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
  • 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
  • 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
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
  • A61M1/15—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit
  • A61M1/152—Details related to the interface between cassette and machine
  • A61M1/1524—Details related to the interface between cassette and machine the interface providing means for actuating on functional elements of the cassette, e.g. plungers
• • 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
  • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
  • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
  • A61M5/142—Pressure infusion, e.g. using pumps
• • 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
  • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
  • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
  • A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
  • A61M5/172—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic
• • 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
  • A61M60/13—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 by means of a catheter allowing explantation, e.g. catheter pumps temporarily introduced via the vascular system
• • 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
  • A61M60/205—Non-positive displacement blood pumps
  • A61M60/216—Non-positive displacement blood pumps including a rotating member acting on the blood, e.g. impeller
• • 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
  • A61M60/531—Regulation using real-time patient data using blood pressure data, e.g. from blood pressure sensors
• • 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
  • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
  • A61M1/15—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit
  • A61M1/155—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit with treatment-fluid pumping means or components thereof
• • 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
  • A61M60/247—Positive displacement blood pumps
  • A61M60/253—Positive displacement blood pumps including a displacement member directly acting on the blood
  • A61M60/268—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders
  • A61M60/279—Peristaltic pumps, e.g. roller pumps
• • 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
  • A61M60/403—Details relating to driving for non-positive displacement blood pumps
  • A61M60/408—Details relating to driving for non-positive displacement blood pumps the force acting on the blood contacting member being mechanical, e.g. transmitted by a shaft or cable
  • A61M60/411—Details relating to driving for non-positive displacement blood pumps the force acting on the blood contacting member being mechanical, e.g. transmitted by a shaft or cable generated by an electromotor
  • A61M60/414—Details relating to driving for non-positive displacement blood pumps the force acting on the blood contacting member being mechanical, e.g. transmitted by a shaft or cable generated by an electromotor transmitted by a rotating cable, e.g. for blood pumps mounted on a catheter
• • 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
  • A61M60/538—Regulation using real-time blood pump operational parameter data, e.g. motor current
  • A61M60/546—Regulation using real-time blood pump operational parameter data, e.g. motor current of blood flow, e.g. by adapting rotor speed
• • 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

Definitions

• This application is directed to pumps for mechanical circulatory support of a heart, in particular, this application is directed to a console and controller for a catheter pump and a fluid handling system configured to convey and remove fluids to and from the catheter pump.
• Heart disease is a major health problem that has high mortality rate. Physicians increasingly use mechanical circulatory support systems for treating heart failure. The treatment of acute heart failure requires a device that can provide support to the patient quickly. Physicians desire treatment options that can be deployed quickly and mmimally-mvasively.
• Intra-aortic balloon pumps are currently the most common type of circulatory support devices for treating acute heart failure, lABPs are commonly used to treat heart failure, such as to stabilize a patient after cardiogenic shock, during treatment of acute myocardial infarction (MI) or decompensated heart failure, or to support a patient during high risk percutaneous coronary intervention (PCI). Circulatory support systems may be used alone or with pharmacological treatment.
• MI myocardial infarction
• PCI percutaneous coronary intervention
• an IABP is positioned in the aorta and actuated in a counterpulsation fashion to provide partial support to the circulatory system.
• minimally- invasive rotary blood pumps have been developed in an attempt to increase the level of potential support (i.e., higher flow).
• a rotary blood pump is typically inserted into the body and connected to the cardiovascular system, for example, to the left ventricle and the ascending aorta to assist the pumping function of the heart.
• Other known applications pumping venous blood from the right ventricle to the pulmonary artery for support of the right side of the heart.
• An aim of acute circulatory support devices is to reduce the load on the heart muscle for a period of time, to stabilize the patient prior to heart transplant or for continuing support.
• a pump with improved performance and clinical outcomes.
• a pump that can provide elevated flow rates with reduced risk of hemolysis and thrombosis.
• a pump that can be inserted minimally-invasively and provide sufficient flow rates for various indications while reducing the risk of major adverse events.
• a heart pump that can be placed minimally -invasively, for example, through a 15FR or 12FR incision.
• a heart pump that can provide an average flow rate of 4 Lpm or more during operation, for example, at 62 mmHg of head pressure.
• a controller may be provided to control the flow into and out of the catheter assembly. It can be advantageous to provide improved mechanisms for engaging the catheter assembly with the controller, which may be housed in a console.
• a fluid handling system can include a housing.
• the housing can include one or more pumps, and a controller configured to operate the pump(s).
• the system can farther include a catheter assembly.
• the catheter assembly may include a catheter body having a proximal portion and an operative device at a distal portion.
• An infusion system can be in fluid communication with the proximal portion of the catheter body.
• the infusion system can include a closure member configured to be separate from the housing in a first state and to at least partially secure the infusion system to the housing in a second state. Upon engagement of the closure member with the housing in the second state, the infusion system may be operably engaged with the pump(s).
• a removable interface member for a fluid handling system can include an interface body sized and shaped to be inserted into an interface aperture of a console housing.
• An electrical component can be disposed on the interface body.
• an occlusion bed can be disposed on the interface body.
• a tube segment can be disposed on the interface body near the occlusion bed.
• the interface body can be dimensioned such that when the interface body is inserted into the interface aperture of the console housing, a pump in the console housing is operably engaged with the tube segment and the occlusion bed, and an electrical interconnect in the console housing is electrically coupled with the electrical component on the interface body.
• a method for operably coupling an infusion system to a console housing can comprise positioning an interface body of the infusion system in an interface aperture of the console housing.
• the interface body can comprise an occlusion bed, a tube segment mounted on the interface body near the occlusion bed, and an electrical component.
• the method can further comprise inserting the interface body through the interface aperture until a pump roller of the console housing compresses the tube segment against the occlusion bed and until an electrical interconnect of the console housing is electrically coupled to the electrical component of the interface body.
• a method for priming a catheter assembly can include an elongate body and an operative device.
• the method can comprise inserting the operative device of the catheter assembly into a priming vessel.
• the method can further comprise securing a proximal portion of the priming vessel to a distal portion of the elongate body, such that the elongate body is in fluid communication with the priming vessel. Fluid can be delivered through the elongate body and the priming vessel to expel air within the catheter assembly.
• Figure 1 is a schematic view of an operative device of a catheter assembly in position within the anatomy for assisting the left ventricle.
• Figure 2 is a three-dimensional perspective view of a catheter assembly, according to some embodiments.
• Figure 3 A is a three-dimensional perspective view of a fluid handling system that includes a console and catheter assembly.
• Figure 3B is a three-dimensional perspective view of an interface region of the console shown in Figure 3 A.
• Figure 4 is a three-dimensional perspective view of an interface member, according to one embodiment.
• Figure 5 A is a three-dimensional perspective view of a cap.
• Figure 5B is a three-dimensional perspective view of an interface member in an unlocked configuration.
• Figure 5C is a three-dimensional perspective view of an interface member in a locked configuration.
• Figure 6A is a three-dimensional perspective view of a first side of an electrical component, according to one embodiment.
• Figure 6B is a three-dimensional perspective view of a second, opposite side of the electrical component of Figure 6A.
• Figure 7 is a schematic diagram of an infusate system, according to one embodiment.
• Figure 8 is an enlarged view of a priming apparatus shown in Figure 2.
• This application is directed to fluid handling systems that are configured to control and/or manage fluid and electrical pathways in a catheter assembly, such as a catheter assembly of a percutaneous heart pump system.
• the disclosed percutaneous heart pump systems may include a catheter assembly and a console that includes a controller configured to control the fluid and electrical pathways that pass through the catheter assembly .
• the console may be configured to control the flow rate of the pump and to monitor various physiological parameters and pump performance through the various electrical and fluid pathways of the catheter assembly.
• the catheter assembly may be disposable, such that the catheter assembly can be discarded after use, while the console and controller are reusable.
• a catheter assembly is used in a percutaneous heart pump system having an operative device (e.g., an impeller assembly) that is configured to assist the patient's heart in pumping blood.
• the heart pump system may be configured to at least temporarily support tire workload of tire left ventricle in some embodiments.
• the exemplary heart pump can be designed for percutaneous entry through the femoral artery to a patient's heart.
• the exemplary impeller assembly can include a collapsible impeller and cannula, which can be inserted into the patient's vasculature at a catheter size of less than 1 3 FR, for example, about 12.5 FR in some arrangements.
• a sheath may maintain the impeller and cannula assembly in a stored configuration.
• the impeller and cannula can expand to a larger diameter, for example to a catheter size of about 24 FR when the sheath is removed from the impeller assembly.
• the expanded diameter of the impeller and cannula may allow for the generation of higher flow rates, according to some embodiments,
• Figure I illustrates one use of the disclosed catheter pump system.
• a distal portion of the pump which can include an impeller assembly 1 16A, is placed in the left ventricle (LV) of the heart to pump blood from the LV into the aorta.
• the pump can be used in this way to treat patients with a wide range of conditions, including cardiogenic shock, myocardial infarction, and other cardiac conditions, and also to support a patient during a procedure such as percutaneous coronary intervention.
• One convenient manner of placement of the distal portion of the pump in the heart is by percutaneous access and delivery using the Seldinger technique, or other methods familiar to cardiologists. These approaches enable the pump to be used in emergency medicine, a catheter lab and in other non-surgical settings.
• Modifications can also enable the pump 10 to support the right side of the heart.
• Example modifications that could be used for right side support include providing delivery features and/or shaping a distal portion that is to be placed through at least one heart valve from the venous side, such as is discussed in US 6,544,216; US 7,070,555; and US 2012-0203056A1, all of which are hereby incorporated by reference herein in their entirety for all purposes.
• the catheter assembly 100 A may correspond to the disposable portion of the heart pump systems described herein.
• the catheter assembly 100 A may include the impeller assembly 1 6 A near a distal portion of the catheter assembly i OOA, an elongate body 174 A extending proximaliy from the impeller assembly 1 16A, an infusion system 195 configured to supply infusate to the catheter assembly 1 00 A, a motor assembly comprising a driven assembly 101 and a drive assembly 103, one or more conduits 302 (e.g., electrical and/or fluid conduits) extending proximaliy from the motor assembly, and an interface member 300 coupled at a proximal portion of the conduits 302.
• conduits 302 e.g., electrical and/or fluid conduits
• the impeller assembly 1 1 6A may be disposed at a distal portion of the catheter assembly 100A, As explained above, the impeller assembly 1 16A can include an expandable cannula or housing and an impeller with one or more blades. As the impeller rotates, blood can be pumped proximaliy (or distal ly in some implementations) to function as a cardiac assist device.
• a priming apparatus 1400 can be disposed over the impeller assembly 1 16A. As explained herein with reference to Figures 7-8, the priming apparatus 1400 can be configured to expedite a process of expelling air from the catheter assembly 100 A before insertion of the operative device of the catheter assembly into the patient.
• the elongate body 174A extends proximaliy from the impeller assembly 1 16A to an infusion system 195 configured to allow infusate to enter the catheter assembl 100A and waste fluid to leave the catheter assembly 100A.
• a catheter body 120A (which also passes through the elongate body ⁇ 74 ⁇ ) can extend proximaliy and couple to the driven assembly 101 of the motor assembly.
• the catheter body 120A can pass within the elongate body 174A, such that the elongate body 174A can axially translate relative to the catheter body 120 A.
• Axial translation of the elongate body 174A relative to the catheter body 120 A can enable the expansion and collapse of the impeller assembly 1 16A,
• the impeller assembly 1 16A coupled to a distal portion of the catheter body 120A, may expand into an expanded state by moving the elongate body 174A proximaliy relative to the impeller assembly 1 16A.
• the impeller assembly 1 16A may self-expand into the expanded state in some embodiments. In the expanded state, the impeller assembly 1 16A is able to pump blood at high flow rates.
• the impeller assembly 1 16A may be compressed into a collapsed state by advancing a distal portion 170 A of the elongate body ⁇ 74 ⁇ distal ly over the impeller assembly 1 16 A to cause the impeller assembly 1 16A to collapse.
• the catheter body 120A cars couple to the drivers assembly 101 of the motor assembly.
• the driven assembly 101 can be configured to receive torque applied by the drive assembly 103, which is shown as being decoupled from the driven assembly 101 and the catheter assembly 100 in Figure 2.
• the drive assembly 103 can be coupled to the driven assembly 101 by engaging a proximal portion of the driven assembly 101 with the drive assembly, e.g., by inserting the proximal portion of the driven assembly 101 into an aperture 105 of the drive assembly 103.
• a drive shaft can extend from the driven assembly 101 through the catheter body 120A to couple to an impeller shaft at or proximal to the impeller assembly 1 16A.
• the drive assembly 103 can electrically communicate with a controller in a console (see, e.g., Figures 3A-3B), which can be configured to control the operation of the motor assembly and the infusion system 195 that supplies a flow of infusate in the catheter assembly 100A.
• the impeller of the impeller assembly 1 16A may thus be rotated remotely by the motor assembly during operation of the catheter pump in various embodiments.
• the motor assembly can be disposed outside the patient.
• the motor assembly is separate from the controller or console, e.g., to be placed closer to the patient. In other embodiments, the motor assembly is part of the controller. In still other embodiments, the motor assembly is miniaturized to be insertable into the patient. Such embodiments allo the drive shaft to be much shorter, e.g., shorter than the distance from the aortic valve to the aortic arch (about 5 cm or less).
• the motor assembly (e.g., the drive assembly 103 and the driven assembly 101 ) is in electrical communication with the controller and console by way of the conduits 302, which may include electrical wires.
• the electrical wires may extend from the motor assembly proximally to the interface member 300.
• the controller in the console to electrically communicate with the motor assembly and/or other sensors in the catheter assembly 100 A (such as pressure sensors, flow sensors, temperature sensors, bubble detectors, etc.), it can be advantageous to provide a reliable electrical connection between the interface member 300 and the console.
• the removable interface member 300 may include electrical components configured to couple to one or more electrical contacts (sometimes referred to herein as interconnections) in the console.
• the electrical connections may be achieved in a simple, user-friendly manner, in various embodiments disclosed herein, for example, the electrical connections may be made substantially at the same time, e.g., substantially simultaneously, as fluid connections are made between the interface member 300 and console.
• the mechanical components rotatably supporting the impeller within the impeller assembly 1 16A permit high rotational speeds while controlling heat and particle generation that can come with high speeds.
• the infusion system 195 may deliver a cooling and lubricating solution to the distal portion of the catheter assembly 100A for these purposes.
• tire infusion system 195 may be in fluid communication with tire interface member 300 by way of the conduits 302, which may also include fluid conduits or tubes. Because the catheter assembly 100 A may be disposable and/or removable from a console, it can be important to securely couple interface member 300 to the console. Furthermore, it can be important to provide an easy-to-use interface such that users can easily complete fluid connections that remain secure during a treatment procedure.
• Maintaining security of the connection is important because the fluids and signals earned by the conduits 302. enable tire impeller to operate in a continuous manner. Stoppage of the pump system may require the catheter assembly 100 A to be removed from the patient and replaced in certain circumstances, which may be life-threatening or extremely inconvenient at a minimum,
• the catheter pump system When activated, the catheter pump system can effectively increase the flow of blood out of the heart and through the patient's vascular system.
• the pump can be configured to produce a maximum flow- rate (e.g. low mm Hg) of greater than 4 Lpm, greater than 4.5 Lpm, greater than 5 Lpm, greater than 5.5 Lpm, greater than 6 Lpm, greater than 6.5 Lpm, greater than 7 Lpm, greater than 7.5 Lpm, greater than 8 Lpm, greater than 9 Lpm, or greater than 10 Lpm.
• a maximum flow- rate e.g. low mm Hg
• the pump can be configured to produce an average flow rate at 62 mmHg pressure head of greater than 2 Lpm, greater than 2.5 Lpm, greater than 3 Lpm, greater than 3.5 Lpm, greater than 4 Lpm, greater than 4.25 Lpm, greater than 4.5 Lpm, greater than 5 Lpm, greater tha 5.5 Lpm, or greater tha 6 Lpm.
• Figure 3A is a three-dimensional perspective view of a fluid handling system 350 thai includes a console 301 and the catheter assembly 100A of Figure 2.
• the console 301 can provide electrical power, control signals, medical fluids (e.g., saline) for infusion, and fluid waste extraction to the catheter assembly 100 A by way of its interface with the interface member 300.
• medical fluids e.g., saline
• the removable interface member 300 may be disposed at a proximal portion of the catheter assembly 100 A and may be configured to couple to the console 301 at an interface region 303.
• the fluid handling system 350 can be configured to deliver fluids to and/ or remove fluids from the catheter assembly 100A.
• saline and/or other medical solutions can lubricate and/or cool component between the motor assembly and the operative device.
• waste fluids can be removed from the catheter assembly 100A. using the fluid handling system 350.
• the fluid handling system 350 can include a multilumen catheter body having a proximal end and a distal end. The catheter body can include one or more lumens through which medical solutions (e.g., saline), waste fluids, and/or blood can flow.
• the console 301 may include one or more pump(s) configured to apply positive or negative pressure to the catheter assembly 100A when the catheter assembly 1 00 is coupled to the console 301 and engages the pump(s).
• the fluid handling system 350 may also be configured to provide electrical communication between the console 301 and the catheter assembly 100 A
• the console can include a controller (e.g., a processor) that is programmed to control and/or manage the operation of the motor assembly.
• the console 301 may also include electrical interfaces configured to supply power to the motor assembly and/or other components that are driven by electrical power when the interface member 300 is coupled to the console 301.
• one or more electrical or electronic sensors may be provided in the catheter assembly 100 A and may electrically couple to tire console 301 by way of the fluid handling system 350. The embodiments disclosed herein may thereby provide fluid and electrical connections between the catheter assembly 100A and the console 301.
• the fluid handling system 350 may provide a removable interface between the catheter assembly 100A and the console 301 , which may include various components, including, e.g., one or more pump(s), processors (e.g., the controller), electrical interconnections, etc.
• the console 301 may include various components, including, e.g., one or more pump(s), processors (e.g., the controller), electrical interconnections, etc.
• a user may simply insert a distal portion of the interface member 300 (e.g., including a closure member) along the illustrated Z-direction into an aperture 304 of the interface region 303 until the pump(s) are engaged and the electrical connection(s) are formed.
• the insertion of the interface member along the Z-direction may engage the pump(s) and complete the electrical connection(s) substantially simultaneously.
• the interface member 300 may be secured to the console 3 i by engaging a locking device between the interface region 303 and the interface member 300.
• a locking device is by rotating a portion of the interface member 300 relative to another portion of the interface member or relative to the console 301, as explained herein.
• rotation of an outermost structure (opposite the direction Z), sometimes referred to herein as a "cap" relative to the console may engage a locking mechanism configured to mechanically secure the interface member 300 to the console 301 to prevent the interface member 300 from being accidentally disengaged during a treatment procedure.
• the console 301 may also include a user interface 312, which may comprise a display device and/or a touch-screen display.
• the user may operate the percutaneous heart pump system by interacting with the user interface 312 to select, e.g., desired flo rates and other treatment parameters.
• the user may also monitor properties of the procedure on the user interface 312.
• Figure 3B is a three-dimensional perspective view of the interface region 303 of the console 301 shown in Figure 3A.
• the interface region 303 can include the aperture 304 configured to receive the distal portion of the interface member 303.
• the aperture 304 may include a generally circular cavity shaped and sized to receive a portion of the interface member 300.
• a bubble detector 308 e.g., an optical sensor in some embodiments
• the bubble detector 308 may include a recess portion defined by two walls sized and shaped to receive a segment of tubing.
• the bubble detector 308 may monitor the fluid to determine whether or not the fluid includes unwanted matter, e.g., bubbles of air or other gas. In some embodiments, the bubble detector 308 may measure the amount (number or volume) of bubbles in the fluid passing though the tube segment. It should be appreciated that it can be important to detect bubbles in the treatment fluid to avoid inducing embolisms in the patient.
• the bubble detector 308 may electrically communicate with the controller in the console 301 and can indicate the amount of bubbles in the treatment fluid. The console 301 , in turn, can alert the user if there are bubbles in the treatment fluid.
• the interface regio 303 can also include one or more pumps, e.g., peristaltic pumps in some embodiments.
• the peristaltic pumps ca be used to pump fluid into or out of the catheter assembly 100A to deliver medical fluids and to remove waste fluids, respectively.
• Such pumps may employ one or more rollers 306 to control delivery of a fluid within a respective tube (see, e.g., pump lube segments 324a, 324b of Figure 4).
• the one or more pump rollers 306 can be housed within the console 301. As shown, two pump rollers 306 are mounted about their rotational axes (e.g., the Y- direction illustrated in Figure 3B) at the back wall of the aperture 304.
• the pump rollers 306 can be rotated by a peristaltic pump motor within the console (not shown in Figures 3A-3B). As explained in more detail herein with respect to Figure 4 below, the rollers 306 can engage pump tube segments 324a, 324b to pump fluid into or out of the catheter assembly 100 A.
• the pump rollers 306 may be configured to be received within occlusion bed regions of the interface member 300 (see, e.g., occlusion beds 322a and 322b of Figure 4) to pump fluid through the catheter assembly 100 A.
• An electrical interconnect 307 can also be provided in the back wall of the aperture 304.
• the electrical interconnect 307 can be configured to provide power to the motor assembly and/or electrical signals or instructions to control the operation of the motor assembly.
• the electrical interconnect 307 can also be configured to receive electrical signals indicative of sensor readings for monitoring pressure, flow rates, and/or temperature of one or more components in the catheter assembly 100 A
• a recessed channel 309 can extend from the bottom of the aperture 304 along the side to the lower edge of the console 301.
• the recessed channel 309 can be shaped and sized to receive one or more of the conduits 302 (e.g. , electrical and/or fluid conduits) extending between the interface member 300 and the motor assembly, in one embodiment, all of the conduits 302 can be received within the channel 309 providing a flush side surface when the interface member 300 is disposed in the interface aperture 304.
• the interface region 303 can include a groove 313 sized and shaped to receive a locking mechanism (e.g., a tab or flange projecting in the X direction) on the interface member 300.
• a locking mechanism e.g., a tab or flange projecting in the X direction
• a disengaging member 305 includes a spring-loaded release mechanism 310 provided above the aperture 304 and a pin 31 1 that can be inserted into a hole in the interface member 300 (see, e.g., Figures 5A-5C and the accompanying disclosure below).
• the pin 311 can assist in releasing the interface member 300 relative to the console 30 i .
• the spring- loaded release mechanism 310 can be pressed to release the pin 31 1 and unlock the interface member 300 from the console 301.
• the spring-loaded release mechanism 310 can therefore act as a further safety mechanism to ensure that the cassette is not accidentally disengaged by the user.
• FIG 4 is a three-dimensional perspective view of the interface member 300, according to one embodiment.
• the interface member 300 can comprise a body that is shaped and sized to fit into the interface region 303 of the console 301. As shown in Figure 4, the interface member 300 can have a substantially circular profile, and is sometimes referred to as a puck.
• the interface member 300 can include an outer body 333 opcrably coupled to a manual interface 320, sometimes referred to as a cap.
• the manual interface 320 is generally palm-sized so that a user can receive it in their hand and operate it comfortably, e.g., with finger pressure on the outer rim of the cap.
• One or more occlusion beds can be formed or provided at the interface between the interface member 300 and the console 301 , e.g., in or on the interface member 300.
• first and second occlusion beds 322a and 322b may be formed in the interface member 300, As shown in Figure 4, for example, the occlusion beds 322a, 322b, can include arcuate recessed regions formed in the interface member 300.
• the interface member 300 can further include first and second pump tube segments 324a, 324b positioned along the occlusion beds 322a, 322b formed in the interface member 300.
• the pump rollers 306 can engage with the interface member 300 and compress the tube segments) 324a, 324b against the occlusion bed(s) 322a, 32.2b, respectively.
• the pump motor(s) in the console 301 rotate the rollers 306, fluid flows into uncompressed portions of the tube segments) 32.4a, 324b and continues flowing throughout the catheter assembly 100A.
• the fluid may be pumped into or out of the catheter assembly 100A by way of the conduits 302 extending from the interface member 300 to the motor assembly and distally beyond the motor assembly.
• the body of the interface member 300 e.g., the outer body 333 and/or an inner body, such as inner body 339 illustrated in Figures 5B-5C
• the pump rollers 306 precisely and automatically engage with the tube segments 324a, 324b and occlusion beds 322a, 322b to reliably occlude the tube segments 32.4a, 324b and pump fluids through the catheter assembly 100A.
• the pump in the console 301 can automatically engage the interface member
• the gap between the rollers 306 and the occlusion beds 322a, 322b can be less than about two wail thicknesses of the tube segments 324a, 324b in some arrangements, such that the tubes 324a, 324b can be efiectively occluded.
• the pump can be engaged by simply inserting the interface member 300 into the console 301. There is no need to separately activate the pump in some embodiments.
• the dimensions of the interface member 300 may be selected such that the occlusion bed(s) 322a, 322b automatically engages the respective pump rollers 306 upon insertion of the interface member 300 into the console 301.
• the interface member 300 and interface region 303 provide an easy-to-use, quick connection of the tubing segments to one or more respective rollers 306. Moreover, the components can be manufactured easily and cost-effectively because only certain components require tight tolerances and the interface of member 300 to region 303 is essentially self-aligning. The interface also eliminates any need to engage the pump through a second mechanism or operator step, streamlining operation of the heart pump and simplifying the engagement of the catheter assembly 100A to the console 301.
• the simplified engagement mechanisms disclosed herein can be advantageous because there is only a minimal applied force against the pole, which prevents the pole from rolling or tipping when the pump is engaged.
• the pump tube segments 324a, 324b can be mounted on the interface body 300 near or in the respective occlusion beds 322a, 322b. As illustrated, the first and second pump tube segments 324a, 324b can be configured to engage with the pump rollers 306 in the console 301 , as explained above.
• the first and second pump tube segments 32.4a, 324b can have an arcuate shape (which may be pre-formed in various arrangements) that generally conforms to the curved shape of each respective occlusion bed 322a, 322b,
• the pump rollers 306 within the console 301 can thereby be positioned within the occlusion beds 322a, 322b to compress the tube segments 324a, 324b against the wall of the occlusion beds 322a, 322b.
• a bubble detector tube segment 326 can also be mounted in or on the interface member 300 and can be configured to engage with or be positioned adjacent to the bubble detector 308 illustrated in Figure 3B.
• the bubble detector tube segment 326 can be any suitable shape.
• the bubble detector tube segment can be substantially straight and can be sized and shaped to be received by the bubble detector 308 within the console 301 .
• the bubble detector 308 (which may be an optical sensor) can be used to detect air bubbles in the treatment or lubricating fluid being supplied to the patient.
• the tube segments can be fluidly connected to the remainder of the catheter assembly iOOA, including, e.g. , one or more lumens of the catheter body, by way of the conduits 302.
• the removable interface member 300 may allo fluid to be pumped into and out of the patient within a controlled system, e.g., such that the fluids within the catheter assembly 100A can be pumped while maintaining a sterile environment for the fluids.
• the volume of medical solution into the catheter body can be equal to, or can exceed by a minimum amount, the volume of medical solution out of the catheter body to assure that blood does not enter a blood-free portion of the heart pump.
• one or more electrical contacts 328 can be provided in the interface member 300.
• the electrical contacts 328 can be any suitable electrical interface configured to transmit electrical signals between the console 301 and the catheter assembly 100 A (e.g., the motor assembly and/ or any suitable sensors).
• the electrical contacts 328 can be configured to electrically couple to the electrical interconnect 307 disposed in the console 301. Electrical control signals and/or power may be transmitted between the console 301 and the catheter assembly 100A by way of the electrical connection between the electrical contacts 328 and the electrical interconnect 307.
• the electrical connection between the electrical contacts 328 and the electrical interconnect 307 may be formed or completed when the interface member 300 is inserted into the interface region 303 of the console 301.
• the electrical connection between the electrical contacts 328 and the electrical interconnect 307 may be formed substantially simultaneously with the fluid connection (e.g., the engagement of the pump) when the interface member 300 is inserted into the interface region 303.
• the electrical connection can be formed by inserting electrical pins from the electrical contacts 328 into corresponding holes of the electrical interconnect 307 of the console 301, or vice versa.
• the manual interface 320 can be mechanically coupled to a proximal portion of the outer body 333 and may be configured to rotate relative to the outer body 333 i a constrained manner, as explained below relative to Figures 5A-5C.
• the outer body 333 can include one or more locking apertures 331 configured to receive locking tabs 332 that are configured to lock the manual interface 320 relative to the console 301 .
• the outer body 333 may include a pin hole 321 sized and shaped to receive the pin 31 1 illustrated in Figure 3B to releasably couple the removable interface member 300 relative to the console 301.
• the configuration of the pump rollers, occlusion bed, and tubing can be modified depending on the application in accordance with the present inventions.
• the configuration may be modified to provide easier access for service and repair.
• the pump rollers may be disposed external to the console.
• the pump rollers and occlusion bed may be both disposed within the cassette.
• the console includes a mechanism to actuate the pump rollers in the cassette.
• the rollers may be fixed.
• the rollers may be configured to rotate, translate, or both.
• the rollers and/or the occlusion bed may be positioned on a base that is configured to move.
• the console-cassette interface can include a positive pressure interface to pump fluid (e.g., saline) into the patient's vasculature and a negative pressure interface to pump fluid (e.g., waste fluid) out of the patient's vasculature.
• pump fluid e.g., saline
• negative pressure interface to pump fluid (e.g., waste fluid) out of the patient's vasculature.
• the interface member 300 advantageously can be fully engaged with the console 301 by simply inserting it into a correspondingly shaped aperture 304 in the housing of the console 301.
• a locking mechanism in the interface member 300 can be provided for additional security, which can be particularly useful for patient transport and other more dynamic settings. For example, it is desirable to ensure that the catheter assembly 100 A is secured to the console 301 during the entire procedure to ensure that the procedure is not disrupted due to accidental disengagement of the interface member 300 from the console 301.
• the locking mechanism can be disposed between the console 301 and the interface member 300 and can be configured to be engaged by a minimal movement of an actuator.
• the manual interface 320 can be provided to cause engagement of a locking device by a small rotational turn of the manual interface 320 relative to the console 301.
• Figure 5A is a three-dimensional perspective view of the manual interface 320.
• the manual interface 320 can include or be coupled with an internal cam 335.
• the cam 335 can include one or more protruding lobes, such as lobes 336a and 336b. Further, the cam 335 can include a recessed region 337 recessed inwardly relative to the lobes 336a, 336b.
• the cam 335 can also include a stepped region 338 which can enable the interface member 300 to be locked and unlocked relative to the console 301, as explained herein.
• Figure 5B is a three-dimensional perspective view of an interface member 300A in an unlocked configuration
• Figure 5C is a three-dimensional perspective view of an interface member 300B in a locked configuration.
• the interface members 300A, 300B of Figures 5B and 5C are illustrated without the outer body 333, which has been hidden in Figures 5B and 5C for purposes of illustration.
• the components of Figures 5B and 5C are the same as or similar to the components illustrated with respect to Figure 4.
• the interface members 300A, 300B can include an inner body 339 that can be disposed within the outer body 333 shown in Figure 4.
• the occlusion beds 322a, 322b can be formed in the inner body 339 of the interface member 300A, 300B, as shown in Figures 5B-5C; however, in other arrangements, the occlusio beds 322a, 322b may be formed i the outer body 333 or other portions of the interface member 300 A, 300B.
• an electrical component 340 can be disposed in a recess or other portio of the inner body 339. Additional details regarding the electrical component 340 are explained below with respect to Figures 6A-6B.
• the inner body 339 of the interface member 300 A, 300B can further include a protrusion 330 that includes the tab 332 at a distal portion of the protrusion 330.
• the protrusion 330 can be disposed in or near the recess 337 of the cam 335 in the manual interface 320.
• the cam 335 may therefore not contact or apply a force against the protrusion 330 when the interface member 300A is in the unlocked configuration, as shown in Figure 5B.
• the interface member 300 can be locked into place b rotating the manual interface 320 relative to the inner body 339 and the console 30 i, e.g., rotated in the A-direction illustrated in Figure 5B.
• the internal cam 335 is also rotated within the interface member 300A, 300B.
• the lobes 336a, 336b of the cam 335 can engage with the one or more protrusions 330 of the inner body 339 and can push the protrusions 330 outwardly relative to the inner body 339.
• the tabs 332 may extend outwardly through the locking apertures 331 formed on the outer body 333.
• the tabs 332 When the tab(s) 332 are pushed through the locking aperture(s) 331, the tabs 332 project laterally outward from the outer body 333.
• each of the tabs 332 can lock into the groove(s) 313 in the console 301 (see Figure 3B) to secure the interface member 300B to the console 301.
• the tab 332 in the unlocked position, the tab 332 can be substantially flush with the outer surface of the interface member 300A, and in the locked position, the tab 332 can extend through the locking aperture 33 i and lock into the grooves 313 in the console 301.
• the protrusion 330 can be a cantilevered protrusion from the inner body 339. As mentioned above, it can be important to maintain tight tolerances between the occlusion beds 322a, 322b, which is also formed in the interface member, and the pump rollers 306 when the interface member 300 engages with the console 301. Because the occlusion beds 322a, 322b may be formed in the same body as the eantilevered protrusions 330, conventional manufacturing processes, such as molding processes, can be used to manufacture the interface member 300 (e.g., the outer body 333 and/or the inner body 339) according to precise dimensions.
• the protmsion(s) 330, tab(s) 332 and the occlusion bed(s) 322a, 322b can be made within tight dimensional tolerances, and the tabis) 332 and/or protrusion(s) 330 can be positioned relative to the occlusion bed(s) 322a, 322b with very high precision such that when the interface member 300 is engaged with the console 301 , the tube segments 324a, 324b are optimally occluded.
• the interface member 300 can be locked by rotating the manual interface 320 on the interface member 300, only minimal forces are applied to the console 301. This enhances the advantages of minimizing disruption of a mobile cart or IV pole to which the system may be coupled.
• the disengaging member 305 of the console 301 can be configured to disengage and unlock the interface member 300 from the console 301.
• the pin 311 may be spring-loaded such that when the interface member 300 A is in the unlocked configuration, the pin 311 extends through the pin hole 321 of the outer body 333 but only contacts a side surface of one of the lobes 336b of the cam 335.
• the pin 311 may simply slide along the cam surface, permitting rotation of the manual interface 320 relative to the pin 31 1 and the console 301 .
• the pin 31 1 can engage with the stepped region 338 of the internal cam 335, e.g., the spring-biased pin 31 1 can extend into the stepped region 338 or shoulder of the cam 335.
• the pin 311 prevents the cam 335 from rotating from the locked configuration to the unlocked configuration.
• a user can disengage the cassette by pressing the spring-loaded release mechanism 310 to release the spring and remove the pin 311 from the stepped region 338.
• the pin 31 1 can thereby be disengaged from the stepped region 338, and the internal cam 335 can rotate back into the unlocked position.
• the tab 332 can be withdrawn from the groove 313 in the console 301 to unlock the interface member 300.
• Figure 6A is a three-dimensional perspective view of a first side of the electrical component 340 illustrated in Figure 4.
• Figure 6B is a three-dimensional perspective view of a second, opposite side of the electrical component 340 of Figure 6A.
• the electrical component 340 may be disposed in a recess of the interface member 300.
• the electrical component 340 can be any suitable electrical or electronic component, including, e.g., a printed circuit board (PCB) configured to provide an electrical interface between various components in tire catheter assembly 100 A and the console 301.
• the electrical component 340 can form an electrical interface between the interface member 300 and the console 301 to provide electrical communication between the console 301 and the catheter assembly 100A (such as the motor assembly and/or various sensors).
• the electrical component 340 of the interface member 300 can include the one or more electrical contacts 328 configured to mate with the corresponding electrical interconnect 307 in the console 301.
• the electrical contacts 328 and/or the electrical interconnect 307 can be, for example, nine-pin electrical interconnects, although any suitable interconnect can be used.
• the motor assembly that drives the operative device (e.g., impeller) of the catheter pump can be electrically connected to the interface member 300 by way of one or more electrical cables, e.g., the conduits 302.
• the console 301 can be coupled to a power source, which can drive the catheter pump motor assembly by way of the interface member's contacts 328 and the electrical conduits 302 connecting the interface member 300 to the motor assembly.
• the electrical component 340 can also include communications interconnects configured to relay electrical signals between the console 301 and the catheter pump motor assembly or other portions of the catheter assembly 100A.
• a controller within the console 301 (or interface member) can send instructions to the catheter pump motor assembly via the electrical component 340 between the console 301 and the interface member 300.
• the electrical component 340 can include interconnects for sensors (such as pressure or temperature sensors) within the catheter assembly 100A, including sensors at the operative device.
• the sensors may be used to measure a characteristic of the fluid in one or more of the tubes (e.g., saline pressure).
• the sensors may be used to measure an operational parameter of the system (e.g., ventricular or aortic pressure).
• the sensors may be provided as part of an adjunctive therapy.
• the electrical component 340 within the interface member 300 can be used to electrically couple the cable (and the motor assembly, sensors, etc.) with the corresponding interconnects 307 in the console 301.
• one or more internal connectors 346 and 348 on the second side of the electrical component 340 may provide electrical communication between the contacts 328 (configured to couple to the interconnects 307 of the console 301 ) and the catheter assembly 100.
• electrical cables e.g., the conduits 302
• the internal connectors 346, 348 may electrically communicate with the contacts 328 on the first side of the electrical component 340, which in turn communicate with the interconnects 307 of the console 301 .
• the electrical component 340 is fiuidly sealed to prevent the internal electronics from getting wet. This ma be advantageous in wet and/or sterile environments. This may also advantageously protect the electronics in the event one of the fluid tubes leaks or bursts, which is a potential risk in high pressure applications,
• the electrical component 340 can include various electrical or electronic components mounted thereon. As shown in Figure 6B, for example, two pressure sensors 344a, 344b can be mounted on the electrical component
• 344a, 344b may be used to monitor the flow of fluids in the tube segments 324a, 324b to confirm proper operation of the heart pump, for example, confirming a proper balance of medical solution into the catheter body and waste out of the catheter body.
• Various other components such as a processor, memory, or an Application-Specific Integrated Circuit
• ASIC application specific integrated circuit
• ASICs 345a, 345b can be coupled to the pressure sensors 344a, 344b to process the signals detected by the pressure sensors 344a, 344b.
• the processed signals may be transmitted from the ASICs 345a, 345b to the console 301 by way of internal traces (not shown) in the PCB and the contacts 328.
• FIG. 7 One embodiment of an infusate system 1300 is illustrated in Figure 7.
• the infusate system 1300 can be configured to supply treatment and/or lubricating fluids to the operative device of the catheter assembly (e.g., an impeller assembly 1 16), and to remove waste fluid from the assembly.
• an elongate body 174 can be slidably disposed over a catheter body 120, such that there may be gaps or channels betwee the outer surface of the catheter body 120 and the inner surface of the elongate body 174.
• gaps or channels can contain air pockets harmful to the patient during a medical procedure.
• the lumen or lumens extending within the catheter body 120 also can contain air pockets harmful to the patient.
• the system 1300 of Figure 7 may be configured to supply fluid to the catheter assembly during treatment, to remove waste fluid during treatment, and/or to expel air from the elongate body 174, e.g., between the inner surface of the elongate body 174 and the outer surface of the catheter body 120 before treatment.
• an interface member 1313 (similar to or the same as the interface member 300 described herein, in some aspects) may be provided to connect various components of the catheter assembly, as discussed herein.
• An outer sheath tubing 1303a can extend from a fluid reservoir 1305 to a luer 102 configured to be coupled to an infusate device.
• the outer sheath tubing 1303a can be configured to deliver fluid to the outer sheath, e.g., the space between the elongate body 174 and the catheter body 120.
• the fluid reservoir 1305 may optionally include a pressure cuff to urge fluid through the outer sheath tubing 1303a. Pressure cuffs may be particularly useful in fluid delivery embodiments using gravity-induced fluid flow.
• the luer 102 can be configured to deliver infusate or other priming fluid to the elongate body 174 to expel air from the elongate body 174 as described herein in order to "prime" the system 1300.
• a pressure sensor 1309a which may be disposed on a motor housing 1314, can be coupled to the outer sheath tubing 1303a to measure the pressure of the infusate or priming fluid flowing through the outer sheath tubing 1303a and into the l er 102.
• the motor housing 1314 illustrated in Figure 7 may be the same as or similar to the motor assembly described above with reference to Figure 2, for example, when the drive assembly 103 is coupled to the driven assembly 101.
• inner catheter tubing 1303b can extend between the motor housing 1314 and the fluid reservoir 1305, by way of a T-junction 1320.
• the inner catheter tubing 1303b can be configured to deliver fluid to the lumen or lumens within catheter body 120 during treatment and/ or to expel air from the catheter 120 and prime the system 1300
• a pumping mechanism 1306a such as a roller pump for example, can be provided along inner catheter tubing 1303b to assist in pumping the infusate or priming fluid through the system 1300, As explained herein, the roller pump can be a peristaltic pump in some arrangements.
• an air detector 1308 can be coupled to the inner catheter tubing 1303b and can be configured to detect any air or bubbles introduced into the system 1300,
• a pressure sensor 1309b can couple to inner catheter tubing 1303b to detect the pressure of the fluid within the tubing.
• a filter 131 1 can be employed to remove debris and other undesirable particles from the infusate or priming fluid before the catheter body 120 is infused or primed with liquid.
• the air detector 1308, the pressure sensor 1309b, and the pumping mechanism 1306a can be coupled to the interface member 1313 described above (such as the interface member 300),
• One or more electrical lines 1315 can connect the motor housing 1314 with the cassette 1313.
• the electrical lines 1315 can provide electrical signals for energizing a motor or for powering the sensor 1309a or for other components.
• infusate or priming fluid can be introduced at the proximal end of the catheter assembly. The fluid can be driven distal ly to drive air out of the catheter body 120 to prime the system.
• a waste fluid line 1304 can fluidiy connect the catheter body 120 with a waste reservoir 1310.
• a pressure sensor 1309c which may be disposed on or coupled to the interface member 1313, can measure the pressure of the fluid within the waste fluid line 1304.
• a pumping mechanism 1306b such as a roller pump, for example, can be coupled to the interface member 1313 and can pump the waste fluid through the waste fluid line 1304 to the waste reservoir 1310.
• Figure 8 is an enlarged view of the priming apparatus 1400 shown in Figure 2.
• the priming apparatus 1400 may be disposed over the impeller assembly 116A near the distal end 170 A of the elongate body 174A.
• the priming apparatus 1400 can be used in connection with a procedure to expel air from the impeller assembly 1 16A, e.g. , any air thai is trapped within the housing or that remains within the elongate body 174A near the distal end 170A.
• the priming procedure may be performed before the pump is inserted into the patient's vascular system, so that air bubbles are not allowed to enter and/or injure the patient.
• the priming apparatus 1400 can include a primer housing 1401 configured to be disposed around both the elongate body 174A and the impeller assembly ⁇ 6 ⁇ .
• a sealing cap 1406 can be applied to the proximal end 1402 of the primer housing 1401 to substantially seal the priming apparatus 1400 for priming, i.e., so that air does not proximally enter the elongate body 174A and also so that priming fluid does not flow out of the proximal end of the housing 1401.
• the sealing cap 1406 can couple to the primer housing 1401 in any way known to a skilled artisan.
• the sealing cap 1406 is threaded onto the primer housing by way of a threaded connector 1405 located at the proximal end 1402 of the primer housing 1401.
• the sealing cap 1406 can include a sealing recess disposed at the distal end of the sealing cap 1406.
• the sealing recess can be configured to allow the elongate body 174A to pass through the sealing cap 1406.
• the priming operation can proceed by introducing fluid into the sealed priming apparatus 1400 to expel air from the impeller assembly 1 16A and the elongate body 174A.
• Fluid can be introduced into the priming apparatus 1400 in a variety of ways.
• fluid can be introduced distally through the elongate body 174A into the priming apparatus 1400,
• an inlet such as a luer, can optionally be formed on a side of the primer housing 1401 to allow for introduction of fluid into the priming apparatus 1400.
• a gas permeable membrane can be disposed on a distal end 1404 of the primer housing 1401.
• the gas permeable membrane can permit air to escape from the primer housing 1401 during priming.
• the priming apparatus 1400 also can advantageously be configured to collapse an expandable portion of the catheter assembly 100A.
• the primer housing 1401 can include a funnel 1415 where the inner diameter of the housing decreases from distal to proximal.
• the funnel may be gently curved such that relative proximal movement of the impeller housing causes the impeller housing to be collapsed by the funnel 1415.
• the distal end 170A of the elongate body 174A can be moved distally relative to the collapsed housing.
• the catheter assembly 100A can be removed from the priming housing 1400 before a percutaneous heart procedure is performed, e.g., before the pump is activated to pump blood.
• the embodiments disclosed herein may be implemented such that the total time for infusing the system is minimized or reduced.
• the time to fully infuse the system can be about six minutes or less.
• the infusate time can be less than 5 minutes, less than 4 minutes, or less than 3 minutes.
• the total time to infuse the system can be about 45 seconds or less, it should be appreciated that lower infusate times can be advantageous for use with cardiovascular patients.
• the heart pump is inserted in a less invasive manner, e.g., using techniques that can be employed in a catheter lab.
• the catheter assembly 100A can be primed to remove gas that could be contained therein prior to any method being performed on the patient.
• This priming technique can be performed by placing a distal portion of the catheter assembly 100 A in a priming vessel, such as the apparatus 1400. Thereafter, a media is delivered into the catheter assembly 100A under pressure to displace any potentially harmful matter, e.g., air or other gas, out of the catheter assembl 100A.
• the apparatus 1400 is filled with a biocompatible liquid such as saline.
• a pressure or flow rate for priming can be provided that is suitable for priming, e.g., a pressure or flow rate that is lower than the operational pressure or flow rate.
• the biocompatible liquid is pushed under positive pressure from the proximal end through the catheter assembly 100 A until all gas is removed from voids therein.
• One technique for confirming that all gas has been removed is to observe the back-pressure or the current draw of the pump.
• the priming apparatus 1400 can be configured to permit gas to escape while preventing saline or other biocompatible liquid from escaping. As such, the back-pressure or current draw to maintain a pre-selected flow will change dramatically once all gas has been evacuated.
• the priming apparatus 1400 can include a source of negative pressure for drawing a biocompatible liquid into the proximal end of the catheter assembly 100 A.
• Applying a negative pressure to the priming apparatus 1400 can have the advantage of permitting the catheter assembly 100 A to be primed separate from the pumps that are used during operatio of the heart pump.
• the priming can be done in parallel with other medical procedures on the patient by an operator that is not directly working on the patient.
• a positive pressure pump separate from the pump that operates the heart pump can be used to prime under positiye pressure applied to the proximal end.
• Various priming methods may also be expedited by providing a separate inlet for faster filling of the enclosed volume of the priming apparatus 1400.
• the 100A for insertion into a patient can involve collapsing the impeller housing 1 16A.
• the collapsed state of the impeller housing 1 16A reduces the size, e.g., the crossing profile, of the distal end of the system. This enables a patient to have right, left or right and left side support through a small vessel that is close to the surface of the skin, e.g., using catheter lab-type procedures.
• the priming apparatus 1400 has a funnel configuration that has a large diameter at a distal end and a smaller diameter at a proximal end. The funnel gently transitions from the large to the small diameter.
• the impeller housing i 16A can be collapsed by providing relative movement between the priming apparatus 1400 and the impeller housing 1 16A.
• the priming housing 1400 can be held in a fixed position, e.g., by hand, and the catheter assembly iOOA can be withdrawn until at least a portion of the impeller assembly 1 16A is disposed in the small diameter segment of the priming apparatus 1400.
• the elongate body 174A of the sheath assembly can be advanced over the collapsed impeller assembly 1 16A.
• the catheter assembly 100 A is held still and the priming apparatus 1400 is slid distally over the impeller assembly 1 16A to cause the impeller assembly 1 16A to collapse. Thereafter, relative movement between the elongate body ⁇ 74 ⁇ and the impeller assembly ⁇ 6 ⁇ can position the distal end ⁇ 70 ⁇ of the elongate body 174 A over the impeller assembly 1 16.A after the catheter assembly 100A has been fully primed.
• the inventions herein have been described with reference to particular embodiments, it is to be understood that these embodiments are merely illustrative of the principles and applications of the present inventions.

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