Surgical instruments for stabilizing the beating heart during coronary artery bypass graft surgery

• US 6,315,717 B1
• Filed: 04/17/2000
• Issued: 11/13/2001
• Est. Priority Date: 02/20/1996
• Status: Expired due to Term

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Cardiothoracic Systems, Inc. (Boston Scientific Corporation)
• Inventors: Regan, Brent, Aldrich, William N., Sepetka, Ivan, Taylor, Charles S., Benetti, Federico J., Glines, Robert C., Salahieh, Amr, Frantzen, John J.
• Primary Examiner(s): Smith, Jeffrey A.
• Application Number:
  US09/550,447
• Time in Patent Office: 575 Days
• Field of Search: 600/201, 600/204, 600/210, 600/226, 600/227, 600/228, 600/229, 600/231, 600/232, 600/233, 600/235, 600/37, 606/1
• US Class Current: 600/210
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• CPC Class Codes: A61B 2017/00858 high friction, non-slip on handles A61B2017/00429
• CPC Class Codes: A61B 2017/0243 for immobilizing local areas of the heart, e.g. while it beats trocars attached to inner organs or inner body tissue A61B2017/3488
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61B 2017/2825 Inserts of different material in jaws
• CPC Class Codes: A61B 2017/2913 cams or guiding means
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/349 Trocar with thread on outside
• CPC Class Codes: A61B 90/00 Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges protective face masks A41D13/11; surgeon's or patient's gowns or dresses A41D13/12; devices for carrying-off, for treatment of, or for carrying-over, body liquids A61M1/00

Abstract

Methods and devices used to stabilize a beating heart during a surgical procedure on the heart are disclosed. The stabilizing device is introduced through an opening through the chest and brought into contact with the beating heart, and by exerting a stabilizing force on the device, the motion of the heart caused by the contractions of the heart muscles is effectively eliminated. Accordingly, the heart is stabilized and movement of the site of the surgery is minimized. Typically, in separate steps, a surgeon contacts the heart with the stabilizing device, assesses the degree of movement of the anastomosis site, and exerts a force with a stabilizing device such that the contractions of the beating heart causes only minimal excess motion at the surgery site. The stabilizing device may be attached to a rigid support or may be attached to a semi-rigid support which is rendered motionless mechanically, chemically or by human intervention.

Claims

1. A device for use in cardiovascular surgery on a beating heart, comprising:

a shaft means having a distal end and a proximal end;

a stabilizing member adapted to engage a surface of the beating heart; and

a ball-joint connecting said shaft means and said stabilizing member, said ball-joint allowing said stabilizing member to be positioned about three degrees of freedom relative to said shaft means.

2. The device of claim 1, wherein said stabilizing member is freely moveable about said ball-joint when in a first condition, and is locked relative to said ball-joint when in a second condition.

3. The device of claim 1, wherein said shaft means is a shaft.

4. The device of claim 3, wherein said shaft is substantially rigid.

5. The device of claim 1, wherein said shaft means is a curved tubular member.

6. The device of claim 5, wherein said curved tubular member is substantially rigid.

7. The device of claim 5, wherein said stabilizing member comprises a substantially planar base section having a central aperture.

8. The device of claim 1, wherein said shaft means is a flexible member having a plurality of interconnecting links.

9. The device of claim 1, wherein said stabilizing member is substantially U-shaped.

10. The device of claim 1, wherein said stabilizing member comprises a substantially planar base section having a central aperture.

11. The device of claim 10, wherein said stabilizing member further comprises at least one opening adapted to receive and hold a suture or other flexible support line.

12. The device of claim 11, wherein said at least one opening comprises at least one slot.

13. The device of claim 11, wherein said at least one opening comprises at least one hole.

14. The device of claim 10, wherein said stabilizing member further comprises a side opening in said substantially planar base section extending into said central aperture.

15. A device for use in cardiovascular surgery on a beating heart, comprising:

a curved tubular member having a distal end and a proximal end, said tubular member being curved along a substantial portion of its length between said distal end and said proximal end; and

a stabilizer member connected to said distal end, said stabilizer member adapted to engage the surface of the beating heart for localized stabilizatin of an area where a surgical procedure is to be performed.

16. The device of claim 15, further comprising a ball-joint connecting said curved tubular member and said stabilizing member.

17. The device of claim 16, wherein said ball-joint allows said stabilizing member to be positioned about three degrees of freedom relative to said curved tubular member, said ball-joint further being lockable so as to prevent movement of said stabilizing member relative to said curved tubular member when said ball-joint is in a locked condition.

18. The device of claim 16, further comprising a locking mechanism movably mounted to said curved tubular member, said locking mechanism being movable relative to said curved tubular member to abut against said ball-joint thereby locking a position of said ball-joint.

19. The device of claim 15, further comprising an anchor portion attachable to said curved tubular member and to a stationary object.

20. The device of claim 19, wherein the stationary object is a retractor.

21. The device of claim 15, wherein said stabilizer member comprises a rigid retaining element having an aperture exposing an artery at an operative site, the retaining element further including planar compression surface regions on opposite sides of the aperture.

22. The device of claim 21, wherein the retaining element comprises a planar section surrounding the aperture.

23. The device of claim 21, wherein the retaining element comprises a side opening in a base section extending into the aperture.

24. A device for use in cardiovascular surgery on a beating heart, comprising;

a shaft means having a distal end and a proximal end; and

a stabilizing member connectable to said shaft means and adapted to engage a surface of the beating heart, said stabilizing member having a substantially rigid heart contacting surface adapted to contact and stabilize a portion of the heart without application of a vacuum, and an aperture that exposes an operative site, the aperture extending along a longitudinal axis of the stabilizing member.