EP0791330A2
Expired / Lapsed
EP
⏱️ 0.0 years remaining
Surgical instruments and procedures for stabilizing the beating heart during coronary artery bypass graft surgery
Assignee: Cardiothoracic Systems LLC
•
Filing: 1997-02-20
•
Granted: —
•
Expires: 2017-02-20
Abstract
Abstract The invention is methods and devices which a surgeon may use to stabilize the beating heart during a surgical procedure on the heart. Pursuant to the invention, a stabilizing device is introduced through an opening in the chest and brought into contact with the beating heart. By contacting the heart with the device and by exerting a stabilizing force on the device, the motion of the heart caused by the contraction of the heart muscles is effectively eliminated such that the heart is stabilized and the site of the surgery moves only minimally if at all. Typically, in separate steps, the surgeon contacts the heart with the stabilizing means, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing means such that the contraction of the beating heart causes orgy minimal excess motion at the surgery site. By fixing the position of the stabilizing means in a configuration where the motion of the beating heart is effectively eliminated, the surgeon is able to stabilize the beating heart for the duration of the procedure. The stabilizing means may be attached to a rigid support or may be attached to a semi-rigid support which is rendered motionless mechanically, chemically, or by human intervention. In certain preferred embodiments, the stabilizing means is affixed to a semi-rigid support which is caused to become rigid, by any of a variety of techniques, such that the position of the stabilizing means becomes fixed by the support, and the heart remains substantially motionless for the duration of the procedure.
Inventors
- 👤 Charles S. Taylor
- 👤 William N. Aldrich
- 👤 Thomas L. Baughman
- 👤 Federico J Bennetti
- 👤 Brian J. Bennett
- 👤 Michael J. Billing
- 👤 Thomas J. Fogarty
- 👤 John J. Frantzen
- 👤 Richard S. Ginn
- 👤 Robert C. Glines
- 👤 Harry L. Green
- 👤 Dwight P. Morejohn
- 👤 Brent Regan
- 👤 Eugene E. Reis
- 👤 Amr Salahieh
- 👤 Ivan Sepetka
- 👤 Benjamin Sherman
- 👤 Christian Skieller
- 👤 Valavanur A. Subramanian
- 👤 Gary B. Weller
- 👤 William F. Witt
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-23 01:11
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/34; A61B17/3417; A61B17/3421; A61B17/00234; A61B17/02; A61B17/0206; A61B17/0218; A61B17/3423; A61B90/00; A61B17/064; A61B17/0642; A61B17/12; A61B17/56; A61B17/58; A61B17/68; A61B17/80; A61B17/8061; A61B17/8076; A61B2017/00238; A61B2017/00243; A61B2017/00535; A61B2017/00539; A61B2017/00681; A61B2017/00694; A61B2017/00703; A61B2017/00831; A61B2017/00858; A61B2017/00982; A61B2017/00991; A61B2017/0237; A61B2017/0243; A61B2017/0647; A61B2017/0648; A61B17/11; A61B2017/1139; A61B17/28; A61B17/2812; A61B17/282; A61B2017/2825; A61B17/29; A61B17/2909; A61B2017/2912; A61B2017/2913; A61B2017/2926; A61B2017/2927; A61B2017/2929; A61B17/30; A61B2017/306; A61B2017/348; A61B2017/3482; A61B2017/349
Claims Analysis
Total Claims: 189
Claim 1
Independent Claim
33 words
A device for use in a cardiovascular surgery on the beating heart comprising: a means for stabilizing the beating heart comprising a contact member shaped to engage the surface of the beating heart.
Claim 2
Dependent Claim
15 words
The device of claim 1 wherein said contact member is attached to a shaft means.
Claim 3
Dependent Claim
15 words
The device of claim 2 wherein said shaft means are affixed to a stable support.
Claim 4
Dependent Claim
33 words
The device of claim 1 wherein said means for stabilizing the beating heart are comprised of two individual contact members having a greater overall thickness at their outer edges and a passage therebetween.
Claim 5
Dependent Claim
17 words
The device of claim 1 wherein said contact members have a friction material on the bottom surface.
Claim 6
Dependent Claim
23 words
The device of claim 5 wherein said friction material is comprised of a diamond plate, nail bed, open pore foam, or textured material.
Claim 7
Dependent Claim
16 words
The device of claim 5 wherein said bottom surface is releasably affixed to said contact members.
Claim 8
Dependent Claim
22 words
The device of claim 5 wherein said bottom surface is provided with a cushioning member having air or a fluid contained therein.
Claim 9
Dependent Claim
21 words
The device of claim 1 wherein said means for stabilizing the beating heart are a pair of substantially planar contact members.
Claim 10
Dependent Claim
16 words
The device of claim 9 wherein said substantially planar contact members are fixed in parallel orientation.
Claim 11
Dependent Claim
45 words
The device of claim 9 further comprising a counter contact member affixed to an interconnecting shaft is affixed to said contact members, wherein said counter-contact member and said contact members are at opposite ends of a said interconnecting shaft means affixed to said interconnecting shaft.
Claim 12
Dependent Claim
18 words
The device of claim 1 wherein said contact members have a hollow portion containing a conformable material therein.
Claim 13
Dependent Claim
16 words
The device of claim 12 wherein said conformable material is granular, a polymeric, or a gel.
Claim 14
Dependent Claim
33 words
The device of claim 13 wherein said contact member further comprises a plurality of disk elements disposed within said hollow portion of said contact member and a rigid member interconnecting said disk elements.
Claim 15
Dependent Claim
24 words
The device of claim 1 wherein said contact member has a plurality ports formed therein to receive the distal end of a shaft means.
Claim 16
Dependent Claim
33 words
The device of claim 15 wherein said plurality of ports are disposed about the periphery of the contact member and wherein said plurality of ports are releasably connected to a single shaft means.
Claim 17
Dependent Claim
24 words
The device of claim 15 further comprising a second shaft means having a distal end adapted to engage said ports on said contact members.
Claim 18
Dependent Claim
11 words
The device of claim 1 wherein said contact member is annular.
Claim 19
Dependent Claim
18 words
The device of claim 18 wherein said annular contact member has a fixture to receive a shaft means.
Claim 20
Dependent Claim
19 words
The device of claim 19 wherein said annular contact member has a passage formed through the bottom surface thereof.
Claim 21
Dependent Claim
20 words
The device of claim 1 further comprising means for introducing a positive or negative air pressure to said contact members.
Claim 22
Dependent Claim
31 words
The device of claim 21 wherein said means for introducing a positive or negative pressure to said contact members is comprised of a tube having a plurality of ports disposed therein.
Claim 23
Dependent Claim
34 words
The device of claim 21 wherein said contact member is further comprised of a manifold disposed within the body of said contact member and a plurality of ports in pneumatic connection with said manifold.
Claim 24
Dependent Claim
23 words
The device of claim 21 wherein said contact member has a slit in pneumatic connection with a positive or negative air pressure source.
Claim 25
Dependent Claim
29 words
The device of claim 21 wherein said tube has a malleable portion that is separable from said contact member and at least one port disposed in said malleable portion.
Claim 26
Dependent Claim
32 words
The device of claim 21 wherein at least one port communicates a positive pressure proximate to said contact members and a second port communicates a negative pressure proximate to said contact members.
Claim 27
Dependent Claim
39 words
The device of claim 21 wherein said positive or negative pressure is communicated by a single tube having a distal end with an opening proximate to said contact members and a proximal end operably associated with a shaft means.
Claim 28
Dependent Claim
15 words
The device of claim 1 further comprising a light source proximate to said contact members.
Claim 29
Dependent Claim
10 words
The device of claim 1 further comprising a surgical drape.
Claim 30
Dependent Claim
18 words
The device of claim 29 wherein said surgical drape is disposed about the periphery of said contact members.
Claim 31
Dependent Claim
15 words
The device of claim 30 further comprising structural support members affixed to said surgical drape.
Claim 32
Dependent Claim
15 words
The device of claim 29 wherein said surgical drape is affixed to a shaft means.
Claim 33
Dependent Claim
22 words
The device of claim 32 wherein said surgical drape has a retracted configuration wherein said drape is affixed to a shaft means.
Claim 34
Dependent Claim
19 words
The device of claim 29 further comprising extensions attached to said contact members and having a drape attachment means.
Claim 35
Dependent Claim
23 words
The device of claim 1 further comprising a mechanism for attaching a source vessel to a target artery attached to said contact members.
Claim 36
Dependent Claim
16 words
The device of claim 35 further comprising a vessel receiving member affixed to said contact members.
Claim 37
Dependent Claim
12 words
The device of claim 36 further comprising a movable vessel support member.
Claim 38
Dependent Claim
25 words
The device of claim 37 wherein said movable vessel support member is mounted on a hinge and rotatable to align with said vessel receiving member.
Claim 39
Dependent Claim
21 words
The device of claim 2 further comprising a source vessel holder operably associated with said shaft means or said contact members.
Claim 40
Dependent Claim
26 words
The device of claim 39 wherein said vessel retention means is comprised of at least one clamp for gripping the distal end of a source vessel.
Claim 41
Dependent Claim
9 words
The device of claim 1 further comprising a cannula.
Claim 42
Dependent Claim
26 words
The device of claim 41 wherein said cannula is a component of a cannula assembly further comprising means for attaching said cannula assembly to the chest.
Claim 43
Dependent Claim
16 words
The device of claim 41 wherein said cannula has a threaded portion about the periphery thereof.
Claim 44
Dependent Claim
36 words
The device of claim 41 wherein said cannula is operably associated with a cannula locking mechanism having means for engaging adjacent ribs, and a locking mechanism to maintain said locking mechanism in engagement with adjacent ribs.
Claim 45
Dependent Claim
61 words
A means for stabilizing the beating heart comprised of a conical cannula having a distal end of a smaller diameter adapted to engage said beating heart at a bottom surface thereof and a proximal end having a larger diameter with an opening for introducing surgical instruments to the surface of the beating heart engaged by the distal end of said cannula.
Claim 46
Dependent Claim
15 words
The device of claim 1 wherein said contact members are formed of a malleable material.
Claim 47
Dependent Claim
24 words
The device of claim 1 wherein said contact member is retractable by rotation about a hinge connecting said contact members to a shaft means.
Claim 48
Dependent Claim
17 words
The device of claim 46 wherein said contact member formed of a material having a shape memory.
Claim 49
Dependent Claim
28 words
The device of claim 47 wherein a pair of contact members are maintained in a retracted position in the interior of the hollow portion of a shaft means.
Claim 50
Dependent Claim
34 words
The device of claim 49 wherein said contact members are connected to a central shaft means by and wherein said central shaft is movable in relation to the hollow portion of said shaft means.
Claim 51
Dependent Claim
44 words
The device of claim 47 wherein a distal portion of each of two contact members are affixed to a the distal end of a shaft means, and a proximal portion of each contact member is affixed to the distal end of a guide means.
Claim 52
Dependent Claim
32 words
The device of claim 47 wherein said contact members are affixed to a plurality of struts at least two of which affix said contact member to said shaft means opposite said hinge.
Claim 53
Dependent Claim
16 words
The device of claim 1 wherein said contact member is formed of a single continuous wire.
Claim 54
Dependent Claim
14 words
The device of claim 52 wherein said single wire forms at least one loop.
Claim 55
Dependent Claim
15 words
The device of claim 1 wherein said contact member is formed of a helical coil.
Claim 56
Dependent Claim
18 words
The device of claim 54 wherein said helical coil is retractable into the body of a shaft means.
Claim 57
Dependent Claim
23 words
The device of claim 54 wherein said helical coil further comprises a spacing member disposed between the adjacent coils of said helical coil.
Claim 58
Dependent Claim
11 words
The device of claim 1 wherein said contact member is inflatable.
Claim 59
Dependent Claim
15 words
The device of claim 58 wherein said inflatable contact member forms a substantially annular cuff.
Claim 60
Dependent Claim
18 words
The device of claim 59 further comprising separate contact members disposed within the interior of said annular cuff.
Claim 61
Dependent Claim
22 words
The device of claim 58 wherein said inflatable contact member is retracted within the hollow portion of a shaft means when deflated.
Claim 62
Dependent Claim
24 words
The device of claim 1 when said contact members are formed of a unitary shaft having a split portion at the distal end thereof.
Claim 63
Dependent Claim
19 words
The device of claim 62 wherein said split portion is joined at a tip distal to said split portion.
Claim 64
Dependent Claim
25 words
The device of claim 2 wherein the length of said shaft means is adjusted by independent motion of an internal shaft and an external shaft.
Claim 65
Dependent Claim
23 words
The device of claim 64 wherein said shaft means has a ball joint at the distal end thereof for positioning said contact members.
Claim 66
Dependent Claim
17 words
The device of claim 65 wherein said ball joint is lockable by rotation of said inner shaft.
Claim 67
Dependent Claim
15 words
The device of claim 2 wherein said shaft means has an adjustable weight affixed thereto.
Claim 68
Dependent Claim
35 words
The device of claim 67 wherein said shaft means has a counter-weight at a proximal portion thereof, and a fulcrum attached to said shaft means at a point between said counter-weight and said adjustable weight.
Claim 69
Dependent Claim
45 words
The device of claim 2 wherein said contact members are attached to said shaft means by being integrally formed from a distal portion of a plurality of said shaft means wherein said distal portion of said shaft means is shaped to engage the beating heart.
Claim 70
Dependent Claim
21 words
The device of claim 69 wherein the distal ends of said plurality of shaft means are attached by an interconnecting member.
Claim 71
Dependent Claim
19 words
The device of claim 2 wherein said shaft means has a positive or negative pressure source operably associated therewith.
Claim 72
Dependent Claim
16 words
The device of claim 2 wherein said shaft means has a light source operably associated therewith.
Claim 73
Dependent Claim
19 words
The device of claim 1 wherein said contact members are further comprised of a means for positioning epicardial tissue.
Claim 74
Dependent Claim
26 words
The device of claim 73 wherein said means for positioning epicardial tissue is comprised of sutures attached to said epicardial tissue and engaging said contact members.
Claim 75
Dependent Claim
15 words
The device of claim 74 wherein said sutures pass through openings in said contact members.
Claim 76
Dependent Claim
21 words
The device of claim 73 wherein said means for positioning epicardial tissue is comprised of open passages in said contact members.
Claim 77
Dependent Claim
27 words
The device of claim 76 wherein said means for positioning epicardial tissue is further comprised of a slidable member that engages epicardial tissue in said open passages.
Claim 78
Dependent Claim
26 words
The device of claim 73 wherein said means for positioning epicardial tissue is a functional clamp formed from crimping said contact member about said epicardial tissue.
Claim 79
Dependent Claim
26 words
The device of claim 1 wherein said contact members are rotatable circular rollers, wherein said rotatable circular rollers are also a means for positioning epicardial tissue.
Claim 80
Dependent Claim
31 words
The device of claim 1 wherein a contact members is further comprised of a frame, a spring mechanism, and a frame extension operably connected to said frame and said spring mechanism.
Claim 81
Dependent Claim
20 words
The device of claim 80 wherein said frame extension has a plurality of pins extending from the bottom surface thereof.
Claim 82
Dependent Claim
17 words
The device of claim 2 wherein a single shaft means is connected to a single contact member.
Claim 83
Dependent Claim
21 words
The device of claim 82 wherein a pair of said shaft means are interconnected by a pivot at an intermediate point.
Claim 84
Dependent Claim
36 words
The device of claim 82 wherein the said shaft means is adjustable along its length by continuous positioning of a first portion of said shaft means which engages a second portion and slides in relation thereto.
Claim 85
Dependent Claim
27 words
The device of claim 84 wherein said shaft means is further comprised of a spring mechanism disposed between said first and second portions of said shaft means.
Claim 86
Dependent Claim
21 words
The device of claim 1 wherein further comprising a plurality of pins extending from the bottom surface of said contact member.
Claim 87
Dependent Claim
26 words
The device of claim 86 wherein said plurality of pins engage a pair of contact members at a guide attached to each of said contact members.
Claim 88
Dependent Claim
33 words
The device of claim 1 wherein said contact member is comprised of the pair of plates having a deflected edge along one side thereof and a shaft means affixed to the opposite side.
Claim 89
Dependent Claim
29 words
The device of claim 88 further comprising a lever member positioned between the edge and the shaft means, and underneath said stabilizer plate in contact with said beating heart.
Claim 90
Dependent Claim
24 words
The device of claim 89 further comprising a suture for tilting said plate about said lever member when tension is exerted on said suture.
Claim 91
Dependent Claim
67 words
The device of claim 1 further comprising a lockable mechanism affixed to said contact members to depress epicardial tissue on either side of a target vessel, wherein said lockable mechanism is comprised of a block having a movable edge formed along one side and which rotates about a support member, wherein said lockable mechanism further comprises a hinge pin affixed to said block and said contact member.
Claim 92
Dependent Claim
22 words
The device of claim 91 wherein said lockable mechanism further comprises a locking member that fixes the position of said movable edge.
Claim 93
Dependent Claim
38 words
The device of claim 1 wherein said means for stabilizing the beating heart is comprised of a contact member having a shaft means with a distal portion adapted to fit within an arteriotomy in a target coronary artery.
Claim 94
Dependent Claim
25 words
The device of claim 93 wherein the distal portion of said shaft means is a substantially cylindrical lumen positioned substantially perpendicular to said shaft means.
Claim 95
Dependent Claim
25 words
The device of claim 91 wherein said substantially cylindrical lumen has cuffs at the edges thereof for engagement with the interior of the target artery.
Claim 96
Dependent Claim
29 words
The device of claim 1 wherein said contact member is substantially planar and has a substantially rigid surface with a centrally disposed opening for placement of a target artery.
Claim 97
Dependent Claim
24 words
The device of claim 96 further comprising an occluder extending beneath the surface of the rigid surface for engagement with the target coronary artery.
Claim 98
Dependent Claim
39 words
The device of claim 97 further comprising springed tissue retractors comprised of a coiled spring affixed to the planar surface of said contact member at one end at least one pin at the opposite end for engaging epicardial tissue.
Claim 99
Dependent Claim
43 words
The device of claim 1 further comprising an artery occluder comprised of a shaft with a blunt portion for engaging the target artery and wherein said shaft is affixed to a connecting shaft affixed to each of a pair of said contact members.
Claim 100
Dependent Claim
14 words
The device of claim 1 further comprising means for occluding said target coronary artery.
Claim 101
Dependent Claim
41 words
The device of claim 1 further comprising means for occluding a target coronary artery comprising a push bolt affixed to said contact member and wherein said push bolt is positioned downward to engage a target artery proximate to said contact member.
Claim 102
Dependent Claim
31 words
The device of claim 1 wherein said contact member is further comprised of means for occluding a target artery comprised of a roller having a portion positioned beneath said contact member.
Claim 103
Dependent Claim
47 words
The device of claim 1 wherein said contact member is further comprised means for occluding a target artery comprised of a movable clip affixed to said contact member, wherein said movable clip may be positioned to occlude a target coronary artery positioned proximate to said contact member.
Claim 104
Dependent Claim
44 words
The device of claim 2 comprising a pair of contact members and means for occluding a target artery comprised of a movable shaft within said shaft means, wherein the distal portion of said movable shaft engages a target artery disposed between said contact members.
Claim 105
Dependent Claim
33 words
The device of claim 100 wherein said means for occluding said target artery is comprised of a flange protruding from said contact member to permit a suture to be drawn about the flange.
Claim 106
Dependent Claim
16 words
The device of claim 105 further comprising a sliding shaft that is traversed by said suture.
Claim 107
Dependent Claim
14 words
The device of claim 105 further comprising a movable rod having a suture guide.
Claim 108
Dependent Claim
13 words
The device of claim 1 further comprising fixtures adapted to receive surgical instruments.
Claim 109
Dependent Claim
10 words
The device of claim 108 wherein said fixtures are magnetic.
Claim 110
Dependent Claim
15 words
The device of claim 2 wherein said shaft means have at least one flexible joint.
Claim 111
Dependent Claim
26 words
The device of claim 110 wherein said flexible joint is between said shaft means and a connecting shaft affixed to a pair of said contact members.
Claim 112
Dependent Claim
18 words
The device of claim 110 wherein said flexible joint is between said interconnecting shaft and said contact members.
Claim 113
Dependent Claim
14 words
The device of claim 110 further comprising a locking mechanism at each flexible joint.
Claim 114
Dependent Claim
20 words
The device of claim 2 wherein said shaft means is a flexible, lockable arm having a plurality of interconnecting links.
Claim 115
Dependent Claim
38 words
The device of claim 114 wherein said interconnecting links are comprised of a ball portion and a receiving portion wherein said ball portion fits conformably within said receiving portion and wherein a cable passes within said interconnecting links.
Claim 116
Dependent Claim
27 words
The device of claim 114 wherein said flexible, lockable arm is comprised of sphere joints and cylindrical tubes having a tensioning cable passing within said interconnecting links.
Claim 117
Dependent Claim
15 words
The device of claim 114 having an inflatable internal balloon passing within said interconnecting links.
Claim 118
Dependent Claim
50 words
The device of claim 114 wherein said flexible, lockable arm is comprised of a plurality of curved segments interconnected by a tensioning cable wherein each of said curved segments has an interfacing surface having teeth adapted to engage the interfacing surface of an adjacent curved segment to prevent rotation therebetween.
Claim 119
Dependent Claim
29 words
The device of claim 118 further comprising bushings traversed by said tensioning cable and shaped to fit within a recessed portion of each of two of said interfacing surfaces.
Claim 120
Dependent Claim
25 words
The device of claim 2 wherein said shaft means is comprised of a flexible shaft having means for fixing the position of said flexible shaft.
Claim 121
Dependent Claim
29 words
The device of claim 119 wherein said means is comprised of a granular material that fixes the position of said flexible shaft rigid upon introduction of a negative pressure.
Claim 122
Dependent Claim
45 words
The device of claim 120 wherein said means is a plurality of interconnected disks in a substantially parallel relationship wherein the outer portion of said disks engages the inner surface of the flexible shaft and wherein said disks are interconnected by an internal tensioning cable.
Claim 123
Dependent Claim
24 words
The device of claim 120 wherein said means is a gel or polymer which becomes substantially rigid upon exposure to light, heat, or chemicals.
Claim 124
Dependent Claim
34 words
The device of claim 2 wherein said shaft means is comprised of a plurality of adjustable links having retaining rings positioned between said adjustable links, and an elastomeric hydraulic medium within said adjustable links.
Claim 125
Dependent Claim
18 words
The device of claim 124 further comprising means for exerting a compressing force of said elastomeric hydraulic medium.
Claim 126
Dependent Claim
20 words
The device of claim 125 wherein said means is a pushrod having a distal end engaging said elastomeric hydraulic medium.
Claim 127
Dependent Claim
38 words
The device of claim 120 wherein said flexible shaft is further comprised of a plurality of strands contained therein and wherein said means is a mechanism at the proximal end of said shaft means for compressing said strands.
Claim 128
Dependent Claim
26 words
The device of claim 119 wherein said flexible shaft is further comprised of fluid-filled lumens and wherein said means is a fixture for sealing said lumens.
Claim 129
Dependent Claim
27 words
The device of claim 2 further comprising a fine adjustment mechanism having a plurality of threaded cables traversing ports at a proximal portion of a shaft means.
Claim 130
Dependent Claim
20 words
The device of claim 2 wherein said shaft means is affixed to a stable support comprised of an access platform.
Claim 131
Dependent Claim
18 words
The device of claim 130 wherein said shaft means traverses a ball joint affixed to said access platform.
Claim 132
Dependent Claim
45 words
The device of claim 2 wherein said shaft means is further comprised of a spring-loaded mechanism having a spring disposed about said shaft means wherein an end of said spring engages an inner shaft and an opposite end of said spring engages an outer shaft.
Claim 133
Dependent Claim
40 words
The device of claim 2 wherein said shaft means if further comprised of a fluid-dampening mechanism having a chamber with an internal plunger wherein said plunger has a piston with an annular seal engaging the internal portion of said chamber.
Claim 134
Dependent Claim
31 words
The device of claim 132 wherein said spring mechanism abuts an interconnecting shaft of said contact members at a distal end and abuts an outer shaft at the proximal portion thereof.
Claim 135
Dependent Claim
41 words
The device of claim 2 wherein said shaft means is comprised of an adjustable central shaft having a threaded portion, wherein rotation of a thumbscrew at a proximal portion of said shaft means engages the threaded portion of said central shaft.
Claim 136
Dependent Claim
69 words
The device of claim 2 wherein said shaft means is comprised of an outer sleeve engaging a second shaft having a plurality of splines at the exterior, wherein said outer sleeve and second shaft surround a first internal shaft having a ball joint at the most distal end thereof for positioning of said contact members, wherein said first internal shaft further comprises threads to permit adjustment by a handle.
Claim 137
Dependent Claim
26 words
The device of claim 136 further comprising a circular clip abutting the distal portion of said outer sleeve and having inner ridges engaging said ball joint.
Claim 138
Dependent Claim
28 words
The device of claim 2 wherein said shaft means is comprised of a malleable shaft having passing through a fixture for attaching said malleable shaft to a retractor.
Claim 139
Dependent Claim
54 words
The device of claim 2 wherein said shaft means is comprised of a plurality of link members interconnected by a cable connected to each linked member a pivotable attachment point, and wherein each said linked members has a torsion spring connected to a hinge displaced at the pivotable attachment points between said link members.
Claim 140
Dependent Claim
45 words
The device of claim 2 wherein the position of said contact members are adjustable by a plurality of positioning cables affixed to a ball joint at the distal end of said shaft means and a positioning handle at the proximal end of said shaft means.
Claim 141
Dependent Claim
32 words
The device of claim 140 wherein said positioning handle has a recessed portion in the bottom thereof adapted to receive a post extending from the proximal end of said shaft means 3.
Claim 142
Dependent Claim
15 words
The device of claim 141 wherein said shaft means is affixed to a stable support.
Claim 143
Dependent Claim
32 words
The device of claim 2 wherein said shaft means has a pair of curved stabilizing arms having a proximal and a distal portion engaging a ratcheting fixture affixed to a retractor blade.
Claim 144
Dependent Claim
32 words
The device of claim 143 wherein said stabilizing arms are comprised of a pair of curved shafts wherein the curved portion of said shafts are intermediate to said proximal and distal ends.
Claim 145
Dependent Claim
44 words
The device of claim 2 wherein said shaft means are comprised of a plurality of malleable shafts wherein one end of each of said plurality of malleable shafts is affixed to a stable support and an opposite end is affixed to a contact member.
Claim 146
Dependent Claim
35 words
The device of claim 145 wherein said proximal ends of at least two malleable shafts are attached to opposing retractor blades and the distal ends of said malleable shafts are attached to a contact member.
Claim 147
Dependent Claim
19 words
The device of claim 2 further comprising an adjustable arm for affixing said shaft means to a stable support.
Claim 148
Dependent Claim
39 words
The device of claim 147 wherein said shaft means is comprised of a pair of parallel shafts which slide relative to an axle contained in a tightening mechanism having a lock for tightening said mechanism about the parallel shafts.
Claim 149
Dependent Claim
48 words
The device of claim 147 wherein said adjustable arm has an adjustable slide mechanism allowing said shaft means to move relative to said stable support, wherein said shaft means are affixed to a stable support by said adjustable arm and wherein said adjustable arm has a locking mechanism.
Claim 150
Dependent Claim
48 words
The device of claim 147 wherein said adjustable arm is comprised of a ball joint traversed by said shaft means, a tightening shaft for fixing the position of said ball joint, and a locking mechanism for fixing the position of the shaft means relative to said stable support.
Claim 151
Dependent Claim
70 words
The device of claim 2 wherein said shaft means is comprised of upper and lower dual shaft members wherein said upper dual shaft members are attached to said lower dual shaft members by an elbow joint wherein the attachment point of said upper and lower shaft members is a hinge in the body of said elbow joint, and wherein said lower dual shaft members are affixed to said contact member.
Claim 152
Dependent Claim
47 words
The device of claim 2 wherein said shaft means is comprised of a plurality of individual shaft members connected by horizontal rotating joints wherein a proximal portion of said shaft means is affixed to a retractor blade and a distal portion is affixed to a vertical shaft.
Claim 153
Dependent Claim
26 words
The device of claim 2 wherein said shaft means are affixed to a retractor for adjustable positioning of said shaft means relative to a retractor blade.
Claim 154
Dependent Claim
51 words
The device of claim 153 wherein said shaft means is comprised of a lower shaft concentrically oriented within an upper shaft and locking means for fixing the position of the lower shaft relative to the upper shaft, wherein a proximal portion of said upper shaft is affixed to a retractor blade.
Claim 155
Dependent Claim
29 words
The device of claim 153 wherein a plurality of adjustable shafts have a distal end affixed to a contact member and a proximal end affixed to a retractor blade.
Claim 156
Dependent Claim
46 words
The device of claim 153 wherein said shaft means is comprised of a lockable, rotatable arm having a first hinge for rotation of said arm relative to said retractor blade and a second hinge for vertical positioning of said rotatable arm relative to said retractor blade.
Claim 157
Dependent Claim
39 words
The device of claim 153 wherein said shaft means has an adjusting knob affixed to a proximal end and a telescoping shaft member extendable from said retractor blade and having a contact member affixed to the distal end thereof.
Claim 158
Dependent Claim
49 words
The device of claim 153 wherein said shaft means is comprised of a flexible central shaft having a handle at one end, wherein said flexible shaft traverses a series of shaft guides wherein and wherein the distal portion of said flexible central shaft is affixed to said contact member.
Claim 159
Dependent Claim
19 words
The device of claim 158 wherein the most proximal shaft guide is affixed to the cross-member of a retractor.
Claim 160
Dependent Claim
21 words
The device of claim 158 wherein said shaft guides have a predetermined curve to fix the position of said central shaft.
Claim 161
Dependent Claim
42 words
The device of claim 2 wherein said shaft means traverses the body of a retractor and is held in place by an upper plate and a lower plate wherein said upper and lower plate engage a sphere traversed by said shaft means.
Claim 162
Dependent Claim
61 words
The device of claim 2 wherein said shaft means if comprised of a curved shaft extending from a cross-arm of a retractor, wherein said curved shaft extends from said cross-arm and has a length sufficient to extend below the position of said retractor blades, and wherein the distal portion of said shaft has substantially horizontal shaft attached to said contact member.
Claim 163
Dependent Claim
51 words
The device of claim 2 wherein said shaft means is affixed to a rib locking mechanism, wherein said rib locking mechanism provides a stable support for said shaft means, and wherein said rib locking mechanism is comprised of adjustable posts engaging opposite sides of a rib proximate to a surgical incision.
Claim 164
Dependent Claim
36 words
The device of claim 163 wherein said rib locking mechanism is comprised of a post that is slidably engaged within a slot formed in said rib locking mechanism and that is positioned by a locking latch.
Claim 165
Dependent Claim
28 words
The device of claim 2 wherein said shaft means is comprised of a hollow unitary shaft wherein the bottom surface of said unitary shaft engages the beating heart.
Claim 166
Dependent Claim
19 words
The device of claim 165 wherein said hollow shaft has a lower cylindrical portion that splits into semi-cylindrical portions.
Claim 167
Dependent Claim
18 words
The device of claim 165 further comprising a plurality of openings in the body of the hollow shaft.
Claim 168
Dependent Claim
31 words
The device of claim 165 wherein a pair of said contact members are formed from the body of said hollow shaft and are rotatable away from said body by a hinge.
Claim 169
Dependent Claim
37 words
The device of claim 165 wherein said hollow shaft has an annular ring formed in the bottom portion of said hollow shaft, and wherein said annular ring rotates about a movable rod to abut a target artery.
Claim 170
Dependent Claim
27 words
The device of claim 169 wherein said annular ring has at least one passage formed in said annular ring for positioning of a target coronary artery therein.
Claim 171
Dependent Claim
20 words
The device of claim 1 wherein said means for stabilizing the beating heart is comprised of an elongated sheath member.
Claim 172
Dependent Claim
21 words
The device of claim 171 wherein said elongated sheath member has a plurality of support attachments that are air or fluid-filled.
Claim 173
Dependent Claim
17 words
The device of claim 172 wherein said support attachments have a lumen for providing air or fluid.
Claim 174
Dependent Claim
17 words
The device of claim 171 wherein said elongated sheet is affixed to a crank at either end.
Claim 175
Dependent Claim
27 words
A means for positioning the beating heart comprising a substantially flat, flexible sheet, having one side coated with a hydrogel-like material for adherence to an epicardial surface.
Claim 176
Dependent Claim
22 words
The device of claim 175 wherein said sheet is a two-sided structure having an interstitial space therebetween for perfusion of a fluid.
Claim 177
Dependent Claim
34 words
The device of claim 2 wherein said shaft means is comprised of a plurality of telescoping shafts having a distal end affixed to a contact member and a proximal end affixed to hydraulic actuator.
Claim 178
Dependent Claim
31 words
The device of claim 177 wherein each of said hydraulic actuators is attached to a retractor blade and is affixed to a hydraulic hose for remote actuation by a hand-activated switch.
Claim 179
Dependent Claim
20 words
The device of claim 2 wherein said shaft means is comprised of a plurality of arms connected by friction joints.
Claim 180
Dependent Claim
50 words
The device of claim 179 wherein said friction joints are comprised of an upper and lower housing surrounding a ball joint wherein one of said upper and lower housing has a friction surface disposed therein and the opposite housing has a friction engaging means positioned to engage the friction surface.
Claim 181
Dependent Claim
34 words
The device of claim 179 further comprising a rotatable shaft means having a central rod located within a housing and tongue forming a ratchet mechanism to fix the position of the rotatable shaft means.
Claim 182
Dependent Claim
18 words
The device of claim 181 wherein said rotatable shaft means are affixed to contact members by a hinge.
Claim 183
Dependent Claim
33 words
The device of claim 179 further comprising a locking mechanism attaching said shaft means to a retractor blade, wherein said locking mechanism is released by an internal cam shaft actuated by a handle.
Claim 184
Dependent Claim
52 words
The device of claim 2 wherein said shaft means is comprised of a flexible slide having a contractible shaft at the distal end thereof wherein said contractible shaft is attached to a contact member, and wherein said flexible slide is shaped to be inserted into a clip attached to a retractor blade.
Claim 185
Dependent Claim
16 words
The device of claim 184 further comprising hydraulic tubing containing fluid to extend said contractible shaft.
Claim 186
Independent Claim
30 words
The device of claims 1, 2, 3, 29, 35, 39, 41, 93, or 153 wherein said means for stabilizing the beating heart is disposable and contained in a sterilized package.
Claim 187
Dependent Claim
21 words
The device of claim 175 wherein said means for positioning the beating heart is disposable and contained in a sterilized package.
Claim 188
Independent Claim
35 words
The device of claims 1, 2, 3, 29, 35, 39, 41, 93, or 153 wherein said means for stabilizing the beating heat is sterilized and completely enclosed within a container that prevents contamination by microorganisms.
Claim 189
Dependent Claim
26 words
The device of claim 175 wherein said means for positioning the beating heart is sterilized and completely enclosed within a container that prevents contamination by microorganisms.
References Cited (Backward Citations)
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