Devices and systems for accessing cardiac tissue

Abstract

Devices, systems, and methods for accessing the internal and external tissues of the heart are disclosed. At least some of the embodiments disclosed herein provide access to the external surface of the heart through the pericardial space for localized delivery of substances to the heart tissue. In addition, various disclosed embodiments provide access to the internal surface of the heart for aspiration and delivery of substances to a targeted region without disturbing or interfering with nearby structures or surfaces.

1 . An engagement catheter, comprising:
 an elongated tube comprising a proximal end, a distal end, an internal lumen extending between the proximal end and the distal end, a vacuum port capable of operative connection to a vacuum source, and a suction port at or near the distal end of the elongated tube that is configured to removably attach to a targeted tissue within a patient due to vacuum from the vacuum source;   wherein the engagement catheter is configured for percutaneous intravascular insertion into the patient through a blood vessel of the patient and further configured for advancement to the targeted tissue through the blood vessel;   wherein the engagement catheter is configured so that at least a portion of the engagement catheter can be retracted, while remaining removably attached to the targeted tissue, so to locally increase a distance between the targeted tissue and a tissue or organ adjacent to the targeted tissue; and   wherein the engagement catheter is configured to receive and operate at least part of a second device within the internal lumen of the engagement catheter while maintaining the reversible seal under vacuum.   
     
     
         2 . The engagement catheter of  claim 1 , wherein when the engagement catheter is used to removably engage the targeted tissue, the second device, configured as a delivery catheter or a needle, may be inserted into and/or removed from the internal lumen of the engagement catheter. 
     
     
         3 . The engagement catheter of  claim 1 , wherein the suction port is configured to removably engage a portion of an atrial wall, an atrial appendage, a right atrial wall, or a right atrial appendage. 
     
     
         4 . The engagement catheter of  claim 1 , further comprising:
 at least one internal lumen support positioned within the internal lumen and attached to the elongated tube, the at least one internal lumen support extending from the distal end of the elongated tube along at least part of a length of the elongated tube.   
     
     
         5 . The engagement catheter of  claim 1 , wherein the elongated tube further comprises a second lumen extending between the proximal end and the distal end. 
     
     
         6 . The engagement catheter of  claim 1 , further comprising:
 an injection channel formed along the length of the elongated tube, the injection channel having at its distal end at least one opening for administering a fluid to the targeted tissue, the injection channel capable of operable attachment to an external fluid source at the proximal end of the injection channel, such that fluid from the external fluid source can flow through the injection channel to the targeted tissue when the external fluid source is operatively attached to the injection channel.   
     
     
         7 . A system for use with a vacuum source for engaging a tissue, the system comprising:
 an engagement catheter, comprising:
 an elongated tube comprising a proximal end, a distal end, an internal lumen extending between the proximal end and the distal end, a vacuum port capable of operative connection to a vacuum source, and a suction port at or near the distal end of the elongated tube that is configured to removably attach to a targeted tissue within a patient due to vacuum from the vacuum source; and 
   a second device configured to at least partial insertion into the internal lumen;   wherein the engagement catheter is configured for percutaneous intravascular insertion into the patient through a blood vessel of the patient and further configured for advancement to the targeted tissue through the blood vessel;   wherein the engagement catheter is configured so that at least a portion of the engagement catheter can be retracted, while remaining removably attached to the targeted tissue, so to locally increase a distance between the targeted tissue and a tissue or organ adjacent to the targeted tissue; and   wherein the engagement catheter is configured to receive and operate at least part of the second device within the internal lumen of the engagement catheter while maintaining the reversible seal under vacuum.   
     
     
         8 . The system of  claim 7 , wherein when the engagement catheter is used to removably engage the targeted tissue, the second device, configured as a delivery catheter or a needle, may be inserted into and/or removed from the internal lumen of the engagement catheter. 
     
     
         9 . The system of  claim 7 , wherein the suction port is configured to removably engage a portion of an atrial wall, an atrial appendage, a right atrial wall, or a right atrial appendage. 
     
     
         10 . The system of  claim 7 , wherein the engagement catheter further comprises at least one internal lumen support positioned within the internal lumen and attached to the elongated tube, the at least one internal lumen support extending from the distal end of the elongated tube along at least part of a length of the elongated tube. 
     
     
         11 . The system of  claim 7 , wherein the elongated tube further comprises a second lumen extending between the proximal end and the distal end. 
     
     
         12 . The system of  claim 7 , wherein the engagement catheter further comprises an injection channel formed along the length of the elongated tube, the injection channel having at its distal end at least one opening for administering a fluid to the targeted tissue, the injection channel capable of operable attachment to an external fluid source at the proximal end of the injection channel, such that fluid from the external fluid source can flow through the injection channel to the targeted tissue when the external fluid source is operatively attached to the injection channel. 
     
     
         13 . The system of  claim 7 , wherein the engagement catheter is configured for advancement to a heart through the blood vessel. 
     
     
         14 . The system of  claim 7 , wherein the tissue or organ adjacent to the targeted tissue comprises a pericardium surrounding a heart, and wherein the engagement catheter is capable of locally increasing a pericardial space between the targeted tissue and the pericardium. 
     
     
         15 . The system of  claim 7 , wherein the second device comprises a delivery catheter or a needle.