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1. US5799661 - Devices and methods for port-access multivessel coronary artery bypass surgery

Office United States of America
Application Number 08486941
Application Date 07.06.1995
Publication Number 5799661
Publication Date 01.09.1998
Grant Number 5799661
Grant Date 01.09.1998
Publication Kind A
IPC
A61H 31/00
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
31Artificial respiration or heart stimulation, e.g. heart massage
A61B 19/00
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
BDIAGNOSIS; SURGERY; IDENTIFICATION
19Instruments, implements or accessories for surgery or diagnosis not covered by any of the groups A61B1/-A61B18/149
A61B 17/00
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
BDIAGNOSIS; SURGERY; IDENTIFICATION
17Surgical instruments, devices or methods, e.g. tourniquets
A61M 25/00
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
25Catheters; Hollow probes
A61B 17/02
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
BDIAGNOSIS; SURGERY; IDENTIFICATION
17Surgical instruments, devices or methods, e.g. tourniquets
02for holding wounds open; Tractors
A61B 17/04
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
BDIAGNOSIS; SURGERY; IDENTIFICATION
17Surgical instruments, devices or methods, e.g. tourniquets
03for closing wounds, or holding wounds closed, e.g. surgical staples; Accessories for use therewith
04for suturing wounds; Holders or packages for needles or suture materials
CPC
A61F 7/10
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
7Heating or cooling appliances for medical or therapeutic treatment of the human body
10Cooling bags, e.g. ice-bags
A61B 17/00234
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
BDIAGNOSIS; SURGERY; IDENTIFICATION
17Surgical instruments, devices or methods, e.g. tourniquets
00234for minimally invasive surgery
A61B 17/0057
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
BDIAGNOSIS; SURGERY; IDENTIFICATION
17Surgical instruments, devices or methods, e.g. tourniquets
0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
A61B 17/0218
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
BDIAGNOSIS; SURGERY; IDENTIFICATION
17Surgical instruments, devices or methods, e.g. tourniquets
02for holding wounds open; Tractors
0218for minimally invasive surgery
A61B 17/0467
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
BDIAGNOSIS; SURGERY; IDENTIFICATION
17Surgical instruments, devices or methods, e.g. tourniquets
04for suturing wounds; Holders or packages for needles or suture materials
0467Instruments for cutting sutures
A61B 17/0469
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
BDIAGNOSIS; SURGERY; IDENTIFICATION
17Surgical instruments, devices or methods, e.g. tourniquets
04for suturing wounds; Holders or packages for needles or suture materials
0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
Applicants Heartport, Inc.
Inventors Boyd Stephen W.
Rapacki Alan R.
Peters William S.
Agents Grainger Jeffry J.
Hoekendijk Jens E.
Lynch Michael J.
Title
(EN) Devices and methods for port-access multivessel coronary artery bypass surgery
Abstract
(EN)

Surgical methods and instruments are disclosed for performing port-access or closed-chest coronary artery bypass (CABG) surgery in multivessel coronary artery disease. In contrast to standard open-chest CABG surgery, which requires a median sternotomy or other gross thoracotomy to expose the patient's heart, port-access CABG surgery is performed through small incisions or access ports made through the intercostal spaces between the patient's ribs, resulting in greatly reduced pain and morbidity to the patient. In situ arterial bypass grafts, such as the internal mammary arteries and/or the right gastroepiploic artery, are prepared for grafting by thoracoscopic or laparoscopic takedown techniques. Free grafts, such as a saphenous vein graft or a free arterial graft, can be used to augment the in situ arterial grafts. The graft vessels are anastomosed to the coronary arteries under direct visualization through a cardioscopic microscope inserted through an intercostal access port. Retraction instruments are provided to manipulate the heart within the closed chest of the patient to expose each of the coronary arteries for visualization and anastomosis. Disclosed are a tunneler and an articulated tunneling grasper for rerouting the graft vessels, and a finger-like retractor, a suction cup retractor, a snare retractor and a loop retractor for manipulating the heart. Also disclosed is a port-access topical cooling device for improving myocardial protection during the port-access CABG procedure. An alternate surgical approach using an anterior mediastinotomy is also described.