Apparatus for endoscopic cardiac mapping and lead placement

• US 7,526,342 B2
• Filed: 10/29/2003
• Issued: 04/28/2009
• Est. Priority Date: 08/10/1999
• Status: Expired due to Fees

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Inventors: Westlund, Randy W., Chin, Albert K., Davis, John W.
• Primary Examiner(s): Bockelman; Mark W
• Assistant Examiner(s): Bertram; Eric D
• Application Number:
  US10/697,906
• Publication Number:
  US 20040153098A1
• Time in Patent Office: 2,008 Days
• Field of Search: 607/17, 607/18, 607/119, 607/127, 607/129, 607/130, 600104-106, 600/123, 600/129, 600154-158
• US Class Current: 607/119
• CPC Class Codes: A61B 1/00094 Suction openings
• CPC Class Codes: A61B 17/00008 Vein tendon strippers tube strippers A61M1/83
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/061 hollow or tubular suture extending inside a hollow needle A61B2017/06052; hollow sutures A61B2017/06185
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/308 with suction cups
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2090/036 : abutting on tissue or skin
• CPC Class Codes: A61B 2090/062 : penetration depth
• CPC Class Codes: A61B 90/11 : with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers

Abstract

Apparatus and surgical methods establish temporary suction attachment to a target site on the surface of a beating heart for analyzing electrical signals or hemodynamic responses to applied signals at the target sites for enhancing the accuracy of placement of cardiac electrodes at selected sites and for enhancing accurate placement of a surgical instrument maintained in alignment with the suction attachment. A suction port on the distal end of a supporting cannula carries surface-contacting electrodes and provides suction attachment to facilitate temporary positioning of the electrodes in contact with tissue at the target site, and a clamping and release mechanism to facilitate anchoring a cardiac electrode on the moving surface of a beating heart at a selected site. Analyses of sensed signals or responses to applied signals at target sites promote epicardial mapping of a patient'"'"'s heart for determining optimum sites at which to attach cardiac electrodes.

Claims

1. Apparatus for performing a surgical procedure on the heart of a patient through a working cavity in tissue between the heart and an entry incision, the apparatus comprising:

a cannula configured for passing extravascularly through the entry incision and working cavity toward the heart;

a suction attachment supported by the cannula and configured for contacting an exterior target site on the heart; and

a support channel for a cardiac lead that is disposed on the suction attachment and that includes coaxial mating segments that are relatively rotatable about a coaxial axis thereof, each segment having a longitudinal slot extending along the entire length of an outer wall between distal and proximal ends of the segment for selective configuration as a closed channel in one relative rotational orientation for confining a cardiac lead in the support channel or as a channel open longitudinally along the entire length of the outer wall between proximal and distal ends of the segment in another relative rotational orientation of the segments that aligns the longitudinal slots for releasing a cardiac lead laterally from within the entire length of the support channel through the aligned slots.

2. Apparatus according to claim 1 including a cardiac lead connected to an electrode disposed near a surface of the suction attachment to contact the heart externally, the cardiac lead extending along the support channel in the closed configuration to the proximal ends of the segments for connecting the electrode to a utilization circuit and being releasable laterally from the support channel through the longitudinal slots formed in the segments as rotationally oriented in the open configuration.