The present disclosure relates to extracorporeal blood circuits, systems, and methods of use. More particularly, it relates to mounting systems for mounting one or more components of an extracorporeal blood circuit (blood reservoir, oxygenator, filter, etc.) relative to other components, such as to a cart maintaining one or more circuit pumps.
An extracorporeal blood circuit is commonly used during cardiopulmonary bypass to withdraw blood from the venous portion of the patient's circulation system (via a venous cannula) and return the blood to the arterial portion (via an atrial cannula). The extracorporeal circuit generally includes a venous drainage or return line, a venous blood reservoir, a venous blood pump, an arterial line, and blood transporting tubing, ports, and connection pieces interconnecting these components. Additional components, such as an oxygenator, a venous filter, an arterial filter, etc., are also commonly employed. Further, cardiotomy blood suctioned from the surgical site can be incorporated into the extracorporeal circuit (with appropriate filtering), and entails an additional pump and reservoir (that can be separate from, or integrated with, the venous blood reservoir). In addition to the venous blood and cardiotomy pumps, the cardiovascular surgical procedure may require additional pumps (e.g., cardioplegia pump, vent pump, etc.), as well as one or more back-up pumps in the event of failure.
Conventionally, the pumps as well as other non-disposable extracorporeal circuit components (e.g., controllers, monitors, etc.), are carried to and from the surgical suite by a wheeled console or cart for convenient storage, transport, and use. Other disposable components (e.g., blood reservoir, oxygenator, filter, etc.) are mounted to the cart as desired by the user (i.e., a perfusionist). More particularly, one or more upright poles or masts are provided with the cart, and the disposable components are mounted to the mast(s) in accordance with the procedure to be performed, a location of the patient and preferences of the user/perfusionist.
The physical arrangement of fluid lines, pumps, reservoir(s), oxygenator, and other components of the extracorporeal blood circuit directly affect proper operation of the perfusion system. It is generally considered important to have an arrangement that reduces the extracorporeal volume of all blood-containing circuits so as to reduce the need for transfusion or dilution. Additionally, the physical arrangement should be such that the perfusionist can scan, take samples, and consistently be aware of the status of all equipment, systems, and patient parameters. It is also highly desirable that the perfusionist be able to observe the surgical team and operating table, and to observe and have direct access to the oxygenator, the fluid lines, the pumps, the reservoirs, etc., from a single standing or sitting position.
While specialty brackets or other holders are available for connecting or mounting extracorporeal blood circuit disposable component(s) to the cart/mast, the brackets are typically unique to the design of the component in question, and even to a size of the particular component. For example, a pump cart mounting device for an adult-sized reservoir may not be compatible with a pediatric-sized reservoir from the same manufacturer. This in turn requires the perfusionist to have multiple holders on hand to accommodate differently-sized disposable components. Further, existing mounting systems may overtly limit arrangement of certain circuit components relative to one another. For example, extracorporeal blood circuits often entail both a reservoir and an oxygenator; some surgical site applications and/or perfusionist preferences will desirably position the oxygenator immediately below the reservoir while others employ an offset arrangement. Unfortunately, many existing mounting devices do not afford the perfusionist the ability to select a desired arrangement from procedure to procedure. Along these same lines, most pump carts provide two masts, one to the left of the pumps, and the other to the right. This facilitates use of the pump cart in a surgical suite to either side of the patient (i.e., where the surgical suite is established at the patient's left, the right mast is likely to be used for mounting of the disposable extracorporeal circuit components, and vice-versa). Existing holder designs (e.g., combination reservoir and oxygenator holders) do not readily permit both right side and left side mounting arrangements; instead, the perfusionist must have two different versions of the circuit component(s) in question on hand (e.g., a left side reservoir and a right side reservoir) to arrange the circuit as desired once the surgical suite constraints are known.
In light of the above, a need exists for an extracorporeal blood circuit mounting system for mounting one or more components to a pump cart mast.
Some aspects in accordance with principles of the present disclosure relate to a mounting system for mounting one or more components of an extracorporeal blood circuit to an upstanding mast provided with a cart otherwise maintaining one or more pumps employed with the extracorporeal blood circuit. The system includes a clamp device, a primary arm, a seat, a post, and a locking mechanism. The clamp device is configured for releasable mounting to an upstanding pole. The primary arm defines first and second end portions, with the first end portion being pivotably coupled to the clamp device. The seat defines a base, an intermediate section, and a head. The base is mounted to the second end portion of the primary arm. The intermediate section tapers in outer diameter from the base to the head, and is configured to receive a corresponding feature associated with an extracorporeal blood circuit component. The post projects from the head in a direction opposite the primary arm. Finally, the locking mechanism is configured to releasably secure a feature associated with an extracorporeal blood circuit component, otherwise located over the seat, to the primary arm. With this configuration, the extracorporeal blood circuit component can be selectively located and locked to the primary arm at a variety of different rotational orientations about an axis defined by the post. In some embodiments, the locking mechanism includes a spring biased lever forming a leading face having a plurality of transversely extending fingers, and provides a locked state in which a feature associated with an extracorporeal blood circuit component is captured by one or more of the fingers. In other embodiments, the mounting system further includes an auxiliary arm defining a leading region and a trailing region, with the trailing region forming a sleeve sized to be removably disposed over the intermediate section of the seat. In related embodiments, the leading region is configured to selectively receive and maintain an extracorporeal blood circuit component, such as an oxygenator.
Other aspects in accordance with principles of the present disclosure relate to an assembly for use in an extracorporeal blood circuit. The assembly includes a blood reservoir and a mounting system. The blood reservoir includes a housing forming a chamber and a mounting portion. The mounting portion defines a foot and a passage. In this regard, the passage is open at, and extends from, the foot. The mounting system includes a clamp device, a primary arm, a seat, a post, and a locking mechanism as described above. With this in mind, the assembly is configured to provide first and second locked states in which the post is received within the passage and the foot is locked over the seat via the locking mechanism. The blood reservoir can rotate relative to the primary arm about an axis of the post such that a spatial rotational location of the blood reservoir relative to the primary arm differs between the first and second locked states. In some embodiments, the mounting system further includes an auxiliary arm forming a sleeve and a grasping structure. The sleeve sized to be received over the post and the seat, with the grasping structure configured for selective coupling to an extracorporeal blood circuit component apart from the blood reservoir (e.g., an oxygenator, a filter, etc.). With this in mind, the assembly is configured to provide a stacked arrangement in which the sleeve is located directly over the seat, and the foot is received directly over the sleeve, with the locking mechanism operating to lock the blood reservoir and the auxiliary arm relative to the primary arm.
Yet other aspects in accordance with principles of the present disclosure relate to a method of arranging components of an extracorporeal blood circuit. The method includes coupling a clamp device of a mounting system to an upstanding mast provided with a cart otherwise maintaining at least one pump to be used in the extracorporeal blood circuit. The mounting system further include a primary arm pivotably coupled to the clamp device, a seat carried by the primary arm, a post projecting from the seat, and a locking mechanism. A blood reservoir is assembled to the mounting system. In this regard, the blood reservoir includes a housing forming a mounting section defining a foot and a passage open at, and extending from, the foot. Assembly of the blood reservoir to the mounting system includes sliding the passage over the post. The blood reservoir is rotated relative to the primary arm about an axis defined by the post to a desired spatial orientation. Finally, the blood reservoir is locked relative to the primary arm in the desired spatial orientation via operation of the locking mechanism. In some embodiments, the method further includes assembling a sleeve portion of an auxiliary arm over the post and onto the seat, followed by mounting of the foot over the post and onto the sleeve. A separate extracorporeal blood circuit component is mounted to a grasping structure of the auxiliary arm. The blood reservoir and the auxiliary arm are rotated about the post axis and thus relative to the primary arm in an independent fashion to desired spatial locations, and the locking mechanism operated to simultaneously lock the blood reservoir and the auxiliary arm relative to the primary arm.
One embodiment of an extracorporeal blood circuit perfusion assembly 50 incorporating a mounting system 52 in accordance with principles of the disclosure is shown in
The mounting system 52 includes a holder assembly 70 and optionally one or more auxiliary arms 72. The holder assembly 70 is configured for coupling to the selected mast 58, and can directly maintain one or more of the disposable components 60 and/or indirectly maintain one or more disposable components 60 via the auxiliary arm(s) 72.
One embodiment of the holder assembly 70 is shown in greater detail in
The clamp device 80 can assume a variety of forms appropriate for releasable coupling to the mast 58 (
For example, the shoe 102 can define a mast interface surface 116 and a rear surface 118 opposite the mast interface surface 116. The mast interface surface 116 is configured to contact and engage a cylindrical mast or pole. An aperture (hidden in the view of
The shoulder 108 is interposed between the arms 104, 106 and the platform 110, and establishes an angular direction of extension of the platform 110. As described below, the platform 110 is coupled to the primary arm 82, with the primary arm 82 desirably extending generally away from the first arm 104 of the clamp body 100.
The platform 110 is configured to receive the primary arm 82 in a rotatable fashion as described in greater detail below. In general terms, the platform 110 extends from the shoulder 108, and defines opposing, first and second bearing surfaces 140, 142 and a perimeter edge 144. As shown, a thickness of the platform 110 is, in some constructions, less than that of the shoulder 108, with the platform 110 being generally centered relative to a thickness of the shoulder 108 to define opposing, first and second side walls 146, 148. The perimeter edge 144 is generally curved to facilitate guided articulating motion of the primary arm 82 along the edge 144. In some embodiments, the edge 144 optionally forms a nose 150 that, upon final assembly, interfaces with a corresponding feature of the primary arm 82 to prevent or stop overt movement. Finally, the platform 110 optionally can form a passage 152 or any other feature that facilitates coupling with the primary arm 82 via a connector mechanism 154 (referenced generally) described below (e.g., a threaded piece can be press-fitted within the passage 152).
Regardless of exact form, by approximately centering the platform 110 relative to the clamp body 100 and providing the opposing bearing surfaces 140, 142, the clamp device 80 is effectively reversible relative to the primary arm 82. More particularly, the primary arm 82 can be assembled to the first bearing surface 140 as shown (i.e., the clamp body 100 is arranged with the first bearing surface 140 facing up); alternatively, the clamp body 100 can be inverted from the orientation of
The primary arm 82 defines a first end region 160, an opposing second end region 162, and an intermediate region 164 extending between the end regions 160, 162. In general terms, the first end region 160 is configured for pivotable coupling to the clamp device 80, whereas the second end region 162 is configured to retain the seat 84 and the locking mechanism 88. The intermediate region 164 contributes to an overall length of the primary arm 82 that, in some constructions, is on the order of 10-24 inches. Other lengths are also envisioned. The primary arm 82 can be akin to a hollow frame or beam, defined by an upper wall 166 and a depending flange 168 that extend across the regions 160-164. Other configurations (e.g., solid block, I-beam, etc.), are also contemplated.
The first end region 160 terminates at an end 170 that, in some constructions, is curved or rounded, and can include a cut-out 172 in the flange 168 that creates a ledge 174. As described below, this construction promotes pivoting articulation of the primary arm 82 relative to the clamp device 80, with the ledge 174 serving as a stop to overt movement. Further, the first end region 160 provides one or more features that facilitate assembly to the clamp device 80, such as an aperture 176 in the wall 166 that is sized to receive a corresponding component of the connector mechanism 154. Alternatively, the first end region 160 can incorporate additional or other features that facilitate coupling with the clamp device 80.
The second end region 162 can assume various forms, and is generally configured to provide a support surface 178 (e.g., an outer face of the upper wall 166) for locating the seat 84 and the locking mechanism 88, as well as a separate structure placed over the seat 84. In some embodiments, the second end region 162 can form one or more holes 180a-180c that promote coupling of other mounting system components as described below.
The seat 84 is a generally conically shaped body defining a base 182, an intermediate section 184, and a head 186. The base 182 can have a ring-like construction (e.g., uniform outer diameter), and is configured for flush abutment against the support surface 178. The intermediate section 184 projects upwardly (relative to the orientation of
The post 86 is a cylindrical body, defining opposing, leading and trailing ends 200, 202. The leading end 200 can have the rounded shape illustrated to promote placement of a structure over the leading end 200; alternatively, the leading end 200 can be flat or nearly flat. Regardless, the trailing end 202 is configured for assembly to the head 186 of the seat 84, and thus can be sized in accordance with the opening 190. In some constructions, the post 86 is mounted to the seat 84 via a threaded rod 204, with the post 86 forming a threaded, internal bore (not shown) adapted to threadably receive the rod 204. Other mounting constructions are also envisioned.
The locking mechanism 88 is retained by the primary arm 82 and includes, in some constructions, a lever 210 including a lever body 212 and a neck 214. The neck 214 extends from the lever body 212, with the lever body 212 defining a leading face 216 and a trailing handle 218. The neck 214 facilitate rotatable coupling of the lever 210 to the primary arm 82.
The leading face 216 defines a primary surface or plane 220 and a plurality of fingers 222. The fingers 222 project transversely outwardly from the primary surface 220, and are vertically spaced from one another (relative to an upright orientation of the lever 210). While the lever 210 is depicted in
As indicated above, the lever 210 is rotatably coupled to the primary arm 82 via the neck 214. For example, in some constructions, the locking mechanism 88 further includes a ramp body 230, a biasing device 232, an optional washer 233 and a rod 234. The rod 234 couples the ramp body 230 to the neck 214, with the biasing device 232 (e.g., a spring) biasing the ramp body 230 into engagement with the neck 214. The ramp body 230 forms a notch 236 and opposing guide surfaces 238a, 238b. Upon final assembly of the locking mechanism 88 to the primary arm 82, the neck 214 projects through the third hole 180c, and the ramp body 230 is biased or pressed into engagement with a cam surface 240 formed by the neck 214. A bushing 242 is optionally provided to promote a rotational relationship between the neck 214 and the third hole 180c, and serves to retain the ramp body 230 relative to the primary arm 82 (e.g., the ramp body 230 does not rotate with rotation of the lever 210). A shape of the cam surface 240 corresponds with a shape of the notch 236 such that the cam surface 240 naturally resides within the notch 236 due to the bias applied by the biasing device 232. In this natural or normal state or position, the leading face 216, and thus the fingers 222, is immediately adjacent and faces the seat 84. The lever 210 can be rotated or articulated from this normal state via a turning force applied to the trailing handle 218. When a sufficient moment force is applied to the lever body 212, and thus the neck 214, the cam surface 240 is rotationally displaced from the notch 236 and moves or slides along the guide surfaces 238a, 238b. With rotation of the lever 210, then, the leading face 216, and thus the fingers 222, are rotationally displaced from the seat 84. When the moment force is reduced or removed, the biased interface of the ramp body 230 with the cam surface 240 causes the lever 210 to move back toward the normal state or position described above. The locking mechanism 88 can alternatively incorporate other components/constructions that do not employ the rotatable lever 210 in selectively locking a circuit component to the seat 84. For example, a torsion spring-based latch or similar mechanism can be used.
Construction of the holder assembly 70 includes assembling the seat 84 and the post 86 to the primary arm 82. For example, the trailing end 202 of the post 86 is lodged within the head 186 of the seat 84, and the threaded rod 204 employed to secure the post 86 to the seat 84, as well as the post 86 (and thus the seat 84) to the primary arm 82 via the second hole 180b. A pin 250 can also be employed, interconnecting the seat 84 with the primary arm 82 via the first hole 180a. The pin 250 essentially serves to impede or prevent rotation of the seat 84 relative to the primary arm 82. Finally, the locking mechanism 88 is assembled to the primary arm 82 as described above.
As shown in the final assembled state of
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The sleeve 282 is configured to interface with the holder assembly 70 (
The intermediate portion 292 includes or forms a hub 298 and a guide region 300. The hub 298 has a uniform outer diameter in some embodiments, and is akin to the base 182 of the seat 84. The guide region 300 defines a tapering diameter corresponding with a taper of the intermediate section 184 of the seat 84 (i.e., the inner and outer diameters of the guide region 300 taper in extension from the hub 298 to the top portion 294 in accordance with a taper of the intermediate section 184). In some constructions, the guide region 300 further includes or defines internal grooves 302 and external teeth 304. The internal grooves 302 are circumferentially spaced from one another, and each define a width corresponding with a width of respective ones of the ribs 188 provided with the seat 84. Thus, the internal grooves 302 can selectively receive respective ones of the ribs 188 in a meshing-type interface upon assembly of the sleeve 282 over the seat 84. The external teeth 304 are also circumferentially spaced from one another, and provide for a similar, meshed-type interface with a similarly-configured sleeve otherwise included with a separate component (i.e., the internal grooves 302 of a second, identically-configured sleeve (not shown) coaxially disposed over the sleeve 282 will engage with the external teeth 304). Finally, the top portion 294 is configured to slidably receive the post 86, and thus defines an opening (hidden in the view of
The grasping structure 284 can assume a variety of forms appropriate for selectively receiving and retaining a separate component, such as an extracorporeal blood circuit component (not shown). For example, in some constructions, the grasping structure 284 is a disk-like body, defining a circumferential slot 310 separating opposing first and second disks 312, 314. A width of the slot 310 corresponds with a thickness of a feature provided with the circuit component to be assembled to the auxiliary arm 72, with the disks 312, 314 serving to frictionally retain the component relative to the grasping structure 284 and/or the first disk 312 is frictionally received by the component feature. In some constructions, the first disk 312 can optionally further form an inner groove 315 sized to selectively capture a corresponding feature of the circuit component to be assembled to the auxiliary arm 72. Regardless, sliding rotation of the component along or about the slot 310 can occur. The grasping structure 284 can be assembled to the arm body 280 in a variety of manners, such as via a bolt 316 that couples the grasping structure 284 to the arm body 280, and a pin 318 that serves to prevent rotation of the grasping structure 284 relative to the arm body 280 upon a design of final assembly.
Depending upon the particular component to be retained by the auxiliary arm 72, the grasping structure 284 can alternatively assume a wide variety of other constructions and/or incorporate other devices or mechanisms. For example, the grasping structure 284 can include a clamp mechanism. Alternatively, and as shown with the auxiliary arm 72′ of
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Conversely,
Once the holder assembly 70 is coupled to the selected mast 58, one or more extracorporeal blood circuit components can be mounted to the holder assembly 70. For example, and as shown in
To permit rotation of the auxiliary arm 72 relative to the primary arm 82 and/or complete removal from the holder assembly 70, the lever 210 can be rotated as described above, such that the bottom-most finger 222a no longer bears against the rim 296. In this released state of the locking mechanism 88, the auxiliary arm 82 can be rotated about an axis of the post 86 to virtually any desired spatial rotational orientation relative to the primary arm 82 as desired by the user/perfusionist. Once in the desired rotational arrangement, the auxiliary arm 72 is manipulated to position the sleeve 282 on the seat 84 as described above, and the locking mechanism 88 returned to the locked state.
The desired extracorporeal blood circuit component 60 (
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For example, and as shown in
In addition, or as an alternative to the auxiliary arm 72 being assembled to the holder assembly 70, correspondingly configured disposable extracorporeal blood circuit components can be directly mounted over the post 86. For example,
The above-described blood reservoir 360 (or any other extracorporeal blood circuit disposable component incorporating the mounting portion 366 as described) can be directly assembled to the holder assembly 70 and onto the seat 84 as shown in
Alternatively, the blood reservoir 360 (or any other extracorporeal circuit disposable component incorporating the mounting portion 366 as described) can be assembled over the post 86 and onto the previously-mounted auxiliary arm 72 as shown in
The extracorporeal blood circuit component mounting systems and methods of the present disclosure provide a marked improvement over previous designs, and facilitate flexible positioning of a plethora of different extracorporeal disposable components such as oxygenators, blood reservoirs, filters, hemoconcentrators, centrifugal pumps, etc. The mounting systems and methods are ergonomic and intuitive to use, facilitate desirable ambidextrous positioning of various components, and effectively allow the perfusionist to create a customized circuit in accordance with the circumstances presented by each particular surgical procedure.
Although the present disclosure has been described with reference to preferred embodiments, workers skilled in the art will recognize that changes can be made in form and detail without departing from the spirit and scope of the present disclosure.