摘要:
A cardiac pacing lead for electrically communicating with a human heart is attached to the heart using an adhesive. The lead includes a flexible, elongated lead body having a proximal end and a distal end, a pad having an interface surface coupled to the lead body at the distal end. An electrode is coupled to the pad. The lead further includes an adhesive for bonding the pad to the heart such that the electrode is electrically coupled to the heart. The adhesive is delivered to the interface surface after the lead has been inserted into a subject. In one embodiment, the lead system includes an anchor having an interface surface adapted for adhesive coupling to the heart. In this embodiment, the anchor is coupled to a tether and the lead includes a lumen adapted to accept the tether and to allow advancement of the lead over the tether.
摘要:
Methods, devices and instruments provided for performing ablation transmurally across the wall of an organ. Devices may directly access tissue to be ablated through direct access openings formed in the patient and, optionally, an organ where the ablation is to be performed. Instruments facilitating making openings, dissecting, and delivery of ablation instruments are also described.
摘要:
A surgical apparatus and methods for severing and welding tissue, in particular blood vessels. The apparatus includes an elongated shaft having a pair of relatively movable jaws at a distal end thereof. A first heating element on one of the jaws is adapted to heat up to a first temperature and form a welded region within the tissue, while a second heating element on one of the jaws is adapted to heat up to a second temperature and sever the tissue within the welded region. The first and second heating elements may be provided on the same or opposite jaws. A control handle provided on the proximal end of the elongated shaft includes controls for opening and closing the jaws, and may include an actuator for sending current through the first and second heating elements. The first and second heating elements may be electrically connected in series, and the first heating element may be bifurcated such that it conducts about one half of the current as the second heating element. A force-limiting mechanism provided either within the control handle, in the elongated shaft, or at the jaws limits the pressure applied to the tissue by the jaws to ensure that the tissue is severed and the ends effectively welded within a short amount of time.
摘要:
Methods of performing an anastomosis. A ring is installed at an incision or other orifice in a vessel or other organ, for use in performing an anastomosis. To install the ring, tines are advanced against an anvil to cause them to grab tissue around the orifice and curl radially. The anvil is then retracted to fold the tines so their curled ends move radially outward. A sleeve may be advanced to fold or bend the tines as their curled ends move further radially outward. The folding, curling, and further bending of the tines evert tissue near the orifice edges to expose the vessel's or organs' intima.
摘要:
Disclosed are implantable tissue augmentation devices, methods, and associated tools. The devices include an inflatable body, having a self-sealing membrane operably attached to a wall of the implant. The self-sealing membrane provides access for filling the device, and includes a first layer comprising a fabric. The fabric has a first plurality of yarn strands positioned in a first direction, and a second plurality of yarn strands positioned in a second direction. The first and second plurality of yarn strands intersect to form a matrix pattern with cells defined by free spaces between yarn strands. The membrane also includes a first elastomeric material configured to fill the cells as well as form a coating over the first and second plurality of yarn strand, and a second layer comprising a second elastomeric material. The second elastomeric material has a lower durometer than the first elastomeric material. Kits and systems are also disclosed.
摘要:
Apparatus and methods for performing endoscopic surgical procedures where only a minimal number of (or even one) openings are required to perform the procedures. Ablation procedures, including epicardial ablation procedures and apparatus for performing such procedures. Epicardial atrial ablation may be performed epicardially with access through only one side of a patient's chest required to perform all procedures.
摘要:
Devices and methods are provided for manipulating and supporting an organ. The subject devices are characterized by having an inflatable annular member having a central opening and an organ contacting surface, a vacuum distribution element configured to create a diffused vacuum space in the central opening, and a positioning element having a lumen coupled to a vacuum source and to the inflatable annular member. The subject devices are suitable for use in a variety of surgical approaches and, as such, may be configured to be inserted into a patient's chest cavity through a sheath. Methods are also provided for using the subject devices, where the order of the methods may be altered. Also provided are systems and kits for manipulating and positioning an organ.
摘要:
Devices for use in anastomosis, methods and apparatus for installing the devices around long incisions or other orifices in tubular members such as vessels (tissue or artificial graft, or combinations), organs, ducts and the like, and method for performing anastomosis. The devices evert the walls of the tubular members to which they are attached so that an anastomosis performed with the devices joins the two members by contacting the inner walls of the members.
摘要:
A ring for use in preparing a first organ for anastomosis with a second organ, wherein the first organ has an orifice, and the ring has a central ring portion sized to extend around the orifice and malleable tines that extend from the ring portion. The ring portion is configured to dilate and contract radially relative to the central axis. Malleable tines may extend out from the ring portion. The tubular shape of the ring provides rigidity parallel to the central axis thereof and flexibility in directions perpendicular to the central axis. In another class of embodiments, the central ring portion is a tubular member, which is preferably but not necessarily capable of dilating and contracting radially relative to the central axis. In some embodiments, the central ring portion includes rigid sections alternating with bowed sections, each of the bowed sections functioning as a spring capable of flexing to allow the rigid sections adjacent thereto to move radially inward and outward. In other embodiments, the central ring portion includes rigid sections, which can be made of metal, alternating with elastic sections, which can be made of elastomeric material such as silicone rubber or superelastic material or memory metal. Installation tools are also provided.
摘要:
Devices and methods for stabilizing a portion of an organ or tissue in a closed or restricted space surgical site. Devices and methods for manipulating an organ or tissue in a closed or restricted space surgical site. Devices and methods for positioning and orienting stabilizers and manipulators I a closed or restricted space surgical site.