A cardiac assist system includes a pneumatic effector which is implanted beneath a pericardial sac and over a myocardial surface overlying the patient's left ventricle. A port is implanted and receives a percutaneously introduced cannula. The port is connected to supply a driving gas received from the cannula to the pneumatic effector. An external drive unit includes a pump assembly and control circuitry which operate the pump to actuate the pneumatic effector in response to the patient's sensed heart rhythm. A connecting tube has a pump end connected to the pump and a percutaneous port-connecting end attached to the implantable port.

Some embodiments of percutaneous ventricular assist devices have a two-part design that includes a housing component and a separately deployable rotatable inner catheter component. The housing component can include an expandable pump housing. The inner catheter can include an expandable pump impeller and an associated flexible drive shaft. The drive shaft can be coupled to a motor located external to the patient. The motor can rotate the drive shaft to spin the pump impeller inside of the pump housing, causing blood to be pumped within the patient. In some embodiments, the pump impeller is inflatable or self-expandable. The two-part percutaneous ventricular assist devices with inflatable or self-expandable pump impellers are designed to have very small delivery profiles. Accordingly, various deployment modalities, including radial artery deployment, are practicable using the two-part percutaneous ventricular assist devices described herein.

Some embodiments of percutaneous ventricular assist devices have a two-part design that includes a housing component and a separately deployable rotatable inner catheter component. The housing component can include an expandable pump housing. The inner catheter can include an expandable pump impeller and an associated flexible drive shaft. The drive shaft can be coupled to a motor located external to the patient. The motor can rotate the drive shaft to spin the pump impeller inside of the pump housing, causing blood to be pumped within the patient. In some embodiments, the pump impeller is inflatable or self-expandable. The two-part percutaneous ventricular assist devices with inflatable or self-expandable pump impellers are designed to have very small delivery profiles. Accordingly, various deployment modalities, including radial artery deployment, are practicable using the two-part percutaneous ventricular assist devices described herein.

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.

A circulatory assist apparatus comprises an inflatable pumping balloon having a proximal end joined to an elongated balloon catheter, the catheter having a distal end joined to the pumping balloon and a proximal end, separated from the distal end by a length sufficient to extend from within the circulatory lumen to the outside of a patient's body, for receiving positive and negative pressure pulses from a pump to inflate and deflate the pumping balloon; a proximal expandable frame comprising a distal portion of an elongated shaft surrounding the catheter; and a distal expandable frame. The distal end of the elongated shaft is abuttable against a stopping element surrounding the catheter as the shaft is advanced towards the inflatable pumping balloon, or is joined to the catheter in which case the proximal expandable frame is heat set to deploy spontaneously to a predetermined diameter upon release of the elongated shaft.

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.

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.

A pericardial access system includes an introducer sheath and a mandrel. The introducer sheath has a proximal end, a distal end, and a lumen extending therethrough. The mandrel has a proximal end, a distal end, end a handle at the proximal end. A wire electrode is disposed at the distal end of the mandrel, and a power supply is coupled to the wire electrode and configured to apply a short burst of energy sufficient to allow the wire electrode to penetrate a pericardial sac of a patient. The pericardial access system is used to deliver an implantable cardiac assist catheter connectable to an external drive unit. An anchor catheter is percutaneously advanced into a patient's pericardial sac and includes an anchor at its distal which may be expanded within the pericardial sac.

A pericardial access system includes an introducer sheath and a mandrel. The introducer sheath has a proximal end, a distal end, and a lumen extending therethrough. The mandrel has a proximal end, a distal end, end a handle at the proximal end. A wire electrode is disposed at the distal end of the mandrel, and a power supply is coupled to the wire electrode and configured to apply a short burst of energy sufficient to allow the wire electrode to penetrate a pericardial sac of a patient. The pericardial access system is used to deliver an implantable cardiac assist catheter connectable to an external drive unit. An anchor catheter is percutaneously advanced into a patient's pericardial sac and includes an anchor at its distal which may be expanded within the pericardial sac.

Some embodiments of percutaneous ventricular assist devices have a two-part design that includes a housing component and a separately deployable rotatable inner catheter component. The housing component can include an expandable pump housing. The inner catheter can include an expandable pump impeller and an associated flexible drive shaft. The drive shaft can be coupled to a motor located external to the patient. The motor can rotate the drive shaft to spin the pump impeller inside of the pump housing, causing blood to be pumped within the patient. In some embodiments, the pump impeller is inflatable or self-expandable. The two-part percutaneous ventricular assist devices with inflatable or self-expandable pump impellers are designed to have very small delivery profiles. Accordingly, various deployment modalities, including radial artery deployment, are practicable using the two-part percutaneous ventricular assist devices described herein.