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    Surgical instruments and procedures for stabilizing the beating heart during coronary artery bypass graft surgery
    63.
    发明授权
    Surgical instruments and procedures for stabilizing the beating heart during coronary artery bypass graft surgery 失效
    用于在冠状动脉旁路移植手术期间稳定跳动心脏的手术器械和程序

    公开(公告)号：US06394951B1

    公开(公告)日：2002-05-28

    申请号：US09525774

    申请日：2000-03-13

    申请人： Charles S. Taylor ,  Dwight P. Morejohn ,  Benjamin Sherman ,  Gary B. Weller ,  William Friederich Witt ,  Caralin R. Adair

    发明人： Charles S. Taylor ,  Dwight P. Morejohn ,  Benjamin Sherman ,  Gary B. Weller ,  William Friederich Witt ,  Caralin R. Adair

    IPC分类号： A61B132

    CPC分类号： A61B17/3421 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0218 ,  A61B17/0642 ,  A61B17/12 ,  A61B17/3423 ,  A61B17/8076 ,  A61B90/00 ,  A61B2017/00243 ,  A61B2017/00539 ,  A61B2017/00703 ,  A61B2017/00858 ,  A61B2017/00991 ,  A61B2017/0243 ,  A61B2017/0648 ,  A61B2017/1139 ,  A61B2017/2825 ,  A61B2017/2913 ,  A61B2017/2929 ,  A61B2017/306 ,  A61B2017/349

    摘要： The invention is methods and devices which a surgeon may use to stabilize the beating heart during a surgical procedure on the heart. Pursuant to the invention, a stabilizing device is introduced through an opening in the chest and brought into contact with the beating heart. By contacting the heart with the device and by exerting a stabilizing force on the device, the motion of the heart caused by the contraction of the heart muscles is effectively eliminated such that the heart is stabilized and the site of the surgery moves only minimally if at all. Typically, in separate steps, the surgeon contacts the heart with the stabilizing device, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing device such that the contraction of the beating heart causes only minimal excess motion at the surgery site. By fixing the position of the stabilizing device in a configuration where the motion of the beating heart is effectively eliminated, the surgeon is able to stabilize the beating heart for the duration of the procedure. The stabilizing device may be attached to a rigid support or may be attached to a semi-rigid support which is rendered motionless mechanically, chemically, or by human intervention. In certain preferred embodiments, the stabilizing device is affixed to a semi-rigid support which is caused to become rigid, by any of a variety of techniques, such that the position of the stabilizing device becomes fixed by the support, and the heart remains substantially motionless for the duration of the procedure.

    摘要翻译： 本发明是外科医生可以在心脏手术过程中稳定跳动心脏的方法和装置。 根据本发明，稳定装置通过胸部的开口引入并与打浆心接触。 通过将心脏与装置接触并且通过在装置上施加稳定力，由心脏肌肉收缩引起的心脏的运动被有效地消除，使得心脏稳定，并且手术部位仅在最小程度上移动，如果在 所有。 通常，在单独的步骤中，外科医生与稳定装置接触心脏，评估吻合部位的移动程度，并且在稳定装置上施加力，使得跳动心脏的收缩在手术时仅引起极小的过度运动 现场。 通过将稳定装置的位置固定在跳动心脏的运动被有效地消除的构造中，外科医生能够在手术期间稳定跳动的心脏。 稳定装置可以附接到刚性支撑件，或者可以附接到半刚性支撑件，其通过机械，化学方式或通过人为干预使其不动。 在某些优选实施例中，稳定装置通过各种技术中的任何一种固定到刚性刚性的半刚性支撑件上，使得稳定装置的位置由支撑件固定，心脏基本保持 在程序期间不动。

    Bifurcated venous cannula
    64.
    发明授权
    Bifurcated venous cannula 失效
    分叉静脉插管

    公开(公告)号：US6086557A

    公开(公告)日：2000-07-11

    申请号：US165162

    申请日：1998-10-01

    申请人： Dwight P. Morejohn ,  Michael V. Morejohn

    发明人： Dwight P. Morejohn ,  Michael V. Morejohn

    IPC分类号： A61B17/00 ,  A61B17/22 ,  A61F2/958 ,  A61M1/36 ,  A61M25/00 ,  A61N5/00

    CPC分类号： A61M25/0041 ,  A61M1/3659 ,  A61B2017/00243 ,  A61B2017/22067 ,  A61M2025/0036 ,  A61M2025/1045 ,  A61M25/0032 ,  A61M25/1011

    摘要： A cannula for draining blood from a patient's heart during cardiac surgery including a main body and a pair of branches extending distally therefrom. The branches are biased to extend away from one another by pre-shaped stiffening elements, and have "D" shaped cross-sections defining flat surfaces oriented generally towards one another. The branches may be constrained in a retracted position, the flat surfaces abutting one another, and the resulting profile forming a substantially continuous extension of the main body. The branches have distal tips including drainage holes and occlusion balloons, and elbow portions including accordion-like ridges for preventing kinking. Grooves in the flat surfaces define a secondary lumen in the retracted position through which a cardioplegia delivery or an imaging device may be advanced. The cannula is directed into a trocar to constrain the branches in the retracted position, and the trocar is inserted into the right atrium. The trocar is withdrawn to deploy the branches, which automatically extend away from one another, assuming a tripartite configuration wherein the branches extend substantially transversely from the main body, and enter the superior and inferior vena cavae. The occlusion balloons are inflated to isolate the vena cavae and blood is drained therefrom for delivery to a pump-oxygenator. A cardioplegia delivery device is advanced through the secondary lumen into the coronary sinus, an occlusion balloon on a distal tip of the device is inflated to isolate the coronary sinus, and retrograde delivery of cardioplegia is achieved.

    摘要翻译： 用于在心脏手术期间从患者心脏排出血液的插管，包括主体和从其向远端延伸的一对分支。 分支被偏置以通过预形加固元件彼此远离延伸，并且具有限定通常彼此朝向的平坦表面的“D”形横截面。 分支可以被限制在缩回位置，平坦表面彼此邻接，并且所得到的轮廓形成主体的基本上连续的延伸部。 分支具有远端尖端，包括排水孔和闭塞气囊，肘部包括用于防止扭结的手风琴状脊。 在平坦表面中的凹槽限定了处于缩回位置的第二内腔，通过该凹陷可以使心麻痹输送或成像装置前进。 套管被引导到套管针中以将分支限制在缩回位置，套针针插入右心房。 套管针被撤回以部署分支，其自动地彼此延伸，假设分支基本上横向于主体延伸并进入上下腔静脉的三方结构。 闭塞气囊被充气以分离腔静脉，并且将血液从其中排出以输送到泵 - 氧合器。 心麻痹递送装置通过次级内腔进入冠状窦，将装置的远端顶端的闭塞气囊充气以隔离冠状窦，并实现逆行递送麻痹。

    Devices and methods for minimally invasive harvesting of a vessel especially the saphenous vein for coronary bypass grafting
    66.
    发明授权
    Devices and methods for minimally invasive harvesting of a vessel especially the saphenous vein for coronary bypass grafting 失效
    用于微创收集血管的装置和方法，特别是用于冠状动脉搭桥术的隐静脉

    公开(公告)号：US6019771A

    公开(公告)日：2000-02-01

    申请号：US759102

    申请日：1996-12-02

    申请人： Brian J. Bennett ,  Dwight P. Morejohn ,  Ivan Sepetka

    发明人： Brian J. Bennett ,  Dwight P. Morejohn ,  Ivan Sepetka

    IPC分类号： A61B17/00 ,  A61B17/128 ,  A61B17/32

    CPC分类号： A61B17/00008 ,  A61B17/32002 ,  A61B17/1285 ,  A61B17/3201

    摘要： Devices and methods for minimally invasive harvesting of a vessel, especially the saphenous vein for coronary artery bypass grafting, are disclosed which facilitate a minimally invasive vessel harvesting procedure. Generally, an instrument is provided which facilitates introduction of vessel harvesting tools through a minimally invasive incision, and provides the capability to separate the vessel from surrounding tissue while minimizing trauma to the patient and preserving the patency of the vessel. The instrument includes a mechanism for separating the vessel from surrounding tissue and may also include mechanisms for severing side branches from the vessel during the harvesting procedure. In one embodiment, an integrated vessel harvesting assembly is provided which may rotate around a vessel and provides a unitary mechanism for separating the vessel from surrounding tissue and for severing the side branches.

    摘要翻译： 公开了用于微创收集血管，尤其是用于冠状动脉旁路移植术的隐静脉的装置和方法，其有助于微创血管收获程序。 通常，提供了便于通过微创切口引入血管收集工具的仪器，并且提供了将血管与周围组织分开同时最小化对患者的创伤并保持血管通畅性的能力。 该仪器包括用于将容器与周围组织分开的机构，并且还可包括用于在收获过程期间切断侧分支的装置。 在一个实施例中，提供集成的血管收集组件，其可围绕血管旋转并且提供用于将血管与周围组织分离并用于切断侧枝的整体机构。

    Low profile vessel occluder with and without detachable applicator
    67.
    发明授权
    Low profile vessel occluder with and without detachable applicator 失效
    具有和不具有可拆卸涂抹器的低轮廓血管封堵器

    公开(公告)号：US6001111A

    公开(公告)日：1999-12-14

    申请号：US8113

    申请日：1998-01-16

    申请人： Ivan Sepetka ,  Robert G. Matheny ,  James A. Magovern ,  Dwight P. Morejohn ,  Robert C. Glines

    发明人： Ivan Sepetka ,  Robert G. Matheny ,  James A. Magovern ,  Dwight P. Morejohn ,  Robert C. Glines

    IPC分类号： A61B17/04 ,  A61B17/06 ,  A61B17/064 ,  A61B17/122 ,  A61B17/128 ,  A61B17/00

    CPC分类号： A61B17/122 ,  A61B17/0487 ,  A61B17/06 ,  A61B17/0643 ,  A61B17/128 ,  A61B2017/0461 ,  A61B2017/0464

    摘要： A low profile unobtrusive occluder device is disclosed which is particularly applicable for occluding blood vessels in minimally invasive beating heart CABG surgical procedures, wherein relatively small surgical openings are provided. At least one flexible member is provided on the occluder, which is placed against the vessel. A suture thread is passed under the vessel to encompass the vessel between the occluder and suture thread. The suture thread is selectively attached to the occluder such that the flexible member, when deformed, applies continuous selected tension on the suture thread to apply a corresponding compression on the vessel which occludes the flow of blood. An applicator is attached to the occluder to enable installation thereof, but is detachable after installation such that only the low profile occluder remains on the heart surface during surgery. The applicator is re-attached to the occluder to facilitate removal of the latter. In an alternative embodiment, the occluder is formed as an adjustable part of a heart contacting member of a thoracotomy stabilizer apparatus.

    摘要翻译： 公开了一种低调的不引人注意的闭塞器装置，其特别适用于在微创搏动心脏CABG外科手术中闭塞血管，其中提供了相对较小的手术开口。 至少一个柔性构件设置在封闭器上，其抵靠容器放置。 缝合线在血管下方通过封闭器和缝合线之间的容器。 缝合线选择性地附接到闭塞器，使得当变形时，柔性构件在缝合线上施加连续的选定张力，以在封闭血流的血管上施加相应的压缩。 敷贴器附接到封堵器以使其能够安装，但是在安装之后可拆卸，使得在外科手术期间只有低轮廓的封堵器保留在心脏表面上。 将施用器重新连接到封堵器以便于去除封堵器。 在替代实施例中，封堵器形成为开胸稳定器装置的心脏接触构件的可调部分。

    Integrated cannula and vascular clamp assembly
    68.
    发明授权
    Integrated cannula and vascular clamp assembly 失效
    集成插管和血管钳组件

    公开(公告)号：US5928253A

    公开(公告)日：1999-07-27

    申请号：US40230

    申请日：1998-03-13

    申请人： Benjamin Sherman ,  Dwight P. Morejohn

    发明人： Benjamin Sherman ,  Dwight P. Morejohn

    IPC分类号： A61B17/00 ,  A61B17/122 ,  A61B17/34

    CPC分类号： A61B17/122 ,  A61B17/1227 ,  A61B17/3421 ,  A61B2017/00243

    摘要： The present invention relates to an integrated cannula and vascular clamp assembly. The integrated cannula and vascular clamp assembly includes a pair of clamping members made of a physiologically acceptable material that are pivotally coupled to a cannula for movement between an open position for at least partially surrounding a portion of a blood vessel section to be occluded and a clamping position for compressing the blood vessel with pressure sufficient to occlude blood flow through the section.

    摘要翻译： 本发明涉及集成插管和血管夹具组件。 集成插管和血管夹具组件包括由生理可接受的材料制成的一对夹紧构件，其可枢转地联接到插管，用于在用于至少部分地围绕要被阻塞的血管部分的一部分的打开位置和夹紧 用于压迫血管的位置，该压力足以阻塞通过该部分的血液流动。

    LEFT ATRIAL APPENDAGE TREATMENT SYSTEMS AND METHODS
    70.
    发明申请
    LEFT ATRIAL APPENDAGE TREATMENT SYSTEMS AND METHODS 有权
    左心室附件治疗系统和方法

    公开(公告)号：US20120323262A1

    公开(公告)日：2012-12-20

    申请号：US13524891

    申请日：2012-06-15

    申请人： Tamer Ibrahim ,  Dwight P. Morejohn

    发明人： Tamer Ibrahim ,  Dwight P. Morejohn

    IPC分类号： A61B17/12

    CPC分类号： A61B17/12009 ,  A61B17/12013 ,  A61B2017/2923 ,  A61B2017/2927

    摘要： Embodiments of the present invention encompass systems and methods to prevent complications from atrial fibrillation by preventing or reducing the likelihood of blood flow out of the left atrial appendage, to eliminate a possible source of aberrant electrical circuits, or both. Accordingly, techniques are provided for delivering ligature loops or closure means to the left atrial appendage, and to other anatomical structures of a patient which may be desirable in other surgical procedures.

    摘要翻译： 本发明的实施方案包括通过预防或降低血液流出左心耳的可能性来消除心房颤动的并发症的系统和方法，以消除可能的异常电路源或两者。 因此，提供了用于将结扎环或闭合装置输送到左心耳的技术以及在其它外科手术中可能需要的患者的其他解剖结构。