Cardiac drainage cannula and related methods and systems
A method of placing a cardiac drainage cannula into a patient's heart is provided. The method may comprise the steps of (a) inserting the cannula percutaneously into an internal jugular vein, (b) advancing the cannula through the internal jugular vein and into the right atrium of the heart, and (c) advancing the cannula through the atrial septum into the left atrium of the heart. A method of draining blood from the left atrium or left ventricle of a patient's heart using a cardiac drainage cannula is provided. A cardiac drainage cannula and a mechanical circulatory support system are also provided.
1 . A cardiac drainage cannula for draining blood from a heart, the cardiac drainage cannula comprising:
an elongate body including a proximal end portion, a distal end portion, and at least one lumen extending along a length and through the elongate body from the distal end portion to the proximal end portion, the cannula comprising at least one inlet at the distal end portion of the elongate body and at least one proximal outlet at the proximal end portion of the elongate body, the at least one inlet being in fluid communication with the at least one outlet via the at least one lumen, wherein the at least one lumen of the elongate body includes:
a right atrial pressure line extending from a proximal outlet of the right atrial pressure line at the proximal end portion of the elongate body to a right atrial inlet of the right atrial pressure line located at the distal end portion of the elongate body at a fixed position along the length of the elongate body,
a left atrial pressure line extending from a proximal outlet of the left atrial pressure line at the proximal end portion of the elongate body to a left atrial inlet of the left atrial pressure line located at the distal end portion of the elongate body at a fixed position along the length of the elongate body,
and
a left ventricular pressure line extending from a proximal outlet of the left ventricular pressure line at the proximal end portion of the elongate body to a left ventricular inlet of the left ventricular pressure line located at the distal tip of the elongate body at a fixed position along the length of the elongate body.
2 . The cardiac drainage cannula of claim 1 , wherein an outer diameter of the elongate body is in a range of 4 mm to 11 mm.
3 . The cardiac drainage cannula of claim 1 , wherein the length of the elongate body is in a range of 16 cm to 52 cm.
4 . The cardiac drainage cannula of claim 1 , wherein the at least one inlet includes:
a left ventricular drainage inlet located at a distal tip of the elongate body and
a left atrial drainage inlet located proximal to the left ventricular drainage inlet.
5 . The cardiac drainage cannula of claim 4 , wherein a distance between the left ventricular drainage inlet and the left atrial drainage inlet is in a range of 2 cm to 8 cm.
6 . The cardiac drainage cannula of claim 4 , wherein the at least one lumen of the elongate body includes a main drainage lumen, wherein the left ventricular drainage inlet and the left atrial drainage are in fluid communication with the main drainage lumen of the elongate body.
7 . The cardiac drainage cannula of claim 1 , wherein
the right atrial pressure inlet is located proximal to the distal tip of the elongate body, wherein a distance between the right atrial pressure inlet and the distal tip is in range of 3 cm to 13 cm,
the left atrial pressure inlet is located proximal to the distal tip of the elongate body, wherein a distance between the left atrial pressure inlet and the distal tip is in range of 2 cm to 8 cm.
8 . The cardiac drainage cannula of claim 1 , wherein
the right atrial pressure inlet is located proximal to the left atrial pressure inlet, wherein a distance between the right atrial pressure inlet and the left atrial pressure inlet is in range of 1 cm to 5 cm.
9 . The cardiac drainage cannula of claim 1 , further comprising a securing means for securing the proximal end portion of the elongated body of the cannula to a skin portion adjacent to a percutaneous insertion site of the cannula.
10 . The cardiac drainage cannula of claim 1 , wherein the elongate body includes a tubular outer wall extending from the proximal end portion of the elongate body to the distal end portion of the elongate body and surrounding the at least one lumen of the elongate body, wherein the right atrial inlet, the left atrial inlet and/or the left ventricular inlet extend through the tubular outer wall of the elongate body.
11 . A mechanical circulatory support system, comprising
the cardiac drainage cannula of claim 1 and
an extracorporeal or implantable blood pump connectable to the drainage cannula.
12 . The system of claim 11 , further comprising:
at least one pressure sensor and
a pump controller configured to receive signals from the at least one pressure sensor and to control the blood pump on the basis of the received signals of the at least one pressure sensor.
13 . The system of claim 12 , wherein the at least one pressure sensor includes one or more external pressure sensors connectable to one or more pressure lines of the cardiac drainage cannula.
14 . The system of claim 12 , wherein the pump controller is configured to compare a right atrial pressure with a first threshold and generate an alert indicating right ventricular failure when the right atrial pressure is greater than the first threshold.
15 . The system of claim 14 , wherein the first threshold is 10 mmHg.
16 . The system of claim 12 , wherein the pump controller is configured to compare a left atrial pressure with a second threshold and generate an alert indicating right ventricular failure when the left atrial pressure is greater than the second threshold.
17 . The system method of claim 16 , wherein the second threshold is 15 mmHg or 20 mmHg.
18 . The system method of claim 12 , wherein the pump controller is configured to compare a left ventricular pressure with a third threshold and generate an alert indicating left ventricular failure when the left ventricular pressure is greater than the third threshold.
19 . The system of claim 18 , wherein the third threshold is 15 mmHg.
20 . The system of claim 12 , wherein the pump controller is configured to measure at least one blood pressure on the basis of the signals of the at least one blood pressure sensor and to automatically trend the measured blood pressure.
21 . The system of claim 12 , wherein the pump controller is configured to measure at least one blood pressure on the basis of the signals of the at least one blood pressure sensor and to compare the measured blood pressure with a corresponding threshold value.
22 . The system of claim 12 , wherein the pump controller is configured to measure at least one blood pressure on the basis of the signals of the at least one blood pressure sensor and to use the at least one measured blood pressure to determine or detect a degree or an amount of right ventricular unloading.
23 . The system of claim 12 , wherein the pump controller is configured to measure at least one blood pressure on the basis of the signals of the at least one blood pressure sensor and to use the at least one measured blood pressure to determine or detect a precursor or an onset of right ventricular failure.
24 . The system of claim 12 , wherein the pump controller is configured to measure at least one blood pressure on the basis of the signals of the at least one blood pressure sensor and to use the at least one measured blood pressure to determine or detect a degree or an amount of left ventricular unloading.
25 . The system of claim 12 , wherein the pump controller is configured to measure at least one blood pressure on the basis of the signals of the at least one blood pressure sensor and to use the at least one measured blood pressure to determine or detect a precursor or an onset of left ventricular failure.
26 . The system of claim 11 , further comprising:
an extracorporeal oxygenation device connectable to the blood pump and
a perfusion cannula connectable to the extracorporeal oxygenation device.
27 . The system of claim 11 , wherein the system is a left ventricular assist system.