Coring knife

• US 9,044,236 B2
• Filed: 05/17/2012
• Issued: 06/02/2015
• Est. Priority Date: 05/18/2011
• Status: Active Grant

• Current Assignee: Thoratec LLC
• Original Assignee: Thoratec LLC
• Inventors: Nguyen, John Duc, Curtis, Donald, Hoarau, Carine
• Primary Examiner(s): Nguyen, Tuan V
• Assistant Examiner(s): IGBOKO, CHIMA U
• Application Number:
  US13/474,096
• Publication Number:
  US 20120296358A1
• Time in Patent Office: 1,111 Days
• Field of Search: 606167-170, 606/184, 606/185, 836/83
• US Class Current: 1/1
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/1204 temporary occlusion
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1125 Forceps, specially adapted for performing or assisting anastomosis
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2017/12004 for haemostasis, for prevention of bleeding
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61M 60/148 in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
• CPC Class Codes: A61M 60/178 drawing blood from a ventricle and returning the blood to the arterial system via a cannula external to the ventricle, e.g. left or right ventricular assist devices
• CPC Class Codes: A61M 60/232 Centrifugal pumps
• CPC Class Codes: A61M 60/237 the blood flow through the rotating member having mainly axial components, e.g. axial flow pumps
• CPC Class Codes: A61M 60/863 Apex rings
• CPC Class Codes: A61M 60/865 : Devices for guiding or inserting pumps or pumping devices into the patient's body
• CPC Class Codes: A61M 60/88 : Percutaneous cables
• CPC Class Codes: A61M 60/896 : having flexible or resilient parts, e.g. flap valves

Abstract

A coring knife can be used to make a circular incision. The coring knife includes an abutment that is inserted into an initial slit through the heart wall. The abutment can be inserted into the slit while oriented in a direction that minimizes its insertion profile. After insertion, the abutment is reoriented by turning a key so that its abutment surface faces toward a circular cutting edge of the coring knife on the other side of the heart wall. The circular incision through the heart wall is made by pressing the circular cutting edge of the coring knife against the abutment.

Claims

1. A coring knife comprising:

a coring blade including a circular cutting edge;

a coring abutment located forward of the cutting edge;

a key socket located to the rear of the coring blade, the key socket including a bearing surface; and

a key connected to the coring abutment and including a key edge in contact with the bearing surface, the key configured to be moved relative the key socket,

wherein when the key is moved relative the key socket, the key edge slips against the bearing surface and the key pivots the coring abutment relative to the coring blade, wherein when the coring abutment pivots, a portion of the coring abutment moves closer to the coring blade,

wherein the key includes a cylinder having an outer surface that terminates at the key edge,

wherein the key edge is disposed within a rear cavity of the key socket, and

wherein the coring blade is mounted over a central shaft extending out of a forward cavity of the key socket, the coring blade is configured to be rotated around the central shaft, and wherein when the coring blade is rotated, the coring blade moves toward the coring abutment.

2. The coring knife of claim 1, further comprising a control arm connecting the coring abutment to the key, the control arm extending through the coring blade and the key socket.

3. The coring knife of claim 2, wherein the key is configured to be twisted about a twist axis, and wherein when the key is twisted, the key edge slips against the bearing surface and the key pivots the coring abutment relative to the coring blade.

4. The coring knife of claim 3, wherein when the key is twisted, the control arm moves along a longitudinal axis that is parallel to the twist axis.

5. The coring knife of claim 1, further comprising a coring knife case configured to be moved away from the key socket, wherein the coring blade is movable into and out of the coring knife case.

6. The coring knife of claim 5, wherein the coring blade is configured to move out of the coring knife case by rotating the coring blade relative to the coring knife case.

7. A coring knife comprising:

a coring blade including a circular cutting edge;

a coring abutment located forward of the cutting edge;

a key socket located to the rear of the coring blade, the key socket including a bearing surface; and

a key connected to the coring abutment and including a key edge in contact with the bearing surface, the key configured to be moved relative the key socket,

wherein when the key is moved relative the key socket, the key edge slips against the bearing surface and the key pivots the coring abutment relative to the coring blade, wherein when the coring abutment pivots, a portion of the coring abutment moves closer to the coring blade,

wherein the key includes a cylinder having an outer surface that terminates at the key edge,

wherein the key edge is disposed within a rear cavity of the key socket, and

wherein the coring blade is carried on an internal sleeve, the internal sleeve is carried on a central shaft extending out of a forward cavity of the key socket, the internal sleeve is configured to slide relative the central shaft in a direction toward the coring abutment, the coring blade is configured to be rotated relative the internal sleeve, and wherein when the coring blade is rotated, the coring blade moves toward the coring abutment.

8. The coring knife of claim 7, further comprising a control arm connecting the coring abutment to the key, the control arm extending through the coring blade and the key socket.

9. The coring knife of claim 8, wherein the key is configured to be twisted about a twist axis, and wherein when the key is twisted, the key edge slips against the bearing surface and the key pivots the coring abutment relative to the coring blade.

10. The coring knife of claim 9, wherein when the key is twisted, the control arm moves along a longitudinal axis that is parallel to the twist axis.

11. A coring knife comprising:

a coring blade including a circular cutting edge;

a coring abutment located forward of the cutting edge;

a key socket located to the rear of the coring blade, the key socket including a bearing surface;

a key connected to the coring abutment and including a key edge in contact with the bearing surface, the key configured to be moved relative the key socket, wherein when the key is moved relative the key socket, the key edge slips against the bearing surface and the key pivots the coring abutment relative to the coring blade, wherein when the coring abutment pivots, a portion of the coring abutment moves closer to the coring blade;

a coring knife case configured to be moved away from the key socket, wherein the coring blade is movable into and out of the coring knife case; and

a control sleeve attached to the coring blade, the control sleeve having a helical slot that extends into the coring knife case, wherein the coring knife case includes a guide peg that protrudes into the helical slot, and wherein rotation of the control sleeve causes the coring blade to move out of the coring knife case.

12. The coring knife of claim 11, wherein the key includes a cylinder having an outer surface that terminates at the key edge.

13. The coring knife of claim 12, wherein the key edge is disposed within a rear cavity of the key socket.

14. The coring knife of claim 13, wherein the key socket includes a forward cavity and a septum wall separating the forward cavity from the rear cavity, and the bearing surface forms a side of the of the septum wall within the rear cavity.

15. The coring knife of claim 13, wherein the coring blade is mounted over a central shaft extending out of a forward cavity of the key socket, the coring blade is configured to be rotated around the central shaft, and wherein when the coring blade is rotated, the coring blade moves toward the coring abutment.

16. The coring knife of claim 11, further comprising an internal sleeve and a central shaft, the central shaft fixedly attached to the key socket and extending into the internal sleeve, the internal sleeve carrying the control sleeve, the coring blade, and the coring knife case, and wherein the internal sleeve is configured to be selectively positioned and locked at any one of a plurality of locations on the central shaft.

17. A coring knife comprising:

a coring blade including a cylindrical wall defining a circular cutting edge and a hollow interior;

a coring abutment;

a coring knife case containing the coring blade, the coring blade configured to be extended out of the coring knife case and toward the coring abutment; and

a key coupled to the coring abutment by a control arm extending into the coring blade, the key disposed within a key socket and configured to be rotated relative to the key socket, wherein when the key is rotated relative the key socket, the key pulls the control arm in a manner that pivots the coring abutment relative to the coring blade.

18. The coring knife of claim 17, wherein the coring knife case includes a stop feature configured to fit in an alignment feature of a separate device for aligning the coring knife prior to extension of the coring blade out of the coring knife case.

19. The coring knife of claim 17, wherein the coring knife case is configured to be selectively positioned and locked at any one of a plurality of locations between the key socket and the coring abutment prior to extension of the coring blade out of the coring knife case.

20. The coring knife of claim 19, further comprising a detent mechanism that selectively locks and unlocks the coring knife case at any one of the plurality of locations between the key socket and the coring abutment.

21. The coring knife of claim 17, wherein when the coring abutment pivots, a portion of the coring abutment moves closer to the coring blade.