Catheter system for left heart access
A pair of cooperating catheters are used together to provide rapid access to the Left heart for diagnostic or therapeutic interventions. The initial entry point for the catheter pair is the groin. The pair of catheters can be used to carry out an electrographic determination of the location of the Fossa Ovalis on the septum. Features on the Catheter system permit quick and reliable confirmation of the catheter location via echo or x-rays. Once across the septum the inner catheter is removed from the outer catheter and a standard intervention may be carried out through the lumen of the outer catheter.
1. A catheter system for crossing into the left heart from the right heart comprising:
an inner catheter, the inner catheter defining a needle lumen which extends from an inner catheter proximal end to an inner catheter distal end, a piercing needle positioned within the needle lumen, the piercing needle defining a guide wire lumen for receipt of a guidewire therethrough, the piercing needle having a piercing needle distal tip,
the inner catheter proximal end further comprising an inner catheter handle having a thumb lever, the thumb lever being actuatable between an unactuated state and an actuated state, in the unactuated state the piercing needle distal tip does not extend distally out of the needle lumen, and in the actuated state the piercing needle distal tip extends distally out of the needle lumen, the inner catheter handle further comprising an electrical connector in electrical contact with the piercing needle;
the guide wire, the guide wire having a guide wire distal tip; and
an outer catheter which defines an outer catheter lumen which extends from an outer catheter proximal end to and outer catheter distal end, the outer catheter lumen sized to accept the inner catheter therethrough, the outer catheter distal end is deflectable along an arc of a plane, a control knob is positioned at the outer catheter proximal end, the control knob configured to turn on a control axis,
the control knob is in communication with a pinion, the pinion is in communication with a first rack and a second rack,
a first pull wire anchored to and extending between the first rack and the outer catheter distal end, a second pull wire anchored to and extending between the second rack and the outer catheter distal end,
whereby turning the control knob in a first direction about the control axis causes the pinion to move the first rack and the first pull wire in a first longitudinal direction and the second rack and the second pull wire in a second longitudinal direction opposite to that of the first longitudinal direction, resulting in the outer catheter distal end being deflected through an arc of up to 180 degrees.
2. The system of claim 1 further comprising a spring, the spring located within said inner catheter handle, the spring biasing the thumb lever into the unactuated state.
3. The system of claim 1 , wherein the control knob includes a thumb actuated control button, the control button having an actuated position and an unactuated position, in the actuated position the control knob is free to turn about the control knob axis, in the unactuated position the control knob is locked into its current position.
4. The system of claim 1 , wherein the control knob positioned at the outer catheter proximal is configured for left handed use.
5. The catheter system of claim 1 further comprising a display, the display in electronic communication with the electrical connector and the piercing needle, the catheter system displaying at the display an electrogram formed by contacting the distal end of the inner catheter along with an electrode to a first anatomical region of the heart while the thumb lever is in the unactuated state and the piercing needle distal tip does not extend distally out of the needle lumen.
6. The catheter system of claim 5 wherein the electrogram includes an injury current.
7. A catheter system for crossing into the left heart from the right heart comprising:
an inner catheter, the inner catheter defining a needle lumen which extends from an inner catheter proximal end to an inner catheter distal end, a piercing needle positioned within the needle lumen, the piercing needle defining a guide wire lumen for receipt of a guidewire therethrough, the piercing needle having a piercing needle distal tip,
the inner catheter proximal end further comprising an inner catheter handle having a thumb lever, the thumb lever being actuatable between an unactuated state and an actuated state, in the unactuated state the piercing needle distal tip does not extend distally out of the needle lumen, and in the actuated state the piercing needle distal tip extends distally out of the needle lumen, the inner catheter handle further comprising an electrical connector in electrical contact with the piercing needle;
the guide wire, the guide wire having a guide wire distal tip; and
an outer catheter which defines an outer catheter lumen which extends from an outer catheter proximal end to and outer catheter distal end, the outer catheter lumen sized to accept the inner catheter therethrough, the outer catheter proximal end defining a torque handle and a side port in communication with the outer catheter lumen, wherein the side port does not cross the torque handle.
8. The system of claim 7 further comprising a spring, the spring located within said inner catheter handle, the spring biasing the thumb lever into the unactuated state.
9. The catheter system of claim 7 further comprising a display, the display in electronic communication with the electrical connector and the piercing needle, the catheter system displaying at the display an electrogram formed by contacting the distal end of the inner catheter along with an electrode to a first anatomical region of the heart while the thumb lever is in the unactuated state and the piercing needle distal tip does not extend distally out of the needle lumen.
10. The catheter system of claim 9 wherein the electrogram includes an injury current.
11. The catheter system of claim 7 wherein the torque handle has a longitudinal axis as defined by the outer catheter lumen, the side port being aligned with the longitudinal axis.