Device for delivering therapeutic agents and medical devices to the coronary sinus

This technology is an introducer that is capable of effectively delivering medical devices and therapeutic agents to the coronary sinus by being configured to access the coronary sinus from the right parasternal mediastinotomy.

Unmet Need: A cannula which can access the coronary sinus through a right atriotomy

A current treatment for both congestive heart failure and ventricular desynchrony is cardiac resynchronization therapy. This necessitates access to the coronary sinus to allow for implantation of a pacemaker to allow for biventricular pacing. Standard endocardial techniques for coronary sinus cannulation are technically difficult due necessitating a flexible cannula to travel a long distance from the site of venous entry, resulting in a failure rate of 5-10%. Alternatively, a right parasternal mediastinotomy allows for the coronary sinus to be accessed through a right atriotomy, a much closer access point which allows for a less custom-curved cannula which reduces procedure difficulty, however, there are currently no marketed cannulas designed for this approach.

The Technology: A custom-curved introducer for delivering medical devices and therapeutics to the coronary sinus

This invention describes an introducer which is custom curved to facilitate coronary sinus access through a right atriotomy accessed through a right parasternal mediastinotomy. The cannula has been improved over previous designs by the addition of multiple channels which could allow for intracardiac echo or infra-red imaging, hydraulic or electrical steering of the catheter tip, and passage of flexible guidewires. Furthermore, accessing the coronary sinus through a right parasternal mediastinotomy allows for larger cannulas, increasing the ease of manipulation for endocardial lead insertion.

This technology has been validated in anesthetized pigs.

Applications:

• Coronary sinus access through a right parasternal mediastinotomy
• Implantation of pacemaker for cardiac resynchronization therapy
• Access for PiCSO
• Access for intracardiac echo imaging
• Access for annuloplasty
• Access for angiography

Advantages:

• Matches the most frequent curvatures found in human patients with coronary sinus leads
• Contains multiple channels, allowing the housing of various instruments simultaneously
• Allows for coronary sinus access through a physically close point
• Reduces procedure difficulty and length
• Relatively larger size allows for easier manipulation

Lead Inventor:

Henry Spotnitz, M.D.

Patent Information:

Patent Pending (US 20170182287)

Related Publications:

• Wang DY, Gerrah R, Rusanov A, Yalamanchi V, Cabreriza SE, Spotnitz HM. “Left ventricular pacing lead insertion via the coronary sinus cardioplegia cannula: a novel method for temporary biventricular pacing during reoperative cardiac surgery” J Thorac Cardiovasc Surg. 2011 Jul; 142(1): 737-6.

• Spotnitz HM, Yeager KJ, Cabreriza SE, Vunjak-Novakovic G, Wang DY, Pearson GD. “Introducer Development for Coronary Sinus Access From Parasternal Mediastinotomy” Innovations (Phila). 2015 May-Jun; 10(3): 202-208.

Tech Ventures Reference:

• IR CU15217, CU14007, CU14193, CU14198, CU16068

• Licensing Contact: Sara Gusik