摘要:
The present invention provides methods and apparatus for endovascularly replacing a patient's heart valve. The apparatus includes a replacement valve and an anchor having an expandable braid. In some embodiments, the expandable braid is fabricated from a single strand of wire. In some embodiments, the expandable braid comprises at least one turn feature. The anchor and the valve preferably are configured for endovascular delivery and deployment.
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 means, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing means such that the contraction of the beating heart causes orgy minimal excess motion at the surgery site. By fixing the position of the stabilizing means 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 means 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 means 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 means becomes fixed by the support, and the heart remains substantially motionless for the duration of the procedure.
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:
A plurality of embodiments of a distal perfusion device are disclosed, which device facilitates anastomosis constructions by maintaining a dry anastomosis site while simultaneously maintaining blood flow distally in the blood vessel to prevent ischemia and reduce overall patient trauma. The perfusion device is configured for installation into a blood vessel such as a left anterior descending coronary artery through an incision therein, to which is to be grafted a distal end of a blood vessel such as an internal mammary artery. The device includes a central member of selected configuration and material, terminating at either end thereof in respective selectively tapered end members. A lumen extending through the central member and end members, and selected perforations in the end members, maintain blood flow through the perfusion device. A selected portion or portions of the device's outer circumference fit snugly within the artery in the regions beyond and/or at the anastomosis site, to maintain the latter free of blood. Several methods for deploying and removing respective embodiments of the device also are illustrated.
摘要:
Methods and devices for revascularization of a patient's coronary artery system which obviate the need to place the patient on cardiopulmonary bypass. A method is provided for revascularizing a patient while the-heart is beating, and includes performing at least one minimally invasive coronary artery bypass graft procedure, or other cardiac surgical procedure, and contemporaneously performing at least one catheter-based procedure in at least one coronary artery. The catheter-based procedure(s) may be either therapeutic or diagnostic or both, and may involve delivering at least one catheter to a coronary artery via a surgical or percutaneous opening in the thoracic cavity or via a percutaneous opening at a location peripheral to the thoracic cavity. The catheter-based procedure or procedures is performed contemporaneously with the bypass graft procedure, and specifically prior to, during, or after anesthetizing the patient for purposes of the bypass graft procedure. An arterial access device is also provided for central cannulation and direct intraoperative catheterization of a patient's coronary artery system on a beating heart. The device includes a tubular member, such as a cannula, having a proximal end and a distal end, and an elongated puncturing member, such as a trocar, which is slideably disposed within the tubular member. The puncturing member has a sharp distal end for puncturing through the wall of a coronary lumen. The arterial access device further includes a sealing member for engaging the coronary lumen wall at the puncture site in order to minimize the leakage of blood from the puncture site.
摘要:
The present invention provides methods and apparatus for endovascularly replacing a patient's heart valve. The apparatus includes a replacement valve and an anchor having an expandable braid. In some embodiments, the expandable braid is fabricated from a single strand of wire. In some embodiments, the expandable braid comprises at least one turn feature. The anchor and the valve preferably are configured for endovascular delivery and deployment.
摘要:
The invention includes methods of and apparatus for endovascularly replacing a heart valve of a patient. One aspect of the invention provides a method including the steps of endovascularly delivering a replacement valve and an expandable anchor to a vicinity of the heart valve in an unexpanded configuration; and applying an external non-hydraulically expanding or non-pneumatically expanding actuation force on the anchor to change the shape of the anchor, such as by applying proximally and/or distally directed force on the anchor using a releasable deployment tool to expand and contract the anchor or parts of the anchor. Another aspect of the invention provides an apparatus including a replacement valve; an anchor; and a deployment tool comprising a plurality of anchor actuation elements adapted to apply a non-hydraulically expanding or non-pneumatically expanding actuation force on the anchor to reshape the anchor.
摘要:
A tissue electrode assembly includes a membrane configured to form an expandable, conformable body that is deployable in a patient. The assembly further includes a flexible circuit positioned on a surface of the membrane and comprising at least one base substrate layer, at least one insulating layer and at least one planar conducting layer. An electrically-conductive electrode covers at least a portion of the flexible circuit and a portion of the surface of the membrane not covered by the flexible circuit, wherein the electrically-conductive electrode is foldable upon itself with the membrane to a delivery conformation having a diameter suitable for minimally-invasive delivery of the assembly to the patient.
摘要:
Medical devices and delivery systems for delivering medical devices to a target location within a subject. In some embodiments the medical devices can be locked in a fully deployed and locked configuration. In some embodiments the delivery systems are configured with a single actuator to control the movement of multiple components of the delivery system. In some embodiments the actuator controls the independent and dependent movement of multiple components of the delivery system.