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公开(公告)号：US06564805B2
公开(公告)日：2003-05-20
申请号：US10198513
申请日：2002-07-18
IPC分类号： A61B1900
CPC分类号： A61B17/0057 , A61B17/00234 , A61B17/0218 , A61B17/0293 , A61B17/0467 , A61B17/0469 , A61B17/06061 , A61B17/122 , A61B17/29 , A61B17/2909 , A61B17/3421 , A61B18/1492 , A61B90/36 , A61B90/50 , A61B2017/00053 , A61B2017/00243 , A61B2017/00247 , A61B2017/00575 , A61B2017/00867 , A61B2017/00907 , A61B2017/00946 , A61B2017/0237 , A61B2017/0243 , A61B2017/047 , A61B2017/0472 , A61B2017/0474 , A61B2017/0475 , A61B2017/0496 , A61B2017/2912 , A61B2017/2926 , A61B2017/2927 , A61B2017/2932 , A61B2017/2943 , A61B2017/306 , A61B2017/308 , A61B2017/3405 , A61B2017/3492 , A61B2018/00214 , A61B2018/00232 , A61B2018/00261 , A61B2018/00291 , A61B2018/00363 , A61B2018/00392 , A61B2018/00577 , A61B2018/00982 , A61B2090/061 , A61B2090/306 , A61F2/2427 , A61F2/2442 , A61F2/2445 , A61F2/2448 , A61F2/2466 , A61F2/2496 , A61F7/10 , A61F2007/0001 , A61F2007/0054 , A61F2007/101 , A61M1/3621 , A61M25/1011 , A61M39/0247 , A61M2025/028 , A61M2039/027 , A61M2039/0279 , A61M2202/047 , A61M2205/3344 , A61M2205/3355 , A61M2205/366
摘要： Devices and methods are provided for less-invasive surgical treatment of cardiac valves whereby the need for a gross thoracotomy or median sternotomy is eliminated. In one aspect of the invention, a delivery system for a cardiac valve prosthesis such as an annuloplasty ring or prosthetic valve includes an elongated handle configured to extend into the heart through an intercostal space from outside of the chest cavity, and a prosthesis holder attached to the handle for releasably holding a prosthesis. The prosthesis holder is attached to the handle in such a way that the holder, prosthesis and handle have a profile with a height smaller than the width of an intercostal space when the adjacent ribs are unretracted, preferably less than about 30 mm. In a further aspect, the invention provides a method for repairing or replacing a heart valve which includes the steps of introducing a prosthesis through an intercostal space and through a penetration in a wall of the heart, and securing the prosthesis to an interior wall of the heart, wherein each step is carried out without cutting, removing, or significantly retracting the ribs or sternum.
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公开(公告)号：US5972030A
公开(公告)日：1999-10-26
申请号：US949282
申请日：1997-10-21
IPC分类号： A61B17/00 , A61B17/02 , A61B17/04 , A61B17/06 , A61B17/122 , A61B17/28 , A61B17/30 , A61B17/34 , A61B18/00 , A61B18/14 , A61B19/00 , A61F2/24 , A61F2/958 , A61F7/00 , A61F7/10 , A61M1/00 , A61M1/36
CPC分类号： A61B17/0057 , A61B17/00234 , A61B17/0218 , A61B17/0293 , A61B17/0469 , A61B17/06061 , A61B17/122 , A61B17/29 , A61B17/3421 , A61B18/1492 , A61B90/36 , A61B90/50 , A61F2/2427 , A61F2/2448 , A61F2/2466 , A61F2/2496 , A61F7/10 , A61M39/0247 , A61B17/0467 , A61B17/2909 , A61B2017/00053 , A61B2017/00243 , A61B2017/00247 , A61B2017/00575 , A61B2017/00867 , A61B2017/00907 , A61B2017/00946 , A61B2017/0237 , A61B2017/0243 , A61B2017/047 , A61B2017/0472 , A61B2017/0474 , A61B2017/0475 , A61B2017/0496 , A61B2017/2912 , A61B2017/2926 , A61B2017/2927 , A61B2017/2932 , A61B2017/2943 , A61B2017/306 , A61B2017/308 , A61B2017/3405 , A61B2017/3492 , A61B2018/00214 , A61B2018/00232 , A61B2018/00261 , A61B2018/00291 , A61B2018/00363 , A61B2018/00392 , A61B2018/00577 , A61B2018/00982 , A61B2090/061 , A61B2090/306 , A61F2/2442 , A61F2/2445 , A61F2007/0001 , A61F2007/0054 , A61F2007/101 , A61M1/3621 , A61M2025/028 , A61M2039/027 , A61M2039/0279 , A61M2202/047 , A61M2205/3344 , A61M2205/3355 , A61M2205/366 , A61M25/1011
摘要： Devices and methods are provided for less-invasive surgical treatment of cardiac valves whereby the need for a gross thoracotomy or median sternotomy is eliminated. In one aspect of the invention, a delivery system for a cardiac valve prosthesis such as an annuloplasty ring or prosthetic valve includes an elongated handle configured to extend into the heart through an intercostal space from outside of the chest cavity, and a prosthesis holder attached to the handle for releasably holding a prosthesis. The prosthesis holder is attached to the handle in such a way that the holder, prosthesis and handle have a profile with a height smaller than the width of an intercostal space when the adjacent ribs are unretracted, preferably less than about 30 mm. In a further aspect, the invention provides a method for repairing or replacing a heart valve which includes the steps of introducing a prosthesis through an intercostal space and through a penetration in a wall of the heart, and securing the prosthesis to an interior wall of the heart, wherein each step is carried out without cutting, removing, or significantly retracting the ribs or sternum.
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公开(公告)号：US06651671B1
公开(公告)日：2003-11-25
申请号：US09416492
申请日：1999-10-12
IPC分类号： A61B1900
CPC分类号： A61B17/00234 , A61B17/0057 , A61B17/0218 , A61B17/0293 , A61B17/0467 , A61B17/0469 , A61B17/06061 , A61B17/122 , A61B17/29 , A61B17/2909 , A61B17/3417 , A61B17/3421 , A61B18/1492 , A61B90/36 , A61B90/50 , A61B2017/00053 , A61B2017/00243 , A61B2017/00247 , A61B2017/00278 , A61B2017/00575 , A61B2017/00867 , A61B2017/00907 , A61B2017/00946 , A61B2017/0237 , A61B2017/0243 , A61B2017/047 , A61B2017/0472 , A61B2017/0474 , A61B2017/0475 , A61B2017/0496 , A61B2017/2912 , A61B2017/2926 , A61B2017/2927 , A61B2017/2932 , A61B2017/2943 , A61B2017/306 , A61B2017/308 , A61B2017/3405 , A61B2017/3492 , A61B2018/00214 , A61B2018/00232 , A61B2018/00261 , A61B2018/00291 , A61B2018/00363 , A61B2018/00392 , A61B2018/00577 , A61B2018/00982 , A61B2090/061 , A61B2090/306 , A61F2/2427 , A61F2/2496 , A61F7/10 , A61F2007/0001 , A61F2007/0054 , A61F2007/101 , A61M1/3621 , A61M25/1011 , A61M39/0247 , A61M2025/028 , A61M2039/027 , A61M2039/0279 , A61M2202/047 , A61M2205/3344 , A61M2205/3355 , A61M2205/366 , Y10S623/902
摘要： Systems and methods are disclosed for performing less-invasive surgical procedures within the heart. A method for less-invasive repair or replacement of a cardiac valve comprises placing an instrument through an intercostal access port and through a penetration in a wall of a vessel in communication with the heart, advancing the instrument into the heart, and using the instrument to perform a surgical intervention on a cardiac valve in the heart under visualization through an intercostal access port. The surgeons hands are kept outside of the chest during each step. The surgical intervention may comprise replacing the cardiac valve with a prosthetic valve, wherein the native valve is removed using a tissue removal instrument, the native valve annulus is sized with a specialized sizing device, a prosthetic valve is introduced through an intercostal access port and through the penetration in the vessel, and the prosthetic valve is secured at the native valve position, all using instruments positioned through intercostal access ports without placing the hands inside the chest. Systems and devices for performing these procedures are also disclosed.
摘要翻译： 公开了用于在心脏内执行较小侵入性外科手术的系统和方法。 一种用于少量修复或更换心脏瓣膜的方法包括将器械放置在肋间通路口中，并通过与心脏通信的血管壁穿透，将仪器推入心脏，并使用仪器 通过肋间进入口在可视化的心脏内对心脏瓣膜进行手术干预。 在每一步中，外科医生的手都保持在胸前。 外科手术可以包括用假性瓣膜替换心脏瓣膜，其中使用组织去除器械去除天然瓣膜，使用专门的上浆装置来确定天然瓣膜的大小，通过肋间进入口引入人工瓣膜并通过 容器中的渗透和人造瓣膜固定在天然瓣膜位置，所有这些都使用通过肋间通路口定位的器械，而不将手放在胸部内。 还公开了用于执行这些程序的系统和装置。
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公开(公告)号：US6010531A
公开(公告)日：2000-01-04
申请号：US594870
申请日：1996-01-31
IPC分类号： A61B17/00 , A61B17/02 , A61B17/04 , A61B17/06 , A61B17/122 , A61B17/28 , A61B17/30 , A61B17/34 , A61B18/00 , A61B18/14 , A61B19/00 , A61F2/24 , A61F2/958 , A61F7/00 , A61F7/10 , A61M1/00 , A61M1/36
CPC分类号： A61B17/00234 , A61B17/0057 , A61B17/0218 , A61B17/0293 , A61B17/0469 , A61B17/06061 , A61B17/122 , A61B17/29 , A61B17/3417 , A61B17/3421 , A61B18/1492 , A61B90/36 , A61B90/50 , A61F2/2427 , A61F7/10 , A61M39/0247 , A61B17/0467 , A61B17/2909 , A61B2017/00053 , A61B2017/00243 , A61B2017/00247 , A61B2017/00278 , A61B2017/00575 , A61B2017/00867 , A61B2017/00907 , A61B2017/00946 , A61B2017/0237 , A61B2017/0243 , A61B2017/047 , A61B2017/0472 , A61B2017/0474 , A61B2017/0475 , A61B2017/0496 , A61B2017/2912 , A61B2017/2926 , A61B2017/2927 , A61B2017/2932 , A61B2017/2943 , A61B2017/306 , A61B2017/308 , A61B2017/3405 , A61B2017/3492 , A61B2018/00214 , A61B2018/00232 , A61B2018/00261 , A61B2018/00291 , A61B2018/00363 , A61B2018/00392 , A61B2018/00577 , A61B2018/00982 , A61B2090/061 , A61B2090/306 , A61F2/2496 , A61F2007/0001 , A61F2007/0054 , A61F2007/101 , A61M1/3621 , A61M2025/028 , A61M2039/027 , A61M2039/0279 , A61M2202/047 , A61M2205/3344 , A61M2205/3355 , A61M2205/366 , A61M25/1011 , Y10S623/902
摘要： Systems and methods are disclosed for performing less-invasive surgical procedures within the heart. A method for less-invasive repair or replacement of a cardiac valve comprises placing an instrument through an intercostal access port and through a penetration in a wall of a vessel in communication with the heart, advancing the instrument into the heart, and using the instrument to perform a surgical intervention on a cardiac valve in the heart under visualization through an intercostal access port. The surgeons hands are kept outside of the chest during each step. The surgical intervention may comprise replacing the cardiac valve with a prosthetic valve, wherein the native valve is removed using a tissue removal instrument, the native valve annulus is sized with a specialized sizing device, a prosthetic valve is introduced through an intercostal access port and through the penetration in the vessel, and the prosthetic valve is secured at the native valve position, all using instruments positioned through intercostal access ports without placing the hands inside the chest. Systems and devices for performing these procedures are also disclosed.
摘要翻译： 公开了用于在心脏内执行较小侵入性外科手术的系统和方法。 一种用于小面积修复或更换心脏瓣膜的方法包括将器械放置在肋间通路口中，并通过与心脏连通的血管壁穿透，将仪器推入心脏，并使用仪器 通过肋间进入口在可视化的心脏内对心脏瓣膜进行手术干预。 在每一步中，外科医生的手都保持在胸前。 外科手术可以包括用假性瓣膜替换心脏瓣膜，其中使用组织去除器械去除天然瓣膜，使用专门的上浆装置来确定天然瓣膜的大小，通过肋间进入口引入人工瓣膜并通过 容器中的渗透和人造瓣膜固定在天然瓣膜位置，所有这些都使用通过肋间通路口定位的器械，而不将手放在胸部内。 还公开了用于执行这些程序的系统和装置。
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公开(公告)号：US5618307A
公开(公告)日：1997-04-08
申请号：US567996
申请日：1995-12-04
申请人： Brian S. Donlon , Richard L. Mueller, Jr. , S. Christopher Daniel , Hanson S. Gifford, III , John H. Stevens
发明人： Brian S. Donlon , Richard L. Mueller, Jr. , S. Christopher Daniel , Hanson S. Gifford, III , John H. Stevens
IPC分类号： A61B17/00 , A61B17/064 , A61B17/12 , A61B17/122 , A61B17/128 , A61B17/28 , A61B17/34
CPC分类号： A61B17/29 , A61B17/00234 , A61B17/12013 , A61B17/122 , A61B17/064 , A61B17/1227 , A61B17/1285 , A61B17/2909 , A61B17/34 , A61B2017/00243 , A61B2017/00353 , A61B2017/00544 , A61B2017/2905 , A61B2017/2933 , A61B2017/2943 , A61B2017/2945 , A61B2017/2946 , A61B2017/3445 , A61B2018/1432 , A61M2205/3344 , A61M2205/3355
摘要： A deployable clamp for clamping a patient's ascending aorta between the coronary arteries and the brachiocephalic artery. The clamp is detachably mounted to the distal end of an elongated clamp positioner and is manipulated and actuated from the proximal end of the clamp positioner at a location outside of the patient's thoracic cavity. When actuated, the clamp blocks blood flow through the ascending aorta.
摘要翻译： 用于将患者升主动脉夹在冠状动脉和头臂动脉之间的可展开夹具。 夹具可拆卸地安装到细长夹具定位器的远端，并且在夹持定位器的近端处于患者胸腔外侧的位置处被操纵和致动。 当启动时，夹具阻止血流通过升主动脉。
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公开(公告)号：US5860992A
公开(公告)日：1999-01-19
申请号：US594869
申请日：1996-01-31
申请人： Sean Christopher Daniel , Brian S. Donlon , Michi E. Garrison , Hanson S. Gifford, III , Daniel C. Rosenman , William S. Peters , Robert L. Lathrop, II , George Crothall , James B. Mullin , Gerald R. Anderson , Wiley A. Kittrell
发明人： Sean Christopher Daniel , Brian S. Donlon , Michi E. Garrison , Hanson S. Gifford, III , Daniel C. Rosenman , William S. Peters , Robert L. Lathrop, II , George Crothall , James B. Mullin , Gerald R. Anderson , Wiley A. Kittrell
CPC分类号： A61B17/0491 , A61B17/0469 , A61B17/062 , A61B17/0625 , A61B2017/047 , A61B2017/0472 , A61B2017/061 , A61F2/2409
摘要： The invention provides devices and methods for suture placement while performing less invasive surgical procedures within a body cavity. In an exemplary embodiment, the invention provides for the placement of sutures within the heart or a great vessel that is accessed from outside the closed chest. According to one exemplary method, the patient's heart valve is accessed through an intercostal port in the patient's chest. At least one needle having a suture is then directed into the annulus while visualizing through the port placement of the needle into the annulus. The needle is then passed through the annulus.
摘要翻译： 本发明提供了用于缝合放置的装置和方法，同时在体腔内执行较少侵入性的外科手术。 在一个示例性实施例中，本发明提供将缝合线放置在心脏内或从封闭胸部外部进入的大容器中。 根据一种示例性方法，患者的心脏瓣膜通过患者胸部的肋间端口进入。 至少一根具有缝合线的针头然后被引导到环形空间中，同时通过针头插入环形空间的端口可视化。 然后针穿过环。
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公开(公告)号：US5849005A
公开(公告)日：1998-12-15
申请号：US585871
申请日：1996-01-16
CPC分类号： A61M25/1011 , A61B17/00234 , A61B90/40 , A61F2/2427 , A61F2/2466 , A61M25/0041 , A61B17/0218 , A61B17/0293 , A61B2017/00243 , A61B2090/401 , A61F2/2403 , A61F2/2448 , A61F2/2496 , A61M25/0133
摘要： An apparatus for minimizing the risk of air embolism includes an instrument delivery member 2 having a gas outlet 38 for delivering gas into a patient's thoracic cavity. The gas is directed across an opening 48 in the instrument delivery member 2 to help retain the gas in the patient's thoracic cavity. The gas is preferably carbon dioxide which is more soluble in blood than air which will thereby decrease the likelihood of the patient receiving an embolism due to trapped air in the patient's heart and great vessels after surgery.
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8.发明授权Method and apparatus for minimizing the risk of air embolism when performing a procedure in a patient's thoracic cavity 有权在患者胸腔内进行手术时，尽量减少空气栓塞风险的方法和装置公开(公告)号：US06309382B1
公开(公告)日：2001-10-30
申请号：US09209558
申请日：1998-12-11
IPC分类号： A61B1700
CPC分类号： A61M25/1011 , A61B17/00234 , A61B17/0218 , A61B17/0293 , A61B90/40 , A61B2017/00243 , A61B2090/401 , A61F2/2403 , A61F2/2427 , A61F2/2448 , A61F2/2466 , A61F2/2496 , A61M25/0041 , A61M25/0133
摘要： An apparatus for minimizing the risk of air embolism includes an instrument delivery member 2 having a gas outlet 38 for delivering gas into a patient's thoracic cavity. The gas is directed across an opening 48 in the instrument delivery member 2 to help retain the gas in the patient's thoracic cavity. The gas is preferably carbon dioxide which is more soluble in blood than air which will thereby decrease the likelihood of the patient receiving an embolism due to trapped air in the patient's heart and great vessels after surgery.
摘要翻译： 用于最小化空气栓塞风险的装置包括具有用于将气体输送到患者胸腔中的气体出口38的仪器输送构件2。 气体被引导穿过仪器输送构件2中的开口48，以帮助将气体保持在患者的胸腔中。 气体优选比空气更溶于血液的二氧化碳，从而降低患者由于患者心脏中被捕获的空气和手术后的大血管而接受栓塞的可能性。
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公开(公告)号：US06645197B2
公开(公告)日：2003-11-11
申请号：US09872637
申请日：2001-06-01
IPC分类号： A61B1700
CPC分类号： A61M25/1011 , A61B17/00234 , A61B17/0218 , A61B17/0293 , A61B90/40 , A61B2017/00243 , A61B2090/401 , A61F2/2403 , A61F2/2427 , A61F2/2448 , A61F2/2466 , A61F2/2496 , A61M25/0041 , A61M25/0133
摘要： An apparatus for minimizing the risk of air embolism includes an instrument delivery member 2 having a gas outlet 38 for delivering gas into a patient's thoracic cavity. The gas is directed across an opening 48 in the instrument delivery member 2 to help retain the gas in the patient's thoracic cavity. The gas is preferably carbon dioxide which is more soluble in blood than air which will thereby decrease the likelihood of the patient receiving an embolism due to trapped air in the patient's heart and great vessels after surgery.
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公开(公告)号：US06802319B2
公开(公告)日：2004-10-12
申请号：US09535141
申请日：2000-03-24
申请人： John H. Stevens , Lee R. Bolduc , Stephen W. Boyd , Brian S. Donlon , Hanson S. Gifford, III , Philip R. Houle , Daniel C. Rosenman
发明人： John H. Stevens , Lee R. Bolduc , Stephen W. Boyd , Brian S. Donlon , Hanson S. Gifford, III , Philip R. Houle , Daniel C. Rosenman
IPC分类号： A61B1900
CPC分类号： A61B17/0057 , A61B17/00234 , A61B17/0218 , A61B17/0293 , A61B17/0467 , A61B17/0469 , A61B17/06061 , A61B17/122 , A61B17/29 , A61B17/2909 , A61B17/3421 , A61B18/1492 , A61B90/36 , A61B90/50 , A61B2017/00053 , A61B2017/00243 , A61B2017/00247 , A61B2017/00575 , A61B2017/00867 , A61B2017/00907 , A61B2017/00946 , A61B2017/0237 , A61B2017/0243 , A61B2017/047 , A61B2017/0472 , A61B2017/0474 , A61B2017/0475 , A61B2017/0496 , A61B2017/2912 , A61B2017/2926 , A61B2017/2927 , A61B2017/2932 , A61B2017/2943 , A61B2017/306 , A61B2017/308 , A61B2017/3405 , A61B2017/3492 , A61B2018/00214 , A61B2018/00232 , A61B2018/00261 , A61B2018/00291 , A61B2018/00363 , A61B2018/00392 , A61B2018/00577 , A61B2018/00982 , A61B2090/061 , A61B2090/306 , A61F2/2442 , A61F2/2445 , A61F7/10 , A61F2007/0001 , A61F2007/0054 , A61F2007/101 , A61M1/3621 , A61M25/1011 , A61M39/0247 , A61M2025/028 , A61M2039/027 , A61M2039/0279 , A61M2202/047 , A61M2205/3344 , A61M2205/3355 , A61M2205/366
摘要： A method of treatment of congestive heart failure comprises the steps of introducing an aortic occlusion catheter through a patient's peripheral artery, the aortic occlusion catheter having an occluding member movable from a collapsed position to an expanded position; positioning the occluding member in the patient's ascending aorta; moving the occluding member from the collapsed shape to the expanded shape after the positioning step; introducing cardioplegic fluid into the patient's coronary blood vessels to arrest the patient's heart; maintaining circulation of oxygenated blood through the patient's arterial system; and reshaping an outer wall of the patient's heart while the heart is arrested so as to reduce the transverse dimension of the left ventricle. The ascending aorta may be occluded and cardioplegic fluid delivered by means of an occlusion balloon attached to the distal end of an elongated catheter positioned transluminally in the aorta from a femoral, subclavian, or other appropriate peripheral artery.
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