US5536251A — Thoracoscopic devices and methods for arresting t…

Claim 1

Independent Claim 191 words

A thoracoscopic system for arresting a patient's heart, the system comprising: a clamp positionable about a patient's ascending aorta between a coronary artery and a brachiocephalic artery, the clamp being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest, the clamp being movable between an open position and a closed position; an elongated handle having a distal end and a proximal end opposite the distal end for positioning the clamp about the ascending aorta from a location outside of the patient's thoracic cavity, the elongated handle including an outer shaft having a length sized so that the clamp can reach the ascending aorta from a lateral side or an anterior side of the patient's chest; means coupled to the proximal end of the handle for actuating the clamp and moving the clamp from the open position to the closed position so as to block blood flow through an aortic lumen in the ascending aorta; and a cardioplegic fluid delivery device for delivering cardioplegic fluid into the aortic lumen upstream of the clamp from a location outside of the patient's thoracic cavity.

Claim 2

Dependent Claim 191 words

A thoracoscopic system for arresting a patient's heart, the system comprising: a clamp positionable about a patient's ascending aorta between a coronary artery and a brachiocephalic artery, the clamp being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest, the clamp being movable between an open position and a closed position; an elongated handle having a distal end and a proximal end opposite the distal end for positioning the clamp about the ascending aorta from a location outside of the patient's thoracic cavity, the elongated handle including an outer shaft having a length sized so that the clamp can reach the ascending aorta from a lateral side or an anterior side of the patient's chest; means coupled to the proximal end of the handle for actuating the clamp and moving the clamp from the open position to the closed position so as to block blood flow through an aortic lumen in the ascending aorta; and a cardioplegic fluid delivery device for delivering cardioplegic fluid into the aortic lumen upstream of the clamp from a location outside of the patient's thoracic cavity.

Claim 3

Dependent Claim 56 words

The system of claim 1 wherein: the means for delivering cardioplegic fluid includes an endovascular delivery catheter transluminally positionable within the aortic lumen from an artery downstream of the ascending aorta, the endovascular delivery catheter being positionable within a portion of the ascending aorta; and the clamp being positionable about the portion of the ascending aorta.

Claim 4

Dependent Claim 24 words

The system of claim 2 wherein the clamp is configured to block blood flow through the aortic lumen with the delivery catheter positioned therein.

Claim 5

Dependent Claim 73 words

The system of claim 1 wherein the cardioplegic fluid delivery device includes a delivery cannula positionable through a percutaneous penetration in the patient's chest, the delivery cannula having a distal end with a port therein, a proximal end, a delivery lumen in fluid communication with the port, means at the distal end for penetrating a wall of the aorta, and means at the proximal end for delivering cardioplegic fluid into the delivery lumen.

Claim 6

Dependent Claim 31 words

The system of claim 4 wherein the delivery cannula is coupled to the handle and/or the clamp to facilitate penetration of the aorta at a predetermined location relative to the clamp.

Claim 7

Dependent Claim 33 words

The system of claim 4 further comprising means coupled to the distal end of the handle means for closing a penetration in the aorta formed by the penetrating means of the delivery cannula.

Claim 8

Dependent Claim 20 words

The system of claim 6 wherein the closing means includes closure actuation means at the proximal end of the handle.

Claim 9

Dependent Claim 33 words

The system of claim 7 further comprising a delivery actuator at the proximal end of the handle coupled to the delivery cannula to facilitate selective penetration of the delivery cannula into the aorta.

Claim 10

Dependent Claim 21 words

The system of claim 6 wherein the closing means comprises means for applying a staple to the wall of the aorta.

Claim 11

Dependent Claim 44 words

The system of claim 9 wherein the staple has a first leg, a second leg, and a connecting segment therebetween, the first and second legs each having a proximal end and a distal point for penetrating a portion of the wall of the aorta.

Claim 12

Dependent Claim 29 words

The system of claim 10 wherein the first and second legs are configured such that the points are closer together than the proximal ends thereof in an unstressed condition.

Claim 13

Dependent Claim 27 words

The system of claim 11 wherein the connecting segment is resiliently bendable to facilitate spreading the points of the first and second legs to an open position.

Claim 14

Dependent Claim 26 words

The system of claim 12 wherein the staple applying means is configured to apply the staple with the first and second legs in the open position.

Claim 15

Dependent Claim 40 words

The system of claim 12 wherein the staple applying means comprises a sleeve having a proximal end, a distal end, a passage therebetween, and means at the distal end of the passage for holding the staple in the open position.

Claim 16

Dependent Claim 21 words

The system of claim 14 further comprising means in the passage of the sleeve for ejecting the staple from the passage.

Claim 17

Dependent Claim 18 words

The system of claim 15 wherein the delivery cannula is slidably disposed in the passage of the sleeve.

Claim 18

Dependent Claim 30 words

The system of claim 16 wherein the delivery cannula is configured to engage the staple as the delivery cannula is advanced distally within the passage to eject the staple therefrom.

Claim 19

Dependent Claim 26 words

The system of claim 1, further comprising: a source of cardioplegic fluid; the cardioplegic fluid delivery device being fluidly coupled to the source of cardioplegic fluid.

Claim 20

Dependent Claim 19 words

The system of claim 1, further comprising: a cardiopulmonary bypass system configured to place the patient on cardiopulmonary bypass.

Claim 21

Dependent Claim 26 words

The system of claim 1 wherein the clamp comprises a flexible cable or strap positionable around the aorta, and means for tensioning the cable or strap.

Claim 22

Dependent Claim 69 words

The system of claim 1 wherein the clamp comprises a first jaw having a first contact surface for engaging a first side of the aorta, and a second jaw having a second contact surface for engaging a second side of the aorta, the first and second jaws being movable toward each other from an open position to a clamping position configured to block blood flow through the aortic lumen.

Claim 23

Dependent Claim 16 words

The system of claim 21 wherein the first jaw is pivotally coupled to the second jaw.

Claim 24

Dependent Claim 19 words

The system of claim 21 wherein the first and second contact surfaces are generally parallel in the clamping position.

Claim 25

Dependent Claim 28 words

The system of claim 23 wherein the first and second contact surfaces are generally parallel through a range of motion between the open position and the clamping position.

Claim 26

Dependent Claim 175 words

A thoracoscopic system for arresting a patient's heart, the system comprising: a clamp positionable about a patient's ascending aorta between a coronary artery and a brachiocephalic artery, the clamp being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest; elongated handle means having a distal end coupled to the clamp and a proximal end opposite the distal end for positioning the clamp about the ascending aorta from a location outside of the patient's thoracic cavity; means coupled to the proximal end of the handle means for actuating the clamp so as to block blood flow through an aortic lumen in the ascending aorta; and means for delivering cardioplegic fluid into the aortic lumen upstream of the clamp from a location outside of the patient's thoracic cavity, the means for delivering cardioplegic fluid having an endovascular delivery catheter transluminally positionable within the aortic lumen from an artery downstream of the ascending aorta, the delivery catheter being transluminally positionable into the aortic lumen from a femoral artery.

Claim 27

Dependent Claim 175 words

A thoracoscopic system for arresting a patient's heart, the system comprising: a clamp positionable about a patient's ascending aorta between a coronary artery and a brachiocephalic artery, the clamp being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest; elongated handle means having a distal end coupled to the clamp and a proximal end opposite the distal end for positioning the clamp about the ascending aorta from a location outside of the patient's thoracic cavity; means coupled to the proximal end of the handle means for actuating the clamp so as to block blood flow through an aortic lumen in the ascending aorta; and means for delivering cardioplegic fluid into the aortic lumen upstream of the clamp from a location outside of the patient's thoracic cavity, the means for delivering cardioplegic fluid having an endovascular delivery catheter transluminally positionable within the aortic lumen from an artery downstream of the ascending aorta, the delivery catheter being transluminally positionable into the aortic lumen from a femoral artery.

Claim 28

Dependent Claim 241 words

A thoracoscopic system for arresting a patient's heart, the system comprising: a clamp positionable about a patient's ascending aorta between a coronary artery and a brachiocephalic artery, the clamp being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest; elongated handle means having a distal end coupled to the clamp and a proximal end opposite the distal end for positioning the clamp about the ascending aorta from a location outside of the patient's thoracic cavity; means coupled to the proximal end of the handle means for actuating the clamp so as to block blood flow through an aortic lumen in the ascending aorta; and means for delivering cardioplegic fluid into the aortic lumen upstream of the clamp from a location outside of the patient's thoracic cavity, the means for delivering cardioplegic fluid having a delivery cannula positionable through a percutaneous penetration in the patient's chest, the delivery cannula comprising a distal end with a port therein, a proximal end, a delivery lumen in fluid communication with the port, means at the distal end for penetrating a wall of the aorta, and means at the proximal end for delivering cardioplegic fluid into the delivery lumen, the delivery cannula being coupled to the handle means and/or the clamp to facilitate penetration of the aorta at a predetermined location relative to the clamp, and the delivery cannula being longitudinally slidable relative to the clamp.

Claim 29

Dependent Claim 241 words

A thoracoscopic system for arresting a patient's heart, the system comprising: a clamp positionable about a patient's ascending aorta between a coronary artery and a brachiocephalic artery, the clamp being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest; elongated handle means having a distal end coupled to the clamp and a proximal end opposite the distal end for positioning the clamp about the ascending aorta from a location outside of the patient's thoracic cavity; means coupled to the proximal end of the handle means for actuating the clamp so as to block blood flow through an aortic lumen in the ascending aorta; and means for delivering cardioplegic fluid into the aortic lumen upstream of the clamp from a location outside of the patient's thoracic cavity, the means for delivering cardioplegic fluid having a delivery cannula positionable through a percutaneous penetration in the patient's chest, the delivery cannula comprising a distal end with a port therein, a proximal end, a delivery lumen in fluid communication with the port, means at the distal end for penetrating a wall of the aorta, and means at the proximal end for delivering cardioplegic fluid into the delivery lumen, the delivery cannula being coupled to the handle means and/or the clamp to facilitate penetration of the aorta at a predetermined location relative to the clamp, and the delivery cannula being longitudinally slidable relative to the clamp.

Claim 30

Dependent Claim 20 words

The system of claim 26 wherein the delivery cannula is slidably positioned within an inner lumen through the handle means.

Claim 31

Dependent Claim 27 words

The system of claim 26 wherein the delivery cannula may be positionally adjusted relative to the clamp to select the location at which to penetrate the aorta.

Claim 32

Dependent Claim 292 words

A thoracoscopic system for arresting a patient's heart, the system comprising: a clamp positionable about a patient's ascending aorta between a coronary artery and a brachiocephalic artery, the clamp being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest; elongated handle means having a distal end coupled to the clamp and a proximal end opposite the distal end for positioning the clamp about the ascending aorta from a location outside of the patient's thoracic cavity; means coupled to the proximal end of the handle means for actuating the clamp so as to block blood flow through an aortic lumen in the ascending aorta; and means for delivering cardioplegic fluid into the aortic lumen upstream of the clamp from a location outside of the patient's thoracic cavity, the means for delivering cardioplegic fluid having a delivery cannula positionable through a percutaneous penetration in the patient's chest, the delivery cannula comprising a distal end with a port therein, a proximal end a delivery lumen in fluid communication with the port, means at the distal end for penetrating a wall of the aorta, and means at the proximal end for delivering cardioplegic fluid into the delivery lumen, the delivery cannula being coupled to the handle means and/or the clamp to facilitate penetration of the aorta at a predetermined location relative to the clamp, the means for delivering cardioplegic fluid having a delivery lumen within the handle means extending from the proximal end to the distal end thereof, and a means coupled to the distal end of the handle means for penetrating a wall of the aorta, the penetrating means having an inner lumen therethrough in fluid communication with the delivery lumen in the handle means.

Claim 33

Dependent Claim 292 words

A thoracoscopic system for arresting a patient's heart, the system comprising: a clamp positionable about a patient's ascending aorta between a coronary artery and a brachiocephalic artery, the clamp being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest; elongated handle means having a distal end coupled to the clamp and a proximal end opposite the distal end for positioning the clamp about the ascending aorta from a location outside of the patient's thoracic cavity; means coupled to the proximal end of the handle means for actuating the clamp so as to block blood flow through an aortic lumen in the ascending aorta; and means for delivering cardioplegic fluid into the aortic lumen upstream of the clamp from a location outside of the patient's thoracic cavity, the means for delivering cardioplegic fluid having a delivery cannula positionable through a percutaneous penetration in the patient's chest, the delivery cannula comprising a distal end with a port therein, a proximal end a delivery lumen in fluid communication with the port, means at the distal end for penetrating a wall of the aorta, and means at the proximal end for delivering cardioplegic fluid into the delivery lumen, the delivery cannula being coupled to the handle means and/or the clamp to facilitate penetration of the aorta at a predetermined location relative to the clamp, the means for delivering cardioplegic fluid having a delivery lumen within the handle means extending from the proximal end to the distal end thereof, and a means coupled to the distal end of the handle means for penetrating a wall of the aorta, the penetrating means having an inner lumen therethrough in fluid communication with the delivery lumen in the handle means.

Claim 34

Dependent Claim 295 words

A thoracoscopic system for arresting a patient's heart, the system comprising: a clamp positionable about a patient's ascending aorta between a coronary artery and a brachiocephalic artery, the clamp being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest; elongated handle means having a distal end coupled to the clamp and a proximal end opposite the distal end for positioning the clamp about the ascending aorta from a location outside of the patient's thoracic cavity; means coupled to the proximal end of the handle for actuating the clamp so as to block blood flow through an aortic lumen in the ascending aorta; means for delivering cardioplegic fluid into the aortic lumen upstream of the clamp from a location outside of the patient's thoracic cavity, the means for delivering cardioplegic fluid including a delivery cannula positionable through a percutaneous penetration in the patient's chest, the delivery cannula comprising a distal end with a port therein, a proximal end, a delivery lumen in fluid communication with the port, means at the distal end for penetrating a wall of the aorta, and means at the proximal end for delivering cardioplegic fluid into the delivery lumen; means coupled to the distal end of the handle means for closing a penetration in the aorta formed by the penetrating means of the delivery cannula, the closing means including closure actuation means at the proximal end of the handle; and a delivery actuator at the proximal end of the handle coupled to the delivery cannula to facilitate selective penetration of the delivery cannula into the aorta; the closure actuation means being coupled to the delivery actuator such that the closing means is actuated upon removal of the delivery cannula from the aorta.

Claim 35

Dependent Claim 295 words

A thoracoscopic system for arresting a patient's heart, the system comprising: a clamp positionable about a patient's ascending aorta between a coronary artery and a brachiocephalic artery, the clamp being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest; elongated handle means having a distal end coupled to the clamp and a proximal end opposite the distal end for positioning the clamp about the ascending aorta from a location outside of the patient's thoracic cavity; means coupled to the proximal end of the handle for actuating the clamp so as to block blood flow through an aortic lumen in the ascending aorta; means for delivering cardioplegic fluid into the aortic lumen upstream of the clamp from a location outside of the patient's thoracic cavity, the means for delivering cardioplegic fluid including a delivery cannula positionable through a percutaneous penetration in the patient's chest, the delivery cannula comprising a distal end with a port therein, a proximal end, a delivery lumen in fluid communication with the port, means at the distal end for penetrating a wall of the aorta, and means at the proximal end for delivering cardioplegic fluid into the delivery lumen; means coupled to the distal end of the handle means for closing a penetration in the aorta formed by the penetrating means of the delivery cannula, the closing means including closure actuation means at the proximal end of the handle; and a delivery actuator at the proximal end of the handle coupled to the delivery cannula to facilitate selective penetration of the delivery cannula into the aorta; the closure actuation means being coupled to the delivery actuator such that the closing means is actuated upon removal of the delivery cannula from the aorta.

Claim 36

Dependent Claim 217 words

An endoscopic system for clamping a hollow or tubular body structure and infusing a fluid therein, the system comprising: a clamp positionable about the body structure, the clamp being configured for introduction into a body cavity of the patient through a percutaneous penetration, the clamp having a first jaw and a second jaw, the first and second jaws having contact surfaces which engage one another when the first and second jaws are in a closed position; elongated handle means having a distal end coupled to the clamp and a proximal end opposite the distal end for positioning the clamp about the body structure from a location outside of the body cavity, the handle means including an outer tube having a longitudinal axis; means coupled to the proximal end of the handle means for actuating the clamp so as to block an inner lumen in the body structure; and a fluid delivery device for delivering a fluid into the inner lumen from a location outside of the patients body cavity, the fluid delivery device being at least partially positioned on the longitudinal axis of the outer tube; the contact surfaces of the first and second jaws being offset relative to the longitudinal axis of the outer tube when the first and second jaws are in the closed position.

Claim 37

Dependent Claim 217 words

An endoscopic system for clamping a hollow or tubular body structure and infusing a fluid therein, the system comprising: a clamp positionable about the body structure, the clamp being configured for introduction into a body cavity of the patient through a percutaneous penetration, the clamp having a first jaw and a second jaw, the first and second jaws having contact surfaces which engage one another when the first and second jaws are in a closed position; elongated handle means having a distal end coupled to the clamp and a proximal end opposite the distal end for positioning the clamp about the body structure from a location outside of the body cavity, the handle means including an outer tube having a longitudinal axis; means coupled to the proximal end of the handle means for actuating the clamp so as to block an inner lumen in the body structure; and a fluid delivery device for delivering a fluid into the inner lumen from a location outside of the patients body cavity, the fluid delivery device being at least partially positioned on the longitudinal axis of the outer tube; the contact surfaces of the first and second jaws being offset relative to the longitudinal axis of the outer tube when the first and second jaws are in the closed position.

Claim 38

Dependent Claim 77 words

A clamp for clamping a structure in a body, comprising: a handle having a distal end and a proximal end; a flexible element having an end, the flexible element being coupled to the handle and extending from the distal end; a coupler configured to engage the end of the flexible element; and a tensioning device attached to at least one of the flexible element and the coupler, the tensioning device being configured to tension the flexible element.

Claim 39

Dependent Claim 77 words

A clamp for clamping a structure in a body, comprising: a handle having a distal end and a proximal end; a flexible element having an end, the flexible element being coupled to the handle and extending from the distal end; a coupler configured to engage the end of the flexible element; and a tensioning device attached to at least one of the flexible element and the coupler, the tensioning device being configured to tension the flexible element.

Claim 40

Independent Claim 89 words

A system for clamping an aorta in a patient and delivering a fluid into the aorta, comprising: a clamp for clamping an aorta having an aortic lumen; and a fluid delivery device configured to be transluminally positionable within the aortic lumen, the fluid delivery device including a first lumen having an opening for delivering a fluid into the aortic lumen; the clamp being configured to be positioned around a portion of the aorta and the fluid delivery device being configured to be positioned within the portion of the aorta.

Claim 41

Independent Claim 89 words

A system for clamping an aorta in a patient and delivering a fluid into the aorta, comprising: a clamp for clamping an aorta having an aortic lumen; and a fluid delivery device configured to be transluminally positionable within the aortic lumen, the fluid delivery device including a first lumen having an opening for delivering a fluid into the aortic lumen; the clamp being configured to be positioned around a portion of the aorta and the fluid delivery device being configured to be positioned within the portion of the aorta.

Claim 42

Dependent Claim 25 words

The system of claim 33, further comprising: a pressure measuring device; the fluid delivery device having a second lumen coupled to the pressure measuring device.

Claim 43

Dependent Claim 23 words

The system of claim 33, further comprising: a source of cardioplegic fluid fluidly coupled to the first lumen of the fluid delivery device.

Claim 44

Independent Claim 80 words

A device for clamping a structure in a patient and delivering a fluid into the structure, comprising: an outer tube; an inner tube at least partially disposed within the outer tube; a first jaw and a second jaw each being coupled to at least one of the inner and outer tubes; an actuator for moving the jaws between an open position and a closed position; and a fluid delivery cannula at least partially positioned within the inner and outer tubes.

Claim 45

Independent Claim 80 words

A device for clamping a structure in a patient and delivering a fluid into the structure, comprising: an outer tube; an inner tube at least partially disposed within the outer tube; a first jaw and a second jaw each being coupled to at least one of the inner and outer tubes; an actuator for moving the jaws between an open position and a closed position; and a fluid delivery cannula at least partially positioned within the inner and outer tubes.

Claim 46

Dependent Claim 15 words

The device of claim 36, wherein: the delivery cannula is coupled to the inner tube.

Claim 47

Dependent Claim 16 words

The device of claim 36, wherein: the delivery cannula is not coupled to the inner tube.

Claim 48

Independent Claim 119 words

A device for clamping an ascending aorta in a patient, comprising: a handle including an elongate outer tube having a longitudinal axis; a first jaw coupled to the handle; a second jaw movable relative to the first jaw between an open position and a closed position, the first and second jaws being configured to clamp an ascending aorta in a patient; and an actuator configured to move the second jaw from the open position to the closed position, the actuator having a slidable element which slidably engages the second jaw, the slidable element being slidably movable in a direction parallel to the longitudinal axis of the elongate outer tube and being at least partially positioned within the outer tube.

Claim 49

Independent Claim 119 words

A device for clamping an ascending aorta in a patient, comprising: a handle including an elongate outer tube having a longitudinal axis; a first jaw coupled to the handle; a second jaw movable relative to the first jaw between an open position and a closed position, the first and second jaws being configured to clamp an ascending aorta in a patient; and an actuator configured to move the second jaw from the open position to the closed position, the actuator having a slidable element which slidably engages the second jaw, the slidable element being slidably movable in a direction parallel to the longitudinal axis of the elongate outer tube and being at least partially positioned within the outer tube.

Claim 50

Dependent Claim 21 words

The device for clamping an ascending aorta of claim 39, wherein: the slidable element slidably engages the first and second jaws.

Claim 51

Independent Claim 78 words

A device for clamping an aorta in a patient and closing an opening in the aorta, comprising: a handle; a clamp configured to clamp around an aorta in a patient, the clamp being coupled to the handle and being movable between an open position and a closed position; an actuator configured to move the clamp between the open and closed positions; and means for closing an opening in the aorta, the closing means being coupled to the handle.

Claim 52

Independent Claim 78 words

A device for clamping an aorta in a patient and closing an opening in the aorta, comprising: a handle; a clamp configured to clamp around an aorta in a patient, the clamp being coupled to the handle and being movable between an open position and a closed position; an actuator configured to move the clamp between the open and closed positions; and means for closing an opening in the aorta, the closing means being coupled to the handle.

Claim 53

Dependent Claim 24 words

The device of claim 41, wherein: the closing means is a stapler configured to apply a staple to close the opening in the aorta.

Claim 54

Dependent Claim 19 words

The device of claim 41, further comprising: a fluid delivery device configured to deliver a fluid into the aorta.

Claim 55

Dependent Claim 25 words

The system of claim 43, wherein: the closing means is a stapler configured to apply a staple to close the opening in the body structure.

Claim 56

Dependent Claim 34 words

The system of claim 44, wherein: the closing means is configured to apply a staple having a bore therethrough; and the fluid delivery device includes a needle extending through the bore in the staple.

Claim 57

Independent Claim 80 words

A system for clamping an aorta and removing fluids from the aorta, comprising: a clamp configured to clamp around a portion of an aorta; a cardioplegic fluid delivery device having an occluding member configured for occluding the aorta, the cardioplegic fluid delivery device also having a first lumen for delivering cardioplegic fluid to the ascending aorta; and means for removing air, fluids thrombus and/or other emboli from the aorta, the removing means being coupled to the cardioplegic fluid delivery device.

Claim 58

Independent Claim 80 words

A system for clamping an aorta and removing fluids from the aorta, comprising: a clamp configured to clamp around a portion of an aorta; a cardioplegic fluid delivery device having an occluding member configured for occluding the aorta, the cardioplegic fluid delivery device also having a first lumen for delivering cardioplegic fluid to the ascending aorta; and means for removing air, fluids thrombus and/or other emboli from the aorta, the removing means being coupled to the cardioplegic fluid delivery device.

Claim 59

Dependent Claim 19 words

The system of claim 46, further comprising: a source of cardioplegic fluid coupled to the cardioplegic fluid delivery device.

Claim 60

Dependent Claim 25 words

The system of claim 46, further comprising: a pressure measuring device; the cardioplegic fluid delivery device having a lumen coupled to the pressure measuring device.

Claim 61

Dependent Claim 12 words

The system of claim 46, wherein: the occluding member is a balloon.

Claim 62

Dependent Claim 11 words

The system of claim 46, wherein: the occluding member is funnel-shaped.

Annuity Stage	Window Opens	Payment Deadline	Surcharge Period Until	Estimated Fee	Status
3.5 Years (Year 4)	1999-07-16	2000-01-15	2000-07-16	$2000.00	Window Closed / Lapsed
7.5 Years (Year 8)	2003-07-16	2004-01-15	2004-07-16	$3760.00	Window Closed / Lapsed
11.5 Years (Year 12)	2007-07-16	2008-01-15	2008-07-16	$7700.00	Window Closed / Lapsed

Thoracoscopic devices and methods for arresting the heart

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