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1. WO2020112622 - MÉTHODE ET APPAREIL DE CATHÉTÉRISATION

Note: Texte fondé sur des processus automatiques de reconnaissance optique de caractères. Seule la version PDF a une valeur juridique

[ EN ]

WHAT IS CLAIMED IS:

1. A catheter coupler, comprising:

a housing having a catheter connection lumen, a plurality of passages, and an outer circumferential channel, wherein the plurality of passages each connect the catheter connection lumen to the outer circumferential channel;

a cap rotatably coupled to the housing, wherein the cap has an outlet port in fluid communication with the outer circumferential passage; and

one or more seals that provide seals between the housing and the cap that direct fluid flow from the outer circumferential passage to the outlet port;

wherein the cap is rotatable to position the outlet port a vertical orientation without rotating the housing.

2. The catheter coupler of claim 1, wherein the outlet port is coupled to a pressure sensor.

3. The catheter coupler of any of claims 1 and 2, wherein the one or more sealing members comprise a first sealing member and a second sealing member that are positioned at least partially within grooves on the housing.

4. The catheter coupler of claim 3, wherein the first sealing member is positioned next to the outer circumferential channel on a first side, and wherein the second sealing member is positioned next to the outer circumferential channel on a second side.

5. A method of flushing a catheter coupler, comprising:

fixing a catheter to a housing;

rotating a cap while keeping the position of the housing stationary to position an outlet port of the cap in top-dead-center position;

applying a vacuum to the outlet port.

6. A delivery system comprising:

a first a catheter coupler comprising:

a housing having a first catheter connection lumen, a plurality of passages, and an outer circumferential channel, wherein the plurality of passages each connect the first catheter connection lumen to the outer circumferential channel;

a cap rotatably coupled to the housing, wherein the cap has an outlet port in fluid communication with the outer circumferential passage; and

one or more seals that provide seals between the housing and the cap that direct fluid flow from the outer circumferential passage to the outlet port;

wherein the cap is rotatable to position the outlet port in a vertical orientation without rotating the housing;

a first catheter connected to the first catheter connection lumen of the first catheter coupler;

a second catheter coupler comprising:

a housing having a second catheter connection lumen, a plurality of passages, and an outer circumferential channel, wherein the plurality of passages each connect the second catheter connection lumen to the outer circumferential channel;

a cap rotatably coupled to the housing, wherein the cap has an outlet port in fluid communication with the outer circumferential passage; and

one or more seals that provide seals between the housing and the cap that direct fluid flow from the outer circumferential passage to the outlet port;

wherein the cap is rotatable to position the outlet port in a vertical orientation without rotating the housing;

a second catheter connected to the second catheter connection lumen of the second catheter coupler;

wherein the second catheter extends through the first catheter coupler and the first catheter.

7. The delivery system of claim 6 further comprising a pusher element positioned within the second catheter.

8. The delivery system of claim 7 wherein a valve implant or repair device is detachably connected to the pusher element.

9. The delivery system of any of claims 6-8 wherein the outlet port of the first catheter coupler is coupled to a pressure sensor.

10. The delivery system of any of claims 6-9 wherein the outlet port of the second catheter coupler is coupled to a pressure sensor.

11. The delivery system of any of claims 6-10, wherein the at least one seal of the first catheter coupler comprises a first sealing member and a second sealing member disposed between the housing and the cap.

12. The delivery system of claim 11, wherein the first sealing member and the second sealing member are positioned at least partially within grooves on the housing of the first catheter coupler.

13. The delivery system of any of claims 11-12, wherein the first sealing member is positioned next to the outer circumferential channel on a first side, and wherein the second sealing member is positioned next to the outer circumferential channel on a second side.

14. The delivery system of any of claims 6-13 wherein the first catheter includes a radially inwardly extending projection that maintains a flow path between the first catheter and the second catheter.

15. The delivery system of claim 14 wherein the radially inwardly extending projection contains a catheter steering wire.

16. A method of measuring a fluid pressure, comprising:

inserting a first catheter through a second catheter;

maintaining a flow space between the first catheter and the second catheter with a radially inwardly extending projection on an inside surface of the second catheter;

measuring a pressure of the fluid in the flow space.

17. The method of claim 15 further comprising rotating a pressure monitoring port without moving the catheter.

18. The method of any of claims 16-17 further comprising bending the first and second catheters by pulling a wire that extends through the radially inwardly extending projection.

19. The method of any of claims 16-18 further comprising measuring a pressure of fluid in the first catheter.

20. The method of any of claims 16-19 wherein the fluid pressure is the pressure of blood in an atrium of a heart.

21. The method of claim 20 wherein blood pressure measurement is at a designated time during a cardiac cycle.

22. The method of claim 20, further comprising the steps of:

positioning a valve implant or repair device in a mitral valve;

analyzing the blood pressure measurement to determine whether the valve implant or repair device is positioned correctly in the mitral valve.

23. A catheter coupler, comprising:

a catheter connection lumen;

an outer circumferential passage;

a plurality of connecting passages that each connect the catheter connection lumen to the outer circumferential passage;

an outlet port in fluid communication with the outer circumferential passage; and wherein the outer circumferential passage and the plurality of connecting passages are sized such that when:

the outlet port is oriented in a direction that is not vertically upward;

upper ones of the connecting passages contain air; and

lower ones of the connecting passages contain liquid;

the air is drawn out of the outlet port.

24. The catheter coupler of claim 23, wherein the outlet port is coupled to a pressure sensor.

25. A delivery system comprising:

a first a catheter coupler comprising:

a first catheter connection lumen;

an outer circumferential passage;

a plurality of connecting passages that each connect the catheter connection lumen to the outer circumferential passage;

an outlet port in fluid communication with the outer circumferential passage; and

wherein the outer circumferential passage and the plurality of connecting passages are sized such that when:

the outlet port is oriented in a direction not vertically upward;

upper ones of the connecting passages contain air; and

lower ones of the connecting passages contain liquid;

the air is drawn out of the outlet port a first catheter connected to the first catheter connection lumen of the first catheter coupler;

a first catheter connected to the first catheter connection lumen of the first catheter coupler;

a second catheter coupler comprising:

a second catheter connection lumen;

an outer circumferential passage;

a plurality of connecting passages that each connect the catheter connection lumen to the outer circumferential passage;

an outlet port in fluid communication with the outer circumferential passage; and

wherein the outer circumferential passage and the plurality of connecting passages are sized such that when:

the outlet port is oriented in a direction not vertically upward;

upper ones of the connecting passages contain air; and

lower ones of the connecting passages contain liquid;

the air is drawn out of the outlet port a first catheter connected to the first catheter connection lumen of the first catheter coupler;

a second catheter connected to the second catheter connection lumen of the second catheter coupler;

wherein the second catheter extends through the first catheter coupler and the first catheter.

26. The delivery system of claim 25 further comprising a pusher element positioned within the second catheter.

27. The delivery system of claim 26 wherein a valve implant or repair device is detachably connected to the pusher element.

28. The delivery system of any of claims 25-27 wherein the outlet port of the first catheter coupler is coupled to a pressure sensor.

29. The delivery system of any of claims 25-28 wherein the outlet port of the second catheter coupler is coupled to a pressure sensor.

30. The delivery system of any of claims 25-29 wherein the first catheter includes a radially inwardly extending projection that maintains a flow path between the first catheter and the second catheter.

31. The delivery system of claim 30 wherein the radially inwardly extending projection contains a catheter steering wire.

32. A method of measuring pressure in a heart chamber, comprising the steps of:

inserting a valve implant or repair device delivery system into a left atrium, wherein the valve implant or repair device delivery system comprises:

a first catheter having a delivery lumen,

a pusher element positioned within the delivery lumen of the first catheter, wherein a valve implant or repair device is detachably connected to the pusher element,

a pressure sensor lumen in at least one of the first catheter and the pusher element;

a pressure sensor and a fluid disposed in the pressure sensor lumen;

exposing an open distal end of the pressure sensor lumen to the left atrium;

taking a first blood pressure measurement within the left atrium with the pressure sensor at a designated time during a cardiac cycle.

33. The method of claim 32 wherein the pressure sensor lumen extends along a length of the first catheter.

34. The method of any of claims 32-33 wherein the first catheter is a steerable catheter.

35. The method of any of claims 32-34 wherein the first catheter is an outer catheter sheath.

36. The method of any of claims 32-35 wherein the pressure sensor lumen comprises another catheter within the delivery lumen of the first catheter that is connected to an interior wall of the first catheter.

37. The method of any of claims 32-36 wherein the pressure sensor lumen further comprises an additional catheter, wherein the pressure sensor is in the additional catheter, and the pressure sensor lumen surrounds the additional catheter along at least a length of the additional catheter.

38. The method of any of claims 32-37 wherein the pressure sensor lumen extends along a length of a second catheter, within a wall of the second catheter.

39. The method of any of claims 32-38 wherein the pressure sensor lumen extends along a length of the first catheter, at least partially embedded in a wall of the first catheter.

40. The method of any of claims 32-39 wherein the pressure sensor is an electric pressure sensor.

41. The method of any of claims 32-40 wherein the fluid is saline and the pressure sensor can measure the pressure of the saline.

42. The method of any of claims 32-41, further comprising the steps of:

positioning a valve implant or repair device in a mitral valve;

taking at least a second blood pressure measurement within the left atrium with the pressure sensor at the designated time during the cardiac cycle when the valve implant or repair device is positioned;

using the second blood pressure measurement to determine if the valve implant or repair device is positioned properly to repair mitral valve regurgitation.

43. The method of any of claims 32-42 wherein the designated time during the cardiac cycle is at the end of systole.

44. The method of any of claims 32-43, wherein exposing the pressure sensor to the left atrium further comprises the step of extending the open distal end of the pressure sensor lumen out of a side opening in a wall of the first catheter.

45. The method of any of claims 32-44 wherein the pusher element is a tube.

46. The method of any of claims 32-42 wherein the pusher element is a rod.

47. A device for measuring pressure in a heart chamber using a valve implant or repair device delivery system, comprising:

a first catheter having a delivery lumen;

a pusher element positioned within the delivery lumen of the first catheter, wherein a valve implant or repair device is detachably connected to the pusher element;

a pressure sensor lumen in at least one of the first catheter and the pusher element; and

a pressure sensor and a fluid disposed in the pressure sensor lumen,

wherein the pressure sensor lumen comprises an open distal end.

48. The device of claim 47 wherein the pressure sensor lumen is within another catheter positioned within the delivery lumen of the first catheter and is connected to an interior wall of the first catheter.

49. The device of any of claims 47-48 wherein the pressure sensor lumen is within an additional catheter, and the pressure sensor lumen surrounds the additional catheter along at least a length of the additional catheter.

50. The device of any of claims 47-50 wherein the pressure sensor lumen extends along a length of a second catheter, within a wall of the second catheter.

51. The device of any of claims 47-50 wherein the pressure sensor lumen extends along a length of the first catheter, at least partially embedded in a wall of the first catheter.

52. The device of any of claims 47-51 wherein the pressure sensor is an electric pressure sensor.

53. The device of any of claims 47-52 wherein the fluid is saline and the pressure sensor can measure the pressure of the saline.

54. The device of any of claims 47-53 wherein the open distal end of the pressure sensor lumen extends through a wall of the first catheter.