Device to permit offpump beating heart coronary bypass surgery

A heart manipulation system for use in cardiac surgery comprising:

• a frame that is located inside a patient during beating heart surgery and which includes means for engaging the pericardial cavity of the patient for mounting said frame on the patient to move with the patient if the patient is moved or reoriented during surgery;
• a source of suction;
• a suspension head movably mounted on said frame for lifting the heart and which is located near the apical region of the right ventricle to prevent collapse of the right ventricle during manipulation of the heart and at least partially overlying the right ventricle and which includes a flexible means for permitting multiplanar relative movement between the beating heart and means mounting the suspension head on said frame means, said suspension head including a suction cup connected to the source of suction and which includes a flexible rim engaging the myocardium of the heart and being flexible in a plurality of planes so multiplanar movement of the myocardium during operation of the heart will be accommodated by said flexible rim whereby suction applied to the myocardium by said suction cup will not be broken by separation of the myocardium from the suction cup, said suction cup further including mesh grid means for preventing heart tissue from interfering with suction being applied to the myocardium via said suction cup;
• a means for locally engaging a selected section of the heart and locally immobilizing the heart adjacent to a surgery target so the heart is supported and free to operate during surgery while it is also locally immobilized at the surgery target with non-engaged sections of the heart free to move in a manner whereby essentially unabated cardiac output is maintained while the heart is locally immobilized, and further including a suction cup connected to the source of suction and which includes a flexible rim engaging the myocardium of the heart and being flexible in a plurality of planes so multiplanar movement of the myocardium during operation of the heart will be accommodated by the flexible rim of said means for locally engaging a selected section of the heart whereby suction applied to the myocardium by the suction cup of said means for locally engaging a selected section of the heart will not be broken by separation of the myocardium from the suction cup of said means for locally engaging a selected section of the heart, said suction cup of said means for locally engaging a selected section of the heart further including mesh grid means for preventing heart tissue from interfering with suction being applied to the myocardium via said suction cup of said means for locally engaging a selected section of the heart;
• and
• a gross support means movably mounted on said frame for engaging the heart to support the heart when the heart is oriented for surgery and which is located at the base of the heart and which cradles the myocardium of the left ventricle along the arterial ventricular groove and which includes means for movably connecting said gross support means to said frame, the gross support means supporting the mitral valve annulus to maintain competent mitral valve function and is placed beneath an infolded section of myocardium, said gross support means including a handle which extends outside of the patient during surgery for adjusting the location of said gross support means, and further including a head having a malleable rod means for connecting said head to said means for mounting said gross support means on said frame, said head including a plurality of sections which are movable relative to each other and means for maintaining said sections in a selected relative orientation, said head further including a means for applying suction from said source of suction to the heart and which includes mesh grid means for preventing heart tissue from interfering with suction applied by said suspension head to the heart.

A heart manipulation system for use in cardiac surgery comprising:

• a frame which is located inside a patient during beating heart surgery and which is mounted on the patient to move with the patient;
• a suspension head mounted on said frame for lifting the beating heart and which includes a flexible head, said flexible head including a flexible rim, said flexible rim being flexible in a plurality of planes to accommodate multiplanar movement of the surface of the beating heart without breaking contact between the surface of the heart and the flexible rim, and means for accommodating multiplanar movement of the beating heart during beating heart surgery;
• and
• means for engaging a selected section of the heart to immobilize that selected section as a surgery target while permitting non-engaged sections of the heart to move in a manner whereby essentially unabated cardiac output is maintained while the heart is locally immobilized.

A method of performing heart surgery comprising steps of:

• slightly infolding the left atrium of a heart adjacent to the base of the heart;
• engaging the heart under the edge of the myocardium at the base of the heart to tilt and lift the heart;
• and
• engaging the heart near the apex of the heart to lift the heart and preventing right ventricle collapse.

A manipulation system for use in cardiac surgery comprising:

• a gross support means for engaging and supporting a beating heart when the heart is located and oriented for surgery and which is located at the base of the heart and engages the beating heart at a location that supports the mitral valve annulus and which includes a flexible head which is sized and shaped to extend along the arterial ventricular groove of the heart;
• means for immobilizing the heart adjacent to a surgery target so the heart is supported and free to operate during surgery while it is also locally immobilized at the surgery target;
• and
• a suspension head for lifting the heart and which is located near the apex of the heart and which includes a flexible head.

A manipulation system for use in minimally invasive cardiac surgery comprising:

• a gross support means for engaging and supporting a beating heart when the heart is located and oriented for surgery and which is located so mitral valve operation of the beating heart is not interrupted;
• means for immobilizing the heart adjacent to a surgery target so the heart is supported and free to operate during surgery while it is also locally immobilized at the surgery target;
• and
• a suspension head for lifting the beating heart and which is located near the apex of the heart.

A method for manipulating a heart during cardiac surgery comprising:

• engaging the heart near the apical region of the right ventricle and preventing collapse of the right ventricle;
• lifting the heart into a position and orientation for surgery using the engagement near the apical region;
• and
• maintaining engagement of the heart while the heart and its myocardium move during essentially unabated operation of the heart.