RS20100468A2 - CARDIO-CIRCULATORY DEVICE DEVICE - Google Patents

Abstract

Invention herewith described refers to the device for invasive cardio-circulatory resuscitation. A large-volume syringe with a mechanism for the electric motor cyclic drive (128) is connected to the access cannula (200) with a large inner lumen placed into the left ventricular cavity of the circulatory arrest victim. A rearward movement of the motor actuated lever (112) enables aspiration of a large volume of the oxygenated blood out of the left ventricle and of the left atrium into the big syringe (128). By forward movement of the lever, the blood is injected back into the left ventricle through the same access cannula. The left ventricular unidirectional inflow check valve i.e. mitral valve closes during the injection due to increased left ventricular pressure. Since the volume of the injected blood exceeds the volume capacity of the non-contracting left ventricle, the surplus of injected blood is through the aortic valvula transported into the aorta. Repeating this manoeuvre as long as necessary provides vascularisation of the vital organs during arrest of the spontaneous circulation. In the process, the right heart functions as a passive pathway based on the pressure difference between aorta and the right and left atrium, additionally aided by dynamics of mechanical ventilation.

Description

Device for cardio-circulatory resuscitation

This patent application is a continuation of patent application P-2010/0326 by the same inventor.

Field to which the invention relates

The invention belongs to the wider field of emergency and intensive medicine and refers to a system for the emergency establishment of artificial mechanical circulation in case of cardiocirculatory arrest. According to the international classification of patents (MKP-IPC), the designation is A61M1/10.

Technical problem

The invention solves the problem of emergency establishment of effective blood supply (perfusion) of the vital structures of the body during cardiac arrest and circulation in all conditions (in medical institutions as well as in the field). The existing methods of reviving the heart and circulation are either not effective enough, such as external heart massage, or are complex and reserved for use in specialized medical institutions.

State of the art

Acute heart failure and cessation of circulation are the most common causes of sudden death. Emergency medical measures consist of artificial respiration and external cardiac massage.

The treatment of cardiocirculatory arrest has not changed for 50 years. Today, electrical instability of the heart is simply and effectively treated with defibrillators, respiratory arrest can be completely compensated by mechanical ventilation after inserting a tube into the airways. To maintain circulation and blood supply to the vital structures of the body (brain and heart muscle), mechanical compression of the chest is practiced. The low rate of success in reviving victims of cardiac and circulatory arrest is a consequence of the ineffectiveness of mechanical pressure on the chest to maintain minimal blood flow to the vital organs. The pressure difference between the aorta and the right atrium, as the most important determinant of effective circulation, is negligible during resuscitation with mechanical chest compressions.

There are many versions of mechanical cardiac compression apparatus: US Patent No. 7,131,953 to Sherman (2006) describes an automatic chest compression resuscitator with a belt that is attached to a bed on which the victim lies; US Patent No. 5,399,148 by Waide (1995) describes a device for external cardiac massage consisting of a source for pressing (compression) and active decompression adapted to the chest hair of the victim. There are also numerous versions of devices for internal heart massage: W.O.patent No. 94/03228 by Zadini (1994) describes an apparatus that is placed under the sternum surgically, the apparatus has a part that inflates and deflates, whereby the heart repeatedly presses and relaxes between the apparatus at the front and the spine at the back; W.O. patent No. 98/05289 to Fogarth (1998) describes another variant of an inflation and deflation device which is placed through the intercostal space between the sternum and the heart.

None of these systems significantly contributed to greater resuscitation efficiency.

In specialized hospital centers, systems for artificial circulation are sporadically applied, which consist of accessing the blood reservoir (cavity of the heart), pumping that blood to a mechanical pump and re-pumping it into the arterial system. US Pat. No. US5190528 describes a cannula system (plastic medical tube) for access to the left atrium by the so-called transseptal route: Under Roentgen control, a cannula is introduced from the right inguinal vein through the atrial septum to the left atrium, from where the oxygen-rich blood is pumped out and returned by a roller pump to the cannula placed over the inguinal artery into the arterial system. The installation of this system requires a highly specialized team, the conditions of a catheterization laboratory, and the cannulas introduced through the groin blood vessels are of large diameter and can endanger the circulation of the legs. Also, the time to install the described procedure is long enough to be applied in acute conditions that occur outside the catheterization laboratory. A similar system is described in US Pat. No. US4790825 by Bernard A. 1988. Access to the blood reservoir of the left heart without surgery is further described in Japanese patent JP7275350 Hirobumi in 1995: A cannula is introduced retrograde through the inguinal artery through the aortic valve into the left ventricle and the blood is drained and pumped into the systemic circulation via a pump. And this method has similar drawbacks: it requires a long time to install and threatens the circulation of the legs. Figulla HR and Scholz from Goettingen, Germany describe in the published book "Circulatorv Support Devices in Interventional Cardiology" (S.Karger Medical and Scientific Publishers, 1994, ISBN 3-8055-5977-1) and in "Cardiology 1994;84:3". it is not usable during arrest; The Hemopump TM turbine pump is located on top of a catheter system that is introduced from the inguinal artery retrograde through the aortic valve to the left ventricle from where it pumps blood at high speed back into the aorta. It is necessary to surgically open a large inguinal or even lumbar artery to introduce the pump into the blood vessel and then maneuver it under Roentgen control over the aortic valve to the left ventricle. The pump is designed to support a weak left ventricle, and it has been used sporadically for total heart failure replacement, in which case it reaches a pumping capacity of up to 2 liters/minute and an average pressure in the aorta of 50 mmHg. The disadvantage of this pump is the difficult introduction into the artery, and the low pumping capacity, as well as the need to open the artery most often surgically, although there is a version for percutaneous introduction; the cardiopulmonary support system consists of thicker cannulas that are introduced from the inguinal vein to the right atrium, from where the blood is drained to the console with the membrane oxygenator (which replaces the lungs) and then pumped back through the larger cannula into the arterial system through the inguinal artery. This system was even used to bridge the time until heart transplantation in children (Barclav L. LANCET 2003;362:1948-1949). Children with acute heart failure were helped by this system to survive for several days while a donor heart for transplantation was found.

The advantage of this system is a large pumping capacity of up to 6 Liters/minute; the disadvantage of the system is that the circulation bypasses the left heart, which is not decompressed by this system, i.e. the blood remains in the lungs and the left heart, also the large diameter of the cannula often injures the groin vessels and nerves, additional blood transfusion is often required, and to install the system it is necessary to have trained personnel and enough time, which in emergency conditions is short. Furthermore, due to the high price and complexity, the use of this system is limited to highly specialized centers in economically well-off areas. All described systems for percutaneous mechanical circulation foresee access via veins and/or arteries. In emergency cases, however, in acute arrest, it is difficult to puncture an artery and/or vein in the absence of a pulse. Circulation assistance for several months is practiced with so-called LVAD (left ventricular assist devices) systems that are surgically implanted in the heart, such as the Jarvik 2000, which consists of a drainage cannula surgically placed in the apex of the left ventricle and a return aortic cannula placed in the thoracic aorta and a pump that is built into the cannula system and is powered by accumulator-battery energy (Frazier OH colleagues. Circulation105(24):2855-2860, 2002) The heart pump filled with blood is much larger in dimensions than the inguinal artery and/or vein and can be punctured more easily even during arrest. Percutaneous transthoracic puncture of the left ventricle was performed for diagnostic purposes (diagnostic catheterization) in patients with implanted mechanical mitral and aortic artificial valves. The rate of serious complications was acceptable (Walters DL et al. Catheter Cardiovasc Interv 2003 Apr 58:539-44 : Transthoracic left ventricular puncture for the assessment of patients with aortic and mitral valve prostheses: the Massachusetts General Hospital experience, 1989-2000). A transapical approach to the aorta has also been used in surgery in patients with acute aortic dissection to place an aortic cannula during surgical extracorporeal circulation ( Terada Y. J et al. Thorac Cardiovasc Surg 2003 Mar 125:739-40.). Access to the interior of the heart using thoracoscopic methods is described in US patent US2002100485 for so-called minimally invasive surgical interventions. A rigid tube is placed in the cavities of the heart and the point of entry through the mvocard is secured against bleeding either with a purse string suture or a balloon. The access tube is used to introduce minimally invasive instruments into the interior of the heart. US patent 6,406,422 BI by Landsberg (2002) describes an assist device that uses a single cannula to pump and pump blood from a weakened ventricle (single cannula ventricular assist apparatus). This system is intended to support a weak ventricle (usually the left ventricle) by computer-determining the time and moment of blood suction from the ventricle during cardiac relaxation (diastole), when the ventricle is filling normally, and the pumping of blood into the same ventricle through the same cannula is computer-synchronized with the ventricular systole - contraction. This method practically adds strength to the chamber during contraction. The volume of additional blood that can be added to the weakened chamber during its own contraction is small and amounts to about 30 ml. This system is not intended for the treatment of cardiocirculatory arrest, but only as a support for a weakened heart.

From the above, the need for a system, method, device that will enable effective blood supply to vital organs (brain and heart) during cardiac arrest is obvious. Such a device should have the following additional characteristics: it can be installed - put into operation in a short time (1-3 minutes); that it can be applied in every place where the victim is found; that it is smaller in size so that it can be available to emergency doctors in the field outside medical rooms.

Presentation of the essence of the invention

The goal of the invention is to create a system for quick access to the left heart, from where the oxygen-enriched blood would be pumped to a mechanical pump and then pumped back into the body to supply all organs with blood in a state of total cardiac and circulatory arrest. Essential concept of the invention: One approach to the left ventricle by the shortest path; using the anatomy and physiology of the heart. The left ventricle in a state of stagnation is a closed passive muscular space that has an inlet (repulsive) valve ("check valve" - mitral inflow valve) and an outlet valve (aortic outflow valve). When the heart and circulation stop (arrest), the pressures in the entire closed cardiovascular system are equalized; the pressure in the left atrium is the same as in the left atrium, and the pressure in the left atrium is the same as in the aorta or in the right atrium.

The concept of the invention is to insert the communication tube (access cannula) into the left ventricle by the shortest route; blood is first drawn through that tube under negative pressure from the left ventricle - during which, due to the pressure gradient, the inlet valve (mitral valve) opens and the outlet valve (aortic valve) closes. This maneuver results in the aspiration (pumping out) of the blood that is in the left atrium and in the left ventricle. The extracted blood is then injected through the same communication tube (access cannula) under pressure back into the left ventricle which, due to the newly created pressure gradient, closes the inlet (mitral valve) and opens the outlet aortic valve. The amount of blood that is forced into the left ventricle under pressure is greater than the volume of the left ventricle. The excess blood injected in this way is ejected through the outlet valve in the aorta, i.e. the excess blood represents the stroke volume of each individual act of blood injection into the left ventricle.

The aforementioned goals are achieved by making a device that consists of a large bore access cannula (large bore access cannula) that is placed in the heart chamber, and a pump with a larger volume capacity. The cannula is designed so that it can be introduced into the heart chamber by the so-called percutaneous (through the skin non-surgical) technique over a wire.

(Seldinger's technique) and is additionally equipped with a device for sealing the channels by which it is introduced into the body. The cannula is made of medical plastic that is coated inside with heparin (anti-clotting) and its wall can be reinforced with wire reinforcement (braided) to ensure stability-unbreakability (kink resistant). 2 balloons are mounted on the outer wall of the end part of the cannula (hereinafter the distal part). One inner smaller one made of so-called non-compliant material (such as Polyurethane); one larger outer balloon made of compliant material. The smaller inner balloon has a strictly defined diameter in the inflated state, which should prevent the cannula from falling out of the chamber; The outer large balloon made of stretchable material covers the entire entrance path of the access cannula starting from the point of entry through the goat and over the small balloon all the way to the inside of the chamber. The function of the large balloon is to block the entrance channel through the chest and through the heart muscle and thus prevent bleeding from the chamber and air entering the chamber. The pump can be made predominantly, but not exclusively, in the form of a large syringe with a built-in electromotor driven mechanism. The access pipe is connected to the pump with plastic flexible hoses of the appropriate internal diameter and via a quick connection adapter (connector). An access cannula is placed through the sternum through the skin into the left heart chamber and connected to a large syringe via quick connectors and hoses, and oxygenated blood is sucked from the left ventricle and from the left atrium, and then the suctioned volume of blood is injected under higher pressure back into the left ventricle through the same access cannula.

The system uses the existence of 2 unidirectional valves (check valve = check valve) in the left heart: one inlet (inflow mitral valve) into the left ventricle and one outlet (outflow aortic valve) from the left ventricle. If the pressure in the left ventricle is reduced, the outlet valve closes and the inlet valve opens, which allows the aspiration of blood from the entire left heart (from the left ventricle and from the left atrium).

Aspiration volume = left ventricular volume + left atrial volume.

When a large volume of blood or fluid is rapidly injected into the left ventricle, the pressure in the left ventricle increases, which closes the inlet (mitral) valve. Since the volume of injected blood exceeds the capacity of the left ventricle, the excess blood is ejected through the exit aortic valve into the aorta. The part of blood that is injected into the aorta in this way is equal to the stroke volume of each individual act of injection.

Injection stroke volume = total injection volume minus left ventricular capacity. Assuming that the volume of blood in the left atrium is 80 ml, in the left ventricle 100 ml - the maximum volume of suction into the pump (aspiration) will be 180 ml;

When 180 ml of blood is suddenly injected back into the left ventricle, 100 ml will remain in the left ventricle and 80 ml will be injected into the aorta - the stroke volume of each injection is calculated to be 80 ml.

Brief description of the draft images

Figure 1A shows a motor-driven pump device with a large syringe

volume.

Figure 1B shows the pump device in the aspiration phase.

Figure 1C shows the pump device in the injection phase.

Figure 2A shows a longitudinal cross-section of an access cannula with balloons (non-inflated) and with a guidewire introducer dilator

Figure 2B shows the access cannula with inflated balloons.

Figure 2C shows an access cannula placed through an introducer sheath that can be split after introduction. (splittable sheath).

Figure 3 shows a longitudinal oblique section of the fully assembled device.

Figure 4A shows a longitudinal section of the device installed in the aspiration position.

Figure 4b shows a longitudinal section of the installed device in the injection phase.

Detailed description of the invention

Figures 1 (A,B,C) show one possible variant of the pumping device 100 according to the invention. A large volume syringe (n.p. > 200 ml) 128 with a cap 122 is mounted on the stand with a fastener 124 and clamps 126. The construction of the stand consists of a base 102, a vertical part of the stand 104, an inclined part of the stand 106 and a front part 107 on which the syringe fastener 124 is mounted. A sterile syringe with a cap can be manually mounted and dismantled on the stand with syringe clamps 126. At the front part, the syringe is connected to a sterile medical hose (tubing) via a connector 130. 132 of a suitable diameter (n.p. 3/8"-inch-about 9mm). Syringe pin 122 continues to syringe piston 120 which moves the pin back and forth. Syringe pin 120 is of sufficient length to allow its movement outside the syringe through the central channels of plunger holders 118 on the beveled portion of base 106. Plunger holders 118 allow smooth movement of the plunger through their central channels while maintaining direction of movement of the piston and prevent its dislocation Lever 112 is mounted by means of a pivot pin 110 on the rotating part-coupling head 109 of the engine 108. The pivot pin 110 enables the hinged circular movement of the lever. At the end towards the syringe, the lever is attached to the piston 120 with a fastener 114. The place of attachment of the lever to the piston determines the excursion - the forward and backward movement of the piston, this place of attachment can be changed. The piston lever fastener 114 can be manually assembled and disassembled. The engine 108 is installed on the rear part of the inclined part of the base 106, and its coupling head for rotation 109 is connected by the hinged pivot for rotation 110 with the lever 112. On the upper part of the inclined part 106, the regulator (134) of the motor speed is mounted. The motor and the speed regulator are powered by electricity from the 136 batteries that are located there on the base of the stand 102 and fastened with a tensioner 138 that can be manually assembled and disassembled.

When the lever 112 is pulled back by turning the motor coupling 109, the syringe piston 120 with the cap 122 is also pulled back into the suction (aspiration) position as in Figure 1 B.

When by turning the motor coupling 109, the lever 112 is pushed forward and the piston 120 with the plug 122 moves forward, i.e. the syringe 128 is emptied - ejection phase (injection) - picture 1C.

A medical plastic hose of suitable length and diameter (n.p. 3/8 inch-9mm) 132 is connected to the syringe via a coupling 130 or is structurally integrated into the front end of the syringe.

At the distal end of the plastic hose, there is a connector 131 for quick connection of the plastic hose with the access cannula via the 3-tap connector 208 - Figure 3.

The syringe stand as well as the syringe lever and piston can be made of light metal or stable plastic. Figures 2A and 2B show the access cannula system 200. A portion of the length of the access cannula tube 202 is made of a medical grade polymer reinforced with a thin wire to ensure kink resistance. The proximal part of the reinforced part of the cannula 204 has a thickened wall of the tube for the passage of the channel for inflation and deflation of the balloon. Part of the plastic hose is integrated on the proximal part of the access cannula; a large-diameter 3-way stopcock 208 is integrated into the proximal end of the hose 206. The 3-way stopcock has a large internal lumen so as not to reduce the flow capacity of the access cannula and connector hose 205. The access cannula has a distal wide opening 210 and at least one side opening 211 that allows for high flow during aspiration and injection. The inner smaller balloon 218 is installed on the distal part of the outer wall of the access cannula tube. This balloon is inflated and deflated with a syringe 224 through the opening 220 and the access channel 222. The smaller inner balloon 218 can be made of non-compliant medical polymers such as polyurethane. The size of the inflated balloon is such that it prevents the access cannula from falling out of the chamber during a strong injection of liquid (blood) into the chamber. Over this inner smaller balloon 218 is installed an outer larger balloon 212 attached distally to the outer part of the reinforced tube 202 of the access cannula and proximally to the thickened part of the wall of the access cannula 204. The large balloon is made of a stretchable (compliant) polymer. This balloon is inflated and deflated through the channel 216 with the syringe 215 through the opening 214. The large balloon covers the entire length of the intracorporeal path of the access cannula (from the skin through the intercostal space, through the heart muscle to the interior of the left ventricle) providing protection from bleeding from the heart and protection from the entry of air from the outside to the inside of the heart. proximal entrance 235 and distal exit 233 through which the J-shaped guide wire 240 passes 242. With deflated balloons and with the guide wire introduced to the heart chamber, the complete access cannula system can be placed - introduced into the heart without surgical assistance percutaneously (Seldinger's) technique. Figure 2C shows an access cannula 200 positioned through a separate splittable sheath 250 having a distal open end 252 and a proximal 2-part portion 254 and 255 for splitting and removal after cannula insertion is complete. This sheath can be used for the alternative introduction of the access cannula into the heart, which somewhat protects the access cannula structures and the tissue structures through which the system is introduced.

Figure 3 shows the complete system device for cardiocirculatory resuscitation - pump device 100 with mounted access cannula 200. According to one variant of the invention, the plastic hose connectors and connectors have a lumen larger than the lumen of the access cannula with the aim of reducing the resistance to the flow of blood and/or liquid during injection and aspiration.

Figure 4A shows the system with a cannula installed in the victim's heart during the aspiration phase (drawing blood from the left heart). The inlet valve to the left ventricle (mitral valve) is open, allowing the drainage of blood from the left ventricle, the left atrium, and even from the pulmonary veins, which flow freely into the left atrium. The outlet valve of the left ventricle (aortic valve) is closed during aspiration (lower pressure in the left ventricle). A large distensible balloon occludes the entire entry path of the access cannula, while a small non-distensible balloon inside the left ventricle prevents the cannula from falling out through the access path. Figure 4B shows the system installed in the victim's heart during the injection phase (injecting blood back into the heart). The inlet valve to the left ventricle (mitral valve) is closed due to increased pressure in the left ventricle, the outlet valve of the left ventricle (aortic valve) is open due to the pressure in the left ventricle being greater than the pressure in the aorta, and the excess blood that cannot fit into the non-beating-passive left ventricle is ejected into the aorta. In cases of delayed aspiration of blood from the left ventricle, an additional amount of fluid (e.g., cold saline) can be aspirated into the syringe via an infusion that can be installed on the side-arm of the three-arm connector 208 and injected as additional "volume".

liquids. With this addition, the amount of liquid injection can be increased in certain cases

prolonged blood aspiration. This system can also achieve very fast cooling (hypothermia) of the body, which is very desirable during the act of reviving. Furthermore, this is the fastest way to inject all necessary drugs into the circulation, including anti-clotting drugs (e.g. heparin).

A combined variant of motorized and manual starting (this variant is not on the drawings) of the piston is also possible.

In cases where an attempt to revive the circulation in the described manner, i.e. with access only to the left heart prolonged or insufficiently effective, it is possible to use a device with two syringes and two access cannulas, one for the left and one for the right chamber of the heart (this variant is not shown in the drawings.) Two syringes are installed in parallel on the stand; access cannulae are placed in the top of the right and in the top of the left ventricle, and the same amount of blood is pumped out and pumped in from the right ventricle and from the left ventricle with a single mechanism, which would mean that the volume of blood entering the lungs is equal to the volume of blood ejected from the left ventricle.

Application of the invention

The described device can be used as an alternative for reviving patients with cardiac and circulatory arrest in cases where normal resuscitation measures do not give results as a last attempt to prevent the victim from dying. There are a large number of cardiac arrest victims who are healthy enough that it would be a shame to leave them to die after a failed attempt at resuscitation with external massage (chest pressure) alone. If the professional rescuer exhausts all traditional available options to establish spontaneous circulation of the victim with cardiac arrest, the device described by this invention can be applied: Puncture of the top of the left ventricle (left ventricular apex) with a 17 gauge vascular needle through the fifth intercostal space of the left mid-clavicular line. Puncture does not require any apparatus control; the red color through the puncture needle of the aspirated blood is evidence that the blood originates from the left ventricle, i.e. that the left ventricle has been punctured. An anti-clotting agent (heparin) is injected through the puncture needle.

Placement of a J-shaped guide wire through the needle into the left heart; after removal of the needle, the access cannula device 200 (Fig. 2A) with the introducer-introducer 230 is introduced through the goat-per Seldinger technique through the wire into the left ventricle; the dilator 230 is removed, the 3-way stopcock 208 is made; first, a small inner balloon 218 is inflated by injecting fluid through channel 222. Then, an outer larger expandable balloon 214 is inflated through channel 216, which ensures stabilization of the cannula within the access path (Fig. 4A). The pump device 100 with the high-volume syringe 128 is connected to the access cannula 200 using the 3-tap connector 208 (Fig.3), the 3-tap connector is opened and a bottle of infusion fluid (cold saline with heparin-anti-clotting) is installed through the side-connector. Any air present in the syringe can be ejected through this opening on the side. About 100 ml of physiological solution from the infusion is aspirated into the large syringe, and the 3-valve connector is opened in the direction to release the direction of movement from the syringe to the cannula and back, and begin with the aspiration of blood from the left ventricle into the large syringe (Figure 4A) and continue with the injection of blood and fluid from the syringe into the left ventricle (Figure 4B). If there is not enough blood in the left heart during aspiration, an additional amount of fluid can be aspirated from the "infusor" attached to the side (sidearm) of the system. After eventual successful establishment of spontaneous cardiocirculatory function, the large syringe can be detached and the access cannula can be left installed with the infusion for adding fluids or drugs or electrical aids (pacemaker probe). After the successful completion of resuscitation, the access point to the heart can be managed surgically or with a catheter-based suturing technique or implantation of a myocardial wall stopper (oceludera) without surgical intervention. Alternatively, an access cannula can be installed using a splittable sheath 250 (Fig.2C).

It is also possible to apply the invention with the aim of maintaining minimal circulation and blood supply to the organs of a victim who has no chance of survival. This comes into consideration in the conditions of modern medicine where attempts are made to save the victim's organs for donation to persons who have signed consent for organ donation in case of imminent death. It is known that, especially in war conditions, there are many victims whose organs can save the lives of other people, but the possibilities of preserving the organs of such victims to the point where explantation can be done are very limited, which results in the loss of a valuable reservoir of organs for donation. This invention greatly simplifies the preservation of the organs of such victims.

The application of this invention is primarily oriented towards human medicine, but the indications for application are also valid for veterinary medicine, i.e. the application of the invention is the same for all mammals.

Reference numerals in drawings

100 pumping device

102 pedestal base

104 vertical part of the stand 106 inclined part of the stand 107 front part of the stand

108 engine

109 clutch engine head - for rotation 110 pivot for turning the lever 112 lever

114 lever attachment for the syringe piston 118 holders through which the piston passes 120 syringe piston that continues on the syringe pin 122 syringe pin

124 Syringe sharpener for stand 126 Syringe tensioners for stand 128 Syringe

130 hose connector with syringe 131 connector for connecting the syringe hose with the access cannula 132 plastic hose on the syringe 134 engine speed regulator 136 battery accumulator

138 battery tensioner for stand 200 access cannula system 202 access cannula reinforced part

202 reinforced part of the access cannula

204 reinforced part of the cannula with a thickened wall 206 part of the hose integrated into the access cannula 208 connector with 3 openings of large diameters 210 distal end opening of the access cannula 211 side holes of the access cannula

212 large (external) stretch balloon.

214 inlet for inflating and deflating a large balloon 215 syringe for inflating and deflating a large balloon 216 channel for inflating and deflating a large balloon 218 smaller non-stretchable balloon

220 inlet for inflating and deflating a small balloon 222 channel for inflating and deflating a small balloon 224 syringe for inflating and deflating a small balloon 230 large expander (dilators) introducer 232 pointed end part of the dilator

233 opening for the passage of the wire at the extreme end of the dilator 234 proximaIni (initial) part of the dilator 235 opening for the passage of the wire at the initial part of the dilator 240 guide wire

242 end "J-shaped" part of the guide wire 250 introducer (sheath) that can be split 252 end part of introducer sheath that can be split 254 initial part - introducer arm of the sheath that can be split 255 second leg of the initial part of introducer sheath that can be split

500 victim to be resuscitated.

AV aortic valve of the heart

LA left atrium of the heart

LV left ventricle of the heart

MV mitral valve of the heart

Claims (5)

1. Device for reviving cardio-circulatory arrest indicated by that which consists of: a motor-driven pump device (100), b large-lumen cannula for access to the heart chamber (200), c elements for connecting the pump device (100) to the cannula (200); 2. Device according to the request 1 indicated by that that the pumping device (100) is equipped with a motor drive mechanism that enables repeated rapid aspiration and rapid injection of a large amount of liquid; indicated by that there is an access cannula (200) equipped with elements (212) for blocking the path that passes through the rib cage and through the heart muscle to the interior of the heart chamber, said cannula (200) equipped with elements for its own stabilization (218) inside the heart chamber. 3. Device according to request 2 indicated by that that the pumping device (100) consists of a high-volume syringe (128) whose piston (120) is functionally connected to a lever system (112), which high-volume syringe contains at its distal end a length of hose (132) for connection to the access cannula (200). Device according to request 3 indicated by that there is an access cannula (200) equipped with elements (230,240,250) for non-surgical-percutaneous -directly through the chest - rapid introduction - placement in the chamber of a stagnant heart, which said access cannula (200) contains in its proximal end an integrated hose (206) which hose ends proximally with a three-pronged coupling (208) for quick connection to a pumping device (100) which the mentioned three-pronged connector serves to remove any air present in the system as well as to supply additional liquid through the infuser. 5. Device for reviving cardio-circulatory arrest marked by it which consists of a pumping device (100) which pumping device consists of a high-volume syringe (128) with a built-in motor-driven mechanism (108), which motor drive is powered by a battery pack (136), which motor-driven mechanism includes a lever system (112), which said lever enables repeated movements of the syringe piston (120), which movements of the syringe piston enable repeated suction into the syringe and pumping out of larger quantities of liquid, which said syringe (128) can be manually assembled and disassembled in the immobilization stand (102,104,106,107), which said syringe (128) contains a length of hose (132) at its distal end, which hose can be connected via a coupling (131) to an access cannula (200) via three-pronged connector (208), which said cannula is equipped with elements (230,240,250) for percutaneous - non-surgical introduction into the heart chamber, which cannula is equipped with elements (212, 218) for blocking the path that passes through the chest and heart muscle to the inside of the chamber of the stopped heart. (1\/l