Means and method of replacing a heart valve in a minimally invasive manner
First Claim
1. A tool for placing a prosthesis in a patient in a minimally invasive manner comprising:
- A) a housing;
B) an operating shaft associated with said housing and extending out of a patient'"'"'s body during use;
C) an operating handle mounted on a proximal end of said operating shaft;
D) a means associated with said housing for delivering and forming at least one fastener to attach a sewing cuff of a prosthesis valve to a patient and including(1) an anvil located in position to engage and close a fastener when that fastener has been forced against said anvil, and(2) a driver element in position to engage a fastener and force that fastener against said anvil for closing the fastener; and
E) means for releasably mounting the sewing cuff on said housing during operation of said means for delivering and forming at least one fastener.
4 Assignments
0 Petitions
Accused Products
Abstract
A heart valve can be replaced using minimally invasive methods which include a sutureless sewing cuff that and a fastener delivery tool that holds the cuff against the patient'"'"'s tissue while delivering fasteners, two at a time to attach the cuff to the tissue from the inside out. The tool stores a plurality of fasteners. Drawstrings are operated from outside the patient'"'"'s body and cinch the sewing cuff to the valve body. The cuff is releasably mounted on the tool and the tool holds the cuff against tissue and drives the fastener through the cuff and the tissue before folding over the legs of the fastener whereby secure securement between the cuff and the tissue is assured. At least two rows of staggered fasteners are formed whereby fasteners are located continuously throughout the entire circumference of the cuff. A minimally invasive surgical method is disclosed, and a method and tool are disclosed for repairing abdominal aortic aneurysms in a minimally invasive manner.
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Citations
104 Claims
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1. A tool for placing a prosthesis in a patient in a minimally invasive manner comprising:
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A) a housing; B) an operating shaft associated with said housing and extending out of a patient'"'"'s body during use; C) an operating handle mounted on a proximal end of said operating shaft; D) a means associated with said housing for delivering and forming at least one fastener to attach a sewing cuff of a prosthesis valve to a patient and including (1) an anvil located in position to engage and close a fastener when that fastener has been forced against said anvil, and (2) a driver element in position to engage a fastener and force that fastener against said anvil for closing the fastener; and E) means for releasably mounting the sewing cuff on said housing during operation of said means for delivering and forming at least one fastener. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 43, 44, 45, 46)
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2. A tool for placing a prosthesis in a patient during surgery comprising:
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A) a housing; B) a driver mechanism on said housing for driving and forming a first W-shaped fastener; C) a means on said housing for loading a second W-shaped fastener in the driver mechanism for driving and forming; and D) means on said housing for approximating a prosthesis against a patient while said fasteners are driven and formed to attach the prosthesis to the patient. - View Dependent Claims (72)
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3. A tool for placing a prosthesis in a patient in a minimally invasive manner comprising:
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A) a housing; B) an operating handle connected to said housing; C) a means associated with said housing and controlled by said operating handle for delivering and forming at least one fastener to attach a prosthesis to a patient and including means for storing a plurality of fasteners, whereby fasteners are accommodated on a tool used to place the prosthesis in the patient, and including a stapler containing a plurality of W-shaped staples; D) means for releasably supporting a flexible cuff portion of the prosthesis while a fastener is being formed; and E) means for approximating said flexible sewing cuff against a patient while a fastener is being forced through said flexible sewing cuff and is being formed.
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4. In combination:
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A) a prosthesis including (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) means for securely attaching said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system for placing said prosthesis in the patient in a minimally invasive manner including (1) a housing, (2) an operating handle connected to said housing, (3) means associated with said housing and controlled by said operating handle for delivering and forming at least one fastener to attach said flexible sewing cuff to the patient and including means for storing a plurality of fasteners which are used for attaching said flexible sewing cuff to the patient whereby fasteners are accommodated on said tool, (4) means for supporting said flexible sewing cuff while a fastener is being formed, and (5) means for expanding and approximating said flexible sewing cuff against the patient while a fastener is being forced through said flexible sewing cuff and into the patient'"'"'s tissue and is being formed to attach said flexible sewing cuff to the patient. - View Dependent Claims (42, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 73, 89)
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5. In combination:
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A) a multiple part prosthesis which includes (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) means for securely attaching said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system for placing said prosthesis in the patient in a minimally invasive manner including (1) a housing, (2) an operating handle, (3) means associated with said housing and controlled by said operating handle for delivering and forming a fastener to attach one part of said multiple part prosthesis to the patient, (4) means for storing fasteners on said tool, (5) means for releasably supporting said flexible sewing cuff while the fastener is being formed, and (6) means for expanding and approximating said flexible sewing cuff against the patient while the fastener is being formed. - View Dependent Claims (71, 74, 90)
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6. In combination:
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A) a prosthesis including (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) means for securely attaching said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system for placing said prosthesis in the patient in a minimally invasive manner including (1) a housing, (2) an operating shaft, (3) a mechanism on said housing for delivering and forming a fastener and including means for storing a plurality of fasteners during operation of said fastener delivery and forming mechanism to attach said prosthesis to a patient, (4) means on said housing and connected to said operating shaft for actuating said fastener delivery and forming mechanism, (5) means for releasably supporting said flexible sewing cuff of said prosthesis while fasteners are being formed, and (6) means for expanding and releasably approximating said flexible sewing cuff against the patient while fasteners are being penetrated through said flexible sewing cuff of the prosthesis and are being formed to attach said flexible sewing cuff to the patient. - View Dependent Claims (75, 91)
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7. In combination:
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A) a prosthesis including (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) means for securely attaching said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system for placing said prosthesis in the patient in a minimally invasive manner including (1) a housing, (2) a plurality of tissue penetrating fasteners stored in said housing, (3) an operating shaft, (4) a fastener delivery and forming mechanism on said housing for delivering and forming a tissue-penetrating fastener and including means for storing tissue-penetrating fasteners during operation of said fastener delivery and forming mechanism to attach the flexible sewing cuff to the patient, (5) means on said housing and connected to said operating shaft for actuating said fastener delivery and forming mechanism, (6) means for releasably supporting said flexible sewing cuff of the prosthesis while fasteners are being formed, and (7) means for expanding and releasably approximating said flexible sewing cuff of the prosthesis against a patient while fasteners are being formed. - View Dependent Claims (76, 92)
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8. In combination:
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A) a prosthesis including (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) means for securely attaching said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system for placing said prosthesis in the patient in a minimally invasive manner including (1) a housing, (2) an operating handle connected to said housing, (3) a means associated with said housing and controlled by said operating handle for delivering and forming at least one fastener to attach said flexible sewing cuff to the patient and including means for storing a plurality of fasteners, whereby fasteners are accommodated on the tool used to place the flexible sewing cuff in the patient, (4) means for releasably supporting said flexible sewing cuff of said prosthesis while a fastener is being formed, (5) means for expanding and approximating said flexible sewing cuff against the patient while a fastener is being forced through a portion of said flexible sewing cuff and is being formed; and (6) means on said means for delivering and forming at least one fastener for releasably holding the portion of said flexible sewing cuff against the patient. - View Dependent Claims (77, 93)
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9. In combination:
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A) a multiple part prosthesis including (1) a prosthesis body, said prosthesis body including a valve, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) means for securely attaching said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system for placing said prosthesis in the patient in a minimally invasive manner including (1) a housing, (2) an operating handle, (3) a means associated with said housing and controlled by said operating handle for delivering and forming a fastener to attach one part of said multiple part prosthesis to the patient whereby fasteners are accommodated on the tool used to place the flexible sewing cuff of the prosthesis in the patient and including means for storing a plurality of fasteners, (4) means for releasably supporting said flexible sewing cuff while a fastener is being formed, and (5) means for expanding and approximating said flexible sewing cuff of the multipart prosthesis against the patient while the fastener is being formed. - View Dependent Claims (78, 94)
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10. In combination:
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A) a prosthesis including (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) means for securely attaching said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system for placing said prosthesis in the patient in a minimally invasive manner including (1) a housing, (2) an operating handle connected to said housing, (3) a means associated with said housing and controlled by said operating handle for delivering and forming at least one fastener to attach said flexible sewing cuff of the prosthesis to the patient and including means for storing a plurality of fasteners, whereby fasteners are accommodated on the tool used to place the sewing cuff in the patient, said fastener delivering and forming means including a plurality of arcuately spaced apart fastener delivery locations thereon, (4) means for releasably supporting said flexible sewing cuff of the prosthesis while a fastener is being formed, (5) means for expanding and approximating said flexible sewing cuff against the patient while a fastener is being forced through a portion of said flexible sewing cuff and is being formed, and (6) a pre-fire rod means for extending tips of the fasteners through said flexible sewing cuff into the patient'"'"'s tissue prior to forming the fasteners to attach the flexible sewing cuff of the prosthesis to the patient. - View Dependent Claims (79, 95)
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11. In combination:
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A) a prosthesis which includes a sewing cuff which is flexible, expandable and deformable to fit the size and shape of a patient'"'"'s tissue during installation of said flexible sewing cuff in the patient; and B) a tool system for placing said prosthesis in the patient in a minimally invasive manner including (1) a housing, (2) an operating handle connected to said housing, (3) a means associated with said housing and controlled by said operating handle for delivering and forming at least one fastener to attach a prosthesis to a patient and including means for storing a plurality of fasteners, whereby fasteners are accommodated on the tool used to place the flexible sewing cuff in the patient, (4) means for releasably supporting said flexible sewing cuff of said prosthesis while a fastener is being formed, and (5) expander arms for approximating a portion of said sewing cuff against the patient while a fastener is being forced through said flexible sewing cuff and is being formed. - View Dependent Claims (80, 96)
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12. In combination:
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A) a prosthesis including (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) drawstrings which securely attach said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system including (1) a housing, (2) an operating handle connected to said housing, (3) a driver and anvil associated with said housing and controlled by said operating handle which deliver and form at least one fastener to attach said flexible sewing cuff to the patient and including a storage pocket which stores a plurality of fasteners which are used for attaching said flexible sewing cuff to the patient whereby fasteners are accommodated on said tool, (4) an anchor which supports said flexible sewing cuff while a fastener is being formed, and (5) expander arms positioned to engage the inside of said flexible sewing cuff and urge said flexible sewing cuff against the patient'"'"'s tissue while a fastener is being forced through said flexible sewing cuff and into the patient'"'"'s tissue and is being formed to attach said flexible sewing cuff to the patient. - View Dependent Claims (81, 97)
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13. In combination:
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A) a multiple part prosthesis which includes (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) drawstrings which securely attach said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system including (1) a housing, (2) an operating handle, (3) an anvil and driver associated with said housing and controlled by said operating handle and which deliver and form a fastener to attach one part of said multiple part prosthesis to the patient, (4) a storage pocket which stores fasteners on said tool, (5) an anchor which releasably supports said flexible sewing cuff while the fastener is being formed, and (6) expander arms which expand and approximate said flexible sewing cuff against the patient while the fastener is being formed. - View Dependent Claims (82, 98)
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14. In combination:
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A) a prosthesis including (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) drawstrings which securely attach said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system including (1) a housing, (2) an operating shaft, (3) a driver and anvil on said housing which delivers and forms a fastener and including a storage pocket in which a plurality of fasteners are stored during operation of said driver and anvil and which attaches said flexible sewing cuff of said prosthesis to the patient, (4) an anchor which releasably supports said flexible sewing cuff of said prosthesis while fasteners are being formed, and (5) engaging arms which engage said flexible sewing cuff and expand and approximate said flexible sewing cuff against the patient while fasteners are being penetrated through said flexible sewing cuff of the prosthesis and are being formed to attach said flexible sewing cuff to the patient. - View Dependent Claims (83, 99)
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15. In combination:
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A) a prosthesis including (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) drawstrings which securely attach said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system including (1) a housing, (2) a plurality of tissue penetrating fasteners stored in said housing, (3) an operating shaft, (4) an anvil and driver on said housing which deliver and form a tissue-penetrating fastener and including a storage pocket in which is stored tissue-penetrating fasteners during operation of said anvil and driver to attach said sewing cuff to the patient, (5) anchors which releasably support said flexible sewing cuff of the prosthesis while fasteners are being formed, and (6) engaging arms which expand and approximate said flexible sewing cuff of the prosthesis against a patient while fasteners are being formed. - View Dependent Claims (84, 100)
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16. In combination:
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A) a prosthesis including (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) drawstrings which securely attach said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system including (1) a housing, (2) an operating handle connected to said housing, (3) an anvil and driver associated with said housing and controlled by said operating handle which deliver and form at least one fastener to attach said flexible sewing cuff of said prosthesis to the patient and including a pocket in which a plurality of fasteners are stored, whereby fasteners are accommodated on the tool used to place the flexible sewing cuff in the patient, (4) anchors which releasably supports said flexible sewing cuff of said prosthesis while the fastener is being formed, and (5) engaging arms which expand and approximate the flexible sewing cuff against the patient while a fastener is being forced through a portion of said flexible sewing cuff and is being formed. - View Dependent Claims (85, 101)
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17. In combination:
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A) a multiple part prosthesis including (1) a prosthesis body, said prosthesis body including a valve, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) drawstrings which securely attach said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system including (1) a housing, (2) an operating handle, (3) an anvil and driver associated with said housing and controlled by said operating handle and which deliver and form a fastener to attach one part of said multiple part prosthesis to the patient whereby fasteners are accommodated on the tool used to place the flexible sewing cuff of the prosthesis in the patient and including a pocket in which a plurality of fasteners are stored, (4) an anchor which releasably supports said flexible sewing cuff while a fastener is being formed, and (5) engaging arms which expand and approximate said flexible sewing cuff of the multipart prosthesis against the patient while the fastener is being formed. - View Dependent Claims (86, 102)
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18. In combination:
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A) a prosthesis including (1) a prosthesis body, (2) an expandable flexible sewing cuff separate and spaceable from said prosthesis body, and (3) drawstrings which securely attach said prosthesis body to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and B) a tool system including (1) housing, (2) an operating handle connected to said housing, (3) a an anvil and driver associated with said housing and controlled by said operating handle and which deliver and form at least one fastener to attach said flexible sewing cuff of the prosthesis to the patient and including a pocket in which a plurality of fasteners are stored whereby fasteners are accommodated on the tool used to place the sewing cuff in the patient, said anvil and driver including a plurality of arcuately spaced apart fastener delivery locations thereon, (4) an anchor which releasably supports said flexible sewing cuff of the prosthesis while a fastener is being formed, (5) engaging arms which approximate said flexible sewing cuff against the patient while the fastener is being forced through a portion of said flexible sewing cuff and is being formed, and (6) a pre-fire rod which extends tips of the fasteners through said flexible sewing cuff into the patient'"'"'s tissue prior to forming the fasteners to attach the flexible sewing cuff of the prosthesis to the patient. - View Dependent Claims (87, 103)
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19. In combination:
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A) a prosthesis which includes a sewing cuff which is flexible and deformable to fit the size and shape of a patient'"'"'s tissue during installation of said flexible sewing cuff in the patient; and B) a tool system including (1) a housing, (2) an operating handle connected to said housing, (3) an anvil and driver associated with said housing and controlled by said operating handle and which delivers and forms at least one fastener to attach said flexible sewing cuff to the patient and including a pocket in which a plurality of fasteners are stored, whereby fasteners are accommodated on the tool used to place the flexible sewing cuff in the patient, (4) an anchor which releasably supports said flexible sewing cuff of said prosthesis while a fastener is being formed, and (5) expander arms which approximate a portion of said flexible sewing cuff against the patient while a fastener is being forced through said flexible sewing cuff and is being formed. - View Dependent Claims (88, 104)
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Specification