Trans-septal catheter with retention mechanism

Abstract

A trans-septal guide catheter for providing access through the septum separating a first heart chamber from a second heart chamber that includes an elongated guide catheter body extending between guide catheter proximal and distal ends. A distal segment of the guide catheter is adapted to be inserted through the septum to locate the distal segment of the guide catheter within one of the first heart chamber and the second heart chamber. The catheter body encloses a guide catheter lumen adapted to provide access into the one of the first heart chamber and the second heart chamber through a guide catheter lumen proximal end opening and a guide catheter lumen distal end opening. A retention mechanism engages the septum and maintains the distal segment of the guide catheter extending into the one of the first heart chamber and the second heart chamber

What is claimed is:  
     
         1 . A trans-septal guide catheter for providing access through the septum separating a first heart chamber from a second heart chamber comprising: 
 an elongated guide catheter body extending between guide catheter proximal and distal ends, a distal segment of the guide catheter adapted to be inserted through the septum to locate the distal segment of the guide catheter within one of the first heart chamber and the second heart chamber, the catheter body enclosing a guide catheter lumen adapted to provide access into the one of the first heart chamber and the second heart chamber through a guide catheter lumen proximal end opening and a guide catheter lumen distal end opening; and    a retention mechanism engaging the septum and maintaining the distal segment of the guide catheter extending into the one of the first heart chamber and the second heart chamber.    
     
     
         2 . The trans-septal guide catheter of  claim 1 , wherein the retention mechanism engages the septum along the one of the first heart chamber and the second heart chamber, inhibiting retraction of the distal segment of the guide catheter from the one of the first heart chamber and the second heart chamber to other than the one of the first heart chamber and the second heart chamber through the septum.  
     
     
         3 . The trans-septal guide catheter of  claim 1 , wherein the retention mechanism engages the septum along other than the one of the first heart chamber and the second heart chamber, inhibiting advancement of the distal segment of the guide catheter from the other than one of the first heart chamber and the second heart chamber to the one of the first heart chamber and the second heart chamber through the septum.  
     
     
         4 . The trans-septal guide catheter of  claim 1 , wherein the retention mechanism engages the septum along both the first heart chamber and the second heart chamber, inhibiting retraction and advancement of the distal segment of the guide catheter between the first heart chamber and the second heart chamber through the septum.  
     
     
         5 . The trans-septal guide catheter of  claim 1 , wherein the retention mechanism includes a plurality of flexible, pliant tines each extending outwardly from a tine attachment with the distal segment of the guide catheter body to a tine free end, the tine free end of each such tine deflecting inward toward the guide catheter body when restrained during advancement of the guide catheter and extending outward from the guide catheter body when restrained against the septal wall during retraction of the guide catheter.  
     
     
         6 . The trans-septal guide catheter of  claim 1 , wherein the retention mechanism includes an inflatable balloon formed about the guide catheter body at the distal segment; 
 a balloon lumen positioned within the guide catheter body, extending from a proximal inflation and deflation port located along the guide catheter proximal end to a distal inflation and deflation port located within the inflatable balloon, the balloon lumen introducing an inflation medium to inflate the balloon after the balloon and the distal segment are advanced through the septum into the one of the first heart chamber and the second heart chamber, wherein the inflated balloon engages the septum within the one of the first heart chamber and the second heart chamber, inhibiting retraction of the distal segment of the guide catheter through the septum, the inflation medium being evacuated from the balloon to enable retraction of the distal segment through the septum.    
     
     
         7 . The trans-septal guide catheter of  claim 1 , wherein the retention mechanism further comprises: 
 a first inflatable balloon and a second inflatable balloon formed about the guide catheter body at the distal segment;    a balloon lumen positioned within the guide catheter body, extending from a proximal inflation and deflation port located along the guide catheter proximal end to a distal inflation and deflation port located within the first inflatable balloon and the second inflatable balloon, the balloon lumen introducing an inflation medium to inflate the first inflatable balloon and the second inflatable balloon after the first inflatable balloon is advanced through the septum into the one of the first heart chamber and the second heart chamber, wherein the inflated first balloon engage the septal wall and inhibits retraction of the distal segment of the guide catheter through the septum, and the second inflated balloon engages the septum and inhibits advancement of the guide catheter through the septum.    
     
     
         8 . The trans-septal guide catheter of  claim 1 , wherein the retention mechanism further comprises: 
 a deployment lumen extending between a deployment lumen proximal end opening and a deployment lumen distal end opening in the distal segment of the guide catheter body; and    means extendable from the deployment lumen proximal end opening through the deployment lumen and out of the deployment lumen distal end opening into engagement with the septal wall of the septum within the one of the first heart chamber and the second heart chamber that inhibits retraction through the septum of the distal segment of the guide catheter extending into the one of the first heart chamber and the second heart chamber.    
     
     
         9 . The trans-septal guide catheter of  claim 1 , wherein the retention mechanism further comprises: 
 a wire deployment lumen extending between a deployment lumen proximal end opening and a deployment lumen distal end opening in the distal segment of the guide catheter body; and    an elongated retention wire adapted to be advanced through the wire deployment lumen to dispose a distal wire segment within the one of the first heart chamber and the second heart chamber, the distal wire segment adapted to be straightened when advanced through the wire deployment lumen and to form a non-straight configuration when extended out of the deployment lumen distal end opening and into engagement with a septal wall of the septum within the one of the first heart chamber and the second heart chamber, the non-straight configuration inhibiting retraction of the distal segment of the guide catheter through the septum.    
     
     
         10 . The trans-septal guide catheter of  claim 9 , wherein the non-straight configuration of the retention wire further comprises a wire coil formed of a plurality of wire turns.  
     
     
         11 . The trans-septal guide catheter of claim, wherein the non-straight configuration of the retention wire further comprises a wire coil formed of a plurality of wire turns wound in a common plane.  
     
     
         12 . The trans-septal guide catheter of  claim 9 , wherein the non-straight configuration of the retention wire further comprises an acute bend in the wire that is straightened during advancement through the wire deployment lumen.  
     
     
         13 . The trans-septal guide catheter of  claim 9 , wherein the retention wire is formed of a shape memory alloy and possesses superelasticity that enables straightening of the non-straight configuration within the wire deployment lumen.  
     
     
         14 . A method of introducing a mapping/ablation catheter through the septum separating a first heart chamber from a second heart chamber for ablation and/or mapping of the heart wall of the second heart chamber, the method comprising the steps of: 
 advancing a distal segment of a guide catheter into the first heart chamber, the guide catheter including an elongated guide catheter body extending between guide catheter proximal and distal ends, the catheter body enclosing a guide catheter lumen adapted to receive a mapping/ablation catheter and including a deployable retention mechanism;    perforating the septal wall and advancing the distal segment of the guide catheter through the perforation and into the second heart chamber;    deploying the retention mechanism into engagement with the septum to inhibit movement of the distal segment of the guide catheter through the septum; and    introducing the mapping/ablation catheter through the guide catheter for ablation and/or mapping of the heart wall of the second heart chamber.    
     
     
         15 . The method of  claim 14 , wherein the step of deploying further comprises the step of deploying the retention mechanism against the septum within the second heart chamber when retraction force is applied to the guide catheter.  
     
     
         16 . The method of  claim 14 , wherein the step of deploying further comprises the step of deploying the retention mechanism against the septum within one or both of first heart chamber and the second heart chamber when one of retraction force and advancement force is applied to the guide catheter.  
     
     
         17 . The method of  claim 14 , wherein the retention mechanism includes at least one flexible, pliant tine extending outwardly from a tine attachment with the distal segment of the guide catheter body to a tine free end, wherein the step of perforating and advancing includes advancing the distal segment of the guide catheter through the perforation in the septal wall such that the pliant tine is deflected inward toward the guide catheter body as the tine passes through the septal wall during passage through the perforation and extends outward when positioned in the second heart chamber.  
     
     
         18 . The method of  claim 17 , further comprising the step of applying traction to the guide catheter proximal end of sufficient force to bend over the flexible pliant tine and retract the guide catheter distal segment through the perforation in the septal wall.  
     
     
         19 . The method of  claim 14 , wherein the retention mechanism includes an inflatable balloon formed about the guide catheter body at the distal segment, and further comprising the step of introducing an inflation medium through a balloon inflation and deflation lumen within the guide catheter body to inflate the balloon after the balloon is advanced through the septum into the second heart chamber, wherein the inflated balloon engages the septum and inhibits retraction of the distal segment of the guide catheter from the second heart chamber to the first heart chamber through the septum.  
     
     
         20 . The method of  claim 19 , further comprising the step of evacuating the inflation medium to deflate the balloon and enable retraction of the distal segment through the septum into the first heart chamber.  
     
     
         21 . The method of  claim 14 , wherein the retention mechanism includes a first inflatable balloon and a second inflatable balloon formed about the guide catheter body at the distal segment, and further comprising the step of introducing an inflation medium through a balloon inflation and deflation lumen positioned within the guide catheter body to inflate the first inflatable balloon and the second inflatable balloon after the first inflatable balloon is advanced through the septum into the one of the first heart chamber and the second heart chamber, wherein the inflated first balloon engage the septal wall and inhibits retraction of the distal segment of the guide catheter through the septum, and the second inflated balloon engages the septum and inhibits advancement of the guide catheter through the septum.  
     
     
         22 . The method of  claim 21 , further comprising the step of evacuating the inflation medium to deflate the first balloon and the second balloon and enable one of advancement and retraction of the distal segment through the septum between the first heart chamber and the second heart chamber.  
     
     
         23 . The method of  claim 14 , wherein the retention mechanism includes an elongated retention wire and further comprises the step of advancing the retention wire through a wire deployment lumen of the guide catheter body, disposing a distal wire segment within the second heart chamber, wherein the distal wire segment is adapted to be straightened when advanced through the wire deployment lumen and to form a non-straight configuration when extended out of the deployment lumen and into engagement with the septum within the second heart chamber, inhibiting retraction of the distal segment of the guide catheter from the second heart chamber to the first heart chamber through the septum.  
     
     
         24 . The method of  claim 23 , further comprising the step of retracting the retention wire within the deployment lumen and disengaging the retention wire from the septal wall of the septum within the second heart chamber to enable retraction of the distal segment of the guide catheter into the first heart chamber through the septum.  
     
     
         25 . The method of  claim 23 , wherein the non-straight configuration of the retention wire further comprises a wire coil formed of a plurality of wire turns.  
     
     
         26 . The method of  claim 23 , wherein the non-straight configuration of the retention wire further comprises a wire coil formed of a plurality of wire turns wound in a common plane.  
     
     
         27 . The method of  claim 23 , wherein the non-straight configuration of the retention wire further comprises an acute bend in the wire that is straightened during advancement through the wire deployment lumen.  
     
     
         28 . The method of  claim 23 , wherein the retention wire is formed of a shape memory alloy and possesses superelasticity enabling straightening of the non-straight configuration within the wire deployment lumen.