Method for intraluminally inducing cardioplegic arrest and catheter for use therein

Abstract

A process for inducing cardioplegic arrest of a heart in situ in a patients body. comprising maintaining the patient's systemic circulation by peripheral cardiopulmonary by-pass, occluding the ascending aorta through a percutaneously placed arterial balloon catheter, venting the left side of the heart, and introducing a cardioplegic agent into the coronary circulation. This procedure readies the heart for a variety of surgical procedures that can be performed percutaneously through lumina in the catheter. An aortic catheter for use in the process is also described.

What is claimed is:  
     
         1 . A method for inducing cardioplegic arrest of a heart in situ in a patient's body, comprising the steps of: 
 (a) maintaining systemic circulation with peripheral cardiopulmonary by-pass:    (b) occluding the ascending aorta through a percutaneously placed arterial balloon catheter;    (c) introducing a cardioplegic agent into the coronary circulation; and    (d) venting the left side of the heart.    
     
     
         2 . A method as claimed in  claim 1  in which the ascending aorta is occluded by a balloon catheter percutaneously placed through one of the femoral arteries.  
     
     
         3 . A method as claimed in  claim 2  in which the catheter has a lumen or lumina through which the cardioplegic agent or medical instruments and/or a cardioscope may be introduced into the heart and/or through which the left side of the heart is vented.  
     
     
         4 . A method as claimed in  claim 1  in which the systemic circulation is maintained through a cardiopulmonary by-pass that includes a percutaneous catheter introduced into the right atrium and/or into one or both of the vena cavae to draw venous blood into the cardiopulmonary by-pass.  
     
     
         5 . A method as claimed in  claim 4  in which the percutaneous catheter has two inflatable cuffs, each cuff being adapted to occlude one of the vena cavae and the percutaneous catheter having a lumen or lumenae to draw venous blood from each of the vena cavae into the cardiopulmonary by-pass.  
     
     
         6 . A method as claimed in  claim 5  in which saline is introduced into the right atrium through a lumen in the percutaneous catheter which opens between the two cuffs.  
     
     
         7 . A method as claimed in  claim 4  in which the percutaneous catheter is introduced into the heart through the femoral vein.  
     
     
         8 . A method as claimed in  claim 1  in which the systemic circulation is maintained through a cardiopulmonary by-pass that includes an oxygenated blood return catheter introduced into one of the femoral arteries.  
     
     
         9 . A balloon catheter for use in occluding the ascending aorta comprising an elongate tube having one or more continuous lumina along its length, an inflatable cuff disposed about the tube adjacent one end thereof, the cuff being of such a size that upon being inflated it is able to occlude the ascending aorta of a patient.  
     
     
         10 . A catheter as claimed in  claim 9  in which the inflatable cuff is of such a length that its occlusion of the ascending aorta will not impede blood flow to the coronary arteries onto the brachiocephalic, left carotid or left subclavian arteries.  
     
     
         11 . A catheter as claimed in  claim 9  in which the inflatable cuff is cylindrical when inflated and has a length of about 40 mm and a diameter of about 35 mm when inflated.  
     
     
         12 . A catheter as claimed in  claim 10  in which the catheter is of a length of about 900 mm.  
     
     
         13 . A catheter as claimed in  claim 9  in which the inflatable cuff is connected to the lumen of the catheter through which it is inflated at the end of the cuff distal to the adjacent end of the catheter.