WO2011117566A1 - Pompe sanguine pulsée - Google Patents
Pompe sanguine pulsée Download PDFInfo
- Publication number
- WO2011117566A1 WO2011117566A1 PCT/GB2011/000354 GB2011000354W WO2011117566A1 WO 2011117566 A1 WO2011117566 A1 WO 2011117566A1 GB 2011000354 W GB2011000354 W GB 2011000354W WO 2011117566 A1 WO2011117566 A1 WO 2011117566A1
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- WO
- WIPO (PCT)
- Prior art keywords
- blood
- blood pump
- tubular body
- fluid
- fluid chamber
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/40—Details relating to driving
- A61M60/424—Details relating to driving for positive displacement blood pumps
- A61M60/427—Details relating to driving for positive displacement blood pumps the force acting on the blood contacting member being hydraulic or pneumatic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/13—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel by means of a catheter allowing explantation, e.g. catheter pumps temporarily introduced via the vascular system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/135—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel inside a blood vessel, e.g. using grafting
- A61M60/139—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel inside a blood vessel, e.g. using grafting inside the aorta, e.g. intra-aortic balloon pumps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/80—Constructional details other than related to driving
- A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
- A61M60/871—Energy supply devices; Converters therefor
- A61M60/876—Implantable batteries
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/02—General characteristics of the apparatus characterised by a particular materials
- A61M2205/0266—Shape memory materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/148—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/80—Constructional details other than related to driving
- A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
- A61M60/89—Valves
- A61M60/894—Passive valves, i.e. valves actuated by the blood
- A61M60/896—Passive valves, i.e. valves actuated by the blood having flexible or resilient parts, e.g. flap valves
Definitions
- the present invention relates to a pulsatile blood pump for implantation into a patient.
- the invention also relates to a blood pump system incorporating such a pulsatile blood pump, and to a method for the treatment of heart failure in a patient.
- Heart failure is a major cause of death in the developed and developing world; it is estimated that there are currently 901 ,500 sufferers in the United Kingdom with 65,000 new cases added annually.
- the British Heart Foundation estimates the annual cost of heart failure is £625 million in the UK alone. In the United States, the corresponding statistics are 5,000,000 sufferers with 550,000 new cases annually and an annual cost to the US economy of $296,000 million.
- the World Health Organisation estimates that cardiovascular disease (CVD), around 7% of which is heart failure, contributed to 1/3 of all deaths worldwide and will be the major cause of death by 2010.
- CVD cardiovascular disease
- the other main therapies commonly available are medical, such as inotropes, ACE inhibitors, Beta blockers, diuretics and nitrates, or are mechanical support therapies, such as the use of a Total Artificial Hearts (TAHs) or Ventricular Assist Devices.
- TAHs Total Artificial Hearts
- Rotary Blood Pumps take blood typically from the ventricle of the native heart, energise it through the action of a rotating impeller, and deliver the blood to the ascending aorta. These devices allow the patient to ambulate, but do not produce pulsatile blood flow as does the native heart. In contrast, RBPs typically act at a constant rotational speed, can be difficult to control, and are expensive in their implanted form.
- lABPs such as those described in US6210318 and EP0192574, are well established technology and comprise small balloons which are inserted into the aorta and which are inflated and deflated, typically in anti-phase with the native heart, through the action of pneumatic fluid acting behind a flexible polymeric membrane.
- EABPs such as those described in EP1318848, EP1560614, and US4733652, are attached to the external surface of the aorta rather than being implanted within the aorta.
- Disadvantages of EABPs can include atheromous emboli through interaction with the aortic wall, and migration and interference with neighbouring structures, e.g. erosion of the pulmonary artery or lungs.
- Other technologies which similarly augment blood flow using balloon pumps include: a balloon pump for insertion into the descending aorta described in US6030355, but this device has a rigid outer body which precludes its implantation at the
- the present invention extends the inventors' work on the "Chronic
- CI MS Intermittent Mechanical Support
- the present invention seeks to provide an alternative pump which provides various advantages over those of the prior art when used in cardiac support.
- pulsatile blood pump for implantation into a patient.
- pulsatile blood pump means a pulsatile pump suitable for pumping blood.
- the pulsatile blood pump of the first aspect of the present invention is suitable for pumping blood, it could also be used to pump other fluids if desired.
- the pulsatile blood pump comprises a flexible, substantially tubular body, deformable elements, and a flexible membrane.
- the flexible, substantially tubular body is for disposal coaxially within a blood vessel of the patient.
- the "substantially” wording means that the cross section of the tubular body need not be exactly circular. For example, an oval cross-section might be considered to be “substantially” circular.
- the cross section of the substantially tubular member may change in shape and/or size axially along its length so as to best match the portion of blood vessel into which it is placed or so as to afford other benefits whilst in use.
- the tubular body has first and second ends with a blood passageway extending therebetween for the passage of blood.
- the tubular body has a collapsed state for use during delivery and an expanded state for use during pumping.
- the deformable elements are coupled to the tubular body and are arranged to retain the tubular body in the expanded state following delivery of the blood pump to the desired blood vessel.
- the flexible membrane is attached to the tubular body so as to form a fluid chamber within the tubular body. The flexible membrane separates the fluid chamber from the blood
- the blood pump In the expanded state of the tubular body, the blood pump is arranged such that fluid is able to flow into and out of the fluid chamber whereby the volume of the fluid chamber increases and the volume of the blood
- the tubular body is connectable to a fluid conduit to allow fluid to flow into and out of the fluid chamber.
- the outflow from the native heart may be augmented through the use of the blood pump of the present invention.
- the blood pump is surgically placed coaxially within the aorta or other blood vessel by minimally invasive surgery and delivered by a catheter device. This is facilitated by the substantially circular section of the blood pump being collapsible so that it can be catheter fed to the site of installation and then expanded so as to make intimate contact with the inner lumen of the blood vessel.
- the shape and dimension of the substantially tubular body of the blood pump remains expanded through the use of super-elastically deformable elements or other elements which hold the tubular body open in a way similar to that in which a stent graft is held open.
- the cross-sectional area of the blood passageway through the blood pump is caused to contract due to the flow of fluid into and out of the fluid chamber between the tubular body and the flexible membrane of the blood pump.
- the blood pump may be used in the temporary or long-term treatment of patients suffering heart failure through intermittent or temporary continuous use when counter-pulsed with the natural heart. Additional embodiments can also be contemplated so as to reduce the workload required from the native heart, to augment coronary artery perfusion, and/or to treat other circulatory diseases by introducing such a blood pump into the peripheral circulation. Patients who would most benefit from use of the blood pump of the present invention may be divided into groups, as described below.
- the first group of patients who would derive a significant benefit are patients needing temporary support or bridge to recovery treatment. This group of patients is refractory to medical therapies and will present with declining cardiac and end-organ function, but when supported with a mechanical device will recover cardiac function, typically within around twenty weeks of mechanical support, such that support may then be withdrawn.
- current mechanical LVADs do not incorporate one-way valves making it infeasible to leave them in- situ and deactivated due to significant retrograde flow through them once they have been inactivated. Current LVADs therefore do not provide a life-line to recovered patients, and re-operation is necessary to implant an additional device if cardiac function declines once again.
- the present invention will allow support to be withdrawn on recovery, but for the blood pump to remain in place should intermittent support be required thereafter; it is also feasible to withdraw the blood pump by collapsing it back to the size and state it was in during delivery and withdrawing it should this be considered a better option for the patient.
- the second group of patients for whom the present invention would be particularly beneficial are patients needing long term chronic support. This group of patients will never recover cardiac function and will be maintained on medical therapies in the long term. The "healthier" of these are minimally supported with medical therapies but require more aggressive support intermittently;
- the flexible membrane is attached to the tubular body so as to form the fluid chamber between the flexible membrane and an inner surface of the tubular body.
- the flexible membrane may be formed as a sheet and may be attached across a chord of the tubular body such that the fluid chamber and the blood passageway are disposed side by side within the tubular body.
- the flexible membrane may be formed as a tube and may be attached at or near each end of the tubular body such that the blood passageway is disposed concentrically within the fluid chamber.
- the flexible membrane is attached to the tubular body such that the formed fluid chamber is entirely bounded by the flexible membrane.
- This embodiment provides the advantage that the tubular body need not be formed from a material which is impermeable to the pneumatic or hydraulic fluid which is to be pumped in and out of the fluid chamber. This allows a wider selection of material to be used.
- the flexible membrane is attached to the tubular body.
- the flexible membrane may be attached to the inner surface of the tubular body. It may be attached in a parallel or doubled-back configuration. Alternatively/additionally, the flexible membrane may be attached to the ends of the tubular body.
- the blood pump may further comprise one or more baffles in the fluid chamber to channel fluid in a direction from the first end
- the baffles may comprise a spiral configuration.
- the flexible membrane may have elastic properties.
- the blood pump may further comprise a check valve arranged to allow fluid to flow through the blood passageway in one direction only.
- the tubular body may comprise one or more non- stretch elements for preventing the tubular body from distending significantly when fluid flows into the fluid chamber.
- the non-stretch elements may be non-stretch filaments having an axial configuration with respect to the tubular body.
- the tubular body may have a smooth outer profile.
- tubular body and the deformable elements may together form a stent graft.
- the deformable elements may comprise a superelastic shape memory alloy.
- the deformable elements may be coupled to an external surface of the tubular body. In an alternative embodiment, the deformable elements may be coupled to an internal surface of the tubular body.
- the deformable elements may comprise wires formed into a substantially tubular structure coaxial with the tubular body.
- the wires may be in the form of a diamond mesh or may form rings of zig-zags.
- a wall of the tubular body may be puncturable from outside to enable insertion of one end of a fluid conduit into the fluid chamber such that the fluid chamber is in fluid communication with the fluid conduit.
- a wall of the tubular body may comprise a pre-fabricated aperture for insertion of one end of a fluid conduit into the fluid chamber.
- 420268 fluid chamber can be connected to the tubular body of the blood pump following deployment of the blood pump.
- the blood pump may be deliverable by catheter when the tubular body is in its collapsed state.
- the blood pump may further comprise a securing device arranged to secure the blood pump within the blood vessel of the patient.
- a blood pump system comprising: a blood pump in accordance with the first aspect of the present invention, a fluid conduit connected to the tubular body of the blood pump to allow fluid to flow into and out of the fluid chamber, and a drive unit coupled to the fluid conduit and operable to drive fluid alternately into and out of the fluid chamber via the fluid conduit.
- the blood pump system may further comprise a pressure sensor operable to measure pressure in the fluid conduit, and the drive unit may be responsive to the measured pressure.
- the blood pump system may further comprise a pressure sensor operable to measure pressure in the fluid chamber, and the drive unit may be responsive to the measured pressure.
- the blood pump system may further comprise an
- electrocardiograph and the drive unit may be responsive to electrocardiographic data.
- the drive unit may be operable to drive the blood pump in counter-pulsation with the patient's heart.
- a porous biocompatible material may be attached to an outer surface of a portion of the fluid conduit.
- the drive unit may be portable and wearable by a patient.
- a first end of the fluid conduit is connected to the tubular body of the blood pump, and a second end of the fluid conduit comprises a connector.
- the connector is self-sealing. Thus, if the connector is disposed just under the patient's skin, the connector will self seal on removal of the
- a method for the treatment of heart failure in a patient comprises: providing a blood pump of the first aspect of the present invention; using a catheter to deliver the blood pump to a blood vessel of the patient, the tubular body of the blood pump being in its collapsed state during delivery; expanding the tubular body into its expanded state following delivery of the blood pump to the blood vessel; inserting a first end of a fluid conduit through the blood vessel and the tubular body to allow fluid to flow into and out of the fluid chamber via the fluid conduit; and driving fluid along the fluid conduit alternately into and out of the fluid chamber of the blood pump, thereby enabling the blood pump to pump blood along the blood passageway.
- the blood pump can be thought of as a stent graft which houses an inflatable-deflatable membrane.
- the blood pump is initially collapsed to a suitably small size to enable it to pass through a blood vessel or small incision for catheter delivery to the treatment site. Once at the treatment site, the catheter may be removed and the blood pump may be expanded in situ.
- the fluid conduit may be a percutaneous drive line with a second end extending out of the patient.
- the blood vessel may be the ascending aorXa.
- access to the treatment site may be via an incision in the apex of the left ventricle or left atrium following a partial thoracotomy or stenotomy, or may be via an entry site in a major blood vessel such as the femoral artery or subclavian artery.
- the fluid conduit i.e. the percutaneous drive line
- the blood pump via a different access route.
- the method may further comprise measuring a pressure within the fluid conduit, and the driving of fluid along the fluid conduit may be responsive to the measured pressure.
- the method may further comprise measuring a pressure within the fluid chamber, and the driving of fluid along the fluid conduit may be responsive to the measured pressure.
- the method may further comprise measuring
- electrocardiographic data of the patient and the driving of fluid along the fluid conduit may be responsive to the measured electrocardiographic data.
- the driving of fluid along the fluid conduit may also be responsive to both pressure and electrocardiographic measurements.
- the blood pump may be driven in counter-pulsation with the patient's heart.
- the method may further comprise correcting the underlying cardiac defect leading to the patient's heart failure.
- the method may further comprise one of partial thoracotomy, thoracotomy, partial sternotomy, sternotomy, and arterial access to enable the delivery of the blood pump to the blood vessel. Any of a range of minimally invasive access and catheter-delivery methods may also be used to enable the delivery of the blood pump to the blood vessel.
- the outer diameter of the tubular body may match the inner diameter of the blood vessel.
- a method for augmenting the peripheral blood circulation in a patient comprises: providing a blood pump of the first aspect of the present invention; using a catheter to deliver the blood pump to a peripheral blood vessel of the patient, the tubular body of the blood pump being in its collapsed state during delivery; expanding the tubular body into its expanded state following delivery of the blood pump in the blood vessel; inserting a first end of a fluid conduit through the blood vessel and the tubular body to allow fluid to flow into and out of the fluid chamber via the fluid conduit; and driving fluid along the fluid conduit alternately into and out of the fluid chamber of the blood pump, thereby enabling the blood pump to pump blood along the blood passageway.
- Other preferred features of the present invention are set out in the appended claims.
- Figure 1 is a schematic diagram of the heart with an enlarged partial view showing a section of the aorta into which a pulsatile blood pump according to one embodiment of the present invention may be inserted;
- Figure 2 is a lateral cross-sectional view of a pulsatile blood pump according to one embodiment of the present invention
- Figure 3 is an axial cross-sectional view of the pulsatile blood pump of Figure 2;
- Figure 4 is a schematic representation of a blood pump system
- Figure 5 shows a fluid conduit to convey fluid into and out of a fluid chamber of the pulsatile pump of Figure 2;
- Figure 6 shows a lateral cross-sectional view of an embodiment of a pulsatile blood pump having a built-in one-way check valve
- Figure 7 shows a schematic perspective view of a pulsatile blood pump according to an embodiment of the present invention which incorporates non- stretch filaments into the tubular body of the blood pump;
- Figure 8 shows two lateral cross-sectional views of pulsatile blood pumps according to embodiments of the present invention, both of which configured are to pump blood in a preferred direction shown by the arrow B;
- Figure 9 shows four lateral cross-sectional views of pulsatile blood pumps according to embodiments of the present invention showing different ways of attaching a flexible membrane of the pump to the tubular body of the pump;
- Figure 10 shows an axial cross-sectional view of an alternative
- Figure 11 shows schematic perspective views of pulsatile blood pumps according to embodiments of the present invention showing three ways of incorporating deformable elements into the tubular bodies of the blood pumps;
- Figure 12 shows the pulsatile blood pump of Figure 2 with its tubular body in the collapsed configuration during catheter delivery.
- FIG 1 shows a schematic representation of a human heart .
- a healthy heart 1 pumps blood to the body via the aorta 2.
- a pulsatile blood pump is placed within a portion 3 of the aorta 2 just distal of the aortic root and the remainder of the heart 1 , as shown in the enlarged view 4 of Figure 1. It will be appreciated that other placement sites of the blood pump 10 within a patient's vascular system are also possible. Having been placed within the preferred blood vessel, the blood pump 10 may then be activated intermittently for short periods as required, or may be activated continuously for periods of limited or unlimited duration. Therefore, this embodiment of the present invention provides a small pulsatile blood pump 10 having a volume of between 10 and 70ml_ which may be temporarily or permanently incorporated into the aorta 2 (or elsewhere) as an active graft.
- a blood pump 10 in accordance with an embodiment of the present invention will now be described in more detail with reference to Figure 2 which shows such a blood pump 0 in situ within the aorta 2 of a human patient.
- the blood pump 10 comprises a substantially tubular body 12 and a flexible membrane 14.
- the tubular body 12 further comprises deformable elements 80, 82, 84 as will be described in more detail below with reference to Figure 11 .
- the tubular body 12 has a first end 18 and a second end 20.
- the tubular body 12 is tightly disposed within a section of the aorta, with the external surface of the tubular body 12 pressed up against the internal wall of the aorta such that blood flows through the tubular body 12 in a direction substantially away from the heart 1 from the first end 18 of the tubular body 2 towards the second end 20 as shown by the arrow B.
- the tubular body 12 is disposed coaxially within the aorta 2.
- the tubular body 12 is formed from a flexible, gas-impermeable material which may be collapsed during delivery of the blood pump 10.
- a suitable material might be polyethylene terephthalate (e.g. DacronTM) or woven PTFE
- the tubular body has an expanded configuration for use when the blood pump 10 is in use, and a collapsed configuration for use during delivery of the blood pump 10 to the desired blood vessel.
- the tubular body 12 comprises deformable elements which act to stiffen the flexible tubular body 12 to retain it in its expanded, tubular configuration (i.e. having a substantially circular cross section) when disposed in situ in the aorta 2.
- the deformable elements are present to hold open the lumen of the tubular body 12 in use, and to prevent the collapse of the tubular body 12 in the absence of significant external forces.
- the deformable elements will prevent the collapse of the tubular body 12 even if there are reasonable external forces on the tubular body from the lumen or from surrounding tissue. Nonetheless, the deformable elements are deformable (rather than rigid) so as to enable the tubular body 12 to be deformed or collapsed during catheter delivery of the blood pump 10 to the desired blood vessel.
- the deformable elements effectively form a stent such that the tubular body 12 and the deformable elements together form a stent graft.
- deformable elements may be superelastic (e.g. formed from a material such as nickel titanium) to provide the required stiffness during use of the blood pump 10, but other materials are also readily envisaged.
- Figure 1 1 shows three different embodiments of the deformable elements
- the deformable elements 80, 82, 84 are formed as wires in particular configurations.
- the deformable elements 80 in Figure 1 1a form rings of zig-zags around the tubular body 12, with all the rings of zig-zags being in phase with one another.
- the deformable elements 80 are attached to the tubular body 2 at the apexes 81 of the zig-zag formations.
- the deformable elements 82 in Figure 1 1 b again form rings of zig-zags around the tubular body 12, but each ring of zig-zags is in anti-phase with the two adjacent rings of zigzags.
- the deformable elements 82 are attached to the tubular body 12 at the apexes 83 of the zig-zag formations.
- the deformable elements 84 in Figure 11c form a net structure or diamond mesh around the tubular body 12.
- the deformable elements 84 are attached to the tubular body 12 at the corners 85 of each diamond shape.
- the deformable elements 80, 82, 84 are advantageously
- the deformable elements 80, 82, 84 could be disposed on the internal surface of the tubular body 12 or at least partially within the structure of tubular body 12. Many other configurations of deformable elements would be appropriate for the blood pump 10, as will be evident to one familiar with stent design. Thus the simple examples shown in Figure 11 are not intended to be limiting.
- the flexible membrane 14 is formed as a tube and is attached concentrically within the tubular body 12 so as to line an inner surface 24 of the tubular body 12.
- a fluid chamber 22 is formed between the flexible membrane 14 and the inner surface 24 of the tubular body 12.
- the fluid chamber 22 is therefore partially bounded by the flexible membrane 4 and partially bounded by the inner surface 24 of the tubular body 12.
- a blood passageway 26 extends between the first and second ends 18 and 20 of the tubular body 12 and is at least partially bounded by the flexible membrane 14.
- the flexible membrane 14 separates the fluid chamber 22 from the blood passageway 26. This is most clearly seen in the axial cross-sectional view of the blood pump 0 of Figure 3 which is a view looking along the axis of blood flow that shows the blood passageway 26 disposed concentrically within the fluid chamber 22.
- a fluid conduit 28 passes through the aorta wall and the wall of the tubular body 12 to enable fluid to flow into and out of the fluid chamber 22 of the blood pump 10.
- the fluid conduit 28 carries fluid towards and away from the fluid chamber 22 of the blood pump 10.
- a blood pump system 34 incorporating the blood pump 10 of the present invention is shown schematically in Figure 4.
- the blood pump 10 (not to scale) is shown implanted within the patient's body 32.
- the fluid conduit 28 is shown to exit the patient's body 32 percutaneously at the exit site 36.
- a pressure sensor 39 may be provided to measure the pressure within the fluid conduit 28 close to the blood pump 0.
- a pressure sensor (not shown) may be incorporated into the tubular body 12 of the blood pump 10 to measure pressure within the fluid chamber 22.
- the fluid conduit 28 terminates at the tubular body 12 of the blood pump 10.
- the fluid conduit is transverse to the tubular body 12.
- the fluid conduit 28 is substantially perpendicular to the tubular body 12.
- the fluid conduit 28 is attached to the tubular body 12 of the blood pump 10 in such a way that it may not become detached accidentally.
- the connection may have a locking mechanism.
- the connection between the fluid conduit 28 and the tubular body 12 may also be detachable such that the fluid conduit 28 may be easily replaced if it becomes infected.
- connection of the fluid conduit 28 to the tubular body 12 may be made after placement of the blood pump 10 into the blood vessel. This requires an additional minimally invasive surgical procedure wherein a tunnel is made in the patient's tissue from the exit site 36 to the outer surface of the tubular body 12, Hence the connection has a design which allows and facilitates connection in-situ.
- An alternative method of connecting the fluid conduit 28 to the tubular body 12 in-situ envisaged here is facilitated by the use of a special tool which follows the tunnel in the patient's tissue and which punctures the tubular body 12 in-situ making a port 96.
- connection may then be made by surgically sewing the fluid conduit 28 to the tubular body 12 at the site of the port 96 or by deploying a connector which is pre-installed on the end of the fluid conduit 28 or is installed just prior to insertion of the fluid connector 28.
- the fluid conduit 28 is flexible and biocompatible. Silicone or PVC are examples of materials appropriate for its construction.
- tissue incorporation into the exit site 36 so as to prevent infection tracking up the portion of the fluid conduit 28 within the patient's body 32.
- This may be achieved by wrapping a biocompatible and porous material 38 around the fluid conduit 28 at the exit site 36.
- Woven or felt polyester or polytetrafluoroethylene (PTFE) may well be best suited to this purpose.
- the material 38 is wound around the fluid conduit 28 right at the exit site 36 so as to become incorporated into the patient's body tissue.
- the material 38 might extend along a substantial portion of the fluid conduit 28 even
- a distal end of the fluid conduit 28 is coupled to a drive unit 30 which is an electromechanical device operable to drive fluid alternately into and out of the fluid chamber 22 via the fluid conduit 28.
- the drive unit 30 may be a
- the drive unit 30 may be a small battery powered wearable device so that patients can be treated completely untethered.
- the fluid may be a liquid or a gas, so that the drive unit 30 is operable to provide pulses of hydraulic or pneumatic fluid flow into the fluid conduit 28.
- the fluid would be helium, but it is envisaged that the pneumatic fluid might be air, carbon dioxide, or any readily available non-toxic gas.
- a hydraulic fluid might be water or any readily available non-toxic liquid.
- Figure 4 additionally shows an optional connector 40 which forms part of the fluid conduit 28 between the exit site 36 and the drive unit 30.
- the drive unit 30 may be disconnected from the blood pump 0 by means of this connector 40.
- the connector 40 is disposed just outside the surface of the skin (i.e. just outside the patient's body 32).
- the connector 40 may be implanted just below the skin surface of the patient's body 32.
- the use of the connector 40 allows the portion of the fluid conduit 28 outside the patient's body 32 to be easily replaced should it become damaged. It is envisaged that, in a
- the skin would be allowed to heal over the connector 40 if the blood pump 10 is not actuated for a long period of time and that, on withdrawal of the extracorporeal section of the fluid conduit 28, the connector 40 would self-seal. Reconnection would be made by puncturing the skin overlying the connector 40 and breaching the self-sealing mechanism.
- control unit 42 which may be a computer, and which is programmable and operable to run software 44 to control the drive unit 30.
- a cable 46 coupled between the drive unit 30 and the control unit 42 to allow data communication therebetween.
- the control unit 42 may be used to set up controllable parameters of the drive unit 30 and/or to download patient and blood pump data which may be stored on the drive unit 30.
- Either the drive unit 30 or the control unit 42 might be able to communicate with a remote computer or network 48 so as to remotely configure the system 34 or to monitor its performance and/or patient data. Communication with the remote computer or network 48 is via telecommunication means 50 such as a telephone line, Internet connection, Bluetooth, Wi-Fi or similar.
- the fluid conduit 28 comprises an outer layer 52 disposed substantially concentrically around an inner tube 54.
- the outer layer 52 is an armouring layer which enables the fluid conduit 28 to withstand a degree of mechanical loading (e.g. twisting, flexing, tension and/or crushing) without sustaining any significant damage.
- the inner tube 54 conveys the hydraulic or pneumatic fluid from the drive unit 30 to the fluid chamber 22 of the blood pump 10.
- a data cable 56 is disposed between the outer layer 52 and the inner tube 54.
- the data cable 56 provides data communication between the blood pump 10 and any pressure sensors (e.g. pressure sensor 39), ECG sensors, or implanted devices.
- the data cable 56 may be disposed within the inner tube 54.
- the fluid conduit 28 since the fluid conduit 28 is not disposed in the patient's blood stream, it poses a much reduced risk of infection than does an IABP cannula.
- the blood pump 10 is delivered to the desired position in a patient's blood vessel using a catheter.
- the tubular body 12 assumes a collapsed state in which the deformable elements 80, 82, 84 are also collapsed.
- Figure 2 shows the blood pump 10 with its tubular body 12 in the collapsed configuration during catheter delivery. The catheter is not shown in Figure 12.
- the blood pump 10 is being surgically introduced into the heart 1 through a hole 90 in the apex of the left ventricle.
- the hole 90 is crafted via a small surgical incision.
- Figure 12 shows a guidewire 92 inserted through the hole 90 such that the guidewire 92 extends through the aortic valve 94 and into the lower ascending aorta 2.
- the blood pump 10 is slid along the guidewire 92 into place within the ascending aorta 2 whereupon it is deployed (e.g. by balloon).
- the tubular body 12 moves from its collapsed configuration to its expanded configuration.
- the catheter (not shown) and guidewire 92 are withdrawn.
- the hole 90 in the apex of the left ventricle is then closed surgically.
- Other techniques are readily envisaged for delivery of the blood pump 10, as are other access sites through the heart 1 , including the left atrium.
- the blood pump 10 may be delivered on a catheter which is introduced through any number of access routes, e.g. via the subclavian or femoral arteries.
- the blood pump 10 pumps blood along the blood vessel within which it is situated.
- the drive unit 30 alternately develops relatively high and low pressures which cause pneumatic or hydraulic fluid to flow along the fluid conduit 28 into and out of the fluid chamber 22 of the blood pump 0.
- the ingress and egress of pneumatic or hydraulic fluid from the fluid chamber 22 is indicated by double-headed arrow A in figure 2.
- the drive unit 30 develops a relatively high pressure
- fluid is driven hydraulically or pneumatically along the fluid conduit 28 and into the fluid chamber 22.
- the pressure of the fluid ingress flexes the flexible membrane 14 such that the volume of the inner chamber 22 increases.
- the flexible membrane 14 is forced away from the inner surface 24 of the tubular body 12 and the tubular flexible membrane 14 contracts
- the volume of the fluid chamber 22 decreases and there is a corresponding increase in the volume of the blood passageway 26 such that blood is drawn into the first end 18 (and the second end 20) of the tubular body 12.
- the blood passageway 26 remains essentially circular in cross-section during the use of the blood pump 10, but the diameter of the blood passageway 26 increases and decreases with the flexing of the flexible member 14.
- the fluid chamber 22 is alternately expanded and contracted as the flexible membrane 14 is inflated and deflated by the action of the hydraulic or pneumatic fluid flow from the drive unit 30.
- the cross-sectional area of the blood passageway 26 changes so as to aid in the pumping of blood along the aorta 2.
- the flexing of the flexible membrane 14 is shown by double-headed arrows C in figures 2 and 3.
- the blood pump 10 aids the normal flow of blood through the aorta 2 in the normal flow direction shown by arrow B.
- the check valve 58 may be included even if the patient's aortic valve is functional. In this case, the additional check valve 58 may further augment the action of the blood pump 10.
- the check valve 58 may be incorporated into the blood pump 10 at either the first end 18 or the second end 20, or both.
- the check valve 58 is capable of being collapsed so as to allow catheter delivery whilst incorporated into the blood pump 10 in its collapsed state, or is capable of insertion into the blood pump 10 in an additional (preferably minimally invasive) surgical procedure.
- securing devices 98 which protrude from the tubular body 2 and which maintain intimate contact with the inner wall of the aorta 2 so as to hold the blood pump 10 in place against fluid dynamical and other forces which act on the blood pump 10.
- the securing devices 98 resemble hooks which bite into the inner wall of the aorta 2, as shown in Figure 6.
- the securing devices 98 are absent and the position of the blood pump 10 within the aorta 2 is maintained through the action of deformable elements 80, 82, 84 which, when expanded, bring to bear sufficient frictional forces between the tubular body 2 and the aorta 2 to retain the blood pump 10 in its correct place.
- the deformable elements 80, 82, 84 are described further below with reference to Figure 1 1 .
- sutures might also be used to help to maintain correct positioning of the blood pump 10 within the aorta 2.
- the pressure sensor 39 (and/or other pressure sensors described above) is used to assist with the timing of the fluid flow into and out of the fluid chamber 22 of the blood pump 10.
- the pressure measurements from the pressure sensor 39 are relayed to the drive unit 30 and/or the control unit 42.
- the contraction of the blood pump 10 is controlled such that it occurs in anti-phase with the contractions of the natural heart 1. In other words, when the heart 1 is in diastole, the blood pump 10 is in systole, and vice-versa.
- Other measurements may also be used to control the timing and/or amount of fluid flow into and out of the fluid chamber 22.
- an electrocardiograph may additionally be provided to monitor electrocardiographic data from the patient's heart.
- the drive unit 30 and/or the control unit 42 may be coupled to the electrocardiograph to receive the measured data.
- the drive unit 30 and the control unit 42 may be separate devices as shown in Figure 4, or may
- the beneficial effect of the blood pump 10 of the present invention on the heart 1 derives from the aorta 2 being partially "emptied” and more readily distensible with the next cardiac ejection. This reduces the amount of work the heart 1 has to do and allows a degree of recovery and demodelling (reverse remodelling) of the myocardium. It is envisaged that the blood pump 10 would operate for a support period of around two weeks, after which the blood pump 10 would will be turned off and remain dormant until the next programmed or emergency support period. Experience with related devices suggests no ill effects in the period of dormancy.
- the blood pump 0 is implanted operatively. This provides the opportunity for a surgeon to anatomically correct the underlying cardiac defect leading to heart failure (e.g. valve disease, coronary artery disease, cardiomyopathies). This is preferentially carried out through minimally invasive procedures. This defect correction, when combined with the subsequent intermittent use of the blood pump 10, should significantly improve the patient's prognosis.
- heart failure e.g. valve disease, coronary artery disease, cardiomyopathies.
- the flexible membrane 14 is impermeable to the hydraulic or pneumatic fluid used to inflate and deflate the fluid chamber 22.
- the tubular body 2 is also impermeable to the hydraulic or pneumatic fluid used to inflate and deflate the fluid chamber 22.
- the fluid chamber 22 is not partially bounded by the tubular body 12. Instead, the fluid chamber is entirely bounded by the flexible membrane 14, except at the entry point formed by the fluid conduit 28.
- tubular body 12 need not be impermeable to the hydraulic fluid used to inflate and deflate the fluid chamber 22.
- more traditional materials such as bovine collagen impregnated woven PTFE may be used without being impregnated with silicone or other material to make the tubular body 12 impermeable.
- the flexible membrane 14 is stretchable (i.e. distendable/elastic/resilient).
- the flexible membrane 14 may simply be flexible (i.e. bendy but not stretchy).
- the flexible membrane 14 is preferred so as to reduce the chance of parts of the flexible membrane 14 blocking the blood passageway 26 when the fluid chamber 22 is almost empty of fluid.
- the flexible membrane 14 may be fabricated from silicone or another biocompatible flexible and distensible material.
- the tubular body 12 of the blood pump 10 is fabricated from polyester (e.g. woven polyester fibre) or
- tubular body 12 may be fabricated from silicone, but any biocompatible material might be appropriate.
- the degree of flexibility of the tubular body 2 in the expanded configuration should be less than that of the flexible membrane 14.
- This relative lack of flexibility of the tubular body 12 ensures that it is the flexible membrane 14 which deforms due to the flow of fluid into and out of the fluid chamber 22, rather than it being the tubular body 2 which deforms in response to the fluid flow.
- the volume of the tubular body 12 remains substantially constant during the flow of fluid into and out of the fluid chamber 22.
- the deformation of the flexible membrane 14 allows the volume (and the cross- sectional area) of the blood passageway 26 to vary in use so that the blood pump 10 pumps blood.
- the tubular body 12 may comprise a flexible material and may also incorporate relatively non-stretchable elements such as carbon, carbon fibre or Kevlar fibres, filaments, windings, metallic springs, or similar to constrain the tubular body 12 axially.
- relatively non-stretchable elements such as carbon, carbon fibre or Kevlar fibres, filaments, windings, metallic springs, or similar to constrain the tubular body 12 axially.
- non-stretchable elements may be applied in a variety of orientations including axial filaments 62 as shown in Figure 7.
- Other configurations of non- stretchable elements are also envisaged within the scope of the invention.
- the blood pump 10 preferentially pumps blood along the blood passageway 26 in a particular axial direction.
- the blood pump should then be implanted in the patient's blood vessel in the correct orientation such that the preferential pumping direction corresponds to the normal direction of blood flow along the blood vessel.
- This normal direction of blood flow is from the first end 18 towards the second end 20 of the tubular body 12 as shown by arrow B in the Figures.
- Figures 8a and 8b show lateral cross sections of pumps having a preferential pumping direction along arrow B.
- the end of the fluid conduit 28 is not centrally disposed along the length of the tubular body 12 in an axial direction.
- the end of the fluid conduit 28 is located off-centre along the length of the tubular body 12 such that it is nearer the first end 18 than the second end 20.
- the blood pump 10 preferentially pumps blood along the blood passageway 26 from the first end 18 towards the second end 20.
- the end of the fluid conduit 28 is located proximally to preferentially pump blood in a proximal-to-distal direction.
- baffles 66 are additionally provided within the fluid chamber
- the baffles 66 are flexible and collapsible and are formed in a spiral configuration so as to further constrain the hydraulic or pneumatic fluid to flow in the preferred direction from the first end 18 towards the second end 20.
- the baffles 66 serve to constrain the flow of fluid within the fluid chamber 22 such that fluid does not reach the second (far) end of the fluid chamber until the first (near) end of the fluid chamber has been filled with fluid.
- Figure 9 depicts four different ways of attaching the flexible membrane 14 to the tubular body 12.
- the flexible membrane is attached at/near the first and second ends 18 and 20 of the tubular body so as to form a sealed watertight/airtight fluid chamber 22 within the tubular body 2.
- the fluid chamber 22 in each of Figures 9a, 9b and 9c is bounded partially by the flexible membrane 14 and partially by the inner surface 24 of the tubular body 12.
- both the flexible membrane 14 and the tubular body 12 should be impermeable to the pneumatic or hydraulic fluid pumped into and out of the fluid chamber 22.
- the flexible membrane 4 the flexible membrane 4
- the configuration shown in Figure 9a is the same as that shown in Figures 2, 6 and 8.
- the flexible membrane 14 is attached to the tubular body 12 such that the flexible membrane 14 runs essentially parallel to the tubular body 12 in the attachment regions 68 of the flexible membrane 14 to the tubular body 2.
- the tubular flexible membrane 4 essentially sits flush to the inner surface 24 of the tubular body 12 when the fluid chamber 22 is empty.
- the active region 70 of the blood pump 10 does not extend along the full axial length of the tubular body 12 since the attachment regions 68 of the flexible membrane 14 to the tubular body 12 are located near, but not at, the ends 18 and 20.
- the tubular flexible membrane 14 could be the same length as the tubular body 12 such that the attachment regions 68 would be at the ends 18 and 20 of the tubular body 12 and the active region 70 would extend along the full axial length of the blood pump 10.
- FIG. 9c A further alternative configuration is shown in Figure 9c in which the flexible membrane 14 extends out of each end 18 and 20 of the tubular body 12.
- the attachment regions 68 are at each end 18 and 20 of the blood pump 10.
- the flexible membrane 14 fully encloses the fluid chamber 22.
- the flexible membrane 14 is preferentially attached to the tubular body 12 at the first end 18 and at the second end 20. There may also be attachment between the flexible membrane 14 and the tubular body 12 along the entire length of the interface between the flexible membrane 14 and the inner wall of the tubular body 12. Alternatively, there may just be attachment along parts of this interface.
- the optimum configuration may be accomplished with any combination of the attachments shown in Figures 9a-9c, and the attachment methods may be dissimilar at the first and second ends 18 and 20.
- the optimum configuration might be accomplished through the configuration shown in Figure 9d which incorporates a flexible membrane 14 which fully encloses the fluid chamber 22.
- the flexible membrane 14 may be formed as a sheet rather than as a tube.
- the flexible membrane 14 is disposed in a chord-like manner across the circular cross-section of the tubular body 12. The appropriate chord is shown by dashed line XX' in Figure 0.
- the flexible membrane 14 divides the tubular body 12 into two axial
- the flexible membrane 14 is also attached to the tubular body 12 at or near the ends 18 and 20 or forms a complete enclosure W
- the fluid chamber 22 expands and contracts eccentrically, rather than concentrically as in the embodiment of Figures 2 and 3. Concentric actuation allows the greatest displacement of blood for a given size of blood pump 10. Eccentric actuation may be desirable in some anatomical locations where concentric actuation would obstruct important features, e.g. at the root of the ascending aorta where concentric actuation may obstruct the coronary arteries.
- the present invention therefore extends the modality or method for treatment of heart failure which has been termed Chronic Intermittent Mechanical Support (CIMS) by the inventors.
- CIMS Chronic Intermittent Mechanical Support
- the original CIMS system is described in WO2009/040560.
- Benefits of the present CIMS approach are summarised below: a) Because of the ability to collapse the blood pump 10 to enable it to be
- catheter delivered it may be inserted without resecting a portion of the aorta, as was needed in the original CIMS patent application
- WO2009/040560 Additionally it may be implanted into the patient's arterial or venous systems through minimally invasive surgery. It is possible to collapse the present invention to allow it to be removed if desirable, e.g. if demodelling were so complete that the need for the device was removed, and no detriment will be suffered by the section of aorta into which the present invention was implanted.
- the present CIMS approach includes an embodiment ( Figure 9d) in which the flexible membrane 14 fully encloses the fluid chamber 22 and which will therefore not require the material of the tubular body 12 to itself be impregnated with a material which will be impermeable to the hydraulic or pneumatic fluid.
- the present CIMS approach includes a port 96 which allows connection of the fluid conduit 28 to the tubular body 12 being cut into the the tubular body through minimally invasive surgical procedures whilst the blood pump 10 is in situ in the blood vessel.
- the present CIMS approach uses securing devices 98, or the action of deformable elements 80, 82, 84, or sutures to maintain the blood pump 10 in its correct position within the aorta 2.
- the present CIMS approach includes a connector 40 just under the
- the present CIMS approach may include a check valve 58 preferentially placed at the first end 18 or the second end 20 of the blood pump 10.
- the check valve 58 may be collapsible so as to allow it to be placed in situ via catheter delivery and through minimally invasive surgical procedures.
- the present CIMS approach retains all of the benefits of the previous CIMS device described in WO2009/040560: h)
- One main benefit of the CIMS approach will be to improve perfusion to the head, coronary arteries and systemic circulation, and to unload the natural (diseased) heart and allow it to recover through a process known as demodelling or reverse-remodelling. Some hearts will recover almost completely allowing CIMS to be discontinued though the blood pump 10 will remain in place in case of relapse. Other hearts will not recover and medical therapies will continue, but will benefit from CIMS as a therapy similar to, but more aggressive than medical respite.
- Counter-pulsation is a proven and dependable support method which is incorporated into a large number of commercial lABPs and which is also being developed in EABPs.
- the use of the percutaneous fluid conduit 28 removes the need for cannulation to support the blood pump 10. This has a number of advantages: it reduces the likelihood of septicaemia posed by lABPs; it ameliorates ischemia distal to the insertion point of the cannula; it removes thromboembolic complications caused by tracking a cannula through the veins; and, unlike lABPs, it allows patients to ambulate,
- the blood pump 10 has distinct advantages over EABPs in that it cannot migrate and will not interfere with neighbouring structures (e.g. causing erosion of the pulmonary artery). Positioning a CI MS blood pump 10 within the aorta 2 also gives greater flexibility in the profile design and the use of an eccentric blood pump 10 will enable CIMS to be used where Coronary Artery Bypass Grafting (CABG) is necessary.
- CABG Coronary Artery Bypass Grafting
- Cost the cost of LVAD interventions in bridge to transplantation
- LCTS Long Term Chronic Support, or LCTS
- QALY Quality-Adjusted Life-Year
- the blood pump 10 and system 34 of the present invention may be adapted for use in other blood vessels (e.g. a peripheral vein or artery) to increase regional or peripheral perfusion of organs or tissue.
- a blood pump 10 into the femoral or popliteal arteries for the treatment of intermittent claudication, or into the subclavian artery to augment central arterial blood flow and pressure.
- this technique could be used to provide ventricular unloading and pressure augmentation in the major vessels and flow augmentation in the coronary artery through action in a near-distal artery such as the subclavian artery.
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- Heart & Thoracic Surgery (AREA)
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- Life Sciences & Earth Sciences (AREA)
- Mechanical Engineering (AREA)
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- Biomedical Technology (AREA)
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Abstract
La présente invention concerne une pompe sanguine pulsée destinée à être implantée dans le corps d'un patient. La pompe sanguine comprend un corps sensiblement tubulaire flexible destiné à être disposé de manière coaxiale à l'intérieur d'un vaisseau sanguin du patient. Le corps tubulaire a des premières et secondes extrémités entre lesquelles s'étend une voie de passage pour le sang destinée au passage du sang, et le corps tubulaire a un état affaissé destiné à être utilisé pendant la délivrance et un état dilaté destiné à être utilisé pendant le pompage. La pompe sanguine comporte en outre des éléments déformables couplés au corps tubulaire et disposés pour maintenir le corps tubulaire dans l'état dilaté après la délivrance. La pompe sanguine comprend en outre une membrane flexible fixée au corps tubulaire pour former une chambre pour fluide à l'intérieur du corps tubulaire. La membrane flexible sépare la chambre de fluide de la voie de passage du sang. Dans l'état dilaté du corps tubulaire, la pompe sanguine est disposée de manière à ce que le fluide puisse s'écouler dans et hors de la chambre pour fluide, entrainant ainsi l'augmentation du volume de la chambre pour fluide et la diminution du volume de la voie de passage du sang lorsque le fluide s'écoule dans la chambre de fluide, et entrainant la réduction du volume de la chambre pour fluide et l'augmentation du volume de la voie de passage du sang lorsque le fluide s'écoule hors de la chambre de fluide, permettant ainsi que la pompe sanguine pompe le sang le long de la voie de passage du sang. La présente invention concerne en outre un système de pompe sanguine qui comprend la présente pompe, un procédé de traitement de l'insuffisance cardiaque chez un patient à l'aide de la présente pompe sanguine, et un procédé d'augmentation de la circulation sanguine périphérique chez un patient en utilisant la présente pompe sanguine.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GBGB1005198.5A GB201005198D0 (en) | 2010-03-26 | 2010-03-26 | Pulsatile blood pump |
GB1005198.5 | 2010-03-26 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2011117566A1 true WO2011117566A1 (fr) | 2011-09-29 |
Family
ID=42228480
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/GB2011/000354 WO2011117566A1 (fr) | 2010-03-26 | 2011-03-11 | Pompe sanguine pulsée |
Country Status (2)
Country | Link |
---|---|
GB (1) | GB201005198D0 (fr) |
WO (1) | WO2011117566A1 (fr) |
Cited By (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB2553801A (en) * | 2016-09-14 | 2018-03-21 | Haemaflow Ltd | Blood pump |
WO2019071148A1 (fr) * | 2017-10-06 | 2019-04-11 | Troy Thornton | Dispositif de décongestion rénale |
US10722631B2 (en) | 2018-02-01 | 2020-07-28 | Shifamed Holdings, Llc | Intravascular blood pumps and methods of use and manufacture |
CN112512623A (zh) * | 2018-07-27 | 2021-03-16 | 天主教大学基金会 | 具有定向流动辅助的心脏支持装置 |
US11185677B2 (en) | 2017-06-07 | 2021-11-30 | Shifamed Holdings, Llc | Intravascular fluid movement devices, systems, and methods of use |
US11511103B2 (en) | 2017-11-13 | 2022-11-29 | Shifamed Holdings, Llc | Intravascular fluid movement devices, systems, and methods of use |
US11654275B2 (en) | 2019-07-22 | 2023-05-23 | Shifamed Holdings, Llc | Intravascular blood pumps with struts and methods of use and manufacture |
US11724089B2 (en) | 2019-09-25 | 2023-08-15 | Shifamed Holdings, Llc | Intravascular blood pump systems and methods of use and control thereof |
US11964145B2 (en) | 2019-07-12 | 2024-04-23 | Shifamed Holdings, Llc | Intravascular blood pumps and methods of manufacture and use |
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GB2553801A (en) * | 2016-09-14 | 2018-03-21 | Haemaflow Ltd | Blood pump |
US11957820B2 (en) | 2016-09-14 | 2024-04-16 | Haemaflow Limited | Blood pump |
US11717670B2 (en) | 2017-06-07 | 2023-08-08 | Shifamed Holdings, LLP | Intravascular fluid movement devices, systems, and methods of use |
US11185677B2 (en) | 2017-06-07 | 2021-11-30 | Shifamed Holdings, Llc | Intravascular fluid movement devices, systems, and methods of use |
WO2019071148A1 (fr) * | 2017-10-06 | 2019-04-11 | Troy Thornton | Dispositif de décongestion rénale |
US11534304B2 (en) | 2017-10-06 | 2022-12-27 | Troy Thornton | Device for renal decongestion |
US11511103B2 (en) | 2017-11-13 | 2022-11-29 | Shifamed Holdings, Llc | Intravascular fluid movement devices, systems, and methods of use |
US11229784B2 (en) | 2018-02-01 | 2022-01-25 | Shifamed Holdings, Llc | Intravascular blood pumps and methods of use and manufacture |
US10722631B2 (en) | 2018-02-01 | 2020-07-28 | Shifamed Holdings, Llc | Intravascular blood pumps and methods of use and manufacture |
CN112512623A (zh) * | 2018-07-27 | 2021-03-16 | 天主教大学基金会 | 具有定向流动辅助的心脏支持装置 |
US11964145B2 (en) | 2019-07-12 | 2024-04-23 | Shifamed Holdings, Llc | Intravascular blood pumps and methods of manufacture and use |
US11654275B2 (en) | 2019-07-22 | 2023-05-23 | Shifamed Holdings, Llc | Intravascular blood pumps with struts and methods of use and manufacture |
US11724089B2 (en) | 2019-09-25 | 2023-08-15 | Shifamed Holdings, Llc | Intravascular blood pump systems and methods of use and control thereof |
Also Published As
Publication number | Publication date |
---|---|
GB201005198D0 (en) | 2010-05-12 |
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