US5618307A — Clamp assembly and method of use

Claim 1

Independent Claim 96 words

A method of clamping an aorta of a patient for performing a medical procedure, comprising the steps of: introducing a clamp positioner having a clamp located at a distal end into a patient; clamping the clamp around the patient's ascending aorta so that a blood flow through the ascending aorta is at least substantially restricted; disengaging at least the distal end of the clamp positioner from the clamp after the clamping step; performing a medical procedure on the patient's cardiopulmonary system; releasing the clamp from the patient's ascending aorta; and removing the clamp from the patient.

Claim 2

Independent Claim 96 words

A method of clamping an aorta of a patient for performing a medical procedure, comprising the steps of: introducing a clamp positioner having a clamp located at a distal end into a patient; clamping the clamp around the patient's ascending aorta so that a blood flow through the ascending aorta is at least substantially restricted; disengaging at least the distal end of the clamp positioner from the clamp after the clamping step; performing a medical procedure on the patient's cardiopulmonary system; releasing the clamp from the patient's ascending aorta; and removing the clamp from the patient.

Claim 3

Dependent Claim 39 words

The method of claim 1, further comprising the step of: introducing a hollow tube into the patient through a percutaneous intercostal penetration; the clamp positioner introducing step being carried out by passing the clamp positioner through the hollow tube.

Claim 4

Dependent Claim 26 words

The method of claim 1, further comprising the step of: introducing another instrument into the hollow tube after the disengaging step for performing the medical procedure.

Claim 5

Dependent Claim 18 words

The method of claim 1, wherein: the releasing and removing steps are carried out using the clamp positioner.

Claim 6

Dependent Claim 29 words

The method of claim 1, further comprising the steps of: injecting a cardioplegic fluid into the patient to arrest the patient's heart; and placing the patient on cardiopulmonary by-pass.

Claim 7

Dependent Claim 18 words

The method of claim 1, wherein: the medical procedure performing step is a heart valve repair or replacement.

Claim 8

Dependent Claim 17 words

The method of claim 1, wherein: the medical procedure performing step is a coronary artery bypass grafting.

Claim 9

Independent Claim 116 words

A method of constricting a hollow body structure in a thoracic cavity of a patient, the method comprising: introducing a clamp into a patient's thoracic cavity using a clamp positioner having a proximal end positioned outside of the patient's thoracic cavity and a distal end within the patient's thoracic cavity; positioning the clamp at a hollow body structure using the clamp positioner; securing the clamp onto the hollow body structure using the proximal end of the clamp positioner to at least partially seal said hollow body structure; disengaging at least a part of the clamp positioner from the clamp; detaching the clamp from the hollow body structure; and removing the clamp from the patient's thoracic cavity.

Claim 10

Independent Claim 116 words

A method of constricting a hollow body structure in a thoracic cavity of a patient, the method comprising: introducing a clamp into a patient's thoracic cavity using a clamp positioner having a proximal end positioned outside of the patient's thoracic cavity and a distal end within the patient's thoracic cavity; positioning the clamp at a hollow body structure using the clamp positioner; securing the clamp onto the hollow body structure using the proximal end of the clamp positioner to at least partially seal said hollow body structure; disengaging at least a part of the clamp positioner from the clamp; detaching the clamp from the hollow body structure; and removing the clamp from the patient's thoracic cavity.

Claim 11

Dependent Claim 25 words

The method of claim 8 wherein the introducing step is carried out by passing the clamp through a percutaneous intercostal penetration in the patient's chest.

Claim 12

Dependent Claim 23 words

The method of claim 8 further comprising the step of: viewing an interior portion of the patient's thoracic cavity using a viewing device.

Claim 13

Dependent Claim 29 words

The method of claim 10, wherein: the viewing step is carried out with the viewing device being a scope positioned in a percutaneous intercostal penetration in the patient's chest.

Claim 14

Dependent Claim 18 words

The method of claim 8 further comprising the step of: detaching the clamp from the hollow body structure.

Claim 15

Dependent Claim 17 words

The method according to claim 12 wherein: the detaching step is carried out using the clamp positioner.

Claim 16

Dependent Claim 23 words

The method of claim 12 further comprising the step of: removing the clamp positioner from the patient's thoracic cavity before the detaching step.

Claim 17

Dependent Claim 19 words

The method of claim 8 wherein: the securing step is carried out to substantially seal said hollow body structure.

Claim 18

Dependent Claim 20 words

The method of claim 8 wherein: the securing step is carried out on an aorta as the hollow body structure.

Claim 19

Dependent Claim 35 words

The method of claim 8 further comprising the steps of: injecting a cardioplegic fluid into the patient to arrest the heart; placing the patient on cardiopulmonary bypass; and performing a procedure on the patient's heart.

Claim 20

Dependent Claim 17 words

The method of claim 17 wherein: the performing step is a heart valve repair or replacement procedure.

Claim 21

Dependent Claim 37 words

The method of claim 8 wherein: the disengaging step is carried out by completely separating the distal end of the clamp positioner from the clamp and removing the distal end of the clamp positioner from the patient.

Claim 22

Dependent Claim 33 words

The method of claim 8 further comprising the steps of: positioning a hollow tube between ribs of the patient to define a percutaneous intercostal penetration; and inserting the clamp through the hollow tube.

Claim 23

Dependent Claim 31 words

The method of claim 20 wherein: the positioning step is carried out with the cannula having maximum internal cross-sectional dimensions of no more than about 20 mm by about 32 mm.

Claim 24

Dependent Claim 18 words

The method of claim 8 wherein: the clamp introducing step is carried out using a hydraulic clamp introducer.

Claim 25

Dependent Claim 40 words

The method of claim 8 wherein: the securing step is carried out using a clamp positioner having a rotatable driver, the rotatable driver being coupled to the clamp for moving the clamp from an open position to a closed position.

Claim 26

Dependent Claim 55 words

The method of claim 8 wherein: the clamp introducing step is carried out using a clamp positioner having a coaxial cable, said coaxial cable having an outer hollow sheath and an inner tension cable, the coaxial cable being drivingly coupled to the clamp for moving the clamp from an open position to a closed position.

Claim 27

Dependent Claim 22 words

The method of claim 24 wherein: the clamp securing step includes the step of moving said tension cable relative to said sheath.

Claim 28

Dependent Claim 38 words

The method of claim 8 further comprising the step of: providing a flexible tether, having first and second ends, between the clamp at the first end and a position outside the patient's thoracic cavity at the second end.

Claim 29

Dependent Claim 20 words

The method of claim 26 further comprising the step of: guiding the clamp positioner to the clamp using the tether.

Claim 30

Dependent Claim 129 words

A clamping assembly for constricting an ascending aorta in a thoracic cavity of a patient, the assembly comprising: a clamp having first and second jaws configured to clamp a patient's ascending aorta, the first and second jaws having jaw surfaces being movable between open and closed positions, the clamp having a locking mechanism configured to the first and second jaws in the closed position; and a clamp positioner having a distal end releasably coupled to the clamp, the clamp positioner having a clamp actuator configured to move the clamp from the open position to the closed position; the distal end of the clamp positioner and the clamp coupled thereto being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest.

Claim 31

Dependent Claim 129 words

A clamping assembly for constricting an ascending aorta in a thoracic cavity of a patient, the assembly comprising: a clamp having first and second jaws configured to clamp a patient's ascending aorta, the first and second jaws having jaw surfaces being movable between open and closed positions, the clamp having a locking mechanism configured to the first and second jaws in the closed position; and a clamp positioner having a distal end releasably coupled to the clamp, the clamp positioner having a clamp actuator configured to move the clamp from the open position to the closed position; the distal end of the clamp positioner and the clamp coupled thereto being configured for introduction into a thoracic cavity of the patient through a percutaneous intercostal penetration in the patient's chest.

Claim 32

Dependent Claim 25 words

The assembly according to claim 28 wherein: the clamp is sized to pass through an opening no greater than about 20 mm by 32 mm.

Claim 33

Dependent Claim 23 words

The assembly according to claim 28 wherein: said jaw surfaces remain parallel to one another during movement between said open and closed positions.

Claim 34

Dependent Claim 21 words

The assembly according to claim 28 wherein: said jaw surfaces are spaced apart from one another when in said closed position.

Claim 35

Dependent Claim 41 words

The assembly according to claim 28 wherein: said distal end of said clamp positioner includes a rotary drive, the rotary drive element being drivingly coupled to the clamp for moving the jaw surfaces from the open position to the closed position.

Claim 36

Dependent Claim 51 words

The assembly according to claim 28 wherein: said clamp positioner includes a cable puller and a coaxial cable, said coaxial cable having a hollow sheath and a cable passing through the sheath, said cable having a proximal end connected to the cable puller and a distal end coupled to the clamp.

Claim 37

Dependent Claim 22 words

The assembly according to claim 28 wherein: said clamp positioner comprises first and second elongate manipulators movable longitudinally relative to one another.

Claim 38

Dependent Claim 36 words

The assembly according to claim 34 wherein: said first and second jaws are secured to one another at a pivot; and said clamp positioner includes a slidable actuator slidably coupled to the first and second jaws.

Claim 39

Dependent Claim 102 words

A clamp for clamping a structure in a patient, comprising: a clamp having a first jaw and a second jaw, the first jaw being movable relative to the second jaw between an open position and a closed position; and a clamp positioner at least partially detachable from the clamp when the clamp is positioned within a patient, the clamp positioner having a clamp actuator configured to move at least the first jaw from the open position to the closed position, the clamp actuator having a rotatable driver for moving at least the first jaw from the open position to the closed position.

Claim 40

Dependent Claim 102 words

A clamp for clamping a structure in a patient, comprising: a clamp having a first jaw and a second jaw, the first jaw being movable relative to the second jaw between an open position and a closed position; and a clamp positioner at least partially detachable from the clamp when the clamp is positioned within a patient, the clamp positioner having a clamp actuator configured to move at least the first jaw from the open position to the closed position, the clamp actuator having a rotatable driver for moving at least the first jaw from the open position to the closed position.

Claim 41

Dependent Claim 15 words

The clamp of claim 36, wherein: the clamp positioner is completely detachable from the clamp.

Claim 42

Dependent Claim 35 words

The clamp of claim 36, wherein: the clamp positioner is re-engageable with the clamp and configured to move the clamp from the closed position to the open position for unclamping the structure in the patient.

Claim 43

Dependent Claim 35 words

The clamp of claim 36, wherein: the clamp includes a threaded sleeve; and the rotatable driver engages the threaded sleeve for moving the first and second jaws from the open position to the closed position.

Claim 44

Dependent Claim 39 words

The clamp of claim 39, wherein: the first jaw is biased towards the open position by a spring; and the threaded sleeve includes a shoulder which engages the first jaw for holding the first jaw in the closed position.

Claim 45

Dependent Claim 11 words

The clamp of claim 40, wherein: the second jaw is fixed.

Claim 46

Dependent Claim 17 words

The clamp of claim 36, wherein: the first and second jaws are configured for clamping an aorta.

Claim 47

Dependent Claim 46 words

The clamp of claim 36, wherein: the clamp positioner is configured for introduction into a thoracic cavity through a percutaneous intercostal penetration, the clamp positioner having a length sufficient to reach an ascending aorta from a lateral side or an anterior side of the patient's chest.

Claim 48

Dependent Claim 63 words

A clamp for clamping a structure in a patient, comprising: a clamp having a first jaw and a second jaw, the first and second jaws being movable relative to one another between an open position and a closed position; and a clamp positioner including a clamp actuator having a coaxial cable for moving the clamp from the open position to the closed position.

Claim 49

Dependent Claim 63 words

A clamp for clamping a structure in a patient, comprising: a clamp having a first jaw and a second jaw, the first and second jaws being movable relative to one another between an open position and a closed position; and a clamp positioner including a clamp actuator having a coaxial cable for moving the clamp from the open position to the closed position.

Claim 50

Dependent Claim 18 words

The clamp of claim 44, wherein: the coaxial cable includes an end which is detachable from the clamp.

Claim 51

Dependent Claim 26 words

The clamp of claim 44, wherein: the first and second jaws move parallel to one another when moving from the open position to the closed position.

Claim 52

Dependent Claim 63 words

The clamp of claim 44, further comprising: first and second links coupled to one another at a first pivot, the first and second jaws being coupled to one another at a second pivot; the coaxial cable being coupled to at least one of the first and second pivots for moving the first and second jaws from the open position to the closed position.

Claim 53

Dependent Claim 72 words

A clamp for clamping a structure in a patient, comprising: a clamp having a first jaw and a second jaw, at least the first jaw being movable relative to the second jaw between an open position and a closed position; and a clamp positioner including a hydraulic actuator having a piston, the piston being coupled to at least the first jaw for moving the first jaw between the open and closed positions.

Claim 54

Dependent Claim 72 words

A clamp for clamping a structure in a patient, comprising: a clamp having a first jaw and a second jaw, at least the first jaw being movable relative to the second jaw between an open position and a closed position; and a clamp positioner including a hydraulic actuator having a piston, the piston being coupled to at least the first jaw for moving the first jaw between the open and closed positions.

Claim 55

Dependent Claim 21 words

The clamp of claim 48, further comprising: a pressure relief valve coupled to the hydraulic actuator for limiting a working pressure.

Claim 56

Dependent Claim 44 words

A clamp for clamping a structure in a patient, comprising: a first jaw having a first inflatable element mounted thereto; a second; means for inflating the first inflatable element for clamping a body structure positioned between the first inflatable element and the second jaw.

Claim 57

Dependent Claim 44 words

A clamp for clamping a structure in a patient, comprising: a first jaw having a first inflatable element mounted thereto; a second; means for inflating the first inflatable element for clamping a body structure positioned between the first inflatable element and the second jaw.

Claim 58

Dependent Claim 24 words

The clamp of claim 50, wherein: the second jaw includes a second inflatable element, the second inflatable element being coupled to the inflating means.

Annuity Stage	Window Opens	Payment Deadline	Surcharge Period Until	Estimated Fee	Status
3.5 Years (Year 4)	2000-04-07	2000-10-07	2001-04-08	$2000.00	Window Closed / Lapsed
7.5 Years (Year 8)	2004-04-07	2004-10-07	2005-04-08	$3760.00	Window Closed / Lapsed
11.5 Years (Year 12)	2008-04-07	2008-10-07	2009-04-08	$7700.00	Window Closed / Lapsed

Clamp assembly and method of use

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