Cardiac stabilizers and methods of use thereof

• US 20020147406A1
• Filed: 04/02/2002
• Published: 10/10/2002
• Est. Priority Date: 04/02/2001
• Status: Abandoned Application

• Current Assignee: University of Lausanne
• Original Assignee: University of Lausanne
• Inventors: von Segesser, Ludwig K.
• Application Number:
  US10/114,199
• Publication Number:
  US 20020147406A1
• Time in Patent Office: Days
• US Class Current: 600/509
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 2017/0243 for immobilizing local areas of the heart, e.g. while it beats
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/1473 invasive, e.g. introduced into the body by a catheter A61B5/1482 takes precedence
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 8/0858 involving measuring tissue layers, e.g. skin, interfaces
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium
• CPC Class Codes: A61N 1/362 Heart stimulators heart defibrillators A61N1/39

Abstract

The present invention relates to cardiac stabilizers and methods of use thereof in cardiac surgical procedures. In particular, the invention relates to the uses of cardiac stabilizers having one or more sensors operably attached to one or more stabilizing members to detect and treat reduced cardiac output during coronary bypass surgery.

Claims

1. An apparatus for detecting signals of a beating heart during a surgical procedure, the apparatus comprising:

i) a stabilizing member capable of contacting a local area of cardiac tissue in said beating heart at one or more contact areas between said apparatus and said beating heart, and

ii) a detection means for detecting the cardiac signals.

2. The apparatus of claim 1, wherein said detection means comprises one or more sensors capable of measuring a cardiac constriction signal, current, impedance, pH, pressure, oxygen saturation, temperature, ion elution, cardiac wall thickening, or a combination of two or more of these factors.

3. The apparatus of claim 1, wherein said detection means comprises one or more electrocardiogram signal collecting means.

4. The apparatus of claim 3, wherein said detection means comprises two or more electrocardiogram signal collecting means.

5. The apparatus of claim 4, wherein a first electrocardiogram signal collecting means is located distal to a second electrocardiogram signal collecting means relative to the trunk of the aorta.

6. The apparatus of claim 4, wherein a first electrocardiogram signal collecting means is located proximal to a second electrocardiogram signal collecting means relative to the trunk of the aorta.

7. The apparatus of claim 2, wherein a first sensor is located distal to a second sensor relative to the trunk of the aorta.

8. The apparatus of claim 2, wherein a first sensor is located proximal to a second sensor relative to the trunk of the aorta.

9. The apparatus of claim 4, wherein a first electrocardiogram signal collecting means is located opposite a second electrocardiogram signal collecting means relative to an incision within the cardiac tissue.

10. The apparatus of claim 1, wherein said contact between said apparatus and said cardiac tissue is accomplished by a contact enhancing factor selected from the group consisting of mechanical force, suction created by a vacuum, one or more sutures, one or more conducting pins, a bio-compatible adhesive, or a combination of two or more of these factors.

11. The apparatus of claim 1, further comprising a shaft having a proximal and a distal end, said stabilizing member being operably connected to said distal end.

12. The apparatus of claim 10, wherein said shaft is substantially rigid.

13. The apparatus of claim 11, wherein said shaft is malleable and can be made rigid.

14. The apparatus of claim 3, wherein said electrocardiogram signal collecting means is one or more electrodes.

15. The apparatus of claim 14, wherein said one or more electrodes are reversibly attached to said stabilizing member at one or more points on said member.

16. The apparatus of claim 14, wherein said one or more electrodes are irreversibly attached to said stabilizing member at one or more points on said member.

19. The apparatus of claim 18, wherein said stimulation means comprises one or more electrodes.

20. The apparatus of claim 19, wherein said stimulation means comprises two or more electrodes.

21. The apparatus of claim 20, wherein a first electrode is located distal to a second electrode relative to the trunk of the aorta.

22. The apparatus of claim 20, wherein a first electrode is located proximal to a second electrode relative to the trunk of the aorta.

23. The apparatus of claim 20, wherein a first electrode is located opposite a second electrode relative to an incision within the cardiac tissue.

24. The apparatus of claim 18, wherein said contact between said apparatus and said cardiac tissue is accomplished by a contact enhancing factor selected from the group consisting of mechanical force, suction created by a vacuum, one or more sutures, one or more conducting pins, a bio-compatible adhesive, or a combination of two or more of these factors.

25. The apparatus of claim 18, further comprising a shaft having a proximal and a distal end, said stabilizing member being operably connected to said distal end.

26. The apparatus of claim 25, wherein said shaft is substantially rigid.

27. The apparatus of claim 25, wherein said shaft is malleable and can be made rigid.

29. The apparatus of claim 28, wherein said detection means comprises one or more sensors capable of measuring a cardiac constriction signal, current, impedance, pH, pressure, oxygen saturation, temperature, ion elution, cardiac wall thickening, or a combination of tow or more of these signals.

30. The apparatus of claim 28, wherein said detection means comprises at least one electrocardiogram signal collecting means comprising one or more first electrodes, and wherein said stimulation means comprises one or more second electrodes.

31. The apparatus of claim 29, wherein said detection means and said stimulation means comprise the same electrode.

32. The apparatus of claim 28, further comprising a shaft having a proximal and a distal end, said stabilizing member being operably connected to said distal end.

33. The apparatus of claim 32, wherein said shaft is substantially rigid.

34. The apparatus of claim 32, wherein said shaft is malleable and can be made rigid.

35. The apparatus of claim 28, wherein said contact between said apparatus and said cardiac tissue is accomplished by a contact enhancing factor selected from the group consisting of mechanical force, suction created by a vacuum, one or more sutures, one or more conducting pins, a bio-compatible adhesive, or a combination of two or more of these factors.

38. The apparatus of claim 37, wherein said shaft is insulated from electrical conductance.

39. A method of monitoring the activity of a beating heart comprising:

a) contacting the surface of a beating heart with the apparatus of claim 26 at one or more contact areas; and

b) monitoring the activity of the beating heart.

40. The method of claim 39, wherein said monitoring occurs during coronary artery bypass surgery.

41. The method of claim 39, wherein said monitoring comprises measuring a cardiac constriction signal, current, impedance, pH, pressure, oxygen saturation, temperature, ion elution, cardiac wall thickening, or a combination of two or more of these factors.

42. The method of claim 39, wherein said contact between said apparatus and said beating heart is accomplished by a contact enhancing factor selected from the group consisting of mechanical force, suction created by a vacuum, one or more sutures, one or more conducting pins, a bio-compatible adhesive, or a combination of two or more of these factors.

43. The method of claim 39, further comprising detecting one or more cardiac constriction signals of said contacted cardiac tissue.

44. The method of claim 39, further comprising stimulating said contacted cardiac tissue.

45. The method of claim 39, further comprising detecting one or more cardiac constriction signals of said contacted cardiac tissue and stimulating said contacted cardiac tissue in response to said monitored activity.

47. The method of claim 46, wherein said stimulation prevents deterioration of cardiac output or reduces ischemic damage in cardiac tissue distal to the trunk of the aorta relative to the contacted cardiac tissue.

48. The method of claim 46, wherein said detecting of one or more cardiac signals comprises measuring a cardiac constriction signal, current, impedance, pH, pressure, oxygen saturation, temperature, ion elution, cardiac wall thickening, or a combination of two or more of these signals.

49. The method of claim 46, wherein said ischemic damage is caused by irregular cardiac constriction signals to cardiac tissue during coronary bypass surgery.

50. The method of claim 46, wherein a first cardiac constriction signal is detected in a region distal to a second cardiac constriction signal relative to the aorta.

51. The method of claim 46, wherein a first cardiac constriction signal is detected in a region proximal to a second cardiac constriction signal relative to the aorta.

52. The method of claim 46, wherein a first cardiac constriction signal is detected in a region distal to an incision site in the cardiac tissue relative to the aorta.

53. The method of claim 46, wherein a first cardiac constriction signal is detected in a region proximal to an incision site in the cardiac tissue relative to the aorta.

54. The method of claim 53, wherein said incision site is a site of anastomosis in a coronary artery bypass surgery.

17. An apparatus for detecting cardiac constriction signals of a beating heart during a surgical procedure, the apparatus comprising:

i) a stabilizing member capable of contacting a local area of cardiac tissue in said beating heart at one or more contact areas between said apparatus and said beating heart, and

ii) a detection means for detecting the cardiac constriction signals, wherein said detection means comprises one or more electrodes.

18. An apparatus for delivering an electrical stimulus to a local area of a heart during a surgical procedure, the apparatus comprising:

i) a stabilizing member capable of contacting a local area of cardiac tissue in the heart at one or more contact areas between said apparatus and said heart, and

ii) a stimulation means capable of delivering an electrical stimulus to said cardiac tissue.

28. An apparatus for detecting one or more cardiac signals of a beating heart and delivering an electrical stimulus to a local area of the heart during a surgical procedure, comprising:

i) a stabilizing member capable of contacting a local area of cardiac tissue in the heart at one or more contact areas between said apparatus and said beating heart;

ii) a detection means for detecting cardiac signals; and

iii) a stimulation means capable of delivering an electrical stimulus to said cardiac tissue.

46. A method of preventing ischemic damage during coronary bypass surgery, comprising:

a) contacting the surface of a beating heart with the apparatus of claim 28;

b) performing the coronary bypass surgery on the local area of the beating heart;

c) detecting one or more cardiac signals of said contacted cardiac tissue; and

d) stimulating said contacted cardiac tissue in response to said cardiac constriction signals;

wherein said stimulation prevents deterioration of cardiac output or reduces ischemic damage in the entire body.

36. An apparatus for detecting one or more cardiac signals of a beating heart during a surgical procedure, comprising:

i) a stabilizing member capable of contacting a local area of cardiac tissue in the heart at one or more contact areas between said apparatus and said beating heart; and

ii) a shaft operably connected to said stabilizing member,

whereby said shaft is capable of detecting a cardiac signal.

37. An apparatus for detecting one or more cardiac signals of a beating heart and delivering an electrical stimulus to a local area of the heart during a surgical procedure, comprising:

i) a stabilizing member capable of contacting a local area of cardiac tissue in the heart at one or more contact areas between said apparatus and said beating heart; and

ii) a shaft operably connected to said stabilizing member,

whereby said stabilizing member operably connected to said shaft is capable of delivering an electrical stimulus to said heart.