WO1999060930B1 - Beating heart coronary bypass surgical device - Google Patents

Beating heart coronary bypass surgical device

Info

Publication number
WO1999060930B1
WO1999060930B1 PCT/US1999/011655 US9911655W WO9960930B1 WO 1999060930 B1 WO1999060930 B1 WO 1999060930B1 US 9911655 W US9911655 W US 9911655W WO 9960930 B1 WO9960930 B1 WO 9960930B1
Authority
WO
WIPO (PCT)
Prior art keywords
heart
chamber
suction
flexible
suction cup
Prior art date
Application number
PCT/US1999/011655
Other languages
French (fr)
Other versions
WO1999060930A2 (en
WO1999060930A3 (en
Inventor
Paul A Spence
Warren P Williamson Iv
Mark Ortiz
Original Assignee
Guidant Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Guidant Corp filed Critical Guidant Corp
Priority to CA002333567A priority Critical patent/CA2333567C/en
Priority to EP99953275A priority patent/EP1082058B1/en
Priority to JP2000550398A priority patent/JP4307724B2/en
Priority to AU43151/99A priority patent/AU760282B2/en
Priority to DE69938657T priority patent/DE69938657D1/en
Publication of WO1999060930A2 publication Critical patent/WO1999060930A2/en
Publication of WO1999060930A3 publication Critical patent/WO1999060930A3/en
Publication of WO1999060930B1 publication Critical patent/WO1999060930B1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0206—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with antagonistic arms as supports for retractor elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00491—Surgical glue applicators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0293—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with ring member to support retractor elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00305—Constructional details of the flexible means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00305—Constructional details of the flexible means
    • A61B2017/00309—Cut-outs or slits
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B2017/0237—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for heart surgery
    • A61B2017/0243—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for heart surgery for immobilizing local areas of the heart, e.g. while it beats
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30—Surgical pincettes without pivotal connections
    • A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction
    • A61B2017/308—Surgical pincettes without pivotal connections holding by means of suction with suction cups

Abstract

A system for manipulating a heart during cardiac surgery links lifting of the heart and regional immobilization which stops one part of the heart from moving to allow expeditious suturing while permitting other parts of the heart to continue to function whereby coronary surgery can be performed on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system for manipulating a heart during cardiac surgery of the present invention. The system is an improvement on the retractor disclosed in parent application Serial Number 08/936,184 filed on 09/17/97 and locates a suspension head near the apical region of the heart and a gross support near the base of the heart near the AV groove. A frame is positioned within the patient's thoracic region and moves with the patient, and a surgical target immobilizer can be used to assist in the movement of the heart if desired. A special suction cup is used which accommodates multiplanar movement of the heart and the myocardium while also preventing heart tissue from interrupting the suction being applied to the heart. One form of the system can be used in minimally invasive surgery.

Claims

AMENDED CLAIMS _ [received by the International Bureau on 27 December 1999 (27.12.99); original claims 1-76 replaced by amended claims 1-71 (18 pages)]
1. A manipulation system for cardiac surgery, comprising: a gross support means for engaging and supporting a beating heart when the heart is located and oriented for surgery; an arm configured to position the gross support means at the base of the heart and wherein the gross support means includes a head which is sized and shaped to cradle the myocardium of the left ventricle along the arterialventricular groove; a suspension head configured to exert lifting force on the heart ; and another arm configured to position the suspension head near the apical region of the heart and at least partially overlying the right ventricle.
2. In a manipulation system for cardiac surgery which includes means for engaging a selected section of a beating heart to immobilize that selected section as a surgery target while permitting non-engaged sections of the heart to move in a manner whereby essentially unabated cardiac output is maintained while the heart is regionally immobilized, the improvement comprising: a suspension head configured to apply suction to the surface of the beating heart to lift the heart and which is located near the apical region of the heart, said suspension head including a head abutting the surface of the beating heart, said head having means for accommodating multiplanar surface movement of the beating heart while maintaining suction application to the surface of the beating heart, said head also including means for preventing heart tissue from clogging a fluid connection between a source of
66 suction applied to the heart via said head and said heart .
3. A manipulation system for cardiac surgery comprising: a gross support means for engaging a beating heart to support the heart when the heart has been oriented into an unnatural position or orientation for cardiac surgery, an immobilizing element configured to engage a selected section of the heart to immobilize that selected section as a surgery target while permitting non-engaged sections of the heart to move in a manner whereby essentially unabated cardiac output is maintained while the heart is regionally immobilized, wherein the gross support means includes a suction head having a first chamber, a second chamber for fluidically connecting the first chamber to a source of suction and a mesh grid configured to prevent heart tissue from interfering with suction being applied to the heart via said suction head.
4. The system of Claim 3 wherein the suction head has a shoulder between the first chamber and the second chamber, and the mesh grid is attached to said suction head adjacent to said shoulder and spanning said first chamber for preventing heart tissue from clogging the fluid connection between the second chamber and the source of suction.
5. The system of Claim 3 further including a suspension head configured to lift the heart and an arm configured to position the suspension head near the apex of the heart adjacent to the right ventricle, wherein the suspension head includes a suction cup having a flexible rim.
67
6. The system of Claim 5 wherein said suction cup is a multi-section suction cup, said multi- section suction cup including a first chamber having said flexible rim for engaging the heart, a second chamber for fluidically connecting the first chamber to a source of suction, said second chamber having a size that is different from the size of said first chamber, said flexible rim being flexible in a plurality of planes to accommodate multiplanar movement of the surface of the beating heart without breaking contact between the surface of the heart and the suction cup.
7. The system of Claim 3, wherein the immobilizing element includes a multi-section suction cup having a first chamber having a flexible rim for engaging the heart, a second chamber for fluidically connecting the first chamber of the suction cup to the source of suction, the second chamber of the suction cup having a size that is different from the size of said first chamber of the suction cup, the flexible rim of the suction cup being flexible in a plurality of planes to accommodate multiplanar movement of the surface of the beating heart without breaking contact between the surface of the heart and the flexible rim of the suction cup.
8. The improvement defined in Claim 2 wherein the improvement further includes a gross support means which includes at least one malleable rod configured to allow movement of the gross support means into a desired position relative to the heart and to retain the gross support means in the desired position.
9. The system of Claim 5, also including:
68 a frame means for supporting said gross support and said suspension head.
10. The system of Claim 9 wherein said frame means is configured to be mounted within the patient's thoracic cavity.
11. The system of Claim 10 wherein said frame means includes a cross bar.
12. The system of Claim 6 wherein said suction cup includes a shoulder between the first chamber and the second chamber.
13. The system of Claim 1 wherein said gross support means includes a handle thereon, said handle having a length sufficient to allow placement of said gross support means at the base of the heart from above the heart when said gross support means is in place on the heart .
1 . The system of Claim 9 wherein said frame means at least partially surrounds the patient's heart when said gross support means is in place on the heart .
15. The system of Claim 1 wherein said gross support means is located adjacent to the left atrium.
16. A heart manipulation system for use in cardiac surgery comprising: a frame that is located inside a patient during beating heart surgery and which includes means for engaging the pericardial cavity of the patient for mounting said frame on the patient to move with the patient if the patient is moved or reoriented during surgery; a source of suction; a suspension head mount attached to the frame and having a flexible state and a rigid state; a suspension head mounted on said suspension head mount, configured to exert lifting force on the heart when positioned near the apical region of the right ventricle and at least partially overlying the right ventricle so as to prevent collapse of the right ventricle during manipulation of the heart, wherein the suspension head includes a flexible means for permitting multiplanar relative movement between the beating heart and the suspension head mount, and a suction cup connected to the source of suction and which includes a flexible rim engaging the myocardium of the heart and being flexible in a plurality of planes so multiplanar movement of the myocardium during operation of the heart will be accommodated by said flexible rim whereby suction applied to the myocardium by said suction cup will not be broken by separation of the myocardium from the suction cup, said suction cup further including a mesh grid element configured to prevent heart tissue from interfering with suction being applied to the myocardium via said suction cup; an immobilizing element configured to engage a selected section of the heart and locally immobilize the heart adjacent to a surgery target so the heart is supported and free to operate during surgery while it is also locally immobilized at the surgery target with non-engaged sections of the heart free to move in a manner whereby essentially unabated cardiac output is maintained while the heart is locally immobilized, and further including an immobilizing element suction cup connected to the source of suction and which also includes a flexible rim engaging the myocardium of the heart and being flexible in a plurality of planes so multiplanar movement of the myocardium during operation of the heart will be accommodated by the flexible rim of said immobilizing element suction cup whereby suction applied to the myocardium by the immobilizing element suction cup will not be broken by separation of the myocardium from the immobilizing element suction cup, said immobilizing element suction cup further including a mesh grid configured to prevent heart tissue from interfering with suction being applied to the myocardium via said immobilizing element suction cup ; and a gross support means movably mounted on said frame for engaging the heart to support the heart when the heart is oriented for surgery and which is configured to be positioned at the base of the heart so as to cradle the myocardium of the left ventricle along the arterialventricular groove, the gross support means supporting the mitral valve annulus to maintain competent mitral valve function and placed beneath an infolded section of myocardium, said gross support means including a handle which extends outside of the patient during surgery for adjusting the location of said gross support means, and further including a head connected by a malleable rod means to an arm, said arm being connected to said frame, said head including a plurality of sections which are movable relative to each other and means for maintaining said sections in a selected relative orientation, said head further including a means for applying suction from said source of suction to the heart .
71
17. A heart manipulation system for use in cardiac surgery comprising: a frame which is located inside a patient during beating heart surgery and which is mounted on the patient to move with the patient; a suspension head mounted on said frame for lifting the beating heart and which includes a flexible head, said flexible head including a flexible rim, said flexible rim being flexible in a plurality of planes to accommodate multiplanar movement of the surface of the beating heart without breaking contact between the surface of the heart and the flexible rim, and means for accommodating multiplanar movement of the beating heart relative to the frame during beating heart surgery; and an immobilizing element configured to engage a selected section of the heart to immobilize that selected section as a surgery target while permitting non-engaged sections of the heart to move in a manner whereby essentially unabated cardiac output is maintained while the heart is locally immobilized.
18. The system of Claim 1, also including means for engaging a selected section of the heart to immobilize that selected section as a surgery target while permitting non-engaged sections of the heart to move in a manner whereby essentially unabated cardiac output is maintained while the heart is regionally immobilized.
19. The system of Claim 17 further including a gross support means mounted to the frame, the gross suppport means having a suction head including a first chamber and a second chamber for fluidically connecting the first chamber to a source of suction,
72 said second chamber having a size that is different from the size of said first chamber.
20. The system of Claim 17 wherein said frame at least partially surrounds the patient's heart.
21. The system of Claim 18, wherein said means for engaging a selected section of the heart includes a multi-section cup configured to engage the selected section of the heart.
22. The method defined in Claim 24 wherein the step of engaging a selected section of the heart includes a step of applying suction to the myocardium adjacent to the selected section.
23. The system of Claim 21 wherein said multi- section suction cup includes a first chamber having a flexible rim for engaging the heart, a second chamber for fluidically connecting the first chamber to a source of suction, said second chamber having a size that is different from the size of said first chamber, and a shoulder at the connection between said first chamber and said second chamber, said flexible rim being flexible in a plurality of planes to accommodate multiplanar movement of the surface of the beating heart without breaking contact between the surface of the heart and the flexible rim.
24. The system of Claim 3 wherein the immobilizing element further includes a multi-section suction cup which includes a first chamber having a flexible rim for engaging the heart, a second chamber for fluidically connecting the first chamber to a source of suction, said second chamber having a size that is different from the size of said first
73 chamber, said flexible rim being flexible in a plurality of planes to accommodate multiplanar movement of the surface of the beating heart without breaking contact between the surface of the heart and the flexible rim.
25. A manipulation system for use in cardiac surgery comprising: a gross support means for engaging and supporting a beating heart when the heart is located and oriented for surgery and which is located at the base of the heart and engages the beating heart at a location that supports the mitral valve annulus and which includes a flexible head which is sized and shaped to extend along the arterialventricular groove of the heart; means for immobilizing the heart adjacent to a surgery target so the heart is supported and free to operate during surgery while it is also locally immobilized at the surgery target; and a suspension head for lifting the heart and which is located near the apex of the heart and which includes a flexible head.
26. A manipulation system for use in cardiac surgery comprising: means for supporting a beating heart adjacent to a surgery target so the heart is free to operate during surgery while it is also locally immobilized at the surgery target ; and a suspension head for lifting the beating heart including a heart attachment means for attaching said suspension head to the heart, said heart attachment means including a flexible heart engaging portion that is flexible in a plurality of planes to
74 accommodate heart surface multiplanar movement during beating of the heart.
27. A manipulation system for use in minimally invasive cardiac surgery comprising: means for supporting a beating heart adjacent to a surgery target so the heart is free to operate during surgery while it is also locally immobilized at the surgery target; and a suspension head for lifting the beating heart including a suction cup means for attaching said suspension head to the heart, said suction cup means including a flexible heart-engaging portion that is flexible in a plurality of planes to accommodate heart surface multiplanar movement during beating of the heart .
28. A suction cup for use with a source of suction in cardiac surgery, the suction cup comprising: a first chamber having a flexible rim for engaging the heart, and a second chamber for fluidically connecting the first chamber to the source of suction, said rim being flexible in a plurality of planes to accommodate multiplanar movement of the surface of the beating heart without breaking suction applied to the heart via said first chamber .
29. The suction cup defined in Claim 28 further including a mesh grid element connected to said suction cup spanning said first chamber for preventing heart tissue from clogging the fluid connection between the first chamber and the source of suction.
75
30. The system of Claim 1 further including a flexible means on said suspension head for permitting the heart to move in a plurality of planes.
31. The system of Claim 1 wherein the gross support means has a malleable section.
32. The system of Claim 17 further including a flexible means on said suspension head for permitting the heart to move in a plurality of planes.
33. The system of Claim 17 wherein the gross support means has a malleable section.
34. The system of Claim 3 further including a flexible means on said suspension head for permitting the heart to move in a plurality of planes .
35. The system of Claim 3 wherein the gross support means has a malleable section.
36. The manipulation system defined in Claim 26 further including a gross support means for engaging and supporting a heart when the heart is located and oriented for surgery and which cradles myocardium of the left ventricle along the arterialventricular groove .
37. The manipulation system defined in Claim 26 wherein the heart attachment means comprises a suction cup, and said suspension head further includes means on said suction cup for permitting said suction cup to move in a plurality of directions to accommodate beating heart movement.
76
38. The manipulation system defined in Claim 37 wherein said suction cup includes means for preventing heart tissue from interrupting suction applied by said suction cup.
39. The manipulation system defined in Claim 17 further including a support head mounted on said frame and configured to engage and support the heart when the heart is oriented for surgery and including by cradling the myocardium of the left ventricle along the arterialventricular groove.
40. A manipulation system for use in minimally invasive cardiac surgery comprising: a gross support means for engaging and supporting a beating heart when the heart is located and oriented for surgery and which is located so mitral valve operation of the beating heart is not interrupted; an immobilizing element configured to immobilize the heart adjacent to a surgery target so the heart is supported and free to operate during surgery while it is also locally immobilized at the surgery target; and a suspension head for lifting the beating heart and which is located near the apex of the heart.
41. The system defined in Claim 16 wherein the suction cup includes a first chamber for engaging the myocardium of the heart, a second chamber for fluidically connecting the first chamber to said source of suction, the second chamber of said suspension head having a size that is different from the size of the first chamber said suspension head, the mesh grid element of said suspension head being connected so as to span the first chamber for
77 preventing the heart tissue from interfering with suction applied to the heart via said suspension head.
42. The manipulation system defined in Claim 16 wherein the immobilizing element suction cup is a multi-section suction cup which includes a first chamber having a flexible rim for engaging the heart, a second chamber for fluidically connecting the first chamber to the source of suction, the second chamber having a size that is different from the size of the first chamber, and a shoulder at the connection between first chamber and the second chamber and wherein the mesh grid is mounted adjacent to the shoulder and spanning the first chamber, the flexible rim of the immobilizing element suction cup being flexible in a plurality of planes to accommodate multiplanar movement of the surface of the beating heart without breaking contact between the surface of the heart and the flexible rim.
43. The system defined in Claim 16 wherein said flexible means on the suspension head includes a spring means and said suction cup has a first chamber having said flexible rim thereon for engaging the heart, a second chamber for fluidically connecting the first chamber to the source of suction, the second chamber having a size that is different from the size of the first chamber, and a shoulder between the first chamber and the second chamber, and said mesh grid element being connected to the suction cup adjacent to the shoulder of the suction cup and spanning the first chamber of the suction cup.
44. The system defined in claim 16 wherein the head on said gross support means includes a proximal
78 section and a distal section, with said proximal section being flexible.
45. A manipulation system for cardiac presentation in cardiac surgery on a patient, said system comprising: a suspension means for suspending a beating heart in an unnatural position for surgery and which engages the heart near the apical region of the heart and at least partially overlies the right ventricle of the heart and which includes means for attaching said suspension means to the heart and which accommodates multiplanar movement of the heart.
46. The system defined in Claim 45 further including a frame to which said suspension system is attached and which is located inside the patient during the cardiac surgery.
47. The system defined in claim 45 further including a sternal retractor, wherein the suspension means is mounted on the sternal retractor.
48. The manipulation system defined in Claim 45 further including a surgery target immobilizing means for engaging a selected section of the heart to immobilize that selected section as a surgery target while permitting non-engaged sections of the heart to move in a manner whereby essentially unabated cardiac output is maintained while the heart is locally immobilized.
49. The manipulation system defined in Claim 45 wherein the means for attaching the suspension means to the heart includes a suction cup having a rim which engages the myocardium and which moves in a
79 plurality of planes in conjunction with movement of the myocardium to remain attached to the myocardium while the heart beats.
50. The manipulation system defined in Claim 49 wherein the means for attaching the suspension means to the heart further includes means for accommodating multiplanar movement of the heart while the heart beats .
51. The manipulation system defined in Claim 49 wherein said suction cup includes means for engaging heart tissue to prevent that heart tissue from interfering with suction applied by the suction cup to the heart .
52. The manipulation system defined in Claim 51 wherein the means for preventing heart tissue from interfering with suction applied by the suction cup to the heart includes a mesh grid.
53. The manipulation system defined in Claim 51 wherein the suction cup includes a plurality of chambers .
54. The manipulation system defined in Claim 50 wherein the means for accommodating multiplanar movement of the heart includes a flexible element.
55. The manipulation system defined in Claim 48 wherein the surgery target immobilizing means includes a suction cup having a rim which engages the myocardium and which moves in a plurality of planes in conjunction with movement of the myocardium to remain attached to the myocardium while the heart beats .
80
56. The manipulation system defined in Claim 55 wherein the surgery target immobilizing means includes a suction cup having a rim which engages the myocardium and which moves in a plurality of planes in conjunction with movement of the myocardium to remain attached to the myocardium while the heart beats.
57. The manipulation system defined in Claim 56 wherein the means for engaging heart tissue to prevent heart tissue from interfering with suction applied by the suction cup of the surgery target immobilizing means to the heart includes a mesh grid.
58. The manipulation system defined in claim 48 wherein the surgery target immobilizing means includes an inflexible section for locally immobilizing a selected section of the heart, and a flexible section for attachment to the myocardium, said flexible section being flexible in a plurality of planes to accommodate movement of the myocardium, during operation of the hear .
59. The manipulation system defined in Claim 45 further including a gross support means for supporting the mitral valve of the heart and lifting the heart and being located at the base of the heart at the left ventricle along the arterialventricular groove .
60. The manipulation system defined in Claim 59 wherein said gross support means includes means for exerting suction force on the heart.
61. The manipulation system defined in Claim 60 wherein the means for exerting suction force on the
81 heart includes means for engaging heart tissue to prevent heart tissue from interfering with suction applied to the heart .
62. The manipulation system defined in Claim 60 wherein the means for exerting suction force on the heart includes a mesh grid.
63. The manipulation system defined in Claim 59 wherein said gross support means further includes a handle .
64. The manipulation system defined in Claim 46 further including a gross support means for supporting the mitral valve of the heart and lifting the heart and being located at the base of the heart, said gross support means being attached to said frame .
65. The manipulation system defined in Claim 59 wherein said gross support means further includes a head that comprises sections, at least some of the section being flexible sections.
66. The manipulation system defined in Claim 65 wherein at least one the flexible sections of the head of said gross support means is formed of material that maintains a second configuration after being deformed from a first configuration.
67. The heart manipulation system defined in claim 16 wherein said immobilizing element further includes a handle means which extends outside of the patient during surgery for adjusting the location and position of said immobilizing element and moving the
82 selected section into a desired position and orientation.
68. The improvement of Claim 2, wherein the suspension head includes a first chamber and at least one additional chamber which fluidically connects the first chamber to a source of suction and a mesh grid configured to prevent said heart tissue from interfering with suction being applied to the heart via said head.
69. The improvement of Claim 2, wherein the suspension head includes a first chamber and a second chamber which fluidically connects the first chamber to a source of suction and a mesh grid configured to prevent said heart tissue from interfering with suction being applied to the heart via said head.
70. The improvement of Claim 2, wherein the suspension head includes at least one chamber configured to be coupled to at least two suction lines .
71. The system of Claim 3, wherein the gross support means includes an arm configured to position the suction head in a desired position relative to the heart, and at least one malleable rod connecting the arm to the suction head.
83
PCT/US1999/011655 1998-05-29 1999-05-27 Beating heart coronary bypass surgical device WO1999060930A2 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
CA002333567A CA2333567C (en) 1998-05-29 1999-05-27 Device to permit offpump beating heart coronary bypass surgery
EP99953275A EP1082058B1 (en) 1998-05-29 1999-05-27 Beating heart coronary bypass surgical device
JP2000550398A JP4307724B2 (en) 1998-05-29 1999-05-27 Coronary artery bypass surgery instrument for beating heart
AU43151/99A AU760282B2 (en) 1998-05-29 1999-05-27 Device to permit offpump beating heart coronary bypass surgery
DE69938657T DE69938657D1 (en) 1998-05-29 1999-05-27 DEVICE FOR CORONARY BYPASS SURGERY AT A BALLING HEART

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US09/087,511 US6338712B2 (en) 1997-09-17 1998-05-29 Device to permit offpump beating heart coronary bypass surgery
US09/087,511 1998-05-29

Publications (3)

Publication Number Publication Date
WO1999060930A2 WO1999060930A2 (en) 1999-12-02
WO1999060930A3 WO1999060930A3 (en) 2000-01-13
WO1999060930B1 true WO1999060930B1 (en) 2000-02-24

Family

ID=22205629

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1999/011655 WO1999060930A2 (en) 1998-05-29 1999-05-27 Beating heart coronary bypass surgical device

Country Status (8)

Country Link
US (7) US6338712B2 (en)
EP (1) EP1082058B1 (en)
JP (1) JP4307724B2 (en)
AT (1) ATE394071T1 (en)
AU (1) AU760282B2 (en)
CA (1) CA2333567C (en)
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US20040092798A1 (en) 2004-05-13
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US20090099412A1 (en) 2009-04-16
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ATE394071T1 (en) 2008-05-15
US8162817B2 (en) 2012-04-24

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