A pericardial access device includes a first tube, a second tube coupled to the first tube, and a biasing mechanism coupled to the second tube. The pericardial access device is moveable between an expanded configuration and a contracted configuration. The biasing mechanism biases the pericardial access device towards the expanded configuration, and the pericardial access device moves towards the contracted configuration when a force is applied to the second tube.

A pericardial access device includes a first tube, a second tube coupled to the first tube, and a biasing mechanism coupled to the second tube. The pericardial access device is moveable between an expanded configuration and a contracted configuration. The biasing mechanism biases the pericardial access device towards the expanded configuration, and the pericardial access device moves towards the contracted configuration when a force is applied to the second tube.

The invention provides a flushing system (1) configured to flush the pericardial cavity (PC) of a patient, wherein the system comprises: an infusion liquid outlet (4) to connect a first tube(20) having an infusion liquid lumen to guide a flow of infusion liquid from the system to the pericardial cavity, and an effusion liquid inlet (6) to connect to a second tube (21) having an effusion liquid lumen to guide the effusion liquid flow from the pericardial cavity to the system, a flow rate control system to control the flow rate of the infusion liquid flow at the infusion liquid outlet (4) on the basis of multiple sensor signals, wherein the flow rate control system comprises: a control unit (5) to provide a control signal on the basis of the sensor signals, and a pump device (3) to pump infusion liquid to the infusion liquid outlet (4) at an infusion liquid flow rate, wherein the infusion liquid flow rate is adjustable by the control signal of the control unit (5) and wherein the sensor signals registered by the control unit (5) comprise: an infusion liquid signal representative for the infusion liquid flow to the pericardial cavity, an effusion liquid signal representative for the effusion liquid flow rate from the pericardial cavity, a blood volume signal generated by a hematocrit sensor (12) representative for a blood loss flow rate in the effusion liquid from the pericardial cavity, and a pressure control signal representative for the pressure in the pericardial cavity generated by a pressure sensor positioned inside or in connection with the first tube (20), the second tube (21) or the pericardial cavity. The invention also provides a method of monitoring the blood loss volume or flow rate from the pericardium based on multiple sensor signals as well as, a method of treatment of postoperative cardiac patients in order to reduce the risk of cardiac tamponade, reduce post-operative blood loss and reduce the accumulation of blood and clots in the pericardial cavity, wherein the pericardial cavity of the patient is flushed with a flushing system according to the invention.

Improved medical guide elements for use with dilators to be inserted into an organ or body structure of a patient, such as the kidney. The guide element includes a proximal segment and a distal segment. The diameter of the distal segment is greater than the diameter of the proximal segment. The change in diameter is abrupt, providing a discrete step transition at a point along the filament which presents a proximally-facing surface on the distal segment. When the proximal segment of the guide element is fully inserted into a dilator having a distal tip adapted for insertion into a patient, the dilator distal tip firmly abuts the proximally-facing end surface of the distal segment. The relative dimensions of the dilator tip and the discrete stepped transition of the guide element provides full shielding or over shielding of the dilator tip, thereby facilitating passage of the dilator tip along the tissue track, through the puncture hole and into the orifice.

An irrigated ablation system with retrograde flow includes one or more medical devices (e.g., an ablation catheter and sheath) encompassing an irrigation lumen that terminates distally at an irrigation orifice and a drainage lumen that terminates distally at a drainage orifice. One or more pumps are coupled to the irrigation lumen and to the drainage lumen to deliver irrigant through the irrigation lumen and to extract fluid through the at least one drainage lumen. For example, a peristaltic pump can be used to simultaneously deliver irrigant through the irrigation lumen and to extract an equivalent volume of fluid through the drainage lumen. Alternatively, a feedback controller can be used to monitor parameters, such as impedance, pressure, ablation time, and/or irrigant volume, and control based thereon the rate at which the pump extracts fluid.

Devices and methods for assisting cardiac function. In an exemplary embodiment of a device for assisting heart function of the present disclosure, the device includes a first plate and an opposing second plate, each plate having an inner surface, a cardiac processor coupled to at least one of the first plate and the second plate, a bladder having an inner chamber and disposed between the inner surfaces, and a first catheter having a proximal end in communication with the inner chamber of the bladder and a distal end having a first pericardial balloon coupled thereto, wherein a gas and/or a liquid within the inner chamber of the bladder can be injected into the first pericardial balloon upon compression of the first plate relative to the second plate, and wherein the gas and/or the liquid can be removed from the first pericardial balloon upon retraction of the first plate relative to the second plate.

Improved methods for percutaneously creating, entering and/or dilating an opening in the wall of a blood vessel or other anatomic structure. The improvement comprises deploying a guide element having a proximal segment and a distal segment, the diameter of said distal segment being greater than the diameter of said proximal segment at their juncture, and which at said juncture forms an abrupt circumferential step comprising a proximally-facing surface. Said proximally-facing surface abuts the catheter's tip and shields said tip, thereby facilitating passage of said catheter as it enters and passes through said opening in said wall of a blood vessel or other anatomic structure.

Medical devices and instruments, particularly pericardial access systems and devices and related methods are disclosed. Some example pericardial access devices may include a distally located, expandable skirt configured to engage the pericardium. When extended, the skirt may be wider than the tubular body of the device. Some example pericardial access devices may include an at least partially transparent, repositionable tip.

Steering engagement catheter devices, systems, and methods of using the same for accessing a tissue, including internal and external tissues of a heart, are disclosed. In at least one embodiment, a steering engagement catheter is provided, comprising an elongated tube having a proximal end, a distal end, and a first wall positioned circumferentially along a length of the elongated tube, the elongated tube configured such that a delivery catheter is capable of at least partial insertion into the elongated tube, at least one steering wire having a proximal end and a distal end, the distal end of the at least one steering wire coupled to the first wall of the elongated tube at or near the distal end of the elongated tube, and a controller operably coupled to the at least one steering wire at or near the proximal end of the at least one steering wire.

Improved methods for percutaneously creating, entering and/or dilating an opening in the wall of a blood vessel or other anatomic structure. The improvement comprises deploying a guide element having a proximal segment and a distal segment, the diameter of said distal segment being greater than the diameter of said proximal segment at their juncture, and which at said juncture forms an abrupt circumferential step comprising a proximally-facing surface. Said proximally-facing surface abuts the catheter's tip and shields said tip, thereby facilitating passage of said catheter as it enters and passes through said opening in said wall of a blood vessel or other anatomic structure.