Device to permit offpump beating heart coronary bypass surgery

• US 7,377,895 B2
• Filed: 10/31/2003
• Issued: 05/27/2008
• Est. Priority Date: 09/17/1997
• Status: Expired due to Fees

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Origin Medsystems Inc. (Boston Scientific Corporation)
• Inventors: Ortiz, Mark, Williamson, Warren P. IV, Spence, Paul A.
• Primary Examiner(s): Gilbert; Samuel G
• Application Number:
  US10/698,798
• Publication Number:
  US 20040092798A1
• Time in Patent Office: 1,670 Days
• Field of Search: 600/37, 600/229, 600/201, 600/208, 600/210, 600/227, 600/228, 600/231, 600/233, 600/234, 600/235, 600/211, 606/1, 128/897, 128/898
• US Class Current: 600/37
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• 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 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00305 Constructional details of the flexible means
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• 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 2017/308 with suction cups

Abstract

A system for use in conducting coronary surgery permits coronary surgery on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system. The system includes a first device for engaging and repositioning the beating heart to a displaced position, and is capable of maintaining the heart in the displaced position to perform a surgical procedures. The system includes a second device adapted to engage a portion of the heart to immobilize that portion for conducting a surgical procedure in the immobilized location, while the remainder of the heart continues to beat. Both first and second devices may be adapted to be fixed to a relatively stationary object, such as a frame, which may be a sternal retractor.

Claims

1. A system for use during coronary surgery on a beating heart, comprising:

a suction head adapted to positively engage the beating heart;

an arm which is flexible in an unlocked condition and rigid in a locked condition;

a spring suspension connecting said suction head to said arm; and

a surgery target immobilizing element adapted to contact a portion of the heart to immobilize the location of the heart on which the surgery is being performed.

2. The system of claim 1, wherein said surgery target immobilizing element includes a support arm and a target-defining element attached to a distal end of said support arm.

3. The system of claim 2, wherein said target-defining element is U-shaped.

4. The system of claim 2, wherein said support arm is adapted to be fixed to said arm, and when in said locked condition, said arm comprises a relatively stationary object.

5. The system of claim 2, further comprising a sternal retractor, wherein said support arm is adapted to be fixed to said sternal retractor to immobilize said target-defining element with respect to the portion of the heart contacted.

6. The system of claim 2, wherein said target defining element comprises a pair of flexible sections adapted to contact the portion of the heart.

7. The system of claim 6, wherein said support arm comprises a pair of support arms connected with said pair of flexible sections, respectively.

8. The system of claim 6, wherein said target defining element further comprises a pair of rigid elements, and said support arm comprises a pair of support arms, said rigid elements interconnecting respective ones of said flexible sections with said support arms.

9. The system of claim 2, wherein said target defining element comprises a pair of suction members adapted to contact the portion of the heart.

10. The system of claim 9, wherein said support arm comprises a pair of support arms connected with said pair of suction members, respectively.

11. The system of claim 1, wherein said support arm is adapted to be fixed to a relatively stationary object to immobilize said target-defining element.

12. The system of claim 1, wherein said suction head is adapted to engage the heart near an apical region thereof, and said arm is adapted to be fixed to a relatively stationary object.

13. The system of claim 12, wherein said spring suspension permits movement of the heart in at least one plane when said suction head is engaged with the heart, said arm is fixed to the relatively stationary object, and said arm is in said locked condition.

14. The system of claim 13, wherein said spring suspension permits multiplanar movement of the heart when said suction head is engaged with the heart, said arm is fixed to the relatively stationary object, and said arm is in said locked condition.

15. The system of claim 1, wherein said suction head comprises a vacuum input adapted to fluidically connect with a source of vacuum.

16. The system of claim 1, wherein said suction head comprises a flexible rim adapted to engage the heart.

17. The system of claim 1, wherein said suction head comprises a flexible suction cup.

18. The system of claim 1, further comprising a sternal retractor, wherein said arm is adapted to be fixed to said sternal retractor, and wherein said suction head is free to move, relative to said arm via said spring suspension, even when said arm is in said locked condition.

19. The system of claim 18, wherein said surgery target immobilizing element is adapted to be fixed to said sternal retractor to immobilize said surgery target immobilizing element with respect to the portion of the heart contacted.

20. The system of claim 1, wherein said surgery target immobilizing element comprises at least one suction cup fluidically connected to a source of suction, for attachment to and immobilization of the portion of the heart.

21. The system of claim 20, wherein said surgery target immobilizing device includes a pair of sections each including a plurality of said suction cups.

22. A system for use during coronary surgery on a beating heart, comprising:

a suction head adapted to engage a region of the heart;

an arm which is flexible in an unlocked condition and rigid in a locked condition;

a suspension mechanism connecting said suction head to said arm;

an attachment mechanism adapted to fix said arm to a relatively stationary object, wherein said suction head is free to move, relative to said arm via said suspension mechanism, even when said arm is in said locked condition; and

a surgery target immobilizing device adapted to contact a portion of the heart to immobilize the location of the heart during performance of the surgery.

23. The system of claim 22, further comprising a frame adapted to maintain an opening for access to the heart.

24. The system of claim 23, wherein said attachment mechanism is adapted to fix said arm to said frame.

25. The system of claim 23, wherein said surgery target immobilizing device is adapted to be fixed to said frame.

26. The system of claim 23, wherein said frame comprises a sternal retractor.

27. The system of claim 26, wherein said attachment mechanism is adapted to fix said arm to said sternal retractor.

28. The system of claim 26, wherein said surgery target immobilizing device is adapted to be fixed to said sternal retractor.

29. The system of claim 22, wherein said suspension mechanism is biased upon engaging the heart with said suction head and lifting the heart with said arm through said suction head.

30. The system of claim 22, wherein said surgery target immobilizing device includes a support arm and a target-defining element attached to a distal end of said support arm.

31. The system of claim 30, wherein said target-defining element is U-shaped.

32. The system of claim 30, wherein said target defining element comprises at least one suction cup fluidically connected to a source of suction, for attachment to and immobilization of the portion of the heart.

33. The system of claim 30, wherein said target defining element includes a pair of sections each including a plurality of said suction cups.

34. The system of claim 30, wherein said target defining element comprises a pair of flexible sections adapted to contact the portion of the heart.

35. The system of claim 34, wherein said support arm comprises a pair of support arms connected with said pair of flexible sections, respectively.

36. The system of claim 34, wherein said target defining element further comprises a pair of rigid elements, and said support arm comprises a pair of support arms, said rigid elements interconnecting respective ones of said flexible sections with said support arms.

37. The system of claim 30, wherein said target defining element comprises a pair of suction members adapted to contact the portion of the heart.

38. The system of claim 37, wherein said support arm comprises a pair of support arms connected with said pair of suction members, respectively.

39. A system for use during coronary surgery on a beating heart, comprising:

a first device configured to engage and reposition the beating heart to a displaced position and maintain the heart in the displaced position while allowing cardiac output to be maintained substantially unabated and uninterrupted, said first device having an engaging portion adapted to engage the heart and a proximal portion configured to be fixed relative to a relatively stationary object, wherein said engaging portion moves with movements of the beating heart, while maintaining the beating heart in the displaced position, when said proximal portion is fixed; and

a second device adapted to engage a portion of the heart to immobilize the portion, while a remainder of the heart continues to beat, to facilitate surgery in the location of the portion of the heart.

40. The system of claim 39, further comprising a frame adapted to maintain an opening for access to the heart.

41. The system of claim 40, wherein said proximal portion of said first device is adapted to be fixed to said frame, whereby said frame supports said device during said repositioning and maintaining.

42. The system of claim 40, wherein said second device is adapted to be fixed to said frame, whereby said frame immobilizes said second device to stabilize the portion of the heart.

43. The system of claim 40, wherein said frame comprises a sternal retractor.

44. The system of claim 43, wherein said proximal portion of said first device is adapted to be fixed to said sternal retractor, whereby said sternal retractor supports said device during said repositioning and maintaining.

45. The system of claim 43, wherein said second device is adapted to be fixed to said sternal retractor, whereby said sternal retractor immobilizes said second device to stabilize the portion of the heart.

46. The system of claim 39, wherein said engaging portion of said first device comprises a suction head adapted to engage the region of the heart.

47. The system of claim 46, wherein said proximal portion of said first device comprises an arm which is flexible in an unlocked condition and rigid in a locked condition;

a suspension mechanism connecting said suction head to said arm; and

an attachment mechanism adapted to fix said arm to the a relatively stationary object, wherein said suction head is free to move, relative to said arm via said suspension mechanism, even when said arm is in said locked condition.