Devices and methods for intracardiac procedures
First Claim
1. A method of closed-chest surgical intervention within an internal cavity of a patient'"'"'s heart or great vessel, the method comprising:
- establishing cardiopulmonary bypass;
arresting the patient'"'"'s heart;
viewing an internal portion of the patient'"'"'s chest through a scope extending through a percutaneous intercostal penetration in the patient'"'"'s chest;
forming an internal penetration in a wall of the heart or great vessel using cutting means introduced through a percutaneous intercostal penetration in the patient'"'"'s chest; and
introducing an interventional tool through a percutaneous intercostal penetration and through the internal penetration to perform a surgical procedure within the internal cavity under visualization by means of said scope.
5 Assignments
0 Petitions
Accused Products
Abstract
The invention provides devices and methods for performing less-invasive surgical procedures within an organ or vessel. In an exemplary embodiment, the invention provides a method of closed-chest surgical intervention within an internal cavity of a patient'"'"'s heart or great vessel. According to the method, the patient'"'"'s heart is arrested and cardiopulmonary bypass is established. A scope extending through a percutaneous intercostal penetration in the patient'"'"'s chest is used to view an internal portion of the patient'"'"'s chest. An internal penetration is formed in a wall of the heart or great vessel using cutting means introduced through a percutaneous penetration in an intercostal space in the patient'"'"'s chest. An interventional tool is then introduced, usually through a cannula positioned in a percutaneous intercostal penetration. The interventional tool is inserted through the internal penetration in the heart or great vessel to perform a surgical procedure within the internal cavity under visualization by means of the scope. In a preferred embodiment, a cutting tool is introduced into the patient'"'"'s left atrium from a right portion of the patient'"'"'s chest to remove the patient'"'"'s mitral valve. A replacement valve is then introduced through an intercostal space in the right portion of the chest and through the internal penetration in the heart, and the replacement valve is attached in the mitral valve position.
61 Citations
81 Claims
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1. A method of closed-chest surgical intervention within an internal cavity of a patient'"'"'s heart or great vessel, the method comprising:
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establishing cardiopulmonary bypass;
arresting the patient'"'"'s heart;
viewing an internal portion of the patient'"'"'s chest through a scope extending through a percutaneous intercostal penetration in the patient'"'"'s chest;
forming an internal penetration in a wall of the heart or great vessel using cutting means introduced through a percutaneous intercostal penetration in the patient'"'"'s chest; and
introducing an interventional tool through a percutaneous intercostal penetration and through the internal penetration to perform a surgical procedure within the internal cavity under visualization by means of said scope. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method of closed-chest replacement of a heart valve in a patient'"'"'s heart, the method comprising:
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establishing cardiopulmonary bypass;
arresting the patient'"'"'s heart;
viewing the patient'"'"'s heart through a scope extending through a percutaneous intercostal penetration in the patient'"'"'s chest;
forming an internal penetration through a wall of the patient'"'"'s heart using a cutting tool introduced through a percutaneous intercostal penetration in the patient'"'"'s chest;
positioning a replacement valve through a percutaneous intercostal penetration in the patient'"'"'s chest and through the internal penetration into a chamber of the heart; and
securing the replacement valve in a valve position in the heart. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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26. A system for closed-chest surgical intervention within a patient'"'"'s heart or great vessel, the system comprising:
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means for forming a percutaneous penetration in an intercostal space in the patient'"'"'s chest;
a visualization scope configured to pass through an intercostal space in the patient'"'"'s chest for viewing an internal chest cavity;
means for arresting the patient'"'"'s heart from a location outside of the chest cavity;
a cardiopulmonary bypass system, including means for delivering oxygenated blood to the patient'"'"'s arterial system;
cutting means positionable through a percutaneous intercostal penetration into the chest cavity for forming an internal penetration in a wall of the patient'"'"'s heart or great vessel; and
interventional means positionable through a percutaneous intercostal penetration and through the internal penetration for performing a surgical procedure within the heart or great vessel. - View Dependent Claims (27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42)
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43. A percutaneous access cannula to facilitate closed-chest replacement of a heart valve in a patient'"'"'s heart, the access cannula comprising:
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a cannula body configured for placement in an intercostal space in the patient'"'"'s chest, the cannula body having a distal end, a proximal end, and a lumen extending therebetween, the lumen being configured to allow passage of a replacement valve therethrough; and
an obturator positionable in the lumen, the obturator having a cross-sectional width less than the width of the intercostal space and a cross-sectional height greater than the cross-sectional width. - View Dependent Claims (44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56)
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57. A cannula system to facilitate surgical intervention in a patient'"'"'s body cavity, the cannula system comprising:
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a cannula body having a distal end, a proximal end, and a lumen therebetween, the lumen being configured for introduction of surgical instruments therethrough; and
organizer means at the proximal end of the cannula body for retaining a plurality of sutures extending through the lumen from the body cavity in spaced apart positions outside of the body cavity. - View Dependent Claims (58, 59, 60, 61, 62, 63, 64, 65, 66, 67)
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68. A thoracoscopic device for placement of a replacement valve in a valve position of a patient'"'"'s heart, the thoracoscopic device comprising:
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an elongated handle having a distal end and a proximal end, the handle configured for positioning through an intercostal space in the patient'"'"'s chest, and means at the distal end of the handle for releasably holding a replacement valve in an orientation for introduction through the intercostal space. - View Dependent Claims (69, 70, 71, 72)
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73. A prosthesis assembly for closed-chest replacement of a heart valve, the prosthesis assembly comprising:
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replacement valve having an annular attachment portion and a movable valve portion coupled to the attachment portion; and
holder means releasably mounted to the attachment portion, wherein the holder means is configured to allow introduction of the replacement valve through an intercostal space in the patient'"'"'s chest. - View Dependent Claims (74, 75, 76, 77, 78, 79, 80, 81)
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Specification