公开(公告)号：US06613069B2

公开(公告)日：2003-09-02

申请号：US09982504

申请日：2001-10-19

申请人： Stephen W. Boyd ,  Alan R. Rapacki ,  Matthias Vaska ,  Brian S. Donlon ,  William S. Peters ,  John H. Stevens

发明人： Stephen W. Boyd ,  Alan R. Rapacki ,  Matthias Vaska ,  Brian S. Donlon ,  William S. Peters ,  John H. Stevens

IPC分类号： A61B1744

CPC分类号： A61F7/10 ,  A61B17/00234 ,  A61B17/0057 ,  A61B17/0218 ,  A61B17/0467 ,  A61B17/0469 ,  A61B17/06061 ,  A61B17/064 ,  A61B17/068 ,  A61B17/12013 ,  A61B17/122 ,  A61B17/1227 ,  A61B17/1285 ,  A61B17/29 ,  A61B17/2909 ,  A61B17/30 ,  A61B17/3403 ,  A61B18/1442 ,  A61B18/1492 ,  A61B90/36 ,  A61B90/50 ,  A61B2017/00243 ,  A61B2017/00247 ,  A61B2017/00637 ,  A61B2017/00663 ,  A61B2017/0225 ,  A61B2017/0237 ,  A61B2017/0243 ,  A61B2017/047 ,  A61B2017/0472 ,  A61B2017/0474 ,  A61B2017/0475 ,  A61B2017/2912 ,  A61B2017/2927 ,  A61B2017/2932 ,  A61B2017/2943 ,  A61B2017/306 ,  A61B2017/308 ,  A61B2017/3405 ,  A61B2017/3427 ,  A61B2017/3492 ,  A61B2018/00214 ,  A61B2018/00232 ,  A61B2018/00261 ,  A61B2018/00291 ,  A61B2018/00363 ,  A61B2018/00392 ,  A61B2018/00577 ,  A61B2090/064 ,  A61B2090/306 ,  A61F2/2427 ,  A61F2007/0001 ,  A61F2007/0054 ,  A61F2007/101 ,  A61M25/0023 ,  A61M25/0032 ,  A61M25/1011 ,  A61M39/0247 ,  A61M2025/0003 ,  A61M2025/0031 ,  A61M2025/028 ,  A61M2025/1052 ,  A61M2039/0279 ,  A61M2202/047 ,  A61M2205/3344 ,  A61M2205/3355 ,  A61M2205/366 ,  A61M2210/127 ,  A61M2230/005

摘要： Surgical methods and instruments are disclosed for performing port-access or closed-chest coronary artery bypass (CABG) surgery in multivessel coronary artery disease. In contrast to standard open-chest CABG surgery, which requires a median sternotomy or other gross thoracotomy to expose the patient's heart, port-access CABG surgery is performed through small incisions or access ports made through the intercostal spaces between the patient's ribs, resulting in greatly reduced pain and morbidity to the patient. In situ arterial bypass grafts, such as the internal mammary arteries and/or the right gastroepiploic artery, are prepared for grafting by thoracoscopic or laparoscopic takedown techniques. Free grafts, such as a saphenous vein graft or a free arterial graft, can be used to augment the in situ arterial grafts. The graft vessels are anastomosed to the coronary arteries under direct visualization through a cardioscopic microscope inserted through an intercostal access port. Retraction instruments are provided to manipulate the heart within the closed chest of the patient to expose each of the coronary arteries for visualization and anastomosis. Disclosed are a tunneler and an articulated tunneling grasper for rerouting the graft vessels, and a finger-like retractor, a suction cup retractor, a snare retractor and a loop retractor for manipulating the heart. Also disclosed is a port-access topical cooling device for improving myocardial protection during the port-access CABG procedure. An alternate surgical approach using an anterior mediastinotomy is also described.

摘要翻译： 公开了手术方法和手段，用于在多支冠状动脉疾病中进行门禁或封闭式冠状动脉旁路（CABG）手术。 与标准的胸腔CABG手术相比，其需要中位胸骨切开术或其他大胸廓切开术来暴露患者的心脏，通过患者肋骨之间的肋间空间形成的小切口或进入端口进行口腔进入CABG手术，导致 大大减轻患者的疼痛和发病率。 通过胸腔镜或腹腔镜移植技术准备原位动脉旁路移植物，例如乳内动脉和/或右胃腹动脉，用于移植。 可以使用游离移植物，例如隐静脉移植物或自由动脉移植物来增加原位动脉移植物。 通过插入通过肋间进入口的心脏显微镜，直接观察移植血管与冠状动脉吻合。 提供收缩器械以操纵患者的封闭胸部内的心脏以暴露每个冠状动脉以进行可视化和吻合。 公开了一种用于重新路由移植血管的隧道器和铰接隧道抓紧器，以及用于操纵心脏的手指状牵开器，吸盘牵开器，圈套牵开器和回卷器。 还公开了一种用于在端口访问CABG过程期间改善心肌保护的端口访问局部冷却装置。 还描述了使用前纵隔切开术的替代手术方法。

公开(公告)号：US06478029B1

公开(公告)日：2002-11-12

申请号：US09634608

申请日：2000-08-05

申请人： Stephen W. Boyd ,  Alan R. Rapacki ,  Matthias Vaska ,  Brian S. Donlon ,  William S. Peters

发明人： Stephen W. Boyd ,  Alan R. Rapacki ,  Matthias Vaska ,  Brian S. Donlon ,  William S. Peters

IPC分类号： A61B1900

CPC分类号： A61B17/29 ,  A61B17/00234 ,  A61B17/0218 ,  A61B17/2909 ,  A61B18/1492 ,  A61B90/36 ,  A61B2017/00243 ,  A61B2017/00247 ,  A61B2017/0237 ,  A61B2017/0243 ,  A61B2017/047 ,  A61B2017/0472 ,  A61B2017/2901 ,  A61B2017/2905 ,  A61B2017/2912 ,  A61B2017/2927 ,  A61B2017/2932 ,  A61B2017/306 ,  A61B2017/308 ,  A61B2017/3405 ,  A61B2017/3492 ,  A61B2018/00214 ,  A61B2018/00232 ,  A61B2018/00261 ,  A61B2018/00291 ,  A61B2018/00363 ,  A61B2018/00392 ,  A61B2018/00577 ,  A61B2090/306 ,  A61F2/2427 ,  A61F7/10 ,  A61F2007/0001 ,  A61F2007/0054 ,  A61F2007/101 ,  A61M25/1011 ,  A61M39/0247 ,  A61M2025/028 ,  A61M2039/0279 ,  A61M2205/3344 ,  A61M2205/3355 ,  A61M2205/366

摘要： Surgical methods and instruments are disclosed for performing port-access or closed-chest coronary artery bypass (CABG) surgery in multivessel coronary artery disease. In contrast to standard open-chest CABG surgery, which requires a median sternotomy or other gross thoracotomy to expose the patient's heart, post-access CABG surgery is performed through small incisions or access ports made through the intercostal spaces between the patient's ribs, resulting in greatly reduced pain and morbidity to the patient. In situ arterial bypass grafts, such as the internal mammary arteries and/or the right gastroepiploic artery, are prepared for grafting by thoracoscopic or laparoscopic takedown techniques. Free grafts, such as a saphenous vein graft or a free arterial graft, can be used to augment the in situ arterial grafts. The graft vessels are anastomosed to the coronary arteries under direct visualization through a cardioscopic microscope inserted through an intercostal access port. Retraction instruments are provided to manipulate the heart within the closed chest of the patient to expose each of the coronary arteries for visualization and anastomosis. Disclosed are a tunneler and an articulated tunneling grasper for rerouting the graft vessels, and a finger-like retractor, a suction cup retractor, a snare retractor and a loop retractor for manipulating the heart. Also disclosed is a port-access topical cooling device for improving myocardial protection during the port-access CABG procedure. An alternate surgical approach using an anterior mediastinotomy is also described.

摘要翻译： 公开了手术方法和手段，用于在多支冠状动脉疾病中进行门禁或封闭式冠状动脉旁路（CABG）手术。 与标准的胸腔CABG手术相比，其需要中位胸骨切开术或其他大胸廓切开术来暴露患者的心脏，通过穿过患者肋骨之间的肋间空间形成的小切口或进入口进行后访问CABG手术，导致 大大减轻患者的疼痛和发病率。 通过胸腔镜或腹腔镜移植技术准备原位动脉旁路移植物，例如乳内动脉和/或右胃腹动脉，用于移植。 可以使用游离移植物，例如隐静脉移植物或自由动脉移植物来增加原位动脉移植物。 通过插入通过肋间进入口的心脏显微镜，直接观察移植血管与冠状动脉吻合。 提供收缩器械以操纵患者的封闭胸部内的心脏以暴露每个冠状动脉以进行可视化和吻合。 公开了一种用于重新路由移植血管的隧道器和铰接隧道抓紧器，以及用于操纵心脏的手指状牵开器，吸盘牵开器，圈套牵开器和回卷器。 还公开了一种用于在端口访问CABG过程期间改善心肌保护的端口访问局部冷却装置。 还描述了使用前纵隔切开术的替代手术方法。

公开(公告)号：US07017581B2

公开(公告)日：2006-03-28

申请号：US09982502

申请日：2001-10-19

申请人： Stephen W. Boyd ,  Alan R. Rapacki ,  Matthias Vaska ,  Brian S. Donlon ,  William S. Peters

发明人： Stephen W. Boyd ,  Alan R. Rapacki ,  Matthias Vaska ,  Brian S. Donlon ,  William S. Peters

IPC分类号： A61B19/00

CPC分类号： A61B17/00234 ,  A61B17/0218 ,  A61B17/29 ,  A61B17/2909 ,  A61B18/1492 ,  A61B90/36 ,  A61B2017/00243 ,  A61B2017/00247 ,  A61B2017/0225 ,  A61B2017/0237 ,  A61B2017/0243 ,  A61B2017/047 ,  A61B2017/0472 ,  A61B2017/2912 ,  A61B2017/2927 ,  A61B2017/2932 ,  A61B2017/306 ,  A61B2017/308 ,  A61B2017/3405 ,  A61B2017/3492 ,  A61B2018/00214 ,  A61B2018/00232 ,  A61B2018/00261 ,  A61B2018/00291 ,  A61B2018/00363 ,  A61B2018/00392 ,  A61B2018/00577 ,  A61B2090/306 ,  A61F2/2427 ,  A61F7/10 ,  A61F2007/0001 ,  A61F2007/0054 ,  A61F2007/101 ,  A61M25/1011 ,  A61M39/0247 ,  A61M2025/028 ,  A61M2039/0279 ,  A61M2205/3344 ,  A61M2205/3355 ,  A61M2205/366

摘要： Surgical methods and instruments are disclosed for performing port-access or closed-chest coronary artery bypass (CABG) surgery in multivessel coronary artery disease. In contrast to standard open-chest CABG surgery, which requires a median sternotomy or other gross thoracotomy to expose the patient's heart, port-access CABG surgery is performed through small incisions or access ports made through the intercostal spaces between the patient's ribs, resulting in greatly reduced pain and morbidity to the patient. In situ arterial bypass grafts, such as the internal mammary arteries and/or the right gastroepiploic artery, are prepared for grafting by thoracoscopic or laparoscopic takedown techniques. Free grafts, such as a saphenous vein graft or a free arterial graft, can be used to augment the in situ arterial grafts. The graft vessels are anastomosed to the coronary arteries under direct visualization through a cardioscopic microscope inserted through an intercostal access port. Retraction instruments are provided to manipulate the heart within the closed chest of the patient to expose each of the coronary arteries for visualization and anastomosis. Disclosed are a tunneler and an articulated tunneling grasper for rerouting the graft vessels, and a finger-like retractor, a suction cup retractor, a snare retractor and a loop retractor for manipulating the heart. Also disclosed is a port-access topical cooling device for improving myocardial protection during the port-access CABG procedure. An alternate surgical approach using an anterior mediastinotomy is also described.

公开(公告)号：US06494211B1

公开(公告)日：2002-12-17

申请号：US09487024

申请日：2000-01-19

申请人： Stephen W. Boyd ,  Alan R. Rapacki ,  Matthias Vaska ,  Brian S. Donlon ,  William S. Peters

发明人： Stephen W. Boyd ,  Alan R. Rapacki ,  Matthias Vaska ,  Brian S. Donlon ,  William S. Peters

IPC分类号： A61B1900

CPC分类号： A61B17/00234 ,  A61B17/0218 ,  A61B17/29 ,  A61B17/2909 ,  A61B18/1492 ,  A61B90/36 ,  A61B2017/00243 ,  A61B2017/00247 ,  A61B2017/0225 ,  A61B2017/0237 ,  A61B2017/0243 ,  A61B2017/047 ,  A61B2017/0472 ,  A61B2017/2912 ,  A61B2017/2927 ,  A61B2017/2932 ,  A61B2017/306 ,  A61B2017/308 ,  A61B2017/3405 ,  A61B2017/3492 ,  A61B2018/00214 ,  A61B2018/00232 ,  A61B2018/00261 ,  A61B2018/00291 ,  A61B2018/00363 ,  A61B2018/00392 ,  A61B2018/00577 ,  A61B2090/306 ,  A61F2/2427 ,  A61F7/10 ,  A61F2007/0001 ,  A61F2007/0054 ,  A61F2007/101 ,  A61M25/1011 ,  A61M39/0247 ,  A61M2025/028 ,  A61M2039/0279 ,  A61M2205/3344 ,  A61M2205/3355 ,  A61M2205/366

摘要： Surgical methods and instruments are disclosed for performing port-access or closed-chest coronary artery bypass (CABG) surgery in multivessel coronary artery disease. In contrast to standard open-chest CABG surgery, which requires a median stemotomy or other gross thoracotomy to expose the patient's heart, port-access CABG surgery is performed through small incisions or access ports made through the intercostal spaces between the patient's ribs, resulting in greatly reduced pain and morbidity to the patient. In situ arterial bypass grafts, such as the internal mammary arteries and/or the right gastroepiploic artery, are prepared for grafting by thoracoscopic or laparoscopic takedown techniques. Free grafts, such as a saphenous vein graft or a free arterial graft, can be used to augment the in situ arterial grafts. The graft vessels are anastomosed to the coronary arteries under direct visualization through a cardioscopic microscope inserted through an intercostal access port. Retraction instruments are provided to manipulate the heart within the closed chest of the patient to expose each of the coronary arteries for visualization and anastomosis. Disclosed are a tunneler and an articulated tunneling grasper for rerouting the graft vessels, and a finger-like retractor, a suction cup retractor, a snare retractor and a loop retractor for manipulating the heart. Also disclosed is a port-access topical cooling device for improving myocardial protection during the port-access CABG procedure. An alternate surgical approach using an anterior mediastinotomy is also described.

摘要翻译： 公开了手术方法和手段，用于在多支冠状动脉疾病中进行门禁或封闭式冠状动脉旁路（CABG）手术。 与标准的胸腔CABG手术相比，其需要中位切开术或其他彻底的胸廓切开术来暴露患者的心脏，通过在患者肋骨之间的肋间隙形成的小切口或进入端口进行口腔进入CABG手术，导致 大大减轻患者的疼痛和发病率。 通过胸腔镜或腹腔镜移植技术准备原位动脉旁路移植物，例如乳内动脉和/或右胃腹动脉，用于移植。 可以使用游离移植物，例如隐静脉移植物或自由动脉移植物来增加原位动脉移植物。 通过插入通过肋间进入口的心脏显微镜，直接观察移植血管与冠状动脉吻合。 提供收缩器械以操纵患者的封闭胸部内的心脏以暴露每个冠状动脉以进行可视化和吻合。 公开了一种用于重新路由移植血管的隧道器和铰接隧道抓紧器，以及用于操纵心脏的手指状牵开器，吸盘牵开器，圈套牵开器和回卷器。 还公开了一种用于在端口访问CABG过程期间改善心肌保护的端口访问局部冷却装置。 还描述了使用前纵隔切开术的替代手术方法。

公开(公告)号：US5799661A

公开(公告)日：1998-09-01

申请号：US486941

申请日：1995-06-07

申请人： Stephen W. Boyd ,  Alan R. Rapacki ,  William S. Peters

发明人： Stephen W. Boyd ,  Alan R. Rapacki ,  William S. Peters

IPC分类号： A61B1/00 ,  A61B17/00 ,  A61B17/02 ,  A61B17/04 ,  A61B17/06 ,  A61B17/064 ,  A61B17/068 ,  A61B17/12 ,  A61B17/122 ,  A61B17/128 ,  A61B17/28 ,  A61B17/30 ,  A61B17/34 ,  A61B18/14 ,  A61B19/00 ,  A61F2/24 ,  A61F2/958 ,  A61F7/00 ,  A61F7/10 ,  A61M1/00 ,  A61M25/00

CPC分类号： A61F7/10 ,  A61B17/00234 ,  A61B17/0218 ,  A61B17/0469 ,  A61B17/06061 ,  A61B17/122 ,  A61B17/1227 ,  A61B17/1285 ,  A61B17/29 ,  A61B18/1442 ,  A61B18/1492 ,  A61B90/36 ,  A61B90/50 ,  A61F2/2427 ,  A61M39/0247 ,  A61B17/0057 ,  A61B17/0467 ,  A61B17/064 ,  A61B17/068 ,  A61B17/12013 ,  A61B17/2804 ,  A61B17/2909 ,  A61B17/30 ,  A61B17/3403 ,  A61B2017/00243 ,  A61B2017/00247 ,  A61B2017/00637 ,  A61B2017/00663 ,  A61B2017/0237 ,  A61B2017/0243 ,  A61B2017/047 ,  A61B2017/0472 ,  A61B2017/0474 ,  A61B2017/0475 ,  A61B2017/2912 ,  A61B2017/2927 ,  A61B2017/2932 ,  A61B2017/2943 ,  A61B2017/306 ,  A61B2017/308 ,  A61B2017/320056 ,  A61B2017/3405 ,  A61B2017/3427 ,  A61B2017/3492 ,  A61B2018/00214 ,  A61B2018/00232 ,  A61B2018/00261 ,  A61B2018/00291 ,  A61B2018/00363 ,  A61B2018/00392 ,  A61B2018/00577 ,  A61B2090/064 ,  A61B2090/306 ,  A61B2217/005 ,  A61F2007/0001 ,  A61F2007/0054 ,  A61F2007/101 ,  A61M2025/0003 ,  A61M2025/028 ,  A61M2039/0279 ,  A61M2202/047 ,  A61M2205/3344 ,  A61M2205/3355 ,  A61M2205/366 ,  A61M2210/127 ,  A61M25/1011

摘要： Surgical methods and instruments are disclosed for performing port-access or closed-chest coronary artery bypass (CABG) surgery in multivessel coronary artery disease. In contrast to standard open-chest CABG surgery, which requires a median sternotomy or other gross thoracotomy to expose the patient's heart, port-access CABG surgery is performed through small incisions or access ports made through the intercostal spaces between the patient's ribs, resulting in greatly reduced pain and morbidity to the patient. In situ arterial bypass grafts, such as the internal mammary arteries and/or the right gastroepiploic artery, are prepared for grafting by thoracoscopic or laparoscopic takedown techniques. Free grafts, such as a saphenous vein graft or a free arterial graft, can be used to augment the in situ arterial grafts. The graft vessels are anastomosed to the coronary arteries under direct visualization through a cardioscopic microscope inserted through an intercostal access port. Retraction instruments are provided to manipulate the heart within the closed chest of the patient to expose each of the coronary arteries for visualization and anastomosis. Disclosed are a tunneler and an articulated tunneling grasper for rerouting the graft vessels, and a finger-like retractor, a suction cup retractor, a snare retractor and a loop retractor for manipulating the heart. Also disclosed is a port-access topical cooling device for improving myocardial protection during the port-access CABG procedure. An alternate surgical approach using an anterior mediastinotomy is also described.

公开(公告)号：US5814016A

公开(公告)日：1998-09-29

申请号：US797229

申请日：1997-02-07

申请人： Kirsten L. Valley ,  David W. Snow ,  Timothy C. Corvi ,  Brian S. Donlon ,  Stephen W. Boyd ,  Sylvia W. Fan ,  Alex T. Roth ,  William S. Peters ,  Richard J. Mueller, Jr. ,  Hanson S. Gifford, III

发明人： Kirsten L. Valley ,  David W. Snow ,  Timothy C. Corvi ,  Brian S. Donlon ,  Stephen W. Boyd ,  Sylvia W. Fan ,  Alex T. Roth ,  William S. Peters ,  Richard J. Mueller, Jr. ,  Hanson S. Gifford, III

IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B17/04 ,  A61B17/06 ,  A61B17/28 ,  A61B17/30 ,  A61B17/34 ,  A61B18/14 ,  A61B19/00 ,  A61F2/24 ,  A61F2/958 ,  A61M1/00 ,  A61M1/36 ,  A61M25/00 ,  A61M25/01 ,  A61M25/06 ,  A61M29/02 ,  A61M29/00

CPC分类号： A61M25/0147 ,  A61B17/00234 ,  A61B17/0218 ,  A61B17/0469 ,  A61B17/06061 ,  A61B18/1492 ,  A61B90/50 ,  A61F2/2427 ,  A61M1/3653 ,  A61M1/3659 ,  A61M25/0028 ,  A61M25/0041 ,  A61M25/0152 ,  A61M25/0155 ,  A61M25/0662 ,  A61M25/10 ,  A61M25/1002 ,  A61M25/1011 ,  A61M25/1029 ,  A61M25/1038 ,  A61M39/0247 ,  A61B17/0467 ,  A61B17/2909 ,  A61B2017/00243 ,  A61B2017/00247 ,  A61B2017/0243 ,  A61B2017/047 ,  A61B2017/0472 ,  A61B2017/0474 ,  A61B2017/0475 ,  A61B2017/2943 ,  A61B2017/306 ,  A61B2017/3405 ,  A61B2017/3492 ,  A61B2018/00214 ,  A61B2018/00232 ,  A61B2018/00261 ,  A61B2018/00291 ,  A61B2018/00363 ,  A61B2018/00392 ,  A61B2018/00577 ,  A61B2090/064 ,  A61B2090/306 ,  A61M1/3621 ,  A61M2025/0002 ,  A61M2025/0004 ,  A61M2025/0031 ,  A61M2025/0046 ,  A61M2025/0078 ,  A61M2025/015 ,  A61M2025/0161 ,  A61M2025/028 ,  A61M2025/1047 ,  A61M2025/105 ,  A61M2025/1052 ,  A61M2025/1059 ,  A61M2025/1077 ,  A61M2025/1095 ,  A61M2202/047 ,  A61M2205/11 ,  A61M2205/3344 ,  A61M2205/3355 ,  A61M2205/366 ,  A61M2210/125 ,  A61M2210/127 ,  A61M25/0023 ,  A61M25/0032 ,  A61M25/0054 ,  A61M25/0125 ,  A61M25/1034

摘要： Devices and methods are provided for temporarily inducing cardioplegic arrest in the heart of a patient and for establishing cardiopulmonary bypass in order to facilitate surgical procedures on the heart and its related blood vessels. Specifically, a catheter based system is provided for isolating the heart and coronary blood vessels of a patient from the remainder of the arterial system and for infusing a cardioplegic agent into the patient's coronary arteries to induce cardioplegic arrest in the heart. The system includes an endoaortic partitioning catheter having an expandable balloon at its distal end which is expanded within the ascending aorta to occlude the aortic lumen between the coronary ostia and the brachiocephalic artery. Means for centering the catheter tip within the ascending aorta include specially curved shaft configurations, eccentric or shaped occlusion balloons and a steerable catheter tip, which may be used separately or in combination. The shaft of the catheter may have a coaxial or multilumen construction. The catheter may further include piezoelectric pressure transducers at the distal tip of the catheter and within the occlusion balloon. Means to facilitate nonfluoroscopic placement of the catheter include fiberoptic transillumination of the aorta and a secondary balloon at the distal tip of the catheter for atraumatically contacting the aortic valve. The system further includes a dual purpose arterial bypass cannula and introducer sheath for introducing the catheter into a peripheral artery of the patient.

公开(公告)号：US06913601B2

公开(公告)日：2005-07-05

申请号：US09863135

申请日：2001-05-22

申请人： Frederick G. St. Goar ,  William S. Peters ,  Philip C. Evard ,  Stephen W. Boyd ,  Craig L. Adams ,  Richard L. Mueller, Jr. ,  John H. Stevens

发明人： Frederick G. St. Goar ,  William S. Peters ,  Philip C. Evard ,  Stephen W. Boyd ,  Craig L. Adams ,  Richard L. Mueller, Jr. ,  John H. Stevens

IPC分类号： A61B17/00 ,  A61F2/24 ,  A61F2/958 ,  A61M1/36 ,  A61M25/00 ,  A61M25/01 ,  A61M25/06 ,  A61M25/14 ,  A61M29/02 ,  A61M31/00

CPC分类号： A61M25/0068 ,  A61B2017/00243 ,  A61B2018/00232 ,  A61B2018/00261 ,  A61F2/2427 ,  A61M1/3653 ,  A61M1/3659 ,  A61M25/0041 ,  A61M25/005 ,  A61M25/008 ,  A61M25/01 ,  A61M25/0125 ,  A61M25/0662 ,  A61M25/10 ,  A61M25/1002 ,  A61M2025/0031 ,  A61M2025/0034 ,  A61M2025/0036 ,  A61M2025/004 ,  A61M2025/0057 ,  A61M2025/0078 ,  A61M2025/0087 ,  A61M2025/028 ,  A61M2025/1047 ,  A61M2025/1077 ,  A61M2205/11 ,  A61M2205/366 ,  A61M2210/125

摘要： A catheter system is provided for accessing the coronary ostia transluminally from a peripheral arterial access site, such as the femoral artery, and for inducing cardioplegic arrest by direct infusion of cardioplegic solution into the coronary arteries. In a first embodiment, the catheter system is in the form of a single perfusion catheter with multiple distal branches for engaging the coronary ostia. In a second embodiment, multiple perfusion catheters are delivered to the coronary ostia through a single arterial cannula. In a third embodiment, multiple perfusion catheters are delivered to the coronary ostia through a single guiding catheter. In a fourth embodiment, multiple catheters are delivered to the coronary ostia through a single guiding catheter which has distal exit ports that are arranged to direct the perfusion catheters into the coronary ostia. In each embodiment, the catheters are equipped with an occlusion means at the distal end of the catheter for closing the coronary ostia and isolating the coronary arteries from the systemic blood flow. The occlusion means can take the form of an inflatable occlusion balloon cuff, a tapered occlusion device or an O-ring encircling the distal end of the catheter. An optional ventricular venting catheter can be included in the system for venting blood and fluids from the left ventricle of the heart. The catheter system is combined with a femoral-to-femoral cardiopulmonary bypass system to provide a system for cardioplegic arrest and total cardiopulmonary support during minimally invasive cardiac surgical procedures.

摘要翻译： 提供导管系统用于从外周动脉进入部位（例如股动脉）平均进入冠状动脉口，并且通过将心脏停搏液直接输注到冠状动脉中诱发心脏停搏。 在第一实施例中，导管系统是具有用于接合冠状动脉口的多个远端分支的单次灌注导管的形式。 在第二实施例中，多个灌注导管通过单个动脉插管递送至冠状动脉口。 在第三实施例中，多个灌注导管通过单个引导导管输送到冠状动脉口。 在第四实施例中，多个导管通过单个引导导管输送到冠状动脉口，该引导导管具有设置成将灌注导管引导到冠状动脉口中的远侧出口。 在每个实施例中，导管在导管的远端配备有闭塞装置，用于封闭冠状动脉口，并将冠状动脉与全身血流隔离。 闭塞装置可采取充气闭塞球囊，锥形闭塞装置或围绕导管远端的O形环的形式。 系统中可以包括可选的心室通气导管，用于从心脏的左心室排出血液和液体。 导管系统与股骨 - 股骨心肺旁路系统组合，以在微创心脏手术过程中提供心脏停搏和全心肺支持的系统。

公开(公告)号：US06913600B2

公开(公告)日：2005-07-05

申请号：US09161109

申请日：1998-09-25

申请人： Kirsten L. Valley ,  David W. Snow ,  Timothy C. Corvi ,  Brian S. Donlon ,  Stephen W. Boyd ,  Sylvia W. Fan ,  Alex T. Roth ,  William S. Peters ,  Richard J. Mueller, Jr. ,  Hanson S. Gifford, III

发明人： Kirsten L. Valley ,  David W. Snow ,  Timothy C. Corvi ,  Brian S. Donlon ,  Stephen W. Boyd ,  Sylvia W. Fan ,  Alex T. Roth ,  William S. Peters ,  Richard J. Mueller, Jr. ,  Hanson S. Gifford, III

IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B17/04 ,  A61B17/06 ,  A61B17/28 ,  A61B17/30 ,  A61B17/34 ,  A61B18/14 ,  A61B19/00 ,  A61F2/24 ,  A61F2/958 ,  A61M1/00 ,  A61M1/36 ,  A61M25/00 ,  A61M25/01 ,  A61M25/06 ,  A61M29/02 ,  A61M31/00 ,  A61M29/00

CPC分类号： A61M25/0147 ,  A61B17/00234 ,  A61B17/0218 ,  A61B17/0467 ,  A61B17/0469 ,  A61B17/06061 ,  A61B17/2909 ,  A61B18/1492 ,  A61B90/50 ,  A61B2017/00243 ,  A61B2017/00247 ,  A61B2017/0243 ,  A61B2017/047 ,  A61B2017/0472 ,  A61B2017/0474 ,  A61B2017/0475 ,  A61B2017/2943 ,  A61B2017/306 ,  A61B2017/3405 ,  A61B2017/3492 ,  A61B2018/00214 ,  A61B2018/00232 ,  A61B2018/00261 ,  A61B2018/00291 ,  A61B2018/00363 ,  A61B2018/00392 ,  A61B2018/00577 ,  A61B2090/064 ,  A61B2090/306 ,  A61F2/2427 ,  A61M1/3621 ,  A61M1/3653 ,  A61M1/3659 ,  A61M25/0023 ,  A61M25/0028 ,  A61M25/0032 ,  A61M25/0041 ,  A61M25/0054 ,  A61M25/0125 ,  A61M25/0152 ,  A61M25/0155 ,  A61M25/0662 ,  A61M25/10 ,  A61M25/1002 ,  A61M25/1011 ,  A61M25/1029 ,  A61M25/1034 ,  A61M25/1038 ,  A61M39/0247 ,  A61M2025/0002 ,  A61M2025/0004 ,  A61M2025/0031 ,  A61M2025/0046 ,  A61M2025/0078 ,  A61M2025/015 ,  A61M2025/0161 ,  A61M2025/028 ,  A61M2025/1047 ,  A61M2025/105 ,  A61M2025/1052 ,  A61M2025/1059 ,  A61M2025/1077 ,  A61M2025/1095 ,  A61M2202/047 ,  A61M2205/11 ,  A61M2205/3344 ,  A61M2205/3355 ,  A61M2205/366 ,  A61M2210/125 ,  A61M2210/127

摘要： Devices and methods are provided for temporarily inducing cardioplegic arrest in the heart of a patient and for establishing cardiopulmonary bypass in order to facilitate surgical procedures on the heart and its related blood vessels. Specifically, a catheter based system is provided for isolating the heart and coronary blood vessels of a patient from the remainder of the arterial system and for infusing a cardioplegic agent into the patient's coronary arteries to induce cardioplegic arrest in the heart. The system includes an endoaortic partitioning catheter having an expandable balloon at its distal end which is expanded within the ascending aorta to occlude the aortic lumen between the coronary ostia and the brachiocephalic artery. Means for centering the catheter tip within the ascending aorta include specially curved shaft configurations, eccentric or shaped occlusion balloons and a steerable catheter tip, which may be used separately or in combination. The shaft of the catheter may have a coaxial or multilumen construction. The catheter may further include piezoelectric pressure transducers at the distal tip of the catheter and within the occlusion balloon. Means to facilitate nonfluoroscopic placement of the catheter include fiberoptic transillumination of the aorta and a secondary balloon at the distal tip of the catheter for atraumatically contacting the aortic valve. The system further includes a dual purpose arterial bypass cannula and introducer sheath for introducing the catheter into a peripheral artery of the patient.

摘要翻译： 提供了设备和方法，用于临时诱导患者心脏中的心脏停搏停滞并建立心肺分流术，以便于心脏及其相关血管的外科手术。 特别地，提供一种基于导管的系统，用于将患者的心脏和冠状动脉血管与动脉系统的其余部分隔离，并将心脏停搏药物注入患者的冠状动脉以诱发心脏停搏。 该系统包括内主动脉分配导管，其在其远端具有可膨胀气囊，其在升主动脉内扩张以封闭冠状动脉口和头臂动脉之间的主动脉腔。 用于将导管末端定心在升主动脉内的装置包括特殊弯曲的轴构造，偏心或成形的闭塞气囊和可导向的导管尖端，其可以单独使用或组合使用。 导管的轴可以具有同轴或多腔结构。 该导管还可以包括位于导管的远侧末端处和闭塞气囊内的压电换能器。 促进导管的非荧光放置的手段包括主动脉的光纤透照和在导管的远端处的次级球囊，用于与主动脉瓣无创接触。 该系统还包括用于将导管引入患者的外周动脉的双用途动脉旁路插管和引导器护套。

公开(公告)号：US06814700B1

公开(公告)日：2004-11-09

申请号：US09527485

申请日：2000-03-16

申请人： Richard L. Mueller ,  Stephen W. Boyd ,  James R. Flom ,  Lorraine F. Mangosong ,  William S. Peters

发明人： Richard L. Mueller ,  Stephen W. Boyd ,  James R. Flom ,  Lorraine F. Mangosong ,  William S. Peters

IPC分类号： A61B132

CPC分类号： A61B17/0293 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/025 ,  A61B17/3417 ,  A61B17/3423 ,  A61B17/3431 ,  A61B17/3468 ,  A61B2017/00243 ,  A61B2017/3482 ,  A61B2090/306

摘要： The present invention provides a retractor for providing surgical access through a passage in tissue, together with methods for its use and deployment. The retractor comprises an anchoring frame having an upper surface, a lower surface, and an opening therethrough which defines an axial axis. A flexible tensioning member is attached to the frame, and is extendable from the frame out of the body through the passage when the frame is positioned through the passage and into a body cavity. This tensioning member is selectively tensionable to spread the tissue radially outwardly from the axial axis. Hence, it is the tension imposed on the flexible liner which effects retraction of the tissue, rather than relying on the structural integrity of an artificial lumen.

摘要翻译： 本发明提供一种用于通过组织中的通道提供外科手术进入的牵开器，以及用于其使用和部署的方法。 牵开器包括具有上表面，下表面和通过其限定轴向轴线的开口的锚固框架。 柔性张紧构件附接到框架，并且当框架通过通道定位并进入体腔时，柔性张紧构件附接到框架并且可从框架伸出身体穿过通道。 该张紧构件可选择性地张紧以使组织从轴向轴线向外径向扩张。 因此，施加在柔性衬垫上的张力会影响组织的缩回，而不是依靠人造管腔的结构完整性。

公开(公告)号：US5695457A

公开(公告)日：1997-12-09

申请号：US351850

申请日：1994-12-07

申请人： Frederick G. St. Goar ,  William S. Peters ,  Philip C. Evard ,  Stephen W. Boyd ,  Craig L. Adams ,  Richard L. Mueller, Jr. ,  John H. Stevens

发明人： Frederick G. St. Goar ,  William S. Peters ,  Philip C. Evard ,  Stephen W. Boyd ,  Craig L. Adams ,  Richard L. Mueller, Jr. ,  John H. Stevens

IPC分类号： A61B17/00 ,  A61F2/24 ,  A61F2/958 ,  A61M1/36 ,  A61M25/00 ,  A61M25/01 ,  A61M25/06 ,  A61M25/14 ,  A61M29/02 ,  A61M37/00

CPC分类号： A61M25/0068 ,  A61F2/2427 ,  A61M1/3653 ,  A61M1/3659 ,  A61M25/0041 ,  A61M25/01 ,  A61M25/0662 ,  A61M25/10 ,  A61B2017/00243 ,  A61B2018/00232 ,  A61B2018/00261 ,  A61M2025/0031 ,  A61M2025/0034 ,  A61M2025/0036 ,  A61M2025/004 ,  A61M2025/0057 ,  A61M2025/0078 ,  A61M2025/0087 ,  A61M2025/028 ,  A61M2025/1047 ,  A61M2025/1077 ,  A61M2205/11 ,  A61M2205/366 ,  A61M2210/125 ,  A61M25/005 ,  A61M25/008 ,  A61M25/0125 ,  A61M25/1002

摘要： A catheter system is provided for accessing the coronary ostia transluminally from a peripheral arterial access site, such as the femoral artery, and for inducing cardioplegic arrest by direct infusion of cardioplegic solution into the coronary arteries. In a first embodiment, the catheter system is in the form of a single perfusion catheter with multiple distal branches for engaging the coronary ostia. In a second embodiment, multiple perfusion catheters are delivered to the coronary ostia through a single arterial cannula. In a third embodiment, multiple perfusion catheters are delivered to the coronary ostia through a single guiding catheter. In a fourth embodiment, multiple catheters are delivered to the coronary ostia through a single guiding catheter which has distal exit ports that are arranged to direct the perfusion catheters into the coronary ostia. In each embodiment, the catheters are equipped with an occlusion means at the distal end of the catheter for closing the coronary ostia and isolating the coronary arteries from the systemic blood flow. The occlusion means can take the form of an inflatable occlusion balloon cuff, a tapered occlusion device or an O-ring encircling the distal end of the catheter. An optional ventricular venting catheter can be included in the system for venting blood and fluids from the left ventricle of the heart. The catheter system is combined with a femoral-to-femoral cardiopulmonary bypass system to provide a system for cardioplegic arrest and total cardiopulmonary support during minimally invasive cardiac surgical procedures.

摘要翻译： 提供导管系统用于从外周动脉进入部位（例如股动脉）平均进入冠状动脉口，并且通过将心脏停搏液直接输注到冠状动脉中诱发心脏停搏。 在第一实施例中，导管系统是具有用于接合冠状动脉口的多个远端分支的单次灌注导管的形式。 在第二实施例中，多个灌注导管通过单个动脉插管递送至冠状动脉口。 在第三实施例中，多个灌注导管通过单个引导导管输送到冠状动脉口。 在第四实施例中，多个导管通过单个引导导管输送到冠状动脉口，该引导导管具有设置成将灌注导管引导到冠状动脉口中的远侧出口。 在每个实施例中，导管在导管的远端配备有闭塞装置，用于封闭冠状动脉口，并将冠状动脉与全身血流隔离。 闭塞装置可采取充气闭塞球囊，锥形闭塞装置或围绕导管远端的O形环的形式。 系统中可以包括可选的心室通气导管，用于从心脏的左心室排出血液和液体。 导管系统与股骨 - 股骨心肺旁路系统组合，以在微创心脏手术过程中提供心脏停搏和全心肺支持的系统。