Catheter to cannulate the coronary sinus

Claim 2

A double catheter, comprising: an outer, resilient catheter having shape memory and a hook shaped distal end configured for cannulation of the coronary sinus with at least one curved bend; an inner, pliable catheter slidably disposed in the outer catheter and of greater length than the outer catheter so that a distal end portion of the inner catheter can be extended or retracted from a distal end opening of the outer catheter to vary the overall length of the double catheter, the inner catheter having an internal lumen configured for the introduction of contrast media and a pacing lead into the coronary sinus; and a mechanism operable from the proximal end of the outer catheter for changing the curvature of the distal end of the outer catheter.

Claim 3

The double catheter of claim 1 , wherein the mechanism for changing the curvature of the hook shaped distal end further comprises an obturator slidably disposed inside of the inner catheter, wherein the obturator is configured to reduce the curvature of the hook shaped distal end when inserted in the inner catheter.

Claim 4

The double catheter of claim 1 , further comprising a balloon mounted on the outside of the distal end of the outer catheter positioned for occlusion of the proximal coronary sinus, and a conduit permitting inflation of the balloon at the proximal end of the outer catheter.

Claim 5

A double catheter, comprising: an outer, resilient catheter having shape memory and a hook-shaped distal end with at least one curved bend; an inner, pliable catheter slidably disposed in the outer catheter and of greater length than the outer catheter so that a distal end portion of the inner catheter can be extended or retracted from a distal end opening of the outer catheter to vary the overall length of the double catheter, the inner catheter having an internal lumen suitable for the introduction of a fluid therethrough; and a mechanism operable from the proximal end of the outer catheter for changing the curvature of the distal end of the outer catheter, wherein the mechanism for changing the curvature of the hook shaped distal end comprises a cable anchored to the outer catheter at a point proximate the distal end of the outer catheter and at a point proximate the proximal end of the outer catheter, whereby shortening of the cable from the point proximate the proximal end of the outer catheter results in increased curvature of the hook shaped distal end.

Claim 6

A double catheter, comprising: an outer, resilient catheter having shape memory and a hook-shaped distal end with at least one curved bend; an inner, pliable catheter slidably disposed in the outer catheter and of greater length than the outer catheter so that a distal end portion of the inner catheter can be extended or retracted from a distal end opening of the outer catheter to vary the overall length of the double catheter, the inner catheter having an internal lumen suitable for the introduction of a fluid therethrough; and a mechanism operable from the proximal end of the outer catheter for changing the curvature of the distal end of the outer catheter, wherein the mechanism for changing the curvature of the hook shaped distal end comprises a cable anchored to the outer catheter at a point proximate the distal end of the outer catheter and at a point proximate the proximal end of the outer catheter, whereby shortening of the cable from the point proximate the proximal end of the outer catheter results in increased curvature of the hook shaped distal end.

Claim 7

The double catheter of claim 4 , wherein the cable runs inside a wall of the outer catheter.

Claim 8

The double catheter of claim 1 , further comprising a mechanism operable from a proximal end of the outer catheter for securing the inner catheter against sliding movement relative to the outer catheter.

Claim 9

The double catheter of claim 6 , further comprising a port for introducing a fluid into a space between the inner and outer catheters.

Claim 10

The double catheter of claim 1 , wherein the hook-shaped distal end comprises substantially straight segments spanning three bends.

Claim 11

The double catheter of claim 8 , wherein a first bend adjoining a straight, proximal portion of the outer catheter is in the range of 130° to 175°, a second, intermediate bend is in the range of 75° to 100°, and a third bend nearest the distal end of the outer catheter is in the range of to 130° to 175°.

Claim 12

The double catheter of claim 1 , wherein the mechanism for changing the curvature of the hook shaped distal end comprises a portion of the inner catheter configured to reduce the curvature of the hook shaped distal end when inserted in the outer catheter.

Claim 15

The method of claim 11 , further comprising: adjusting the curvature of the double catheter in order to enter the coronary sinus.

Claim 16

An outer catheter configured for use with an inner, pliable catheter which can be slidably disposed in the outer catheter and of greater length than the outer catheter so that a distal end portion of the inner catheter can be extended or retracted from a distal end opening of the outer catheter, the outer catheter comprising a resilient tube having shape memory and sufficient stiffness to permit advancement of the outer catheter into a distal coronary sinus, and having a hook-shaped distal end wherein a first bend adjoining a straight, proximal portion of the outer catheter is in the range of 130° to 180°, a second, intermediate bend is in the range of 75° to 100° in a direction opposite the first bend, and a third bend nearest the distal end of the outer catheter in the same direction as the second bend is in the range of to 130° to 175°.

Claim 17

An outer catheter configured for use with an inner, pliable catheter which can be slidably disposed in the outer catheter and of greater length than the outer catheter so that a distal end portion of the inner catheter can be extended or retracted from a distal end opening of the outer catheter, the outer catheter comprising a resilient tube having shape memory and sufficient stiffness to permit advancement of the outer catheter into a distal coronary sinus, and having a hook-shaped distal end wherein a first bend adjoining a straight, proximal portion of the outer catheter is in the range of 130° to 180°, a second, intermediate bend is in the range of 75° to 100° in a direction opposite the first bend, and a third bend nearest the distal end of the outer catheter in the same direction as the second bend is in the range of to 130° to 175°.

Claim 18

The catheter of claim 13 , wherein the first bend equals 180°, rendering the outer catheter substantially J-shaped.

Claim 19

The catheter of claim 13 , wherein the first bend is in the range of 130-175°, rendering the outer catheter substantially question mark-shaped.

Claim 20

The catheter of claim 13 , wherein the outer catheter is made of a braided silastic.

Claim 21

The catheter of claim 13 , wherein the outer catheter further comprises: an external inflatable cuff near the distal end of the outer catheter; and means for inflation of the cuff sufficient to permit occlusion of the proximal coronary sinus.

Claim 22

A double catheter, comprising: an outer catheter comprising a resilient tube having shape memory and sufficient stiffness to permit advancement of the outer catheter into a distal coronary sinus, and having a hook-shaped distal end wherein a first bend adjoining a straight, proximal portion of the outer catheter is in the range of 130° to 180°, a second, intermediate bend is in the range of 75° to 100° in a direction opposite the first bend, and a third bend nearest the distal end of the outer catheter in the same direction as the second bend is in the range of to 130° to 175°, and an inner, pliable catheter slidably disposed in the outer catheter and of greater length than the outer catheter so that a distal end portion of the inner catheter can be extended or retracted from a distal end opening of the outer catheter to vary the overall length of the double catheter, wherein the inner catheter has an internal lumen suitable for the introduction of a fluid therethrough and a hemostatic valve at a proximal end thereof that prevents leakage of blood when a pacing lead is introduced through the inner catheter into the coronary system.

Claim 23

A double catheter, comprising: an outer catheter comprising a resilient tube having shape memory and sufficient stiffness to permit advancement of the outer catheter into a distal coronary sinus, and having a hook-shaped distal end wherein a first bend adjoining a straight, proximal portion of the outer catheter is in the range of 130° to 180°, a second, intermediate bend is in the range of 75° to 100° in a direction opposite the first bend, and a third bend nearest the distal end of the outer catheter in the same direction as the second bend is in the range of to 130° to 175°, and an inner, pliable catheter slidably disposed in the outer catheter and of greater length than the outer catheter so that a distal end portion of the inner catheter can be extended or retracted from a distal end opening of the outer catheter to vary the overall length of the double catheter, wherein the inner catheter has an internal lumen suitable for the introduction of a fluid therethrough and a hemostatic valve at a proximal end thereof that prevents leakage of blood when a pacing lead is introduced through the inner catheter into the coronary system.

Claim 24

The double catheter of claim 18 , wherein the first bend equals 180°, rendering the outer catheter substantially J-shaped.

Claim 25

The double catheter of claim 18 , wherein the first bend is in the range of 130-175°, rendering the outer catheter substantially question mark-shaped.

Claim 26

The double catheter of claim 18 , wherein the outer catheter is made of a braided silastic.

Claim 27

The double catheter of claim 18 , wherein the outer catheter further comprises: an external inflatable cuff near the distal end of the outer catheter; and means for inflation of the cuff sufficient to permit occlusion of the proximal coronary sinus.

Claim 28

The double catheter of claim 18 , further comprising a mechanism operable from a proximal end of the outer catheter for changing the curvature of the distal end of the outer catheter.

Claim 31

The method of claim 24 , wherein a first bend adjoining a straight, proximal portion of the outer catheter is in the range of 130° to 180°, a second, intermediate bend is in the range of 75° to 100° in a direction opposite the first bend, and a third bend nearest the distal end of the outer catheter in the same direction as the second bend is in the range of to 130° to 175°.

Claim 32

The method of claim 25 , wherein the first bend equals 180°, rendering the outer catheter substantially J-shaped.

Claim 33

The method of claim 25 , wherein the first bend is in the range of 130-175°, rendering the outer catheter substantially question mark-shaped.