Aortic shunt for selective cerebral perfusion in stroke and cardiac arrest

Abstract

An aortic shunt comprising a second tubular member nested within a lumen of a first tubular member, wherein aortic blood flows through the lumen of the first tubular member and oxygenated and/or cooled blood is infused through a lumen and distal port(s) of the second tubular member to perfuse the cerebral vasculature. Alternatively, a cooling cylinder is nested within the first member, such that aortic blood is cooled through the cylinder before being delivered to the brain. A venous return catheter comprising an elongate tubular member is also provided to remove and isolate the cooled blood entering through jugular veins from the blood entering through the subclavian veins, when the cannula is positioned in the superior vena cava. Methods of using the aortic shunt and/or venous return cannula in providing selective cerebral perfusion in patients suffering from stroke and cardiac arrest are also disclosed.

What is claimed is:  
     
         1 . An aortic shunt, comprising: 
 a first tubular member expandable between a first diameter suitable for passage through the lumen of the aorta and a second diameter that frictionally engages the lumen of the aorta, the first tubular member having a length that spans from the ascending aorta upstream of the brachiocephalic trunk to the descending aorta downstream of the left subclavian artery, the first tubular member having a proximal opening, a distal opening, and a lumen therebetween; and    a second tubular member having a proximal end, a distal end, and a lumen therebetween, the distal end of the second tubular member communicating with a port mounted on an intermediate portion of the first tubular member, the port adapted to communicate with the carotid arteries when in use, the proximal end of the second tubular member extending to a position outside of the patient's body and adapted to receive infusion of oxygenated blood,    wherein, during use, oxygenated blood flows through the second tubular member into the carotid arteries while blood from the ascending aorta flows through the first tubular member into the descending aorta.    
     
     
         2 . The aortic shunt of  claim 1 , wherein the lumen of the second tubular member communicates with a plurality of ports at the distal end of the second tubular member.  
     
     
         3 . The aortic shunt of  claim 1 , wherein the first tubular member is a stent.  
     
     
         4 . The aortic shunt of  claim 1 , wherein the first tubular member is a cylindrical balloon, and wherein the shunt further comprises an inflation lumen that communicates with the first tubular member.  
     
     
         5 . The aortic shunt of  claim 1 , wherein the first tubular member further comprises a balloon disposed about a portion of the first tubular member, wherein the balloon inflates to isolate a portion of the first tubular member where the port of the second tubular member communicates with the carotid arteries from blood flow in the aorta.  
     
     
         6 . The aortic shunt of  claim 5 , wherein the first tubular member is a stent.  
     
     
         7 . The aortic shunt of  claim 5 , wherein the first tubular member is a cylindrical balloon, and wherein the shunt further comprises an inflation lumen that communicates with the first tubular member.  
     
     
         8 . The aortic shunt of  claim 1 , further comprising a manometer mounted in the first tubular member.  
     
     
         9 . The aortic shunt of  claim 1 , wherein the first tubular member further comprises radiopaque markers at the proximal end and the distal end.  
     
     
         10 . A method for treating stroke and cardiac arrest, comprising the steps of: 
 providing an aortic shunt comprising a first tubular member having a proximal opening, a distal opening, and a lumen therebetween, and a second tubular member having a proximal opening, a distal end, and a lumen therebetween, the distal end of the second tubular member communicating with a port mounted on an intermediate portion of the first tubular member;    advancing the aortic shunt into the aorta;    positioning the shunt so that the proximal opening of the first tubular member is upstream of the brachiocephalic trunk, the distal opening of the first tubular member is downstream of the left-subclavian artery, and the distal port of the second tubular member communicates with the carotid arteries;    expanding the shunt so that the first tubular member engages the lumen of the aorta; and    infusing oxygenated blood through the lumen of the second tubular member into the carotid arteries.    
     
     
         11 . The method of  claim 10 , wherein the lumen of the second tubular member communicates with a plurality of ports at the distal end of the second tubular member.  
     
     
         12 . The method of  claim 10 , wherein the first tubular member is a stent.  
     
     
         13 . The method of  claim 10 , wherein the first tubular member is a cylindrical balloon, and wherein the shunt further comprises an inflation lumen that communicates with the first tubular member.  
     
     
         14 . The method of  claim 10 , wherein the first tubular member further comprises a balloon disposed about a portion of the first tubular member, wherein the balloon inflates to isolate a portion of the first tubular member where the port of the second tubular member communicates with the carotid arteries from blood flow in the aorta.  
     
     
         15 . The method of  claim 14 , wherein the first tubular member is a stent.  
     
     
         16 . The method of  claim 14 , wherein the first tubular member is a cylindrical balloon, and wherein the shunt further comprises an inflation lumen that communicates with the first tubular member.  
     
     
         17 . The method of  claim 10 , wherein the shunt further comprises a manometer mounted in the first tubular member.  
     
     
         18 . The method of  claim 10 , wherein the first tubular member further comprises radiopaque markers at the proximal end and the distal end.  
     
     
         19 . The method of  claim 10 , wherein the oxygenated blood is cooled oxygenated blood.  
     
     
         20 . The method of  claim 10 , further comprising the step of inserting the shunt into the femoral artery.