Apparatus is provided, including a flexible intraventricular receptacle positionable within a heart ventricle, and configured to assume a first volume upon passage of fluid that is not blood into the receptacle and a second, smaller volume upon passage of the fluid out of the receptacle. An expandable extracardiac receptacle is positionable outside of the heart, and is configured to expand upon transfer of the fluid into the extracardiac receptacle from the intraventricular receptacle and to contract upon passage the fluid out of the extracardiac receptacle. A transmyocardial conduit is disposed and allows passage of the fluid between the intraventricular receptacle and the extracardiac receptacle responsively to a cardiac cycle. During ventricular systole, a volume of fluid is expelled from the intraventricular receptacle, through the conduit, and the extracardiac receptacle, producing a corresponding decrease in a total volume of the ventricle during isovolumetric contraction of the ventricle.

Apparatus includes a flexible intraventricular receptacle that assumes a first volume upon passage of fluid that is not blood into the receptacle and a second, smaller volume upon passage of the fluid out of the receptacle. An expandable extracardiac receptacle expands upon transfer of the fluid into the extracardiac receptacle from the intraventricular receptacle and contracts upon passage of the fluid out of the extracardiac receptacle. A transmyocardial conduit allows passage of the fluid between the intraventricular receptacle and the extracardiac receptacle responsively to a cardiac cycle. During ventricular systole, a volume of fluid is expelled from the intraventricular receptacle, through the conduit, and into the extracardiac receptacle, producing a corresponding decrease in a total volume of the ventricle during isovolumetric contraction of the ventricle. Other embodiments are also described.

Apparatus, systems, and methods are provided for optimizing intracardiac filling pressures and cardiac output in patients with heart failure, conduction disease, and atrial fibrillation. The system is able to adjust and optimize intracardiac filling pressures and cardiac output by adjusting heart rate and the effective amount of total body blood volume. The device includes an adjustable member that may create a mean pressure differential in order to manifest an effective “mechanical diuresis” by sequestering extraneous blood volume to the high-capacitance of the venous vasculature. The system is therefore designed to reduce intracardiac filling pressures while maintaining or even increasing cardiac output.

Several embodiments of a catheter are described, having a balloon configured to slowly inflate and then quickly deflate to create an area of low pressure in the vessels. The balloon can be cycled near the vessels of the kidneys, thereby helping to draw out blood from the kidneys and enhance fluid processing to the bladder.

The present invention relates to a perfusion balloon catheter that has an expandable (enlargeable) inner lumen with a novel design feature that allows a continuous flow through this enlarged lumen sufficient perfusion to the distal lumen of the blood vessel or air passage concurrent to and independently of balloon inflation or deflation resulting in the prolonged dilatation and avoiding the high risks of blood or air flow stricture during balloon inflation.

Systems and methods for blood flow control are described herein. In some variations, a blood flow control system may comprise a blood flow control device. The blood flow control device may be placed within a body of a patient and may comprise an expandable member and a sensor. The sensor may be configured to measure at least one of a physiologic condition of the patient and a pressure associated with the expandable member. The blood flow control system may include at least one controller communicably coupled to the sensor to: receive data indicative of at least one of the physiologic condition of the patient and the pressure associated with the expandable member from the sensor, compare the received data with target data, identify at least one error based on the comparison, and in response to identifying the error, inhibit at least one function of the blood flow control system.

The invention relates to a catheter assembly for the intermittent occlusion of the coronary sinus (CS, 60). The catheter assembly comprises a shaft (17, 126). The shaft (17, 126) has a plurality of lumens (7A, 7B, 35, 38, 40, 40A, 40B), a distal end (22) with a distal tip (20A, 20B, 20C), an occlusion device (24, 56, 142) fixed to the distal tip (20A, 20B, 20C) and operable through at least one of the plurality of lumens (7A, 7B, 35, 38, 40, 40A, 40B) and a proximal handle (10). The catheter assembly further having at least one of the following: the occlusion device (24, 142) having a diameter of 5 - 20 mm and adapted to occlude the coronary sinus ostium, means of measuring the pressure at the distal tip (20 a, 20B, 20C) of the catheter assembly and distally to the occlusion device (24, 142), preferably using an optical pressure sensor (28), an anchoring device (30, 54, 65, 80, 90A, 122) for anchoring the occlusion device (24, 142) in a predefined position in the coronary sinus (CS, 60), preferably in the ostium, the distal end (22) being deflectable/steerable with deflection being controlled by an actuator arranged at the proximal handle (10).

The invention relates to a catheter assembly for the intermittent occlusion of the coronary sinus (CS, 60). The catheter assembly comprises a shaft (17, 126). The shaft (17, 126) has a plurality of lumens (7A, 7B, 35, 38, 40, 40A, 40B), a distal end (22) with a distal tip (20A, 20B, 20C), an occlusion device (24, 56, 142) fixed to the distal tip (20A, 20B, 20C) and operable through at least one of the plurality of lumens (7A, 7B, 35, 38, 40, 40A, 40B) and a proximal handle (10). The catheter assembly further having at least one of the following: the occlusion device (24, 142) having a diameter of 5 - 20 mm and adapted to occlude the coronary sinus ostium, means of measuring the pressure at the distal tip (20 a, 20B, 20C) of the catheter assembly and distally to the occlusion device (24, 142), preferably using an optical pressure sensor (28), an anchoring device (30, 54, 65, 80, 90A, 122) for anchoring the occlusion device (24, 142) in a predefined position in the coronary sinus (CS, 60), preferably in the ostium, the distal end (22) being deflectable/steerable with deflection being controlled by an actuator arranged at the proximal handle (10).

Some embodiments of the disclosure are directed to a novel system for pumping liquid such as blood without damaging cells. In some embodiments, the system includes one or more inflatable elements such as balloons which force liquid from an implanted pump. In some embodiments, one or more elements are configured to directionally inflate. In some embodiments, the directional inflation enables pumping in a bidirectional manner. In some embodiments, the system includes a plurality of elements that inflate sequentially to pump liquid in one direction or another. In some embodiments, the one or more elements are coupled to a tube or stent.

An integrated sheath assembly for inserting a medical device such as a percutaneous pump into a vessel can include a first sheath having a first lumen defining a first opening between proximal and distal ends of the first sheath for passage of a portion of the pump and a second sheath having a second lumen defining a second opening between proximal and distal ends of the second sheath. The second lumen is expandable to allow passage of the first sheath containing the portion of the pump. The first sheath fills a space between the second sheath and the portion of the percutaneous pump when the first sheath containing the percutaneous pump is inserted into the second lumen. The first sheath has a first hub, and the second sheath has a second hub. In some embodiments, a single sheath and a movable connector can be integrated on the medical device.