System and methods for catheter procedures with circulatory support in high risk patients

摘要

A system and methods are described for performing catheter based procedures on high risk patients that mitigate the risk to the patient and extend the acceptable time window for response when emergencies or complications arise. The system is useful for stopped heart catheter procedures or as a safety backup in beating heart catheter procedures and is compatible with concurrent or sequential surgical interventions. The system combines a therapeutic or diagnostic catheter subsystem with a selective aortic perfusion and cardiopulmonary bypass subsystem. The catheter subsystem may include catheters for angioplasty, stent delivery, atherectomy, valvuloplasty or other diagnostic or therapeutic procedures. The selective aortic perfusion and cardiopulmonary bypass subsystem generally includes catheters and/or cannulas for draining blood from the patient's venous or arterial system, a perfusion pump, a blood oxygenator, at least one blood heat exchanger and catheters and/or cannulas for perfusing oxygenated blood into the patient's arterial system. The arterial perfusion catheters and/or cannulas are constructed with an upstream flow control member located in the patient's ascending aorta and a downstream flow control member located in the patient's descending aorta. The external flow control members may take the form of inflatable occlusion balloons and/or selectively deployable external catheter flow control valves. The external flow control members may be mounted on a single elongated catheter or cannula shaft or they may be mounted on separate catheter or cannula shafts for independent placement and deployment.