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Direct manual cardiac compression device    
United States Patent5582580   
Link to this pagehttp://www.wikipatents.com/5582580.html
Inventor(s)Buckman, Jr.; Robert F. (Radnor, PA); Badellino; Michael M. (Hatboro, PA)
AbstractA heart massager for substernal heart massage is disclosed. The heart massager has a heart-contacting member having a surface which is at least partially concave for contacting the heart, cushioning on the surface of the contact member, and a handle attached to the heart-contacting member for manually manipulating the massager. The partially concave surface allows the heart-contacting member to conform to the shape of the heart. The handle is substantially upright with respect to the surface of the heart-contacting member. The handle is significantly offset from a central portion of the heart-contacting member in the region where it attaches to the member. The cushioning covers substantially the entire surface of the heart-contacting member so as to form a solid surface.
   














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Drawing from US Patent 5582580
Direct manual cardiac compression device - US Patent 5582580 Drawing
Direct manual cardiac compression device
Inventor     Buckman, Jr.; Robert F. (Radnor, PA); Badellino; Michael M. (Hatboro, PA)
Owner/Assignee     Temple University - Of The Commonwealth System of Higher Education (Philadelphia, PA)
Patent assignment
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Publication Date     December 10, 1996
Application Number     08/250,307
PAIR File History     Application Data   Transaction History
Image File Wrapper   Patent Term   Fees
Litigation
Filing Date     May 27, 1994
US Classification     601/41 601/107 601/134 607/3 607/5
Int'l Classification     A61H 001/00
Examiner     Hafer; Robert A.
Assistant Examiner     Kenealy; David J.
Attorney/Law Firm     Seidel, Gonda, Lavorgna & Monaco, P.C.
Address
Parent Case     This is a continuation of application Ser. No. 07/922,714, filed on Jul. 30, 1992, abandoned.
Priority Data    
USPTO Field of Search     606/237 606/238 601/41 601/15 601/107 601/84 601/133 601/134 601/135 601/85 601/97 128/639 128/419 P 128/419 PG 128/419 G 128/419 D 128/634 128/642 128/632 128/633 128/784 600/16 15/244.3 15/210.10 15/229.2
Patent Tags     direct manual cardiac compression
   
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Market Size
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Market Share
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 Technical Review Submit all comments and votes
 Claims Submit all comments and votes
 


What we claim is:

1. An apparatus for intra-thoracic direct substernal heart massage comprising:

(a) a heart-contacting member having a surface which is at least partially concave and cushioning means on substantially said entire surface, the member being adapted for insertion into a thoracic cavity for directly contacting the heart, the partially concave surface allowing the member to conform to the shape of the heart's surface, the cushioning means being of a deformable material and having a portion which generally conforms to the shape of the heart's surface, and

(b) a handle attached to the heart-contacting member for manually manipulating the apparatus, the heart-contacting member having a plane tangential to the member's surface in a region where the handle is attached to the heart-contacting member, the handle being substantially upright with respect to the plane, the handle thereby adapted to impart downward forces to the heart-contacting member, wherein the handle comprises first and second telescoping tubes.

2. An apparatus for substernal heart massage according to claim 1, wherein said handle further comprises means for limiting axial movement of said first and second tubes relative to each other.

3. An apparatus for substernal heart massage according to claim 1, wherein said handle further comprises a shock absorber disposed in one of said tubes.

4. An apparatus for substernal heart massage according to claim 1, wherein said handle further comprises means for releasably engaging said first and second tubes to allow unison movement thereof.

5. An apparatus for substernal heart massage according to claim 4, wherein said means for releasably engaging said first and second tubes further comprises resilient biasing means for releasing the engagement of said first and second tubes when the force applied to said tubes exceeds a predetermined limit.

6. An apparatus for substernal heart massage according to claim 5, wherein said handle further comprises means for indicating that said predetermined limit is exceeded.

7. An apparatus for intra-thoracic direct substernal heart massage comprising:

(a) a heart-contacting member having a surface which is at least partially concave and cushioning means on substantially said entire surface, the member being adapted for insertion into a thoracic cavity for directly contacting the heart, the partially concave surface allowing the member to conform to the shape of the heart's surface, the cushioning means being of a deformable material and having a portion which generally conforms to the shape of the heart's surface, and

(b) a handle attached to the heart-contacting member for manually manipulating the apparatus, the heart-contacting member having a plane tangential to the member's surface in a region where the handle is attached to the heart-contacting member, the handle being substantially upright with respect to the plane, the handle thereby adapted to impart downward forces to the heart-contacting member, wherein said handle is a hollow cylinder.

8. An apparatus for substernal heart massage according to claim 7, wherein said heart-contacting member comprises a generally curved plate.

9. An apparatus for substernal heart massage according to claim 7, further comprising a rough-surfaced pad covering the cushioning means for inhibiting the heart-contacting member from slipping on the heart's surface when the cushioning means contacts the heart's surface.

10. An apparatus for substernal heart massage according to claim 7, wherein one dimension of said heart-contacting member is defined by two opposed edges, the distance between the two edges not exceeding about three inches.

11. An apparatus for substernal heart massage according to claim 7, further comprising at least one electrode disposed on the heart-contacting member for contacting the heart.

12. An apparatus for substernal heart massage according to claim 7, further comprising at least one sensor disposed on the heart-contacting member for contacting the heart.

13. An apparatus for substernal heart massage according to claim 7, wherein the concavity of the heart contacting member's surface is of a degree that allows the entire concave surface, including its edges, to contact the heart.

14. An apparatus for intra-thoracic direct substernal heart massage, comprising:

(a) a heart-contacting member having a solid surface which is at least partially concave and cushioning means on said surface, the member being adapted for insertion into a thoracic cavity for directly contacting the heart, the partially concave surface allowing the member to conform to the shape of the heart's surface, the cushioning means being of a deformable material and having a portion which generally conforms to the shape of the heart's surface, and

(b) a handle attached to the heart-contacting member for manually manipulating the apparatus, the heart-contacting member having a plane tangential to the member's surface in a region where the handle is attached to the heart-contacting member, the handle being substantially upright with respect to the plane, the handle thereby adapted to impart downward forces to the heart-contacting member wherein the handle further comprises first and second telescoping tubes.

15. An apparatus for substernal heart massage according to claim 14, wherein the handle comprises an elongated rod attached at one end thereof to the heart-contacting member.

16. An apparatus for substernal heart massage according to claim 15, further comprising grip means at an end of the rod opposite the end attached to the heart-contacting member.

17. An apparatus for substernal heart massage according to claim 14, wherein said handle further comprises means for limiting axial movement of said first and second tubes relative to each other.

18. An apparatus for substernal heart massage according to claim 14, wherein said handle further comprises a shock absorber disposed in one of said tubes.

19. An apparatus for substernal heart massage according to claim 14, wherein said handle further comprises means for releasably engaging said first and second tubes to allow unison movement thereof.

20. An apparatus for substernal heart massage according to claim 19, wherein said means for releasably engaging said first and second tubes further comprises resilient biasing means for releasing the engagement of said first and second tubes when the force applied to said tubes exceeds a predetermined limit.

21. An apparatus for substernal heart massage according to claim 20, wherein said handle further comprises means for indicating that said predetermined limit is exceeded.

22. An apparatus for intra-thoracic direct substernal heart massage comprising:

(a) a heart-contacting member having a solid surface which is at least partially concave and cushioning means on said surface, the member being adapted for insertion into a thoracic cavity for directly contacting the heart, the partially concave surface allowing the member to conform to the shape of the heart's surface, the cushioning means being of a deformable material and having a portion which generally conforms to the shape of the heart's surface, and

(b) a handle attached to the heart-contacting member for manually manipulating the apparatus, the heart-contacting member having a plane tangential to the member's surface in a region where the handle is attached to the heart-contacting member, the handle being substantially upright with respect to the plane, the handle thereby adapted to impart downward forces to the heart-contacting member wherein said handle is a hollow cylinder.

23. An apparatus for substernal hear massage according to claim 14, wherein said heart-contacting member comprises a generally curved plate.

24. An apparatus for substernal heart massage according to claim 14, further comprising a rough-surfaced pad covering the cushioning means for inhibiting the heart-contacting member from slipping on the heart's surface when the cushioning means contacts the heart's surface.

25. An apparatus for substernal heart massage according to claim 14, wherein one dimension of said heart-contacting member is defined by two opposed edges, the distance between the two edges not exceeding about three inches.

26. An apparatus for substernal heart massage according to claim 14, further comprising at least one electrode disposed on the heart-contacting member for contacting the heart.

27. An apparatus for substernal heart massage according to claim 14, further comprising at least one sensor disposed on the heart-contacting member for contacting the heart.

28. An apparatus for substernal heart massage according to claim 14, wherein the concavity of the heart contacting member's surface is of a degree that allows the entire concave surface, including its edges, to contact the heart.

29. An apparatus for intra-thoracic direct substernal heart massage, comprising:

(a) a heart-contacting member having a surface which is at least partially concave and cushioning means on said surface, the member being adapted for insertion into a thoracic cavity for directly contacting the heart, the partially concave surface allowing the member to conform to the shape of the heart's surface, the cushioning means being of a deformable material and having a portion which generally conforms to the shape of the heart's surface, and

(b) a handle attached to the heart-contacting member for manually manipulating the apparatus, the heart-contacting member having a plane tangential to the member's surface in a region where the handle is attached to the heart-contacting member, the handle being substantially upright with respect to the plane, the handle thereby adapted to impart downward forces to the heart-contacting member, the region where the handle attaches to the heart-contacting member being significantly offset from a central portion of the heart-contacting member wherein the handle comprises first and second telescoping tubes.

30. An apparatus for substernal heart massage according to claim 29, wherein the handle comprises an elongated rod attached at one end thereof to the heart-contacting member.

31. An apparatus for substernal heart massage according to claim 30, further comprising grip means at an end of the rod opposite the end attached to the heart-contacting member.

32. An apparatus for substernal heart massage according to claim 29, wherein said handle further comprises means for limiting axial movement of said first and second tubes relative to each other.

33. An apparatus for substernal heart massage according to claim 29, wherein said handle further comprises a shock absorber disposed in one of said tubes.

34. An apparatus for substernal heart massage according to claim 29, wherein said handle further comprises means for releasably engaging said first and second tubes to allow unison movement thereof.

35. An apparatus for substernal heart massage according to claim 34, wherein said means for releasably engaging said first and second tubes further comprises resilient biasing means for releasing the engagement of said first and second tubes when the force applied to said tubes exceeds a predetermined limit.

36. An apparatus for substernal heart massage according to claim 35, wherein said handle further comprises means for indicating that said predetermined limit is exceeded.

37. An apparatus for intra-thoracic direct substernal heart massage comprising:

a) a heart-contacting member having a surface which is at least partially concave and cushioning means on said surface, the member being adapted for insertion into a thoracic cavity for directly contacting the heart, the partially concave surface allowing the member to conform to the shape of the heart's surface, the cushioning means being of a deformable material and having a portion which generally conforms to the shape of the heart's surface, and

(b) a handle attached to the heart-contacting member for manually manipulating the apparatus, the heart-contacting member having a plane tangential to the member's surface in a region where the handle is attached to the heart-contacting member, the handle being substantially upright with respect to the plane, the handle thereby adapted to impart downward forces to the heart-contacting member, the region where the handle attaches to the heart-contacting member being significantly offset from a central portion of the heart-contacting member, wherein said handle is a hollow cylinder.

38. An apparatus for substernal heart massage according to claim 37, wherein said heart-contacting member comprises a generally curved plate.

39. An apparatus for substernal heart massage according to claim 37, further comprising a rough-surfaced pad covering the cushioning means for inhibiting the heart-contacting member from slipping on the heart's surface when the cushioning means contacts the heart's surface.

40. An apparatus for substernal heart massage according to claim 37, wherein one dimension of said heart-contacting member is defined by two opposed edges, the distance between the two edges not exceeding about three inches.

41. An apparatus for substernal heart massage according to claim 37, further comprising at least one electrode disposed on the heart-contacting member for contacting the heart.

42. An apparatus for substernal heart massage according to claim 37, further comprising at least one sensor disposed on the heart-contacting member for contacting the heart.

43. An apparatus for substernal heart massage according to claim 37, wherein the concavity of the heart contacting member's surface is of a degree that allows the entire concave surface, including its edges, to contact the heart.
 Description Submit all comments and votes
 


FIELD OF THE INVENTION

The present invention relates to heart massagers and a method of use thereof and, more particularly, to various heart massagers each of which is introduced through a relatively small surgical incision made in the chest wall so that the massagers may be positioned to directly massage the heart during cardiac arrest.

BACKGROUND OF THE INVENTION

In the medical profession it is recognized that it is necessary, in the event of a cardiac arrest, to assist the heart in its pumping function until effective spontaneous cardiac contraction can restore normal blood circulation. During cardiac arrest, the pumping action of the heart ceases and blood flow stops. If blood flow or circulation is not sustained or reinstituted, either by restoration of spontaneous cardiac activity or by some other provision of artificial circulatory support, irreversible vital organ damage and clinical death will ensue.

Currently, several method are employed to sustain circulation during cardiac arrest. These methods include closed chest external and open chest internal cardio-pulmonary resuscitation (CPR) techniques. All of the external CPR techniques, as well as the devices which are used therewith, rely on depressing the sternum producing a generalized increase in intrathoracic pressure. This produces a low level of blood flow to the organs of the body. However, none of these external. CPR devices nor their related techniques, develop enough direct mechanical compression of the ventricular chambers of the heart to produce physiologically significant blood flow. Open-chest, bi-manual cardiac compression, in which the heart is directly compressed by the hands of the operator, produces far more blood flow than any method of closed chest CPR. It is capable of supplying vital organs with more blood and produces a higher probability of survival than any method of closed chest CPR. During open-chest, internal CPR, an anterior-lateral chest incision is commonly used with the surgical incision being large enough to accommodate introduction into the chest cavity of both hands of an operator, so that a manual compression of the heart muscle may take place.

Both the external (closed chest) CPR and open chest techniques can be performed manually or with the aid of mechanical devices. With either technique, the goal is to maintain artificial circulation, including circulation through the heart itself, until spontaneous cardiac activity can be restored. This restoration almost always involves electrical defibrillation of the heart in which a direct current shock is administered to the heart muscle to restore its spontaneous contraction.

A method of performing internal CPR is described in U.S. Pat. No. 3,496,932 of Prisk et al. issued, Feb. 24, 1970. This described method uses a small surgical incision, about one (1) inch, to accommodate the placement of a direct mechanical compression device on the heart muscle. The compression device comprises a generally cone-shaped plastic film serving as an inflatable and deflatable bladder which is connected to an air supplying stem which, in turn, is attached to an external pneumatic apparatus.

In the method of the '932 patent, a surgical incision is made in the upper abdomen below the lower tip (xiphoid) of the sternum for the purpose of introducing the device which is placed behind the sternum onto the heart. Before such an introduction, a trocar carrying a large tube and having a pointed tip is inserted into the incision, in an upward manner, into the space between the sternum and the anterior aspect of the pericardium, or alternatively into the pericardial sac itself. Entrance of this device carrying a sharp tip between the posterior aspect of the sternum and anterior aspect of the heart involves risk of accidently wounding the heart. After insertion, the tip of the trocar is moved until the desired location for the later placement of the inflatable/deflatable bladder on the heart is reached. Then, the trocar is withdrawn but the large tube carried by the trocar remains, allowing for the bladder to be inserted through the tube and onto the heart ready for periodic pneumatic inflation and deflation cycles of the bladder. These cycles are accomplished with the assistance of a mechanical pump apparatus to produce corresponding compression/relaxation cycles of the heart muscle to produce an artificial circulation during cardiac arrest.

Although the '932 patent may advantageously accomplish mechanical compression/relaxation of the heart by means of a small surgical incision so as to avoid an open-chest procedure, it is desired that such compression/relaxation be accomplished by a self-contained heart massager device having no reliance on any external mechanical device. Moreover, it is desired that a heart massager be positioned on the heart without the need for any sharp probing tip that might damage contacting elements of the body because of inadvertent contact therewith. Further, it is desired that the heart massager not only be devoid of a pointed tip but also have relatively small dimensions for insertion into the chest and a contoured surface for mating with the heart. Still further, it is desired that a heart massager be provided having collapsible features so as to minimize the size of the surgical incision needed for the introduction of the massager into the chest.

It is further desired that a method for inserting the heart massager be provided so that a surgical incision is not made through the abdomen.

It is still further desired, that means be provided to allow the heart massager to be guided to not only its most desirable/optimum position on the heart, but also be monitored and maintained at such a position during the direct mechanical compression of the heart muscle. Moreover, it is desired that the heart massager be provided with means to allow the massager to be re-positioned during use so that an optimum hemodynamic compression of the heart muscle and maximal blood flow to vital organs may be obtained during the massage and until spontaneous cardiac action can be restored.

Further, it is desired that the heart massager have provisions to accommodate direct cardiac defibrillation, detection of any abnormal electrocardiograph rhythm that might occur during the heart massage, and means for stabilizing any irregular heartbeats that might occur during the cardiac arrest condition.

Accordingly, it is an object of the present invention to provide a massager having no reliance on any external mechanical device apart from the massager per se to accomplish a direct massage of the hea