Method for coronary artery bypass

• US 20030094180A1
• Filed: 01/07/2003
• Published: 05/22/2003
• Est. Priority Date: 04/10/1995
• Status: Active Grant

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Cardiothoracic Systems, Inc. (Boston Scientific Corporation)
• Inventors: Benetti, Frederico J.
• Granted Patent: US 7,219,671 B2
• Time in Patent Office: Days
• US Class Current: 128/898
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2017/3427 for intercostal space

Abstract

The invention comprises a method for performing a coronary artery bypass graft on a beating heart under thoracoscopic visualization without opening the chest wall. At least one small opening is formed in the patient'"'"'s chest, a target artery for an arterial blood supply is located, instruments are introduced through one or more small openings formed in the patient'"'"'s chest to prepare the target artery for fluid connection to the coronary artery, and instruments are introduced through one or more small openings formed in the patient'"'"'s chest to connect the target artery to the coronary artery distal from a stenosis. In a preferred embodiment, a minimal left anterior intercostal thoracotomy provides access to form an anastomosis between the left internal mammary artery (LIMA) and the left anterior descending artery (LAD) while thoracoscopic viewing facilitates harvesting the LIMA. In other embodiments, access to the patient'"'"'s heart may be obtained through a trocar sheath or other means for providing percutaneous access to the patient'"'"'s thoracic cavity without opening the chest wall. Thoracoscopic visualization, depending on the procedure, is used to locate the arterial blood supply, the location of the coronary artery to be bypassed and the location of the occlusion in the artery. In other embodiments, the diagonal (Dx) or circumflex (Cx) arteries may be bypassed.

Claims

1. A method for performing a coronary artery bypass graft on a patient'"'"'s beating heart comprising the steps of:

a) forming at least one opening in the patient'"'"'s chest,

b) percutaneously introducing a viewing means through the patient'"'"'s chest;

c) locating a target artery for an arterial blood supply;

d) introducing instruments through one or more small openings formed in the patient'"'"'s chest to prepare the target artery for fluid connection to a portion of a coronary artery distal from a stenosis;

e) introducing instruments through one or more small openings formed in the patient'"'"'s chest to connect the target artery in fluid communication with the coronary artery in fluid communication and thereby supply arterial blood from the target artery to the coronary artery; and

f) viewing at least one of steps c), d) and e) with the viewing means.

2. The method of claim 1 wherein the step of connecting the target artery in fluid communication with the coronary artery comprises forming an anastomosis between the target artery and the coronary artery.

3. The method of claim 1 wherein the step of connecting the target artery in fluid communication with the coronary artery comprises supplying a free graft means having first and second ends, forming a first anastomosis between the first end of the graft means and the target artery, and forming a second anastomosis between the second end of the graft means and the coronary artery.

4. The method of claim 1 further comprising the step of stabilizing the coronary artery before connecting the target artery thereto.