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WO2011119060A2 - Ensemble manuel pour réanimation en cas d'arrêt cardio-circulatoire - Google Patents

Ensemble manuel pour réanimation en cas d'arrêt cardio-circulatoire Download PDF

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Publication number
WO2011119060A2
WO2011119060A2 PCT/RS2011/000003 RS2011000003W WO2011119060A2 WO 2011119060 A2 WO2011119060 A2 WO 2011119060A2 RS 2011000003 W RS2011000003 W RS 2011000003W WO 2011119060 A2 WO2011119060 A2 WO 2011119060A2
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WO
WIPO (PCT)
Prior art keywords
cannula
syringe
assembly
heart
wall
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/RS2011/000003
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English (en)
Other versions
WO2011119060A3 (fr
Inventor
Uros Babic
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Individual
Original Assignee
Individual
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Filing date
Publication date
Priority claimed from RS20100326A external-priority patent/RS20100326A2/sr
Application filed by Individual filed Critical Individual
Publication of WO2011119060A2 publication Critical patent/WO2011119060A2/fr
Publication of WO2011119060A3 publication Critical patent/WO2011119060A3/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A61M25/1002—Balloon catheters characterised by balloon shape
    • 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
    • A61M60/497—Details relating to driving for balloon pumps for circulatory assistance
    • 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
    • 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
    • A61M60/104—Extracorporeal pumps, i.e. the blood being pumped outside the patient's body
    • A61M60/117—Extracorporeal pumps, i.e. the blood being pumped outside the patient's body for assisting the heart, e.g. transcutaneous or external ventricular 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
    • 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
    • A61M60/135—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 inside a blood vessel, e.g. using grafting
    • 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
    • A61M60/258—Piston 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
    • A61M60/20—Type thereof
    • A61M60/295—Balloon pumps for circulatory assistance
    • 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
    • A61M60/424—Details relating to driving for positive displacement blood pumps
    • A61M60/438—Details relating to driving for positive displacement blood pumps the force acting on the blood contacting member being mechanical
    • 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
    • A61M60/845—Constructional details other than related to driving of extracorporeal blood 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A61M25/1011—Multiple balloon catheters
    • A61M2025/1013—Multiple balloon catheters with concentrically mounted balloons, e.g. being independently inflatable

Definitions

  • the invention belongs to broad field of urgent and intensive medicine and relates to system for providing of effective perfusion of vital organs during cardio-circulatory arrest in an in-hospital and in out- of- hospital environment.
  • MKP-EPC international patent classification
  • the specification is A61M1/10 (2011.01).
  • Acute cardio- circulatory arrest is the most frequent cause of sudden death.
  • Emergency treatment includes artificial ventilation and external cardiac massage with chest compressions. Treatment of cardio-circulatory arrest has not changed since 50 years. Electrical cardiac instability is effectively treated with defibrillations while pulmonary function is replaced by mechanical ventilation after placement of tracheal tube.
  • FIG. 5,399,148 to Waide (1995) shows an external cardiac massage device comprising a pressure source and depressor means for adjustable cardiac compression.
  • Numerous versions of apparatus for internal cardiac massage also emerged: W.O. Pat. No. 94/03228 to Zadini (1994) shows an apparatus comprising an expandable member placed inside the chest adjacent the heart whereby during inflation of the expandable member the heart is compressed between the thoracic spine and the member itself; W.O Pat. No. 98/05289 to Fogarty (1998) shows a minimal invasive direct cardiac massage device comprising an inflatable bladder introduced through the intercostals space and placed between the sternum and the heart.
  • US7494477 to Rakhorst (2009) shows a pulsatile catheter that is introduced through the aorta retrograde across the aortic valve and placed into the left ventricle. The blood is drained from the left ventricle and pumped back into the aorta through the same catheter.
  • the pulsatile 25Fr catheter with an unidirectional valve situated inside the catheter lumen between distal opening within the left ventricle and side-opening situated in the aorta, and the extracorporeal displacement chamber with a volume of 60 ml provides a flow of up to 2.9 lit/min.
  • Intraaortic balloon pump is useful only as a support to failing heart, it is not useful during cardiac arrest.
  • Hemopump TM turbine pump placed on the tip of the access cannula introduced through a groin artery retrograde into the left ventricle wherefrom it transports the blood to aorta. This system is aimed at supporting a failing heart although sporadically it has been used during cardiac arrest too. For its placement a fluoroscopy is needed, vascular access is a problem, pumping blood volume capacity is low and it produces aortic pressure of up to 50 mmHg.
  • the percutaneous left ventricular assist device "Tandem Heart” is a left atrial to femoral artery bypass having a 21Fr left atrial cannula for withdrawing of the oxygenated blood from left atrium which is then injected by means of a centrifugal pump into the femoral artery establishing the bypass.
  • This system provides a flow of up to 4 L/min. Also this system is aimed at assisting a failing ventricle and not for replacing an arrested pumping function.
  • Cardio-pulmonary support system comprising access cannula for accessing large central systemic veins wherefrom the blood is withdrawn into a console with oxygenators ( apparatus which replaces the lung) after which the blood is pumped back into the aorta through the cannula placed through a groin artery.
  • a miniaturized mobile version of cardio-pulmonary support is available (Arlt M, et al. First experience with a new miniaturized life support system for mobile percutaneous cardiopulmonary bypass. Resuscitation 2008; 77: 345— 350). This system is expensive, complex, and requires a specialized trained team for its utilization.
  • cardio-pulmonary systems are large blood volume pumping capacity of up to 6 Lit/min. Disadvantages of this system are: the lung and the left heart remain without circulation; they are not decompressed; often blood transfusions are needed; for installation of this system a well trained team is needed and time needed for its implementation, which time is not available in urgent situations during cardiac arrest. All described systems for percutaneous mechanical circulation require access through the large veins and/ or arteries.
  • a heart chamber is filled with blood and it has larger volume than any groin artery or vein and thus it can be easier punctured especially during cardiac arrest.
  • Percutaneous transthoracic puncture of the left ventricle has been utilized for diagnostic purposes in patients with implanted metallic heart valves in aortic and mitral position. Complication rates were acceptable (Walters DL . et al. Catheter Cardiovascular Interv 2003; 58:539- 44: Transthoracic left ventricular puncture for assessment of patients with aortic and mitral valve prosthesis : Massachusetts General hospital experience 1989-2000).
  • Percutaneous transthoracic access has been used recently for catheter based procedures like closure of paravalvular leaks (Webb J, The shortest Way to the Heart.
  • this apparatus needs a large diameter of the single entry site and a safety regulation adjusted to available blood volume. Also this system for assisting a heart is complex for an emergency need during a cardiac arrest.
  • transthoracic cannula is equipped with penetration needle and with two axially spaced balloons for stabilization and sealing purposes; this resuscitation transthoracic cannula is aimed at providing electrical support to an arrested heart as well as at providing an application of needed medication during resuscitation. This system however provides no circulatory support.
  • the blood volume added with this system during ventricular native contraction is small - about 30 ml per systole.
  • This system is not suitable for replacement of heart pump function during a cardiac arrest.
  • a system, method, device that could enable an effective perfusion of vital structures (brain and heart muscle) during cardiac arrest.
  • Such a device should have following characteristics: it should be implementable within a short period of time (e.g. within 3 minutes); it should be applicable at any place were a victim could be located; it should be of small size in order to fit into a first aid case and thus affordable to any emergency first aid medicine professionals in hospital as well as in out of hospital environment.
  • the aim of this invention is to provide a system of rapid establishment of circulatory flow during a cardio-circulatory arrest in an in- hospital and in an out -of- hospital environment, a system simple to use and less expensive in order to be affordable to majority of professionals involved in resuscitation activities.
  • a device system for invasive resuscitation of arrested circulation includes a large bore cannula for accessing an arrested cardiac chamber and a large volume syringe attached to a frame.
  • the syringe includes a mechanism for power facilitated manual driving.
  • the access cannula includes means for introduction by over the wire introducing technique.
  • the cannula is equipped with two balloons for sealing and stable anchorage within the intracorporeal passageway.
  • the large volume syringe and access cannula are interconnected by a large bore 3-way stopcock.
  • the cannula is connected to the syringe and the oxygenated blood is manually aspirated from the left ventricle and from the left atrium and rapidly injected back through the same cannula into the left ventricle.
  • the system utilizes the naturally existing two unidirectional check valves within the arrested left heart: mitral inflow check valve, and aortic outflow check valve.
  • Aspiration volume left ventricular volume + left atrial volume.
  • Injecting stroke volume total injecting volume - volume capacity of the arrested left ventricle.
  • a left atrial volume of 80 ml a left ventricular volume of 100 ml the maximal aspirating volume would be 180 ml.
  • an injecting volume of 180 ml by known left ventricular volume capacity of 100 ml the injecting stroke volume would be 80 ml.
  • FIG.1 A shows the syringe pump assembly with double handed driving connected to transthoracic cannula.
  • FIG. IB shows the large syringe of the double handed device.
  • FIG.1C shows the frame into which large syringe is placed during use.
  • FIG.2A is a perspective view of the transthoracic access cannula assembly with balloons deflated and with introducer dilator with guiding wire ready for introduction.
  • FIG.2B is a perspective view of the transthoracic access cannula with inflated balloons.
  • FIG.2C is a perspective close view of distal end of transthoracic cannula with inflated balloons.
  • FIG.2D is a perspective view of the access cannula placed across an introduction splittable introducer sheath.
  • FIG.3A is a perspective view of the device in place during aspiration.
  • FIG.3B is a perspective view of the device in place during injection.
  • FIG.4A shows a transvascular cannula assembly with introducing dilator and pigtail catheter with guiding wire.
  • FIG.4B shows transvascular cannula without introducers.
  • FIG.4C shows transvascular cannula with introducers in place.
  • FIG.5A shows double handed manual device with transtvascular cannula
  • FIG.5B shows the double handed system with transvascular cannula in place introduced through axillary/subclavian artery.
  • FIG.5C shows the system with transvascular cannula in place introduced through a groin artery.
  • FIG.6A shows the syringe pump with lever driving mechanism in aspiration position.
  • FIG.6B shows the pump with lever driving mechanism in injection position.
  • FIG.6C shows the frame used for device with lever driving
  • FIG.6D shows the syringe with fasteners used for device with lever driving.
  • FIG.6E shows syringe pump assembly with lever driving.
  • FIG.7A shows the device with lever driving pump assembly connected to transthoracic cannula
  • FIG.7B shows the device with lever driving and with an added infusor utilized by an aid for resuscitation of a victim.
  • FIG.8A shows double syringe pump assembly with lever driving and with transthoracic cannulas.
  • FIG.8B shows double syringe pump assembly with lever driving and with access cannulas in place.
  • FIG.9A shows double syringe pump assembly connected to double transvascular cannulas.
  • FIG.9B shows double syringe pump assembly connected to double transvascular cannulas introduced into right and left ventricle through subclavian vein and axillary- subclavian artery respectively.
  • FIG.9C shows double syringe pump assembly connected to double transvascular cannulas introduced into right and left ventricle through the left and right groin vein respectively.
  • FIG.9D shows double syringe pump assembly connected to double transvascular cannulas introduced into right and left ventricle through groin vein and groin artery respectively.
  • FIG.1 OA shows double syringe pump assembly connected to transvascular cannula and transthoracic cannula.
  • FIG.1 OB shows double syringe pump assembly connected to transvascular cannula and transthoracic cannula introduced into right and left ventricle through subclavian vein and through left ventricular apex respectively.
  • FIG.11 shows an additional embodiment with manual and alternatively with motorized actuation.
  • vent tube for air removal 35 212 larger (outer) compliant balloon 10
  • piston 214 port for inflation and deflation
  • IVS interventricular septum 35 STERNOTOMY refers to
  • RA right atrium refers
  • RV right ventricle 40 to wall between right and left heart
  • TRANS THORACIC refers to an access ECMO refers to extracorporeal directly through the chest wall and membrane oxygenator- chest cavity apparatus for oxygenation of blood
  • TRANSVASCULAR refers to an access 45 outside body
  • SELDINGER technique refers to PROXIMAL refers to a location close to introducing a catheter- like items over the operator or actuator the wire into a blood vessels or into a
  • DISTAL refers to a location remote from hollow organ without surgically created the operator or actuator 50 entry site
  • EXTRACORPOREAL refers to location
  • Fig.lA shows the manual device with double handed driving for cardio circulatory resuscitation in accordance with described embodiment that has syringe pump assembly 100' and transthoracic cannula 200.
  • the device may have a total weight of less than 3kg.
  • Fig. IB shows the large volume syringe 140' that has a piston 142' and a plunger 144' with a grip 124' for double handed power actuation. Syringe 140' continues distal as a tubing length 148' that ends with a connector 150'.
  • Syringe 140' is made of medical polymer while its distal part tubing length 148' is made of polyvinyl chloride.
  • Stopper 109' has two holes 127' for accepting the fasteners 103' of the frame cylinder 129'.
  • Frame cylinder 129' has top entrance 102' for syringe, side hole 128' for exit of distal syringe part.
  • Frame 129 may be made of transparent firm plastic.
  • Pump assembly 100' can be provided as a sterile compact unit ready for use so that no time is needed to set up.
  • Figs. 2A-C show the transthoracic cannula assembly.
  • the shaft of the large bore cannula 200 has a braided part 202, a braided part with a thicker wall 204, and a proximal non braided part which is a tubing length integrated into cannula shaft 206.
  • Cannula 200 may be of different sizes for pediatrics and adults e.g. 2- 8 mm inner lumen, (6 - 24 Fr).
  • Part 204 has a thickened shaft wall for accommodating the channels for inflation/ deflation of balloons.
  • a 3-way large bore stopcock 208 is incorporated into the proximal end of the tubing length 206.
  • Stopcock 208 has the same large tubular lumen as the cannula 200 in order not to reduce the flow capacity of the cannula and in order to allow the passage of the introducing large dilator 230 during introduction.
  • Cannula 200 has a distal end opening 210 and side holes 211 allowing high flow.
  • the inner surface of cannula 200 and the stopcock 208 have an antithrombotic Heparin coating. Close to the distal end of cannula a non compliant smaller balloon 218 is incorporated into the external part of the shaft wall. There is a port 220 for inflation and deflation of the balloon through the
  • Balloon 218 can be made of medical polymer like non- compliant polyurethane.
  • the balloon size and shape is appropriate so as to preventing the cannula to be expelled out of the cardiac chamber during vigorous injection.
  • Its proximal aspect 219 is expanded in a direction vertical to the shaft long axis which should prevent a sliding of the balloon back across the entry site.
  • Balloon 212 is made of compliant polymer like compliant membrane of polyurethane, it is inflated and deflated trough the channel 216 by a syringe 215 and through the port 214. Balloon 212 exerts a low pressure making a waist within the passageway through the heart chamber wall and through the chest wall, it expands distally within the cavity of heart chamber and proximally out of body in front of the entry site through the chest wall. Balloon 212 covers the whole intracorporeal passageway of the access cannula providing a sealing. Balloons 218 and 212 together provide a stable anchorage of the cannula.
  • the cannula is introduced directly through the chest wall together with a large dilator 230 over a guiding wire 240.
  • the inner lumen of dilator 230 accepts the guiding wire, there is a proximal port for guiding wire entrance 235 and a distal port 233 for exit of wire 240, dilator 230 has a tapered distal end 232 for easier passage through the chest- and heart wall.
  • Fig. 2D shows cannula introduction through a splittable introducing sheath 250 having distal end 252 and proximal two arms 254 and 255 for splitting and removal after inserting the cannula.
  • the splittable sheath is introduced together with cannula 200 and dilator 230 over the wire 240.
  • Cannula 200 can then be introduced through the splittable sheath 250 after which the sheath 250 can be removed by splitting it lengthwise.
  • This alternative way of introduction may protect the balloons during introduction however it might be more time consuming.
  • Fig.3A shows the device assembly with double handed driving in place during an aspiration phase.
  • An aid actuates the pump assembly with both hands and immobilizing it by foot.
  • the inflow check mitral valve is open allowing the blood drainage from the whole left heart and possible even from the pulmonary veins.
  • the aortic valve is closed due to negative aspiration pressure.
  • the large compliant balloon seals the whole intracorporeal passage way of the access cannula, while the small noncompliant balloon inside the left ventricle provides safety against rearward dislodgement.
  • the left ventricular cavity is reduced.
  • the right ventricular cavity is enlarged due to leftwards movement of interventricular septum, the tricuspid valve between the right atrium and the right ventricle is open.
  • Fig. 3B shows the device assembly in place during an injection phase.
  • the mitral inflow check valve is closed due to increased left ventricular pressure
  • the outflow aortic check valve is open due to increased pressure in front of the valve and the surplus of the injected blood volume is expelled into the aorta.
  • the left ventricular cavity is
  • FIGs. 3 A and B illustrate the effects of the device utilization: the mechanical pump function of the left heart is regulated by hydraulically transmitted energy created by power manual driving of the syringe pump 100'.
  • the heart wall expands and contracts while the heart valves open and close in accordance with pressure and volume changes within the arrested chamber.
  • the right ventricular cavity changes also in accordance with significant movement of interventricular septum.
  • the device in accordance with described embodiment can be used as an alternative to prolonged chest compression or as a last resort measure after failure of traditional resuscitation attempts. If a professional aid has exhausted all available measures to restore spontaneous circulation in a victim, this device assembly should be used:
  • the smaller non compliant balloon 218 is inflated by fluid injection through the channel 222 and the cannula is retracted back over the dilator 230 until a resistance is felt which indicates that balloon 218 is contacting the inner wall of the heart chamber (this will indicate the appropriate good placement of the cannula) ; dilator 230 is removed together with guide wire 240; the stopcock 208 is closed; then the larger outer compliant balloon 214 is inflated by injecting fluid through the channel 216 this will provide sealing and stabilization of the cannula within the intracoerporeal passageway ; the syringe pump assembly 100' is connected to the access cannula 200 by the stopcock 208; stopcock 208 is opened and the pump assembly is actuated double handed by pulling the plunger 144' upwards
  • stopcock 208 which provides aspiration of the oxygenated blood from the left ventricle and from the left atrium and even from pulmonary veins; next stopcock 208 is closed and directed to enable removal of air bubbles if any existing; stopcock 208 is directed to free the flow from the syringe 140' into the access cannula 200; the aspirated blood volume is vigorously injected back through the cannula 200 into the left ventricle (Fig. 3B);
  • the system is immobilized by holding the foot on the pedal during operation.
  • the manual driving enables blood withdrawal adjusted to the available blood volume within the left heart avoiding tubing collapse and or aspiration of surrounding tissue and/or aspiration of extracorporeal air alongside the passageway of the access cannula.
  • the right heart functions like a passive conduit having to unidirectional valves which will be open when the central venous pressure is higher than the pressure within lung vessels, as in Fontan's circulation (The "Fontan's circulation” refers to the configuration where the single ventricle pumps blood returning from the lungs to the body, and the blood returning from the body travels to the lungs by direct blood vessel connections without a pumping chamber).
  • the access cannula can be introduced with a splittable introducing sheath 250 (Fig.2D).
  • the splittable sheath together with cannula 200 and dilator 230 is introduced over the wire 240.
  • Sheath 250 is removed by splitting it lengthwise leaving the cannula in place and the procedure proceeded as described.
  • Figs. 4A-C show a transvascular cannula assembly for introduction through the wall of a blood vessel.
  • Transvascular cannula 300 with a lumen large enough to enable adequately high flow, has a longer braided part 302, a shorter proximal non braided part 304, distal end opening 306, side holes 308, large bore 3-way connector 328 is integrated into proximal end of proximal part of transvascular cannula 304.
  • Cannula assembly includes an introducing dilator 310 with tapered tip 312 with a proximal end 314 that has a proximal port for pigtail catheter 316, and a distal port for pigtail catheter 318 through which a pigtail catheter 320 can pass.
  • the pigtail catheter 320 has a distal tapered end 322 and a proximal end with port 324 for a long guiding wire 326.
  • Fig.5 A shows the device in accordance with described alternative embodiment that has a syringe pump assembly 100' connected to transvascular cannula 300. Operation (Fig. 5B)
  • Puncture of subclavian/axillary artery with a vascular needle advancement of the long guiding wire 326 through the needle, removal of the needle; advancement of the transthoracic cannula assembly with pigtail catheter 320, and dilator 310 over the wire, retrograde through the aortic valve until the cannula is situated within the left ventricle; removal of wire 326 and removal of introducing dilator 310 with pigtail catheter 320, and connection of the cannula 300 to pump syringe assembly 100'; manual actuation of the system as described before.
  • FIG. 5C shows described alternative embodiment in place utilizing an installation through a groin artery.
  • Figs. 6 show a syringe pump assembly with lever mechanism 100 constructed in accordance with one embodiment.
  • a large volume syringe 140 having a plunger 144 with piston 142 is attached onto the top plate 102 of frame.
  • Syringe 140 is made of firm medical polymer.
  • the inside surface of the syringe can be covered with a substance against clotting (heparin coating).
  • Syringe 140 has a large volume capacity (e.g. more than 200 ml) that significantly exceeds the volume capacity of an arrested heart chamber.
  • the frame consists of top plate 102, base 106, a vertical part 104 and beveled part 108. There is a flange 110 on the frame (Fig.6A).
  • a lever 122 includes two spaced legs 120 and 121 interconnected by bridge 123 (Fig. 6E). Legs 120 and 121 are attached by pivot pin 112 to the flange 110 (Fig .6A). Pivot attachment enables forward and rearward movement of the lever.
  • Lever 122 has a grip 124 at the top. The longer part of lever 122 with grip 124 may be removable form the legs 120 and 121 by bolt on lever 122b which is connected to nut 123n inside bridge 123 (Fig.6C).
  • the tubing length 148 is integral part of distal end of syringe. Tubing length 148 is made of polyvinyl-chloride and has the inner surface coated with heparin.
  • tubing to cannula connector 150 there is tubing to cannula connector 150 on the distal end of the tubing.
  • Pivot attachment 132 enables low amplitude vertical movement of legs 130 while maintaining the plunger 144 in a stable position during horizontal movement.
  • There is a bolt 144b on proximal end of plunger 144 (Fig.6D).
  • the bolt 144b fits into the nut 138n within the plunger holder 138 (Fig.6C).
  • the plunger 144 is connected to the plunger holder 138 by bolt 144b to nut 138n connection.
  • a small tubing is incorporated into upper distal part of syringe.
  • This vent tube for air removal 141 arises from the opening 145 at the top of syringe 140.
  • Tube 141 has a small 3 -way stopcock 143 for air vent tube at its distal end.
  • Tube 141 enables removal of possible air bubbles from the syringe.
  • Distal arcuate fastener 103 is fixed to top plate 102. There are 2 holes 105h on arcuate fastener 103 (Fig.6C).
  • Fig. 6D shows syringe 140 with muff 147 and with removable arcuate fastenerl07.
  • Muff 147 is fixed integral part of syringe 140 and is made of transparent plastic.
  • Removable arcuate fastener 107 is placed over the proximal syringe part until it contacts muff 147.
  • Two rods 105 extent form fastener 107.
  • Syringe 140 as seen in Fig 6D is placed onto the top plate 102, the tubing length with distal part of syringe is pushed through the arcuate fixed fastener 103 (Fig.6C). Rods 105 are pushed through the holes 105h and the syringe is fastened by bolt on the rod 105 to screw 105s connection. Proximal part of Plunger 144 is situated into plunger holder 138 and fastened by bolt 144b to nut 138n connection. Detached part of lever is fastened by bolt 122b to nut 123 connection and the syringe pump assembly 100 with lever driving is completed as seen in Fig,6E.
  • Arcuate fasteners 103 and 107 , rod 105, screw 105s , and the frame parts 102, 104, 106,108, can be made of light weighed metal or of a firm plastic.
  • Muff 147 should be made of transparent plastic in order to enable visual control of presence of possible air bubbles or presence of possible blood clots within the syringe. Air bubbles can be removed through the vent tube 141.
  • the base of frame 106 and vertical arms 104 may have removable connection to top plate 102 which could reduce the portable size of the assembly.
  • Assembly 100 may be provided as a sterile compact unit ready for use , so that no time is needed for set up.
  • FIG. 7A shows the manual device for cardio circulatory resuscitation in accordance with described embodiment that has syringe pump assembly with facilitated lever mechanism 100 and transthoracic cannula 200.
  • Fig.7 B shows the device for cardio-circulatory resuscitation in accordance with described alternative embodiment showing the manual actuation facilitated by lever mechanism.
  • a rearward movement of lever 122 effects an aspiration while a forward movement of lever 122 the aspirated blood volume can vigorously be injected back into the chamber of arrested heart.
  • the sidearm of the large bore connector is used for attachment of the fluid infusor 400. In this way an additional volume of fluid can be added in case of reduced aspirating volume; also a hypothermic fluid can be rapidly administered, and any needed medication .like substances against reperfusion injury, can be rapidly injected into systemic circulation of a victim.
  • Two transthoracic access cannulas 200" are inserted, and connected to double syringe pump assemblies 100". Both levers 122 are inter connected with the removable connector for common grip 125 to common grip 124" which enables simultaneous actuation of both parallel installed assemblies providing a replacement of the total heart pumping function. Also, installation of two systems parallel for the right and left heart with individually regulated actuation is possible after removal of grip connector 125.
  • transvascular cannulas 300 are placed into the left and right ventricles (LV, RV) and connected to double syringe assembly 100"; by manual actuation the total heart pump function can be replaced.
  • two transvacsular cannulas 300 are placed into the right ventricle through the left groin vein and into the left ventricle transseptally through the right groin vein. After connection to double syringe pump assembly 100" the total heart pump function can be replaced.
  • This alternative embodiment utilizes an installation through a groin vein by transseptal access through the interatrial septum from the right atrium to the left atrium.
  • This alternative embodiment can be used to treat accidents in a catheterization laboratory environment where there are tools for guiding the procedural activities like ultrasound and fluoroscopy.
  • this alternative embodiment can be used in cardiac surgery environment. In some situations after cardiac surgery the patient cannot be disconnected from cardiopulmonary bypass apparatus used during operation.
  • the cannula 300 can be placed from a groin vein transseptally into the left ventricle by direct visual control and the patient can be disconnected from cardiopulmonary bypass. In unstable situations, cannula 300 can be left in place as long as needed. Cannula 300 placed transseptally through a groin vein can be removed without any additional surgical procedure like re- sternotomy or a surgical closure of arterial entry site.
  • transvacsular cannulas 300 are placed into the right and left ventricle through a groin vein and groin artery respectively. After connection to double syringe pump assembly 100" the total heart pump function can be replaced.
  • This alternative embodiment can be used in an in hospital environment where there are tools for guiding the procedural activities like ultrasound and fluoroscopy.
  • transvascular cannula 300, and one transthoracic cannula 200 are connected to double syringe pump assembly 100": having an actuation with manual grips
  • the transthoracic cannula 200 is placed into the left ventricle through the left ventricular apex and a transvascular cannula 300 is placed into the right ventricle through the subclavian vein; the cannulas are connected to double syringe pump assembly 100"; manual actuation of
  • This embodiment can be used even in an out- of- hospital environment since it can be implemented with a guidance of a portable ultrasound.
  • the access cannula 300 is placed into the left ventricle and it is attached to syringe pump assembly 100 for providing perfusion in case of cardiac arrest.
  • a motor is attached to the syringe plunger by an removable connector of motor 500 to plunger of the syringe. Operation (Fig.11)
  • resuscitation is combined with a motorized (electro motorized or pneumatic) actuation.
  • a fatigue of an aid can be compensated by utilization of a battery powered motorized mechanism which can be connected to the syringe plunger by a removable connector 500.
  • the device described can be used as an alternative to prolonged chest compression or as a last resort measure after failure of today's standard resuscitation attempts. There are large number of victims who are too healthy to be left to die after unsuccessful resuscitation attempt with chest compressions.
  • the puncture does not need any apparatus depended guidance -aspirating a small amount of red colored blood indicates that the left ventricle is punctured; injection of Heparin through the puncturing needle into the left ventricle; placement of a J guide wire 240 through the needle; after removal of puncture needle the transthoracic cannula 200 with introducing dilator 230 (Fig.2A) is introduced per Seldinger technique into the left
  • ventricle (takes ⁇ 1 minute); dilator 230 and guide wire 240 are removed, the 3-way stopcock 208 is closed; smaller non compliant balloon 218 is inflated ; larger compliant balloon 212 is inflated; cannula 200 is connected to syringe pump assembly 100 by stopcock 208 (takes ⁇ 1 minute), stopcock 208 is redirected and the syringe plungerl44 is moved upwards with both hands or, if the assembly with lever driving is used, the lever 122 is manually moved rearward, which provides aspiration of oxygenated blood from the whole left heart (Fig.3A); stopcock is re- directed to enable removal of air bubbles if any existing ;stopcock 208 is redirected to free the flow from syringe to cannula and the oxygenated aspirated blood is vigorously injected back into the arrested left ventricle (Fig.3B); aspirations and injections maneuvers are repeated as long as necessary; should there be not enough aspirating blood volume, additional fluid volume can
  • the victim After termination of resuscitation the victim can be transported to an institution where the cardiac access site can be closed with a myocardial free wall occluder or surgically.
  • the transvascular cannula assembly (Fig.4A) is introduced per Seldinger technique through a subclavian/axillary artery (Fig.5B), or groin artery (Fig.5C), and cannula 300 is placed into the left ventricle retrograde through aortic valve ;cannula 300 is connected to syringe assembly 100' or 100 and the described circulatory support is provided.
  • both cannulas are connected to double syringe assembly 100" and by described maneuvers both left and right heart pump functions can be replaced.
  • Percutaneous circulatory assistance like percutaneous left atrial to aorta or left ventricular to aorta bypass, or a miniaturized percutaneous cardiopulmonary bypass (ECMO) are complex, expensive and time consuming. Non-invasive measures for providing some ventilation during resuscitation attempts had not been sufficiently effective in the past.
  • the device is small, portable, light weighted ( ⁇ 3kg) ;
  • organs suitable for donation there is shortfall of organs suitable for donation.
  • a large number of victims who die from trauma or accidents with organs suitable for transplants could have their organs salvaged.
  • the chances to save the organs of these potential donors in difficult environments are very low due to the fact that there is no system that provides organ perfusion on the field and an organ explantation on the field is not possible.
  • the device presented in this application could be implemented to provide perfusion until a victim with expected fatal outcome is transported to a facility where organ explantation could be
  • this device is primarily oriented to human medicine, but the same indications for use are valid for veterinary medicine, i.e. the use of this device is valid for all mammalians.
  • the manual pumping facilitation can be achieved with a spring mechanism.
  • the syringe plunger 144 is functionally connected to a power spring which would be compressed during manual aspiration phase in which way a considerable potential spring energy could be accumulated and so accumulated energy could reduce energy needed during vigorous injections (not shown ).
  • the frame into which syringe 140 is situated may have different
  • top plate 102 of the frame may have
  • the described manually driven pump assembly with a large bore syringe as the pump is only one of possible embodiments.
  • the pump may be construed as a compressible bag.
  • a compressible bag Such a bag may be manually compressed for injecting the blood and
  • Such a bag may be expanded either manually or with an equipped spring system.
  • the volume capacity of such a bag may be appropriately large.
  • Such a bag may be produced from an elastic medical polymer like polyurethane with heparin coated inner surface.
  • the transthoracic cannula may be equipped with two introducing dilators (not shown); one of which is smaller to be advanced over the guiding wire, and the larger one which is placed over the smaller dilator.
  • the smaller dilator, larger dilator placed over the smaller one, and cannula 200 placed over the larger dilator can be introduced percutaneously as a unit. In this way passage of the assembly through the chest wall might be safer especially in obese victims.
  • the braided parts of access cannulas may be manufactured from a memory metal.
  • the braided part of cannula may be expandable after introduction.
  • Such a cannula may have a smaller fixed profile within the passageway through the entry site and an expandable lumen within a blood vessel and within a heart chamber which could increase the flow capacity of such a configuration.
  • Such cannulas are already commercially available, but some configurations could be modified for use as a part of the device described. This version could be useful especially for transvascular cannula 300.
  • Transvascular cannula 300 may have extension of the wires of the braided part of wall. These wires could make non traumatic arms (not shown) radial expanded distal to end opening 306 of cannula which could provide stable anchorage and prevent dislodgement of the cannula during repeated vigorous injections maneuvers.
  • the wires could have folding position during introduction and expanding position after placement into heart chamber.

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Cardiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Hematology (AREA)
  • Anesthesiology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Public Health (AREA)
  • Mechanical Engineering (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Child & Adolescent Psychology (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • External Artificial Organs (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)

Abstract

Dans un mode de réalisation, un ensemble pompe à seringue de grand volume doté d'un mécanisme facilitant l'actionnement manuel (100) est relié à une canule de grand diamètre (200) qui est disposée de façon percutanée dans la cavité ventriculaire gauche de la victime d'un arrêt cardio-circulatoire. La canule est équipée de ballonnets destinés à assurer l'étanchéité et l'immobilisation de celle-ci. Un robinet d'arrêt trois voies de grand diamètre est intégré à l'extrémité proximale de la canule. L'ensemble pompe à seringue comprend une seringue de grand volume avec un évent d'aération pour l'évacuation de l'air. Un tube est présent au niveau de l'extrémité distale de la seringue. Ledit tube comporte un connecteur au niveau de son extrémité distale pour une connexion rapide à la canule. L'ensemble pompe à seringue comprend un piston pivotant relié à la seringue. En déplaçant manuellement vers l'arrière ledit piston, le sang oxygéné est aspiré hors du ventricule gauche et de l'oreillette gauche pour rejoindre la seringue de grand volume. Le grand volume de sang aspiré est vigoureusement réinjecté dans le ventricule gauche à l'arrêt par l'intermédiaire de la même canule (200). Comme le grand volume de sang injecté dépasse la capacité du ventricule gauche ne se contractant plus, l'excès de sang injecté est éjecté par la valvule sigmoïde aortique en direction de l'aorte. En continuant ces manœuvres d'aspiration et d'injection par actionnement manuel de l'ensemble pompe à seringue (100), la perfusion des structures vitales peut être maintenue durant l'arrêt cardio-circulatoire. L'invention concerne également d'autres modes de réalisation.
PCT/RS2011/000003 2010-03-20 2011-03-09 Ensemble manuel pour réanimation en cas d'arrêt cardio-circulatoire Ceased WO2011119060A2 (fr)

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RS20100326A RS20100326A2 (sr) 2010-03-20 2010-07-19 Ručna naprava za kardio-cirkulatorno oživljavanje

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Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10722631B2 (en) 2018-02-01 2020-07-28 Shifamed Holdings, Llc Intravascular blood pumps and methods of use and manufacture
US11185677B2 (en) 2017-06-07 2021-11-30 Shifamed Holdings, Llc Intravascular fluid movement devices, systems, and methods of use
US11511103B2 (en) 2017-11-13 2022-11-29 Shifamed Holdings, Llc Intravascular fluid movement devices, systems, and methods of use
US11654275B2 (en) 2019-07-22 2023-05-23 Shifamed Holdings, Llc Intravascular blood pumps with struts and methods of use and manufacture
US11724089B2 (en) 2019-09-25 2023-08-15 Shifamed Holdings, Llc Intravascular blood pump systems and methods of use and control thereof
US11964145B2 (en) 2019-07-12 2024-04-23 Shifamed Holdings, Llc Intravascular blood pumps and methods of manufacture and use
US12102815B2 (en) 2019-09-25 2024-10-01 Shifamed Holdings, Llc Catheter blood pumps and collapsible pump housings
US12121713B2 (en) 2019-09-25 2024-10-22 Shifamed Holdings, Llc Catheter blood pumps and collapsible blood conduits
US12161857B2 (en) 2018-07-31 2024-12-10 Shifamed Holdings, Llc Intravascular blood pumps and methods of use
US12220570B2 (en) 2018-10-05 2025-02-11 Shifamed Holdings, Llc Intravascular blood pumps and methods of use
US12409310B2 (en) 2019-12-11 2025-09-09 Shifamed Holdings, Llc Descending aorta and vena cava blood pumps
US12465748B2 (en) 2019-08-07 2025-11-11 Supira Medical, Inc. Catheter blood pumps and collapsible pump housings

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3952742A (en) 1974-06-12 1976-04-27 Taylor Duane F Needle-carried, transthoracic, cannula-type cardiac resuscitation instrument
US5190528A (en) 1990-10-19 1993-03-02 Boston University Percutaneous transseptal left atrial cannulation system
WO1994003228A2 (fr) 1992-08-03 1994-02-17 Zadini Filiberto P Pompe cardiaque percutanee de reanimation cardio-respiratoire
US5399148A (en) 1990-07-06 1995-03-21 Baswat Holdings Pty. Ltd. External cardiac massage device
WO1998005289A1 (fr) 1996-08-01 1998-02-12 Fogarty Thomas J Dispositif et procede de massage cardiaque direct avec penetration invasive minimum
US6406422B1 (en) 2000-03-02 2002-06-18 Levram Medical Devices, Ltd. Ventricular-assist method and apparatus
US7131953B2 (en) 2001-05-25 2006-11-07 Zoll Circulation, Inc. CPR assist device adapted for anterior/posterior compressions
US7494477B2 (en) 2003-09-02 2009-02-24 Pulsecath B.V. Catheter pump, catheter and fittings therefore and methods of using a catheter pump
US7524277B1 (en) 2004-02-11 2009-04-28 Board Of Regents, The University Of Texas System Apex to aorta cannula assembly

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5529463A (en) * 1994-04-19 1996-06-25 Cordis Corporation Pumping apparatus for perfusion and other fluid catheterization procedures
SE514428C2 (sv) * 1999-06-23 2001-02-19 Anagram Consultants Ag Implanterbar anordning för utnyttjande av hjärtats hydrauliska energi
US8337518B2 (en) * 2006-12-20 2012-12-25 Onset Medical Corporation Expandable trans-septal sheath

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3952742A (en) 1974-06-12 1976-04-27 Taylor Duane F Needle-carried, transthoracic, cannula-type cardiac resuscitation instrument
US5399148A (en) 1990-07-06 1995-03-21 Baswat Holdings Pty. Ltd. External cardiac massage device
US5190528A (en) 1990-10-19 1993-03-02 Boston University Percutaneous transseptal left atrial cannulation system
WO1994003228A2 (fr) 1992-08-03 1994-02-17 Zadini Filiberto P Pompe cardiaque percutanee de reanimation cardio-respiratoire
WO1998005289A1 (fr) 1996-08-01 1998-02-12 Fogarty Thomas J Dispositif et procede de massage cardiaque direct avec penetration invasive minimum
US6406422B1 (en) 2000-03-02 2002-06-18 Levram Medical Devices, Ltd. Ventricular-assist method and apparatus
US7131953B2 (en) 2001-05-25 2006-11-07 Zoll Circulation, Inc. CPR assist device adapted for anterior/posterior compressions
US7494477B2 (en) 2003-09-02 2009-02-24 Pulsecath B.V. Catheter pump, catheter and fittings therefore and methods of using a catheter pump
US7524277B1 (en) 2004-02-11 2009-04-28 Board Of Regents, The University Of Texas System Apex to aorta cannula assembly

Non-Patent Citations (14)

* Cited by examiner, † Cited by third party
Title
"International Liaison Committee on Resuscitation. Part 2.Adult basic life support", RESUSCITATION, vol. 67, 2005, pages 187 - 201
"International Liaison Committee on Resuscitation. Part 2.Adult basic life support.", RESUSCITATION, vol. 67, no. 2-3, 2005, pages 187 - 201
ARLT M ET AL.: "First experience with a new miniaturized life support system for mobile percutaneous cardiopulmonary bypass", RESUSCITATION, vol. 77, 2008, pages 345 - 350
ARLT M, PHILLIPP A, ZIMMERMANN M, VOELKER S, HILKEN M, HOBBHAHN J, SCHMID CH.: "First experience with a new miniaturized life support system for mobile percutaneous cardiopulmonary bypass", RESUSCITATION, vol. 77, 2008, pages 345 - 350
CHEN SI, KO WJ, LIN FY: "Insertion of Percutaneous ECMO Cannula", AM J EMERG MED, vol. 18, 2000, pages 184 - 185
DE SOUZA C F. ET AL.: "Percutaneous Mechanical Assistance for The Failing Heart", J INTERVEN CARDIOL, vol. 23, 2010, pages 195 - 202
MIHAYLOV D ET AL.: "Evaluation of the optimal driving mode during left ventricular assist with pulsatile catheter pump in calves", ARTIFICIAL ORGANS, vol. 23, 1999, pages 1117 - 1122
MIHAYLOV D. ET AL.: "Evaluation of the optimal driving mode during left ventricular assist with pulsatile catheter pump in calves", ARTIFICIAL ORGANS, vol. 23, 1999, pages 1117 - 1122
SOUZA C F. ET AL.: "Percutaneous mechanical Assistance for The Failing Heart", J INTERVEN CARDIOL, vol. 23, 2010, pages 195 - 202
TURGUT T, DEEB M, MOSCUCCI M: "Left ventricular apical puncture: A procedure surviving well into the new millennium", CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, vol. 49, 2000, pages 68 - 73
WALTERS DL ET AL., CATHETER CARDIOVASCULAR INTERV, vol. 58, 2003, pages 539 - 44
WARD KR, BARBEE W, IVATURY RR: "Cardiopulmonary Resuscitation", 2000, HUMANA PRESS INC., article "Monitoring techniques during CPR", pages: 480 - 482
WEBB J, THE SHORTEST WAY TO THE HEART. CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, vol. 71, 2008, pages 920
WEBB J: "The shortest Way to the Heart", CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, vol. 71, 2008, pages 920

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US11717670B2 (en) 2017-06-07 2023-08-08 Shifamed Holdings, LLP Intravascular fluid movement devices, systems, and methods of use
US11511103B2 (en) 2017-11-13 2022-11-29 Shifamed Holdings, Llc Intravascular fluid movement devices, systems, and methods of use
US11229784B2 (en) 2018-02-01 2022-01-25 Shifamed Holdings, Llc Intravascular blood pumps and methods of use and manufacture
US10722631B2 (en) 2018-02-01 2020-07-28 Shifamed Holdings, Llc Intravascular blood pumps and methods of use and manufacture
US12076545B2 (en) 2018-02-01 2024-09-03 Shifamed Holdings, Llc Intravascular blood pumps and methods of use and manufacture
US12161857B2 (en) 2018-07-31 2024-12-10 Shifamed Holdings, Llc Intravascular blood pumps and methods of use
US12220570B2 (en) 2018-10-05 2025-02-11 Shifamed Holdings, Llc Intravascular blood pumps and methods of use
US11964145B2 (en) 2019-07-12 2024-04-23 Shifamed Holdings, Llc Intravascular blood pumps and methods of manufacture and use
US11654275B2 (en) 2019-07-22 2023-05-23 Shifamed Holdings, Llc Intravascular blood pumps with struts and methods of use and manufacture
US12465748B2 (en) 2019-08-07 2025-11-11 Supira Medical, Inc. Catheter blood pumps and collapsible pump housings
US11724089B2 (en) 2019-09-25 2023-08-15 Shifamed Holdings, Llc Intravascular blood pump systems and methods of use and control thereof
US12121713B2 (en) 2019-09-25 2024-10-22 Shifamed Holdings, Llc Catheter blood pumps and collapsible blood conduits
US12102815B2 (en) 2019-09-25 2024-10-01 Shifamed Holdings, Llc Catheter blood pumps and collapsible pump housings
US12409310B2 (en) 2019-12-11 2025-09-09 Shifamed Holdings, Llc Descending aorta and vena cava blood pumps

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