39 results about "Intercostal space" patented technology

Devices, systems, and methods are provided for accessing the interior of the heart and performing procedures therein while the heart is beating. In one embodiment, a tubular access device having an inner lumen is provided for positioning through a penetration in a muscular wall of the heart, the access device having a means for sealing within the penetration to inhibit leakage of blood through the penetration. The sealing means may comprise a balloon or flange on the access device, or a suture placed in the heart wall to gather the heart tissue against the access device. An obturator is removably positionable in the inner lumen of the access device, the obturator having a cutting means at its distal end for penetrating the muscular wall of the heart. The access device is preferably positioned through an intercostal space and through the muscular wall of the heart. Elongated instruments may be introduced through the tubular access device into an interior chamber of the heart to perform procedures such as septal defect repair and electrophysiological mapping and ablation. A method of septal defect repair includes positioning a tubular access device percutaneously through an intercostal space and through a penetration in a muscular wall of the heart, passing one or more instruments through an inner lumen of the tubular access device into an interior chamber of the heart, and using the instruments to close the septal defect. Devices and methods for closing the septal defect with either sutures or with patch-type devices are disclosed.

The invention provides devices and methods for performing less-invasive surgical procedures within an organ or vessel. In an exemplary embodiment, the invention provides a method of closed-chest surgical intervention within an internal cavity of a patient's heart or great vessel. According to the method, the patient's heart is arrested and cardiopulmonary bypass is established. A scope extending through a percutaneous intercostal penetration in the patient's chest is used to view an internal portion of the patient's chest. An internal penetration is formed in a wall of the heart or great vessel using cutting means introduced through a percutaneous penetration in an intercostal space in the patient's chest. An interventional tool is then introduced, usually through a cannula positioned in a percutaneous intercostal penetration. The interventional tool is inserted through the internal penetration in the heart or great vessel to perform a surgical procedure within the internal cavity under visualization by means of the scope. In a preferred embodiment, a cutting tool is introduced into the patient's left atrium from a right portion of the patient's chest to remove the patient's mitral valve. A replacement valve is then introduced through an intercostal space in the right portion of the chest and through the internal penetration in the heart, and the replacement valve is attached in the mitral valve position.

A combination of an ultrasonic scanner and an omnidirectional receive transducer for producing a two-dimensional image from the echoes received by the single omnidirectional transducer is described. Two-dimensional images with different noise components can be constructed from the echoes received by additional transducers. These can be combined to produce images with better signal to noise ratios and lateral resolution. Also disclosed is a method based on information content to compensate for the different delays for different paths through intervening tissue is described. Specular reflections are attenuated by using even a single omnidirectional receiver displaced from the insonifying probe. The disclosed techniques have broad application in medical imaging but are ideally suited to multi-aperture cardiac imaging using two or more intercostal spaces. Since lateral resolution is determined primarily by the aperture defined by the end elements, it is not necessary to fill the entire aperture with equally spaced elements. In fact, gaps can be left to accommodate spanning a patient's ribs, or simply to reduce the cost of the large aperture array. Multiple slices using these methods can be combined to form three-dimensional images.

A sternum reinforcing device to be used after a sternotomy or a sternal fracture, made of a biocompatible material, comprises an elongated modular member (10) with a pair of legs (20, 30), that are joined each other by a body portion (4), and a pair of arms (6, 7). The legs (20, 30) can be fitted in an intercostal space of the thorax of a patient, laterally to the sternum, and can be bent in a mutually opposite direction, on the internal side of the thorax, after being fitted therein. The arms (6, 7), extending from one side to the other of the body portion (4) and orthogonally to the pair of legs (20, 30), constitute a male part and a female part, respectively, of a prismatic type coupling for consecutive modular members.

Several embodiments of a battlefield defibrillation system (2) comprising external defibrillator (6) and at least one electrode (8) connected thereto are described. The system includes direct cardiac access (8), or indirect subcutaneous electrodes (30). The direct cardiac access electrodes (26) engage the heart muscle directly via the intercostal space. Indirect subcutaneous electrodes are positioned under patient's skin. Several design features are implemented to aid precise electrode positioning and facilitate system operation by an untrained personnel.

A device (100) for medical procedure localization and / or insertion that can be dimensionally adjusted for different patient sizes and properly aligned and stabilized using anatomical landmarks. The device (100) for medical procedure localization and / or insertion provides an adjustable template that indexes the site of interest at the intersection of a first axis or plane and a second axis or plane. An embodiment is disclosed in which a first axis is the axillary line through the patient's axilla (armpit) and iliac crest (pelvis), and a second axis is the patient's ideal horizontal nipple line. The intersection of the first and second axes is the 4th or 5th intercostal space, into which a needle and / or chest tube may be placed for decompression.

Disclosed are several embodiments of a battery-less piezo-electric defibrillation system (2) comprising external piezo-electric defibrillator (4) and at least one electrode (5) connected thereto. The system includes a piezo-electric generator (6) connected to direct cardiac access—(5), or indirect subcutaneous electrode assemblies (30). The piezo-electric generator (6) is energized by a spring-driven striker element (8) and produces electrical pulse for defibrillation. The direct cardiac access electrodes (5) engage the heart muscle directly via the intercostal space. Alternatively, indirect subcutaneous electrodes (34a) are positioned under patient's skin.

An acoustic sensing apparatus and method are disclosed for acoustically surveying the chest area of a subject, and in particular the rib cage. In use the apparatus is placed on the chest, and it includes an arrangement of one or more sound sensors for sensing acoustic signals received from inside the chest. Based on the signal intensities picked up at a plurality of different locations across the chest, the different locations are each classified by a controller as either rib-aligned or intercostal space-aligned. The controller is further adapted to identify one or more sound intensity hotspots (42) within the signal intensity distribution to locate one or more anatomical objects or regions of interest within the chest, such as the heart mitral valve, the heart tricuspid valve, heart aortic valve, and the pulmonary artery as key areas for an auscultation procedure.