# US 6,651,672 B2 · Devices for less-invasive intracardiac interventions

> Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt

- Number: US 6,651,672 B2
- Document ID: US6651672B2
- Status: Granted
- Kind: B2
- Application number: 09/941,188
- Filed: 2001-08-28
- Published: 2002-02-28
- Granted: 2003-11-25
- Earliest claimed: 1993-02-22
- Assignees: Heartport, Inc.
- Inventors: Alex T. Roth
- Web page: https://patentgrep.com/patent/US6651672B2

## CPC

- A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/0057: {Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect (sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009)}
- A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/06061: {Holders for needles or sutures, e.g. racks, stands (hand-held holding instruments A61B17/0483; holders for articles A61B50/20; racks for syringes or for hypodermic or infusion needles A61M5/008)}
- A61B 17/320016: {Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes (A61B10/0233, A61B17/29, A61B17/3207 take precedence)}
- A61B 17/3468: {for implanting or removing devices, e.g. prostheses, implants, seeds, wires (devices for implanting seeds A61M37/0069)}
- A61B 18/1482: {having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy}
- A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)}
- A61B 90/50: Supports for surgical instruments, e.g. articulated arms
- A61F 2/2427: {Devices for manipulating or deploying heart valves during implantation}
- A61M 25/1011: {Multiple balloon catheters}
- A61M 39/0247: {Transcutaneous or percutaneous access sites to the inside of the body}
- A61B 17/0467: {Instruments for cutting sutures (surgical cutting instruments A61B17/32)}
- A61B 17/2909: {Handles}
- A61B 17/3211: Surgical scalpels, knives; Accessories therefor
- A61B 17/3417: {Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating (syringe needles A61M5/32; dilators A61M29/00)}
- A61B 18/1442: {Probes having pivoting end effectors, e.g. forceps}
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61B 2017/00053: {Mapping}
- A61B 2017/00243: {cardiac}
- A61B 2017/00247: {Making holes in the wall of the heart, e.g. laser Myocardial revascularization}
- A61B 2017/00349: {Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue (A61B17/06066 takes precedence)}
- A61B 2017/00575: {for closure at remote site, e.g. closing atrial septum defects}
- A61B 2017/00579: {Barbed implements}
- A61B 2017/00592: {Elastic or resilient implements}
- A61B 2017/00597: {Implements comprising a membrane}
- A61B 2017/00606: {Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening}
- A61B 2017/00619: {Locking means for locking the implement in expanded state}
- A61B 2017/00623: {Introducing or retrieving devices therefor}
- A61B 2017/00867: {shape memory effect}
- A61B 2017/00907: {for light}
- A61B 2017/0243: {for immobilizing local areas of the heart, e.g. while it beats}
- A61B 2017/047: {having at least one proximally pointing needle located at the distal end of the instrument, e.g. for suturing trocar puncture wounds starting from inside the body}
- A61B 2017/0472: {Multiple-needled, e.g. double-needled, instruments}
- A61B 2017/0474: {Knot pushers}
- A61B 2017/0475: {using sutures having a slip knot}
- A61B 2017/2943: {Toothed members, e.g. rack and pinion}
- A61B 2017/2946: {Locking means}
- A61B 2017/306: {holding by means of suction}
- A61B 2017/3405: {using mechanical guide means}
- A61B 2017/3486: {Balloon}
- A61B 2017/3492: {against the outside of the body}
- A61B 2018/00214: {Expandable means emitting energy, e.g. by elements carried thereon}
- A61B 2018/00232: {having an irregular shape}
- A61B 2018/00261: {arranged in a line}
- A61B 2018/00291: {using suction}
- A61B 2018/00363: {Epicardium}
- A61B 2018/00392: {Transmyocardial revascularisation}
- A61B 2018/00577: {Ablation}
- A61B 2018/00898: {Alarms or notifications created in response to an abnormal condition}
- A61B 2018/00982: {combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes}
- A61B 2018/1465: {Deformable electrodes}
- A61M 2025/028: {having a mainly rigid support structure}
- A61M 2039/0273: {for introducing catheters into the body}
- A61M 2039/0279: {for introducing medical instruments into the body, e.g. endoscope, surgical tools}
- A61M 2039/0297: {at least part of it being inflatable, e.g. for anchoring, sealing or removing}
- A61M 2205/3344: Measuring or controlling pressure at the body treatment site
- A61M 2205/3355: Controlling downstream pump pressure
- A61M 2205/366: by liquid heat exchangers
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}

## Abstract

Devices, systems, and methods are provided for accessing the interior of the heart and performing procedures therein while the heart is beating. In one embodiment, a tubular access device having an inner lumen is provided for positioning through a penetration in a muscular wall of the heart, the access device having a means for sealing within the penetration to inhibit leakage of blood through the penetration. The sealing means may comprise a balloon or flange on the access device, or a suture placed in the heart wall to gather the heart tissue against the access device. An obturator is removably positionable in the inner lumen of the access device, the obturator having a cutting means at its distal end for penetrating the muscular wall of the heart. The access device is preferably positioned through an intercostal space and through the muscular wall of the heart. Elongated instruments may be introduced through the tubular access device into an interior chamber of the heart to perform procedures such as septal defect repair and electrophysiological mapping and ablation. A method of septal defect repair includes positioning a tubular access device percutaneously through an intercostal space and through a penetration in a muscular wall of the heart, passing one or more instruments through an inner lumen of the tubular access device into an interior chamber of the heart, and using the instruments to close the septal defect. Devices and methods for closing the septal defect with either sutures or with patch-type devices are disclosed.

## Claims

### Claim 1

A method of locating an existing opening in a patient's heart, comprising:
positioning a visualization scope within a sleeve;
creating a penetration in a wall of the heart;
passing a distal end of the visualization scope into the heart through the penetration;
viewing the existing opening through the visualization scope; and
positioning the sleeve into the existing opening.

### Claim 2 (depends on 1)

The method of claim 1 further comprising the steps of:
positioning the visualization scope in a sheath outside the heart such that a distal end of the visualization scope is adjacent to a transparent bulb on a distal end of the sheath; and
positioning the sheath in the heart through the sleeve;
viewing the existing opening through the transparent bulb.

### Claim 3 (depends on 1)

The method of claim 1 further comprising:
positioning a repair device through the sleeve while the sleeve is positioned through the existing opening; and
closing the existing opening with the repair device.

### Claim 4 (depends on 3)

The method of claim 3 wherein the repair device comprises a patch which is secured across the existing opening.

### Claim 5 (depends on 1)

The method of claim 1 wherein the visualization scope and the sleeve are positioned through an access cannula extending from outside the chest through the penetration.

### Claim 6 (depends on 1)

The method of claim 1 wherein the heart remains beating during each of said steps.

### Claim 7 (depends on 1)

The method of claim 1 wherein the existing opening comprises a septal defect.

### Claim 8

A method of locating an existing opening in a patient's heart, comprising:
positioning a visualization scope within a sleeve;
creating a penetration in a wall of the heart;
passing a distal end of the visualization scope into the heart through the penetration;
viewing the existing opening through the visualization scope;
positioning the sleeve in the existing opening;
positioning a repair device through the sleeve while the sleeve is positioned in the existing opening; and
closing the existing opening with the repair device, the repair device comprising a patch, by securing the patch across the existing opening.

### Claim 9

A method of locating a septal defect in a patient's heart, comprising:
positioning a visualization scope within a sleeve;
creating a penetration in a wall of the heart;
passing a distal end of the visualization scope into the heart through the penetration;
viewing the septal defect through the visualization scope; and
positioning the sleeve in the septal defect.