Abstract: A class of introducers is comprised of a plurality of straight sections and at least two curved sections with a pre-determined sense of curvature preceded, separated and followed by the straight sections, which introducer is adapted by its shape to access the septal wall or apex of a heart. One of the plurality of straight sections is a distal-most straight section. The straight and curved sections define a predetermined three dimensional shape by means of the distal straight section lying out of plane with respect to the remaining curved and straight sections.

Abstract: A vascular access catheter that has a substantially distal end portion that has a distal tip. The distal end portion has a sloped face in the distal portion of the catheter, an outflow lumen aperture, and a second inflow lumen aperture. The outflow lumen aperture is substantially completely open in the sloped face and exits the distal portion adjacent the distal tip. The catheter has a guidewire lumen that is located at least in the region of the distal portion of the catheter and is capable of receiving a guidewire. The guidewire lumen has a proximal aperture and a distal aperture that extends distally of the outflow lumen aperture. The guidewire distal aperture exits at the distal most edge of the distal end portion. The guidewire lumen may extend a partial length of the catheter or substantially the entire length of the catheter. The catheter distal portion may be substantially straight or curved.

Abstract: An intraventricular apparatus includes an elongated body having a substantially tubular sidewall that extends substantially axially between spaced apart first and second ends, an opening located proximal the first end. A valve is located adjacent the first end to provide for substantially unidirectional flow of blood therethrough. At least one aperture extends through the tubular sidewall at an axial location between the valve and the second end to provide for substantially free flow of blood between an interior and an exterior of the sidewall.

Abstract: A catheter for use in an emboli containment system includes a flexible elongate member having self-expanding sealing means mounted on its distal extremity. This self-expanding sealing means can take any suitable form, such as a braided structure formed of a suitable shape memory material such as a nickel titanium alloy. In order to prevent abrasion of a vessel, it is desirable to cover the braided structure with a covering of a suitable material such as a polymer which extends over the braided structure and which moves with the braided structure as it expands and contracts.

Abstract: The present invention provides a polymeric treatment for curved regions in shaft assemblies that increases curve retention without affecting the flexibility within these regions. More specifically, the present invention modifies the underlying crystalline morphology of a polymer in order to decrease crystal fracturing. In particular, the present invention treats polymeric materials suitable for catheter construction with a nucleating agent.

Abstract: A preshaped tubular catheter for percutaneous transradial approach to catheterization, comprises a distal bridge shaped portion having a distal arch defining a primary curve, a top defining a secondary curve, and a proximal arch defining a tertiary curve. The proximal arch is connected to a straight shaft. The shaft is stiff and the bridge shaped portion has a flexibility extending at least up to and including the primary curve and a stiffness extending at least up to and including the tertiary curve.

Abstract: An improved aortic cannula is provided for use in heart by-pass surgery. The cannula includes an elongated tube with a terminal end. The terminal end has a ramped surface leading to the discharge opening. The ramped surface terminates in a spoon-shaped lip. The spoon-shaped lip directs blood out of the cannula opening toward the ascending aorta or aortic arch in a U-shaped dispersion so as to preclude impact on the aortic wall. A bead adjacent the opening facilitates dispersion of the exiting blood. The opening has an upper edge with an inverted V-shaped contour which also facilitates dispersion of the blood.

Abstract: A guiding catheter for use in a body lumen having a stiff inner liner that has an uninterrupted length and is fabricated from a material such as polyimide (PI) and polyetheretherketone (PEEK) is disclosed. The inner liner is created by coating or extruding PI or PEEK on a neckable wire mandrel. A polymeric jacket is provided over the inner liner through a coating and bonding processes. A metallic braid, mesh, or lattice reinforcing member is embedded in the polymeric jacket.

Abstract: A preshaped tubular catheter for percutaneous transradial approach to catheterization, comprises a distal bridge shaped portion having a distal arch defining a primary curve, a top defining a secondary curve, and a proximal arch defining a tertiary curve. The proximal arch is connected to a straight shaft. The shaft is stiff and the bridge shaped portion has a flexibility extending at least up to and including the primary curve and a stiffness extending at least up to and including the tertiary curve.

Abstract: Methods are provided for conducting diagnostic or therapeutic medical or surgical procedures in a patient wherein, during the procedure, autonomous ventricular electrical conductivity and escape beats are reversibly and transiently suppressed to facilitate the procedure. Also provided are compositions which are capable of inducing ventricular asystole in a patient. The compositions may include an atrioventricular (AV) node blocker. In one embodiment, compositions including an AV node blocker and a &bgr;-blocker are provided, wherein the &bgr;-blocker is present in an amount sufficient to substantially reduce the amount of AV node blocker required to induce ventricular asystole in the patient. The compositions and methods may be used for inducing temporary ventricular asystole in a beating heart, and to facilitate the performance of a variety of techniques, including minimally invasive microsurgical techniques.

Abstract: An improved guide catheter provides a distal tip with one or more members that assist a surgeon with locating and inserting the guide catheter through the ostium in the wall of the right atrium that leads to the coronary sinus of the heart. The guide catheter is used to implant a cardiac lead so that its electrodes are positioned in the vasculature associated with the left side of the heart.

Abstract: An improved apparatus and method to catheterize passages is disclosed. The present invention provides a catheter having a soft flexible pre-formed distal tip, that when used in combination with commercially available guidewires of variable stiffness, results in the ability to control the direction and angle of wire advancement allowing cannulation of body passages, including those that arise at acute angles. The catheter can have a longitudinal axis, a proximal section and a distal section having a soft flexible pre-formed tip having a curvature of ninety degrees or greater and shape retention. The catheter can have an inner wall that defines a lumen that runs along said longitudinal axis forming a single continuous tube, a reinforcement braid disposed over the inner wall, and an outside covering disposed over the reinforcement braid. A spacer can be added between said wall liner and said reinforcement braid in the proximal end.

Abstract: Systems and methods for providing a medical device for use in right coronary arteriography or right coronary angioplasty and stent placement, wherein the medial device and use thereof reduces the amount of torque required to perform the cardiovascular procedure. A catheter is provided that is U-shaped and includes an angle near the distal end. The catheter is used to perform a selective right coronary arteriography procedure at or near the orifice of a blood vessel with a limited amount of torque and catheter manipulation. The safety and efficacy of the right coronary arteriography procedure using the limited-torque technique and catheter results in a decreased incidence of intimal injury due to a reduction in the amount of torque required to finalize proper placement of the catheter.

Abstract: A coronary sinus guiding introducer utilized to introduce medical devices, such as electrode leads, into the coronary sinus of a human heart. This guiding introducer contains a precurved distal portion, which curves through an arc of about 50 to 150 degrees. Preferably, the distal portion contains a pair of generally coplanar curves, wherein the arc of the first curve is from about 20 to about 60 degrees and the arc of the second curve is from about 30 to about 90 degrees and wherein the second curve is generally coplanar with the first curve. In an alternative embodiment, the second curve curves out of a plane formed by the first curve from about 15 to about 90 degrees. In addition, preferably the guiding introducer is splittable. Also disclosed is a process for introducing medical devices through the lumen of the precurved, coronary sinus guiding introducer.

Abstract: The invention relates to an apparatus and method for locating and positioning a medical device in a patient. The catheter based drug delivery device uses ultrasound imaging technology to facilitate tracking of the catheter as it is maneuvered through the body of a patient. The device includes a secondary body portion and a main body portion that are in signal communication with each other. Ultrasound signals generated from and received by the device are transmitted to an intravascular ultrasound (IVUS) system. An image of the structures surrounding and including the device is displayed on the IVUS system. A drug delivery needle, housed within the main body portion, can be precisely positioned at the target site using the ultrasound signals. This allows accurate delivery of drug to the target site and, thus, enhanced treatment capabilities.

Abstract: An improved guiding member for use within a body lumen having a unique combination of superelastic characteristics. The superelastic alloy material has a composition consisting of about 30% to about 52% (atomic) titanium, and about 38% to 52% nickel and may have one or more elements selected from the group consisting of iron, cobalt, platinum, palladium, vanadium, copper, zirconium, hafnium and niobium. The alloy material is subjected to thermomechanical processing which includes a final cold working of about 10 to about 75% and then a: heat treatment at a temperature between about 450° and about 600° C. and preferably about 475° to about 550° C. Before the heat treatment the cold worked alloy material is preferably subjected to mechanical straightening. The alloy material is preferably subjected to stresses equal to about 5 to about 50% of the room temperature ultimate yield stress of the material during the thermal treatment.

Abstract: Methods of accessing a destination vessel involve use of a catheter having an outer guide and an inner guide. The outer guide includes an outer guide lumen, a distal end, a proximal end, and a predetermined deflection location proximate the distal end. The inner guide includes an inner guide lumen, a pre-formed distal end, and a proximal end. An access method can involve axially displacing the inner guide beyond the distal end of the outer guide, axially rotating the inner guide relative to the outer guide, and changing a bend angle at the predetermined deflection location of the outer guide to direct the pre-formed distal end of the inner guide for finding and cannulating the destination vessel. A payload can be delivered into the destination vessel via the inner guide, or via the outer guide upon removal of the inner guide.

Abstract: A mapping catheter comprises a catheter body and a mapping assembly. The catheter body has an outer wall, proximal and distal ends, and at least one lumen extending therethrough. The mapping assembly comprises a generally straight proximal region attached to the catheter body, a generally circular main region distal the proximal region having an outer circumference, and a generally straight distal region distal the main region. The mapping assembly also comprises a support member having shape-memory, a non-conductive covering over the support member, and a plurality of electrodes on the non-conductive covering along the generally circular main region.

Abstract: An apparatus is guided by a guidewire within a luminal structure of a patient for receiving a radiation dose delivery wire with a radiation source attached to its distal end, for treating a disease process. The apparatus includes a balloon catheter with a blind lumen sealed at its distal end and a guidewire lumen extending therethrough to accept a guidewire. The blind lumen is adapted to accept the radiation delivery wire into its proximal end. In a method of treating the disease process with the apparatus, the guidewire is inserted into the guidewire lumen of the balloon catheter, the balloon catheter is inserted into the patient's luminal structure at least as far as a predetermined section of the luminal structure, the radiation dose delivery wire is inserted into the blind lumen in the balloon catheter and moved a predetermined distance therein for a predetermined period of time, and, after the period has elapsed, the radiation dose delivery wire is removed from the blind lumen.

Abstract: A catheter for injecting medicants into the endocardium, myocardium or other portions of the cardiovascular system is presented where the catheter has apertures therein for ejection and retraction of a needle. The catheter is designed for the apertures in the catheter to press against the tissue to be injected in the heart while the heart is beating. A needle for inserting a prescribed dose of a medicant is ejected through the aperture and a plunger, pump, or diaphragm is moved to deliver a dose of the medicant to tissue adjacent the aperture. By use of the catheter gene therapy, wherein a small does of a gene are injected into the endocardium of the right or left ventricle, can be used to grow new blood vessels in the injected area of a damaged heart. The apertures in the catheter can be spaced at a prescribed distance for the dosage of medicant to form a precise pattern of injections in the area to be treated.

Abstract: Disclosed is a radiation-crosslinkable thermoplastic polymer composition, a process for the preparation thereof, an angioplasty balloon made using such a composition, and a method of using the angioplasty balloon. The composition contains a reactive monomer cross-linker, that facilitates cross-linking of the reaction product upon contact of the cross-linker-containing composition with a particle beam from a radiation source.

Abstract: An improved guiding member for use within a body lumen having a unique combination of superelastic characteristics. The superelastic alloy material has a composition consisting of about 30% to about 52% (atomic) titanium, and about 38% to 52% nickel and may have one or more elements selected from the group consisting of iron, cobalt, platinum, palladium, vanadium, copper, zirconium, hafnium and niobium. The alloy material is subjected to thermomechanical processing which includes a final cold working of about 10 to about 75% and then a heat treatment at a temperature between about 450° and about 600° C. and preferably about 475° to about 550° C. Before the heat treatment the cold worked alloy material is preferably subjected to mechanical straightening. The alloy material is preferably subjected to stresses equal to about 5 to about 50% of the room temperature ultimate yield stress of the material during the thermal treatment.

Abstract: Methods are provided for partial aortic occlusion for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. Alternatively, the methods can be used to partially occlude aortic blood flow to condition the spinal cord to secrete neuroprotective agents prior to abdominal aortic aneurysm repair. The methods can also be used to partially occlude the renal arteries to reduce renin secretion in hypertensive patients. Partial occlusion of a vessel can be accomplished by a device comprising an elongate catheter, a distally mounted expandable occluder, a variable flow mechanism, and a manometer. The occluder may comprise two conical shells or an inflatable ring-shaped balloon disposed about a cylindrical sleeve. Other medical devices, such as an atherectomy catheter, can be inserted distal the occluder to provide therapeutic intervention.

Abstract: A catheter assembly for cannulating a heart vessel includes a guide handle having proximal and distal ends, a lumen open at least at the distal end of the guide handle, and a stop member disposed within the lumen at a distal end of the guide handle. A catheter of the assembly has a proximal end disposed within the lumen of the guide handle and a preformed distal end. The catheter is longitudinally displaceable within the guide handle to adjust an exposed length of the distal end of the catheter. The stop member is engagable with the proximal end of the catheter to prevent the proximal end of the catheter from passing out of the guide handle. A locking mechanism within the guide handle to selectably prevents and permit axial rotation between the guide handle and catheter while permitting longitudinal displacement of the catheter within the guide handle.

Abstract: A catheter having an elongate body including a central lumen adapted to slidably receive a therapeutic catheter. The catheter includes a soft tip adapted to lodge in the ostium of the right coronary artery. The elongate body is formed near the distal end to impinge against the wall of the aorta opposite the ostium of the coronary artery.

Abstract: A non-deforming deflectable multi-lumen catheter with an outer jacket having a deflectable distal end portion, an eccentric pull wire lumen, coil and shim embedded therein. The deflectable distal portion optionally having one or more transaxial notches in the external surface of the outer jacket. A functional device is disposed within the lumen of an inner tube substantially coaxial with the outer jacket of the catheter. The distal tip of the functional device egressible from the distal tip of the catheter, and upon deflection, automatically aligns with the distal tip of the catheter and functional device.

Abstract: A venting catheter, system and method are provided for withdrawing blood and other fluids from a patient's heart to facilitate decompressing the heart during cardioplegic arrest and cardiopulmonary bypass, without the need for a thoracotomy and without puncturing the aorta, pulmonary artery, or heart itself . The venting catheter is configured to be introduced into a peripheral vein and intraluminally advanced through the right side of the heart and into the pulmonary artery. The venting catheter includes a lumen configured to withdraw blood at a rate of at least about 50 ml/min at a pressure of no less than about −350 mmHg. A flow-directing means is provided to facilitate guiding the catheter into the pulmonary artery by being carried by blood flow through the heart. The cardiac venting system may include, in addition to the cardiac venting catheter, a cardiopulmonary bypass system to maintain circulation of oxygenated blood, and means for arresting the patient's heart.

Abstract: A preshaped tubular catheter for percutaneous transradial approach to catheterization, comprises a distal bridge shaped portion having a distal arch defining a primary curve, a top defining a secondary curve, and a proximal arch defining a tertiary curve. The proximal arch is connected to a straight shaft. The shaft is stiff and the bridge shaped portion has a flexibility extending at least up to and including the primary curve and a stiffness extending at least up to and including the tertiary curve.

Abstract: An angioplastic device used for treating the areas surrounding bifurcated vessels. The device has an elongated and relatively flexible tubular guiding catheter assembly that slidably houses a guide positioning assembly therein. The elongated tubular guiding catheter assembly has a non-circular lumen that cooperatively receives a guides carrier assembly with a non-circular cross-section. The guide carrier assembly includes two internal through passages through which two guide members are slidably passed and directed to different branches in a bifurcated vessel. The guide members carry at the distal end a balloon with or without stents to be positioned against the internal walls of the vessels being treated.

Abstract: A three-dimensional method of imaging the coronary arteries and coronary artery bypass grafts using a catheter contrast enhanced technique. The method involves the percutaneous placement of a catheter via the lower or upper extremity arterial circulation and engaging the distal end of the catheter into the aortic root with subsequent injection of a magnetic resonance imaging (MRI) or iodinated contrast agent and performing rapid first pass imaging with either magnetic resonance angiography (MRA) or computed tomographic angiography (CTA) techniques, respectively. Furthermore, a three dimensional catheter is used which includes a plurality of small distal round openings which are situated at the immediate distal end of the catheter near the small end-hole opening. The immediate distal end of the catheter is pre-formed having a memory and a three-dimensional, instead of a two-dimensional, curve to enhance the delivery of contrast to the aortic root for subsequent delivery of contrast to the coronary arteries.

Abstract: Methods are provided for conducting surgical procedures in a patient wherein, during the surgical procedure, autonomous ventricular electrical conductivity and escape beats are reversibly and transiently suppressed to facilitate the surgical procedure. Also provided are compositions which are capable of inducing ventricular asystole in a patient. The compositions may include an AV node blocker. In one embodiment, compositions including an atrioventricular (AV) node blocker and a &bgr;-blocker are provided, wherein the &bgr;-blocker is present in an amount sufficient to substantially reduce the amount of AV node blocker required to induce ventricular asystole in the patient. The compositions and methods may be used for inducing temporary ventricular asystole in a beating heart, and to facilitate the performance of a variety of surgical techniques, including minimally invasive microsurgical techniques.

Abstract: Right and left coronary catheters that are designed to be used in a transradial coronary catheterization are provided. The catheters have a proximal end, an extended body portion, and a shaped distal end with two curved portions and a tip. When advanced into the ascending aorta, the curved portions of the distal end cooperate with the aorta to engage and maintain the tip of the catheter within the selected coronary ostium during a coronary procedure. Also provided are methods of inserting the catheters into a right or left coronary artery by a transradial approach, and using the catheters in a diagnostic or interventional procedure to selectively deliver an imaging dye or tool to the coronary artery of interest.

Abstract: A catheter for injecting medicants into the endocardium, myocardium or other portions of the cardiovascular system is presented where the catheter has apertures therein for ejection and retraction of a needle. The catheter is designed for the apertures in the catheter to press against the tissue to be injected in the heart while the heart is beating. A needle for inserting a prescribed dose of a medicant is ejected through the aperture and a plunger, pump, or diaphragm is moved to deliver a dose of the medicant to tissue adjacent the aperture. By use of the catheter gene therapy, wherein a small does of a gene are injected into the endocardium of the right or left ventricle, can be used to grow new blood vessels in the injected area of a damaged heart. The apertures in the catheter can be spaced at a prescribed distance for the dosage of medicant to form a precise pattern of injections in the area to be treated.

Abstract: In a torsion control catheter including a tubular body and a flexible tip connected to the tubular body, the improvement comprising a copolymer catheter tip composition comprising a first monomer of polyamide and a second monomer of polyamide having a lower alkyl side chain group attached to a polyamide backbone. The flexible catheter tip may include one or more tip members, at least one of which may be formed of the copolymer composition.

Abstract: A coronary sinus catheter includes a distal electrode portion with optimally-spaced and sized ring electrodes and a proximal electrode portion with at least one optimally-spaced and sized larger surface electrode. The catheter has all or some of the following features. First, at least one ring electrode of the distal electrode portion includes a first diameter less than a second diameter of at least one, more proximally disposed, ring electrode of the distal electrode portion. Second, at least one ring electrode of the distal electrode portion includes a first width less than a second width of at least one, more proximally disposed, ring electrode of the distal electrode portion. Third, the distal electrode portion includes at least two ring electrodes and the proximal shock electrode includes at least two larger surface coil electrodes. Fourth, the catheter further includes a collapsible section, adjacent the proximal electrode portion, to facilitate positioning of the catheter within the right atrium.

Abstract: An implantable bypass device establishes a bypass between an artery and a vein. The device includes an implantable venous connection graft in fluid communication along a vein. The connection graft includes an elongate tubular body, an elongate access lumen extending from an intermediate location of the tubular body. An elongate tubular bypass graft has end secured in fluid communication with an artery and the other end securable to a distal end of the access lumen for establishing fluid communication between the artery and the vein through the venous connection graft. The device provides enhanced life expectancy as well desirable visualization of arterial and venous flows through the device.

Abstract: A method and kit for accessing the pericardial space take advantage of the fact that the right auricle is a thin-walled, low-pressure structure which can be readily penetrated without damaging the pericardium or the epicardium. The method includes the step of passing a guide catheter through a selected peripheral vein to establish a transvenous route to the right auricle of the heart. An infusion guide wire and a leading guide wire are passed through the guide catheter and into the right auricle so that a distal end of the leading guide wire is positioned against a wall of the right auricle. The leading guide wire is located within a lumen of the infusion guide wire and protrudes outward, preferably about 2 mm, from a distal end of the infusion guide wire. The wall of the right auricle is then pierced with the distal end of the leading guide wire. After the wall of the right auricle is pierced, at least one of the infusion guide wire and the leading guide wire are advanced into the pericardial space.

Abstract: A wire housed within a sheath is formed of a shape-retentive and resilient material having a curved shape at its distal-end region resulting in the catheter sheath having the curved shape. The catheter sheath also has an axially oriented tendon for causing deflection of the distal-end region. A movable outer sleeve surrounds the sheath and conforms the portion of the wire positioned within the outer sleeve to the shape of the outer sleeve. Upon relative displacement of the sheath and the outer sleeve a portion of the sheath extends beyond the outer sleeve and resumes its preformed curved distal shape thereby forcing the catheter distal-end region into the same curved shape. The operator may adjust the relative positions of the sheath and outer sleeve to changes the shape of the distal-end region. The operator may also axially move the tendon to adjust the radius or curvature of the distal-end region.

Abstract: An apparatus and method for blood oxygenation is provided, advantageously comprising an extracorporeal circuit for the preparation and delivery of hyperoxic or hyperbaric blood. In one embodiment, an apparatus for gas-supersaturating fluids, e.g., physiologic saline, includes a chamber having a first inlet to receive the fluid; a second inlet to receive a gas, e.g., oxygen, from a gas supply that maintains pressure within the chamber at a predetermined level, advantageously about 600 p.s.i.; and an outlet advantageously coupled to a capillary assembly. An atomizer nozzle coupled to the first inlet advantageously creates within the chamber fine droplets of fluid into which gas diffuses to create the gas-supersaturated fluid, which collects within the chamber below the atomizer nozzle for removal via the outlet.

Abstract: An improved catheter and method for infusing blood to the heart, clamping the aorta and delivering a cardioplegia solution. A single catheter (10, 100) is used having a unique balloon (102, 162, 172) for ccluding the aorta 12 In a first embodiment, a single catheter (10) is transthoracically inserted upwardly in the aorta to infuse oxygenated blood into the ascending aorta via an infusion opening (46) terminating at the distal end (32), with cardioplegia solution being delivered via openings (42) defined closely adjacent the balloon (40) on the proximal side of the balloon. In a second and third embodiment, a single catheter (100) is transthoracically and femorally inserted, respectively, inserted into the aorta to infuse blood via openings (102) into the ascending aorta proximate the Brachiocephalie Artery, and deliver cardioplegia solution via the distal opening (104) downward toward the aortic base.

Abstract: A preshaped tubular catheter for percutaneous transradial approach to catheterization, comprises a distal bridge shaped portion having a distal arch defining a primary curve, a top defining a secondary curve, and a proximal arch defining a tertiary curve. The proximal arch is connected to a straight shaft. The shaft is stiff and the bridge shaped portion has a flexibility extending at least up to and including the primary curve and a stiffness extending at least up to and including the tertiary curve.

Abstract: A method of pressurizing the right ventricle of the heart. The method includes providing a multi-lumen cannula. The multi-lumen cannula includes a first sub-cannula and a second sub-cannula. The first sub-cannula includes a proximal end, a distal end, a lumen extending between the proximal and distal ends, and proximal and distal fluid apertures formed in the lumen. The second sub-cannula includes a proximal end, a distal end, a lumen extending between the proximal and distal ends, and proximal and distal fluid apertures formed in the lumen. The distal fluid apertures of the two lumens are spaced from one another along the axial length of the multi-lumen cannula. The method further includes inserting the cannula into the vasculature system of a patient so that the distal fluid aperture of the lumen of the second sub-cannula is received in one of the right atrium, the superior vena cava, and the inferior vena cava.

Abstract: A balloon catheter for medical applications has a balloon 11 in a tip region facing the patient having a structured outer surface 12. The structured outer surface 12 is formed by wave troughs and wave crests which are not connected to each other. The structured outer surface 12 of a balloon 11 can cling to adjacent surfaces. The balloon catheter is introduced via a left-ventricular cardiotomy in the tip region and inserted into the aorta ascendens. The balloon 11 occludes the aorta ascendens. The balloon allows cardioplegia to be performed and relieves the heart through suctioning-off. Particular applications for the balloon catheter include by calcification of the aorta ascendens, for effecting LIMA/RIMA-anastomoses, and when effecting venovenostomies.

Abstract: Methods are provided for partial aortic occlusion for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. Alternatively, the methods can be used to partially occlude aortic blood flow to condition the spinal cord to secrete neuroprotective agents prior to abdominal aortic aneurysm repair. The methods can also be used to partially occlude the renal arteries to reduce renin secretion in hypertensive patients. Partial occlusion of a vessel can be accomplished by a device comprising an elongate catheter, a distally mounted expandable occluder, a variable flow mechanism, and a manometer. The occluder may comprise two conical shells or an inflatable ring-shaped balloon disposed about a cylindrical sleeve. Other medical devices, such as an atherectomy catheter, can be inserted distal the occluder to provide therapeutic intervention.

Abstract: A catheter assembly including a balloon which incorporates a reverse-cone design for improved stent delivery. The reverse-cone design provides an inflatable area which extends longitudinally over the balloon waist. When folded or deflated, the portions of the balloon extending over the waist in conjunction with the waists provide a bulky mass onto which a stent may be securely crimped without the use of additional structure under the balloon.

Abstract: The present application provides an arterial cannula system for transporting blood from an extracorporeal pump to a patient's femoral artery and aorta comprising first and second cannula portions. The first cannula portion has a proximal portion, a distal portion, and an intermediate portion and is configured for insertion through the femoral artery. It includes a first lumen extending from the proximal portion to the distal portion to deliver cardioplegic fluid, a second lumen communicating with an expandable occluding member at the distal end portion to inflate the occluding member to occlude blood flow, and a third lumen extending from the proximal portion to the intermediate portion to transport blood from the extracorporeal pump to the femoral artery. The second cannula portion is configured for insertion into the subclavian artery so that an opening in the distal portion is in communication with the aorta.

Abstract: Apparatus and methods for delivering a therapeutic or diagnostic agent into extravascular tissue surrounding a body passageway is provided comprising a catheter having a sheath, a tubular member, and a plurality of hollow needles on a distal end of the tubular member. The tubular member is selectively movable between delivery position, wherein the plurality of hollow needles are retracted within the sheath, and an extended position, wherein the plurality of hollow needles extend beyond a distal endface of the sheath to pierce and penetrate extravascular tissue. The catheter also includes a balloon for applying pressure to seal puncture wounds created by the hollow needles.

Abstract: Apparatus and methods are provided for delivering oxygenated blood to a patient undergoing cardiac surgery using a perfusion catheter having a distal end carrying first and second sealing members. When the perfusion catheter is inserted through an arteriotomy site, the first and second sealing members are disposed to engage opposite surfaces of a thickness of a vessel to apply pressure against the opposite surfaces of the thickness to seal blood perfused into the vessel from leaking through the arteriotomy site. Apparatus for placing the perfusion catheter, and methods of using the apparatus also are provided.

Abstract: A method of making a catheter, including an elongated tube structure having a proximal end and at least one preset curved portion proximate a distal end. The preset curved portion includes a first material located generally along an outer surface of the preset curved portion and a second material located generally along an inside surface of the preset curved portion. The first material preferably has a greater stiffness than the second material, so that the catheter is capable of assuming a generally straight configuration without plastic deformation.

Abstract: A pusher-rotator for installing a heart valve prosthesis including a handle and a flexible shaft extending from the handle. A valve holder is attached to a terminal end of the shaft. A bendable member is formed of a material which is bendable to hold a fixed shape. The bendable member includes multiple contact points for supporting the flexible shaft at spaced apart support points and maintaining the flexible shaft rotatable in a flexed orientation.