Fluid jet cutting system for cardiac applications

A - Human Necessities – 61 – B

Patent

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Details

A61B 17/32 (2006.01) A61B 17/00 (2006.01)

Patent

CA 2315673

The present invention is directed to a system (10), and method for generating a high pressure fluid jet for cutting or drilling into the heart, particularly during TMR/PMR procedures. When used in TMR/PMR procedures, the system (10) preferably includes a variable pressure pump (24) for creating a high-pressure fluid jet which drills channels in the heart at predetermined depths corresponding to the pressure, the duration of the jet, with multiple pulses, increased duration, and/or increased pressure increasing the depth of the channel. The size or diameter of the hole is determined by the stand-off distance of the nozzle (44) from the surgical site, the design of the nozzle (44), and diameter of the nozzle's orifice (43). The system also preferably includes a console (22) for housing the pump (24), and other control mechanisms which allows the surgeon to input information into the system (10), for example to selectively vary the diameter of the jet stream, the pressure of the jet, the desired depth of the cut into the heart, and the like, thereby allowing the system to be customized by the surgeon depending upon the details of the application. In one embodiment, the drilling solution may contain additives to achieve certain functional purposes.

Cette invention a trait à un dispositif (10) ainsi qu'à la technique permettant de produire un jet fluidique haute pression pour coupe ou forage dans le coeur, notamment lors de revascularisation transmyocardique/méthode par voie percutanée (TMR/PMR). Ce dispositif (10) comporte alors, de préférence, une pompe (24) à pression variable créant un jet fluidique haute pression forant des canaux dans le coeur à des profondeurs prédéterminées correspondant à la pression du jet, à sa durée, des impulsions multiples, une augmentation de la durée et/ou un renforcement de la pression augmentant la profondeur du canal. Les dimensions ou le diamètre du trou sont déterminés par la distance séparant la tuyère (40) du site chirurgical, la conception de la tuyère (40) et le diamètre de son orifice (43). Ce dispositif comporte également, de préférence, une console (22) permettant de loger la pompe (24) et d'autres mécanismes de commande permettant au chirurgien d'entrer une information dans le dispositif (10), par exemple pour modifier, de manière sélective, le diamètre du jet, sa pression, la profondeur souhaitée de la découpe dans le coeur et analogue, ce qui lui permet de personnaliser le dispositif en fonction des détails de l'application. Dans un mode de réalisation, la solution de forage peut contenir des agents d'addition aux fins de certains objectifs fonctionnels.

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