DE10243335A1 - Apparatus to increase perfusion through heart muscle tissue, in the treatment of heart disease, has an underpressure catheter inserted into a major heart vein - Google Patents

Apparatus to increase perfusion through heart muscle tissue, in the treatment of heart disease, has an underpressure catheter inserted into a major heart vein Download PDF

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Publication number
DE10243335A1
DE10243335A1 DE10243335A DE10243335A DE10243335A1 DE 10243335 A1 DE10243335 A1 DE 10243335A1 DE 10243335 A DE10243335 A DE 10243335A DE 10243335 A DE10243335 A DE 10243335A DE 10243335 A1 DE10243335 A1 DE 10243335A1
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heart
perfusion
muscle tissue
vein
catheter
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Werner Schubert
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/80—Constructional details other than related to driving
    • A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
    • A61M60/857—Implantable blood tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/73—Suction drainage systems comprising sensors or indicators for physical values
    • A61M1/732—Visual indicating means for vacuum pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/10—Location thereof with respect to the patient's body
    • A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
    • A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
    • A61M60/13—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel by means of a catheter allowing explantation, e.g. catheter pumps temporarily introduced via the vascular system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/20—Type thereof
    • A61M60/247—Positive displacement blood pumps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/30—Medical purposes thereof other than the enhancement of the cardiac output
    • A61M60/31—Medical purposes thereof other than the enhancement of the cardiac output for enhancement of in vivo organ perfusion, e.g. retroperfusion
    • A61M60/32—Medical purposes thereof other than the enhancement of the cardiac output for enhancement of in vivo organ perfusion, e.g. retroperfusion of heart muscle tissues, e.g. using coronary sinus occlusion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/40—Details relating to driving
    • A61M60/424—Details relating to driving for positive displacement blood pumps
    • A61M60/427—Details relating to driving for positive displacement blood pumps the force acting on the blood contacting member being hydraulic or pneumatic
    • A61M60/43—Details relating to driving for positive displacement blood pumps the force acting on the blood contacting member being hydraulic or pneumatic using vacuum at the blood pump, e.g. to accelerate filling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
    • A61M2025/0073—Tip designed for influencing the flow or the flow velocity of the fluid, e.g. inserts for twisted or vortex flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A61M2025/1043—Balloon catheters with special features or adapted for special applications
    • A61M2025/1052—Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/12—Blood circulatory system
    • A61M2210/125—Heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Mechanical Engineering (AREA)
  • Vascular Medicine (AREA)
  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • External Artificial Organs (AREA)
  • Materials For Medical Uses (AREA)

Abstract

The apparatus to increase perfusion in heart muscle tissue has an underpressure catheter (1), which is introduced into a major heart vein or coronary sinus. The leading end of the catheter is blunt, or is a jet head. The leading catheter end can be as a balloon, with a variable pressure against the vein wall. The underpressure is formed by pumps, with a pressure monitor and bottles to catch any extracted blood.

Description

Die Erfindung betrifft eine Vorrichtung für die Steigerung der Perfusion im Herzmuskelgewebe.The invention relates to a device for the increase perfusion in the heart muscle tissue.

Zur Perfusion gehört Blut mit Sauerstoff, Lymphe, Körper- bzw. Organflüssigkeit. Ein hohes Druckgefälle im Organ begünstigt die Perfusion, und wir dürfen annehmen, daß eine perfekte Perfusion zumindest die Heilung von Krankheiten wie Herzmuskelinfarkte mit Verschwielung begünstigt. Das Gefäßsystem des Herzens ist eingeschaltet zwischen dem hohen Druck der aufsteigenden Aorta bzw. Aortenwurzel und der Großen Herzvene, die als Vene mit "verbrauchtem Blut" nur einen sehr geringen Blutdruck besitzt. Durch den über die Cava cranialis in die Große Herzvene vorgeschobenen Unterdrucksaugkatheter wird das Druckgefälle zur Aorta bzw, dem Blut in den Herzkranzschlagadern zur physikalischen Therapie vergrößert, die Perfusion im Herzmuskelgewebe gesteigert. Das Einbringen eines Katheters in den rechten Herzvorhof sowie in die darin einmündende Große Herzvene dürfte dem nicht gar zu jungen Herzchirurgen keine Schwierigkeiten machen. Ist der Heilerfolg gegeben, erkennt ist der Unterdruckkatheter wieder herauszuziehen.Perfusion includes blood with oxygen, lymph, Body- or organ fluid. A high pressure drop favored in the organ perfusion and we may assume that a perfect perfusion at least the healing of diseases like myocardial infarction favored with calluses. The vascular system of the heart is switched between the high pressure of the ascending Aorta or aortic root and the great cardiac vein, which acts as a vein with "used up Blood "only one has very low blood pressure. Through the cranial cava into the Size The cardiac vein advanced negative pressure suction catheter becomes the pressure drop Aorta or, the blood in the coronary arteries to the physical Therapy increases that Perfusion in the heart muscle tissue increased. The insertion of a catheter in the right auricle as well as in the great cardiac vein that flows into it might who do not cause any problems even to young cardiac surgeons. If the healing is successful, the negative pressure catheter is recognized pull it out.

Druckschriften bzw. Bilder: Lehrbuch und Atlas der Anatomie des Menschen, Band II, Eingeweide -Gefäße, 16. Auflage, Georg Thieme-Verlag Leipzig, 1941, Seite 369 u. 394. Lehrbuch der Histologie des Menschen, 26. Auflage von W. von Möllendorff, Verlag Gustav Fischer in Jena; Herzmuskulatur 5.126-129. Über Perfusion im Pschyrembel Klinisches Wörterbuch, 258. Auflage. Gerd Heusch, Raimund Erbel: Koronare Mikroembolisation Deutsches Ärzteblatt, Jahrgang 99, Heft 33, S. 2200, 2002.Publications or pictures: textbook and Atlas of Human Anatomy, Volume II, Gut Vessels, 16. Edition, Georg Thieme-Verlag Leipzig, 1941, page 369 u. 394. Textbook of human histology, 26th edition of W. von Möllendorff, Gustav Fischer publishing house in Jena; Heart muscles 5.126-129. About perfusion in the Pschyrembel clinical dictionary, 258th edition. Gerd Heusch, Raimund Erbel: Coronary microembolization Deutsches Ärzteblatt, Volume 99, Issue 33, p. 2200, 2002.

Lehrbuch der Physiologie, Wolf D. Keidel, Thieme Verlag Stuttgart, Der Erfindung liegt die Aufgabe zugrunde , im zentralen Organ Herz die Perfusion durch relativ einfache physikalische. Mittel zur Krankheitsbehandlung, ggf. zur Vorsorge zu steigern.Textbook of Physiology, Wolf D. Keidel, Thieme Verlag Stuttgart, The task is the invention the basis, perfusion in the central organ heart through relatively simple physical. Means for disease treatment, if necessary for preventive care to increase.

Die Aufgabe der Erfindung wird bei gattungsgemäßer Einrichtung durch die kennzeichnenden Merkmale des Patentanspruches 1 gelöst. Die weitere Ausgestaltung der Erfindung ist den Unteransprüchen und der Zeichnung bzw. Abbildungen zu entnehmen.The object of the invention is generic device solved by the characterizing features of claim 1. The Another embodiment of the invention is the subclaims and can be seen from the drawing or illustrations.

Mit der Erfindung erzielten Vorteile: Für den Menschen bzw. den Patienten handelt es sich um ein vergleichsweise schonendes Verfahren, Lediglich auf der rechten Herzseite kommt per Katheter physikalisch begrenzt Unterdruck besonders in der imparen Großen Herzvene zur Anwendung über Stunden , ggf. Tage. Der Unterdruckkatheter kann auch zugleich als Ballonkatheter ausgebildet sein, dadurch kann der vor dem Katheter gelegene Venenraum in Steigerung der Perfusionswirkung im Herzen oder in anderen Organen, auch bei erkranktem Bein/Fuß begrenzt/ abgeschlossen werden. Die Geräte außen am Körper bestehen vor allem aus einer geeigneten Druckpumpe, Druckmesser wie Quecksilbermanometer und eine Wulffsche Flasche , die in 6 dargestellt wurde. Das in der Wulffschen Flasche aufgefangene Blut ist möglichst nach "Auffrischung" wieder in den Körperkreislauf zurückzugeben.Advantages achieved with the invention: For humans and patients, it is a comparatively gentle procedure. Only on the right side of the heart is physically limited negative pressure applied by catheter, especially in the imparent large cardiac vein, for hours, possibly days. The vacuum catheter can also be designed as a balloon catheter, which means that the vein space in front of the catheter can be limited / closed in increasing the perfusion effect in the heart or in other organs, even if the leg / foot is diseased. The devices on the outside of the body mainly consist of a suitable pressure pump, pressure gauges such as mercury pressure gauges and a Wulff bottle, which is in 6 was shown. The blood collected in the Wulff bottle should be returned to the body circulation after "refreshing" if possible.

Während der letzten Jahrzehnte sind Herzkatheter, auch Ballonkatheter besonders zur Aufdehnung stenosierter Stämme der Herzkranschlagadern über die Aorta ins arterille Herzgefäßsystem vorgeschoben worden. Solche Gefässaufdehnungen fördern auch die Perfusion im Herzmuskelgewebe, aber Einengungen und Durchblutungsstörungen in kleineren Kranzarterienästen können in dieser Weise nur schwer behandelt werden. Die Steigerung der Perfusion von der venösen Seite, wie jetzt von mir dargelegt, wirkt generell, bedingt könnte man auch von dreidinensional sprechen. Das eröffnet neue Möglichkeiten der Behandlung von Herzerkrankungen wie auch Myocarditis und aus meiner Sicht, ist das Verfahren mit Unterdruck von der venösen Seite auch schonender.While Cardiac catheters, including balloon catheters, have been special in recent decades for the expansion of stenosed strains the cardiac veins over the aorta into the arterial cardiovascular system been advanced. Such vasodilation promote also perfusion in the heart muscle tissue, but constrictions and circulatory disorders in smaller coronary artery branches can difficult to treat in this way. The increase in Perfusion from the venous Side, as I have now explained, works in general, one could do it conditionally also speak of three-dimensional. This opens up new opportunities the treatment of heart disease as well as myocarditis and from in my view, the procedure with negative pressure is from the venous side too friendly.

Zeichnung und AbbildungenDrawing and pictures

Die 1 zeigt eine Konstruktionszeichnung des menschlichen Herzens. Von mir eingezeichnet im rechten Herzvorhof ist ein Unterdruckkatheter 1 als deutlicher kreisförmiger Ring. Dieser Katheter 1 ist vom Arzt vor allem über die weite und rel. kurze obere Hohlvene in den rechten Herzvorhof (Atrium) vorzuschieben, um in die ziemlich weitlumige Herzvene (impar) ggf, mit Ballon in Erhöhung der Perfusion in der Herzmuskulatur schonend einzubringen. Der arterielle Schenkel des Herzgefäßsystems bleibt bei einem solchen Vorgehen unberührt.The 1 shows a construction drawing of the human heart. I have drawn a negative pressure catheter in the right atrium of the heart 1 as a clear circular ring. This catheter 1 is from the doctor especially about the wide and rel. Advance the short superior vena cava into the right atrium (atrium) to gently insert it into the fairly wide-lumened cardiac vein (impar), with a balloon to increase perfusion in the heart muscles. The arterial leg of the cardiovascular system remains unaffected by this procedure.

Die 2 zeigt einen in die Große Herzvene einzubringenden differenzierten Unterdruckkatheter 1, der keine scharfe Spitze, sondern einen stumpfen Düsenkopf 2 besitzt, zudem einen Ballon mit gesteuertem Überdruck (3). Dieser Ballon dient in der Großen Herzvene zur Abdichtung des im Blutgefässlumen bewirkten Unterdruckes, was der Effizienz der Perfusion im Herzmuskelgewebe zugute kommt . The 2 shows a differentiated negative pressure catheter to be inserted into the large cardiac vein 1 , which does not have a sharp tip, but a blunt nozzle head 2, and also a balloon with controlled excess pressure ( 3 ). This balloon is used in the large cardiac vein to seal the negative pressure created in the blood vessel lumen, which benefits the efficiency of perfusion in the heart muscle tissue.

Die 3 zeigt deutlich die der Zwerchfellseite des Herzens vorhandene Große Herzvene; der kranzförmige Ast hat einen Durchmesser von 8 mm. Dieses venöse Gefäß des Herzgefäßsystems setzt sich zur Mündung in den rechten Herzvorhof in den für Saugeffekte geeigneten Sinus coronarius fort. The 3 clearly shows the large cardiac vein on the diaphragm side of the heart; the ring-shaped branch has a diameter of 8 mm. This venous vessel of the cardiovascular system continues to flow into the right auricle in the coronary sinus, which is suitable for suction effects.

Die 4 stammt aus der Histologie bzw. Gewebskunde des Herzens. Zwischen den kontraktilen Fasern des Herzmuskels befinden im Blickfeld von zartem Bindegewebe umgeben ca 20 Blutgefäßkapillaren als weiße Flecke, da die roten Blutkörperchen bei der histologischen Gewebsbehandlung herausgefallen sind. Dreidimensional greift auch an diesen Kapillaren der Unterdruck an, von der ziemlich leicht zugänglichen venösen SeiteThe 4 comes from the histology or tissue science of the heart. Between the contractile fibers of the heart muscle there are about 20 blood vessel capillaries in the field of view surrounded by delicate connective tissue as white spots, since the red blood cells fell out during histological tissue treatment. Three-dimensional also attacks the capillaries the vacuum from the fairly easily accessible venous side

5 zeigt eine vielfach in der Bedeutung unterschätzte arteriovenöse Anastomose. Der venöse rel. weite Schenkel im -Bild links oben. 5 shows an arteriovenous anastomosis that is often underestimated. The venous rel. wide legs in the picture on the top left.

6. Zur Technik der Perfusionssteigerung im Organ- und Körpergewebe sind nicht nur der Unterdruckkatheter 1, sondern auch zum Auffangen von Blut eine Wulffsche Flasche 6, ein Druckmesser 5 und vor allem eine Unterdruckpumpe 4 erforderlich Selbst eine Wasserstrahlpumpe könnte diesen Dienst verrichten. 6 , The vacuum catheter is not only about the technique of increasing perfusion in organ and body tissue 1 , but also a Wulff bottle to collect blood 6 , a pressure gauge 5 and above all a vacuum pump 4 required Even a water jet pump could do this service.

Claims (5)

Vorrichtung für die Steigerung der Perfusion im Herzmuskelgewebe, dadurch gekennzeichnet, daß mit Unterdruckkathetern (1), die vor allem in die Große Herzvene bzw. Sinus coronarius einzubringen sind, die gesundheitsfördernde Perfusion im Herzmuskelgewebe gesteigert wird.Device for increasing the perfusion in the heart muscle tissue, characterized in that with vacuum catheters ( 1 ), which are to be introduced primarily into the large cardiac vein or coronary sinus, the health-promoting perfusion in the heart muscle tissue is increased. daß dieser Unterdruckkatheter (1) vorn stumpf ist bzw. einen Düsenkopf (2) besitzt.that this vacuum catheter ( 1 ) is dull at the front or a nozzle head ( 2 ) has. Daß dieser Unterdruckkateter (1,2) einen Ballon mit variablen Andruck an der Venenwand besitzt, was die Wirkung zur Herstellung der Perfusion im Herzmuskelgewebe noch verstärkt.That this vacuum catheter ( 1 . 2 ) has a balloon with variable pressure on the vein wall, which further enhances the effect of producing perfusion in the heart muscle tissue. Daß für die Erzeugung dEs Unterdruckes zur Steigerung der Organ-Gewebsperfusion geeignete Pumpen (4), Druckmessxer (5) Wulffsche Flaschee (6) u.a. zum Auffangen auch des abgesaugten venösen Blutes zur Verfügung stehen.That pumps suitable for generating the negative pressure to increase organ-tissue perfusion ( 4 ), Pressure gauge ( 5 ) Wulff bottle ( 6 ) are also available to collect the venous blood that has been drawn out. Daß der Sinus coronarius in Vorschaltung zur Vena cordis magna (7) zur Herstellung des Unterdruckes im coronaren Herzgefäßsystem benutzt wird.That the sinus coronarius upstream of the vena cordis magna ( 7 ) is used to create the negative pressure in the coronary cardiovascular system.
DE10243335A 2002-09-18 2002-09-18 Apparatus to increase perfusion through heart muscle tissue, in the treatment of heart disease, has an underpressure catheter inserted into a major heart vein Withdrawn DE10243335A1 (en)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4985014A (en) * 1989-07-11 1991-01-15 Orejola Wilmo C Ventricular venting loop
DE4038398A1 (en) * 1990-12-01 1992-06-04 Schubert Werner Medical equipment for min. invasive operation e.g. for removal of tumour - introduces knife on long handle through cylinder or tube adjusted into pathological tissue
DE3873024T2 (en) * 1987-10-23 1992-12-17 Schneider Usa Inc ATHEREECTOMY CATHETER.
DE19846630C2 (en) * 1998-10-09 2001-05-17 Norbert Augustin Aortic umbrella catheter
DE10100102A1 (en) * 2001-01-03 2002-07-18 Eckert Rosemarie Catheter puncture set
DE69332091T2 (en) * 1992-04-27 2003-02-20 Terumo Cardiovascular Sys Retrograde coronary sinus catheter

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3873024T2 (en) * 1987-10-23 1992-12-17 Schneider Usa Inc ATHEREECTOMY CATHETER.
US4985014A (en) * 1989-07-11 1991-01-15 Orejola Wilmo C Ventricular venting loop
DE4038398A1 (en) * 1990-12-01 1992-06-04 Schubert Werner Medical equipment for min. invasive operation e.g. for removal of tumour - introduces knife on long handle through cylinder or tube adjusted into pathological tissue
DE69332091T2 (en) * 1992-04-27 2003-02-20 Terumo Cardiovascular Sys Retrograde coronary sinus catheter
DE19846630C2 (en) * 1998-10-09 2001-05-17 Norbert Augustin Aortic umbrella catheter
DE10100102A1 (en) * 2001-01-03 2002-07-18 Eckert Rosemarie Catheter puncture set

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