Through-port heart stabilization system
DC
First Claim
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1. A heart stabilization device, comprising:
- a) a shaft having a proximal end provided with a handle, a distal end, and defining a longitudinal axis; and
b) a pair of stabilization arm assemblies at said distal end of said shaft, each of said stabilization arms provided with a substantially rigid foot having a contact surface which is adapted to contact a surface of the heart, said feet having a first configuration in which said feet extend substantially parallel to said longitudinal axis and are substantially in contact with each other, and a second configuration in which feet extend substantially parallel to said longitudinal axis and are displaced relative to each other; and
c) an actuator adapted to move said feet between said first and second configurations.
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Abstract
A heart stabilizer includes a shaft and two articulating arms coupled to a distal end of the shaft. At the end of each arm is a rotatable foot adapted to be angled relative to the heart wall contour and apply pressure against the wall of the heart to effectively eliminate motion of the heart wall between the feet. The stabilizer is adapted to be collapsible (foldable) to be inserted through the port device and locked longitudinally relative thereto. The stabilizer is also adapted to be deployed into an open configuration and then manipulated by actuation of a proximal control and actuation handle into a selected orientation.
136 Citations
43 Claims
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1. A heart stabilization device, comprising:
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a) a shaft having a proximal end provided with a handle, a distal end, and defining a longitudinal axis; and
b) a pair of stabilization arm assemblies at said distal end of said shaft, each of said stabilization arms provided with a substantially rigid foot having a contact surface which is adapted to contact a surface of the heart, said feet having a first configuration in which said feet extend substantially parallel to said longitudinal axis and are substantially in contact with each other, and a second configuration in which feet extend substantially parallel to said longitudinal axis and are displaced relative to each other; and
c) an actuator adapted to move said feet between said first and second configurations. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23)
e) a controller adapted to move said feet into a third configuration in which said feet extend substantially parallel to each other and are angled relative to said longitudinal axis of said shaft.
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3. A heart stabilization device according to claim 2, further comprising:
f) a lock which locks said feet in at least one of said second configuration and said third configurations.
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4. A heart stabilization device according to claim 3, wherein:
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said shaft includes a tubular outer member and an inner member longitudinally movable within said outer member, said outer member including a distal closer and said inner member including a distal clevis in which said arm assemblies are coupled, wherein said means for locking moves said inner member longitudinally relative to said outer member such that said clevis is compressed within said closer.
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5. A heart stabilization device according to claim 1, wherein:
said controller includes a joystick in said handle, and cables extending from said stabilization arms to said joystick.
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6. A heart stabilization device according to claim 1, wherein:
said joystick is rotatable about two axes.
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7. A heart stabilization device according to claim 1, wherein:
said contact surfaces are in contact with each other when said feet are in said first configuration.
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8. A heart stabilization device according to claim 7, wherein:
each said contact surface has a plurality of spikes and defines a plurality of holes, wherein when said contact surfaces are in contact with each other, said plurality of spikes of a first of said feet enter said plurality of holes of a second of said feet, and said plurality of spikes of said second of said feet enter said plurality of holes of said first of said feet.
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9. A heart stabilization device according to claim 1, wherein:
each said contact surface has a plurality of spikes and defines a plurality of holes, wherein when said feet are in said first configuration said contact surfaces are in contact with each other, said plurality of spikes of a first of said feet enter said plurality of holes of a second of said feet, and said plurality of spikes of said second of said feet enter said plurality of holes of said first of said feet.
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10. A heart stabilization device according to claim 1, wherein:
each said arm assembly includes an upper arm, a lower arm rotatable relative to said upper arm, a wrist rotatable about said lower arm, and said foot fixedly coupled to said wrist.
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11. A heart stabilization device according to claim 10, wherein:
each said upper arm is rotatable about three axes.
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12. A heart stabilization device according to claim 11, wherein:
first and second axes of said three axes about which each of said two upper arms rotate extend perpendicular to and through said longitudinal axis of said shaft, and a third axis of said three axes extends perpendicular to, but not through said longitudinal axis of said shaft.
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13. A heart stabilization device according to claim 12, wherein:
for each arm assembly, said lower arm rotates relative to said upper arm about a fourth axis parallel to said first and second axes of said three axes.
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14. A heart stabilization device according to claim 12, wherein:
said wrist rotates relative to said lower arm about a fifth axis which is perpendicular to each of first, second and third axes.
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15. A heart stabilization device according to claim 10, wherein:
one of said two upper arms is rotatable about an axis which is not coaxial with any of said axes about which said other of said two upper arms is rotatable.
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16. A heart stabilization device according to claim 10, wherein:
each said arm assembly includes a spring which urges said lower arm to rotate relative to its respective said upper arm.
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17. A heart stabilization device according to claim 10, wherein:
each said arm assembly includes a spring which urges each said wrist to rotate relative to its respective said lower arm.
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18. A heart stabilization device according to claim 10, further comprising:
interengaging slides which couple said arm assemblies together.
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19. A heart stabilization device according to claim 18, further comprising:
a resilient member which urges said arm assemblies toward each other at or adjacent said interengaging slides.
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20. A heart stabilization device according to claim 1, wherein:
each of said feet includes holds for suture or vessel loops.
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21. A heart stabilization device according to claim 1, wherein:
each of said feet includes a medial scalloped portion.
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22. A heart stabilization device according to claim 1, further comprising:
e) means for coupling said shaft to a port.
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23. A heart stabilization device according to claim 22, wherein:
said means for coupling is adapted to permit said shaft to be angled relative to a longitudinal axis through said port.
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24. A heart stabilization device, comprising:
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a) a single shaft having a proximal end provided with a handle, a distal end, and defining a longitudinal axis; and
b) a pair of stabilization arm assemblies at said distal end of said single shaft, each of said stabilization arms provided with a foot having a contact surface which is adapted to contact a surface of the heart;
c) a controller which moves said arm assemblies and said feet into selected configurations; and
d) a lock which locks said arm assemblies and said feet in a selected configuration. - View Dependent Claims (25, 26, 27, 28, 29, 30, 31, 32, 33)
said contact surfaces of said feet are substantially parallel to each other in each of said selected configurations.
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26. A heart stabilization device according to claim 24, wherein:
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said shaft includes a tubular outer member and an inner member longitudinally movable within said outer member, said outer member including a distal closing element and said inner member including a distal clevis in which said arm assemblies are coupled, wherein said lock moves said inner member longitudinally relative to said outer member such that said clevis is compressed within said closing element and immobilizes said arm assemblies.
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27. A heart stabilization device according to claim 26, wherein:
said inner member is coupled at its proximal end to a yoke, and a first cam is provided relative to said yoke such that operation of said cam moves said yoke to cause said inner member to move relative to said outer member.
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28. A heart stabilization device according to claim 27, wherein:
said first cam is coupled to a lever provided on said handle, wherein rotation of said lever causes movement of said first cam.
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29. A heart stabilization device according to claim 24, wherein:
said controller includes a joystick movable relative to said handle, and cables extending from said joystick to said arm assemblies.
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30. A heart stabilization device according to claim 29, wherein:
said joystick is rotatable about two perpendicular axes.
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31. A heart stabilization device according to claim 29, wherein:
said first cam is rotatably coupled to a second cam means for moving said joystick longitudinally in said handle, wherein longitudinal movement of said joystick in a proximal direction places sufficient tension on said cables to move and maintain said arm assemblies in an open configuration.
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32. A heart stabilization device according to claim 24, further comprising:
e) means for coupling said shaft to a port.
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33. A heart stabilization device according to claim 32, wherein:
said means for coupling is adapted to permit said shaft to be angled relative to a longitudinal axis through said port.
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34. A heart stabilization device, comprising:
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a) a shaft having a proximal end provided with a handle, a distal end, and defining a longitudinal axis;
b) a first and second stabilization arms at said distal end of said shaft, said first and second arms including resilient biasing means to urge said first and second arms together in an outstretched configuration in which portions of said arms are in contact;
c) a control element coupled to said handle; and
d) a first cable extending from said first arm to said control element and a second cable extending from said second arm to said control element, wherein operation of said control element causes tensioning of said first and second cables such that said arms are moved from said outstretched configuration to a second configuration in which said arms are spaced apart. - View Dependent Claims (35, 36)
e) a lock which locks said arm assemblies in said second configuration.
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36. A heart stabilization device according to claim 34, wherein:
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said first and second stabilization arms are rotatable relative to said distal end of said shaft, and said control element is adapted to tension said first cable more than said second cable, such that when said control element tensions said first cable more than said second cable, said first and second arms are rotated relative to said shaft.
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37. A heart stabilization device, comprising:
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a) a shaft having a proximal end, a distal end, and defining a longitudinal axis; and
b) a pair of stabilization arm assemblies at said distal end of said shaft, each of said stabilization arms provided with an upper arm rotatable relative to said distal end of said shaft in a first plane, and a lower arm rotatable relative to said upper arm in a second plane different than said first plane. - View Dependent Claims (38, 39)
c) a controller which manipulates rotation of said upper arms in said first plane.
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39. A heart stabilization device according to claim 38, wherein:
said controller moves said first plane out of plane with said longitudinal axis.
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40. A heart stabilization device, comprising:
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a) a shaft having a proximal end, a distal end, and defining a longitudinal axis;
b) a pair of stabilization arm assemblies at said distal end of said shaft, each of said stabilization arms provided with a foot having a contact surface which is adapted to contact a surface of the heart; and
c) means for coupling said shaft to a port adapted to be coupled directly to a human body, wherein said means for coupling is adapted to permit said shaft to be angled relative to a longitudinal axis through said port. - View Dependent Claims (41, 42, 43)
said means for coupling includes a housing defining a socket, a slit ball collet through which said shaft extends and which is rotatable within said socket, and a clamp which compresses said collet to substantially lock said shaft within said collet.
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42. A heart stabilization device according to claim 40, wherein:
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said means for coupling further includes, i) a slotted tubular portion, ii) a bushing having a proximal portion with a first diameter, and a relatively distal portion with a second diameter greater than said first diameter, and iii) means for moving said bushing relative to said slotted tubular portion such that said portion of said bushing with said second diameter moves under said slotted tubular portion and increases an exterior diameter of said slotted tubular portion.
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43. A heart stabilization device according to claim 40, wherein:
said feet have a first configuration in which said feet extend substantially parallel to said longitudinal axis and are substantially in contact with each other, and a second configuration in which feet extend substantially parallel to said longitudinal axis and are displaced relative to each other.
Specification
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Litigation Data
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Current AssigneeMedici Life Sciences Licensing Company LLC (The Medici Portfolio LLC)
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Original AssigneePopcab, LLC
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InventorsCastaneda, Javier E., Francese, Jose Luis, Palmer, Matthew A., de la Torre, Ralph
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Primary Examiner(s)Dvorak, Linda C. M.
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Assistant Examiner(s)RAM, JOCELYN DEBRA
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Application NumberUS09/893,099Publication NumberTime in Patent Office748 DaysField of Search600/201, 600/208, 600/215, 600/210, 600/235, 606/1, 606/108, 604/513, 604/533, 604/539, 604/174, 604/164.04US Class Current606/1CPC Class CodesA61B 17/3417 Details of tips or shafts, ...A61B 17/3421 CannulasA61B 17/3462 with means for changing the...A61B 2017/00243 cardiacA61B 2017/00703 correcting for movement of ...A61B 2017/0243 for immobilizing local area...A61B 2017/3405 using mechanical guide meansA61B 2017/3484 Anchoring means, e.g. sprea...A61B 2017/3492 against the outside of the ...
