公开(公告)号：US06554794B1

公开(公告)日：2003-04-29

申请号：US09326118

申请日：1999-06-04

申请人： Richard L. Mueller ,  U. Hiram Chee ,  Steven A. Daniel ,  Amr Salahieh ,  Robert LaDuca ,  Lauren K. Lundquist ,  Richard D. Phipps ,  Daniel S. Brown

发明人： Richard L. Mueller ,  U. Hiram Chee ,  Steven A. Daniel ,  Amr Salahieh ,  Robert LaDuca ,  Lauren K. Lundquist ,  Richard D. Phipps ,  Daniel S. Brown

IPC分类号： A61M3700

CPC分类号： A61M25/0138 ,  A61B17/3478 ,  A61B2017/00243 ,  A61B2017/00247 ,  A61B2018/00392 ,  A61M5/31531 ,  A61M25/0026 ,  A61M25/0084 ,  A61M25/0136 ,  A61M25/0141 ,  A61M25/0144 ,  A61M25/0147 ,  A61M2025/0089

摘要： A non-deforming deflectable multi-lumen catheter with an outer jacket having a deflectable distal end portion, an eccentric pull wire lumen, coil and shim embedded therein. The deflectable distal portion optionally having one or more transaxial notches in the external surface of the outer jacket. A functional device is disposed within the lumen of an inner tube substantially coaxial with the outer jacket of the catheter. The distal tip of the functional device egressible from the distal tip of the catheter, and upon deflection, automatically aligns with the distal tip of the catheter and functional device.

摘要翻译： 具有外护套的不变形可偏转多腔导管，其具有可偏转的远端部分，嵌入其中的偏心拉线管腔，线圈和垫片。 可偏转的远端部分可选地在外护套的外表面中具有一个或多个轴向切口。 功能装置设置在与导管的外护套基本同轴的内管的内腔内。 功能装置的远端从导管的远端可流出并且在偏转时自动与导管和功能装置的远端对齐。

公开(公告)号：US06524324B1

公开(公告)日：2003-02-25

申请号：US09706016

申请日：2000-11-03

申请人： Richard L. Mueller ,  U. Hiram Chee

发明人： Richard L. Mueller ,  U. Hiram Chee

IPC分类号： A61B1734

CPC分类号： A61B17/3203 ,  A61B17/3207 ,  A61B17/320783 ,  A61B17/3478 ,  A61B90/37 ,  A61B2017/00247 ,  A61B2017/22077 ,  A61B2018/00392 ,  A61B2090/374

摘要： Various methods and devices for treating a patient who has lost, or is at risk of losing cardiac function by cardiac ischemia are disclosed. Treatment includes first imaging a patient's heart, or a portion thereof, to identify underperfused regions of cardiac muscle, and a source of oxygenated blood that is proximate to the underperfused region. Between the underperfused regions and the oxygenated blood source, a target area is selected where thermal or mechanical injury is introduced, and optionally reintroduced, to convert initial capillary blush, resulting from the injury.

摘要翻译： 公开了用于治疗由于心脏缺血而失去或有丧失心脏功能风险的患者的各种方法和装置。 治疗包括首先对患者的心脏或其一部分进行成像以识别心肌的不足灌注区域，以及接近欠灌注区域的充氧血液源。 在欠灌注区域和氧合血液源之间，选择引入热或机械损伤的目标区域，并且可选地重新引入，以转化由损伤引起的初始毛细血管腮红。

公开(公告)号：US5403334A

公开(公告)日：1995-04-04

申请号：US130344

申请日：1993-10-01

申请人： Michael Evans ,  Richard L. Mueller

发明人： Michael Evans ,  Richard L. Mueller

IPC分类号： A61B17/22 ,  A61B17/32

CPC分类号： A61B17/320783 ,  A61B2017/22054 ,  A61B2017/320052

摘要： An atherectomy catheter includes a catheter body having a cylindrical housing at its distal end. The cylindrical housing includes an elongate cutting aperture on one side thereof and a mechanism for severing atheroma which enters within the opening. In a first embodiment, the cutting mechanism comprises a circular cutting blade which is advanced over an elongate guide member which defines a path for the blade. Use of the guide means helps assure that the cutting blade will not be lost from the housing during use. In a second embodiment, a rotatable helical cutting blade is mounted within the housing. In that particular embodiment, the helical cutting blade can serve as the guide member for the circular cutting blade.

摘要翻译： 粥样斑块切除术导管包括在其远端具有圆柱形壳体的导管体。 圆柱形壳体在其一侧上包括细长的切割孔，以及用于切断进入开口内的动脉粥样化的机构。 在第一实施例中，切割机构包括圆形切割刀片，该切割刀片在限定刀片的路径的细长引导部件上前进。 使用导向装置有助于确保切割刀片在使用过程中不会从外壳中损失。 在第二实施例中，可旋转的螺旋切割刀片安装在壳体内。 在该特定实施例中，螺旋切割刀片可以用作圆形切割刀片的引导构件。

公开(公告)号：US5300036A

公开(公告)日：1994-04-05

申请号：US41914

申请日：1993-04-02

申请人： Richard L. Mueller ,  Edwin J. Hlavka ,  Tim Kovac ,  Albert K. Chin

发明人： Richard L. Mueller ,  Edwin J. Hlavka ,  Tim Kovac ,  Albert K. Chin

IPC分类号： A61B17/00 ,  A61B17/34 ,  A61M39/06 ,  A61M5/178

CPC分类号： A61M39/06 ,  A61B17/3417 ,  A61B17/3462 ,  A61B2017/0046 ,  A61B2017/347 ,  A61M2039/0626

摘要： An improved trocar is provided which includes converters for adapting to different size surgical instruments while maintaining sealing. The invention also includes an improved trocar tube body seal design which accepts and accommodates surgical tool angulation while still maintaining sealing. Still further, the invention provides a trocar obturator with a snap-fit joint which permits the forward portion of the obturator to be detached from the trocar body and separately used with the trocar tube subassembly. With this option, a latch mechanism is configured opposite to a converter to retain the obturator fixed with the trocar tube subassembly.

摘要翻译： 提供了一种改进的套针针，其包括用于适应不同尺寸的手术器械同时保持密封的转换器。 本发明还包括改进的套管针体密封件设计，其在仍然保持密封的同时接受并适应手术工具的角度。 此外，本发明提供一种具有卡扣配合接头的套管针闭塞器，其允许闭孔器的前部从套针针体脱离并与套管针组件分开使用。 通过该选项，闩锁机构被配置成与转换器相对以保持用套管针组件固定的闭塞器。

公开(公告)号：US5226909A

公开(公告)日：1993-07-13

申请号：US971697

申请日：1992-11-04

申请人： Michael Evans ,  Richard L. Mueller

发明人： Michael Evans ,  Richard L. Mueller

IPC分类号： A61B17/22 ,  A61B17/32

CPC分类号： A61B17/320783 ,  A61B2017/22054 ,  A61B2017/320052

摘要： An atherectomy catheter includes a catheter body having a cylindrical housing at its distal end. The cylindrical housing includes an elongate cutting aperture on one side thereof and a mechanism for severing atheroma which enters within the opening. In a first embodiment, the cutting mechanism comprises a circular cutting blade which is advanced over an elongate guide member which defines a path for the blade. Use of the guide means helps assure that the cutting blade will not be lost from the housing during use. In a second embodiment, a rotatable helical cutting blade is mounted within the housing. In that particular embodiment, the helical cutting blade can serve as the guide member for the circular cutting blade.

摘要翻译： 粥样斑块切除术导管包括在其远端具有圆柱形壳体的导管体。 圆柱形壳体在其一侧上包括细长的切割孔，以及用于切断进入开口内的动脉粥样化的机构。 在第一实施例中，切割机构包括圆形切割刀片，该切割刀片在限定刀片的路径的细长引导部件上前进。 使用导向装置有助于确保切割刀片在使用过程中不会从外壳中损失。 在第二实施例中，可旋转的螺旋切割刀片安装在壳体内。 在该特定实施例中，螺旋切割刀片可以用作圆形切割刀片的引导构件。

公开(公告)号：US6036685A

公开(公告)日：2000-03-14

申请号：US25644

申请日：1998-02-18

申请人： Richard L. Mueller

发明人： Richard L. Mueller

IPC分类号： A61B18/20 ,  A61B1/018 ,  A61B1/267 ,  A61B1/313 ,  A61B17/00 ,  A61B17/30 ,  A61B18/24 ,  A61B19/00 ,  A61N5/06 ,  A61B17/36

CPC分类号： A61B1/00154 ,  A61B1/00098 ,  A61B1/018 ,  A61B18/24 ,  A61B1/267 ,  A61B1/3132 ,  A61B2017/00247 ,  A61B2017/306 ,  A61B2018/00291 ,  A61B2018/00392 ,  A61B90/37 ,  A61B90/39

摘要： A method of visualizing and treating the heart by providing a balloon end contact scope with a main lumen, an essentially transparent contact viewing portion, and integral laser delivery means or other equipment channel suitable for viewing the heart; precisely positioning the contact viewing portion in contact with a portion of the heart adjacent the position to be viewed; and visualizing the heart. The scope may have a gripping surface particularly suitable for percutaneous use. For MIS use, the scope tents the pericardial sac. The method can be used to place a guide wire or tether to the heart to locate a fluoroscopic or other visualization means or to perform additional visualization, fluoroscopic marking or other interventional procedures. The method also comprises the step of delivering laser energy to a portion of the heart to effect transmyocardial revascularization. The method can be performed either by surgically or minimally invasively introducing a balloon end viewing scope into the chest cavity of a patient and through the pericardial sac of the heart to a position between the pericardial sac and the epicardial surface of the heart or by introducing a balloon end viewing scope into the vasculature of a patient, for example at a point on the femoral artery, and into an internal chamber of the heart.

摘要翻译： 通过提供具有主腔，基本上透明的接触观察部分和整体的激光输送装置或适合于观察心脏的其它设备通道的球囊端接触范围来可视化和治疗心脏的方法; 将接触观察部分精确地定位成与邻近观察位置的心脏的一部分接触; 并可视化心脏。 该范围可以具有特别适合于经皮使用的抓握表面。 对于MIS使用，范围帐篷心包囊。 该方法可用于将引导线或系绳放置在心脏上以定位荧光镜或其他可视化装置或执行附加的可视化，荧光镜标记或其他介入程序。 该方法还包括将激光能量递送到心脏的一部分以实现心肌血运重建的步骤。 该方法可以通过手术或最小程度地将气囊末端观察范围入侵到患者的胸腔中并通过心脏的心包囊到心包囊和心脏心外膜表面之间的位置来进行，或者通过引入 气球端观察范围进入患者的脉管系统，例如在股动脉上的一点，并进入心脏的内室。

公开(公告)号：US5989278A

公开(公告)日：1999-11-23

申请号：US023964

申请日：1998-02-13

申请人： Richard L. Mueller

发明人： Richard L. Mueller

IPC分类号： A61B17/34 ,  A61B10/00 ,  A61B10/02 ,  A61B10/04 ,  A61B17/00 ,  A61B17/30 ,  A61B17/32 ,  A61B17/14

CPC分类号： A61B10/0275 ,  A61B17/320016 ,  A61B10/04 ,  A61B17/32002 ,  A61B17/32053 ,  A61B2010/0208 ,  A61B2017/00247 ,  A61B2017/00292 ,  A61B2017/306 ,  A61B2018/00392

摘要： An apparatus for creating revascularization channels in tissue, such as the myocardium of the heart, mechanically cuts the channels using a hand piece with easily removable cutting tip assemblies having angled, sharpened edges to allow rapid tip replacement. The cutting tip assembly has an inner needle within an outer hollow needle with each needle attached to the hand piece for independent rotation and axial movement. The inner needle may be hollow, or formed with a pointed tip, and may rotate counter to the outer needle to enhance gripping and storage of the tissue excised by the outer needle. The hand piece may attach a cylindrical magazine of cutting tip assemblies or one cutting tip assembly. The cutting tip assembly may be heated to provide thermal damage to the heart muscle during the creation of the channel, providing some of the advantages of the laser method of TMR.

摘要翻译： 用于在组织中产生血管重建通道的装置，例如心脏的心肌，使用具有易于移除的具有成角度的锋利边缘的切割尖端组件的手持部件机械地切割通道，以允许快速的尖端更换。 切割刀片组件在内部中空针内具有内针，每个针连接到手柄上，用于独立旋转和轴向运动。 内针可以是中空的或形成有尖头，并且可以相对于外针旋转，以增强由外针切除的组织的夹持和储存。 手持件可附接切割刀片组件或一个切削刀片组件的圆柱形刀库。 可以加热切割尖端组件以在创建通道期间对心脏肌肉提供热损伤，提供TMR的激光方法的一些优点。

公开(公告)号：US5976164A

公开(公告)日：1999-11-02

申请号：US908816

申请日：1997-08-08

申请人： Robert F. Bencini ,  Richard L. Mueller ,  Richard D. Phipps

发明人： Robert F. Bencini ,  Richard L. Mueller ,  Richard D. Phipps

IPC分类号： A61B17/34 ,  A61B10/00 ,  A61B10/02 ,  A61B10/04 ,  A61B17/00 ,  A61B17/30 ,  A61B17/32

CPC分类号： A61B10/0275 ,  A61B17/320016 ,  A61B10/04 ,  A61B17/32002 ,  A61B17/32053 ,  A61B2010/0208 ,  A61B2017/00247 ,  A61B2017/00292 ,  A61B2017/00734 ,  A61B2017/306 ,  A61B2018/00392

摘要： A semi-automatic cardiac tissue removal device for obtaining biopsy samples and/or creating revascularization pathways in the myocardium of the heart, mechanically cuts the pathways using a handpiece with a cutting tip assembly having a hollow needle with an angled, sharpened edge rotatable mounted around a separately advancable stylet. The stylet defines a piercer to spread the myocardium prior to insertion of the needle and to allow creation of a pathway only within the myocardium. The stylet further defines a plug at the cutting edge of the needle to finish the cutting cleanly and to plug the hollow needle thereby forming a closed chamber for excised tissue. A single button on the left or right handed handpiece actuates movement of the stylet into the myocardium, movement of the needle into the path produced by the piercer, and rotation of the needle to cut tissue.

摘要翻译： 一种用于获得活检样本和/或在心脏心肌中产生血运重建途径的半自动心脏组织去除装置，机械地使用具有切割尖端组件的手持式切割通路，所述切割尖端组件具有中空针头，所述中空针头具有可旋转安装的成角度的锋利边缘 一个独立的可行的探针。 探针定义穿刺器在插入针之前扩散心肌，并允许仅在心肌内产生通路。 探针进一步在针的切割边缘处限定一个塞子，以彻底切割切割中空针头，从而形成用于切除的组织的封闭腔室。 左手或右手手柄上的单个按钮启动探针进入心肌的运动，针头进入由穿刺器产生的路径，以及针头旋转以切割组织。

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

IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B17/34 ,  A61B19/00 ,  A61B11/02

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。

公开(公告)号：US5807384A

公开(公告)日：1998-09-15

申请号：US771794

申请日：1996-12-20

申请人： Richard L. Mueller

发明人： Richard L. Mueller

IPC分类号： A61B17/00 ,  A61B18/24 ,  A61F2/02 ,  A61B17/36

CPC分类号： A61B18/24 ,  A61F2/2493 ,  A61B2017/00247 ,  A61B2018/00392

摘要： A transmyocardial revascularization (TMR) enhanced treatment for coronary artery disease and other medical procedures utilizing a source of laser energy and a laser delivery means attached thereto, the treatment or other medical procedure being one in which the coronary artery is temporarily occluded during a surgical procedure, the enhanced treatment comprising the steps of positioning the laser delivery means adjacent the distal anatomy of the heart muscle, delivering laser energy to the distal anatomy of the heart muscle through the laser delivery means to create at least one TMR channel communicating oxygenated blood from the left ventricle to myocardium of the distal anatomy of the heart muscle, such that during treatment or other medical procedure in which the coronary artery is temporarily occluded, the distal anatomy of the heart is essentially continuously supplied with oxygenated blood, and performing the treatment or other medical procedure in which the coronary artery is temporarily occluded during a surgical or other procedure. A device for TMR enhanced treatment of coronary artery disease and other medical procedures in which the coronary artery is temporarily occluded during a surgical procedure, the device having first tubular means communicating oxygenated blood in the left ventricle with the device, second tubular means for perfusing oxygenated blood directly into myocardium in the distal anatomy of the heart muscle, and fluid communication means for communicating oxygenated blood between the first tubular means and the second tubular means. In preferred embodiments, both the first and the second tubular means have sharpened distal ends for mechanically piercing tissue of the heart muscle, and the second tubular means has at least one perfusion aperture on the sidewall adjacent the distal end of the tubular means. Additionally, a pump means for pumping oxygenated blood through the TMR device is disclosed, the pump means to be actuated either manually or automatically, and optionally repeated at a specific rate during the treatment or other medical procedure. The treatment or other medical procedure includes, and is not limited to, coronary artery angioplasty, coronary artery bypass grafting (CABG), and minimally invasive direct coronary artery bypass grafting (MIDCAB).