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39 results about "Intercostal space" patented technology

The intercostal space (ICS) is the anatomic space between two ribs (Lat. costa). Since there are 12 ribs on each side, there are 11 intercostal spaces, each numbered for the rib superior to it.

Method of Forming a Lesion in Heart Tissue

InactiveUS7100614B2Facilitate responsive and precise positionabilitySuture equipmentsElectrotherapyDefect repairPatch type
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.
Owner:HEARTPORT

Method and apparatus for thoracoscopic intracardiac procedures

InactiveUS6955175B2Facilitate responsive and precise positionabilitySuture equipmentsElectrotherapyDefect repairThoracic cavity
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.
Owner:STEVENS JOHN H +4

Sternum Reinforcing Device to be Used After a Sternotomy or a Sternal Fracture

ActiveUS20080221578A1High risk of damageInternal osteosythesisBone implantSternal fractureEngineering
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.
Owner:SIC BREVETTI SRL

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

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, post-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.
Owner:HEARTPORT

Devices and methods for intracardiac procedures

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.
Owner:EDWARDS LIFESCIENCES LLC

Devices and methods for intracardiac procedures

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.
Owner:EDWARDS LIFESCIENCES LLC

Method and apparatus to produce ultrasonic images using multiple apertures

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.
Owner:MAUI IMAGING

Method and apparatus to produce ultrasonic images using multiple apertures

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.
Owner:MAUI IMAGING

Progressive biventricular diastolic support device

A device is proposed to progressively reduce the hemodynamic cardiac symptoms of congestive heart failure as well as those induced by dilated cardiomyopathies. This device affords progressive diastolic ventricular control by offering a method for percutaneous access and adjustments of its gas filled bladders surrounding the heart. After opening the pericardium, the device is not attached to the heart muscle but may be anchored to the pericardial sac. The device actually extends primarily around the heart from below the atrio-ventricular canal to the cardiac apex. Between the device exterior, made of non-elastic material and the epicardium, two independent elastic bladders or chambers provide variable compressive diastolic support to the right and left ventricles, while allowing adequate blood flow to the anterior and posterior descending epicardial branches of the coronary arteries and veins. Progressive hemodynamic increases in diastolic pressures for the right and left ventricles can be individually and repeatedly monitored by pressure gauges and an inert gas separately injected or removed in the enclosed chest through self-sealing access ports. These ports are subcutaneously implanted in the left anterior axillary line and connected by thin tubes across the 4th or 5th intercostal spaces to the pericardial bladders or chambers described above.
Owner:ROBERTSON JR ABEL L

Vibrator with a plurality of contact nodes for treatment of myocardial ischemia

A vibrator for use in enhancement of pre-hospital coronary thrombolysis comprising a vibration source operable to generate vibration at a frequency in the range of 1-1000 Hz with at least a pair of oscillatory contacts spaced to enable simultaneous seating to the anatomic left and right of the sternum (such as to match the geometry of the right and left coronary arteries) of a patient in need of coronary thrombolysis. The preferred vibrator is operable to emit vibration in the low frequency sonic range (at least 20 Hz) with an amplitude of about 1 mm-15 mm (and more preferably greater than 2 mm), such as to provide an effective transthoracic tool for acute coronary thrombolysis applications. In a variation, greater than a pair of contacts are utilized to provide oscillatory contact at differing intercostal space levels (in order to maximize vibratory penetration to the heart which is variably situated depending on the patient's anatomy).
Owner:SIMON FRASER UNIVERSITY

Apparatus and method for treating pectus excavatum

InactiveUS20110251540A1FractureBone platesPectus carinatumChest cavity
An apparatus and method for treating pectus excavatum are disclosed. A pectus bar stabilizer having two or more channels may be used to secure two or more pectus bars within the chest cavity of a patient. The channels of the pectus bar stabilizer may be spaced apart to support pectus bars that are positioned one intercostal space apart or more than one intercostal space apart.
Owner:NOTRICA DAVID

Imaging with Multiple Aperture Medical Ultrasound and Synchronization of Add-On Systems

The benefits of a multi-aperture ultrasound probe can be achieved with add-on devices. Synchronization and correlation of echoes from multiple transducer elements located in different arrays is essential to the successful processing of multiple aperture imaging. The algorithms disclosed here teach methods to successfully process these signals when the transmission source is coming from another ultrasound system and synchronize the add-on system to the other ultrasound system. Two-dimensional images with different noise components can be constructed from the echoes received by individual transducer elements. The disclosed techniques have broad application in medical imaging and are ideally suited to multi-aperture cardiac imaging using two or more intercostal spaces.
Owner:MAUI IMAGING

Surgical access assembly

InactiveUS20100168522A1Easy accessMinimizes force appliedCannulasSurgical departmentSurgical access
A surgical access assembly configured and dimensioned for positioning within an intercostal space defined between a patient's adjacent ribs to facilitate passage of a surgical instrument into an internal work site. The surgical access assembly includes a body portion that may be either partially or wholly formed from a resilient material such that the surgical access assembly is resiliently deformable to facilitate conformity with the intercostal space in order to minimize the application of force to the patient's tissue upon insertion and removal of the access assembly and manipulation of the surgical instrument.
Owner:TYCO HEALTHCARE GRP LP

Imaging with multiple aperture medical ultrasound and synchronization of add-on systems

The benefits of a multi-aperture ultrasound probe can be achieved with add-on devices. Synchronization and correlation of echoes from multiple transducer elements located in different arrays is essential to the successful processing of multiple aperture imaging. The algorithms disclosed here teach methods to successfully process these signals when the transmission source is coming from another ultrasound system and synchronize the add-on system to the other ultrasound system. Two-dimensional images with different noise components can be constructed from the echoes received by individual transducer elements. The disclosed techniques have broad application in medical imaging and are ideally suited to multi-aperture cardiac imaging using two or more intercostal spaces.
Owner:MAUI IMAGING

Piezo-electric defibrillation system

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.
Owner:ABRAMOV IGOR

Automatic external defibrillator for implatable cardiac defibrillator patients undergoing procedures involving electromagnetic interference

ActiveUS9101780B2Heart defibrillatorsExternal electrodesPatient acceptanceFifth intercostal space
An embodiment in accordance with the present invention provides an automatic external defibrillator including an anterior pad designed such that it can be used during an endoscopic or surgical procedure that may generate electromagnetic interference. The anterior pad has a first arm adhered longitudinally along and substantially parallel to a left side of a sternum of the subject and a second arm adhered along a 5th intercostal space of the subject. The device also includes a posterior pad. Both the anterior and posterior pads include electrodes for delivering a shock to the subject. The device can also include a wearable component containing sensing electrodes for measuring heart rhythms and a transmitting them to a monitor. The monitor monitors these heart rhythms and alerts the subject or medical care providers to irregularities in the rhythms.
Owner:THE JOHN HOPKINS UNIV SCHOOL OF MEDICINE

System and method for acoustic imaging with coherent compounding using intercostal spaces

ActiveUS20170184713A1Missing image dataImage enhancementImage analysisTransducerMethod of images
An apparatus and method of imaging an imaging region (7) employ an acoustic transducer array (10′) to produce image data for the imaging region (7), wherein there are one or more obstructions (15-1, 15-2, 15-3) between the acoustic transducer array (10′) and at least a portion (5) of the imaging region (7). One or more processors exploit redundancy in transmit / receive pair paths among the acoustic transducers in the acoustic transducer array (10′) to compensate for missing image data of the imaging region (7) due to the one or more obstructions (15-1, 15-2, 15-3), and produce an image of the imaging region (7) from the compensated image data.
Owner:KONINKLJIJKE PHILIPS NV

Battlefield defibrillation system

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.
Owner:ABRAMOV IGOR

Sternum reinforcing device to be used after a sternotomy or a sternal fracture

ActiveUS8523860B2Internal osteosythesisBone implantEngineeringSternal fracture
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.
Owner:SIC BREVETTI SRL

Ultrasound probe

The invention discloses an ultrasonic probe of which an acoustic head (210) is deflected by a set angle in such a way that the plane (202) of the scanning surface (201) corresponding to the acoustic head (210) intersects the plane (401) of the trigger (400), and an angle alpha formed by the intersection is an acute angle. This angle can be set according to the specific application object of the probe, for example, and the angle can be set according to the inclination angle of a human rib. As the acoustic head (210) and the trigger (400) are staggered by a certain angle, that the scanning surface (201) of the acoustic head (210) can be aligned with the intercostal space without deflection of the trigger can be ensured when the operator uses a probe to detect some obliquely extending targets, such as the human rib. Therefore, the operator can still maintain a normal holding manner without causing discomfort to the operator.
Owner:SHENZHEN MINDRAY BIO MEDICAL ELECTRONICS CO LTD +1

Automatic external defibrillator for implatable cardiac defibrillator patients undergoing procedures involving electromagnetic interference

An embodiment in accordance with the present invention provides an automatic external defibrillator including an anterior pad designed such that it can be used during an endoscopic or surgical procedure that may generate electromagnetic interference. The anterior pad has a first arm adhered longitudinally along and substantially parallel to a left side of a sternum of the subject and a second arm adhered along a 5th intercostal space of the subject. The device also includes a posterior pad. Both the anterior and posterior pads include electrodes for delivering a shock to the subject. The device can also include a wearable component containing sensing electrodes for measuring heart rhythms and a transmitting them to a monitor. The monitor monitors these heart rhythms and alerts the subject or medical care providers to irregularities in the rhythms.
Owner:THE JOHN HOPKINS UNIV SCHOOL OF MEDICINE

Battlefield defibrillation system

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.
Owner:ABRAMOV IGOR

Device for medical procedure localization and/or insertion

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.
Owner:INNOVITAL LLC

Sternum suturing staple

A sternum suturing staple, comprising a central body (1) having at least two threaded portions (2, 2′) with opposite threads; two side members (6) each having a threaded part (7) adapted to couple to one of the central body threaded parts, and a claw (8) adapted to be located laterally to a sternum in an intercostal space, and in which the claws are adapted to cooperatively clamp the sternum so as to suture it, characterized in that the part or portion bearing the male thread has, adjacent and coaxial relative to said male thread, a non-threaded cylindrical stem length (5, 5′), while the part or portion bearing the female thread has, adjacent and coaxial relative to said female thread, a non-threaded cylindrical hole length (18) adapted to receive said stem length.
Owner:PURICELLI CESARE +1

Device For Creating An Intercostal Transcutaneous Access To An, In Particular Endoscopic, Operating Field

A device for creating an intercostal transcutaneous access to an, in particular endoscopic, operating field including a base body, which closely surrounds an incision all-side frame-shaped and with at least two websmounted on the base body, which can be introduced into an intercostal space, by which two ribs arranged next to each other can be moved apart. To create a device for creating an intercostal transcutaneous access to an, in particular endoscopic, operating field which allows individual pressing apart of the ribs, it is proposed according to the invention that the at least two webs are mounted adjustable relative to each other on the base body.
Owner:UNIVERSITY OF DUNDEE

Piezo-electric defibrillation system

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.
Owner:ABRAMOV IGOR

Pacemaker system equipped with a flexible intercostal generator

A pacemaker system is configured to sense electrical and mechanical activity of the heart tissue within a mammalian body and to generate a corresponding signal responsive to the sensed cardiac activity. The system includes a flexible electrical generator that contains EKG (ECG) electrodes for measuring electrical activity and ECHO piezoelectric electrodes for measuring mechanical activity of the heart and Doppler blood flow. The generator is embedded in a flexible shield, and is contoured to conform to the anatomy of the intercostal space to be embedded between the ribs of a patient and in the position overlying the heart. The system provides for pacing as well as defibrillation, responsive to the readings of the heart activities. A microprocessor analyzes a cardiac situation, based on the sensor's readings, produces a diagnosis, and generates control signals, such as “pacing pulse” in a life-threatening situation, or “observe” in a non life-threatening situation.
Owner:HAKKI A HAMID +1

Acoustic sensing apparatus and method

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.
Owner:KONINKLJIJKE PHILIPS NV
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