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Compositions, apparatus and methods for facilitating surgical procedures

Assignee: Duke University
•
Filing: 1999-08-23
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Granted: 2000-07-11
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Expires: 2019-08-23
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Abstract

Abstract Methods are provided for conducting surgical procedures in a patient wherein, during the surgical procedure, autonomous ventricular electrical conductivity and escape beats are reversibly and transiently suppressed to facilitate the surgical procedure. Also provided are compositions which are capable of inducing ventricular asystole in a patient. The compositions may include an AV node blocker. In one embodiment, compositions including an atrioventricular (AV) node blocker and a beta -blocker are provided, wherein the beta -blocker is present in an amount sufficient to substantially reduce the amount of AV node blocker required to induce ventricular asystole in the patient. The compositions and methods may be used for inducing temporary ventricular asystole in a beating heart, and to facilitate the performance of a variety of surgical techniques, including minimally invasive microsurgical techniques. Methods for performing a surgical procedure on a human patient are provided wherein a composition capable of inducing transient reversible ventricular asystole is administered to the heart, for example by intracoronary injection. The heart then is electrically paced using an electrical pacing system, thereby to maintain the patient's blood circulation. The electrical pacing then is selectively intermittently stopped to allow ventricular asystole to occur, and the steps of the surgical or therapeutic procedure, such as suturing, are conducted during the time that the electrical pacing is intermittently stopped. The methods and compositions advantageously may be used in a range of different surgical procedures including cardiac, vascular and neurosurgical procedures.

Inventors

  • 👤 Francis G. Duhaylongsod

Bibliographic Details

Application Number —
Jurisdiction US
Data Source google_patents
Last Synchronized 2026-10-25 15:31
CPC Classifications
A; A61; A61K; A61K31/00; A61K31/21; A61K31/27; A61K31/215; A61K31/22; A61K31/33; A61K31/395; A61K31/435; A61K31/44; A61K31/445; A61K45/00; A61K45/06; A61P; A61P9/00; A61P9/04; A61M; A61M2210/00; A61M2210/12; A61M2210/125

Claims Analysis

Total Claims: 23
Claim 1
Independent Claim 70 words
A method for conducting a surgical procedure on a human patient comprising: placing at least a portion of a delivery device in a coronary vessel of the heart of the patient; delivering an AV node blocker to the AV node of the patient via the coronary vessel with the device; and inducing transient reversible ventricular asystole in the heart, while maintaining the ability of the heart to be electrically paced.
Claim 2
Independent Claim 70 words
A method for conducting a surgical procedure on a human patient comprising: placing at least a portion of a delivery device in a coronary vessel of the heart of the patient; delivering an AV node blocker to the AV node of the patient via the coronary vessel with the device; and inducing transient reversible ventricular asystole in the heart, while maintaining the ability of the heart to be electrically paced.
Claim 3
Dependent Claim 13 words
The method of claim 1 including selecting a catheter as the delivery device.
Claim 4
Dependent Claim 21 words
The method of claim 1 wherein the device is placed in the right coronary artery of the heart of the patient.
Claim 5
Dependent Claim 21 words
The method of claim 1 wherein the device is placed in the left coronary artery of the heart of the patient.
Claim 6
Dependent Claim 35 words
The method of claim 1 wherein the device includes an outlet and the outlet is placed in the right coronary artery of the heart of the patient and immediately proximal to the AV node artery.
Claim 7
Dependent Claim 21 words
The method of claim 1 wherein the device includes an outlet and the outlet is placed in the AV node artery.
Claim 8
Dependent Claim 21 words
The method of claim 1 wherein the device is placed in the middle cardiac vein of the heart of the patient.
Claim 9
Dependent Claim 26 words
The method of claim 1 wherein the device is placed into an ostium of a right or left coronary artery of the heart of the patient.
Claim 10
Dependent Claim 14 words
The method of claim 1 further including introducing the device through the femoral artery.
Claim 11
Dependent Claim 19 words
The method of claim 1 further including introducing the device through an incision in the aorta of the patient.
Claim 12
Dependent Claim 13 words
The method of claim 1, further comprising administering a beta-blocker to the heart.
Claim 13
Dependent Claim 16 words
The method of claim 11, wherein the beta-blocker is administered prior to the AV node blocker.
Claim 14
Dependent Claim 10 words
The method of claim 11, wherein the beta-blocker is propranolol.
Claim 15
Dependent Claim 13 words
The method of claim 11, wherein the beta-blocker is administered with said device.
Claim 16
Dependent Claim 14 words
The method of claim 1, wherein the AV node blocker is a cholinergic agent.
Claim 17
Dependent Claim 12 words
The method of claim 1, wherein the AV node blocker is carbachol.
Claim 18
Dependent Claim 14 words
The method of claim 1, wherein said procedure is a coronary artery bypass procedure.
Claim 19
Dependent Claim 16 words
The method of claim 1, wherein delivery of the AV node blocker is by needle injection.
Claim 20
Independent Claim 47 words
A method for conducting a surgical procedure on a human patient comprising delivering an AV node blocker to a coronary vessel of the patient by needle injection, and inducing transient reversible ventricular asystole in the heart, while maintaining the ability of the heart to be electrically paced.
Claim 21
Independent Claim 47 words
A method for conducting a surgical procedure on a human patient comprising delivering an AV node blocker to a coronary vessel of the patient by needle injection, and inducing transient reversible ventricular asystole in the heart, while maintaining the ability of the heart to be electrically paced.
Claim 22
Dependent Claim 11 words
The method of claim 1, further comprising electrically pacing the heart.
Claim 23
Dependent Claim 17 words
The method of claim 20, further comprising selectively, intermittently stopping the pacing to allow for ventricular asytole.

USPTO Annuity & Maintenance Windows

Annuity Stage Window Opens Payment Deadline Surcharge Period Until Estimated Fee Status
3.5 Years (Year 4) 2003-07-11 2004-01-10 2004-07-11 $2000.00 Window Closed / Lapsed
7.5 Years (Year 8) 2007-07-11 2008-01-10 2008-07-11 $3760.00 Window Closed / Lapsed
11.5 Years (Year 12) 2011-07-11 2012-01-10 2012-07-11 $7700.00 Window Closed / Lapsed

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