Methods for performing heart surgery
First Claim
1. A method for closed-chest cardiac surgical intervention, said method comprising:
- forming at least one percutaneous penetration in the patient'"'"'s chest;
creating an opening in an artery;
endovascularly advancing a distal end of a catheter through the opening to a location within the ascending aorta;
expanding an occluding element on the catheter at said location to inhibit the flow of blood and other fluids past said location;
establishing cardiopulmonary bypass by removing blood through a first catheter lumen positioned in a vein, oxygenating the blood, and returning the blood downstream of said location through a second catheter lumen positioned in an artery;
stopping heart contraction by introducing a cardioplegic agent to the patient'"'"'s heart through the catheter;
viewing the heart through a viewing device placed in one of the at least one percutaneous penetrations; and
performing a surgical procedure on the stopped heart using tools introduced through one of the at least one percutaneous penetrations.
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Accused Products
Abstract
A method for closed-chest cardiac surgical intervention relies on viewing the cardiac region through a thoracoscope or other viewing scope and endovascularly partitioning the patient'"'"'s arterial system at a location within the ascending aorta. The cardiopulmonary bypass and cardioplegia can be induced, and a variety of surgical procedures performed on the stopped heart using percutaneously introduced tools. The method of the present invention will be particularly suitable for forming coronary artery bypass grafts, where an arterial blood source is created using least invasive surgical techniques, and the arterial source is connected to a target location within a coronary artery while the patient is under cardiopulmonary bypass and cardioplegia.
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Citations
20 Claims
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1. A method for closed-chest cardiac surgical intervention, said method comprising:
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forming at least one percutaneous penetration in the patient'"'"'s chest; creating an opening in an artery; endovascularly advancing a distal end of a catheter through the opening to a location within the ascending aorta; expanding an occluding element on the catheter at said location to inhibit the flow of blood and other fluids past said location; establishing cardiopulmonary bypass by removing blood through a first catheter lumen positioned in a vein, oxygenating the blood, and returning the blood downstream of said location through a second catheter lumen positioned in an artery; stopping heart contraction by introducing a cardioplegic agent to the patient'"'"'s heart through the catheter; viewing the heart through a viewing device placed in one of the at least one percutaneous penetrations; and performing a surgical procedure on the stopped heart using tools introduced through one of the at least one percutaneous penetrations. - View Dependent Claims (2, 3)
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4. A method for forming an anastomosis between a mammary artery and a coronary artery of a patient, said method comprising the steps of:
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positioning at least one access device between two ribs in a patient'"'"'s chest thereby forming a percutaneous penetration; cutting the mammary artery using a tool introduced through the access device thereby forming an end; creating an opening in an artery; endovascularly advancing a catheter having an occluding member through the opening to a location within the ascending aorta between the brachiocephalic artery and the coronary ostia; expanding the occluding member at the location to occlude the patient'"'"'s ascending aorta; establishing cardiopulmonary bypass by removing blood through a first catheter lumen positioned in a vein, oxygenating the blood, and returning the blood downstream of said location through a second catheter lumen positioned in an artery; stopping heart contraction by introducing a cardioplegic agent to the patient'"'"'s heart through the catheter; forming an incision in the coronary artery using a cutting tool while the heart is stopped; connecting the end of the internal mammary artery to the incision in the coronary artery; and viewing the mammary artery through a viewing device placed in a percutaneous penetration during at least one of the cutting, forming and connecting steps. - View Dependent Claims (5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A method of less-invasive cardiac surgical intervention, the method comprising:
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forming at least one percutaneous penetration in the patient'"'"'s chest; creating an opening in an artery; positioning a distal end of an occlusion device through the opening to a location within the ascending aorta; expanding an occluding element on the occlusion device at said location to inhibit the flow of blood and other fluids past said location; maintaining circulation of blood in the patient'"'"'s arterial system downstream of the occluding element by removing blood through a first catheter lumen positioned in a vein, oxygenating the blood, and returning the blood downstream of said location through a second catheter lumen positioned in an artery; stopping heart contractions by introducing a cardioplegic agent to the patient'"'"'s heart; positioning a device for viewing the heart in one of the at least one percutaneous penetrations; viewing the heart through the device; and performing a surgical procedure on the stopped heart using tools introduced through one of the at least one percutaneous penetrations. - View Dependent Claims (16, 17, 18, 19, 20)
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Specification