Ventricular assistance assembly with stabilized cardiac pump

Abstract

A ventricular assist assembly, for assisting a heart, includes an anchoring device, a cardiac pump and a stabilizing device. The anchoring device anchors a cardiac pump, is intended to be assembled with an opening in a ventricular wall of the heart, and delimits an internal passage. The cardiac pump is intended to be attached to the anchoring device, is configured for intra-ventricular insertion into the heart, and has a distal end. The cardiac pump extends through the internal passage into the heart when attached to the anchoring device implanted in the opening so that its distal end is placed in a ventricular chamber. The stabilizing device stabilizes the cardiac and includes at least two elongate, biocompatible and flexible connecting members, each elongate connecting member being intended to connect a part of the cardiac pump that is positioned in the ventricular chamber to an internal wall of the ventricular chamber.

Claims

1. A ventricular assist assembly for assisting a heart, said assembly comprising: an anchoring device for anchoring a cardiac pump, which device is intended to be assembled with an opening in a ventricular wall of said heart, said anchoring device delimiting an internal passage, a cardiac pump intended to be attached to said anchoring device, said cardiac pump being configured for intra-ventricular insertion into said heart, said cardiac pump having a distal end, said cardiac pump extending through said internal passage into said heart when attached to said anchoring device implanted in said opening so that its distal end is placed in a ventricular chamber, and a stabilizing device for stabilizing said cardiac pump, comprising at least two elongate, biocompatible and flexible connecting members, each elongate connecting member being intended to connect a part of said cardiac pump that is positioned in said ventricular chamber to an internal wall of said ventricular chamber, wherein for each elongate connecting member, said assembly comprises an attachment element so as to anchor said connecting member in said internal wall, and wherein said attachment element is an anchoring screw axially extending said elongate connecting member and placed at the distal end thereof.

2. The assembly as claimed in claim 1, characterized in that each elongate connecting member is chosen from the group comprising an elongate cable, a filament, a chord, a rod and combinations of these elements.

3. The assembly as claimed in claim 1, characterized in that said assembly also comprises a ring or a collar intended to surround the distal end of said cardiac pump, at least some of said elongate connecting members being secured by one of their ends to this ring or, respectively, to this collar.

4. The assembly as claimed in claim 3, characterized in that, with said elongate connecting members secured to said ring or to said collar, the assembly formed by said ring or said collar and said connecting members is made from a shape memory material so that, when introduced into the chamber, this assembly transitions from a non-deployed configuration to a deployed configuration in which the free ends of the connecting members come to bear against the internal walls of said ventricular chamber.

5. The assembly as claimed in claim 1, characterized in that, with each elongate connecting member being an elongate cable or a rod, said cardiac pump comprises cable passageways configured to each allow the insertion of a corresponding elongate cable or rod, from the outside of the heart toward the inside of said ventricular chamber when said pump is attached to the anchoring device.

6. The assembly as claimed in claim 5, characterized in that the body of each elongate cable or rod is configured to exhibit torsional stiffness for transmitting along its entire length a rotational movement that is imparted from a proximal end of this cable or of this rod.

7. The assembly as claimed in claim 5, characterized in that the cable passageways extend from the proximal end of said cardiac pump as far as a part of said pump that is intended to be placed inside said chamber when said pump is attached to the anchoring device secured to said opening.

8. The assembly as claimed in claim 5, characterized in that at least part of at least one of said passageways is positioned in the thickness of the lateral wall delimiting the pump body and/or is delimited by a hollow and elongate element projecting from the pump body.

9. The assembly as claimed in claim 5, characterized in that each passageway comprises a nonreturnable valve in order to seal same.

10. The assembly as claimed in claim 1, characterized in that said pump is a propulsive cardiac pump.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) Further advantages, objects and particular features of the present disclosure will become apparent from the following description, given for nonlimiting explanatory purposes with reference to the attached drawings, in which:

(2) FIG. 1 schematically depicts a ventricular assist assembly for a human heart according to one particular aspect of the disclosure, the cardiac pump being inserted into the left ventricle of this heart;

(3) FIG. 2 is a schematic view in cross section of just the pump casing or body of the cardiac pump of FIG. 1, showing the cable passageways;

(4) FIG. 3 shows an elongate cable used in the ventricular assist assembly of FIG. 1 and intended to be inserted into one of the cable passageways of the pump body;

(5) FIG. 4 is a schematic view in cross section of just the pump casing or body of a cardiac pump of a ventricular assist assembly according to another aspect of the disclosure.

DETAILED DESCRIPTION

(6) First of all, it should be noted that the figures are not to scale.

(7) FIGS. 1 to 3 schematically show a ventricular assist assembly for a human heart 10 according to one particular aspect of the present disclosure.

(8) This assembly comprises a ring 11 for anchoring a cardiac pump 12, which is assembled with an opening made in the ventricular wall 13 of this heart 10.

(9) This anchoring ring 11 comprises at its ends collars or flanges, which bear on each side of the ventricular wall 13 in order to permanently attach this ring 11 to the ventricular wall 13.

(10) The collar intended to be pressed firmly against the interior surface of the ventricular wall 13 is preferably made from a shape-memory material such as nitinol, so that it can pass through the opening made in the ventricular wall 13 in a deformed state, in which it has a tubular shape or substantially tubular shape, and regain its initial shape, that of a flange, after it has been introduced into the corresponding ventricular chamber.

(11) The anchoring ring 11 has an orifice for the passage of part of the cardiac pump 12 when it is being attached to this anchoring ring 11.

(12) This cardiac pump 12 is additionally configured for intraventricular insertion, which means to say that the distal end of the pump body 14, or casing, is intended to be positioned in the corresponding ventricular chamber once this pump is attached to the anchoring ring 11.

(13) Thus, because this cardiac pump 12 is connected to the anchoring ring 11, part of the pump body 14 passes through the orifice delimited by the anchoring ring 11, while the proximal end of the pump body 14 is positioned externally to, or flush with, the ventricular wall 13. The distal end is positioned in the ventricular chamber upstream of the aortic valve 15, with respect to the direction in which the blood is ejected.

(14) The pump body 14 also defines a housing to accommodate a motor (not depicted) which is placed in the ventricular chamber and/or in the thickness of the ventricular wall 13, so as to draw in and then deliver the blood, from the bottom, into the ventricular chamber and in the direction of the aortic valve 15, through the pump body 14.

(15) In order to stabilize the pump body 14 in the ventricular chamber, in an optimum position facing the aortic valve 15, the pump body 14 or casing has elongate-cable passageways 16 which are configured to each allow the insertion of an elongate and flexible cable 17 from outside the heart toward the inside of the ventricular chamber.

(16) Thus, because these passageways 16 extend axially from the proximal end of the pump body as far as the distal end thereof, the elongate and flexible cables 17 can be manipulated from outside the ventricle.

(17) FIG. 2 shows a view in cross section of just the pump body 14, which has in its thickness passageways 16 uniformly distributed around the periphery of this body.

(18) Each passageway 16 comprises at least one sealing element (not depicted), such as a nonreturn valve, to seal the passageway prior to the insertion of an elongate and flexible cable 17.

(19) As depicted in FIG. 1, a first elongate and flexible cable 17 passes through a first of these cable passageways 16 positioned on a first edge of said cardiac pump 12 and reemerges from this body via the distal end of the pump body 14.

(20) The free end of this cable 17, which comprises a projecting helical screw or attachment element 18 positioned in the axial continuation of the cable and able to penetrate the tissue of a wall of the heart under the effect of a screwing motion imparted from the proximal end of the elongate cable, is anchored in the tissue of a septal wall of the left ventricle of this heart (“left septal wall”).

(21) A second elongate and flexible cable 17 passing through a second passageway 16 placed on the opposite edge of this pump 12 to the edge that accommodates the first passageway, has its distal end anchored in the tissue of a wall internal to said ventricular chamber and adjoining the aortic valve 15. By way of example, this latter wall is the aortic outflow tract.

(22) Because these cables 17 are under tension, the cardiac pump 12 is immobilized in position in the long term, this being regardless of the activity performed by the patient fitted with this ventricular assist assembly.

(23) While the rate of blood flow through the aortic valve 15 is rendered optimal because the distal end of the pump body 14 is centered on the aortic valve 15, any potential formation of a clot is also avoided.

(24) FIG. 4 is a schematic view in cross section of just the pump casing or body or a cardiac pump of a ventricular assist assembly according to another embodiment of the invention.

(25) This pump body 20 comprises a plurality of elongate-cable passageways 21 which are placed external to the pump.

(26) Purely by way of illustration, these passageways 21 are defined for example by elongate and hollow protuberances formed on the exterior surface of the pump body.

(27) Of course, the internal wall delimiting the orifice of the corresponding anchoring ring comprises recesses the shape of which complements these protuberances, so as to allow the cardiac pump to pass through the orifice when it is being attached to this anchoring ring.

(28) These recesses are also configured in order, by collaboration with these protuberances, to provide the assembly of the cardiac pump with the anchoring ring the required sealing.