公开(公告)号：US08313457B2

公开(公告)日：2012-11-20

申请号：US11699668

申请日：2007-01-29

申请人： Gary W. Guenst

发明人： Gary W. Guenst

IPC分类号： A61M31/00 ,  A61M37/00 ,  A61M25/00

CPC分类号： A61B17/11 ,  A61B17/12045 ,  A61B2017/00252 ,  A61B2017/1107 ,  A61B2017/3419

摘要： Methods and devices for perfusing a blood vessel during the entire course of an end-to-side or end-to-end anastomosis procedure. One method can be used to form an end-to-side anastomosis of a saphenous vein graft to a coronary artery during an off-pump, beating heart, coronary artery bypass graft. In this example, the distal end of an elongate tube carrying a saphenous vein graft is advanced into an arteriotomy distal to an occlusion in the coronary artery. Perfusing blood flow is provided through the tube to the coronary artery, the vein graft is advanced over the tube to the arteriotomy and sutured completely to the coronary artery. The elongate tube can be retracted through the now secured vein graft, and the coronary artery supplied again from the proximal end of the vein graft. Some tubular devices include a reversibly expandable distal region, to form a seal between the inserted tube and the coronary artery being perfused, to prevent blood flow into the surgical field.

摘要翻译： 在端对端或端对端吻合手术的整个过程中灌注血管的方法和装置。 一种方法可以用于在非抽血，跳动心脏，冠状动脉旁路移植术期间形成隐静脉移植物到冠状动脉的端对侧吻合。 在该示例中，携带隐静脉移植物的细长管的远端进入远端冠状动脉闭塞的动脉切开术。 将血流通过管道提供给冠状动脉，静脉移植物在管上前进到动脉切开术并且完全缝合到冠状动脉。 细长管可以通过现在固定的静脉移植物缩回，并且从静脉移植物的近端再次供应冠状动脉。 一些管状装置包括可逆扩展的远端区域，以在插入的管和被灌注的冠状动脉之间形成密封，以防止血液流入手术区域。

公开(公告)号：US06786898B2

公开(公告)日：2004-09-07

申请号：US10342960

申请日：2003-01-15

申请人： Gary W. Guenst

发明人： Gary W. Guenst

IPC分类号： A61B1700

CPC分类号： A61B17/0218 ,  A61B2017/00247 ,  A61B2017/306 ,  A61B2018/00392

摘要： A tubular access sleeve and suction tool for accessing an anatomic surface or anatomic space and particularly the pericardium to access pericardial space and the epicardial surface of the heart in a minimally invasive manner are disclosed. A suction tool trunk extending through a suction tool lumen of the sleeve is coupled to suction pads at the ends elongated support arms. The suction pads can be retracted into a sleeve working lumen during advancement of the access sleeve through a passage and deployed from the tubular access sleeve lumen and disposed against the an outer tissue layer. Suction can be applied through suction tool lumens to suction ports of the suction pads that fix to the outer tissue layer so as to tension the outer tissue layer and/or pull the outer tissue layer away from an inner tissue layer so that the anatomic space can be accessed by instruments introduced through the working lumen to penetrate the outer tissue layer.

公开(公告)号：US07063693B2

公开(公告)日：2006-06-20

申请号：US10902314

申请日：2004-07-29

申请人： Gary W. Guenst

发明人： Gary W. Guenst

IPC分类号： A61B17/00

CPC分类号： A61B17/0218 ,  A61B2017/00247 ,  A61B2017/306 ,  A61B2018/00392

摘要： A tubular access sleeve and suction tool for accessing an anatomic surface or anatomic space and particularly the pericardium to access pericardial space and the epicardial surface of the heart in a minimally invasive manner are disclosed. A suction tool trunk extending through a suction tool lumen of the sleeve is coupled to suction pads at the ends elongated support arms. The suction pads can be retracted into a sleeve working lumen during advancement of the access sleeve through a passage and deployed from the tubular access sleeve lumen and disposed against the an outer tissue layer. Suction can be applied through suction tool lumens to suction ports of the suction pads that fix to the outer tissue layer so as to tension the outer tissue layer and/or pull the outer tissue layer away from an inner tissue layer so that the anatomic space can be accessed by instruments introduced through the working lumen to penetrate the outer tissue layer.

公开(公告)号：US09220490B2

公开(公告)日：2015-12-29

申请号：US11411271

申请日：2006-04-26

申请人： Gary W. Guenst

发明人： Gary W. Guenst

IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B17/30 ,  A61B18/00

CPC分类号： A61B17/0218 ,  A61B2017/00247 ,  A61B2017/306 ,  A61B2018/00392

摘要： A tubular access sleeve and suction tool for accessing an anatomic surface or anatomic space and particularly the pericardium to access pericardial space and the epicardial surface of the heart in a minimally invasive manner are disclosed. A suction tool trunk extending through a suction tool lumen of the sleeve is coupled to suction pads at the ends elongated support arms. The suction pads can be retracted into a sleeve working lumen during advancement of the access sleeve through a passage and deployed from the tubular access sleeve lumen and disposed against the an outer tissue layer. Suction can be applied through suction tool lumens to suction ports of the suction pads that fix to the outer tissue layer so as to tension the outer tissue layer and/or pull the outer tissue layer away from an inner tissue layer so that the anatomic space can be accessed by instruments introduced through the working lumen to penetrate the outer tissue layer.

摘要翻译： 公开了用于访问解剖学表面或解剖空间的管状进入套管和抽吸工具，特别是以心脏微创方式进入心包空间和心外膜表面的心包。 延伸穿过套筒的吸入工具内腔的吸引工具躯干在端部细长的支撑臂处联接到吸盘。 在进入套筒通过通道并且从管状进入套管内腔展开并且抵靠外部组织层设置时，吸盘可以缩回到套筒工作腔中。 吸力可以通过吸入工具流体施加到固定到外部组织层的吸盘的吸入口，以便张紧外部组织层和/或将外部组织层拉离内部组织层，使得解剖空间可以 可通过工作腔引入的仪器进入，以穿透外部组织层。

公开(公告)号：US07146225B2

公开(公告)日：2006-12-05

申请号：US10283794

申请日：2002-10-30

申请人： Gary W. Guenst ,  Gerard C. Forest

发明人： Gary W. Guenst ,  Gerard C. Forest

IPC分类号： A61B1/00

CPC分类号： A61N1/0587

摘要： An epicardial lead installation tool having an elongated tool body extending between a tool body proximal and distal ends and encloses a tool body lumen. At least one suction pad supported by a suction pad strut extends distally to a distal end surface of the tool body distal end. A lead implantation tool extending between implantation tool proximal and distal ends is inserted through the tool body lumen to dispose the implantation tool distal end proximate to the tool body distal end. The lead implantation tool distal end is adapted to engage the distal electrode head of an epicardial lead to enable the extension of the assembly of the of the lead installation tool, the lead implantation tool and the epicardial lead through a skin incision and to apply the suction pad against the epicardium. Suction is applied through the suction pad to affix it to the epicardium while the implantation tool proximal end is manipulated to affix the distal fixation mechanism to the myocardium at the implantation site.

摘要翻译： 一种心外膜引导安装工具，其具有在工具主体近端和远端之间延伸的细长工具主体并且包围工具体腔。 由吸盘支柱支撑的至少一个吸盘向远端延伸到工具主体远端的远端表面。 在植入物近端和远端之间延伸的引导植入工具被插入穿过工具体腔，以将植入物远端靠近工具主体远端。 引导植入工具远端适于接合心外膜导线的远端电极头，以使引线安装工具，引线植入工具和心外膜引导件的组件能够延伸通过皮肤切口并且将吸力 垫对着心外膜。 通过吸盘施加抽吸以将其固定到心外膜，同时操作植入工具近端以将植入位置处的远端固定机构固定到心肌。