Devices and methods for intracardiac procedures

A percutaneous access cannula to facilitate closed-chest replacement of a heart valve in a patient's heart, the access cannula comprising:

• a cannula body configured for placement in an intercostal space in the patient's chest, the cannula body having a distal end, a proximal end, and a lumen extending therebetween, the lumen being configured to allow passage of a replacement valve therethrough;
• and
• an obturator positionable in the lumen, the obturator having a cross-sectional width less than the width of the intercostal space and a cross-sectional height greater than the cross-sectional width.

A cannula system to facilitate surgical intervention in a patient's body cavity, the cannula system comprising:

• a cannula body having a distal end, a proximal end, and a lumen therebetween, the lumen being configured for introduction of surgical instruments therethrough;
• and
• organizer means at the proximal end of the cannula body for retaining a plurality of sutures extending through the lumen from the body cavity in spaced apart positions outside of the body cavity.

A thoracoscopic device for placement of a replacement valve in a valve position of a patient's heart, the thoracoscopic device comprising:

• an elongated handle having a distal end and a proximal end, the handle configured for positioning through an intercostal space in the patient's chest, and
• means at the distal end of the handle for releasably holding a replacement valve in an orientation for introduction through the intercostal space.

A prosthesis assembly for closed-chest replacement of a heart valve, the prosthesis assembly comprising:

• replacement valve having an annular attachment portion and a movable valve portion coupled to the attachment portion;
• and
• holder means releasably mounted to the attachment portion, wherein the holder means is configured to allow introduction of the replacement valve through an intercostal space in the patient's chest.