The present disclosure relates to percutaneous circulatory support devices. More specifically, the disclosure relates to percutaneous circulatory support devices having a cannula.
Circulatory support devices support the pumping action of the heart. These devices may be disposed through a valve opening such as, for example, an aortic valve. Blood flow through the circulatory support devices is an important factor when differentiating between different types of circulatory support devices. In some instances, a cannula may be used for providing blood flow through the circulatory support device. Proper positioning and stability of the cannula are important factors for retaining the proper blood flow and function of the circulatory support device.
In Example 1, a percutaneous circulatory support device includes a housing, a cannula coupled to the housing, the cannula having a first portion and a second portion. The cannula includes at least one slot disposed along at least the first portion of the cannula, the at least one slot configured such that the first portion of the cannula is defined by a first stiffness and a second portion of the cannula is defined by a second stiffness, the first stiffness being different than the second stiffness.
In Example 2, the percutaneous circulatory support device of Example 1 includes wherein the at least one slot is formed by laser cutting.
In Example 3, the percutaneous circulatory support device of Example 1, includes wherein the first portion is defined as a distal portion of the cannula and the second position is defined as a proximal portion of the cannula, and the first stiffness is less than the second stiffness.
In Example 4, the percutaneous circulatory support device of Example 1, further includes wherein the at least one slot includes a plurality of circular openings extending through the cannula.
In Example 5, the percutaneous circulatory support device of Example 1, further includes wherein the at least one slot includes a plurality of slots extending around the cannula.
In Example 6, the percutaneous circulatory support device of Example 1, further includes wherein the at least one slot defines a spiral slot extending around and along the cannula.
In Example 7, the percutaneous circulatory support device of Example 1, further includes wherein the cannula includes a coating configured to reduce the coefficient of friction of the cannula.
In Example 8, the percutaneous circulatory support device of Example 1, further includes wherein the cannula includes a shape set curved portion.
In Example 9, the percutaneous circulatory device of Example 3, further includes wherein the distal portion of the cannula includes an atraumatic tip element.
In Example 10, a percutaneous circulatory support device includes an impeller disposed within an impeller housing, the impeller being rotatable relative to the impeller housing to cause blood to flow through the impeller housing, and a motor configured to rotatably drive the impeller within the impeller housing. The device additionally includes a cannula coupled to the impeller housing, the cannula having a proximal portion, a distal portion, and an intermediate portion. The device further includes the cannula having at least one slot extending through the cannula and disposed along at least a first portion of the cannula, the at least one slot formed from laser cutting, and the first portion of the cannula body being defined by a first stiffness and a second portion of the cannula body being defined by a second stiffness that is different than the first stiffness.
In Example 11, the percutaneous circulatory support device of Example 10 further includes wherein the cannula comprises a curved portion, and wherein the curved portion defines a third portion having a third stiffness.
In Example 12, the percutaneous circulatory support device of Example 10 further includes wherein the distal portion of the cannula is operatively coupled to an atraumatic tip.
In Example 13, a method of forming a cannula of a percutaneous circulatory device, the percutaneous circulatory device including an impeller disposed within an impeller housing, the impeller being rotatable relative to the impeller housing to cause blood to flow through the percutaneous circulatory support device, wherein the cannula is configured to provide blood flow into the impeller housing, includes providing a cannula composed of a metallic material, the cannula having a distal portion, a proximal portion, an intermediate portion and a cannula lumen, the cannula lumen extending between the distal portion and the proximal portion. The method further includes shape setting the cannula such that the cannula tube comprises a curved portion, and laser cutting the cannula tube to form at least one slot within the tube such that the proximal portion has a first density of the at least one slot at a first portion of the cannula and a second density of the at least one slot at a second portion of the cannula, the first density being different than the second density.
In Example 14, the method of Example 13 further includes, wherein the at least one slot includes a plurality of openings extending circumferentially around the cannula.
In Example 15, the method of Example 13 further includes wherein the at least one slot includes at least one spiral cut extending along the cannula.
In Example 16, a percutaneous circulatory support device includes an impeller disposed within an impeller housing, the impeller being rotatable relative to the impeller housing to cause blood to flow through the impeller housing and a cannula coupled to the impeller housing, the cannula having a first portion and a second portion. The percutaneous circulatory support device additionally includes wherein the cannula includes at least one slot disposed along at least the first portion of the cannula, the at least one slot configured such that the first portion of the cannula body is defined by a first stiffness and a second portion of the cannula is defined by a second stiffness, the first stiffness being different than the second stiffness.
In Example 17, the device of Example 16 further includes wherein the first portion is defined as a distal portion and the second portion is defined as a proximal portion, and the first stiffness is less than the second stiffness.
In Example 18, the device of Example 16 further includes wherein the at least one slot includes a plurality of openings, and wherein the first portion has a reduced density of the plurality of openings relative to a density of the plurality of openings at the second portion.
In Example 19, the device of Example 16 further includes wherein the at least one slot includes a plurality of circular openings extending through the cannula.
In Example 20, the device of Example 16 further includes wherein the at least one slot includes a plurality of slots extending around the cannula.
In Example 21, the device of Example 16 further includes wherein the at least one slot defines a spiral slot extending around and along the cannula.
In Example 22, the device of Example 16 further includes wherein the cannula body comprises a shape set curved portion.
In Example 23, the device of Example 16 further includes wherein the distal portion of the cannula comprises an atraumatic tip element.
In Example 24, the device of Example 16 further includes wherein the cannula includes a coating configured to reduce the coefficient of friction of the cannula.
In Example 25, the device of Example 16 further includes wherein the cannula is composed of one of nitinol, stainless steel, Inconel and MP35N.
In Example 26, a percutaneous circulatory support device includes an impeller disposed within an impeller housing, the impeller being rotatable relative to the impeller housing to cause blood to flow through the impeller housing and a motor configured to rotatably drive the impeller within the impeller housing. The percutaneous support device further includes a cannula coupled to the impeller housing, the cannula having a proximal portion, a distal portion, and an intermediate portion, and wherein the cannula includes at least one slot extending through the cannula body disposed along at least the distal portion of the cannula, wherein the at least one slot is formed from laser cutting, the distal portion of the cannula being defined by a first stiffness and the proximal portion of the cannula being defined by a second stiffness that is different than the first stiffness.
In Example 27, the device of Example 26 further includes wherein the cannula comprises a curved portion in the intermediate portion, and wherein the intermediate portion defines a third portion having a third stiffness.
In Example 28, the device of Example 26 further includes wherein the third stiffness is different than the first stiffness and the second stiffness.
In Example 29, the device of Example 26 further includes wherein the distal portion of the cannula is operatively coupled to an atraumatic tip.
In Example 30, a method of forming a cannula of a percutaneous circulatory device, the percutaneous circulatory device including an impeller disposed within an impeller housing, the impeller being rotatable relative to the impeller housing to cause blood to flow through the impeller housing, wherein the cannula is configured to provide blood flow into the impeller, includes providing a cannula composed of a metallic material, the cannula having a distal portion, a proximal portion, and a cannula lumen extending between the proximal portion and the distal portion. The method further includes shape setting the cannula such that the cannula tube includes a curved portion and laser cutting the cannula tube to form at least one slot within the cannula such that the proximal portion has a first density of the at least one slot at a first portion of the cannula and a second density of the at least one slot at a second portion of the cannula, the first density being different than the second density.
In Example 31, the method of Example 31 further includes attaching a tip element to the distal portion of the cannula.
In Example 32, the method of Example 30 further includes wherein the metallic material is one of nitinol, stainless shell, Inconel, and MP35N.
In Example 33, the method of Example 30 further includes wherein the at least one slot includes a plurality of openings extending circumferentially around the cannula.
In Example 34, the method of Example 30 further includes wherein the at least one slot includes at least one spiral cut extending along the cannula.
In Example 35, the method of Example 30 further includes an intermediate portion extending between the proximal portion and the distal portion, and wherein the intermediate portion includes the curved portion.
While multiple embodiments are disclosed, still other embodiments of the present invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.
Various modifications and additions can be made to the exemplary embodiments discussed without departing from the scope of the present invention. For example, while the embodiments described above refer to particular features, the scope of this invention also includes embodiments having different combinations of features and embodiments that do not include all of the described features.
Embodiments disclosed herein include circulatory support devices that have an increased flow capability in comparison to conventional embodiments.
In embodiments, a distal portion 116 of the cannula 104 is arranged in the left ventricle 112. An intermediate portion 118 of the cannula 104 extends through the aortic valve 120 so that a proximal portion 122 of the cannula 104 extends into the aorta 114. In embodiments, the proximal portion 122 of the cannula 104 is coupled to the connector 108 and the connector 108 is coupled to the circulatory support device 102. In other embodiments, the cannula 104 is coupled to the circulatory support device without the use of a connector. During operation, the circulatory support device 102 draws blood from the left ventricle 112, through the cannula 104 of the circulatory support device 102 and is released into the aorta 114. Additionally, or alternatively, the circulatory support device 102 may be used to facilitate pumping blood from some other aspect of the subject's vasculature into an adjacent portion of the vasculature.
Further, as illustrated, the cannula 104 may comprise a tip element 154 attached to the distal portion 116 of the cannula 104. As illustrated, the tip element 154 is a spherical element that is coupled to the distal portion 116 through the use of a plurality of wires 158. Specifically, the plurality of wires 158 are coupled to the distal portion 116 of the cannula 104 and coupled directly to the tip element 154. The tip element 154 may prevent suction of tissue into the cannula 104 by spacing the distal portion 116 away from tissue. While illustrated as a sphere, the tip element 154 may be any variety of shapes, for example a rectangle or a cylinder. Additionally, or alternatively, the tip element 154 may be radiopaque to help determine proper positioning of the cannula 104 during or after delivery. Further, the spaces between the plurality of wires 158 may act as an inlet for the blood to enter the cannula 104. In other embodiments, an inlet may be defined by other features, such as a housing coupling the intermediate portion 118 of the cannula 104 to the tip element 154. Additionally, or alternatively, tip element 154 acts as an atraumatic tip element configured to protect the patient's vasculature or the tissue of the heart 110, including valvular tissue, by eliminating harsh edges or surfaces that could come into contact with the surrounding vasculature or tissue as the cannula 104 is navigated to, into, or through the heart 110. For example, the tip element 154 may include a solder ring, a balloon and/or a silicone ring to serve as an atraumatic tip element. Further, in other embodiments, an elongated tip, for example taking shape similar to a guidewire, is used as the tip element 154. In some embodiments, no tip element is incorporated with the cannula 104 at all.
With continued reference to
The impeller housing 130 carries an impeller assembly 134 therein. The impeller assembly 134 includes an impeller shaft 136 that is rotatably supported by at least one bearing, such as a bearing 138. The impeller assembly 134 also includes an impeller 140 that rotates relative to the impeller housing 130 to drive blood through the device 102. More specifically, the impeller 140 causes blood to flow from a blood inlet 142 formed on the impeller housing 130, through the impeller housing 130, and out of a blood outlet 144 formed on the impeller housing 130. In some embodiments and as illustrated, the impeller shaft 136 and the impeller 140 may be separate components, and in other embodiments the impeller shaft 136 and the impeller 140 may be integrated. In some embodiment and as illustrated, the inlet 142 and/or the outlet 144 may each include multiple apertures. In other embodiments, the inlet 142 and/or the outlet 144 may each include a single aperture. In some embodiments and as illustrated, the inlet 142 may be formed on an end portion of the impeller housing 130 and the outlet 144 may be formed on a side portion of the impeller housing 130. In other embodiments, the inlet 142 and/or the outlet 144 may be formed on other portions of the impeller housing 130. As illustrated and previously described, the impeller housing 130 couples to the cannula 104 such that the cannula 104 receives and delivers blood to the blood inlet 142.
With continued reference to
In some embodiments, a controller (not shown) may be operably coupled to the motor 146 and configured to control the motor 146. In some embodiments, the controller may be disposed within the motor housing 132. In other embodiments, the controller may be disposed outside of the motor housing 132 (for example, in a catheter handle, an independent housing, etc.). However, the above described embodiment of the circulatory support device 102 is not meant to be limiting and the cannula 104, and any variations of the cannula described herein with reference to
As shown in
The shape of the cannula 204 may also be manipulated by hand, for example by a physician adjusting the shape of the cannula 204 prior to insertion into a patient. For example, the curved portion 228 may be formed by a physician prior to the cannula 204 being inserted into a patient's vasculature.
As previously mentioned, an additional advantage of the cannula 204 as disclosed herein, is the ability for slots to be cut into the cannula 204, for example by laser cutting the cannula 204. For example, as illustrated in
The distribution of the plurality of slots 230 may be varied as well. For example, as illustrated in the embodiment of
One advantage of the incorporation of the plurality of slots 230, and particularly with varying density along the cannula 204, allows for the cannula 204 to have a varying stiffness and/or varying amounts of flexibility throughout the cannula 204 while maintaining a constant wall thickness. For example, the distal portion 216 may be formed with a higher plurality of slots 230 in order to increase the flexibility at the distal portion 216 of the cannula 204. In this way, the cannula 204 is still capable of flexibility and a range of motion at the distal portion 216. Further, the cannula 204 may have a lower density of the plurality of slots 230 towards the curved portion 228 to increase the stiffness of the curved portion of the cannula 204. This may provide the advantage of increasing the stability of the curved portion 228 when it is positioned at the aorta 114 (
Additionally, between each portion of the cannula 204 that defines varying stiffness values, the plurality of slots 230 may be configured to provide gradual increases (or decreases) in the stiffnesses. Incorporating gradual transition between the varying stiffness values may increase the stability of the cannula 204 as opposed to if abrupt changes in the stiffness were present. Varying the stiffness and/or varying the amounts of flexibility throughout the cannula 204 may also permit manipulation of the cannula 204 by the physician before or after insertion into the vasculature, as described above. For example, the pattern of the slots 230 may be designed to control the bending amount or direction of the cannula 204.
An additional advantage of using the plurality of slots 230 is the ability to optimize the insertion of the cannula 204 through the vasculature and into the heart 110 (
An additional feature that may be incorporated into the cannula 204 is a surface coating 240 disposed around the entirety of the cannula 204. In some embodiments, the surface coating 240 is a silicone, PET, or other biocompatible and/or hydrophobic polymers such as polyether block amide, polytetrafluoroethylene, fluorinated ethylene propylene, or polyurethane. In some embodiments, the surface coating 240 can be hydrophilic. The surface coating 240 may be applied via a dip coating, a spray coating, molding, heat shrink, or polymer reflow process among other methods. The surface coating 240 may be attached to the cannula body 224, and thus the cannula 204. The surface coating 240 may be provided for optimizing the cannula 204 for trackability and biocompatibility. For example, the surface coating 240 may reduce the coefficient of friction of the cannula 204 to increase the ease with which the cannula 204 is delivered into the heart 110. Additionally, the use of the surface coating 240 increases the biocompatibility of the cannula 204 to avoid undesired reactions between the cannula 204 and tissue of the vasculature. Further, the surface coating 240 may be applied such that the entirety of the outer surface and the inner surface of the cannula 204 is covered. In the embodiments wherein the plurality of slots 230 are a plurality of apertures extending entirely through the cannula 204, the surface coating 240 creates a seal over the plurality of slots 230 such that the cannula 204 is a sealed tube and does not allow for fluid or blood flow through the plurality of slots 230. Even further, the cannula 204 may comprise an additional surface coating 242 on an inner surface the cannula 204. Similar to the surface coating 240 as described with reference to
While the at least one slot described with reference to
While the following description is made with reference to the cannula 404 illustrated in
The described features of the cannulas 104, 204, and 404 are not meant to be limited to their embodiments. For example, various features as described with reference to cannula 204 may be used in combination with the cannula 404 or the cannula 104. For example, the tip element 154 may be incorporated into cannula 204 and/or cannula 304 and/or cannula 404 as well. Further, the surface coating 240 as described with reference to the cannula 204 may be used in combination with the cannulas 104, 304, and/or 404 as described with reference to
Various modifications and additions can be made to the exemplary embodiments discussed without departing from the scope of the present invention. For example, while the embodiments described above refer to particular features, the scope of this invention also includes embodiments having different combinations of features and embodiments that do not include all of the described features. Accordingly, the scope of the present invention is intended to embrace all such alternatives, modifications, and variations as fall within the scope of the claims, together with all equivalents thereof.
The present application claims priority to Provisional Application No. 63/280,209, filed Nov. 17, 2021, which is herein incorporated by reference in its entirety.
Number | Date | Country | |
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63280209 | Nov 2021 | US |