Positioning a Medical Device in the Right Atrium or Right Ventricle Using a Non-Flexible Catheter
A device can be introduced into the right atrium of a subject's heart by introducing the distal end of a hollow, straight, and stiff shaft into the subject's right internal jugular vein, and advancing the distal end of the shaft into the right atrium via the superior vena cava. The position of the distal end of the shaft is adjusted by manipulating a handle affixed to a portion of the shaft that remains outside the subject's body. The handle can be used to rotate the shaft about its longitudinal axis, rotate the shaft about an anterior-posterior axis, rotate the shaft about a medial-lateral axis, and/or advance the shaft in the caudal direction. A device is advanced through the interior of the shaft until the device extends beyond the distal end of the shaft and into the right atrium.
1 . An apparatus comprising:
a hollow, straight, and stiff metal shaft having a longitudinal axis and an outer diameter between 5.5 and 7.5 mm, an inner diameter of at least 5 mm, and wherein the shaft has metal sidewalls with no openings in the sidewalls;
a handle affixed to the shaft, the handle having a distal end, wherein the shaft extends distally beyond the distal end of the handle by between 30 and 70 cm, and wherein the handle is affixed to the shaft such that manipulation of the handle can (i) rotate the shaft about the longitudinal axis of the shaft, (ii) rotate the shaft about an anterior-posterior axis, (iii) rotate the shaft about a medial-lateral axis, (iv) advance the shaft in a caudal direction, and (v) withdraw the shaft in a cranial direction; and
a device for (a) reducing a diameter of a tricuspid anulus, (b) replacing a tricuspid valve, or (c) clipping leaflets of a tricuspid valve, wherein the device is disposed in a collapsed state within an interior of the shaft,
wherein the device is configured to be advanced in the caudal direction through the interior of the shaft until the device extends caudally beyond the distal end of the shaft.
2 . The apparatus of claim 1 , wherein the shaft extends distally beyond the distal end of the handle by between 40 and 60 cm.
3 . The apparatus of claim 1 , wherein the device is further configured so that after the device has been extended caudally beyond the distal end of the shaft, the device can bend with only a single degree of freedom in response to movement of a control surface.
4 . The apparatus of claim 1 , further comprising a hollow bending member that extends distally beyond the distal end of the shaft, wherein the bending member is configured to bend with only a single degree of freedom in response to movement of a control surface.
5 . The apparatus of claim 1 , wherein the device is a device for reducing a diameter of a tricuspid anulus.
6 . The apparatus of claim 1 , wherein the device is a device for replacing a tricuspid valve.
7 . The apparatus of claim 1 , wherein the device is a device for clipping leaflets of a tricuspid valve.