US 3034501 A
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Description (OCR text may contain errors)
y 1962 c. E. HEWSON 3,034,501
INFLATABLE HEART MASSAGER Filed Aug. 5, 1958 INVENTOR. CARL HE S BY F75 3 EZEK/EL. W I Wou: I -Grumman 4-15 WRN 'YS United States Patent 3,034,501 INFLATABLE HEART MASSAGER Carl E. Hewson, Marshfield, Mass. (90 Myrtle St., Quincy, Mass.) Filed Aug. 5, 1958, Ser. No. 753,240 4 Claims. (Cl. 128-39) The present invention relates to a heart massager or bag adapted to fit about a human heart during surgical procedure for automatic massaging of the heart.
It is quite common during surgical operations for surgeons to massage the patients heart in order to stimulate it to normal operation. Often however, this massaging must be carried on for relatively long periods of time. Since a surgeon can normally only massage a heart for a period of approximately three minutes, without tiring, it is often necessary for a team of surgeons to hand-massage a heart over prolonged periods. The difficulty with this particularly procedure is that successive handling of the heart by different individuals is deleterious to its proper operation. Furthermore, it makes the maintaining of a uniform and rhythmic pulsating pressure rather diflicult to maintain. Furthermore, this type of procedure does not lend itself to a precisely controlled rhythmic application of pulsating pressures to the heart.
it is therefore an object of the present invention to provide a device adapted to be fitted on a human heart during surgical operation for applying a rhythmic pulsating pressure to the heart suflicient and in such a manner as to keep the heart pumping and therefore maintain blood pressure and circulation artificially until the heart is able to assume its normal function. V 1
The present invention also provides the heart massaging device which is adapted to fit over a wide range of different sized hearts and in which the device is easily inserted over the heart during surgical operative pro-' cedures.
The device also provides gentle uniform pressure to the heart in a manner carefully predetermined and controlled.
The present invention also contemplates modifications for applying rhythmic pulsating pressure to the heart with the pressure being applied to difierent portions of the heart in successive instants of time.
The present invention is also designed to be autoclavable so that it may be reused.
These and other objects and advantages of the present invention will be more clearly understood when considered in connection with the accompanying drawings, in which:
FIGURE 1 is a perspective View of a preferred form of the invention;
FIGURE 2 is a cross sectional view taken substantially along the line 2-2 of FIGURE 1; and,
FIGURE 3 is a perspective View of a modification of the invention.
This massager is preferably entirely made of a flexible distendable resilient auto-clavable material which is nonreactive with the internal organs of the body. A number of suitable materials are presently marketed including certain of the commercially available synthetic plastic materials. Of particular utility is a silicon elastic material commercially sold under the trademark Silastic and manufactured by the Dow Corning Chemical Co. This material is shaped into a bag-like form generally illustrated in FIGURE 1. The bag is formed with inner and outer walls 1 and 2 respectively, with the inner and outer walls joined at their upper peripheral edges 3 by any suitable permanent sealing means. A slot is also formed at 4 end extends substantially vertically with respect to the walls 1 and 2. The edges of the walls 1 and 2 are secured together at this slot 4, as indicated at 5 and 6.
3,034,501 Patented May 1 5, 1962 A tube 7 is formed at the base or vertex of the outer wall 2. By this ararngement there is provided an inner enclosed space 8 between two walls 1 and 2, with fluid or air inlet means through the tube 7.
The shape of this bag and substantially the shape of the inner and outer walls are goblet-like in cross section. Ultimately they may be considered as substantial paraboloids. Attention is directed to the fact that the upper portions of the walls 1 and 2 are bowed slightly inwardly at 10 and 11, about their circumference, so that the interior area of the bag as indicated at 12 has a slightly constricted upper opening. This constriction is somewhat more pronounced when the bag is in use, so that the tendency of the bag to slip from the heart will be minimized by the gripping action of this slightly constricted plied through the opening '7 to the interior 8, the inner wall 1 will be forced inwardly towards the center, thereby providing a squeezing action on the heart which is positioned within the area 12. The relative thicknesses of the inner and outer walls may vary depending upon the particular material used. If desired the outer wall 2 may be provided with an integrally molded or otherwise suitably secured flexible, auto-clavable cloth or woven metal insert which would prevent the outer Wall from distending to any substanutial extent. Satisfactory for such rigidizing member would be a monofilarnent nylon cloth arranged in strips or if desired a single piece about the outer wall 2. Preferably, however the device contemplates the inner and outer wall of the same material only with the outer wall of greater thickness.
The particular shape illustrated is useful for hearts of different sizes. Thus the slot 4 permits easy insertion of a heart Within the area 12 and the subsequent securing of the bag about the heart. The bag may be readily secured particularly for smaller hearts, by surgical clamps applied to the lips 5 and 6. Thus in one particular modification, a bag having approximately a five inch diameter and a length of approximately six inches, has been found satisfactory. The length of the slot 4 should extend preferably almost the height of the walls 1 and 2 so that the bag may be distended and bent for easy insertion of the heart within it.
In the operation of this device, the outlet tube 7 is connected to a suitable hydraulic or pneumatic pressure means which is adapted to apply a rhythmic pulsating pressure to the interior 8 of the bag. The pressure which is alternately applied and released to this interior distends the Walls of the bag. Since the inner wall may be distended more readily than the outer wall, upon the application of a pulse of pressure, it will distend and gently squeeze the heart as described. The normal pressure which is applied to the inlet tube 7 may vary depending upon the particular bag, material, patient and other variables. However, a typical pressure would be for example 15 psi. The pressure would be applied in pulses at a variable rate also depending upon the situation. Normally however, 60 to pulses would be applied per minute.
Occasionally, it is desirable to apply pressure in a controlled manner. For example, it might be desirable to apply the squeezing pressure to the lower portion of the heart first, and then subsequently to the upper portion of the heart. This may be provided for in the arrangement as generally disclosed in FIGURE 1, by carefully varying the thickness of the inner wall. Thus for example, if the inner wall is made thinner at its apex 14, than at its upper area or edge 10, with a gradual or selected variation in the thickness between these two areas, the inner wall would distend and thereby apply pressure to the lower portion of the heart first and then subsequently to the upper portion of the heart. Thus by varying the thickness of the inner wall in any particularly desired area, the sequence in which the pressure is applied is controlled.
Another means of controlling the application of pressure for sequential applications of pressure to various portions, is illustrated in FIGURE 3. Here a bag of generally the same configuration as shown in FIGURE 1 is pro-,
vided having inner and outer walls 2 and 21 respectively. In this modification however, the inlet means for introducing pressure between the walls 26 and 21, is provided by a pair of inlet tubes 22 and 23. These inlet tubes may conveniently be located at the upper edge 24 of the bag, at positions adjacent the slot 25. The slot 25 extends downwardly substantially the height of the bag. The interior of the bag between the walls 20 and 21, is divided in two by, '21 preferably, integrally molded divider 26 which extends from the upper edge 24 to the apex 28 at the side opposite the slot 25 and continues upwardly to the lowermost point of the slot 25, thereby eifectively dividing the interior of the bag between the walls 20 and 21 into two separate compartments each having a separate air inlet. In this arrangement each separate 'air inlet may be connected to a pneumatic or hydraulic device for separately controlled introduction of pressures into the separate chambers.
. Itwill be noted that this device may alsobe used in conjunction with a sensing instrument which is sensitive to the arterial pressure of the patient. In this manner the pressure or amount of squeeze on the heart may be automatically controlled for the maintaining of a selected and established arterial pressure. v Having described my invention, I claim:
1. A heart massaging device formed of flexible material comprising a bag-like member having a globlet-like shape, open at the wide end and having a slot extending from said Wide end toward the vertex of said shape, said member formed of inner and outer walls joined together at their periphery including said wide end and slot and forming therebetween an enclosing space, said outer wall having a thickness substantially greater than said inner wall whereby said inner wall will distend on application of pressure to said space at a greater rate than said outer wall, and inlet means positioned at the vertex of said shape for introducing pulsating pressure into said space.
2. A device as set forth in claim 1 wherein said inner wall has a different thickness in different portions of said inner wall whereby the thinner portions will distend at a rate greater than the thicker portion on application of pressure into said space.
3. A heart massaging device formed of a flexible material comprising a bag-like member having a goblet-like shape, open at the wide end and having a slot extending from said wide end longitudinally toward the vertex of said shape, said member formed of inner and outer walls joined together at their periphery including said Wide end and said slot and forming therebetween an enclosing space, said inner and outer Walls flared outwardly and lying in face to face relation at said slot and forming thereby an outwardly extending lip about the periphery of said slot, said outer wall having a thickness substantially greater than said inner wall whereby said inner wall will distend on application of pressure to said space at a greater rate than said outer wall and inlet means positioned at the vertex of said shape for introducing pulsating pressure into said space.
4. A device set forth in claim 1 wherein the peripheries of said outer and inner walls at said wide end are bowed slightly inwardly to form a construction at said wide end.
References Cited in the file of this patent OTHER REFERENCES Surgery, volume 39, -No. 3, pp. 376-377, March 1956.