Blood Vessel Tester

The present invention relates to a blood-vessel tester for inspecting the degree of clearness or unobstructedness inside a blood vessel as well as the blood flow therein.

After an operation for vascular transplantation has been performed on a human body, it is a common practice to inspect to determine whether or not the sutured parts of the operated blood vessels are uncontracted and whether or not the above blood vessels are unobstructed, so as to learn whether or not the postoperative course is uneventful.

If, for instance, there is any contraction or obstruction in the coronary artery, angina pectoris or myocardial infarction will occur. In one of the methods of treating such a disease, an operation is performed which connects a bypass blood vessel at one end thereof to the coronary artery and at the other end thereof to the aorta by anastomosis so that the bypass blood vessel may share the blood flow with the coronary artery. In this case, the postoperative condition of the patient depends mainly upon the degree of clearness inside the bypass blood vessel and the blood flow rate therein; therefore, it is indispensable for such an operation as above to inspect the degree of clearness inside the bypass blood vessel and the blood flow rate therein. The method heretofore adopted for this purpose is to insert a catheter into a peripheral artery either exposed or tapped through the skin under a locally anesthetized condition and then to introduce the catheter into the bypass blood vessel while transfusing a contrast medium into the blood for X-ray photography. This method is reliable in that it can directly observe the condition of blood flow; however, it has disadvantages in that it is low in sensitivity with respect to the degree of clearness inside the blood vessel and to the blood flow rate, it requires complicated techniques for operation, it cannot be performed without risk, it cannot be performed repeatedly because it gives mental and physical pain to the patient, and it requires great expense.

Therefore, it is an object of the present invention to provide a blood vessel tester which can inspect the degree of clearness inside a blood vessel and the blood flow therein very safely and accurately.

It is another object of the present invention to provide a blood vessel tester which can inspect the degree of clearness inside a blood vessel and the blood flow therein repeatedly without giving mental and physical pain to the patient.

It is still another object of the present invention to provide a blood vessel tester which can be operated very easily and inexpensively.

According to the present invention, two sets of thermocouples are connected, each at one junction, to two points on the surface of a blood vessel which points are properly spaced from each other, respectively, while their other junctions are kept at a predetermined temperature; and means are provided to detect the change of the thermoelectromotive forces of the respective thermocouples with time occurring when a cooling liquid is transfused into the blood vessel, so as to determine the degree of clearness inside the blood vessel and the blood flow rate therein.

FIG. 1 is a schematic drawing showing how the degree of clearness of a blood vessel and the blood flow therein are detected by use of a blood vessel tester according to one preferred embodiment of the present invention;

FIG. 2 is a graph showing the change of the thermoelectromotive forces of two thermocouples with time occurring when a cooling liquid is transfused into the blood vessel shown in FIG. 1 from point A toward point B, the above two thermocouples being connected to points A and B as shown, respectively;

FIGS. 3 and 4 are schematic drawings showing how the degree of clearness of a blood vessel and the blood flow therein are detected by the use of a blood vessel tester according to another preferred embodiment of the present invention; and

FIG. 5 is a schematic drawing showing how the degree of clearness of a blood vessel and the blood flow therein are detected by the use of a blood vessel tester according to still another preferred embodiment of the present invention.

The present invention will be hereinafter described in detail with reference to the accompanying drawings.

Reference is first made to FIG. 1. Reference character H designates the heart, and reference numerals 1 and 2 designate a transplanted bypass blood vessel and the diaphragm, respectively. Reference character T.sub.1 designates a first thermocouple, and T.sub.2 designates a second thermocouple. In the present invention, commonly-used thermocouples may be used, such as those of gold-silver, platinum--German silver, gold--German silver, platinum rhodium (60% platinum, 40% rhodium)--platinum rhodium (80% platinum, 20% rhodium), and iron-constantan.

It is necessary that the portions of the metal wires of the thermocouples with which the human body is or may come in contact should be coated with a proper material of low toxicity to living bodies, such as high molecular compounds and silicone.

Reference characters A and B designate junctions of the thermocouples T.sub.1 and T.sub.2, respectively. The junctions A and B are brought into contact with the outside or inside surface of the bypass blood vessel 1 by sewing, adhesion or butting, and they are positioned spaced from each other a predetermined distance.

Reference characters C designate the terminals of the thermocouple T.sub.1, which terminals are placed in contact with the diaphragm 2 by sewing or butting and these terminals are connected to a potentiometer 3. Reference characters D designate the terminals of the thermocouple T.sub.2, which terminals are placed in contact with the diaphragm 2 by sewing or butting and are connected to the potentiometer 3 like the terminals junctions C. Thus these terminals C and D' are kept substantially at the body temperature.

The temperature difference between the junction A and terminals C and that between the junction B and terminals D are usually very small and can hardly be detected by potentiometers. If, however, a cooling liquid is transfused into the blood through a peripheral artery, the thus cooled blood will flow into the bypass blood vessel 1 through the right atrium, right ventricle, lungs, left ventricle and aorta. Thus the junction A is first cooled and thereby the temperature difference between the junction A and terminals C is increased and, as a result, a thermoelectromotive force is created therebetween. As the cooling liquid passes across the junction A, the above-mentioned thermoelectromotive force gradually increases and then decreases as shown in FIG. 2, which shows a curve of the change of the thermoelectromotive force with time. After passing the junction A, the cooling liquid passes the junction B thereby cooling the junction B in the same manner as in the case of the junction A. Thus the temperature difference between the junction B and terminals D is increased and, as a result, a thermoelectromotive force is created therebetween. As the cooling liquid passes the junction B, the above-mentioned thermoelectromotive force gradually increases and then decreases in the same manner as in the case of the junction A. Thus the curve of the change of the thermoelectromotive force with time in this case is substantially similar in phase to that in the case of the junction A, as shown in FIG. 2. The period of time T required for the cooling liquid to pass through the distance between the junctions A and B may be obtained from the time difference between the corresponding points of the above two curves.

In this case, the blood flow rate in the blood vessel can be obtained from the following expression: ##EQU1## where l is the distance between the junctions A and B, T the period of time required for the cooling liquid to pass through the distance between junctions A and B, and r the inside diameter of the blood vessel.

The degree of clearness or unobstructedness of the blood vessel and the quality of operation can be judged from the blood flow rate thus obtained.

Another preferred embodiment of the present invention will be hereinafter described with reference to FIG. 3.

Reference character H.sub.2 designates the heart. Reference numeral 1b designates a bypass blood vessel provided by an operation. Reference characters T.sub.1a and T.sub.2a designate thermocouples, respectively. A.sub.1 and B.sub.1 designate the junctions of the thermocouples T.sub.1a and T.sub.2a, respectively. The junctions A.sub.1 and B.sub.1 are placed in contact with the surface of the blood vessel 1b, being positioned properly spaced from each other. Reference characters C.sub.1 and D.sub.1 designate other terminals of the thermocouples T.sub.1a and T.sub.2a, which terminals are placed in contact with the diaphragm 2a. Reference numerals 4a and 5a designate terminal plates provided at the ends of the thermocouple T.sub.1a. Reference numerals 6a and 7a designate terminal plates provided at the ends of the thermocouple T.sub.2a. The above terminal plates 4a, 5a, 6a and 7a are coated with material of low toxicity to living bodies such as high molecular compounds and silicone, being embedded beneath the skin of a patient. Reference numeral 3a designates a measuring instrument such as a potentiometer with or without an automatic recording function.

Reference numerals 4'a, 5'a, 6'a and 7'a designate metal needles connected to the measuring instrument 3a, respectively. These needles 4'a, 5'a, 6'a and 7'a are inserted in the skin, being electrically connected to the terminal plates 4a, 5a, 6a and 7a, respectively. In this embodiment, the clearness of the operated blood vessel and the quality of operation can be obtained substantially in the same manner as in the case of the first embodiment.

According to this embodiment, inspection of the blood vessel can be performed accurately and rapidly without giving much pain to the patient, because the metal needles can be brought into contact with the terminal plates very easily by externally inserting the metal needles into the skin of the patient.

Further another embodiment of the present invention will be hereinafter described with reference to FIG. 4.

Reference character A.sub.2 and B.sub.2 designate the junctions of the thermocouples T.sub.1 b and T.sub.2 b respectively. Reference character C.sub.2 and C.sub.2 ' designate other terminals of the thermocouple T.sub.1 b which are positioned out of the patients body and are kept at a definite temperature.

Reference character D.sub.2 and D.sub.2 ' also designate other terminals of the thermocouple T.sub.2 b which are kept at a definite temperature out of the patient's body as in C.sub.2 and C.sub.2 '. The terminals C.sub.2, C.sub.2 ', D.sub.2 and D.sub.2 ' are connected to the measuring instrument 3b with metal wires.

When a cooling liquid is transfused into the bypass blood vessel 1b through a peripheral artery, a thermoelectromotive force is created between the junction A.sub.2 and terminals C.sub.2 ' and whereby it is indicated on the measuring instrument 3b. As the cooling liquid passes through A.sub.2 to B.sub.2, a thermoelectromotive force is created with the thermocouple T.sub.2 b whereby it is indicated on the measuring instrument 3b. Then, according to the same procedure as that described in the foregoing, the degree of clearness inside the blood vessel and the blood flow rate therein may be determined.

Another embodiment of the present invention will be hereinafter described with reference to FIG. 5. Reference character A.sub.3 and B.sub.3 designate the junctions of the thermocouple on the surface of the bypass blood vessel 1C respectively which are connected to the measuring instrument 3C with metal wires so as to form a thermocouple.

According to this embodiment of the present invention, the degree of clearness inside the blood vessel and the blood flow rate therein may be determined by one set of a thermocouple.

Accordingly this procedure is simple.

A bypass blood vessel having a diameter of 4 mm was transplanted to a heart of a man and connecting the coronary artery and the aorta.

The respective junctions of two sets of copper-constantan thermocouples were fixed on two places on the surface of by bypass blood vessel which places were spaced from each other a distance of 5 cm. The terminals of the two sets of the thermocouples were fixed respectively in a thermostat which was located outside the man's body and was kept at 0.degree. C. 24 hours after the operation of closing the said man's chest was over, 7 ml of grape sugar solution at 0.degree. C. was transfused into the bypass blood vessel from the lower vena cava, whereby a maximum thermoelectromotive force of 25 .mu.V was created between the junctions and terminals of the two thermocouples, respectively, as shown in FIG. 2.

The period of time required for the cooling grape sugar solution to pass through the distance between the two junctions of the thermocouples which were fixed on the surface of the bypass blood vessel, was very short.

It was recognized from the result that the blood vessel was clear.

The degree of clearness in the bypass blood vessel described in Example 1 was inspected 2 weeks after the operation of closing the said man's chest over according to the same procedure as that described in Example 1, except that 10 ml of grape sugar solution at 0.degree. C. was transfused into the bypass vessel from the vein of the arm.

The maximum thermoelectromotive force was 15 .mu.V between the junctions and terminals of the two thermocouples, respectively.

It was recognized from the result that the blood vessel was still clear.