Method for organ positioning and stabilization

• US 6,447,443 B1
• Filed: 06/12/2001
• Issued: 09/10/2002
• Est. Priority Date: 01/13/2001
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Guenst, Gary W., Keogh, James R., Jahns, Scott E., Gubbin, Douglas H., Daigle, Thomas, Pignato, Paul A., Olig, Christopher, Colson, Michael A., Jolly, Katherine, Montpetit, Karen, OʼNeill, William G.
• Primary Examiner(s): Smith, Jeffrey A.
• Application Number:
  US09/879,294
• Publication Number:
  US 20020095139A1
• Time in Patent Office: 455 Days
• Field of Search: 600/37, 600/201, 600/205, 600/235, 600/232, 606/1, 128/898, 607/2, 607/4, 607/7, 607/9
• US Class Current: 600/37
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/22004 using mechanical vibrations, e.g. ultrasonic shock waves A61B17/225 takes precedence
• 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 2017/2905 flexible
• CPC Class Codes: A61B 2017/308 with suction cups
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362

Abstract

This invention provides a system and method for positioning, manipulating, holding, grasping, immobilizing and/or stabilizing a heart including one or more tissue-engaging devices, one or more suction sources, one or more fluid sources, one or more energy sources, one or more sensors and one or more processors. The system and method may include an indifferent electrode, a drug delivery device and an illumination device. The system'"'"'s tissue-engaging device may comprise a tissue-engaging head, a support apparatus and a clamping mechanism for attaching the tissue-engaging device to a stable object. The system may be used during various medical procedures including the deployment of an anastomotic device, intermittently stopping and starting of the heart, ablation of cardiac tissues and the placement of cardiac leads.

Claims

1. A method of performing a medical procedure on a heart, comprising:

providing a suction assisted positioning device;

engaging the heart with the positioning device;

positioning the heart into a non-physiological orientation;

stimulating a nerve to adjust the beating of the heart to a first condition;

performing the medical procedure on the heart;

reducing stimulation of the nerve to adjust the beating of the heart to a second condition;

stimulating the nerve a subsequent time in order to re-adjust the beating of the heart to the first condition; and

,

continuing the medical procedure.

2. The method of claim 1 wherein the nerve is stimulated using endotracheal stimulation.

3. The method of claim 1 wherein the stimulation is stopped to achieve the second condition.

4. The method of claim 1 wherein the first condition is a stopped condition.

5. The method of claim 1 wherein the first condition is a slowed condition.

6. The method of claim 1 wherein the second condition is a beating condition.

7. The method of claim 1 further comprising:

stimulating the heart in order to adjust the beating of the heart to the second condition.

8. The method of claim 7 wherein the heart is stimulated by pacing.

9. The method of claim 1 further comprising:

administering at least one drug during the medical procedure.

10. The method of claim 9 wherein the drug is selected from the group consisting of:

a beta-blocker, a cholinergic agent, a cholinesterase inhibitor, a calcium channel blocker, a sodium channel blocker, a potassium channel agent, adenosine, an adenosine receptor agonist, an adenosine deaminase inhibitor, dipyridamole, a monoamine oxidase inhibitor, digoxin, digitalis, lignocaine, a bradykinin agent, a serotoninergic agonist, an antiarrythmic agent, a cardiac glycoside, a local anesthetic, atropine, a calcium solution, an agent that promotes heart rate, an agent that promotes heart contractions, dopamine, a catecholamine, an inotrope glucagon, a hormone, forskolin, epinephrine, norepinephrine, thyroid hormone, a phosphodiesterase inhibitor, prostacyclin, prostaglandin and a methylxanthine.

11. The method of claim 1 wherein the nerve is a vagal nerve.

12. The method of claim 1 wherein the medical procedure is selected from the group consisting of:

surgical procedures, CPB procedures, heart valve repair procedures, heart valve replacement procedures, MAZE procedures, TMR procedures, CABG procedures, anastomosis procedures, non-surgical procedures, endoscopic procedures, non-invasive procedures, invasive procedures, port-access procedures, fluoroscopic procedures, beating heart surgery procedures, vascular surgery procedures, neurosurgery procedures, electrophysiology procedures, diagnostic procedures, therapeutic procedures, ablation procedures, endovascular procedures, aneurysm repair procedures, imaging procedures, CAT scan procedures, MRI procedures, cardiogram procedures, pharmacological therapy procedures, drug delivery procedures, biological agent delivery procedures, gene therapy procedures, cellular therapy procedures, cancer therapy procedures, radiation therapy procedures, genetic procedures, cellular procedures, tissue manipulation procedures, organ manipulation procedures, transplantation procedures, coronary angioplasty procedures, stent placement procedures, stent delivery procedures, LVAD procedures, lead placement procedures, atherectomy procedures, atherosclerotic plaque manipulation procedures, atherosclerotic plaque removal procedures, emergency procedures, reconstructive surgery procedures, procedures including cardiac reinforcement devices, procedures including cardiac assistance devices, biopsy procedures, surgical training procedures, congenital repair procedures, and medical procedures that require positioning one or more organs and/or tissues.

13. The method of claim 1 further comprising:

positioning the heart a subsequent time into a different non-physiological orientation.

14. The method of claim 1 further comprising:

delivering one or more fluids during the medical procedure.

15. The method of claim 14 wherein the one or more fluids comprises at least one diagnostic agent, therapeutic agent or biological agent.

16. The method of claim 1 further comprising:

evaluating the hemodynamic condition of the heart with a sensor.