Abstract:
This invention is a coronary shunt (800B) for occluding both sides of an anastomosis site, and providing a blood flow path across the anastomosis site. The shunt includes two occluding members (802B) sized and configured to occlude the coronary artery. A tether (808) is attached to the coronary shunt, and is used to remove the coronary shunt from the coronary artery before completing the anastomosis.
Abstract:
A parallax reduction device (2) configured to be coupled to a pair of surgical telescopes. The surgical telescopes include two lenses each having holes therethrough which receive magnifying elements. The parallax reduction device includes engaging elements (6, 8) which attach to the magnifying elements. The engaging elements are mounted to a body (4) having first and second reflective surfaces (18, 20) and a front opening (10). Third and fourth reflective surfaces (36, 38) are positioned to receive the light passing through the opening and reflected off the first and second reflective surfaces. The engaging elements are linearly and rotatable movable relative to the body so that the parallax reduction device may be fitted to the particular angular orientation and spacing of the magnifying elements.
Abstract:
A flexible, length-adjustable suture organizer coupled to a retractor having a number of flexible straps. The straps are tensioned to retract tissue while the suture organizer is used to retain sutures extending through an opening created by the retractor. The retractor includes a holder which retains the suture organizer.
Abstract:
Surgical clips, are provided for tissue approximation and attachment, and more particularly, for sealingly joining a graft vessel to a target vessel. The graft vessel has a free end and a graft vessel wall defining a graft lumen. The target vessel has a target vessel wall defining a target lumen and has an opening in the target vessel wall. The anastomosis clip (20) includes a clip body (22) having a distal extremity (24) with a distal end (28) and a proximal extremity (26) with a proximal end (36). The distal end is configured to penetrate through the graft vessel wall near the free end and through the target vessel wall near the opening such that both the distal and proximal ends of the clip body are outside the graft and target vessels. At least a portion of the clip body is shapable so as to compress the graft vessel wall against the target vessel wall with the target vessel lumen in communication with the graft vessel lumen.
Abstract:
The invention provides devices and methods for suture placement while performing less invasive surgical procedures within a body cavity. In an exemplary embodiment, the invention provides for the placement of sutures (24) within the heart (H) or a great vessel that is accessed from outside the closed chest. According to one exemplary method, the patient's heart valve is accessed through an intercostal port (56) in the patient's chest. At least, one needle (26) having a suture (24) is then directed into the annulus while visualizing through the port placement (56) of the needle into the annulus. The needle (26) is then passed through the annulus.
Abstract:
Systems and methods are disclosed for performing less invasive surgical procedures within the heart. A method for less invasive repair or replacement of a cardiac valve (216) comprises placing an instrument (290) through an intercostal access port (212) and through a penetration in a wall of a vessel in communication with the heart, advancing the instrument (290) into the heart, using the instrument (290) to perform a surgical intervention on a cardiac valve (216) in the heart under visualization through an intercostal access port. The surgeons hands are kept outside of the chest during each step. The surgical intervention may comprise replacing the cardiac valve with a prosthetic valve, wherein the native valve is removed using a tissue removal instrument (206), the native valve annulus is sized with a specialized sizing device (216), a prosthetic valve is introduced through an intercostal access port (212) and through the penetration in the vessel, and the prosthetic valve is secured at the native valve position, all using instruments positioned through intercostal access ports without placing the hands inside the chest. Systems and devices for performing these procedures are also disclosed.
Abstract:
This invention is a clamp (304F) for clamping a body structure in a patient. The clamp includes a flexible cable (442) housed within a sheath (440). The cable and sheath extend between a clamp (304F) and a handle (460). The cable extends through a sheath which is anchored at the clamp and the actuator for actuating jaws from a proximal end of the clamp. A malleable positioner (306F) is provided for positioning the clamp about the body structure.
Abstract:
This invention is a system for inducing cardio-plegia arrest and performing an endovascular procedure within the heart or blood vessels of a patient. An endo-aortic partitioning catheter (10) has an inflatable balloon (11) which occludes the ascending aorta (12) when inflated. Cardio-plegia fluid may be infused through a lumen of the endo-aortic partitioning catheter (39) to stop the heart while the patient's circulatory system is supported on cardiopulmonary bypass. One or more endovascular devices (500) are introduced through an internal lumen (40) of the endo-aortic partitioning catheter (30) to perform a diagnostic or therapeutic endovascular procedure within the heart or blood vessels of the patient. Surgical procedures such as coronary artery bypass surgery or heart valve replacement may be performed in conjunction with the endovascular procedure while the heart is stopped. Embodiments of the system are described for performing, e.g., fiberoptic angioscopy of structures within the heart and its blood vessels, and valvuloplasty for correction of valvular stenosis.
Abstract:
A retrograde delivery catheter (10) includes at its distal end a balloon (11) configured to occlude the coronary sinus (21) of a patient's heart, and has a length and flexibility which allow the distal end to be positioned in the coronary sinus (21) with the proximal end extending trans-luminal to a peripheral vein such as an internal jugular vein (44) and out of the body through a puncture (24) therein. The delivery catheter (20) has a delivey lumen (128) extending between its proximal and distal ends which is configured to allow a cardioplegia fluid to be delivered at a flow rate of at least 200 ml/min with a pump pressure less than 300 mm Hg, thereby allowing cardioplegia arrest to be maintained using a blood cardioplegia fluid without causing excessive hemolysis. In a method of inducing cardioplegia arrest according to the invention, the patient is placed on cardiopulmonary bypass (18), the coronary arteries (50, 51) are isolated from remainder of the arterial system, and the delivery catheter (10) is positioned trans-luminal in the coronary sinus (21) from a peripheral vein.
Abstract:
A surgical knot pusher device (11) is described which has a knot pushing head (13) mounted on the distal end of an elongated rod (12). The head of the device has a smoothly radius knot pushing surface (15) on the leading edge with two symmetrical suture paths (16, 17) which curve smoothly away from the knot pushing surface. The suture rests in a shallow groove which has a wall on either side to keep the suture in the groove (19). Near the leading edge of the pushing head the walls of the groove are lower so that the knot can be pushed directly against the tissue being sutured. On one side of the knot pushing head, there is a single eyelet (18) in the path of one of the suture ends. The eyelet is made so that the suture can be easily threaded through the eyelet with the curved needle which is on the end of the suture without any need to remove the needle. Preferably, at least the head of the device is made from polysulfide or another suitable plastic material. A method of using the surgical knot pusher device for tying knots in sutures to secure a valve prosthesis in place during closed chest mitral valve replacement surgery is described.