Device for the intermittent occlusion of the coronary sinus
In a device for the intermittent occlusion of the coronary sinus, including a catheter with several lumens, an occlusion device fixed to the catheter and operable through at least one lumen of the catheter, and at least one pressure measuring device for measuring the fluid pressure in the coronary sinus, the catheter additionally comprises support means for supporting the catheter on the inner wall of the coronary sinus, which support means are reversibly placeable in abutment on the inner wall of the coronary sinus by an operating element.
1. A device for intermittent occlusion of a coronary sinus, comprising:
a catheter comprising a plurality of lumens,
an occlusion device fixed to the catheter, the occlusion device comprising an inflatable balloon configured to at least partially occlude a coronary sinus of a heart and being in fluid communication with at least one of said lumens of the catheter, and
at least one pressure measuring device for measuring fluid pressure in the coronary sinus,
wherein said plurality of lumens of the catheter comprises: a balloon inflation lumen in fluid communication with the inflatable balloon to inflate and deflate the inflatable balloon; a balloon pressure-monitoring lumen to measure fluid pressure in the balloon, the balloon pressure-monitoring lumen being different from and laterally offset from the balloon inflation lumen; a coronary sinus pressure sensor lumen in fluid communication with said pressure measuring device and extending distally of the balloon for communication with fluid in a coronary sinus, the coronary sinus pressure sensor lumen being different from and laterally offset from the balloon inflation lumen and the balloon pressure-monitoring lumen; and a fourth lumen being different from and laterally offset from the balloon inflation lumen, the balloon pressure-monitoring lumen, and the coronary sinus pressure sensor lumen,
wherein the catheter comprises at least one structure extending distally of a distal end of the inflatable balloon and being reversibly placeable in abutment on an inner wall of the coronary sinus.
2. A device according to claim 1 , wherein the at least one structure comprises a support means for supporting the catheter on the inner wall of the coronary sinus.
3. A device according to claim 2 , wherein the support means comprises an expandable basket-like or cage-like structure having two ends, and each one of said ends is fixed to one of two catheter portions that are relatively displaceable in an axial direction of the catheter.
4. A device according to claim 1 , wherein the occlusion device is arranged radially within a basket-like or cage-like structure.
5. A device according to claim 3 , wherein the occlusion device is arranged radially within the basket-like or cage-like structure.
6. A device according to claim 2 , wherein the support means comprises a catheter portion that is helically deformable by operation of a cable pull of the catheter.
7. A device according to claim 1 , further comprising multiple apertures facing radially outward from the at least one structure, and said multiple apertures being in fluid communication with said coronary sinus pressure sensor lumen and said pressure measuring device.
8. A device according to claim 2 , wherein the support means comprises a radiopaque or echogenic coating.
9. A device according to claim 2 , wherein the occlusion device comprises at least one electrically conductive region positioned to be contacted by an electrically conductive region positioned on the support means.
10. A device according to claim 1 , wherein the catheter comprises a plurality of radiopaque or echogenic markings.
11. A device according to claim 2 , wherein a handle is connected with the catheter so as to actuate the support means.
12. A device according to claim 3 , wherein a handle is connected with the relatively displaceable catheter portions for displacement of the catheter portions.
13. A device according to claim 6 , wherein a handle is connected with the cable pull for operation of the cable pull.
14. A device according to claim 2 , wherein the catheter comprises a sheathing hose for sleeving over the support means when the support means is not in abutment on the inner wall of the coronary sinus.
15. A device according to claim 1 , further comprising an ultrasonic measuring device for measuring a blood volume stream when the occlusion device is arranged in the coronary sinus.
16. The device according to claim 1 , wherein the at plurality of lumens extending through a shaft portion of catheter have cross-sectional geometries differing from one another.
17. The device according to claim 16 , wherein the balloon inflation lumen has a ring segment-shaped in cross section and is arranged radially outside the coronary sinus pressure sensor lumen extending centrally through the shaft portion of the catheter.
18. The device according to claim 17 , further comprising wherein the balloon pressure-monitoring lumen has a ring segment-shaped in cross section and is arranged offset from the coronary sinus pressure sensor lumen extending centrally through the shaft portion of the catheter, wherein the ring segment-shaped of the balloon pressure-monitoring lumen is smaller as compared to that of the balloon inflation lumen.
19. The device according to claim 1 , wherein the at least one structure extending distally of a distal end of the inflatable balloon comprises a catheter tip element in fluid communication with the coronary sinus pressure sensor lumen extending centrally through the shaft portion of the catheter, the catheter tip element defining the multiple apertures that are positioned distally of the inflatable balloon of the occlusion device for communication with fluid in a coronary sinus.