Methods for performing heart surgery

A method for forming an anastomosis between a mammary artery and a coronary artery of a patient, said method comprising the steps of:

• positioning at least one access device between two ribs in a patient's chest thereby forming a percutaneous penetration;
• cutting the mammary artery using a tool introduced through the access device thereby forming an end;
• creating an opening in an artery;
• endovascularly advancing a catheter having an occluding member through the opening to a location within the ascending aorta between the brachiocephalic artery and the coronary ostia;
• expanding the occluding member at the location to occlude the patient's ascending aorta;
• establishing cardiopulmonary bypass by removing blood through a first catheter lumen positioned in a vein, oxygenating the blood, and returning the blood downstream of said location through a second catheter lumen positioned in an artery;
• stopping heart contraction by introducing a cardioplegic agent to the patient's heart through the catheter;
• forming an incision in the coronary artery using a cutting tool while the heart is stopped;
• connecting the end of the internal mammary artery to the incision in the coronary artery;
• and
• viewing the mammary artery through a viewing device placed in a percutaneous penetration during at least one of the cutting, forming and connecting steps.

A method of less-invasive cardiac surgical intervention, the method comprising:

• forming at least one percutaneous penetration in the patient's chest;
• creating an opening in an artery;
• positioning a distal end of an occlusion device through the opening to a location within the ascending aorta;
• expanding an occluding element on the occlusion device at said location to inhibit the flow of blood and other fluids past said location;
• maintaining circulation of blood in the patient's arterial system downstream of the occluding element by removing blood through a first catheter lumen positioned in a vein, oxygenating the blood, and returning the blood downstream of said location through a second catheter lumen positioned in an artery;
• stopping heart contractions by introducing a cardioplegic agent to the patient's heart;
• positioning a device for viewing the heart in one of the at least one percutaneous penetrations;
• viewing the heart through the device;
• and
• performing a surgical procedure on the stopped heart using tools introduced through one of the at least one percutaneous penetrations.