Peripheral cardiopulmonary bypass and coronary reperfusion system

An extracorporeal bypass apparatus, comprising:

• a venous catheter for insertion into a femoral vein, such catheter being sufficiently long and flexible to reach the atrium area of a patent's heart;
• an arterial cannula;
• a single pump connected between the venous catheter and the arterial cannula for withdrawing blood from a patient through said venous catheter and pumping it into a patient through the arterial cannula;
• and
• a vent catheter for insertion into an artery sufficiently long and flexible to reach the left ventricle of the heart, said vent catheter being connected in parallel with the venous catheter connected to the pump in a manner such that the negative pressure developed by said pump is applied to the venous catheter and the vent catheter;
• said venous catheter and said pump being constructed such that substantially all of the patient's blood which would normally be returned to the heart is bypassed through the venous catheter, and the blood reaching the left ventricle of the heart is withdrawn through the vent catheter so that the ventricle is decompressed;
• said vent catheter including a plurality of apertures in the side wall of its distal end, and said vent catheter including a pressure lumen extending from the proximal end of the vent catheter to an inlet adjacent said apertures, the apertures being between the tip of the vent catheter and the inlet to the pressure lumen.

An extracorporeal bypass apparatus, comprising:

• a venous catheter for insertion into a femoral vein, such catheter being sufficiently long and flexible to reach the atrium area of a patent's heart;
• an arterial cannula;
• a single pump connected between the venous catheter and the arterial cannula for withdrawing blood from a patient through said venous catheter and pumping it into a patient through the arterial cannula;
• and
• a vent catheter for insertion into an artery sufficiently long and flexible to reach the left ventricle of the heart, said vent catheter being connected in parallel with the venous catheter connected to the pump in a manner such that the negative pressure developed by said pump is applied to the venous catheter and the vent catheter,
• said venous catheter and said pump being constructed such that substantially all of the patient's blood which would normally be returned to the heart is bypassed through the venous catheter, and the blood reaching the left ventricle of the heart is withdrawn through the vent catheter so that the ventricle is decompressed;
• said vent catheter having a flexible coiled distal end which presents an exterior curved surface to the aortic valve when the tip of the vent catheter is to be inserted into the ventricle, and said coiled end being adapted to fit totally within the ventricle.

An extracorporeal bypass apparatus, comprising:

• a venous catheter for insertion into a femoral vein, such catheter being sufficiently long and flexible to reach the atrium area of a patent's heart;
• an arterial cannula;
• a single pump connected between the venous catheter and the arterial cannula for withdrawing blood from a patient through said venous catheter and pumping it into a patient through the arterial cannula;
• a vent catheter for insertion into an artery sufficiently long and flexible to reach the left ventricle of the heart, said vent catheter being connected in parallel with the venous catheter connected to the pump in a manner such that the negative pressure developed by said pump is applied to the venous catheter and the vent catheter,
• said venous catheter and said pump being constructed such that substantially all of the patient's blood which would normally be returned to the heart is bypassed through the venous catheter, and the blood reaching the left ventricle of the heart is withdrawn through the vent catheter so that the ventricle is decompressed;
• and
• a reservoir having an inlet in communication with the output of said pump and having an outlet in communication with the connection between said venous cannula and said pump, and including means for adjusting the flow of liquid into and out of said reservoir.

An extracorporeal bypass apparatus, comprising:

• a venous catheter for insertion into a femoral vein, such catheter being sufficiently long and flexible to reach the atrium area of a patent's heart;
• an arterial cannula;
• a single pump connected between the venous catheter and the arterial cannula for withdrawing blood from a patient through said venous catheter and pumping it into a patient through the arterial cannula;
• a vent catheter for insertion into an artery sufficiently long and flexible to reach the left ventricle of the heart, said vent catheter being connected in parallel with the venous catheter connected to the pump in a manner such that the negative pressure developed by said pump is applied to the venous catheter and the vent catheter,
• said venous catheter and said pump being constructed such that substantially all of the patient's blood which would normally be returned to the heart is bypassed through the venous catheter, and the blood reaching the left ventricle of the heart is withdrawn through the vent catheter so that the ventricle is decompressed;
• and
• a blood cardioplegia delivery system, comprising:
• a cardioplegia delivery pump having an inlet connected to the output of said arterial pump;
• a source of cardioplegic liquid connected as an input to said cardioplegia pump;
• and
• a coronary reperfusion catheter assembly including a catheter connected to the output of said cardioplegia pump, the coronary reperfusion catheter being sufficiently long and flexible to be adapted to be inserted through a patient's artery to reach an area of the heart that has been deprived of blood so that a cardioplegia solution can be applied to that area before resuming normal blood flow.

An extracorporeal bypass apparatus, comprising:

• a venous catheter for insertion into a femoral vein, such catheter being sufficiently long and flexible to reach the atrium area of a patent's heart;
• an arterial cannula;
• a single pump connected between the venous catheter and the arterial cannula for withdrawing blood from a patient through said venous catheter and pumping it into a patient through the arterial cannula;
• a vent catheter for insertion into an artery sufficiently long and flexible to reach the left ventricle of the heart, said vent catheter being connected in parallel with the venous catheter connected to the pump in a manner such that the negative pressure developed by said pump is applied to the venous catheter and the vent catheter,
• said venous catheter and said pump being constructed such that substantially all of the patient's blood which would normally be returned to the heart is bypassed through the venous catheter, and the blood reaching the left ventricle of the heart is withdrawn through the vent catheter so that the ventricle is decompressed;
• and
• said arterial cannula comprising an elongated tube having a tip section adapted to be inserted into the femoral artery, said tube having a shoulder adjacent to said tip section adapted to engage the exterior of the artery to limit insertion of the tip section into the artery and to form a seal at the exterior of the artery.

An extracorporeal bypass apparatus, comprising:

• a venous catheter for insertion into a femoral vein, such catheter being sufficiently long and flexible to reach the atrium area of a patent's heart;
• an arterial cannula;
• a single pump connected between the venous catheter and the arterial cannula for withdrawing blood from a patient through said venous catheter and pumping it into a patient through the arterial cannula;
• a vent catheter for insertion into an artery sufficiently long and flexible to reach the left ventricle of the heart, said vent catheter being connected in parallel with the venous catheter connected to the pump in a manner such that the negative pressure developed by said pump is applied to the venous catheter and the vent catheter,
• said venous catheter and said pump being constructed such that substantially all of the patient's blood which would normally be returned to the heart is bypassed through the venous catheter, and the blood reaching the left ventricle of the heart is withdrawn through the vent catheter so that the ventricle is decompressed;
• and
• a stylet slidably positioned in the cannula and a removable seal extending between the interior of the cannula and the stylet so that, if the tip of the cannula is in the artery, the seal prevents liquid flow out of the cannula.

An extracorporeal bypass system, comprising:

• a venous catheter for insertion into a femoral vein, such catheter being sufficiently long and flexible to reach the right atrium area of a patent's heart;
• an arterial cannula;
• a pump connected between the venous catheter and the arterial cannula for withdrawing blood from a patient through said venous catheter and pumping it into a patient through the arterial cannula;
• and
• a bridging, non-dynamic reservoir having an inlet connected to the output of said pump in an outlet connected to the inlet of said pump;
• whereby said reservoir is connected in parallel with said pump so that blood may be pumped directly from the pump to said arterial cannula without passing through said reservoir and so that said reservoir inlet and outlet can be opened or closed to permit flow into or out of said reservoir.

A percutaneous cardiopulmonary bypass apparatus, comprising:

• a venous catheter for insertion into a femoral vein;
• an arterial cannula for insertion into an artery;
• an oxygenator;
• a pump connected between the venous catheter and the oxygenator for withdrawing blood from a patient through said venous catheter and pumping it through the oxygenator and the arterial cannula into a patient, said catheter being sufficiently long and flexible to reach the atrium area of a patient's heart, said catheter having an interior diameter large enough to permit blood flow of 7 liters per minute with a negative pressure provided by said pump being no greater than 200 mm Hg, and said catheter being thin-walled, but nonkinkable with normal handling,
• said catheter having a plurality of holes in its side wall extending from the distal end of the tip far enough to not only draw blood from the atrium area of the heart, but to also draw blood from the portion of the vein draining in the lower portion of the body.

A percutaneous cardiopulmonary bypass apparatus, comprising:

• a venous catheter for insertion into a femoral vein;
• an arterial cannula for insertion into an artery;
• an oxygenator;
• a pump connected between the venous catheter and the oxygenator for withdrawing blood from a patient through said venous catheter and pumping it through the oxygenator and the arterial cannula into a patient, said catheter being sufficiently long and flexible to reach the atrium area of a patient's heart, said catheter having an interior diameter large enough to permit blood flow of 7 liters per minute with a negative pressure provided by said pump being no greater than 200 mm Hg, and said catheter being thin-walled, but nonkinkable with normal handling;
• and
• said catheter being in the form of two venous catheters one for insertion in a femoral vein and the other for insertion in a second femoral vein, and said two catheters combined permit blood flow up to approximately 7 liters per minute with a negative pressure of no greater than approximately 200 mm Hg.

A method for providing a peripheral cardiopulmonary bypass system, comprising:

• inserting a venous catheter into a femoral vein with the tip of the catheter extending to the right atrium area of a patient's heart;
• inserting an arterial cannula into a femoral artery;
• inserting a vent catheter into a femoral artery with the tip of the vent catheter extending to the left ventricle of the heart;
• connecting the two catheters to the input side of a single heart bypass pump and connecting the output of the pump to the arterial cannula;
• pumping substantially all of the patient's venous return blood out of the patient and back into the patient through the femoral artery while withdrawing blood through the vent catheter so as to maintain the ventricle in a decompressed condition;
• and
• monitoring the negative pressure developed by said pumps so as to maintain the negative pressure with no greater than 200 ml of mercury.

A method for providing a peripheral cardiopulmonary bypass system, comprising:

• inserting a venous catheter into a femoral vein with the tip of the catheter extending to the right atrium area of a patient's heart;
• inserting an arterial cannula into a femoral artery;
• inserting a vent catheter into a femoral artery with the tip of the vent catheter extending to the left ventricle of the heart;
• connecting the two catheters to the input side of a single heart bypass pump and connecting the output of the pump to the arterial cannula;
• pumping substantially all of the patient's venous return blood out of the patient and back into the patient through the femoral artery while withdrawing blood through the vent catheter so as to maintain the ventricle in a decompressed condition;
• and
• monitoring the speed of said pump so as to provide a flow in the system of up to 7 liters per minute.

A method for providing a cardiopulmonary bypass system, comprising:

• inserting a venous catheter into a femoral vein with the tip of the catheter extending to the right atrium area of a patient's heart;
• inserting an arterial cannula into a femoral artery;
• pumping blood from the venous catheter through a blood oxygenator to the arterial cannula;
• connecting a bridging reservoir in parallel to the pumping means with an inlet to the reservoir being connected to the outlet of the pumping means and with an outlet of the reservoir connected to the inlet of the pump;
• and
• selectively opening and closing the reservoir inlet and outlet to add or withdraw liquid from the system as needed.

A method for providing a cardiopulmonary bypass system, comprising:

• inserting an arterial cannula into a femoral artery;
• inserting a vent catheter into a femoral artery with the tip of the vent catheter extending to the left ventricle of the heart;
• pumping blood from the vent catheter to the arterial cannula;
• and
• connecting a reservoir in parallel to the pumping means with an inlet to the reservoir being connected to the outlet of the pumping means and with an outlet of the reservoir connected to the inlet of the pump.

An extracorporeal heart bypass apparatus comprising:

• a venous catheter;
• a positive displacement pump connected to apply negative pressure to said catheter to withdraw blood from a patient;
• a compliance chamber connected between said pump and said catheter to reduce the rate of change of negative pressure applied by said pump on said catheter, said chamber comprising the space between an expandable reservoir connected between said pump and said catheter, and a closed housing surrounding said reservoir whereby the pressure in the chamber is related to the pressure in the reservoir;
• and
• a controller to control the speed of said pump, said controller being responsive to the pressure in said space so as to decrease pump speed with an increase in negative pressure in the compliance chamber.

A method of controlling negative pressure changes to a patient's venous blood supply in withdrawing blood from a patient in connection with a cardiopulmonary bypass system, comprising:

• inserting a venous catheter into a patient's vein;
• operating a positive displacement pump to apply a negative pressure to said catheter;
• reducing the rate at which negative pressure on said catheter can be changed by said pump so as to keep the negative pressure at a safe level and prevent the nucleation of gas in the blood;
• sensing said negative pressure;
• changing pump speed in response to sensed pressure changes;
• said reducing step including applying the negative pressure of said pump to an expandable reservoir positioned in a conduit between said catheter and said pump, with a housing surrounding the reservoir creating a chamber responsive to changes of said pressures, the volume of blood in said reservoir being reduced upon increases in negative pressure, thereby reducing the rate at which negative pressure can be increased;
• and
• said sensing step including sensing the pressure in the chamber between said reservoir and said housing and utilizing the sensed pressure to a said controller to decrease the speed of said pump in response to increases in the negative pressure in said chamber.