281 results about "Cardiac surgery" patented technology

A surgical system or assembly for performing cardiac surgery includes a surgical instrument; a servo-mechanical system engaged to the surgical instrument for operating the surgical instrument; and an attachment assembly for removing at least one degree of movement from a moving surgical cardiac worksite to produce a resultant surgical cardiac worksite. The surgical system or assembly also includes a motion tracking system for gathering movement information on a resultant surgical cardiac worksite. A control computer is engaged to the attachment assembly and to the motion tracking system and to the servo-mechanical system for controlling movement of the attachment assembly and for feeding gathered information to the servo-mechanical system for moving the surgical instrument in unison with the resultant surgical cardiac worksite such that a relative position of the moving surgical instrument with respect to the resultant surgical cardiac worksite is generally constant. A video monitor is coupled to the control computer; and an input system is coupled to the servo-mechanical system and to the control computer for providing a movement of the surgical instrument. The video monitor displays movement of the surgical instrument while the resultant surgical cardiac worksite appears substantially stationary, and while a relative position of the surgical instrument moving in unison with the resultant surgical cardiac worksite, as a result from the movement information gathered by the motion tracking system, remains generally constant. A method of performing cardiac surgery without cardioplegia comprising removing at least one degree of movement freedom from a moving surgical cardiac worksite to produce at least a partially stationary surgical cardiac worksite while allowing a residual heart section, generally separate from the at least partially stationary surgical cardiac worksite, to move as a residual moving heart part. Cardiac surgery is performed on the at least partially stationary cardiac worksite with a surgical instrument such as needle drivers, forceps, blades and scissors.

A system for manipulating and supporting a beating heart during cardiac surgery, including a gross support element for engaging and supporting the heart (the gross support element preferably including a head which is sized and shaped to cradle the myocardium of the left ventricle), a suspension head configured to exert lifting force on the heart when positioned near the apical region of the heart at a position at least partially overlying the right ventricle, and a releasable attachment element for releasably attaching at least one of the gross support element and the suspension head to the heart. The releasable attachment element can be a mechanical element (such as one or more staples or sutures) or an adhesive such as glue. Alternatively, the system includes a suspension head and a releasable attachment element for releasably attaching it to the heart, but does not include a gross support element.

A method for determining cardiac status comprises for a given patient, constructing a patient-specific, three-dimensional, computational model of the patient's heart; and executing the constructed computational model, said executing generating a quantitative analysis of cardiac function. A method of performing cardiac surgeries comprises: a) assessing surgical options based on a patient-specific, three-dimensional, computational model of a patient's heart; and b) performing surgery based on one or more of the surgical options. A computer system comprises: a) a data source containing data of a patient's heart; b) a modeler coupled to receive data from the data source, the modeler generating a patient-specific, three-dimensional, computational model of the heart based on the heart data; and c) a processor routine for computationally providing information about a certain cardiac function using the three-dimensional heart model and for applying computational, quantitative analysis of the cardiac function, wherein the quantitative analysis of the cardiac function provides an assessment for surgical options, optimizing surgical techniques, or predicting outcomes.

Apparatus and surgical methods establish temporary suction attachment to a target site on the surface of a bodily organ for enhancing accurate placement of a surgical instrument maintained in alignment with the suction attachment. A suction port on the distal end of a supporting cannula provides suction attachment to facilitate accurate positioning of a needle for injection penetration of tissue at the target site on the moving surface of a beating heart. Force applied via the suction attachment to the surface of the heart promotes perpendicular orientation of the surface of the myocardium for enhanced accuracy of placement of a surgical instrument thereon. A hollow needle and a supporting channel therefor, each include a slot along an outer wall between ends thereof, are selectably rotatable to align the slots for releasing a cardiac lead from within the needle through the aligned slots.

A deployment device for deploying a material into a patient, said deployment device having a housing and a placement device including a retracted condition within the housing for holding a material, in a collapsed condition, within the housing and an extended condition from the housing for disposing and releasing the material at a predetermined site in an uncollapsed condition. A method of deploying a material by placing the placement device in an extended condition and affixing the material to the extended placement device, retracting the placement device into the housing with the material in a collapsed condition, extending the placement device, and placing the material at a predetermined site in an uncollapsed condition.

A multi-leaflet valve adapted to serve as a prosthesis for diseased native valve of a mammal is constructed of biologic membrane or of biocompatible synthetic membrane. The valve has the shape of a truncated cone that has an inflow and an outflow orifice with leaflets forming the outflow orifice and forming a plurality of commissures. A first flexible stent is removably affixed in a substantially circular fashion around the truncated cone in proximity of the inflow orifice, and a second flexible stent is removably affixed at the location of the commissures to form a circle around the truncated cone in proximity of the outflow orifice. The stents maintain the shape of the valve during the surgical implantation procedure. Each stent independently can be left in the valve or can be removed during the implantation procedure based upon the judgement of the cardiac surgeon performing the implantation procedure. A holder designed to maintain the geometry of the valve during implantation to a mammal is also disclosed.

Methods for using blood pumps to treat heart failure are disclosed. The pump is mounted on an interior of a stent, and the stent is releasably mounted on a distal end of a catheter. The distal end of the catheter is inserted into a peripheral artery and advanced to position at a region of interest within the descending aorta, the ascending aorta, or the left ventricle. The stent and the pump are released from the catheter, and the pump is activated to increase blood flow downstream of the pump. The pump can also be positioned in the vena cava or used to treat right-sided heart failure following the insertion of an LVAD, or to improve venous return in patients with varicose veins. Non-stent pumps are described for insertion between the pulmonary vein and aorta, and between the vena cava and pulmonary artery designed for use during cardiac surgery.

Devices and methods for filtering blood. The devices generally comprise a mesh for filtering blood flowing within a blood vessel, particularly within an artery such as the aorta, a structure adapted to open and close the mesh within the blood vessel, and a means to actuate the structure. The methods generally include the steps of introducing a mesh into a blood vessel to entrap embolic material, and removing the mesh and the entrapped foreign matter from the blood vessel.

Systems and methods are provided for predicting the onset of postoperative atrial fibrillation (AF) from electrocardiogram (ECG) data representing a patient. A signal processing component determines parameters representing the activity of the heart of the patient from the ECG data. A feature extraction component calculates a plurality of features useful in predicting postoperative AF from the determined parameters. A classification component determines an AF index for the patient from the calculated plurality of features. The AF index represents the likelihood that the patient will experience AF.

The present invention is directed to an electromechanical pumping system for simulating the beating of heart in a cardiac surgery training environment. A computer-controllable linear actuator is used to control the electromechanical pumping system.

In a preferred embodiment, the electromechanical pumping system is linked to a porcine heart. The heart is made to beat by inserting intra-ventricular balloons placed inside the heart and connected to the pumping system. When controlled by the electromechanical pumping system, the porcine heart is able to display normal and abnormal beating rhythms, as well as ventricular fibrillation.

In addition, an electronic pressure sensor incorporated into the pumping system can be used to trigger a ventricular fibrillation mode when the porcine heart attached to the pumping system is handled by a trainee surgeon.

This invention is a cannulation apparatus, and related methods for providing indirect access to a surgical site within a patient. The cannulation apparatus includes at least two fluid flow paths that are slidable coupled (40) (50) to one another, and selectively positional within the patient. The first, the second flow path s may be advanced through a single incision disposed remotely from the surgical field to first, and second predetermined locations within the patient. Exemplary sites for the incision include the groin region or in the neck region of the patient. The cannulation apparatus, and method of the present invention are particularly suited for use in providing cardiopulmonary support during cardiac surgery, including coronary artery bypass graft surgery. The cannulation apparatus of the present invention also provides an entry site for one or more support devices used in the surgical procedure.

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 Ser. No. 08/936,184 filed on Sep. 17, 1997 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.

A medical device in cardiac surgery for replacement of the diseased native heart valves in humans increases thromboresistance of heart valve prosthesis. A heart valve prosthesis comprising an annular housing with the inner surface defining the blood flow I through the valve prosthesis and leaflets mounted within the annular housing with the possibility to pivot around the reference axis between an open position which allows the passage of the direct blood flow I, and a closed position which restricts the blood backflow II. Each leaflet has an upstream surface facing the direct blood surface I, a downstream surface facing the blood backflow II, a coaptation surface, and a side surface. Console projections radially oriented are provided at the inner surface of the housing, and each leaflet has a slot which corresponds to the projection. The inner surface of the housing is mainly cylindrical, and the downstream surface of each leaflet is in the form of the crossing cylindrical and conical surfaces. The upstream surface of each leaflet is in the form of the cylindrical surface. Higher thromboresistance of the heart valve prosthesis is achieved through elimination of the elements which introduce disturbances into the blood flow and reduction of the number of hinged joints.

Methods for performing minimally invasive heart surgery include accessing a heart of a patient through a first incision on the left thorax of the patient, contacting the heart through the incision with a heart stabilizing device and/or a heart positioning device, introducing at least one coupling device through a second incision on the patient located apart from the first incision, coupling the coupling device with the heart stabilizing device or the heart positioning device, and performing a surgical procedure on the heart. Systems may include a retractor device, a heart stabilizing device, and a coupling device, for enhancing cardiac surgery. Any suitable heart surgery may be performed using methods, devices or systems of the present invention. In one embodiment, a CABG procedure is performed.

This invention discloses isolated short peptides comprising the amino acid sequence Cys-Glu-Phe-His (CEFH) and analogs thereof as well as compositions comprising CEFH peptides and analogs thereof. The CEFH peptides disclosed herein are effective in mediating the denitration of 3-nitrotyrosines (3-NT) in cellular proteins thereby preventing tissue damage associated with excess nitric oxide (NO) and its reactive species. The CEFH peptides disclosed herein are useful in the treatment of ischemia/reperfusion (I/R) injury of various tissues (e.g., I/R injury of heart muscle associated with heart attack or cardiac surgery, I/R injury of brain tissue associated with stroke, I/R injury of liver tissue, skeletal muscles, etc.), septic shock, anaphylactic shock, neurodegenerative diseases (e.g., Alzheimer's and Parkinson's diseases), neuronal injury, atherosclerosis, diabetes, multiple sclerosis, autoimmune uveitis, pulmonary fibrosis, oobliterative bronchiolitis, bronchopulmonary dysplasia (BPD), amyotrophic lateral sclerosis (ALS), sepsis, inflammatory bowel disease, arthritis, allograft rejection, autoimmune myocarditis, myocardial inflammation, pulmonary granulomatous inflammation, influenza- or HSV-induced pneumonia, chronic cerebral vasospasm, allergic encephalomyelitis, central nervous system (CNS) inflammation, Heliobacterium pylori gastritis, necrotizing entrerocolitis, celliac disease, peritonitis, early prosthesis failure, inclusion body myositis, preeclamptic pregnancies, skin lesions with anaphylactoid purpura, nephrosclerosis, ileitis, leishmaniasis, cancer, and related disorders.

A cardioplegia occluder and methods of using the device during cardiac surgery are disclosed. The system typically includes a substantially rigid cannula with an occluder mounted on the distal region of the cannula that expands upon activation to occlude the aorta downstream of an infusion port which delivers cardioplegia solution to arrest the heart. Systems including cutting blades, blade guards, flanges, radiopaque markers and occluder aligners are also disclosed. In use, the distal end of the cannula is inserted through an incision into the aorta, the occluder is expanded and cardioplegia solution is infused upstream of the aorta to arrest the heart. The infusion port can alternately be used to aspirate cardioplegia or embolic debris or other unwanted material from the aorta.

A balloon arterial cannula and methods for filtering blood. The devices generally include a mesh for filtering blood flowing within a blood vessel, particularly within an artery such as the aorta, a structure adapted to open and close the mesh within the blood vessel, a means to actuate the structure, and a balloon occluder which typically includes a flexible material enclosing a chamber. The methods generally include the steps of introducing a mesh into a blood vessel to capture embolic material, adjusting the mesh, if necessary, during the course of filtration, inflating the balloon occluder to occlude the vessel upstream of the mesh, and thereafter deflating the balloon occluder and removing the mesh and the captured foreign matter from the blood vessel. Additionally, visualization techniques are used to ensure effective filtration.

Methods and compositions including combined use of a serine protease inhibitor and adenosine when administered as a single pharmaceutical composition, concomitantly or sequentially in any order to a living subject for preventing organ ischemia or reperfusion injury. The methods and compositions disclosed herein can be used in such procedures as cardiac surgery, non-surgical cardiac revascularization, organ transplantation, perfusion, ischemia, reperfusion, ischemia-reperfusion injury, oxidant injury, cytokine induced injury, shock induced injury, resuscitations injury or apoptosis.