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公开(公告)号：US08096959B2
公开(公告)日：2012-01-17
申请号：US11923320
申请日：2007-10-24
IPC分类号： A61B17/88
CPC分类号： A61B17/00234 , A61B2017/00252 , A61M25/10
摘要： A trans-septal guide catheter for providing access through the septum separating a first heart chamber from a second heart chamber that includes an elongated guide catheter body extending between guide catheter proximal and distal ends. A distal segment of the guide catheter is adapted to be inserted through the septum to locate the distal segment of the guide catheter within one of the first heart chamber and the second heart chamber. The catheter body encloses a guide catheter lumen adapted to provide access into the one of the first heart chamber and the second heart chamber through a guide catheter lumen proximal end opening and a guide catheter lumen distal end opening. A retention mechanism engages the septum and maintains the distal segment of the guide catheter extending into the one of the first heart chamber and the second heart chamber.
摘要翻译： 一种反间隔导引导管，用于提供通过将第一心室与第二心室隔开的隔膜的通路，该第二心室包括在引导导管近端和远端之间延伸的细长引导导管主体。 引导导管的远侧部分适于插入穿过隔膜以将引导导管的远侧部分定位在第一心室和第二心室之一内。 导管主体包围引导导管内腔，其适于通过引导导管内腔近端开口和引导导管内腔远端开口提供通向第一心室和第二心室之一的通路。 保持机构接合隔膜并且保持引导导管的远端段延伸到第一心室和第二心室中的一个。
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公开(公告)号：US20100292749A1
公开(公告)日：2010-11-18
申请号：US12769345
申请日：2010-04-28
申请人： Mark T. Stewart , Tom P. Daigle , David E. Francischelli , John R. Liddicoat , Paul T. Rothstein , Steven F. Bolling
发明人： Mark T. Stewart , Tom P. Daigle , David E. Francischelli , John R. Liddicoat , Paul T. Rothstein , Steven F. Bolling
CPC分类号： A61B18/1445 , A61B1/00087 , A61B1/05 , A61B1/06 , A61B34/20 , A61B2017/00057 , A61B2017/2945 , A61B2018/00107 , A61B2018/00142 , A61B2018/0022 , A61B2018/00375 , A61B2018/00982 , A61B2018/1432 , A61N1/362
摘要： Device and method for sub-xiphoid ablation of patient tissue. A sub-xiphoid access clamp has a handle, an elongate neck coupled to the handle and first and second opposing jaws. The first and second opposing jaws have first and second opposing relief segments being generally co-planar and concave with respect to one another to form a void therebetween, and first and second opposing elongate ablation elements positioned along the first and second opposing jaws and distal of the first and second opposing relief segments relative to the handle. The first and second opposing jaws are articulate between a closed position and an open position to admit, at least in part, a second portion of tissue of the patient within the void created by the first and second opposing relief segments while the first portion of tissue is positioned between the first and second ablation elements in the closed position.
摘要翻译： 患者组织亚硬膜切除术的装置及方法。 副剑杆通道夹具具有手柄，连接到手柄的细长颈部以及第一和第二相对的夹爪。 第一和第二相对的钳口具有第一和第二相对的浮雕段，它们大致共面并相对于彼此凹入以在它们之间形成空隙，并且第一和第二相对的细长消融元件沿着第一和第二相对的夹爪定位， 第一和第二相对的释放段相对于把手。 第一和第二相对的夹爪在关闭位置和打开位置之间铰接，以至少部分地允许患者在由第一和第二相对的浮雕段产生的空隙内的组织的第二部分，同时组织的第一部分 位于第一和第二消融元件之间处于关闭位置。
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公开(公告)号：US20100204716A1
公开(公告)日：2010-08-12
申请号：US12768200
申请日：2010-04-27
申请人： Mark T. Stewart , Alison Lutterman , David E. Francischelli , Leonard H. Leuer , Daneil C. Haeg , Marie T. Steinbrink , Roderick E. Briscoe , Tom P. Daigel , Eduardo N. Warman , Paul T. Rothstein , Phillip C. Falkner , Douglas A. Hettrick , David J.S. Kim , Steven C. Christian
发明人： Mark T. Stewart , Alison Lutterman , David E. Francischelli , Leonard H. Leuer , Daneil C. Haeg , Marie T. Steinbrink , Roderick E. Briscoe , Tom P. Daigel , Eduardo N. Warman , Paul T. Rothstein , Phillip C. Falkner , Douglas A. Hettrick , David J.S. Kim , Steven C. Christian
IPC分类号： A61B17/128 , A61B17/122
CPC分类号： A61B17/12 , A61B17/0057 , A61B17/12009 , A61B17/12013 , A61B17/122 , A61B17/128 , A61B17/1285 , A61B90/39 , A61B2017/00243 , A61B2017/00575 , A61B2017/12018 , A61B2017/306
摘要： Some embodiments of the invention provide a system for occluding a left atrial appendage of a patient. Some embodiments of the system can include a ring occluder that can be positioned around the left atrial appendage and a ring applicator to position the ring occluder with respect to the left atrial appendage. One embodiment discloses a method of accessing endocardial surfaces of the heart through the atrial appendage. Additional embodiments of the invention provide a clip occluder that can be positioned around the left atrial appendage. A clip applicator can position the clip occluder with respect to the left atrial appendage.
摘要翻译： 本发明的一些实施例提供一种用于闭塞患者左心耳的系统。 该系统的一些实施例可以包括可以围绕左心耳定位的环封闭器和环施加器来相对于左心耳定位环封闭器。 一个实施例公开了通过心房接近心脏心脏表面的方法。 本发明的另外的实施例提供了可以围绕左心耳定位的夹子封堵器。 夹子施放器可以相对于左心耳定位夹子封堵器。
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公开(公告)号：US20100198346A1
公开(公告)日：2010-08-05
申请号：US12570888
申请日：2009-09-30
申请人： James R. Keogh , Timothy R. Ryan , Carol E. Eberhardt , Mark T. Stewart , James R. Skarda , Timothy G. Laske , Alexander J. Hill , Jack D. Lemmon , David E. Francischelli
发明人： James R. Keogh , Timothy R. Ryan , Carol E. Eberhardt , Mark T. Stewart , James R. Skarda , Timothy G. Laske , Alexander J. Hill , Jack D. Lemmon , David E. Francischelli
IPC分类号： A61F2/24
CPC分类号： A61F2/2496 , A61B5/0044 , A61B5/1076 , A61B5/6853 , A61B8/445 , A61B18/1442 , A61B34/20 , A61B90/37 , A61B90/39 , A61B2017/00243 , A61B2018/00291 , A61B2018/00351 , A61B2018/00577 , A61B2034/2051 , A61B2034/2063 , A61B2090/378 , A61B2090/397 , A61F2/2433 , A61F2210/009 , A61F2250/0096 , A61N7/02
摘要： A device and method for valve replacement or valve repair is disclosed comprising the steps of acquiring an anatomical image of a patient, correlating the image to the patient, guiding a valve replacement delivery member or a valve repair delivery member within the patient while tracking the position of the delivery member in the patient, positioning the valve replacement member or valve repair member in a desired position to place a valve or repair valve and removing the delivery member from the patient. In one aspect of the invention, a delivery system is provided for percutaneous delivery of a heart valve to a predetermined position in the heart of a patient, where the delivery system itself includes features that allow it to be accurately positioned in the heart. In another aspect of the invention, a delivery system is provided for percutaneous repair of a heart valve in the heart of a patient, where the repair system itself includes features that allow it to be accurately positioned in the heart. In another aspect of the invention, a method and device are provided that involve imaging a native root using an interoperative technique, then introducing a device that is easily visualized in a chosen imaging modality.
摘要翻译： 公开了一种用于瓣膜置换或瓣膜修复的装置和方法，包括以下步骤：获取患者的解剖图像，将图像与患者相关联，在跟踪位置的同时引导患者内的瓣膜置换输送构件或瓣膜修复递送构件 的患者中的输送构件，将瓣膜置换构件或瓣膜修复构件定位在期望的位置以放置瓣膜或修复瓣膜并从患者移除输送构件。 在本发明的一个方面，提供一种用于将心脏瓣膜经皮递送到患者心脏中的预定位置的递送系统，其中递送系统本身包括允许其准确地定位在心脏中的特征。 在本发明的另一方面，提供一种用于经皮修复患者心脏中的心脏瓣膜的递送系统，其中所述修复系统本身包括允许其准确地定位在心脏中的特征。 在本发明的另一方面，提供了一种方法和装置，其涉及使用手术技术对本地根进行成像，然后引入在选择的成像模式中容易可视化的装置。
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公开(公告)号：US20090326527A1
公开(公告)日：2009-12-31
申请号：US12480926
申请日：2009-06-09
申请人： Jon M. Ocel , Roderick E. Briscoe , David E. Francischelli , Scott E. Jahns , James R. Keogh , Katherine S. Jolly , Matthew D. Bonner
发明人： Jon M. Ocel , Roderick E. Briscoe , David E. Francischelli , Scott E. Jahns , James R. Keogh , Katherine S. Jolly , Matthew D. Bonner
CPC分类号： A61B5/042 , A61B5/7475 , A61B18/14 , A61B2017/2927 , A61B2018/1472 , A61N1/056
摘要： An instrument including an elongated shaft and a non-conductive handle is disclosed. The shaft defines a proximal section and a distal section. The distal section forms an electrically conductive tip. Further, the shaft is adapted to be transitionable from a straight state to a first bent state. The shaft is capable of independently maintaining the distinct shapes associated with the straight state and the first bent state. The handle is rigidly coupled to the proximal section of the shaft. The instrument is useful for epicardial pacing and/or mapping of the heart for temporary pacing on a beating heart, for optimizing the placement of ventricular leads for the treatment of patients with congestive heart failure and ventricular dysynchrony and/or for use in surgical ablation procedures.
摘要翻译： 公开了一种包括细长轴和非导电手柄的仪器。 轴限定近端部分和远端部分。 远侧部分形成导电尖端。 此外，轴适于从直状态转变到第一弯曲状态。 轴能够独立地保持与直线状态和第一弯曲状态相关联的不同形状。 手柄刚性地联接到轴的近端部分。 该仪器可用于心脏起搏和/或心脏在心脏跳动中临时起搏的作用，以优化用于治疗患有充血性心力衰竭和心室异常不适和/或用于外科手术切除手术的患者的心室导线的放置 。
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公开(公告)号：US07294143B2
公开(公告)日：2007-11-13
申请号：US10356868
申请日：2003-02-03
CPC分类号： A61B18/1402 , A61B2018/00809 , A61B2018/1472
摘要： Methods for delivering precise amounts of fluid into cardiac tissue for the purpose of facilitating ablation of the tissue along a desired lesion line. One method injects fluid through a hollow needle. The injected fluid can be a highly conductive fluid injected in conjunction with radiofrequency ablation to create an ablative virtual electrode. The injected conductive fluid can provide deeper and narrower conduction paths and resulting lesions. Radiofrequency ablation can be performed at the same time as the fluid injection, using the injection device as an electrode, or subsequent to the fluid injection, using a separate device. In some methods, the injected fluid is a protective fluid, injected to protect tissue adjacent to the desired lesion line. Fluid delivery can be endocardial, epicardial, and epicardial on a beating heart. The present methods find one use in performing maze procedures to treat atrial fibrillation.
摘要翻译： 用于将精确量的流体输送到心脏组织中以便于沿着期望的损伤线消融组织的方法。 一种方法通过中空针头注入流体。 注射的流体可以是与射频消融一起注入的高导电流体，以产生消融的虚拟电极。 注射的导电流体可以提供更深和更窄的传导路径和所导致的损伤。 射频消融可以在使用注射装置作为电极或在流体注射之后使用单独的装置与流体注射同时进行。 在一些方法中，注射的流体是保护性流体，被注射以保护邻近所需病变线的组织。 流体输送可以是搏动心脏的心内膜，心外膜和心外膜。 本方法可用于进行迷宫手术来治疗房颤。
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公开(公告)号：US07250051B2
公开(公告)日：2007-07-31
申请号：US11411261
申请日：2006-04-26
IPC分类号： A61B18/12
CPC分类号： A61B18/1445 , A61B18/1402 , A61B18/1442 , A61B2018/00994 , A61B2018/126 , A61B2018/1472
摘要： A method for ablation in which a portion of atrial tissue around the pulmonary veins of the heart is ablated by a first elongated ablation component and a second elongated ablation component movable relative to the first ablation component and having means for magnetically attracting the first and second components toward one another. The magnetic means draw the first and second components toward one another to compress the atrial tissue therebetween, along the length of the first and second components and thereby position the device for ablation of the tissue.
摘要翻译： 一种消融方法，其中通过第一细长消融部件消除心脏周围的肺静脉周围的一部分心房组织，并且第二细长消融部件可相对于第一消融部件移动并且具有用于磁吸引第一和第二部件的装置 朝向彼此 磁性装置沿着第一和第二部件的长度将第一和第二部件彼此拉伸以压缩其间的心房组织，从而定位用于组织消融的装置。
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公开(公告)号：US06899711B2
公开(公告)日：2005-05-31
申请号：US10414779
申请日：2003-04-16
CPC分类号： A61B18/1492 , A61B2017/00044 , A61B2017/00243 , A61B2017/00867 , A61B2018/00214 , A61B2018/1407 , A61B2018/1435
摘要： A catheter assembly and method for treatment of cardiac arrhythmia, for example, atrial fibrillation, by electrically isolating a vessel, such as a pulmonary vein, from a chamber, such as the left atrium. The catheter assembly includes a catheter body and at least one electrode. The catheter body includes a proximal portion, an intermediate portion and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and forms a substantially closed loop transverse to the longitudinal axis. The at least one electrode is disposed along the loop. With this configuration, the loop is axially directed into contact with the chamber wall about the vessel ostium. Upon energization, the electrode ablates a continuous lesion pattern about the vessel ostium, thereby electrically isolating the vessel from the chamber.
摘要翻译： 一种用于治疗心律失常（例如心房颤动）的导管组件和方法，通过诸如左心房的腔室电隔离血管（例如肺静脉）。 导管组件包括导管主体和至少一个电极。 导管主体包括近端部分，中间部分和远端部分。 中间部分从近端部分延伸并且限定纵向轴线。 远侧部分从中间部分延伸并且形成横向于纵向轴线的基本上闭合的环。 沿着环设置至少一个电极。 利用这种构造，环路被轴向地指向与容器孔周围的室壁接触。 在通电时，电极消除围绕血管口的连续病变图案，从而将容器与腔室电隔离。
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公开(公告)号：US06773433B2
公开(公告)日：2004-08-10
申请号：US10414757
申请日：2003-04-16
IPC分类号： A61B1814
CPC分类号： A61B18/1492 , A61B2017/00044 , A61B2017/00243 , A61B2017/00867 , A61B2018/00214 , A61B2018/1407 , A61B2018/1435
摘要： A catheter assembly and method for treatment of cardiac arrhythmia, for example, atrial fibrillation, by electrically isolating a vessel, such as a pulmonary vein, from a chamber, such as the left atrium. The catheter assembly includes a catheter body and at least one electrode. The catheter body includes a proximal portion, an intermediate portion and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and forms a substantially closed loop transverse to the longitudinal axis. The at least one electrode is disposed along the loop. With this configuration, the loop is axially directed into contact with the chamber wall about the vessel ostium. Upon energization, the electrode ablates a continuous lesion pattern about the vessel ostium, thereby electrically isolating the vessel from the chamber.
摘要翻译： 一种用于治疗心律失常（例如心房颤动）的导管组件和方法，通过诸如左心房的腔室电隔离血管（例如肺静脉）。 导管组件包括导管主体和至少一个电极。 导管主体包括近端部分，中间部分和远端部分。 中间部分从近端部分延伸并且限定纵向轴线。 远侧部分从中间部分延伸并且形成横向于纵向轴线的基本上闭合的环。 沿着环设置至少一个电极。 利用这种构造，环路被轴向地指向与容器孔周围的室壁接触。 在通电时，电极消除围绕血管口的连续病变图案，从而将容器与腔室电隔离。
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公开(公告)号：US06656175B2
公开(公告)日：2003-12-02
申请号：US10016299
申请日：2001-12-11
IPC分类号： A61B1704
CPC分类号： A61B18/1442 , A61B18/1402 , A61B2017/2945 , A61B2018/00357 , A61B2018/00577 , A61B2018/00797 , A61B2018/00821 , A61B2018/1432 , A61B2018/146 , A61B2218/002
摘要： A method and system for ablating tissue to provide a desired set of lesions. The system includes an ablation apparatus having an elongated shapeable section carrying a mechanism such as an electrode for applying ablation energy along the shapeable section. The shapeable section includes a member of shape memory material having a memorized configuration. The shapeable section is shaped manually or using fixtures to display a configuration corresponding to one of the desired lesions and is then employed to create the desired lesion. Thereafter the shapeable section is heated to cause it to resume its memorized configuration. Shaping, heating and ablating to create lesions are continued as necessary provide the desired set of lesions. In some embodiments of the invention, heating may be accomplished using heating elements built into the shapeable section.
摘要翻译： 一种用于烧蚀组织以提供期望的病变组的方法和系统。 该系统包括具有细长可成形部分的消融装置，该部分承载诸如用于沿着可塑部分施加消融能量的电极的机构。 可成形部分包括具有记忆结构的形状记忆材料的构件。 可成型部分手动地或使用夹具来显示对应于所需病变之一的构造，然后用于产生所需的损伤。 此后，加热可塑部分使其恢复其记忆结构。 根据需要继续整形，加热和消融以产生损伤以提供所需的病变组。 在本发明的一些实施例中，可以使用内置于可塑部分中的加热元件来实现加热。
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