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公开(公告)号：US06955175B2
公开(公告)日：2005-10-18
申请号：US10427438
申请日：2003-05-01
IPC分类号： A61B5/0444 , A61B1/00 , A61B5/0402 , A61B17/00 , A61B17/02 , A61B17/04 , A61B17/06 , A61B17/28 , A61B17/30 , A61B17/32 , A61B17/34 , A61B18/00 , A61B18/14 , A61B19/00 , A61F2/24 , A61F2/958 , A61M1/00 , A61N1/06
CPC分类号： A61B17/00234 , A61B17/0057 , A61B17/0218 , A61B17/0467 , A61B17/0469 , A61B17/06061 , A61B17/2909 , A61B17/320016 , A61B17/3211 , A61B17/3417 , A61B17/3468 , A61B18/1442 , A61B18/1482 , A61B18/1492 , A61B90/37 , A61B90/50 , A61B2017/00053 , A61B2017/00243 , A61B2017/00247 , A61B2017/00349 , A61B2017/00575 , A61B2017/00579 , A61B2017/00592 , A61B2017/00597 , A61B2017/00606 , A61B2017/00619 , A61B2017/00623 , A61B2017/00867 , A61B2017/00907 , A61B2017/0243 , A61B2017/047 , A61B2017/0472 , A61B2017/0474 , A61B2017/0475 , A61B2017/2943 , A61B2017/2946 , A61B2017/306 , A61B2017/3405 , A61B2017/3486 , A61B2017/3492 , A61B2018/00214 , A61B2018/00232 , A61B2018/00261 , A61B2018/00291 , A61B2018/00363 , A61B2018/00392 , A61B2018/00577 , A61B2018/00898 , A61B2018/00982 , A61B2018/1465 , A61F2/2427 , A61M25/1011 , A61M39/0247 , A61M2025/028 , A61M2039/0279 , A61M2039/0297 , A61M2205/3344 , A61M2205/3355 , A61M2205/366 , Y10S623/904
摘要： Devices, systems, and methods are provided for accessing the interior of the heart and performing procedures therein while the heart is beating. In one embodiment, a tubular access device having an inner lumen is provided for positioning through a penetration in a muscular wall of the heart, the access device having a means for sealing within the penetration to inhibit leakage of blood through the penetration. The sealing means may comprise a balloon or flange on the access device, or a suture placed in the heart wall to gather the heart tissue against the access device. An obturator is removably positionable in the inner lumen of the access device, the obturator having a cutting means at its distal end for penetrating the muscular wall of the heart. The access device is preferably positioned through an intercostal space and through the muscular wall of the heart. Elongated instruments may be introduced through the tubular access device into an interior chamber of the heart to perform procedures such as septal defect repair and electrophysiological mapping and ablation. A method of septal defect repair includes positioning a tubular access device percutaneously through an intercostal space and through a penetration in a muscular wall of the heart, passing one or more instruments through an inner lumen of the tubular access device into an interior chamber of the heart, and using the instruments to close the septal defect. Devices and methods for closing the septal defect with either sutures or with patch-type devices are disclosed.
摘要翻译： 提供了设备，系统和方法，用于访问心脏内部并在心脏跳动时执行其中的过程。 在一个实施例中，提供具有内腔的管状进入装置用于通过心脏的肌肉壁中的穿透进行定位，所述进入装置具有用于密封穿透物的装置，以阻止血液渗透穿透。 密封装置可以包括进入装置上的球囊或凸缘，或者放置在心壁中的缝合线，以将心脏组织收集在接近装置上。 闭塞器可拆卸地定位在进入装置的内腔中，封闭器在其远端具有用于穿透心脏肌肉壁的切割装置。 进入装置优选地通过肋间空间并穿过心脏的肌肉壁定位。 细长的仪器可以通过管状进入装置引入心脏的内腔，以执行诸如间隔缺损修复和电生理测绘和消融的过程。 间隔缺损修复的方法包括经由肋间空间穿过管状进入装置并穿过心脏的肌肉壁的穿透，使一个或多个器械通过管状进入装置的内腔进入心脏的内部腔室 ，并使用仪器封闭隔膜缺损。 公开了用缝线或贴片式装置封闭隔膜缺损的装置和方法。
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公开(公告)号：US06679268B2
公开(公告)日：2004-01-20
申请号：US10098838
申请日：2002-03-15
IPC分类号： A61B1900
CPC分类号： A61B17/00234 , A61B17/0057 , A61B17/0218 , A61B17/0467 , A61B17/0469 , A61B17/06061 , A61B17/2909 , A61B17/320016 , A61B17/3211 , A61B17/3417 , A61B17/3468 , A61B18/1442 , A61B18/1482 , A61B18/1492 , A61B90/37 , A61B90/50 , A61B2017/00053 , A61B2017/00243 , A61B2017/00247 , A61B2017/00349 , A61B2017/00575 , A61B2017/00579 , A61B2017/00592 , A61B2017/00597 , A61B2017/00606 , A61B2017/00619 , A61B2017/00623 , A61B2017/00867 , A61B2017/00907 , A61B2017/0243 , A61B2017/047 , A61B2017/0472 , A61B2017/0474 , A61B2017/0475 , A61B2017/2943 , A61B2017/2946 , A61B2017/306 , A61B2017/3405 , A61B2017/3486 , A61B2017/3492 , A61B2018/00214 , A61B2018/00232 , A61B2018/00261 , A61B2018/00291 , A61B2018/00363 , A61B2018/00392 , A61B2018/00577 , A61B2018/00898 , A61B2018/00982 , A61B2018/1465 , A61F2/2427 , A61M25/1011 , A61M39/0247 , A61M2025/028 , A61M2039/0279 , A61M2039/0297 , A61M2205/3344 , A61M2205/3355 , A61M2205/366 , Y10S623/904
摘要： Devices, systems, and methods are provided for accessing the interior of the heart and performing procedures therein while the heart is beating. In one embodiment, a tubular access device having an inner lumen is provided for positioning through a penetration in a muscular wall of the heart, the access device having a means for sealing within the penetration to inhibit leakage of blood through the penetration. The sealing means may comprise a balloon or flange on the access device, or a suture placed in the heart wall to gather the heart tissue against the access device. An obturator is removably positionable in the inner lumen of the access device, the obturator having a cutting means at its distal end for penetrating the muscular wall of the heart. The access device is preferably positioned through an intercostal space and through the muscular wall of the heart. Elongated instruments may be introduced through the tubular access device into an interior chamber of the heart to perform procedures such as septal defect repair and electrophysiological mapping and ablation. A method of septal defect repair includes positioning a tubular access device percutaneously through an intercostal space and through a penetration in a muscular wall of the heart, passing one or more instruments through an inner lumen of the tubular access device into an interior chamber of the heart, and using the instruments to close the septal defect. Devices and methods for closing the septal defect with either sutures or with patch-type devices are disclosed.
摘要翻译： 提供了设备，系统和方法，用于访问心脏内部并在心脏跳动时执行其中的过程。 在一个实施例中，提供具有内腔的管状进入装置用于通过心脏的肌肉壁中的穿透进行定位，所述进入装置具有用于密封穿透物的装置，以阻止血液渗透穿透。 密封装置可以包括进入装置上的球囊或凸缘，或者放置在心壁中的缝合线，以将心脏组织收集在接近装置上。 闭塞器可拆卸地定位在进入装置的内腔中，封闭器在其远端具有用于穿透心脏肌肉壁的切割装置。 进入装置优选地通过肋间空间并穿过心脏的肌肉壁定位。 细长的仪器可以通过管状进入装置引入心脏的内腔，以执行诸如间隔缺损修复和电生理测绘和消融的过程。 间隔缺损修复的方法包括经由肋间空间穿过管状进入装置并穿过心脏的肌肉壁的穿透，使一个或多个器械通过管状进入装置的内腔进入心脏的内部腔室 ，并使用仪器封闭隔膜缺损。 公开了用缝线或贴片式装置封闭隔膜缺损的装置和方法。
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公开(公告)号：US5924424A
公开(公告)日：1999-07-20
申请号：US949593
申请日：1997-10-14
IPC分类号： A61B5/0444 , A61B1/00 , A61B5/0402 , A61B17/00 , A61B17/02 , A61B17/04 , A61B17/06 , A61B17/28 , A61B17/30 , A61B17/32 , A61B17/34 , A61B18/00 , A61B18/14 , A61B19/00 , A61F2/24 , A61F2/958 , A61M1/00
CPC分类号： A61B17/00234 , A61B17/0057 , A61B17/0218 , A61B17/0469 , A61B17/06061 , A61B17/320016 , A61B17/3468 , A61B18/1482 , A61B18/1492 , A61B90/50 , A61F2/2427 , A61M25/1011 , A61M39/0247 , A61B17/0467 , A61B17/2909 , A61B17/3211 , A61B17/3417 , A61B18/1442 , A61B2017/00053 , A61B2017/00243 , A61B2017/00247 , A61B2017/00349 , A61B2017/00575 , A61B2017/00579 , A61B2017/00592 , A61B2017/00597 , A61B2017/00606 , A61B2017/00619 , A61B2017/00623 , A61B2017/00867 , A61B2017/00907 , A61B2017/0243 , A61B2017/047 , A61B2017/0472 , A61B2017/0474 , A61B2017/0475 , A61B2017/2943 , A61B2017/2946 , A61B2017/306 , A61B2017/3405 , A61B2017/3486 , A61B2017/3492 , A61B2018/00214 , A61B2018/00232 , A61B2018/00261 , A61B2018/00291 , A61B2018/00363 , A61B2018/00392 , A61B2018/00577 , A61B2018/00898 , A61B2018/00982 , A61B2018/1465 , A61B90/37 , A61M2025/028 , A61M2039/0279 , A61M2039/0297 , A61M2205/3344 , A61M2205/3355 , A61M2205/366 , Y10S623/904
摘要： Devices, systems, and methods are provided for accessing the interior of the heart and performing procedures therein while the heart is beating. In one embodiment, a tubular access device having an inner lumen is provided for positioning through a penetration in a muscular wall of the heart, the access device having a means for sealing within the penetration to inhibit leakage of blood through the penetration. The sealing means may comprise a balloon or flange on the access device, or a suture placed in the heart wall to gather the heart tissue against the access device. An obturator is removably positionable in the inner lumen of the access device, the obturator having a cutting means at its distal end for penetrating the muscular wall of the heart. The access device is preferably positioned through an intercostal space and through the muscular wall of the heart. Elongated instruments may be introduced through the tubular access device into an interior chamber of the heart to perform procedures such as septal defect repair and electrophysiological mapping and ablation. A method of septal defect repair includes positioning a tubular access device percutaneously through an intercostal space and through a penetration in a muscular wall of the heart, passing one or more instruments through an inner lumen of the tubular access device into an interior chamber of the heart, and using the instruments to close the septal defect. Devices and methods for closing the septal defect with either sutures or with patch-type devices are disclosed.
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公开(公告)号：US5810721A
公开(公告)日：1998-09-22
申请号：US610619
申请日：1996-03-04
申请人： Richard L. Mueller , Stephen W. Boyd , James R. Flom , Lorraine F. Mangosong , William S. Peters
发明人： Richard L. Mueller , Stephen W. Boyd , James R. Flom , Lorraine F. Mangosong , William S. Peters
CPC分类号： A61B17/0293 , A61B17/3423 , A61B17/3439 , A61B17/3468 , A61B17/02 , A61B17/0206 , A61B17/025 , A61B17/3417 , A61B17/3431 , A61B2017/00243 , A61B2017/3427 , A61B2017/3482 , A61B2090/306
摘要： The present invention provides a retractor for providing surgical access through a passage in tissue, together with methods for its use and deployment. The retractor comprises an anchoring frame having an upper surface, a lower surface, and an opening therethrough which defines an axial axis. A flexible tensioning member is attached to the frame, and is extendable from the frame out of the body through the passage when the frame is positioned through the passage and into a body cavity. This tensioning member is selectively tensionable to spread the tissue radially outwardly from the axial axis. Hence, it is the tension imposed on the flexible liner which effects retraction of the tissue, rather than relying on the structural integrity of an artificial lumen.
摘要翻译： 本发明提供一种用于通过组织中的通道提供外科手术进入的牵开器，以及用于其使用和部署的方法。 牵开器包括具有上表面，下表面和通过其限定轴向轴线的开口的锚固框架。 柔性张紧构件附接到框架，并且当框架通过通道定位并进入体腔时，柔性张紧构件附接到框架并且可从框架伸出身体穿过通道。 该张紧构件可选择性地张紧以使组织从轴向轴线向外径向扩张。 因此，施加在柔性衬垫上的张力会影响组织的缩回，而不是依靠人造管腔的结构完整性。
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公开(公告)号：US5807318A
公开(公告)日：1998-09-15
申请号：US615152
申请日：1996-03-12
申请人： Frederick G. St. Goar , William S. Peters , Philip C. Evard , Stephen W. Boyd , Craig L. Adams , Richard L. Mueller, Jr. , John H. Stevens
发明人： Frederick G. St. Goar , William S. Peters , Philip C. Evard , Stephen W. Boyd , Craig L. Adams , Richard L. Mueller, Jr. , John H. Stevens
IPC分类号： A61B17/00 , A61F2/24 , A61F2/958 , A61M1/36 , A61M25/00 , A61M25/01 , A61M25/06 , A61M25/14 , A61M29/02 , A61M1/00
CPC分类号： A61M25/0068 , A61F2/2427 , A61M1/3653 , A61M1/3659 , A61M25/0041 , A61M25/01 , A61M25/0662 , A61M25/10 , A61B2017/00243 , A61B2018/00232 , A61B2018/00261 , A61M2025/0031 , A61M2025/0034 , A61M2025/0036 , A61M2025/004 , A61M2025/0057 , A61M2025/0078 , A61M2025/0087 , A61M2025/028 , A61M2025/1047 , A61M2025/1077 , A61M2205/11 , A61M2205/366 , A61M2210/125 , A61M25/005 , A61M25/008 , A61M25/0125 , A61M25/1002
摘要： A catheter system is provided for accessing the coronary ostia transluminally from a peripheral arterial access site, such as the femoral artery, and for inducing cardioplegic arrest by direct infusion of cardioplegic solution into the coronary arteries. In a first embodiment, the catheter system is in the form of a single perfusion catheter with multiple distal branches for engaging the coronary ostia. In a second embodiment, multiple perfusion catheters are delivered to the coronary ostia through a single arterial cannula. In a third embodiment, multiple perfusion catheters are delivered to the coronary ostia through a single guiding catheter. In a fourth embodiment, multiple catheters are delivered to the coronary ostia through a single guiding catheter which has distal exit ports that are arranged to direct the perfusion catheters into the coronary ostia. In each embodiment, the catheters are equipped with an occlusion means at the distal end of the catheter for closing the coronary ostia and isolating the coronary arteries from the systemic blood flow. The occlusion means can take the form of an inflatable occlusion balloon cuff, a tapered occlusion device or an O-ring encircling the distal end of the catheter. An optional ventricular venting catheter can be included in the system for venting blood and fluids from the left ventricle of the heart. The catheter system is combined with a femoral-to-femoral cardiopulmonary bypass system to provide a system for cardioplegic arrest and total cardiopulmonary support during minimally invasive cardiac surgical procedures.
摘要翻译： 提供导管系统用于从外周动脉进入部位（例如股动脉）平均进入冠状动脉口，并且通过将心脏停搏液直接输注到冠状动脉中诱导心脏停搏。 在第一实施例中，导管系统是具有用于接合冠状动脉口的多个远端分支的单次灌注导管的形式。 在第二实施例中，多个灌注导管通过单个动脉插管递送至冠状动脉口。 在第三实施例中，多个灌注导管通过单个引导导管输送到冠状动脉口。 在第四实施例中，多个导管通过单个引导导管输送到冠状动脉口，该引导导管具有设置成将灌注导管引导到冠状动脉口中的远侧出口。 在每个实施例中，导管在导管的远端配备有闭塞装置，用于封闭冠状动脉口，并将冠状动脉与全身血流隔离。 闭塞装置可采取充气闭塞球囊，锥形闭塞装置或围绕导管远端的O形环的形式。 系统中可以包括可选的心室通气导管，用于从心脏的左心室排出血液和液体。 导管系统与股骨 - 股骨心肺旁路系统组合，以在微创心脏手术过程中提供心脏停搏和全心肺支持的系统。
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公开(公告)号：US5759170A
公开(公告)日：1998-06-02
申请号：US614535
申请日：1996-03-13
申请人： William S. Peters
发明人： William S. Peters
CPC分类号： A61M29/02 , A61M25/0026 , A61M25/104 , A61B2018/00232 , A61B2018/00261 , A61M2025/0031 , A61M2025/028 , A61M2025/1052 , A61M2202/047 , A61M2210/127 , A61M25/0023 , A61M25/0032
摘要： A process for inducing cardioplegic arrest of a heart in situ in a patient's body, comprising maintaining the patient's systemic circulation by peripheral cardiopulmonary by-pass, occluding the ascending aorta through a percutaneously placed arterial balloon catheter, venting the left side of the heart, and introducing a cardioplegic agent into the coronary circulation. This procedure readies the heart for a variety of surgical procedures that can be performed percutaneously through lumina in the catheter. An aortic catheter for use in the process is also described.
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