Methods and systems for accessing the pericardial space

Details Methods and systems for accessing the pericardial space Methods and systems for accessing the pericardial space

A - Human Necessities

61

B

A61B 17/00 (2006.01) A61M 25/01 (2006.01)

Patent

CA 2589362

Methods and systems for transvenously accessing the pericardial space via the vascular system and atrial wall, particularly through the superior vena cava and right atrial wall, to deliver treatment in the pericardial space are disclosed. A steerable instrument is advanced transvenously into the right atrium of the heart, and a distal segment is deflected into the right atrial appendage. A fixation catheter is advanced employing the steerable instrument to affix a distal fixation mechanism to the atrial wall. A distal segment of an elongated medical device, e.g., a therapeutic catheter or an electrical medical lead, is advanced through the fixation catheter lumen, through the atrial wall, and into the pericardial space. The steerable guide catheter is removed, and the elongated medical device is coupled to an implantable medical device subcutaneously implanted in the thoracic region. The fixation catheter may be left in place.

L'invention concerne des procédés et des systèmes pour accéder intraveineusement à l'espace péricardique par le système vasculaire et la paroi auriculaire, tout particulièrement à travers la veine cave supérieure et la paroi auriculaire droite, pour administrer un traitement dans l'espace péricardique. Un instrument orientable est avancé intraveineusement dans l'oreillette droite du coeur, et un segment distal se courbe en arc dans l'auricule cardiaque droit. Un cathéter de fixation est avancé en employant l'instrument orientable pour attacher un mécanisme de fixation distal sur la paroi auriculaire. Un segment distal d'un dispositif médical allongé, par ex. un cathéter thérapeutique ou un fil médical électrique, est avancé à travers la lumière du cathéter de fixation, à travers la paroi auriculaire, et dans l'espace péricardique. Le cathéter orientable est enlevé, et le dispositif médical allongé est accouplé à un dispositif médical implantable sous la peau dans la région thoracique. Le cathéter de fixation peut être laissé en place.

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