134 results about "Superior vena cava" patented technology

Methods and systems for transvenously accessing the pericardial space via the vascular system and atrial wall, particularly through the superior vena cava and right atrial wall, to deliver treatment in the pericardial space are disclosed. A steerable instrument is advanced transvenously into the right atrium of the heart, and a distal segment is deflected into the right atrial appendage. A fixation catheter is advanced employing the steerable instrument to affix a distal fixation mechanism to the atrial wall. A distal segment of an elongated medical device, e.g., a therapeutic catheter or an electrical medical lead, is advanced through the fixation catheter lumen, through the atrial wall, and into the pericardial space. The steerable guide catheter is removed, and the elongated medical device is coupled to an implantable medical device subcutaneously implanted in the thoracic region. The fixation catheter may be left in place.

Apparatus and methods for performing retrograde perfusion, especially during cardiopulmonary bypass operations, including dedicated pediatric scaled apparatus for retrograde perfusion of an adult human organ, organ system, or limb, especially the brain, employing small scale oxygenators and heat exchangers such as are designed for pediatric surgery; also including methods and apparatus for retrograde cerebral perfusion, using nonselective infravalvular cannulation of the superior vena cava, estimating the efficacy of cerebral perfusion by monitoring fluid flow across a valve of an internal jugular vein, modification of inflow pressure and administration of pharmacologic agents, and increasing fluid flow into a brain by occlusion of an inferior vena cava distal to its junction with an azygos vein.

A method of protecting an upper body and a lower body of a patient from high venous pressures comprising implanting a first stented valve at the superior vena cava and a second stented valve at the inferior vena cava, wherein the first and second valves are configured to permit blood flow towards a right atrium of the patient and prevent blood flow in an opposite direction.

A method of inserting a dialysis catheter into a patient comprising the steps of inserting a guidewire into the jugular vein of the patient through the superior vena cava and into the inferior vena cava, providing a trocar having a lumen and a dissecting tip, inserting the trocar to enter an incision in the patient and to create a subcutaneous tissue tunnel, threading the guidewire through the lumen of the trocar so the guidewire extends through the incision, providing a dialysis catheter having first and second lumens, removing the trocar, and inserting the dialysis catheter over the guidewire through the incision and through the jugular vein and superior vena cava into the right atrium.

A method of treating hemodynamic disfunction by simultaneously pacing both ventricles of a heart. At least one ECG amplifier is arranged to separately detect contraction of each ventricle and a stimulator is then activated for issuing stimulating pulses to both ventricles in a manner to assure simultaneous contraction of both ventricles, thereby to assure hemodynamic efficiency. A first ventricle is stimulated simultaneously with contraction of a second ventricle when the first fails to properly contract. Further, both ventricles are stimulated after lapse of a predetermined A-V escape interval. One of a pair of electrodes, connected in series, is placed through the superior vena cava into the right ventricle and a second is placed in the coronary sinus about the left ventricle. Each electrode performs both pacing and sensing functions. The pacer is particularly suitable for treating bundle branch blocks or slow conduction in a portion of the ventricles.

The invention includes a method of locating a tip of a central venous catheter (“CVC”) having a distal and proximal pair of electrodes disposed within the superior vena cava, right atrium, and / or right ventricle. The method includes obtaining a distal and proximal electrical signal from the distal and proximal pair and using those signals to generate a distal and proximal P wave, respectively. A deflection value is determined for each of the P waves. A ratio of the deflection values is then used to determine a location of the tip of the CVC. Optionally, the CVC may include a reference pair of electrodes disposed within the superior vena cava from which a reference deflection value may be obtained. A ratio of one of the other deflection values to the reference deflection value may be used to determine the location of the tip of the CVC.

Methods of locating a tip of a central venous catheter (“CVC”) relative to the superior vena cava, sino-atrial node, right atrium, and / or right ventricle using electrocardiogram data. The CVC includes at least one electrode. In particular embodiments, the CVC includes two or three pairs of electrodes. Further, depending upon the embodiment implemented, one or more electrodes may be attached to the patient's skin. The voltage across the electrodes is used to generate a P wave. A reference deflection value is determined for the P wave detected when the tip is within the proximal superior vena cava. Then, the tip is advanced and a new deflection value determined. A ratio of the new and reference deflection values is used to determine a tip location. The ratio may be used to instruct a user to advance or withdraw the tip.

The present invention provides a dialysis catheter that is designed to function in reverse-flow, having a dual lumen configuration. An embodiment of the present invention includes two lumen cooperatively configured in a co-axial design. The arterial lumen is circular or oval and extends beyond the termination of the venous lumen. The arterial lumen extracts the blood from the blood vessel for hemodialysis treatment. The venous lumen is also circular or oval. Terminating at a proximal point to the distal end of the arterial lumen, this configuration of the venous lumen aids in preventing recirculation. The venous lumen returns dialyzed blood back into the patient. The venous lumen can further include a plurality of apertures to aid in reducing the risk of fibrin sheath growth. In a method of use, the arterial lumen of the invention preferably resides within the right atrium with the venous lumen positioned within the superior vena cava.

The invention includes a method of locating a tip of a central venous catheter (“CVC”) having a distal and proximal pair of electrodes disposed within the superior vena cava, right atrium, and / or right ventricle. The method includes obtaining a distal and proximal electrical signal from the distal and proximal pair and using those signals to generate a distal and proximal P wave, respectively. A deflection value is determined for each of the P waves. A ratio of the deflection values is then used to determine a location of the tip of the CVC. Optionally, the CVC may include a reference pair of electrodes disposed within the superior vena cava from which a reference deflection value may be obtained. A ratio of one of the other deflection values to the reference deflection value may be used to determine the location of the tip of the CVC.

A method of surgical perforation via the delivery of electrical, radiant or thermal energy comprising the steps of: introducing an apparatus comprising an energy delivery device into a patient's heart via the patient's superior vena cava; positioning the energy delivery device at a first location adjacent material to be perforated; and perforating the material by delivering energy via the energy delivery device; wherein the energy is selected from the group consisting of electrical energy, radiant energy and thermal energy.

Techniques are provided for use with an implantable medical device for assessing stroke volume or related cardiac function parameters such as cardiac output based on impedance signals obtained using hybrid impedance configurations that exploit a multi-pole cardiac pacing / sensing lead implanted near the left ventricle. In one example, current is injected between a large and stable reference electrode and a ring electrode in the RV. The reference electrode may be, e.g., a coil electrode implanted within the superior vena cava (SVC). Impedance values are measured along a set of different sensing vectors between the reference electrode and each of the electrodes of the multi-pole LV lead. Stroke volume is then estimated and tracked within the patient using the impedance values. In this manner, a hybrid impedance detection configuration is exploited whereby one vector is used to inject current and other vectors are used to measure impedance.

A peripherally inserted central venous catheter having a position indicator is used in a method of detecting movement of a catheter tip within a patient's superior vena cava. The PICC comprises a catheter having a proximal end with distance marks at measured intervals, an anchor wing system secured to the catheter's proximal end, at least one extension leg secured to the anchor wing system and the position indicator attached to the extension leg. The position indicator has an area for marking a distance signifying an initial external length of catheter which extends from the point the catheter enters the patient to the point it is attached to the anchor wing and / or marking an initial full length or the internal length of catheter which is fully within the patient. Any movement of the catheter's tip is detected by comparing the current external distance mark with the initial external distance mark.

A pump assists left ventricular function of a heart. The pump is configured for implant in the body and has an input connectable to the left atrium and an output connectable to the aorta for pumping blood from the left atrium to the aorta. A power source for powering operation of the pump is connectable to the pump. The pump may be configured for implant within the heart, such as, for example, in the atrium, the super vena cava, or partly within each of the right atrium and the superior vena cava.

The present invention relates to a medical device and uses thereof that supports or changes the shape of tissue near a vessel in which the device is placed. The present invention is particularly useful in reducing mitral valve regurgitation by changing the shape of or supporting a mitral valve annulus. The device includes a support structure, a proximal anchor adapted to be positioned in a superior vena cava, and a distal anchor adapted to be positioned in a coronary sinus. The support structure engages a vessel wall to change the shape of tissue adjacent the vessel in which the intravascular support is placed.

The current invention concerns a method of ablation designed for the treatment of sick sinus syndrome and other medical conditions characterized by abnormal sinus bradycardia. The method includes the steps of inserting an ablation catheter into a heart of a living subject and directing energy from the ablation catheter towards tissue at a targeted location for ablation. In the method, a specific limited location at level of the junction between the right atrium and the superior vena cava is targeted.

Systems and methods and devices are provided for arresting or reversing the effects of myocardial remodeling and degeneration after cardiac injury, without the potential drawbacks associated with previously existing systems and methods, by at least partially occluding flow through the superior vena cava over multiple cardiac cycles, and more preferably, by adjusting the interval or degree of occlusion responsive to a sensed level of patient activity. In some embodiments, a controller is provided that actuates a drive mechanism responsive to a sensed level of patient activity to provide at least partial occlusion of the patient's superior vena cava, while a data transfer circuit of the controller provides bi-directional transfer of physiologic data to the patient's smartphone or tablet to permit display and review of such data.

Systems and methods and devices are provided for arresting or reversing the effects of myocardial remodeling and degeneration after cardiac injury, without the potential drawbacks associated with previously existing systems and methods, by at least partially occluding flow through the superior vena cava over multiple cardiac cycles, and more preferably, by adjusting the interval or degree of occlusion responsive to a sensed level of patient activity. In some embodiments, a controller is provided that actuates a drive mechanism responsive to a sensed level of patient activity to provide at least partial occlusion of the patient's superior vena cava, while a data transfer circuit of the controller provides bi-directional transfer of physiologic data to the patient's smartphone or tablet to permit display and review of such data.

Hemodynamic monitoring systems and methods are disclosed including a device comprising a first sensor configured to measure a velocity of blood flow in an adjacently-located portion of a superior vena cava of a mammalian patient using ultrasound waves; a second sensor configured to measure respiratory cycle data of the mammalian patient; and a computer configured to process the measured velocity of blood flow and the measured respiratory cycle data to provide hemodynamic parameters corresponding to the mammalian patient.

A medical device for providing retrograde venous perfusion to the cerebral vasculature for treatment of global or focal cerebral ischemia is disclosed. The device includes a catheter having an infusion port at its distal end, venous drainage port(s), and an expandable occluder disposed between the infusion port and drainage port(s). The catheter can be inserted into the superior vena cava or the internal jugular vein. The catheter is attached proximally to a pump and an oxygenator with or without a cooling system. Alternatively, the device includes two catheters, each having a lumen communicating with a distal infusion port and an occluder mounted proximal to the port. The catheters can be inserted into the internal jugular veins distal to jugular venous valves. Methods of using the devices to provide retrograde venous perfusion and isolated cerebral hypothermia are disclosed.

Apparatus for assisting a surgeon in procedures involving the heart and methods of employing such apparatus are provided. The apparatus can include a pump, and a first fluid conduit having a distal end adapted to be inserted into the superior vena cava of a beating heart, a second fluid conduit having a distal end adapted to be inserted into the inferior vena cava, and a third fluid conduit having a distal end adapted to be inserted into the pulmonary artery of the beating heart, each in liquid fluid communication with the pump, which in combination can be operatively positioned to form a closed cardiac pathway extending from the vena cavae and to the pulmonary artery to thereby convey blood collected from the vena cavae into the pulmonary artery, operatively bypassing the right side of the heart. The pump is positioned to both convey blood flow from each vena cavae and to the third fluid conduit and to provide a blood reservoir which enables the provision of manual assistance to the blood flow to the lungs when blood flow is insufficient.

A medical fixation system for temporary fixation of an implantable medical device such as a short lead pacemaker outside of the heart in a larger blood vessel such as the superior or inferior vena cava. The fixation mechanism or element is temporary in nature in that the fixation holds the implantable medical device in place until the implantable medical device is grown in to the wall of the vessel and the short lead attached to the implantable medical device and implanted in the heart is grown in. The cell tissue surrounding the implantable medical device and the short lead then keeps the implantable medical device in place without the temporary fixation element.

Systems and methods and devices are provided for treating conditions such as heart failure and / or pulmonary hypertension by at least partially occluding flow through the superior vena cava for an interval spanning multiple cardiac cycles. A catheter with an occlusion device is provided along with a controller that actuates a drive mechanism to provide at least partial occlusion of the patient's superior vena cava, which reduces cardiac filling pressures, and induces a favorable shift in the patient's Frank-Starling curve towards healthy heart functionality and improved cardiac performance. The occlusion device may include a lumen obstructed by a relief valve that may permit fluid flow through the occlusion device to release an excessive build-up of pressure.

A medical device is provided that comprises a lead assembly configured to be at least partially located proximate to the heart. The lead assembly includes an extra-cardiac (EC) electrode to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The lead assembly includes a subcutaneous remote-cardiac (RC) electrode configured to be located remote from the heart such that at least a portion of the greater vessels are interposed between the RC electrode and the EC electrode to establish an extra-cardiac impedance (ECI) vector. The processor module measures extra-cardiac impedance along the ECI vector to obtain ECI measurements. The processor module assesses a hemodynamic performance based on the ECI measurements.

Apparatuses and methods for the perforation of heart tissue of a patient when an inferior approach to the heart is contraindicated are disclosed. The method includes using a superior approach to introduce the apparatus, positioning the apparatus at a tissue location and delivering a controlled amount of non-mechanical energy to the tissue to create a perforation. For example, a method of surgical perforation via the delivery of electrical, radiant or thermal energy may include: introducing an apparatus comprising an energy delivery device into a patient's heart via the patient's superior vena cava; positioning the energy delivery device at a first location adjacent material to be perforated; and perforating the material by delivering energy via the energy delivery device; wherein the energy is selected from the group consisting of electrical energy, radiant energy and thermal energy.

A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An arrhythmia monitoring module is configured to analyze intra-cardiac electrogram (IEGM) signals from the at least one IC electrode to identify a potential atrial arrhythmia. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. The hemodynamic performance (HDP) assessment module is configured to determine a hemodynamic performance based on the ECI measurements. The arrhythmia monitoring module is configured to declare the potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The medical device further provides the HDP assessment module that derives a current ECI waveform from current ECI measurements and compares the current ECI pattern with a prior ECI waveform that is derived from prior ECI measurements.