US20030158464A1
Expired / Lapsed
US
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Methods & devices for minimally invasive cardiac surgery for atrial fibrillation
Assignee: Atricure Inc
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Filing: 2002-12-04
•
Granted: —
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Expires: 2022-12-04
Abstract
Abstract Devices for enhancing minimally invasive cardiac surgery include a visualization device including an inflatable balloon at or near the distal end. Some visualization devices also include one or more lumens for allowing the introduction of one or more devices to a surgical site through the visualization device. Systems of the invention involve a visualization device which has at least one lumen for allowing introduction of an ablation device and/or other devices. A visualization device with an inflatable balloon may be positioned to create a space between a heart and pericardium when the balloon is inflated.
Inventors
- 👤 Arthur Bertolero
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 08:17
CPC Classifications
A; A61; A61B; A61B1/00; A61B1/12; A61B18/00; A61B18/04; A61B18/12; A61B18/14; A61B17/00; A61B17/00234; A61B2017/00238; A61B2017/00243; A61B17/22; A61B2017/22051; A61B2018/00315; A61B2018/00345; A61B2018/00351; A61B2018/00982
Claims Analysis
Total Claims: 61
Claim 1
Independent Claim
74 words
1 . A method for enhancing visualization of a surgical procedure on a heart of a patient, the method comprising: introducing an elongate visualization device into the patient; advancing the visualization device to position at least one inflatable balloon on the visualization device between the heart and a layer of pericardium adjacent the heart; inflating the at least one inflatable balloon; and using the visualization device to visualize the heart during the surgical procedure.
Claim 2
Dependent Claim
74 words
1 . A method for enhancing visualization of a surgical procedure on a heart of a patient, the method comprising: introducing an elongate visualization device into the patient; advancing the visualization device to position at least one inflatable balloon on the visualization device between the heart and a layer of pericardium adjacent the heart; inflating the at least one inflatable balloon; and using the visualization device to visualize the heart during the surgical procedure.
Claim 3
Dependent Claim
30 words
2 . A method as in claim 1 , wherein introducing the visualization device comprises introducing the device through one of a subzyphoid incision, a subcostal incision and a thoracotomy.
Claim 4
Dependent Claim
23 words
3 . A method as in claim 1 , wherein advancing the visualization device comprises advancing the device through the layer of pericardium.
Claim 5
Dependent Claim
27 words
4 . A method as in claim 1 , wherein inflating at least one balloon comprises inflating one balloon disposed around a circumference of the visualization device.
Claim 6
Dependent Claim
52 words
5 . A method as in claim 1 , wherein inflating at least one balloon comprises inflating at least two balloons disposed around a circumference of the visualization device, wherein one balloon is located between the heart and the layer of pericardium and the other balloon is located proximal to the pericardium.
Claim 7
Dependent Claim
33 words
6 . A method as in claim 1 , further comprising protecting an optical element of the visualization device by using the balloon to reduce contact of the optical element with other structures.
Claim 8
Dependent Claim
31 words
7 . A method as in claim 6 , further comprising cleaning the optical element by introducing a fluid through a lumen in the visualization device to contact the optical element.
Claim 9
Dependent Claim
27 words
8 . A method as in claim 1 , further comprising introducing an ablation device through a first lumen in the visualization device to contact the heart.
Claim 10
Dependent Claim
56 words
9 . A method as in claim 8 , further comprising introducing at least one of a clamp, a positioning device, a stabilization device, a cutting device, a cardiac mapping device, a catheter, a left atrial appendage clip applier, an insufflation device and an irrigation device through at least a second lumen in the visualization device.
Claim 11
Dependent Claim
57 words
10 . A method as in claim 8 , further comprising: ablating the heart, using the ablation device; removing the ablation device from the first lumen; introducing a left atrial appendage clip applier through the first lumen to contact a left atrial appendage of the heart; and applying at least one clip to the left atrial appendage.
Claim 12
Dependent Claim
33 words
11 . A method as in claim 8 , further comprising: providing light to the visualization device from a control unit; and providing ablation energy to the ablation device from the control unit.
Claim 13
Dependent Claim
27 words
12 . A method as in claim 11 , further comprising providing at least one of insufflation and irrigation to the visualization device from the control unit.
Claim 14
Dependent Claim
25 words
13 . A method as in claim 11 , further comprising recording at least one image acquired by the visualization device on the control unit.
Claim 15
Dependent Claim
44 words
14 . A visualization device for enhancing minimally invasive heart surgery, the visualization device comprising: an elongate visualization member having a proximal end and a distal end; and at least one inflatable balloon coupled with the visualization member at or near the distal end.
Claim 16
Dependent Claim
44 words
14 . A visualization device for enhancing minimally invasive heart surgery, the visualization device comprising: an elongate visualization member having a proximal end and a distal end; and at least one inflatable balloon coupled with the visualization member at or near the distal end.
Claim 17
Dependent Claim
17 words
15 . A visualization device as in claim 14 , wherein the visualization member comprises an endoscope.
Claim 18
Dependent Claim
35 words
16 . A visualization device as in claim 14 , wherein the visualization member is selected from the group consisting of an ultrasound device, a fluoroscopy device, an MRI device and a stereotactic positioning device.
Claim 19
Dependent Claim
26 words
17 . A visualization device as in claim 14 , wherein the proximal end of the visualization member is removably couplable with an image viewing device.
Claim 20
Dependent Claim
21 words
18 . A visualization device as in claim 14 , further comprising means for inflating the at least one inflatable balloon.
Claim 21
Dependent Claim
36 words
19 . A visualization device as in claim 18 , wherein the means for inflating comprises an infusion lumen for infusing at least one of air or a fluid into the at least one inflatable balloon.
Claim 22
Dependent Claim
54 words
20 . A visualization device as in claim 14 , wherein the at least one balloon comprises a first balloon disposed around a circumference of the visualization device such that when the first balloon is inflated it creates a space between a pericardial layer around a heart and an outer surface of the heart.
Claim 23
Dependent Claim
37 words
21 . A visualization device as in claim 20 , wherein the at least one balloon further comprises a second balloon disposed around the circumference of the visualization device at a location proximal to the first balloon.
Claim 24
Dependent Claim
32 words
22 . A visualization device as in claim 20 , wherein the first balloon, when inflated, at least partially protects an optical element of the visualization device from harm due to contact.
Claim 25
Dependent Claim
26 words
23 . A visualization device as in claim 14 , further comprising a first lumen in the visualization device for allowing passage of an ablation device.
Claim 26
Dependent Claim
59 words
24 . A visualization device as in claim 23 , further comprising at least a second lumen in the visualization device for allowing passage of at least one of a clamp, a positioning device, a stabilization device, a cutting device, a cardiac mapping device, a catheter, a left atrial appendage clip applier, an insufflation device and an irrigation device.
Claim 27
Dependent Claim
31 words
25 . A visualization device as in claim 14 , further comprising an irrigation lumen for introducing a cleaning fluid to contact and clean an optical element of the visualization device.
Claim 28
Dependent Claim
89 words
26 . A clip applier for applying at least one clip to a left atrial appendage of a heart of a patient, the device comprising: an elongate shaft defining a proximal end and a distal end; clip applying means coupled with the shaft at or near the distal end; and an actuator coupled with the shaft at or near the distal end and also coupled with the clip applying means so as to actuate the applying means to apply the at least one clip to the left atrial appendage.
Claim 29
Dependent Claim
89 words
26 . A clip applier for applying at least one clip to a left atrial appendage of a heart of a patient, the device comprising: an elongate shaft defining a proximal end and a distal end; clip applying means coupled with the shaft at or near the distal end; and an actuator coupled with the shaft at or near the distal end and also coupled with the clip applying means so as to actuate the applying means to apply the at least one clip to the left atrial appendage.
Claim 30
Dependent Claim
22 words
27 . A clip applier as in claim 26 , wherein the device is introducible through a lumen of a visualization device.
Claim 31
Dependent Claim
37 words
28 . A clip applier as in claim 26 , further including at least one clip coupled with the device in a position to allow the clip applying means to apply the clip to the atrial appendage.
Claim 32
Dependent Claim
32 words
29 . A clip applier as in claim 28 , wherein the at least one clip does not sever the atrial appendage when applied to the appendage by the clip applying means.
Claim 33
Dependent Claim
62 words
30 . A system for performing an ablation procedure on a heart of a patient, the system comprising: a visualization device comprising; an elongate visualization member having a proximal end and a distal end; and at least one inflatable balloon coupled with the visualization member at or near the distal end; and an ablation device for ablating a portion of the heart.
Claim 34
Dependent Claim
62 words
30 . A system for performing an ablation procedure on a heart of a patient, the system comprising: a visualization device comprising; an elongate visualization member having a proximal end and a distal end; and at least one inflatable balloon coupled with the visualization member at or near the distal end; and an ablation device for ablating a portion of the heart.
Claim 35
Dependent Claim
16 words
31 . A system as in claim 30 , wherein the visualization member comprises an endoscope.
Claim 36
Dependent Claim
34 words
32 . A system as in claim 30 , wherein the visualization member is selected from the group consisting of an ultrasound device, a fluoroscopy device, an MRI device and a stereotactic positioning device.
Claim 37
Dependent Claim
25 words
33 . A system as in claim 30 , wherein the proximal end of the visualization member is removably couplable with an image viewing device.
Claim 38
Dependent Claim
20 words
34 . A system as in claim 30 , further comprising means for inflating the at least one inflatable balloon.
Claim 39
Dependent Claim
35 words
35 . A system as in claim 34 , wherein the means for inflating comprises an infusion lumen for infusing at least one of air or a fluid into the at least one inflatable balloon.
Claim 40
Dependent Claim
53 words
36 . A system as in claim 30 , wherein the at least one balloon comprises a first balloon disposed around a circumference of the visualization device such that when the first balloon is inflated it creates a space between a pericardial layer around a heart and an outer surface of the heart.
Claim 41
Dependent Claim
36 words
37 . A system as in claim 36 , wherein the at least one balloon further comprises a second balloon disposed around the circumference of the visualization device at a location proximal to the first balloon.
Claim 42
Dependent Claim
31 words
38 . A system as in claim 36 , wherein the first balloon, when inflated, at least partially protects an optical element of the visualization device from harm due to contact.
Claim 43
Dependent Claim
25 words
39 . A system as in claim 30 , further comprising a first lumen in the visualization device for allowing passage of an ablation device.
Claim 44
Dependent Claim
58 words
40 . A system as in claim 39 , further comprising at least a second lumen in the visualization device for allowing passage of at least one of a clamp, a positioning device, a stabilization device, a cutting device, a cardiac mapping device, a catheter, a left atrial appendage clip applier, an insufflation device and an irrigation device.
Claim 45
Dependent Claim
30 words
41 . A system as in claim 30 , further comprising an irrigation lumen for introducing a cleaning fluid to contact and clean an optical element of the visualization device.
Claim 46
Dependent Claim
37 words
42 . A system as in claim 30 , further comprising a left atrial appendage clip applier for applying at least one clip to the left atrial appendage to reduce or stop blood flow through the appendage.
Claim 47
Dependent Claim
23 words
43 . A system as in claim 30 , further comprising a heart positioning device for moving the heart into a desired position.
Claim 48
Dependent Claim
41 words
44 . A system as in claim 43 , wherein the heart positioning device comprises: an elongate shaft defining a proximal end and a distal end; and an inflatable positioning member coupled with the shaft at or near the distal end.
Claim 49
Dependent Claim
40 words
45 . A system as in claim 44 , wherein the inflatable positioning member is coupled with the shaft via a flexible joint selected from the group consisting of a ball and socket joint and a ball and collet joint.
Claim 50
Dependent Claim
23 words
46 . A system as in claim 30 , further comprising at least one retractor device for facilitating introduction of the visualization device.
Claim 51
Dependent Claim
39 words
47 . A system as in claim 46 , wherein the at least one retractor device includes at least one retractor blade having a cushioned surface for reducing damage to a nerve when the cushioned surface contacts the nerve.
Claim 52
Dependent Claim
26 words
48 . A system as in claim 47 , wherein the nerve is an intercostal nerve and the retractor device retracts a rib of a patient.
Claim 53
Dependent Claim
53 words
49 . A system as in claim 30 , further comprising a control unit for coupling with at least the visualization device and the ablation device, the control unit comprising: a light source for providing light to the visualization device; and an ablative energy source for providing ablative energy to the ablation device.
Claim 54
Dependent Claim
57 words
50 . A system as in claim 49 , wherein the control unit further comprises: a video source for coupling with the visualization device; at least one of an insufflation source and an irrigation source for providing insufflation and/or irrigation to the visualization device; and a power cord for connecting the control unit with a power source.
Claim 55
Dependent Claim
25 words
51 . A system as in claim 50 , wherein the control unit further comprises an image recorder for recording images from the visualization device.
Claim 56
Dependent Claim
26 words
52 . A system as in claim 49 , wherein the ablative energy source provides at least one of RF energy, cryogenic energy and microwave energy.
Claim 57
Dependent Claim
44 words
53 . A control unit for enhancing a minimally invasive surgical procedure on a heart of a patient, the device comprising: a light source for providing light to the visualization device; and an ablative energy source for providing ablative energy to the ablation device.
Claim 58
Dependent Claim
44 words
53 . A control unit for enhancing a minimally invasive surgical procedure on a heart of a patient, the device comprising: a light source for providing light to the visualization device; and an ablative energy source for providing ablative energy to the ablation device.
Claim 59
Dependent Claim
54 words
54 . A control unit as in claim 53 , further comprising: a video source for coupling with the visualization device; at least one of an insufflation source and an irrigation source for providing insufflation and/or irrigation to the visualization device; and a power cord for connecting the control unit with a power source.
Claim 60
Dependent Claim
22 words
55 . A control unit as in claim 54 , further comprising an image recorder for recording images from the visualization device.
Claim 61
Dependent Claim
27 words
56 . A control unit as in claim 53 , wherein the ablative energy source provides at least one of RF energy, cryogenic energy and microwave energy.
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