Method and apparatus for thoracoscopic intracardiac procedures
First Claim
1. A thoracoscopic electrophysiology device for introduction into an interior chamber of a patient'"'"'s heart by passing through an intercostal space defined between the patient'"'"'s ribs and through an opening in a muscular wall of the patient'"'"'s heart, the device comprising:
- a substantially rigid shaft having a distal end and a proximal end, the shaft being dimensioned and configured for introduction through an intercostal space defined between a patient'"'"'s ribs and through an opening in a muscular wall of the patient'"'"'s heart;
a flexible tip mounted to the distal end of the shaft;
a handle mounted to the proximal end of the shaft;
a movable actuator on the handle;
a linkage coupled to the actuator, extending through the shaft and coupled to the flexible tip, wherein moving the actuator deflects the flexible tip;
at least one electrode mounted to the flexible tip;
an electrical connector mounted to the handle configured for connection to a radiofrequency generator or an electrocardiogram machine; and
electrical coupling means extending through the shaft for connecting the electrode to the electrical connector.
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Accused Products
Abstract
Devices, systems, and methods are provided for accessing the interior of the heart and performing procedures therein while the heart is beating. In one embodiment, a tubular access device having an inner lumen is provided for positioning through a penetration in a muscular wall of the heart, the access device having a means for sealing within the penetration to inhibit leakage of blood through the penetration. The sealing means may comprise a balloon or flange on the access device, or a suture placed in the heart wall to gather the heart tissue against the access device. An obturator is removably positionable in the inner lumen of the access device, the obturator having a cutting means at its distal end for penetrating the muscular wall of the heart. The access device is preferably positioned through an intercostal space and through the muscular wall of the heart. Elongated instruments may be introduced through the tubular access device into an interior chamber of the heart to perform procedures such as septal defect repair and electrophysiological mapping and ablation. A method of septal defect repair includes positioning a tubular access device percutaneously through an intercostal space and through a penetration in a muscular wall of the heart, passing one or more instruments through an inner lumen of the tubular access device into an interior chamber of the heart, and using the instruments to close the septal defect. Devices and methods for closing the septal defect with either sutures or with patch-type devices are disclosed.
657 Citations
16 Claims
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1. A thoracoscopic electrophysiology device for introduction into an interior chamber of a patient'"'"'s heart by passing through an intercostal space defined between the patient'"'"'s ribs and through an opening in a muscular wall of the patient'"'"'s heart, the device comprising:
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a substantially rigid shaft having a distal end and a proximal end, the shaft being dimensioned and configured for introduction through an intercostal space defined between a patient'"'"'s ribs and through an opening in a muscular wall of the patient'"'"'s heart; a flexible tip mounted to the distal end of the shaft; a handle mounted to the proximal end of the shaft; a movable actuator on the handle; a linkage coupled to the actuator, extending through the shaft and coupled to the flexible tip, wherein moving the actuator deflects the flexible tip; at least one electrode mounted to the flexible tip; an electrical connector mounted to the handle configured for connection to a radiofrequency generator or an electrocardiogram machine; and electrical coupling means extending through the shaft for connecting the electrode to the electrical connector. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. In combination, a cardiac access device for introduction into an interior chamber of a patient'"'"'s heart by passing through an intercostal space defined between adjacent ribs and through an opening in a muscular wall of the patient'"'"'s heart, and a thoracoscopic electrophysiology device configured to pass through the access device and into the interior chamber of the heart, the combination comprising:
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a cardiac access device comprising an elongate body configured to extend through an intercostal space defined between a patient'"'"'s adjacent ribs and also through an opening in a muscular wall of the patient'"'"'s heart, the elongate body having a proximal end, a distal end, and an inner lumen extending between the proximal and distal ends, the elongate body including a first portion configured to extend through the intercostal space so as to be located within the patient'"'"'s body, and a second portion distal to the first portion configured to extend through said opening so as to be located in the interior chamber of the patient'"'"'s heart; and an electrophysiology device comprising a substantially rigid shaft having a distal end and a proximal end, the shaft being dimensioned and configured for introduction through the lumen of said cardiac access device, and a flexible tip mounted to the distal end of the shaft; wherein the flexible tip of the electrophysiology device is provided with at least one electrode coupled to an electrical connector configured for connection to a radiofrequency generator or an electrocardiogram machine. - View Dependent Claims (11, 12, 13, 14, 15, 16)
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Specification