Pericardial inflation catheter and systems and methods employing same
Inventors
Van Bladel, Kevin • Annest, Lon S. • Dana, Michael S.
Assignees
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Publication Number
US-11744615-B2
Publication Date
2023-09-05
Expiration Date
Abstract
A method for performing a therapeutic intervention in a pericardial space of a heart includes delivering a catheter into a right atrium of the heart and steering the catheter so that a distal end of the catheter is positioned adjacent an access site in the right atrium. The distal end of the catheter is anchored in a heart wall of the right atrium adjacent the access site and the heart wall is inverted to separate an exterior surface of the inverted heart wall from contact with parietal pericardial tissue. The inverted heart wall is penetrated to provide access to the pericardial space around the heart. A device is delivered through the penetrating in the inverted heart wall to perform the therapeutic intervention in the pericardial space.
Core Innovation
The invention relates to a method for performing a therapeutic intervention in a pericardial space of a heart by delivering a catheter into a right atrium and steering the catheter so that a distal end is positioned adjacent an access site in the right atrium. The distal end is anchored in a heart wall of the right atrium adjacent the access site by engaging the heart wall with an anchoring member disposed within a lumen of the catheter. The anchored configuration enables inversion of the heart wall at the access site to separate an exterior surface of the inverted heart wall from contact with parietal pericardial tissue.
After inverting the heart wall at the access site, the method penetrates the inverted heart wall to provide access to the pericardial space of the heart, including extending a needle through the inverted heart wall. A device is delivered through the penetration to perform the therapeutic intervention in the pericardial space of the heart. In related refinements, the catheter is delivered into a right atrium of a beating heart and the anchored distal end is used to invert a portion of the heart wall to partially separate the exterior surface from parietal pericardial tissue before penetration and device delivery.
The disclosed system includes alternatives for the anchoring member disposed within the catheter lumen, such as a rotatable screw, barb, hook, snare, or suction device. In further refinements, retracting the anchoring member pulls a region of the heart wall into a conically shaped end of the catheter, and a needle is positioned concentrically relative to the anchoring member. Penetration can be performed with a perforating device including a needle, a laser, or a radio frequency energy delivery device.
Claims Coverage
The independent claims are clm-00001 and clm-00013. Each independent claim centers on delivering a catheter into the right atrium, anchoring and inverting the right atrial heart wall at an access site, penetrating the inverted portion to access the pericardial space, and delivering a device through the penetration to perform the therapeutic intervention. The independent claims also set the core relationship among the catheter, an anchoring member disposed within a lumen, wall inversion to separate exterior surface from parietal pericardial tissue, and penetration via a needle or perforating device.
Catheter-delivered access to a pericardial space via right atrium
Delivering a catheter into a right atrium of the heart, steering the catheter within the right atrium so that a distal end of the catheter is positioned adjacent an access site in the right atrium.
Anchoring an inverting-capable catheter distal end in the right atrial wall
Anchoring the distal end of the catheter in a heart wall of the right atrium adjacent the access site including engaging the heart wall with an anchoring member that is disposed within a lumen of the catheter; inverting a portion of the heart wall at the access site to separate an exterior surface of the inverted heart wall from contact with parietal pericardial tissue.
Penetrating the inverted heart wall to access the pericardial space
Penetrating the inverted heart wall at the access site to provide access to the pericardial space of the heart including extending a needle through the inverted heart wall; penetrating with a perforating device the inverted portion of the heart wall by extending a needle through the inverted portion of the heart wall to form a penetration.
Delivering a therapeutic device through the wall penetration
Delivering a device through a penetration in the inverted heart wall to perform the therapeutic intervention in the pericardial space of the heart.
Multi-procedure therapeutic intervention using pericardial access
In the therapeutic intervention, one or more of insufflating the pericardial space, monitoring pressure outside the heart, positioning an implant or instrument exterior to the heart, irrigating an exterior of the heart, suctioning bleeding, draining pericardial fluid, performing an epicardial biopsy, mapping a portion of the heart, and/or pacing the heart.
Across clm-00001 and clm-00013, the claims converge on a method that uses a catheter steered and anchored in the right atrium to invert the right atrial wall portion, thereby separating the exterior surface from parietal pericardial tissue. Penetration of the inverted wall portion provides access to the pericardial space, and a device is delivered through that penetration to perform the therapeutic intervention, with refinements covering anchoring-member types, inversion via retracting into a conically shaped distal end, and penetration with a needle, laser, or radio frequency energy delivery device.
Stated Advantages
Documented Applications
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