Surgery – Instruments – Cutting – puncturing or piercing
Patent
1996-08-22
1998-03-10
Buiz, Michael
Surgery
Instruments
Cutting, puncturing or piercing
128898, A61F 1700
Patent
active
057255440
DESCRIPTION:
BRIEF SUMMARY
TECHNICAL FIELD
The present invention relates to a method for locating an arterial constriction and performing an arteriotomy distally thereof, especially with a view to establishing a connection between the root of the aorta and a selected part of a coronary artery, such as set forth in the preamble of claim 1.
BACKGROUND ART
Modern heart surgery was developed fundamentally in the nineteen-fifties together with the extra-corporeal circulation, based on the use of the heart-and-lung machine, making it possible to replace heart valves and to correct certain congenital heart disorders; this as a whole was designated "open heart surgery", as the heart itself, its ventricles and internal functional parts were opened during the operation.
As a natural extension of this method, the coronary bypass surgery emerged in the mid-sixties, also based on the use of the same per-operative technology, viz. the heart-and-lung machine. In this case the surgeon, although not having to operate within the heart itself, needed peace to work in the operating field, i.e. the "coronary tree", the heart's own circulatory system, substantially embedded in the surface of the heart in the form of two main stems--right and left--gradually branching out down along the heart, finally to end deep below the surface in the form of the end-arterial branches of the heart musculature.
Thus, the techniques already established by the use of the heart-and-lung machine was taken over directly, although the coronary bypass operation could not be categorized as "open heart surgery", but rather as "closed heart surgery"--simply to have peace and quiet in the operating field.
The use of the heart-and-lung machine involves a trauma to the heart itself, and more or less serious complications will often appear post-operatively, during intensive care as well as later; thus, in short, a so-called post-perfusion syndrome has been described.
DISCLOSURE OF THE INVENTION
It is the object of the present invention to provide a method of the kind referred to above, with which it is possible to perform the initial steps of a coronary bypass connection safely, quickly and accurately and without having to use extra-corporeal circulation, and this object is achieved with a method of said kind, which according to the present invention comprises the steps set forth in the characterizing clause of claim 1. By proceeding in this manner, the initial steps of the coronary bypass operation, comprising locating the constriction and performing the arteriotomy needed for the subsequent anastomosis, may be performed on the beating heart.
The invention also relates to an instrument for carrying out the method referred to above, and according to the invention this instrument comprises the features set forth in the characterizing clause of claim 4.
Advantageous embodiments of the method and instrument, the effects of which are explained in more detail in the following detailed portion of the present description, are set forth in claims 2, 3 and 5, respectively.
BRIEF DESCRIPTION OF THE DRAWINGS
In the following detailed portion of the present description, the invention will be explained in more detail with reference to the drawings, in which
FIG. 1 is a simplified perspective view of a sensing and incising instrument with its sensing means placed in contact with a coronary artery and the surrounding surface of the heart,
FIG. 2 shows a first face on the instrument of FIG. 1, comprising said sensing means,
FIG. 3 is a sectional view along the line III--III in FIG. 2,
FIG. 4 at a greatly enlarged scale and in longitudinal section shows an anastomotic instrument prepared for carrying out an end-to-side anastomosis in an incision in the coronary artery made by the sensing and incising instrument shown in FIG. 1,
FIG. 5 is a simplified bottom view of certain parts of the instrument shown in FIG. 4,
FIG. 6 is a set of contour curves illustrating the shape of a part of the instrument shown in FIG. 4,
FIGS. 7-10 show the "front end" of the instrument shown in FIG. 4 during vario
REFERENCES:
patent: 5119983 (1992-06-01), Green et al.
patent: 5158222 (1992-10-01), Green et al.
patent: 5254120 (1993-10-01), Cinberg et al.
patent: 5285944 (1994-02-01), Green et al.
Buiz Michael
Oticon A/S
Truong Kevin
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