WO2005042082A1 - Percutaneous gas-line - Google Patents
Percutaneous gas-line Download PDFInfo
- Publication number
- WO2005042082A1 WO2005042082A1 PCT/AU2004/001485 AU2004001485W WO2005042082A1 WO 2005042082 A1 WO2005042082 A1 WO 2005042082A1 AU 2004001485 W AU2004001485 W AU 2004001485W WO 2005042082 A1 WO2005042082 A1 WO 2005042082A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- gas
- line
- line part
- implanted
- patient
- Prior art date
Links
- 238000007789 sealing Methods 0.000 claims abstract description 10
- 208000015181 infectious disease Diseases 0.000 claims description 11
- 238000000034 method Methods 0.000 claims description 10
- 239000007943 implant Substances 0.000 claims description 6
- 239000000463 material Substances 0.000 claims description 5
- 229920001296 polysiloxane Polymers 0.000 claims description 5
- 206010052428 Wound Diseases 0.000 claims description 4
- 208000027418 Wounds and injury Diseases 0.000 claims description 4
- 230000002085 persistent effect Effects 0.000 claims description 4
- 229920000728 polyester Polymers 0.000 claims description 3
- 230000035876 healing Effects 0.000 claims description 2
- 210000000709 aorta Anatomy 0.000 description 2
- 238000004891 communication Methods 0.000 description 2
- 238000012258 culturing Methods 0.000 description 2
- 238000002513 implantation Methods 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 230000002861 ventricular Effects 0.000 description 2
- 208000037581 Persistent Infection Diseases 0.000 description 1
- 210000001015 abdomen Anatomy 0.000 description 1
- 238000004873 anchoring Methods 0.000 description 1
- 239000003242 anti bacterial agent Substances 0.000 description 1
- 229940088710 antibiotic agent Drugs 0.000 description 1
- 230000005540 biological transmission Effects 0.000 description 1
- 238000001574 biopsy Methods 0.000 description 1
- 229920001400 block copolymer Polymers 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 210000004027 cell Anatomy 0.000 description 1
- 230000003203 everyday effect Effects 0.000 description 1
- 210000002950 fibroblast Anatomy 0.000 description 1
- 238000011065 in-situ storage Methods 0.000 description 1
- 210000005240 left ventricle Anatomy 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 229920002635 polyurethane Polymers 0.000 description 1
- 239000004814 polyurethane Substances 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 230000000246 remedial effect Effects 0.000 description 1
- 238000007390 skin biopsy Methods 0.000 description 1
- 238000007920 subcutaneous administration Methods 0.000 description 1
Classifications
-
- 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
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
-
- 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
- A61M60/289—Devices for mechanical circulatory actuation assisting the residual heart function by means mechanically acting upon the patient's native heart or blood vessel structure, e.g. direct cardiac compression [DCC] 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
- A61M60/10—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
- A61M60/161—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 mechanically acting upon the outside of the patient's blood vessel structure, e.g. compressive structures placed around a vessel
-
- 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
- A61M60/40—Details relating to driving
- A61M60/465—Details relating to driving for devices for mechanical circulatory actuation
- A61M60/468—Details relating to driving for devices for mechanical circulatory actuation the force acting on the actuation means being hydraulic or pneumatic
-
- 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
- A61M60/50—Details relating to control
- A61M60/508—Electronic control means, e.g. for feedback regulation
- A61M60/515—Regulation using real-time patient data
-
- 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
- A61M60/871—Energy supply devices; Converters therefor
- A61M60/878—Electrical connections within the patient's body
-
- 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
- A61M60/871—Energy supply devices; Converters therefor
- A61M60/88—Percutaneous cables
Definitions
- the present invention relates generally to a heart assist device, system and method and more particularly to a percutaneous gas-line for an implanted medical device such as a left ventricular assist device (LVAD), or counter-pulsation or co-pulsation heart assist device and to a heart assist device incorporating such a gas-line.
- LVAD left ventricular assist device
- a heart assist device incorporating such a gas-line.
- implantation involves making a large skin biopsy, isolating the fibroblasts from the biopsy and growing the cells, then culturing them onto the device (which is a 10 day process).
- the PAD can be implanted in the abdomen, and then the counterpulsation device implanted. It is an object of the present invention to provide an improved percutaneous gas- line that, at least in preferred embodiments, requires no antecedent preparation and has a low risk profile for infection, but which allows remedial action to be taken in the event that gas-line infection occurs.
- infection related to percutaneous lines in general is influenced by the diameter, flexibility and nature of the material.
- the present invention provides a percutaneous gas- line for a medical device, the gas-line including: a first gas-line part adapted to be wholly implanted in a patient and having a first end adapted for sealing connection to the medical device and a second end with a connection fitting; and a second gas-line part adapted to be part-implanted and part-external and having a first (external) end adapted for sealing connection to an external driver and a second (implanted) end adapted for removable sealing connection with the connection fitting on the second end of the first gas-line part.
- the second gas-line part is preferably further adapted to be removable, for replacement, in the presence of persistent exit-site infection or damage to the external part.
- the medical device is preferably a heart assist device, more preferably a left ventricular assist device (LVAD), or a counter-pulsation or co-pulsation heart assist device.
- the first (external) end of the second gas line is preferably removably connected to the external driver.
- an ECG lead adapted to connect a patient's heart with a control system for a heart assist device utilising the gas line according to this invention is incorporated into the first gas line part and/or the second gas line part.
- the second gas-line part is preferably constructed to have a minimal outside diameter, more preferably less than 7 mm, and has high flexibility and a resistance to kinking or collapsing.
- the second gas-line part is preferably made of a soft biocompatible, biostable material, such as silicone 45-65A durometer. This gas-line part may be wire-wound internally to allow thin wall and kink/collapse resistance.
- the connection fitting is preferably a Luer-lock or similar gas-tight fitting.
- the first and/or second gas-line parts preferably have a fluffy polyester, or similar, collar over about a short section (eg. 20-50mm) of their implanted length.
- the present invention provides a method of providing heart assistance to a patient using a percutaneous gas-line having a first gas-line part, adapted to be wholly implanted, and a second gas-line part, adapted to be part implanted and part external, connected to the first gas-line part, the method including the steps of: (1) recognising a persistent exit-site infection; (2) disconnecting the second gas-line part from the first gas-line part; (3) removing the second gas-line part from the patient; and (4) connecting a sterile second gas-line part to the first gas-line part wherein the fresh second gas-line part is inserted through a fresh exit-site that is remote to the infected exit-site.
- the fresh second gas- line part is inserted through an implant tunnel that is also substantially remote from the existing implant tunnel.
- the first gas-line part (and the implanted ECG cable, if it is attached to a corresponding interconnect cable associated with the second gas-line part) is sealed and wounds are closed to allow healing to occur (which may include prolonged treatment with antibiotics), at this time the device is non-functional, but can, at a later time, be made functional by re-implanting the second part and sealing attaching it to the first part.
- the present invention provides a gas line for connecting an inflatable heart assist actuator to a driver therefore, the gas line having a first end operatively connected to the inflatable actuator and a second end connectable, directly or indirectly through an extension gas line, to the driver for the heart assist actuator, the gas line having attached to it an ECG lead, the ECG lead having a first end adapted for connection to the heart of a patient and a second end adapted for connection to the driver or a controller for the driver, the attachment between the gas lead and the ECG lead being such that they are adapted to pass through the skin of a patient as a single element.
- Fig. 1 is a schematic view of a percutaneous gas-line according to an embodiment of the invention, connected between an implanted heart assist device and an external driver.
- Fig. 2 is a schematic view of a percutaneous gas-line according to a second embodiment of the invention, connected between an implanted heart assist device and an external driver and in which an ECG cable is incorporated into the gas line.
- Fig.l shows a percutaneous gas-line 10 according to a first embodiment of the invention.
- the gas-line 10 has a first part 10a and a second part 10b.
- the gas-line 10 connects an external gas driver 12 to a left ventricle heart assist device 14, which is positioned around a patient's aorta 16.
- the heart assist device 14 comprises a balloon (not shown), a bushing (not shown), and a wrap 18 to hold the balloon in position around the aorta 16.
- the first part 10a of the gas-line 10 has a first end 10a' sealingly connected to the bushing and in gas communication with the balloon.
- the first part 10a of the gas-line 10 also has a second end 10a" with a gas-tight Leur-lock fitting 20 thereon.
- the first part 10a of the gas-line 10 is made of a polyurethane-polysiloxane block co-polymer similar to that used to form the balloon and bushing.
- the second part 10b of the gas-line 10 is shown positioned percutaneous through an exit site 22.
- the external/un-implanted portion of the second part 10b has a first end 10b' that is connected to the external driver 12 with a gas tight but removable fitting.
- the second gas-line part 10b also has a second end 10b" connected to the second end 10a" of the first part 10a at the Luer fitting 20.
- the implanted portion of the second part 10b also has about it a polyester collar 24 for anchoring the gas-line subcutaneously approx 20-50 mm from an exit site 22.
- the second part 10b can be made of a different material to the first part 10a. It is preferably made of silicone or silicone-polyurethane co-polymer.
- the second part 10b can also be more flexible than the first part 10a and can be wire- wound. hi the event that the external part of the gas-line 10 is damaged in every-day use, or if a persistent infection develops at the exit site 24, then the second part 10b is able to be exchanged for a fresh/new (sterilised) second part 10b which is brought out of the patient via a new exit-site 24 (see phantom lines).
- Fig. 2 shows a percutaneous gas-line 10' according to a second embodiment of the invention. Like features to those of the first embodiment are indicated with like reference numerals in the second embodiment.
- the gas-line 10' includes a first part (implanted) epicardial ECG lead 26, a sleeve
- the lead 26 enters the sleeve 28, which is connected between the first and second parts of the gas line 10a and 10b.
- the sleeve 28 has an electrical connector therein (not shown) that connects the lead 26 to an extension of the lead 30.
- the lead parts 26 and 30 therefore advantageously provide direct communication of ECG signals from the patient's heart to the driver 12.
- the lead 30 is connected to the driver 12 and is contained within the interior of the gas-line second part 10b.
- the lead 30 can be glued to the exterior of the gas-line second part 10b. hi either case, only a single exit site 22 is required, thereby minimising infection risk and patient discomfort.
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Hematology (AREA)
- Veterinary Medicine (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Mechanical Engineering (AREA)
- Vascular Medicine (AREA)
- Medical Informatics (AREA)
- Pulmonology (AREA)
- External Artificial Organs (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/595,603 US7887478B2 (en) | 2003-10-31 | 2004-10-28 | Percutaneous gas-line |
GB0606807A GB2423027B (en) | 2003-10-31 | 2004-10-28 | Percutaneous gas-line |
US12/962,558 US8425397B2 (en) | 2003-10-31 | 2010-12-07 | Percutaneous gas-line |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2003906067 | 2003-10-31 | ||
AU2003906067A AU2003906067A0 (en) | 2003-10-31 | Percutaneous Gas-line |
Related Child Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/595,603 A-371-Of-International US7887478B2 (en) | 2003-10-31 | 2004-10-28 | Percutaneous gas-line |
US12/962,558 Continuation US8425397B2 (en) | 2003-10-31 | 2010-12-07 | Percutaneous gas-line |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2005042082A1 true WO2005042082A1 (en) | 2005-05-12 |
WO2005042082A8 WO2005042082A8 (en) | 2005-07-21 |
Family
ID=34528665
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/AU2004/001485 WO2005042082A1 (en) | 2003-10-31 | 2004-10-28 | Percutaneous gas-line |
Country Status (3)
Country | Link |
---|---|
US (2) | US7887478B2 (en) |
GB (1) | GB2423027B (en) |
WO (1) | WO2005042082A1 (en) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2008071223A1 (en) | 2006-12-15 | 2008-06-19 | Gaetano Azzolina | Cardiocirculatory aiding device |
US11608516B2 (en) | 2015-04-15 | 2023-03-21 | Ecolab Usa Inc. | Method for determination of diversity and viability thresholds used to assess microorganisms in process samples |
Families Citing this family (17)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
AUPQ090499A0 (en) | 1999-06-10 | 1999-07-01 | Peters, William S | Heart assist device and system |
AUPR669001A0 (en) | 2001-07-30 | 2001-08-23 | Sunshine Heart Company Pty Ltd | A fluid pressure generating means |
AU2002952691A0 (en) | 2002-11-15 | 2002-11-28 | Sunshine Heart Company Pty Ltd | Heart assist device utilising aortic deformation |
US7862499B2 (en) * | 2003-10-30 | 2011-01-04 | Sunshine Heart Company Pty Ltd | Blood vessel wrap |
GB2423027B (en) * | 2003-10-31 | 2007-12-27 | Sunshine Heart Co Pty Ltd | Percutaneous gas-line |
DK1677872T3 (en) * | 2003-10-31 | 2016-02-15 | Sunshine Heart Co Pty Ltd | synchronization Control System |
WO2005044338A1 (en) | 2003-11-11 | 2005-05-19 | Sunshine Heart Company Pty Ltd | Actuator for a heart assist device |
US8206278B2 (en) | 2006-08-21 | 2012-06-26 | Sunshine Heart Pty Ltd. | Wrap for a heart assist device |
EP2552509B1 (en) | 2010-04-02 | 2020-11-04 | Sunshine Heart Company Pty Ltd | Combination heart assist systems |
CA2873446A1 (en) * | 2012-05-22 | 2013-11-28 | Sunshine Heart Company, Pty Ltd | Methods, systems, and devices relating to a removable percutaneous interface line |
US9220824B2 (en) | 2013-01-08 | 2015-12-29 | AdjuCor GmbH | Implanting cardiac devices |
DE102013200148A1 (en) | 2013-01-08 | 2014-07-10 | AdjuCor GmbH | Plug system for a cardiac assist device |
DE102013200154A1 (en) * | 2013-01-08 | 2014-07-10 | AdjuCor GmbH | A heart support device having a shell and first and second sheaths |
DE102013200151A1 (en) | 2013-01-08 | 2014-07-10 | AdjuCor GmbH | Heart support device with markings |
DE102013208038B4 (en) | 2013-05-02 | 2016-09-08 | Michael Siegenthaler | Catheter-based cardiac assist system |
EP3233151A1 (en) * | 2014-12-17 | 2017-10-25 | Heartware, Inc. | Implantable connector |
AU2020228377A1 (en) * | 2019-02-26 | 2021-10-14 | Percassist, Inc. | Apparatus, systems, and methods for percutaneous pneumatic cardiac assistance |
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Also Published As
Publication number | Publication date |
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GB2423027B (en) | 2007-12-27 |
US8425397B2 (en) | 2013-04-23 |
WO2005042082A8 (en) | 2005-07-21 |
GB2423027A (en) | 2006-08-16 |
GB0606807D0 (en) | 2006-05-17 |
US20110275883A1 (en) | 2011-11-10 |
US20070021830A1 (en) | 2007-01-25 |
US7887478B2 (en) | 2011-02-15 |
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