Patent EP0417031A2 successfully refreshed from Google Patents.
EP0417031A2
Expired / Lapsed
EP
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Improved method and apparatus for providing intrapericardial access and inserting intrapericardial electrodes
Assignee: Ventritex Inc
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Filing: 1990-09-06
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Granted: —
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Expires: 2010-09-06
Abstract
Abstract Intrapericardial access is provided by clamping the wall of the pericardium between elongate jaw elements carrying axially aligned tubular guides and passing a guide wire through the guides and the pericardial tissue therebetween. In the preferred embodiment the jaw elements include interengageable ratchets for holding the elements in clamping engagement with the wall of the pericardium and aligned pointed extensions for piercing the pericardial tissue clamped between the elements. Further intrapericardial access is provided by an additional tubular guide carried by the jaw element intended to be disposed in the pericardium during placement of the guide wire.
Inventors
- 👤 Albert K. Chin
- 👤 Thomas J. Fogarty
- 👤 Eric Steven Fain
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-23 12:32
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/02; A61N1/04; A61N1/05; A61N1/0587
Claims Analysis
Total Claims: 32
Claim 1
Independent Claim
202 words
A method for implanting an electrode within the interior of the pericardium, comprising the steps of: (a) creating a subxiphoid incision; (b) dissecting a tunnel between the pericardium and the diaphragm from the subxiphoid incision towards the posterior aspect of the pericardium; (c) making a pericardial incision in the inferior border of the pericardium; (d) providing a clamp-like placement device having elongate tubular jaws with aligned open distal ends curved toward one another; (e) passing one of the jaws through the pericardial incision to locate the curved end of said one jaw at a posterior position within the pericardium; (f) passing the other of the jaws into the tunnel to the exterior of the pericardium to locate the curved end of said other jaw in alignment with the curved end of said one jaw; (g) passing a guide wire through the jaws to extend the wire within and through the pericardium; (h) removing the placement device while leaving the guide wire in place; (i) extending a cannula over the wire within the tunnel to pass the cannula through the tunnel and into the pericardium; and, (j) passing an electrode through the cannula and into the pericardium to one side of the heart.
Claim 2
Independent Claim
202 words
A method for implanting an electrode within the interior of the pericardium, comprising the steps of: (a) creating a subxiphoid incision; (b) dissecting a tunnel between the pericardium and the diaphragm from the subxiphoid incision towards the posterior aspect of the pericardium; (c) making a pericardial incision in the inferior border of the pericardium; (d) providing a clamp-like placement device having elongate tubular jaws with aligned open distal ends curved toward one another; (e) passing one of the jaws through the pericardial incision to locate the curved end of said one jaw at a posterior position within the pericardium; (f) passing the other of the jaws into the tunnel to the exterior of the pericardium to locate the curved end of said other jaw in alignment with the curved end of said one jaw; (g) passing a guide wire through the jaws to extend the wire within and through the pericardium; (h) removing the placement device while leaving the guide wire in place; (i) extending a cannula over the wire within the tunnel to pass the cannula through the tunnel and into the pericardium; and, (j) passing an electrode through the cannula and into the pericardium to one side of the heart.
Claim 3
Dependent Claim
71 words
A method according to Claim 1 wherein the electrode is a first electrode and the cannula through which it is passed is a first cannula; further comprising the steps of extending a second cannula into the pericardium through the pericardial incision and passing a second electrode into the pericardium through the second cannula so as to position said second electrode on the opposite side of the heart from the first electrode.
Claim 4
Dependent Claim
36 words
A method according to Claim 2 further comprising the step of fastening the second electrode to the pericardium or the surrounding connective tissue to hold the second electrode in a generally fixed position within the pericardium.
Claim 5
Dependent Claim
56 words
A method according to Claim 3, wherein the step of fastening the second electrode to the pericardium or the surrounding connective tissue comprises the steps of: (a) sliding a crimping ring over the electrode; (b) attaching said ring to the pericardium or the surrounding tissue; and, (c) crimping the ring to firmly grasp the electrode therein.
Claim 6
Dependent Claim
51 words
A method according to Claim 4, wherein: (a) a section of the cannula is left in place between the electrode and button as the crimping ring is slid over the electrode; and, (b) the crimping ring is crimped onto the cannula to compress the cannula into gripping engagement with the electrode.
Claim 7
Dependent Claim
22 words
A method according to Claim 1 further comprising the step of removing the guide wire after the cannula has been extended thereover.
Claim 8
Dependent Claim
23 words
A method according to Claim 6 further comprising the step of removing the cannula while leaving the electrode in place within the pericardium.
Claim 9
Dependent Claim
36 words
A method according to Claim 1 wherein the guide wire has a sharpened tip and is passed first through said one jaw to pierce the pericardium and then enter into and pass through said other jaw.
Claim 10
Dependent Claim
100 words
A method according to Claim 1 wherein: (a) the elongate jaws of the placement device include aligned distal end portions capable of clamping the pericardium therebetween and forming a puncture in the pericardium; (b) after the jaws are passed into place said aligned distal end portions are clamped on the pericardium to form a puncture therein; and, (c) after the puncture is formed the placement device is moved to align the distal ends of the tubular jaws with the puncture and the guide wire is then passed through the jaws and passes through the puncture to extend through the pericardium.
Claim 11
Dependent Claim
65 words
A method according to Claim 1, wherein: (a) the open distal ends of the tubular jaws are sharpened; (b) after the jaws are passed into place said open distal ends are clamped on the pericardium to cut a hole therethrough; and, (c) after the hole is formed the guide wire is passed through the jaws and passes through the hole to extend through the pericardium.
Claim 12
Independent Claim
171 words
A method for accessing the interior of the pericardium, comprising the steps of: (a) creating a subxiphoid incision; (b) dissecting a tunnel between the pericardium and the diaphragm from the subxiphoid incision towards the posterior aspect of the pericardium; (c) making a pericardial incision in the inferior border of the pericardium; (d) providing a clamp-like placement device having elongate tubular jaws with aligned open distal ends curved toward one another; (e) passing one of the jaws through the pericardial incision to locate the curved end of said one jaw within the pericardium proximate to and interior surface thereof; (f) passing the other of the jaws into the tunnel to the exterior of the pericardium to locate the curved end of said other jaw proximate to an exterior surface of the pericardium in alignment with the curved end of said one jaw; (g) passing a guide wire through the jaws to extend the wire within and through the pericardium; and, (h) removing the placement device while leaving the guide wire in place.
Claim 13
Independent Claim
171 words
A method for accessing the interior of the pericardium, comprising the steps of: (a) creating a subxiphoid incision; (b) dissecting a tunnel between the pericardium and the diaphragm from the subxiphoid incision towards the posterior aspect of the pericardium; (c) making a pericardial incision in the inferior border of the pericardium; (d) providing a clamp-like placement device having elongate tubular jaws with aligned open distal ends curved toward one another; (e) passing one of the jaws through the pericardial incision to locate the curved end of said one jaw within the pericardium proximate to and interior surface thereof; (f) passing the other of the jaws into the tunnel to the exterior of the pericardium to locate the curved end of said other jaw proximate to an exterior surface of the pericardium in alignment with the curved end of said one jaw; (g) passing a guide wire through the jaws to extend the wire within and through the pericardium; and, (h) removing the placement device while leaving the guide wire in place.
Claim 14
Dependent Claim
36 words
A method according to Claim 11 wherein the guide wire has a sharpened tip and is passed first through said one jaw to pierce the pericardium and then enter into and pass through said other jaw.
Claim 15
Dependent Claim
100 words
A method according to Claim 11 wherein: (d) the elongate jaws of the placement device include aligned distal end portions capable of clamping the pericardium therebetween and forming a puncture in the pericardium; (a) after the jaws are passed into place said aligned distal end portions are clamped on the pericardium to form a puncture therein; and, (b) after the puncture is formed the placement device is moved to align the distal ends of the tubular jaws with the puncture and the guide wire is then passed through the jaws and passes through the puncture to extend through the pericardium.
Claim 16
Dependent Claim
65 words
A method according to Claim 11, wherein: (a) the open distal ends of the tubular jaws are sharpened; (b) after the jaws are passed into place said open distal ends are clamped on the pericardium to cut a hole therethrough; and, (c) after the hole is formed the guide wire is passed through the jaws and passes through the hole to extend through the pericardium.
Claim 17
Dependent Claim
72 words
Intrapericardial access apparatus comprising: (a) first and second elongate jaw elements, said elements each having a primary open ended tubular guide extending over at least a portion of the length thereof and terminating in an open distal end extending laterally of the element; and, (b) means for securing the elements together in a condition wherein the open distal ends of the tubular guides are in aligned closely disposed relationship with one another.
Claim 18
Dependent Claim
72 words
Intrapericardial access apparatus comprising: (a) first and second elongate jaw elements, said elements each having a primary open ended tubular guide extending over at least a portion of the length thereof and terminating in an open distal end extending laterally of the element; and, (b) means for securing the elements together in a condition wherein the open distal ends of the tubular guides are in aligned closely disposed relationship with one another.
Claim 19
Dependent Claim
51 words
Apparatus according to Claim 15 further comprising a secondary open ended tubular guide secured to and extending along at least one of said jaw elements, said secondary tubular guide extending generally parallel to and terminating short of the distal end of the primary tubular element secured to said one jaw element.
Claim 20
Dependent Claim
21 words
Apparatus according to Claim 15 wherein the means for securing the jaw elements together comprises a hinge connection between the elements.
Claim 21
Dependent Claim
37 words
Apparatus according to Claim 17, further comprising a handle secured to each jaw element and extending beyond the hinge connection between the elements to facilitate selective movement of the jaw elements toward and away from one other.
Claim 22
Dependent Claim
59 words
Apparatus according to Claim 15 wherein one of the jaw elements is adapted to be extended intrapericardially and the other of the jaw elements is adapted to be extended extrapericardially; the apparatus further comprising means for holding the jaw elements with the distal ends of the primary guides aligned in clamping engagement with opposite sides of pericardial tissue therebetween.
Claim 23
Dependent Claim
35 words
Apparatus according to Claim 19 further comprising sharpened edges on the distal ends of the primary guides to cut a hole through pericardial tissue upon being clamped into engagement with opposite sides of the tissue.
Claim 24
Dependent Claim
59 words
Apparatus according to Claim 18 wherein one of the jaw elements is adapted to be extended intrapericardially and the other of the jaw elements is adapted to be extended extrapericardially; the apparatus further comprising means for holding the jaw elements with the distal ends of the primary guides aligned in clamping engagement with opposite sides of pericardial tissue therebetween.
Claim 25
Dependent Claim
34 words
Apparatus according to Claim 20 wherein the means for holding the jaw elements with the distal ends of the primary guides in clamping engagement with pericardial tissue comprises interengageable ratchet elements on the handles.
Claim 26
Dependent Claim
49 words
Apparatus according to Claim 15 further comprising a lateral extension on each of the jaw elements, said extensions being disposed to clampingly engage pericardial tissue therebetween when the jaw elements are secured together in the condition with the distal ends of the tubular guides in closely adjacent aligned relationship.
Claim 27
Dependent Claim
20 words
Apparatus according to Claim 23 wherein the lateral extensions are disposed closely adjacent the open distal ends of the guides.
Claim 28
Dependent Claim
55 words
Apparatus according to Claim 24 further comprising a secondary open ended tubular guide secured to and extending along at least one of at least one of said jaw elements, said secondary tubular guide extending generally parallel to and terminating short of the distal end of the primary tubular element secured to said one jaw element.
Claim 29
Dependent Claim
21 words
Apparatus according to Claim 24 wherein the means for securing the jaw elements together comprises a hinge connection between the elements.
Claim 30
Dependent Claim
37 words
Apparatus according to Claim 26, further comprising a handle secured to each jaw element and extending beyond the hinge connection between the elements to facilitate selective movement of the jaw elements toward and away from one other.
Claim 31
Dependent Claim
55 words
Apparatus according to Claim 27 wherein one of the jaw elements is adapted to be extended intrapericardially and the other of the jaw elements is adapted to be extended extrapericardially; the apparatus further comprising means for holding the jaw elements with the lateral extensions thereof in clamping engagement with opposite sides of pericardial tissue therebetween.
Claim 32
Dependent Claim
30 words
Apparatus according to Claim 28 wherein the means for holding the lateral extensions of the jaw elements in clamping engagement with pericardial tissue comprises interengageable ratchet elements on the handles.
References Cited (Backward Citations)
No citation records indexed.
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