Devices for accessing the pericardial space surrounding the heart

Abstract

Devices for accessing the pericardial space surrounding the heart. In at least one embodiment of a delivery catheter for use in accessing a pericardial space surrounding the external surface of a heart, the delivery catheter comprises comprising an elongated tube comprising a wall extending from a proximal end of the tube to a distal end of the tube, a first lumen, and a steering channel extending from a proximal end of the tube to a distal end of the tube, the steering channel forming an orifice at the distal end of the tube, and a steering wire system at least partially located in the steering channel, the steering wire system comprising at least two steering wires attached to the wall of the tube within the steering channel and a controller attached to a proximal end of each of the at least two steering wires, wherein the first lumen extends from approximately the proximal end of the tube to or near the distal end of the tube, the first lumen having a bend, relative to the tube, at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube.

1 . A delivery catheter for use in accessing a pericardial space surrounding the external surface of a heart, comprising:
 an elongated tube comprising a wall extending from a proximal end of the tube to a distal end of the tube, a first lumen, and a steering channel extending from a proximal end of the tube to a distal end of the tube, the steering channel forming an orifice at the distal end of the tube; and   a steering wire system at least partially located in the steering channel, the steering wire system comprising at least two steering wires attached to the wall of the tube within the steering channel and a controller attached to a proximal end of each of the at least two steering wires;   wherein the first lumen extends from approximately the proximal end of the tube to or near the distal end of the tube, the first lumen having a bend, relative to the tube, at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube.   
     
     
         2 . The delivery catheter of  claim 1 , wherein:
 the steering channel of the tube and the orifice of the tube are sized for insertion over an elongated guide wire such that the elongated guide wire is inserted through the orifice and into the steering channel.   
     
     
         3 . The delivery catheter of  claim 1 , further comprising:
 a pacing lead sized for delivery through the outlet of the first lumen.   
     
     
         4 . The delivery catheter of  claim 1 , wherein:
 the at least two steering wires comprise a first steering wire and a second steering wire; and   the controller of the steering wire system comprises a first handle attached to the proximal end of the first steering wire and a second handle attached to the proximal end of the second steering wire.   
     
     
         5 . The delivery catheter of  claim 1 , wherein:
 the at least two steering wires comprise a first steering wire and a second steering wire; and   the controller of the steering wire System comprises a torque system having a first rotatable spool capable of collecting and dispensing the first steering wire and a second rotatable spool capable of collecting and dispensing the second steering wire.   
     
     
         6 . The delivery catheter of  claim 5 , wherein:
 the first rotatable spool is attached to a first rotatable dial such that rotation of the first rotatable dial causes rotation of the first rotatable spool; and   the second rotatable spool is attached to a second rotatable dial such that rotation of the second rotatable dial causes rotation of the second rotatable spool.   
     
     
         7 . The delivery catheter of  claim 1 , wherein:
 each of the at least two steering wires is attached to the wall of the tube within the steering channel at the distal end of the tube.   
     
     
         8 . The delivery catheter of  claim 1 , wherein:
 the bend of the first lumen forms an angle that is approximately 90-degrees.   
     
     
         9 . The delivery catheter of  claim 8 , further comprising:
 a pacing lead having a tip, the pacing lead positioned at least partially within the first lumen.   
     
     
         10 . The delivery catheter of  claim 9 , wherein:
 the tip of the pacing lead has a substantially screw-like shape.   
     
     
         11 . The delivery catheter of  claim 10 , further comprising:
 a sensing lead positioned at least partially within the first lumen.   
     
     
         12 . The delivery catheter of  claim 9 , further comprising:
 a second lumen extending from approximately the proximal end of the tube to or near the distal end of the tube, the second lumen having a bend at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube.   
     
     
         13 . The delivery catheter of  claim 12 , wherein:
 the bend of the second lumen forms an angle that is approximately 90-degrees.   
     
     
         14 . The delivery catheter of  claim 13 , further comprising:
 a micro-camera system positioned at least partially within the second lumen.   
     
     
         15 . The delivery catheter of  claim 13 , further comprising:
 a laser Doppler tip positioned at least partially within the second lumen.   
     
     
         16 . The delivery catheter of  claim 5 , wherein:
 the tube further comprises a handle at or near the proximal end of the tube; and   the controller of the steering wire system is attached to the handle.   
     
     
         17 . A delivery catheter for use in accessing a pericardial space surrounding the external surface of a heart, comprising:
 an elongated tube comprising:
 a wall extending from a proximal end of the tube to a distal end of the tube, 
 a first lumen extending from approximately the proximal end of the tube to or near the distal end of the tube, the first lumen having a bend, relative to the tube, at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube, and 
 a steering channel extending from a proximal end of the tube to a distal end of the tube, the steering channel forming an orifice at the distal end of the tube; and 
   a steering wire system at least partially located in the steering channel, the steering wire system comprising:
 a first steering wire attached to the wall of the tube within the steering channel at the distal end of the tube, the attachment between the first steering wire and the wall forming a first attachment point, 
 a second steering wire attached to the wall of the tube within the steering channel at the distal end of the tube, the attachment between the second steering wire and the wall forming a second attachment point, 
 a third steering wire is attached to the wall of the tube within the steering channel at the distal end of the tube, the attachment between the third steering wire and the wall forming a third attachment point, wherein the third attachment point is closer to the proximal end of the tube than is the first attachment point or the second attachment point, and 
 a controller attached to a proximal end of each of the first steering wire, the second steering wire, and the third steering wire. 
   
     
     
         18 . A delivery catheter for use in accessing a pericardial space surrounding the external surface of a heart, comprising:
 an elongated tube comprising a wall extending from a proximal end of the tube to a distal end of the tube, a first lumen, and a second lumen;   wherein the first lumen extends from approximately the proximal end of the tube to or near the distal end of the tube, the first lumen having a bend, relative to the tube, at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube; and   wherein the second lumen extends from approximately the proximal end of the tube to or near the distal end of the tube, the second lumen having a bend, relative to the tube, at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube.   
     
     
         19 . The catheter of  claim 18 , wherein:
 the bend of the first lumen forms an angle that is approximately 90-degrees.   
     
     
         20 . The catheter of  claim 19 , wherein:
 the bend of the second lumen forms an angle that is approximately 90-degrees.   
     
     
         21 . The catheter of  claim 18 , further comprising:
 a laser Doppler tip positioned at least partially within the second lumen.   
     
     
         22 . The catheter of  claim 21 , further comprising:
 a needle positioned at least partially within the first lumen.