Intravascular fluid movement devices, systems, and methods of use
Devices for moving blood within a patient, and methods of doing so. The devices can include a pump portion that includes an impeller and a housing around the impeller, as well as a fluid lumen. The impeller can be activated to cause rotation of the impeller and thereby move fluid within the fluid lumen.
1. A method of deploying an intravascular blood pump across an aortic valve, comprising:
advancing an intravascular blood pump to a region of a heart valve, the intravascular blood pump comprising a distal expandable member, a distal impeller, a proximal expandable member, a proximal impeller, and a conduit;
deploying the distal expandable member and the distal impeller each from collapsed delivery configurations to deployed configurations, the distal impeller disposed axially and radially within the distal expandable member in their deployed configurations;
deploying the proximal expandable member and the proximal impeller each from collapsed delivery configurations to deployed configurations, the proximal impeller disposed axially and radially within the proximal expandable member in their deployed configurations,
deploying the conduit such that a conduit distal end is positioned in a left ventricle and a conduit proximal end is deployed in an ascending aorta and such that the conduit distal end is spaced 4 cm to 14 cm from the conduit proximal end;
wherein when the distal and proximal expandable members are in their deployed configurations, they are axially spaced apart such that a proximal end of the distal expandable member is distal to a distal end of the proximal expandable member;
positioning at least a portion of the distal expandable member in the left ventricle so that a distal end of the distal expandable member is distal to aortic valve leaflets;
positioning at least a portion of the proximal expandable member in the ascending aorta so that a proximal end of the proximal expandable member is proximal to the aortic valve leaflets;
positioning a central region of the conduit that is axially in between the deployed distal expandable member and the deployed proximal expandable member at an aortic valve coaptation region such that the central region is positioned to interface with aortic valve leaflets;
maintaining the distal expandable member, the proximal expandable member, and the central region of the conduit in their respective positions at the same time; and
activating the distal and proximal impellers with a common drive mechanism that extends through a catheter, through the proximal impeller, between the proximal impeller and the distal impeller, through the distal impeller, and is coupled to the distal and proximal impellers and extending proximally therefrom towards a motor, to thereby cause them to rotate and move fluid from the left ventricle towards the ascending aorta,
wherein positioning the central region of the conduit at the aortic valve coaptation region further comprises positioning a region of the common drive mechanism that is between the proximal impeller and the distal impeller across the aortic valve leaflets, wherein the region of the common drive mechanism that is between the proximal impeller and the distal impeller is more flexible than the common drive mechanism where it extends through the proximal impeller and more flexible than the common drive mechanism where it extends through the distal impeller.
2. The method of claim 1 , wherein positioning at least a portion of the distal expandable member in a left ventricle comprises positioning the entire distal expandable member distal to aortic valve leaflets.
3. The method of claim 1 , wherein positioning at least a portion of the proximal expandable member in an ascending aorta comprises positioning the entire proximal expandable member proximal to aortic valve leaflets.
4. The method of claim 1 , wherein the deploying steps comprise allowing the distal expandable member and the proximal expandable member to self-expand.
5. The method of claim 1 , further comprising positioning a central region of the intravascular blood pump to interface with the aortic valve leaflets, the central region of the intravascular blood pump including the central region of the conduit,
the central region of the intravascular blood pump is more flexible than a blood pump distal region that is distal to the central region of the intravascular blood pump and is more flexible than a blood pump proximal region that is proximal to the central region of the intravascular blood pump.
6. The method of claim 1 , wherein the intravascular blood pump includes a central region that includes the central region of the conduit, the central region of the intravascular blood pump further including a central expandable member between the distal expandable member and the proximal expandable member.
7. The method of claim 1 , wherein a proximal end of the proximal impeller extends further proximally than a region of a membrane of the blood pump, and wherein activating the proximal impeller creates blood flow into the ascending aorta at a pump outflow that has a centrifugal component and an axial component.