US5888247A
Expired / Lapsed
US
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Method for coronary artery bypass
Assignee: Maquet Cardiovascular LLC
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Filing: 1995-04-10
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Granted: 1999-03-30
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Expires: 2015-04-10
Abstract
Abstract The invention comprises a method for performing a coronary artery bypass graft on a beating heart under thoracoscopic visualization without opening the chest wall. At least one small opening is formed in the patient's chest, a target artery for an arterial blood supply is located, instruments are introduced through one or more small openings formed in the patient's chest to prepare the target artery for fluid connection to the coronary artery, and instruments are introduced through one or more small openings formed in the patient's chest to connect the target artery to the coronary artery distal from a stenosis. In a preferred embodiment, a minimal left anterior intercostal thoracotomy provides access to form an anastomosis between the left internal mammary artery (LIMA) and the left anterior descending artery (LAD) while thoracoscopic viewing facilitates harvesting the LIMA. In other embodiments, access to the patient's heart may be obtained through a trocar sheath or other means for providing percutaneous access to the patient's thoracic cavity without opening the chest-wall. Thoracoscopic visualization, depending on the procedure, is used to locate the arterial blood supply, the location of the coronary artery to be bypassed and the location of the occlusion in the artery. In other embodiments, the diagonal (Dx) or circumflex (Cx) arteries may be bypassed.
Inventors
- 👤 Frederico J. Benetti
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 08:18
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/11; A61B17/02; A61B17/0206; A61B17/04; A61B17/06; A61B17/062; A61B17/00234; A61B2017/00238; A61B2017/00243; A61B2017/1107; A61B2017/1135; A61B17/34; A61B17/3417; A61B17/3421; A61B17/3423; A61B2017/3427
Claims Analysis
Total Claims: 24
Claim 1
Independent Claim
105 words
A method for performing a coronary artery bypass graft procedure on the beating heart of a human patient comprising: forming a thoracotomy in the chest of the human patient to provide access to the beating heart, locating a target artery having an arterial blood supply, introducing a retractor into said thoracotomy, followed by manipulating said retractor to spread the chest both horizontally and vertically, forming an arteriotomy distal to a stenosis in a coronary artery of said beating heart, and bypassing said stenosis in said coronary artery using said arterial blood supply of said target artery to establish arterial blood flow distal to said stenosis.
Claim 2
Independent Claim
105 words
A method for performing a coronary artery bypass graft procedure on the beating heart of a human patient comprising: forming a thoracotomy in the chest of the human patient to provide access to the beating heart, locating a target artery having an arterial blood supply, introducing a retractor into said thoracotomy, followed by manipulating said retractor to spread the chest both horizontally and vertically, forming an arteriotomy distal to a stenosis in a coronary artery of said beating heart, and bypassing said stenosis in said coronary artery using said arterial blood supply of said target artery to establish arterial blood flow distal to said stenosis.
Claim 3
Dependent Claim
25 words
The method of claim 1 wherein the thoracotomy is a minimal thoracotomy having a size of incision which is not substantially greater than 12 cm.
Claim 4
Dependent Claim
16 words
The method of claim 1 or 2 further comprising the step of stabilizing said beating heart.
Claim 5
Dependent Claim
40 words
The method of claim 3 wherein said coronary artery of said beating heart is stabilized by a method selected from the group consisting of contacting tissue proximate to said artery with forcep means, and tensioning ligatures about said coronary artery.
Claim 6
Dependent Claim
27 words
The method of claim 3 wherein said beating heart is stabilized by forcep means engaging tissue proximate to said coronary artery on either side of said arteriotomy.
Claim 7
Dependent Claim
32 words
The method of claim 1 wherein said coronary artery is selected from the group consisting of the left anterior descending, diagonal, circumflex, obtuse marginal, ramus intermedius, right coronary and posterior descending artery.
Claim 8
Dependent Claim
30 words
The method of claim 1 wherein said target artery is selected from the group consisting of the gastroepiploic artery, the right internal mammary artery, and the left internal mammary artery.
Claim 9
Dependent Claim
23 words
The method of claim 7 further comprising the step of separating said target artery from its support using instruments introduced through said thoracotomy.
Claim 10
Dependent Claim
25 words
The method of claim 7 further comprising the step of separating said target artery from its support, wherein said separation is visualized by a thoracoscope.
Claim 11
Dependent Claim
51 words
The method of claim 2 wherein said minimal thoracotomy is intercostal and in the left anterior chest, and wherein said target artery is the left internal mammary artery and said coronary artery is selected from the group consisting of the left anterior descending artery, a diagonal artery, and the circumflex artery.
Claim 12
Dependent Claim
16 words
The method of claim 1 wherein the formation of said arteriotomy is visualized by a thoracoscope.
Claim 13
Dependent Claim
15 words
The method of claim 1 wherein completion of said anastomosis is visualized by a thoracoscope.
Claim 14
Dependent Claim
29 words
The method of claim 1 wherein said anastomosis is completed using a graft selected from the group consisting of a harvested artery, a harvested vein, and a synthetic graft.
Claim 15
Dependent Claim
38 words
The method of claim 1 wherein said anastomosis is between the aorta and said coronary artery and is completed using a graft selected from the group consisting of a harvested artery, a harvested vein, and a synthetic graft.
Claim 16
Independent Claim
208 words
A method for performing a coronary artery bypass graft procedure on the beating heart of a human patient comprising: forming an intercostal minimal thoracotomy in the left anterior chest of the human patient to provide access to the left internal mammary artery and a coronary artery selected from the group consisting of the left anterior descending artery, a diagonal artery, and the circumflex artery of the beating heart, introducing a retractor into said intercostal minimal thoracotomy, followed by providing access to said left internal mammary artery by manipulating said retractor to spread the chest both horizontally and vertically, locating the left internal mammary artery to provide an arterial blood supply by a method selected from the group consisting of direct vision of said left internal mammary artery and insertion of a thoracoscope into the left anterior chest, separating said left internal mammary artery from its support using instruments introduced through said intercostal minimal thoracotomy, stabilizing said coronary artery of said beating heart, forming an arteriotomy in said coronary artery of said beating heart wherein said arteriotomy is distal to a stenosis in said coronary artery, and completing an anastomosis of said left internal mammary artery to said coronary artery to establish arterial blood flow distal to said stenosis.
Claim 17
Independent Claim
208 words
A method for performing a coronary artery bypass graft procedure on the beating heart of a human patient comprising: forming an intercostal minimal thoracotomy in the left anterior chest of the human patient to provide access to the left internal mammary artery and a coronary artery selected from the group consisting of the left anterior descending artery, a diagonal artery, and the circumflex artery of the beating heart, introducing a retractor into said intercostal minimal thoracotomy, followed by providing access to said left internal mammary artery by manipulating said retractor to spread the chest both horizontally and vertically, locating the left internal mammary artery to provide an arterial blood supply by a method selected from the group consisting of direct vision of said left internal mammary artery and insertion of a thoracoscope into the left anterior chest, separating said left internal mammary artery from its support using instruments introduced through said intercostal minimal thoracotomy, stabilizing said coronary artery of said beating heart, forming an arteriotomy in said coronary artery of said beating heart wherein said arteriotomy is distal to a stenosis in said coronary artery, and completing an anastomosis of said left internal mammary artery to said coronary artery to establish arterial blood flow distal to said stenosis.
Claim 18
Dependent Claim
23 words
The method of claim 15 wherein said intercostal minimal thoracotomy has a size of incision which is not substantially greater than 12 cm.
Claim 19
Dependent Claim
41 words
The method of claim 15 wherein said coronary artery of said beating heart is stabilized by a method selected from the group consisting of contacting tissue proximate to said coronary artery with forcep means, and tensioning ligatures about said coronary artery.
Claim 20
Dependent Claim
27 words
The method of claim 15 wherein said beating heart is stabilized by forcep means engaging tissue proximate to said coronary artery on either side of said arteriotomy.
Claim 21
Dependent Claim
23 words
The method of claim 15 wherein said separation of said left internal mammary artery from its support base is visualized by a thoracoscope.
Claim 22
Dependent Claim
20 words
The method of claim 15 wherein the formation of said arteriotomy in said coronary artery is visualized by a thoracoscope.
Claim 23
Dependent Claim
16 words
The method of claim 15 wherein the completion of said anastomosis is visualized by a thoracoscope.
Claim 24
Dependent Claim
29 words
The method of claim 15 wherein said anastomosis is completed using a graft selected from the group consisting of a harvested artery, a harvested vein, and a synthetic graft.
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USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 2002-03-29 | 2002-09-28 | 2003-03-30 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2006-03-29 | 2006-09-28 | 2007-03-30 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2010-03-29 | 2010-09-28 | 2011-03-30 | $7700.00 | Window Closed / Lapsed |