Methods and systems for performing thoracoscopic coronary bypass and other procedures
First Claim
1. A system for facilitating a surgical procedure on or around a patient'"'"'s heart comprising:
- a device positionable in the patient'"'"'s chest wall for forming a viewing passage through the patient'"'"'s chest wall for viewing the interior of the patient'"'"'s chest cavity with the patient'"'"'s sternum at least partially intact;
an aortic occlusion device for internally occluding the patient'"'"'s ascending aorta at a location between the patient'"'"'s coronary arteries and the brachiocephalic artery;
a cardiopulmonary bypass system, including an arterial return lumen to direct oxygenated blood into the patient'"'"'s arterial system downstream from the occluded ascending aorta;
a delivery lumen for delivering cardioplegic fluid to the heart; and
surgical tools which can be manipulated from outside the chest cavity for operating on and around the heart.
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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
17 Claims
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1. A system for facilitating a surgical procedure on or around a patient'"'"'s heart comprising:
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a device positionable in the patient'"'"'s chest wall for forming a viewing passage through the patient'"'"'s chest wall for viewing the interior of the patient'"'"'s chest cavity with the patient'"'"'s sternum at least partially intact; an aortic occlusion device for internally occluding the patient'"'"'s ascending aorta at a location between the patient'"'"'s coronary arteries and the brachiocephalic artery; a cardiopulmonary bypass system, including an arterial return lumen to direct oxygenated blood into the patient'"'"'s arterial system downstream from the occluded ascending aorta; a delivery lumen for delivering cardioplegic fluid to the heart; and surgical tools which can be manipulated from outside the chest cavity for operating on and around the heart. - View Dependent Claims (2, 3, 4, 14, 15)
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5. A system for performing a coronary artery bypass graft procedure comprising:
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device positionable between the patient'"'"'s ribs with the sternum at least partially intact for forming a viewing passage through the patient'"'"'s chest wall to observe a procedure within a patient'"'"'s chest cavity; an aortic occlusion device to internally occlude the patient'"'"'s ascending aorta at a location between the patient'"'"'s coronary arteries and the brachiocephalic trunk; a cardiopulmonary bypass system including a venous drainage lumen to withdraw blood from the patient'"'"'s venous system, an oxygenator to oxygenate the withdrawn blood and an arterial return lumen to direct the oxygenated blood into the patient'"'"'s arterial system downstream of the occluded ascending aorta; a delivery lumen to deliver cardioplegic fluid to the patient'"'"'s heart; a first cutting tool which can be inserted into the chest cavity through a small opening in the patient'"'"'s chest, to transect an artery under observation through the viewing passage to provide a free upstream arterial end within the chest cavity; a second cutting tool which can be inserted into the chest cavity through a relatively small opening in the patient'"'"'s chest, to form an incision in a coronary artery downstream from a blockage therein under observation through the viewing passage; and an anastomosis instrument which can be inserted into the chest cavity through an opening in the patient'"'"'s chest, for securing the free upstream end of the transected artery to the coronary artery about the incision therein under observation through the viewing passage. - View Dependent Claims (6, 7, 8, 9, 10, 12, 13)
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11. A system for performing a coronary artery bypass graft procedure in a patient including:
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an aortic occlusion catheter having a distal end, a proximal end and an expandable member at the distal end configured to occlude the ascending aorta between the coronary ostia and the brachiocephalic artery, the aortic occlusion catheter being adapted to be positioned into the ascending aorta with the sternum at least partially intact, the aortic occlusion catheter having a configuration selected from the group consisting of a peripheral access configuration adapted for introduction into a peripheral artery and a direct access configuration adapted for placement through the chest wall and through an aortic arteriotomy; a first cutting tool which can be inserted into the patient'"'"'s chest cavity through a small opening in the patient'"'"'s chest to create an arterial blood source within the patient'"'"'s chest cavity by severing an artery and providing a free, upstream end of the artery within the chest cavity under observation through a viewing passage between the patient'"'"'s ribs; a second cutting tool which can be inserted into the patient'"'"'s chest cavity through a small opening in the patient'"'"'s chest to form an incision in a coronary artery downstream from a blockage therein under observation through a viewing passage between the patient'"'"'s ribs; and means which can be inserted into the patient'"'"'s chest cavity through a small opening in the patient'"'"'s chest for securing the free, upstream end of the severed artery to the coronary artery about the incision therein under observation through a viewing passage between the patient'"'"'s ribs.
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16. A system for surgical intervention on a patient'"'"'s heart, comprising:
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a first access device adapted to be positioned in the patient'"'"'s chest wall with the patient'"'"'s sternum at least partially intact for forming a first passage into the chest cavity; an aortic occlusion device adapted to be positioned into the aorta through an arteriotomy in a wall thereof for internally occluding the patient'"'"'s ascending aorta at a location between the patient'"'"'s coronary arteries and the brachiocephalic artery, the aortic occlusion device being positionable into the chest cavity through the first passage; an arterial return lumen to direct oxygenated blood into the patient'"'"'s arterial system downstream from the occluded ascending aorta; a delivery lumen for delivering cardioplegic fluid to the heart. - View Dependent Claims (17)
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Specification