摘要:
The invention provides devices and methods for performing less-invasive surgical procedures within an organ or vessel. In an exemplary embodiment, the invention provides a method of closed-chest surgical intervention within an internal cavity of a patient's heart or great vessel. According to the method, the patient's heart is arrested and cardiopulmonary bypass is established. A scope extending through a percutaneous intercostal penetration in the patient's chest is used to view an internal portion of the patient's chest. An internal penetration is formed in a wall of the heart or great vessel using cutting means introduced through a percutaneous penetration in an intercostal space in the patient's chest. An interventional tool is then introduced, usually through a cannula positioned in a percutaneous intercostal penetration. The interventional tool is inserted through the internal penetration in the heart or great vessel to perform a surgical procedure within the internal cavity under visualization by means of the scope. In a preferred embodiment, a cutting tool is introduced into the patient's left atrium from a right portion of the patient's chest to remove the patient's mitral valve. A replacement valve is then introduced through an intercostal space in the right portion of the chest and through the internal penetration in the heart, and the replacement valve is attached in the mitral valve position.
摘要:
A system for accessing a patient's cardiac anatomy which includes an endovascular aortic partitioning device that separates the coronary arteries and the heart from the rest of the patient's arterial system. The endovascular device for partitioning a patient's ascending aorta comprises a flexible shaft having a distal end, a proximal end, and a first inner lumen therebetween with an opening at the distal end. The shaft may have a preshaped distal portion with a curvature generally corresponding to the curvature of the patient's aortic arch. An expandable means, e.g. a balloon, is disposed near the distal end of the shaft proximal to the opening in the first inner lumen for occluding the ascending aorta so as to block substantially all blood flow therethrough for a plurality of cardiac cycles, while the patient is supported by cardiopulmonary bypass. The endovascular aortic partitioning device may be coupled to an arterial bypass cannula for delivering oxygenated blood to the patient's arterial system. The heart muscle or myocardium is paralyzed by the retrograde delivery of a cardioplegic fluid to the myocardium through patient's coronary sinus and coronary veins, or by antegrade delivery of cardioplegic fluid through a lumen in the endovascular aortic partitioning device to infuse cardioplegic fluid into the coronary arteries. The pulmonary trunk may be vented by withdrawing liquid from the trunk through an inner lumen of an elongated catheter. The cardiac accessing system is particularly suitable for removing the aortic valve and replacing the removed valve with a prosthetic valve.
摘要:
A system for accessing a patient's cardiac anatomy which includes an endovascular aortic partitioning device that separates the coronary arteries and the heart from the rest of the patient's arterial system. The endovascular device for partitioning a patient's ascending aorta comprises a flexible shaft having a distal end, a proximal end, and a first inner lumen therebetween with an opening at the distal end. The shaft may have a preshaped distal portion with a curvature generally corresponding to the curvature of the patient's aortic arch. An expandable means, e.g. a balloon, is disposed near the distal end of the shaft proximal to the opening in the first inner lumen for occluding the ascending aorta so as to block substantially all blood flow therethrough for a plurality of cardiac cycles, while the patient is supported by cardiopulmonary bypass. The endovascular aortic partitioning device may be coupled to an arterial bypass cannula for delivering oxygenated blood to the patient's arterial system. The heart muscle or myocardium is paralyzed by the retrograde delivery of a cardioplegic fluid to the myocardium through patient's coronary sinus and coronary veins, or by antegrade delivery of cardioplegic fluid through a lumen in the endovascular aortic partitioning device to infuse cardioplegic fluid into the coronary arteries. The pulmonary trunk may be vented by withdrawing liquid from the trunk through an inner lumen of an elongated catheter. The cardiac accessing system is particularly suitable for removing the aortic valve and replacing the removed valve with a prosthetic valve.
摘要:
Methods for welding a particle-matrix composite body to another body and repairing particle-matrix composite bodies are disclosed. Additionally, earth-boring tools having a joint that includes an overlapping root portion and a weld groove having a face portion with a first bevel portion and a second bevel portion are disclosed. In some embodiments, a particle-matrix bit body of an earth-boring tool may be repaired by removing a damaged portion, heating the particle-matrix composite bit body, and forming a built-up metallic structure thereon. In other embodiments, a particle-matrix composite body may be welded to a metallic body by forming a joint, heating the particle-matrix composite body, melting a metallic filler material forming a weld bead and cooling the welded particle-matrix composite body, metallic filler material and metallic body at a controlled rate.
摘要:
Earth-boring tools include at least one up-drill feature disposed on a transition surface so as to be passive during down drilling and active during up drilling and/or back reaming operations. Systems for down drilling and up drilling with drill bits comprising one or more up-drill features are also disclosed. Furthermore, methods for forming a borehole with an earth-boring tool including such up-drill features and for forming an earth-boring tool comprising such up-drill features are also disclosed.
摘要:
The present invention relates to compositions and methods for forming a bit body for an earth-boring bit. The bit body may comprise hard particles, wherein the hard particles comprise at least one of carbide, nitride, boride, oxide, and solid solutions thereof, and a binder binding together the hard particles. The binder may comprise at least one metal selected from cobalt, nickel, and iron and, optionally, at least one melting point reducing constituent selected from a transition metal carbide in the range of 30 to 60 weight percent, boron up to 10 weight percent, silicon up to 20 weight percent, chromium up to 20 weight percent, and manganese up to 25 weight percent, wherein the weight percentages are based on the total weight of the binder. In addition, the hard particles may comprise at least one of (i) cast carbide (WC+W2C) particles, (ii) transition metal carbide particles selected from the carbides of titanium, chromium, vanadium, zirconium, hafnium, tantalum, molybdenum, niobium, and tungsten, and (iii) sintered cemented carbide particles.
摘要:
Methods for forming bodies of earth-boring drill bits and other tools include milling a plurality of hard particles and a plurality of particles comprising a matrix material to form a mill product comprising powder particles, separating the particles into a plurality of particle size fractions. Some of the particles from the fractions may be combined to form a powder mixture, which may be pressed to form a green body. Additional methods include mixing a plurality of hard particles and a plurality of particles comprising a matrix material to form a powder mixture, and pressing the powder mixture with pressure having an oscillating magnitude to form a green body. In yet additional methods a powder mixture may be pressed within a deformable container to form a green body and drainage of liquid from the container is enabled as the powder mixture is pressed.
摘要:
Methods of forming bit bodies for earth-boring bits include assembling green components, brown components, or fully sintered components, and sintering the assembled components. Other methods include isostatically pressing a powder to form a green body substantially composed of a particle-matrix composite material, and sintering the green body to provide a bit body having a desired final density. Methods of forming earth-boring bits include providing a bit body substantially formed of a particle-matrix composite material and attaching a shank to the body. The body is provided by pressing a powder to form a green body and sintering the green body. Earth-boring bits include a unitary structure substantially formed of a particle-matrix composite material. The unitary structure includes a first region configured to carry cutters and a second region that includes a threaded pin. Earth-boring bits include a shank attached directly to a body substantially formed of a particle-matrix composite material.
摘要:
Earth-boring tools for drilling subterranean formations include a particle-matrix composite material comprising a plurality of silicon carbide particles dispersed throughout a matrix material, such as, for example, an aluminum or aluminum-based alloy. In some embodiments, the silicon carbide particles comprise an ABC—SiC material. Methods of manufacturing such tools include providing a plurality of silicon carbide particles within a matrix material. Optionally, the silicon carbide particles may comprise ABC—SiC material, and the ABC—SiC material may be toughened to increase a fracture toughness exhibited by the ABC—SiC material. In some methods, at least one of an infiltration process and a powder compaction and consolidation process may be employed.