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

• US 8,277,476 B2
• Filed: 10/14/2003
• Issued: 10/02/2012
• Est. Priority Date: 02/20/1996
• Status: Expired due to Fees

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Maguet Cardiovascular LLC
• Inventors: Taylor, Charles S., Aldrich, William N., Baughman, Thomas L., Benetti, Federico J., Bennett, Brian J., Billig, Michael J., Fogarty, Thomas J., Frantzen, John J., Ginn, Richard S., Glines, Robert C., Green, Harry L., Morejohn, Dwight P., Regan, Brent, Reis, Eugene E., Salahieh, Amr, Sepetka, Ivan, Sherman, Benjamin, Skieller, Christian, Subramanian, Valavanur A., Weller, Gary B., Witt, William F.
• Primary Examiner(s): Singh, Sunil K
• Application Number:
  US10/684,557
• Publication Number:
  US 20040230099A1
• Time in Patent Office: 3,276 Days
• Field of Search: 600/204, 600/206, 600/210, 600/235, 600/201, 600226-229, 600231-233, 600/37, 606/191
• US Class Current: 606/191
• 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

The invention is methods and devices which a surgeon may use to stabilize the beating heart during a surgical procedure on the heart. Pursuant to the invention, a stabilizing device is 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 is effectively eliminated such that the heart is stabilized and the site of the surgery moves only minimally if at all. Typically, in separate steps, the surgeon contacts the heart with the stabilizing means, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing means such that the contraction of the beating heart causes orgy minimal excess motion at the surgery site. By fixing the position of the stabilizing means in a configuration where the motion of the beating heart is effectively eliminated, the surgeon is able to stabilize the beating heart for the duration of the procedure. 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. In certain preferred embodiments, the stabilizing means is affixed to a semi-rigid support which is caused to become rigid, by any of a variety of techniques, such that the position of the stabilizing means becomes fixed by the support, and the heart remains substantially motionless for the duration of the procedure.

Claims

1. A device for use in a cardiovascular surgery for insertion into the chest cavity to stabilize the beating heart through communication with a fixed support or retractor located at least partially outside of the chest cavity, the device comprising:

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

a plurality of contact members attachable to said distal end portion of said shaft, said contact members each comprising a flexible main body having a contact surface and an elongated malleable member extending along a length of said flexible main body member;

wherein said malleable members are shapeable to engage the surface of the beating heart and are configured to be placed on opposite sides of a site of anastomosis, wherein each of said malleable members is continuously adjustably shapeable by manipulation thereof to any one of a plurality of desired shapes, and wherein upon release of manipulation forces, said malleable member maintains said desired shape into which it was adjustably shaped and maintains said contact surface in said desired shape; and

wherein said shaft has sufficient strength to withstand a stabilizing force exerted on the heart via manipulation or fixation of said shaft to cause said contact member to exert a stabilizing force on the beating heart.

2. The device of claim 1, wherein introduction of positive or negative pressure to said contact members fixes a present shape of said contact surface.

3. The device of claim 1, wherein said contact members further comprise a vacuum lumen connectable to a source of positive or negative fluid pressure.

4. The device of claim 1, wherein said elongated malleable members are substantially cylindrical.

5. The device of claim 1, wherein said elongated malleable members comprise a wire.

6. The device of claim 1, wherein said shaft is adapted for insertion into a fixture attached to the fixed support or retractor.

7. The device of claim 1, wherein said malleable members are shapeable into said any one of a plurality of desired shapes prior to insertion of said malleable members, and retain said desired shapes that said malleable members have been shaped into after insertion of said malleable members into the chest cavity.

8. The device of claim 1, wherein said plurality of contact members are attached to said distal end portion of said shaft.

9. A device for use in cardiovascular surgery on the beating heart, comprising:

a shaft member having a distal end portion and a proximal end portion; and

a plurality of continuously adjustable contact members connectable to said distal end portion of said shaft member and each said contact member comprising a flexible main body member having a contact surface and an elongated malleable member extending along a length of said flexible main body member;

wherein said malleable members are shapeable to engage the surface of the beating heart and are configured to be placed on opposite sides of a site of anastomosis, wherein each of said malleable members is continuously adjustably shapeable by manipulation thereof to any of a plurality of desired shapes, and wherein upon release of manipulation forces, each said malleable member maintains said desired shape it has been shaped into and maintains said contact surface in said desired shape.

10. The device of claim 9, wherein said contact members further comprise a vacuum lumen connectable to a source of positive or negative fluid pressure.

11. The device of claim 9, wherein said shaft member is configured to assume a rigid configuration in which said shaft member has sufficient strength to withstand a stabilizing force exerted on the heart via manipulation or fixation of said shaft to cause said contact members to exert a stabilizing force on the beating heart.

12. The device of claim 9, wherein said shaft is adapted for insertion into a fixture attached to a fixed support or retractor.

13. The device of claim 9, wherein said malleable members are shapeable into said any one of a plurality of desired shapes prior to insertion of said malleable members, and retain said desired shapes that said malleable members have been shaped into after insertion of said malleable members into the chest cavity.

14. The device of claim 9, wherein said plurality of contact members are connected to said distal end portion of said shaft.

15. A device for use in a cardiovascular surgery for insertion into the chest cavity to stabilize the beating heart through communication with a fixed support or retractor located at least partially outside of the chest cavity, the device comprising:

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

a plurality of contact members attachable to the distal end portion of the shaft, said contact members each comprising;

a flexible main body having a contact surface and an elongated malleable member extending along a length of the flexible main body member; and

a vacuum lumen connectable to a source of positive or negative fluid pressure;

wherein said each of said contact members when attached to the distal end portion of the shaft (i) is shapeable to engage the surface of the beating heart, (ii) is continuously adjustably shapeable by manipulation thereof to any of a plurality of desired shapes, and (iii) maintains the desired shape it has been shaped into and maintains the contact surface in the desired shape upon release of manipulation forces; and

wherein the shaft has sufficient strength to withstand a stabilizing force exerted on the heart via manipulation or fixation of the shaft to cause the contact members to exert a stabilizing force on the beating heart.

16. The device of claim 15, wherein introduction of negative pressure to said contact members to fix a present shape of said contact surface is continuously adjustable.

17. The device of claim 15, wherein each said elongated malleable member is substantially cylindrical.

18. The device of claim 15, wherein each said elongated malleable member comprises a wire.

19. The device of claim 15, wherein said shaft is adapted for insertion into a fixture attached to the fixed support or retractor.

20. The device of claim 15, wherein said malleable members are shapeable into said any one of a plurality of desired shapes prior to insertion of said malleable members, and retain said desired shapes that said malleable members have been shaped into after insertion of said malleable members into the chest cavity.

21. The device of claim 15, wherein said plurality of contact members are attached to said distal end portion of said shaft.