Percutaneous right ventricular assist apparatus and method
A system for assisting the right heart of a patient includes a PA cannula adapted for insertion into a PA of a patient through the right internal jugular vein of the patient. The system includes a percutaneous RA cannula adapted for insertion into an RA of the patient. The system includes a blood pump disposed outside of the patient to which the RA cannula and the PA cannula are connected to provide right ventricular circulatory support to the patient without any left ventricular assist. A method for assisting the right heart of a patient includes the steps of inserting a PA cannula into a PA of a patient. There is the step of inserting an RA cannula into an RA of the patient. There is the step of connecting the RA cannula and the PA cannula to a blood pump disposed outside of the patient. There is the step of activating the blood pump to provide right ventricular circulatory support to assist the heart of the patient.
1. A method for assisting the heart of a patient comprising the steps of:
inserting a pulmonary artery (PA) cannula into the right internal jugular vein of the patient;
moving the PA cannula in the vasculature and into the PA of the patient via an anatomical pathway through the right heart;
inserting a right atria (RA) cannula into the a peripheral vein of the patient;
moving the RA cannula in the vasculature and into the RA of the patient, so that the right ventricle of the patient is bypassed;
connecting the RA cannula and the PA cannula to a blood pump disposed outside of the patient, with the RA cannula connected to an inlet of the blood pump and the PA cannula connected to an outlet of the blood pump; and
activating the blood pump to provide only right ventricular assist to the heart of the patient and without open heart surgery or left ventricle support.
2. A method as described in claim 1 wherein the inserting the PA cannula step includes passing a pulmonary wedge pressure catheter through the PA cannula, floating the catheter into the pulmonary artery, and advancing a super stiff wire through a pulmonary artery port of a Swan-Ganz catheter.
3. A method as described in claim 2 further comprising removing the pulmonary wedge pressure catheter and the wire from the patient once the PA cannula is in the patient.
4. A method as described in claim 1 wherein the PA cannula has an end hole and at least two side holes which allow blood flow to the left and right lungs of the patient, without allowing backflow into the right ventricle of the patient.
5. A method as described in claim 1 wherein the inserting the RA cannula step includes inserting the RA cannula percutaneously into the patient.
6. A method as described in claim 1 further comprising pumping unoxygenated blood from the right atrium with the blood pump through the RA cannula and returning the blood to the pulmonary artery through the PA cannula.
7. A method as described in claim 6 further comprising controlling the blood pump with a controller in communication with the blood pump which detects and manages faults and produces an alert signal in response to a detected fault.
8. A method as described in claim 1 further comprising placing the blood pump in a holder that attaches to the lower body of the patient.
9. A method as described in claim 1 further comprising sewing the PA cannula and the RA cannula to the patient.
10. A method as described in claim 1 wherein the inserting the RA cannula step includes inserting the RA cannula into the peripheral vein of the patient over a wire.
11. A method as described in claim 10 further comprising advancing the RA cannula along the wire into the RA and removing the wire.
12. A method as described in claim 1 wherein the activating step includes starting 2 L/min blood flow for at least two minutes and then adjusting the blood flow based on the patient's requirements.
13. A method as described in claim 1 further comprising using imaging guidance when the RA cannula and the PA cannula are in the RA and PA, respectively.
14. A method as described in claim 1 wherein the activating step includes the step of providing blood flow to the right and left lungs through the PA cannula.
15. A method as described in claim 1 further comprising providing blood flow from the blood pump for right ventricular assist of the patient at a level which is ½ to ⅔ of normal cardiac blood flow of the patient.
16. A closed chest system for assisting the right heart of a patient comprising:
a pulmonary artery (PA) cannula adapted for insertion into the right internal jugular vein of the patient and to extend into the PA of the patient via an anatomical pathway through the right heart;
a percutaneous right atria (RA) cannula adapted for insertion into a peripheral vein of the patient and to extend into the RA of the patient, so that the right ventricle of the patient is bypassed; and
a blood pump disposed outside of the patient, the blood pump comprising an inlet connected to the RA cannula and an outlet connected to the PA cannula for providing only right ventricular circulatory support to the patient without open heart surgery or left ventricle support.
17. A closed chest system as described in claim 16 wherein the pump is a ventricular assist pump.
18. A closed chest system as described in claim 17 wherein the PA cannula has an end hole and two side holes for blood flow to the right and left lungs.
19. A closed chest system as described in claim 16 further comprising a holder which holds the blood pump securely to the patient.
20. A closed chest system as described in claim 16 wherein the blood pump comprises a controller operating the blood pump to provide right ventricular assist of the patient at a level which is ½ to ⅔ of normal cardiac blood flow of the patient.