第1のアンカー要素が、前記第2のアンカー要素より遠位に配置され、前記第1のアンカー要素と前記第2のアンカー要素との間に組織収容空間を画定し、前記第1のアンカー要素の幅寸法が、前記第2のアンカー要素の幅寸法より大きく、それにより、前記第1のアンカー要素が、前記心臓の内腔の内側に配置されるように構成され、前記第2のアンカー要素が、前記心臓の内腔の外側に配置されるように構成され、心臓組織が、前記第1のアンカー要素と前記第2のアンカー要素との間の前記組織収容空間中に保持され、
前記第1または第2のアンカー要素の少なくとも1つが、環状でディスク形の要素を備え、
前記第1及び第2のアンカー要素が、静脈系を介して導入する間の第1のコンパクトな状態と、心臓組織の両側に配置するための第2の拡張状態との間を動くことが可能であることを特徴とするカテーテルシステム。 - 前記第1または第2のアンカー要素の少なくとも1つが、柔軟な弾性材料から形成されることを特徴とする請求項5に記載のシステム。
- 前記第1及び第2のアンカー要素が、第2の拡張状態に自動拡張可能であることを特徴とする請求項5に記載のシステム。
- 前記デリバリーカテーテルが、第1及び第2のアンカー要素を第1のコンパクトな状態に維持する拘束部材になるように構成されることを特徴とする請求項7に記載のシステム。
- 前記第1及び第2のアンカー要素が、組織の成長を可能にするように形成されることを特徴とする請求項5に記載のシステム。
- 患者の循環系において患者の心臓の内腔と離れた位置との間の血流を増加させる補足的血流支援装置であって、
入口及び出口を有する血液ポンプであって、前記出口が、患者の循環系の前記離れた位置に連結するように適合された、血液ポンプと、
外面と近位端部分及び遠位端部分とを有するカニューレであって、前記近位端部分が、前記血液ポンプの入口に接続するように構成され、前記遠位端部分が、開口部を有し、前記心臓の内腔に挿入されるように構成され、カテーテル中を通る血流を可能にするように、血液流入カテーテルの管腔と連絡する、カニューレと、
前記遠位端部分上で運ばれ、前記カニューレの外面から外側に延びる幅寸法をそれぞれ有する、第1及び第2のアンカー要素と、
を備え、
前記第1のアンカー要素が、前記第2のアンカー要素より遠位に配置され、前記第1のアンカー要素と前記第2のアンカー要素との間に組織収容空間を画定し、前記第1のアンカー要素の幅寸法が、前記第2のアンカー要素の幅寸法より大きく、それにより、前記第1のアンカー要素が、前記心臓の内腔の内側に配置されるように構成され、前記第2のアンカー要素が、前記心臓の内腔の外側に配置されるように構成され、心臓組織が、前記第1のアンカー要素と前記第2のアンカー要素との間の前記組織収容空間中に保持され、
前記第1または第2のアンカー要素の少なくとも1つが、環状でディスク形の要素を備え、
前記カニューレがさらに、前記遠位端部分を心臓の内腔に案内するために、患者の静脈
系に挿入されるように構成された血流カテーテルを備え、
前記第1及び第2のアンカー要素が、静脈系を介して導入する間の第1のコンパクトな状態と、心臓組織の両側に配置するための第2の拡張状態との間を動くことが可能であることを特徴とする補足的血流支援装置。 - 前記第1または第2のアンカー要素の少なくとも1つが、柔軟な弾性材料から形成されることを特徴とする請求項10に記載の装置。
- 前記血流カテーテルの遠位端部分が心臓に送達可能になるように、前記血流カテーテル
を受けるように構成されたデリバリーカテーテルをさらに備えることを特徴とする請求項
10に記載の装置。 - 前記第1及び第2のアンカー要素が、第2の拡張状態に自動拡張可能であることを特徴とする請求項10に記載の装置。
- 前記第1及び第2のアンカー要素が、組織の成長を可能にするように形成されることを特徴とする請求項10に記載の装置。
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US82397106P | 2006-08-30 | 2006-08-30 | |
US60/823,971 | 2006-08-30 | ||
PCT/US2007/076956 WO2008027869A2 (en) | 2006-08-30 | 2007-08-28 | Devices, methods and systems for establishing supplemental blood flow in the circulatory system |
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JP2013271353A Expired - Fee Related JP5819927B2 (ja) | 2006-08-30 | 2013-12-27 | 循環系に補足的な血流を確立するための装置、方法、及びシステム |
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US (3) | US9572917B2 (ja) |
EP (3) | EP2845614B1 (ja) |
JP (2) | JP5537939B2 (ja) |
CA (1) | CA2666881C (ja) |
ES (2) | ES2528902T3 (ja) |
HK (2) | HK1188577A1 (ja) |
WO (1) | WO2008027869A2 (ja) |
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JP2012213517A (ja) * | 2011-03-31 | 2012-11-08 | Mitsubishi Heavy Ind Ltd | 脱血管、および、補助人工心臓 |
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