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

• US 7,585,277 B2
• Filed: 02/01/2006
• Issued: 09/08/2009
• Est. Priority Date: 02/20/1996
• Status: Expired due to Fees

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Inventors: Taylor, Charles S., Adair, Caralin R., Witt, William F., Morejohn, Dwight P., Weller, Gary B., Sherman, Benjamin
• Primary Examiner(s): Philogene; Pedro
• Application Number:
  US11/346,004
• Publication Number:
  US 20070055108A1
• Time in Patent Office: 1,315 Days
• Field of Search: 600/201, 600/204, 600/210, 600/206, 600/229, 600/205, 600/208, 600/235, 600/214, 600/215, 600/233, 128/898
• 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 17/8076 for the ribs or the sternum
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00539 hydraulically
• 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 2017/00991 Telescopic means
• 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 2017/0648 threaded, e.g. tacks with a screw thread
• 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 which a surgeon may use to stabilize the beating heart during a surgical procedure on the heart. A stabilizing device may be introduced through an opening in the chest and brought into contact with the beating heart. By contacting the heart with the device and by exerting a stabilizing force on the device, the motion of the heart caused by the contraction of the heart muscles in a vicinity of a site of surgery to be performed, is effectively eliminated. A surgeon may contact the heart with the stabilizing means, assess the degree of movement of the anastomosis site, and exert a force on the stabilizing means such that the contraction of the beating heart causes only minimal excess motion at the surgery site. The stabilizing means 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 stabilizing a portion of a beating heart, using a minimally invasive procedure, said device comprising:

at least one contact member configured to engage the surface of a beating heart in a deployed configuration to stabilize a portion of the beating heart in a vicinity of a location engaged by said at least one contact member, each said at least one contact member having a retracted configuration used for insertion of the at least one contact member through a minimally invasive opening in a patient, wherein each said at least one contact member has a first length in said deployed configuration and a second length in said retracted configuration, said second length being less than said first length;

an elongated member connected to said at least one contact member and extending proximally therefrom, said elongated member having sufficient length such that a proximal end portion can extend outside of a patient, through an opening in the patient, when said at least one contact member engages the surface of the beating heart;

at least one controlling link connecting to said at least one contact member and extending proximally therefrom along a length of said elongated member sufficient to extend a proximal end portion of said at least one controlling link outside of the patient, through an opening in the patient, when said at least one contact member engages the surface of the beating heart ; and

an actuator linked to a proximal end portion of said at least one controlling link and manipulatable, from a location outside the patient, to reposition said at least one contact member when said at least one contact member is inside of the patient.

3. The device of claim 1, wherein each said at least one contact member is rolled into an annular configuration in said retracted configuration.

4. The device of claim 1, wherein each said at least one contact member is folded about a central portion thereof in said retracted configuration.

5. The device of claim 4, wherein each said central portion comprises a hinge.

6. The device of claim 1, wherein each said at least one contact member comprises at least one wire, each said at least one wire being deformable into said retracted configuration.

2. A minimally invasive method of stabilizing a portion of a beating heart to facilitate performance of a surgical procedure, said method comprising the steps of:

positioning a stabilizing device through an opening in a patient such that at least one contact member of the device approximates a beating heart and an elongated member connecting to the at least one contact member extends such that a proximal end portion of the device extends outside of the opening;

manipulating an actuator at said proximal end portion of the device, outside of the patient to reposition at least one of said at least one contact members; and

engaging at least one of said at least one contact members to a surface of the beating heart to stabilize a portion of the beating heart in the vicinity of a location where said at least one contact member engages the surface.

7. A device for stabilizing a portion of a beating heart, using a minimally invasive procedure, said device comprising:

at least one contact member adapted to engage the surface of a beating heart in a deployed configuration to stabilize a portion of the beating heart in a vicinity of a location engaged by said at least one contact member, each said at least one contact member having a retracted configuration used for insertion of the at least one contact member through a minimally invasive opening in a patient, wherein each said at least one contact member is deformed in said retracted configuration and returns to an undeformed configuration in said deployed configuration;

an elongated member connected to said at least one contact member and extending proximally therefrom, said elongated member having sufficient length such that a proximal end portion can extend outside of a patient, through an opening in the patient, when said at least one contact member engages the surface of the beating heart;

at least one controlling link connecting to said at least one contact member and extending proximally therefrom along a length of said elongated member sufficient to extend a proximal end portion of said at least one controlling link outside of the patient, through an opening in the patient, when said at least one contact member engages the surface of the beating heart; and

an actuator linked to a proximal end portion of said at least one controlling link and manipulatable, from a location outside the patient, to reposition said at least one contact member when said at least one contact member is inside of the patient.

8. The device of claim 7, wherein each said at least one contact member is rolled into an annular configuration in said retracted configuration.

9. The device of claim 7, wherein each said at least one contact member is folded into a shortened configuration when in said retracted configuration.

10. The device of claim 7, wherein each said at least one contact member comprises a wire that is deformed when inserted into said elongated member.

11. The device of claim 7, wherein each said at least one contact member comprises a helical wire coil that is deformed in said retracted configuration.

12. The device of claim 7, wherein each said at least one contact member comprises an inflatable balloon preshaped to said deployed configuration.

13. The device of claim 7, wherein each said at least one contact member comprises a pair of contact members joined together at distal tips thereof

14. The device of claim 7, wherein each said at least one contact member is unfolded into an elongated configuration when in said retracted configuration.