Diffusion and infusion resistant implantable devices and methods for reducing pulsatile pressure are provided. The implantable device includes a balloon implantable within a blood vessel of a patient, e.g., the pulmonary artery. The balloon is injected with a fluid mixture comprising a constituent fluid(s) and a diffusion-resistant gas to provide optimal balloon volume and limit fluid diffusion throughout multiple cardiac cycles. The fluid mixture may be pressurized such that the balloon is transitionable between an expanded state and a collapsed state responsive to pressure fluctuations in the blood vessel.

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.

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.

Perfusion systems and methods are provided for increasing peripheral blood flow to reduce limb ischemia, in which an extracorporeal pump having a controller, and catheter/tubing set, employed alone or in conjunction with an interventional or circulatory assist device, withdraws blood from a patient's vasculature and reintroduces that blood at another location within the patient's vasculature at a controlled local pressure or flow rate, without interfering with operation of the interventional or circulatory assist device or surgical intervention.

Perfusion systems and methods are provided for increasing peripheral blood flow to reduce limb ischemia, in which an extracorporeal pump having a controller, and catheter/tubing set, employed alone or in conjunction with an interventional or circulatory assist device, withdraws blood from a patient's vasculature and reintroduces that blood at another location within the patient's vasculature at a controlled local pressure or flow rate, without interfering with operation of the interventional or circulatory assist device or surgical intervention.

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).

The present disclosure is directed towards systems and methods built for predictively timing the inflation and/or deflation of an intra-aortic balloon pump. A controller operates in three states: (1) initialization state, (2) learning state, and (3) peak detection state. The controller decomposes a patient's electrocardiogram signal to a power signal. It then learns characteristics of the patient's electrocardiogram signal during the learning state and computes adaptive threshold parameter values. During the peak detection state, the controller applies the learnt threshold parameter values on a current electrocardiogram signal to identify occurrence and timings of R peaks in the electrocardiogram signal. The R-to-R peak timings are then used to trigger inflation of an intra-aortic balloon pump.

A heart support device for circulatory assistance is disclosed. The device comprises a chamber body (10) defining a chamber having an internal volume configured to be filled with blood. The chamber body (10) has a first opening (12) and the chamber is dimensioned such that the first opening (12) and the chamber are fully disposed within a chamber of the human heart. A dynamic volume body (14) is provided and configured to be inflated or deflated to alternately increase or decrease the interior volume of the chamber. A catheter (16) comprising at least one lumen in fluid communication with the dynamic volume body is configured to deliver fluid to the dynamic volume body to inflate the dynamic volume body. A directional flow structure is configured to direct a flow of blood out of the chamber in a direction substantially aligned with a direction in which the catheter (16) extends.