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    Methods and devices for minimally invasive coronary artery revascularization on a beating heart without cardiopulmonary bypass
    11.
    发明授权
    Methods and devices for minimally invasive coronary artery revascularization on a beating heart without cardiopulmonary bypass 失效
    在没有体外循环的搏动心脏上进行微创冠状动脉血运重建的方法和装置

    公开(公告)号：US5875782A

    公开(公告)日：1999-03-02

    申请号：US752741

    申请日：1996-11-14

    申请人： Richard M. Ferrari ,  Charles S. Taylor ,  Jack W. Lasersohn ,  Federico J. Benetti ,  Jodi J. Akin ,  Richard Ginn ,  Amr Salahieh

    发明人： Richard M. Ferrari ,  Charles S. Taylor ,  Jack W. Lasersohn ,  Federico J. Benetti ,  Jodi J. Akin ,  Richard Ginn ,  Amr Salahieh

    IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B17/34 ,  A61B19/00

    CPC分类号： A61B17/0206 ,  A61B2017/00243 ,  A61B2017/0243 ,  A61B2017/3484 ,  A61B2017/3486 ,  A61B2017/3492

    摘要： Methods and devices for revascularization of a patient's coronary artery system which obviate the need to place the patient on cardiopulmonary bypass. A method is provided for revascularizing a patient while the-heart is beating, and includes performing at least one minimally invasive coronary artery bypass graft procedure, or other cardiac surgical procedure, and contemporaneously performing at least one catheter-based procedure in at least one coronary artery. The catheter-based procedure(s) may be either therapeutic or diagnostic or both, and may involve delivering at least one catheter to a coronary artery via a surgical or percutaneous opening in the thoracic cavity or via a percutaneous opening at a location peripheral to the thoracic cavity. The catheter-based procedure or procedures is performed contemporaneously with the bypass graft procedure, and specifically prior to, during, or after anesthetizing the patient for purposes of the bypass graft procedure. An arterial access device is also provided for central cannulation and direct intraoperative catheterization of a patient's coronary artery system on a beating heart. The device includes a tubular member, such as a cannula, having a proximal end and a distal end, and an elongated puncturing member, such as a trocar, which is slideably disposed within the tubular member. The puncturing member has a sharp distal end for puncturing through the wall of a coronary lumen. The arterial access device further includes a sealing member for engaging the coronary lumen wall at the puncture site in order to minimize the leakage of blood from the puncture site.

    摘要翻译： 用于患者冠状动脉系统血运重建的方法和装置，其不需要将患者置于体外循环。 提供了一种在心脏跳动时使患者血运重建的方法，并且包括执行至少一种微创冠状动脉旁路移植手术或其他心脏外科手术，同时在至少一个冠状动脉中执行至少一个基于导管的程序 动脉。 基于导管的程序可以是治疗性的或诊断的或两者都可以，并且可以涉及通过胸腔中的手术或经皮开口或通过在外周的位置处的经皮开口将至少一个导管递送到冠状动脉 胸腔。 基于导管的程序或程序与旁路移植手术同时进行，特别是在麻醉患者之前，期间或之后进行旁路移植手术。 还提供了一种动脉通路装置，用于中心插管并且在搏动心脏上直接对患者的冠状动脉系统进行导管插入。 该装置包括具有近端和远端的管状构件，例如插管，以及可滑动地设置在管状构件内的细长的穿刺构件，例如套管针。 穿刺构件具有用于刺穿冠状腔的壁的尖锐远端。 动脉进入装置还包括密封构件，用于在穿刺部位处与冠状腔壁接合，以便使来自穿刺部位的血液泄漏最小化。

    Xyphoid access for cardiac surgical procedures
    13.
    发明授权
    Xyphoid access for cardiac surgical procedures 失效
    用于心脏外科手术的螺钉通道

    公开(公告)号：US06736774B2

    公开(公告)日：2004-05-18

    申请号：US09757128

    申请日：2001-01-08

    申请人： Federico J. Benetti ,  Charles S. Taylor ,  Michael V. Morejohn

    发明人： Federico J. Benetti ,  Charles S. Taylor ,  Michael V. Morejohn

    IPC分类号： A61B132

    CPC分类号： A61B17/0206 ,  A61B17/02 ,  A61B17/0293 ,  A61B2017/0237 ,  A61B2017/0243

    摘要： Surgical procedures on the beating heart are enabled by an incision made in the xyphoid area and specially designed retractors and related devices to facilitate cardiac surgical procedures. Specifically, coronary artery bypass graft procedures (CABG) are achieved using a vertically offsetting retractor or access platform in combination with a beating heart stabilizer. The surgical methodology permits procedures such as the CABG procedure without penetrating the rib cage or performing a sternotomy or thorocotomy.

    摘要翻译： 在心脏跳动的外科手术可以通过在假体区域中进行的切口和专门设计的牵开器和相关装置来促进心脏手术。 具体来说，冠状动脉旁路移植手术（CABG）使用垂直抵消的牵开器或进入平台与跳动心脏稳定器组合来实现。 手术方法允许诸如CABG手术的过程，而不穿透肋骨架或执行胸骨切开术或胸腔切开术。

    Surgical method for stabilizing the beating heart during coronary artery bypass graft surgery
    15.
    发明授权
    Surgical method for stabilizing the beating heart during coronary artery bypass graft surgery 失效
    冠状动脉旁路移植手术中稳定跳动心脏的手术方法

    公开(公告)号：US5894843A

    公开(公告)日：1999-04-20

    申请号：US603758

    申请日：1996-02-20

    申请人： Federico J. Benetti ,  Charles S. Taylor ,  Ivan Sepetka ,  Amr Salahieh ,  Robert C. Glines ,  William N. Aldrich ,  Brent Regan ,  John J. Frantzen

    发明人： Federico J. Benetti ,  Charles S. Taylor ,  Ivan Sepetka ,  Amr Salahieh ,  Robert C. Glines ,  William N. Aldrich ,  Brent Regan ,  John J. Frantzen

    IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B17/064 ,  A61B17/11 ,  A61B17/12 ,  A61B17/28 ,  A61B17/30 ,  A61B17/34 ,  A61B19/00

    CPC分类号： A61B17/0218 ,  A61B17/00234 ,  A61B17/0206 ,  A61B17/3423 ,  A61B90/00 ,  A61B17/02 ,  A61B17/0642 ,  A61B17/12 ,  A61B17/3421 ,  A61B2017/00243 ,  A61B2017/00557 ,  A61B2017/00703 ,  A61B2017/00858 ,  A61B2017/0243 ,  A61B2017/1139 ,  A61B2017/2825 ,  A61B2017/2913 ,  A61B2017/2929 ,  A61B2017/306 ,  A61B2017/349

    摘要： The invention is methods and devices which a surgeon may use to stabilize the beating heart during a surgical procedure on the heart. Pursuant to the invention, a stabilizing device is introduced through an opening in the chest and brought into contact with the beating heart. By contacting the heart with the device and by exerting a stabilizing force on the device, the motion of the heart caused by the contraction of the heart muscles is effectively eliminated such that the heart is stabilized and the site of the surgery moves only minimally if at all. Typically, in separate steps, the surgeon contacts the heart with the stabilizing device, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing device such that the contraction of the beating heart causes only minimal excess motion at the surgery site. By fixing the position of the stabilizing device in a configuration where the motion of the beating heart is effectively eliminated, the surgeon is able to stabilize the beating heart for the duration of the procedure. The stabilizing device may be attached to a rigid support or may be attached to a semi-rigid support which is rendered motionless mechanically, chemically, or by human intervention. In certain preferred embodiments, the stabilizing device is affixed to a semi-rigid support which is caused to become rigid, by any of a variety of techniques, such that the position of the stabilizing device becomes fixed by the support, and the heart remains substantially motionless for the duration of the procedure.

    摘要翻译： 本发明是外科医生可以在心脏手术过程中稳定跳动心脏的方法和装置。 根据本发明，稳定装置通过胸部的开口引入并与打浆心接触。 通过将心脏与装置接触并且通过在装置上施加稳定力，由心脏肌肉收缩引起的心脏的运动被有效地消除，使得心脏稳定，并且手术部位仅在最小程度上移动，如果在 所有。 通常，在单独的步骤中，外科医生与稳定装置接触心脏，评估吻合部位的移动程度，并且在稳定装置上施加力，使得跳动心脏的收缩在手术时仅引起极小的过度运动 现场。 通过将稳定装置的位置固定在跳动心脏的运动被有效地消除的构造中，外科医生能够在手术期间稳定跳动的心脏。 稳定装置可以附接到刚性支撑件，或者可以附接到半刚性支撑件，其通过机械，化学方式或通过人为干预使其不动。 在某些优选实施例中，稳定装置通过各种技术中的任何一种固定到刚性刚性的半刚性支撑件上，使得稳定装置的位置由支撑件固定，心脏基本保持 在程序期间不动。

    Surgical instruments for stabilizing the beating heart during coronary bypass graft surgery
    18.
    发明授权
    Surgical instruments for stabilizing the beating heart during coronary bypass graft surgery 失效
    用于在冠状动脉旁路移植手术期间稳定跳动心脏的手术器械

    公开(公告)号：US06213941B1

    公开(公告)日：2001-04-10

    申请号：US09102827

    申请日：1998-06-23

    申请人： Federico J. Benetti ,  Charles S. Taylor

    发明人： Federico J. Benetti ,  Charles S. Taylor

    IPC分类号： A61B132

    CPC分类号： A61B17/0218 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0642 ,  A61B17/12 ,  A61B17/3421 ,  A61B17/3423 ,  A61B90/00 ,  A61B2017/00243 ,  A61B2017/00557 ,  A61B2017/00703 ,  A61B2017/00858 ,  A61B2017/0243 ,  A61B2017/1139 ,  A61B2017/2825 ,  A61B2017/2913 ,  A61B2017/2929 ,  A61B2017/306 ,  A61B2017/349

    摘要： The invention is methods and devices which a surgeon may use to stabilize the beating heart during a surgical procedure on the heart. Pursuant to the invention, a stabilizing device is introduced through an opening in the chest and brought into contact with the beating heart. By contacting the heart with the device and by exerting a stabilizing force on the device, the motion of the heart caused by the contraction of the heart muscles is effectively eliminated such that the heart is stabilized and the site of the surgery moves only minimally if at all. Typically, in separate steps, the surgeon contacts the heart with the stabilizing means, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing means such that the contraction of the beating heart causes only minimal excess motion at the surgery site. By fixing the position of the stabilizing means in a configuration where the motion of the beating heart is effectively eliminated, the surgeon is able to stabilize the beating heart for the duration of the procedure. The stabilizing means may be attached to a rigid support or may be attached to a semi-rigid support which is rendered motionless mechanically, chemically, or by human intervention. In certain preferred embodiments, the stabilizing means is affixed to a semi-rigid support which is caused to become rigid, by any of a variety of techniques, such that the position of the stabilizing means becomes fixed by the support, and the heart remains substantially motionless for the duration of the procedure.

    摘要翻译： 本发明是外科医生可以在心脏手术过程中稳定跳动心脏的方法和装置。 根据本发明，稳定装置通过胸部的开口引入并与打浆心接触。 通过将心脏与装置接触并且通过在装置上施加稳定力，由心脏肌肉收缩引起的心脏的运动被有效地消除，使得心脏稳定，并且手术部位仅在最小程度上移动，如果在 所有。 通常，在单独的步骤中，外科医生将心脏与稳定装置接触，评估吻合部位的移动程度，并对稳定装置施加力，使得跳动心脏的收缩在手术时仅引起极小的过度运动 现场。 通过将稳定装置的位置固定在跳动心脏的运动被有效地消除的构造中，外科医生能够在手术期间稳定跳动的心脏。 稳定装置可以附接到刚性支撑件，或者可以附接到半刚性支撑件，其通过机械，化学方式或通过人为干预使其不动。 在某些优选实施例中，稳定装置通过各种技术中的任一种被固定到半刚性支撑件上，使其变得刚性，使得稳定装置的位置由支撑件固定，并且心脏基本保持 在程序期间不动。

    Xyphoid access for cardiac surgical procedures
    19.
    发明授权
    Xyphoid access for cardiac surgical procedures 失效
    用于心脏外科手术的螺钉通道

    公开(公告)号：US06199556B1

    公开(公告)日：2001-03-13

    申请号：US09071757

    申请日：1998-05-01

    申请人： Federico J. Benetti ,  Charles S. Taylor ,  Michael V. Morejohn

    发明人： Federico J. Benetti ,  Charles S. Taylor ,  Michael V. Morejohn

    IPC分类号： A61B1900

    CPC分类号： A61B17/0206 ,  A61B17/02 ,  A61B17/0293 ,  A61B2017/0237 ,  A61B2017/0243

    摘要： Surgical procedures on the beating heart are enabled by an incision made in the xyphoid area and specially designed retractors and related devices to facilitate cardiac surgical procedures. Specifically, coronary artery bypass graft procedures (CABG) are achieved using a vertically offsetting retractor or access platform in combination with a beating heart stabilizer. The surgical methodology permits procedures such as the CABG procedure without penetrating the rib cage or performing a sternotomy or thorocotomy.

    摘要翻译： 在心脏跳动的外科手术可以通过在假体区域中进行的切口和专门设计的牵开器和相关装置来促进心脏手术。 具体来说，冠状动脉旁路移植手术（CABG）使用垂直抵消的牵开器或进入平台与跳动心脏稳定器组合实现。 手术方法允许诸如CABG手术的过程，而不穿透肋骨架或执行胸骨切开术或胸腔切开术。

    Perfusion device for maintaining blood flow in a vessel while isolating an anastomosis
    20.
    发明授权
    Perfusion device for maintaining blood flow in a vessel while isolating an anastomosis 失效
    用于在分离吻合期间维持血管中的血液流动的灌注装置

    公开(公告)号：US06071297A

    公开(公告)日：2000-06-06

    申请号：US956164

    申请日：1997-10-22

    申请人： Amr Salahieh ,  Charles S. Taylor ,  Alfredo R. Cantu ,  Ivan Sepetka ,  Robert G. Matheny

    发明人： Amr Salahieh ,  Charles S. Taylor ,  Alfredo R. Cantu ,  Ivan Sepetka ,  Robert G. Matheny

    IPC分类号： A61B17/11 ,  A61B17/12 ,  A61M29/00

    CPC分类号： A61B17/12045 ,  A61B17/11 ,  A61B17/12109 ,  A61B17/12131 ,  A61B17/12136 ,  A61B2017/12127

    摘要： A plurality of embodiments of a distal perfusion device are disclosed, which device facilitates anastomosis constructions by maintaining a dry anastomosis site while simultaneously maintaining blood flow distally in the blood vessel to prevent ischemia and reduce overall patient trauma. The perfusion device is configured for installation into a blood vessel such as a left anterior descending coronary artery through an incision therein, to which is to be grafted a distal end of a blood vessel such as an internal mammary artery. The device includes a central member of selected configuration and material, terminating at either end thereof in respective selectively tapered end members. A lumen extending through the central member and end members, and selected perforations in the end members, maintain blood flow through the perfusion device. A selected portion or portions of the device's outer circumference fit snugly within the artery in the regions beyond and/or at the anastomosis site, to maintain the latter free of blood. Several methods for deploying and removing respective embodiments of the device also are illustrated.

    摘要翻译： 公开了一种远端灌注装置的多个实施例，该装置通过维持干吻合部位来促进吻合结构，同时在血管中保持血液向远端流动以防止局部缺血并减少总的患者创伤。 灌注装置被构造成通过其中的切口安装到诸如左前降支冠状动脉的血管中，其将被移植到诸如内部乳腺动脉的血管的远端。 该装置包括选定构型和材料的中心构件，其终端位于相应的选择性锥形端构件的任一端。 延伸穿过中心构件和端构件的内腔以及端构件中选择的穿孔保持血流通过灌注装置。 装置的外周的选定部分或部分适合紧贴在吻合部位之外和/或处于吻合部位的区域内的动脉内，以保持后者无血液。 还示出了用于部署和移除设备的各个实施例的几种方法。