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    Guided cardiac ablation catheters
    31.
    发明授权
    Guided cardiac ablation catheters 有权
    引导心脏消融导管

    公开(公告)号：US08540704B2

    公开(公告)日：2013-09-24

    申请号：US10865558

    申请日：2004-06-10

    申请人： Gerald Melsky ,  Jeffrey M. Arnold ,  Edward L. Sinofsky ,  Norman E. Farr

    发明人： Gerald Melsky ,  Jeffrey M. Arnold ,  Edward L. Sinofsky ,  Norman E. Farr

    IPC分类号： A61B18/22

    CPC分类号： A61B18/1492 ,  A61B1/00045 ,  A61B1/00135 ,  A61B1/00165 ,  A61B1/00195 ,  A61B1/05 ,  A61B1/3137 ,  A61B18/1482 ,  A61B18/1815 ,  A61B18/22 ,  A61B18/24 ,  A61B2018/0022 ,  A61B2018/00351 ,  A61B2018/00375 ,  A61B2018/00577 ,  A61B2018/00982 ,  A61B2018/0212 ,  A61B2018/0262 ,  A61B2018/2261 ,  A61B2090/065 ,  A61B2090/3966 ,  A61N7/022 ,  A61N2005/1003

    摘要： Guided ablation instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias, including atrial fibrillation. In one aspect of the invention, a percutaneous catheter is disclosed with an endoscope positionable in the instrument's distal end region to obtain an image. The image allows the clinician to determine whether contact has been achieved (or blood has been cleared from an ablative energy transmission path) before ablation begins or while ablation is occurring. In one embodiment, percutaneous ablation catheters are disclosed having at least one central lumen and one or more balloon structures at the distal end region of the instrument. Also disposed in the distal end region are an illuminating light source and an endoscope capable of collecting sufficient light to relay an image to the user. The instruments can further include an ablation element. The ablation element can be a contact ablation element, or a radiant energy emitter, which is preferably independently positionable within the lumen of the instrument and adapted to project ablative energy through a transmissive region of the instrument body (and/or balloon) to a target tissue site proximate to the pulmonary veins. The energy can delivered without the need for contact between the energy emitter and the target tissue so long as a clear transmission pathway is established. The endoscope element of the instrument allows the clinician to determine the position of the instrument and, if radiant energy is to be employed, see if such a pathway is clear. Moreover, because the position of the radiant energy emitter can be varied, endoscopic guidance permits the clinician to select a desired location and dose for the lesion.

    摘要翻译： 公开了引导消融器械用于在组织中产生损伤，特别是用于治疗心律失常的心脏组织，包括房颤。 在本发明的一个方面，公开了一种经皮导管，其具有可置于仪器的远端区域中的内窥镜，以获得图像。 图像允许临床医生确定在消融开始之前还是在消融期间已经实现了接触（或者从消融能量传递路径中清除血液）。 在一个实施例中，公开了经皮消融导管，其在器械的远端区域具有至少一个中心腔和一个或多个气囊结构。 还设置在远端区域中的是能够收集足够的光以将图像中继给用户的照明光源和内窥镜。 仪器还可以包括消融元件。 消融元件可以是接触消融元件或辐射能发射器，其优选地可独立地定位在器械的内腔内并且适于将烧蚀能量穿过器械主体（和/或气囊）的透射区域投射到靶 靠近肺静脉的组织部位。 只要建立清晰的传输路径，能量可以传送而不需要能量发射器和目标组织之间的接触。 仪器的内窥镜元件允许临床医生确定仪器的位置，并且如果要使用辐射能量，看看这样的通路是否清晰。 此外，由于辐射能发射器的位置可以改变，所以内窥镜引导允许临床医生选择病变的期望位置和剂量。

    CARDIAC ABLATION SYSTEM WITH PULSED AIMING LIGHT
    33.
    发明申请
    CARDIAC ABLATION SYSTEM WITH PULSED AIMING LIGHT 有权
    具有脉冲瞄准光的心脏吸收系统

    公开(公告)号：US20110082449A1

    公开(公告)日：2011-04-07

    申请号：US12895969

    申请日：2010-10-01

    申请人： Gerald Melsky ,  Susan Ostrowski

    发明人： Gerald Melsky ,  Susan Ostrowski

    IPC分类号： A61B18/18

    CPC分类号： A61B18/24 ,  A61B90/361 ,  A61B2017/22051 ,  A61B2017/22059 ,  A61B2018/2025 ,  A61B2090/3618

    摘要： A method for treating a cardiac condition with visual inspection of a tissue treatment site includes the step of delivering an expanding member formed on a distal end of a catheter to a position adjacent a tissue treatment area within a patient's heart. The expandable member has an elastic portion configured to conform to the tissue treatment area. The method further includes the steps of expanding the expandable member thereby allowing the elastic portion of the expandable member to conform to the tissue treatment area and positioning an energy emitter at a first location within an inner lumen of the catheter. A visible aiming beam is projected during positioning of the energy emitter and ablative energy is delivered from the energy emitter to the tissue treatment area thereby resulting in a first spot lesion. The ablative energy is coincident with the aiming beam and the aiming beam is in the form of pulsed visible light to allow intermittent visual inspection of the first spot lesion at times when the aiming beam is not projected onto the tissue treatment area, thereby allowing visual inspection of the ablative characteristics and sufficiency of the first spot lesion.

    摘要翻译： 通过目视检查组织治疗部位来治疗心脏病状的方法包括将形成在导管的远端上的扩张部件输送到患者心脏内的组织处理区域附近的位置的步骤。 可扩张构件具有构造成符合组织处理区域的弹性部分。 该方法还包括以下步骤：使可膨胀构件膨胀，从而允许可膨胀构件的弹性部分与组织处理区域一致，并将能量发射器定位在导管的内腔内的第一位置处。 在能量发射器的定位期间投射可见的瞄准光束，并且消融能量从能量发射器传送到组织处理区域，从而导致第一斑点损伤。 烧焦能量与瞄准光束重合，瞄准光束呈脉冲可见光的形式，以允许在瞄准光束未投射到组织治疗区域时的第一斑点病变的间歇视觉检查，从而允许目视检查 的烧蚀特征和充足的第一斑点病变。

    Left ventricular conduits and methods for delivery
    35.
    发明申请
    Left ventricular conduits and methods for delivery 审中-公开
    左心室导管和输送方法

    公开(公告)号：US20050288685A1

    公开(公告)日：2005-12-29

    申请号：US11194457

    申请日：2005-08-02

    申请人： Marvin Gulles ,  Gerald Melsky

    发明人： Marvin Gulles ,  Gerald Melsky

    IPC分类号： A61B17/00 ,  A61F2/02 ,  A61F2/82 ,  A61F2/94 ,  A61F11/00

    CPC分类号： A61F2/94 ,  A61B2017/00252 ,  A61F2/2493 ,  A61F2/82 ,  A61F2220/0016 ,  A61F2230/0091

    摘要： Conduits are provided to direct blood flow from the left ventricle to a coronary artery at a location distal to a blockage in the coronary artery. Threaded and nonthreaded conduits are delivered using a guidewire delivered through the posterior and anterior walls of a coronary artery and into the heart wall. A dilator may be provided over the guidewire into the heart wall, and the conduit delivered over the dilator. An introducer sleeve may be provided over the dilator into the heart wall, the dilator removed, and the conduit delivered through the introducer sleeve. A hollow needle also may be inserted into the posterior and anterior walls of the coronary artery prior to inserting the guidewire. A depth measuring tool may determine the appropriate length of the conduit prior to delivery. The depth measuring tool can include the hollow needle with an access port on a proximal end of the needle and an opening on the distal end of the needle in flow communication with the access port so that when the needle is inserted through the heart wall and into the heart chamber, blood flow through the opening.

    摘要翻译： 提供导管以将血液从左心室引导至冠状动脉远端冠状动脉阻塞位置。 螺纹和无螺纹管道使用通过冠状动脉的后壁和前壁递送并进入心脏壁的导丝来递送。 可以将引导线上的扩张器设置到心脏壁中，并且导管在扩张器上传送。 引导器套筒可以在扩张器上方设置到心脏壁中，移除扩张器，并且导管通过导引器套筒输送。 在插入导丝之前，也可以将中空针插入冠状动脉的后壁和前壁。 深度测量工具可以在输送之前确定导管的适当长度。 深度测量工具可以包括具有针的近端上的进入口的中空针和针的远端上的开口，其与进入口流动连通，使得当针穿过心脏壁并进入 心室，血液流过开口。

    Methods of cardiac ablation in the vicinity of the right inferior pulmonary vein
    37.
    发明申请
    Methods of cardiac ablation in the vicinity of the right inferior pulmonary vein 审中-公开
    右下肺静脉附近心脏消融的方法

    公开(公告)号：US20050234436A1

    公开(公告)日：2005-10-20

    申请号：US11062774

    申请日：2005-02-22

    申请人： Lincoln Baxter ,  Jeffrey Arnold ,  Gerald Melsky

    发明人： Lincoln Baxter ,  Jeffrey Arnold ,  Gerald Melsky

    IPC分类号： A61B17/22 ,  A61B18/02 ,  A61B18/04 ,  A61B18/14 ,  A61B18/18 ,  A61B18/20 ,  A61B18/24 ,  A61N7/02

    CPC分类号： A61B18/24 ,  A61B18/1492 ,  A61B2017/22051 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00285 ,  A61B2018/00375 ,  A61B2018/0262 ,  A61N7/02

    摘要： The present invention provides devices and methods for the treatment of atrial fibrillation. In one embodiment a method for ablating tissue about an ostium of a right inferior vein of a heart includes positioning a sheath catheter having a deflectable distal end segment with a bent tip element in the left atrium of a heart, causing the distal end segment to deflect in a compound curve as the catheter is advanced towards an ostium of a right inferior vein, orienting said sheath catheter such that an ablation instrument can be delivered through the sheath catheter to a position proximal to the right inferior vein, and activating the ablation instrument to form at least one lesion about the right inferior vein.

    摘要翻译： 本发明提供了用于治疗房颤的装置和方法。 在一个实施例中，一种用于在围绕心脏右下静脉的口腔上消融组织的方法包括将具有可偏转远端段的鞘导管定位在心脏的左心房中的弯曲尖端元件，使远端段偏转 当导管朝向右下静脉的口向前进时的复合曲线中，使所述鞘导管定向，使得消融器械可以通过鞘导管输送到靠近右下静脉的位置，并且激活消融器械 形成关于右下静脉的至少一个病变。