Abstract: A system for performing through port off-pump coronary artery bypass surgery includes a port insertable between ribs into a chest wall of a patient, a heart stabilizer extendable through and stably couplable to the port, and an instrument stabilizer adapted to dampen extraneous movement to which a surgical instrument extending through the stabilizer is subject.

Abstract: A surgical knife device includes a tubular shaft, a blade guide at the distal end of the shaft, an actuation wire extending through the shaft, a blade coupled to the distal end of the wire, and a handle which moves the wire relative to the shaft to effect extension and retraction of the blade from the guide. The blade height is substantially the same as the outer diameter of the distal end of the shaft and the blade guide to provide a large cutting surface. Movement of the blade is effected with a knob rotatably coupled to the handle and which provides fine longitudinal movement of the blade. The device is also preferably steerable such that it may be controllably articulated about a flexible distal portion of the shaft.

Abstract: A method for performing through-port off-pump beating heart coronary artery bypass surgery is provided. A port device is positioned in the chest wall and directed as necessary. A heart stabilizer is coupled to the port, and operated to apply a compressive force against the heart wall surrounding a location the required bypass such that the location is substantially immobilized. An instrument stabilizer includes a cannula which is inserted through a hole in the chest cavity, and the distal tip of the cannula is located adjacent the surgical site. The instrument stabilizer dampens movement of a surgical instrument, e.g., a scalpel or needle holder, extended therethrough. Once the bypass procedure is complete, the instruments, heart stabilizer, instrument stabilizers, and port are removed from the body of the patient.

Abstract: A heart stabilizer includes a shaft and two articulating arms coupled to a distal end of the shaft. At the end of each arm is a rotatable foot adapted to be angled relative to the heart wall contour and apply pressure against the wall of the heart to effectively eliminate motion of the heart wall between the feet. The stabilizer is adapted to provide a stabilized area sufficiently large to allow an accurate anastomosis to be performed. According to preferred aspects of the invention, the stabilizer is particularly adapted to be collapsible (foldable) to be inserted through the port device and locked longitudinally relative thereto. The stabilizer is also preferably adapted to be automatically deployed into its final configuration by release of a lock actuated at a proximal portion of stabilizer extending outside the port. In addition, the stabilizer is adapted to automatically fold when being pulled back through the port.

Abstract: A port device is insertable between the ribs of a patient and functions as an entryway for surgical instruments. The port device includes a tubular body having proximal and distal portions. The distal portion of the tubular body is coupled to a swivel adapted to be moved between a first orientation in which the swivel extends in substantially a same direction as the body, and a second orientation at an angle relative to, and preferably substantially perpendicular to, the first orientation. In the second orientation, the swivel engages the inside of the chest wall. The proximal portion of the tubular body has a clamping assembly which clamps the chest wall against the swivels to secure the port in its location. The port body can be anchored in a various angular positions.

Abstract: An instrument stabilizer minimizes unwanted motion at the distal end of a surgical instrument by applying a damping force to the instrument. According to one embodiment, the instrument stabilizer preferably includes a cannula through which an instrument can extend, and a distal bushing adapted to contact the instrument. The instrument stabilizer also includes a proximal housing which includes a mechanism which applies a stabilizing or damping force to the proximal portion of the cannula. The mechanism which applies the force may be, by way of example, one or more of elastic bands, springs, struts, etc. When a surgical instrument is extended through the cannula and contacts the bushing, movement of the cannula and consequently the surgical instrument is damped by the stabilization force on the proximal portion of the cannula. In addition, a swivel device for angularly orienting the instrument stabilizer relative to a body of patient is also provided.

Abstract: A heart stabilizer includes a shaft and two articulating arms coupled to a distal end of the shaft. At the end of each arm is a rotatable foot adapted to be angled relative to the heart wall contour and apply pressure against the wall of the heart to effectively eliminate motion of the heart wall between the feet. The stabilizer is adapted to be collapsible (foldable) to be inserted through the port device and locked longitudinally relative thereto. The stabilizer is also adapted to be deployed into an open configuration and then manipulated by actuation of a proximal control and actuation handle into a selected orientation.

Abstract: A port device includes a tubular body sized to be inserted through a pair of ribs in a chest wall of a patient, a ball provided about the body, and a base defining a socket in which the ball is provided. Detent structure permits but limits longitudinal movement of the body relative to the ball. The base includes a clamping system which compresses the ball to lock the ball at a selected orientation within the socket and also immobilizes the port body relative to the ball. The distal end of the body includes a pair of swivels rotatably attached thereto. An obturator is extendable within the body maneuvers the swivels between a closed position (in which the swivels are oriented substantially parallel to the axis of the body), and an open position (in which the swivels are directed outward from the port).

Abstract: A method for performing through-port off-pump beating heart coronary artery bypass surgery is provided. A port device is positioned in the chest wall and directed as necessary. A heart stabilizer is coupled to the port, and operated to apply a compressive force against the heart wall surrounding a location of the required bypass such that the location is substantially immobilized. An instrument stabilizer includes a cannula which is inserted through a hole in the chest cavity, and the distal tip of the cannula is located adjacent the surgical site. The instrument stabilizer dampens movement of a surgical instrument, e.g., a scalpel or needle holder, extended therethrough. Once the bypass procedure is complete, the instruments, heart stabilizer, instrument stabilizers, and port are removed from the body of the patient.

Abstract: A port device includes tubular body with a distal swivel, a platform movable along the length of the port body, and preferably three legs movable relative to the platform. The tubular body is inserted through the chest wall, and the platform is then positioned over the proximal end of the tubular body and adjusted such that feet on the legs contact the chest wall and clamp the chest wall between the feet and the swivel. The legs may be individually adjusted to provide the tubular body at a desired angle relative to the chest wall. According to preferred aspects of the port device, the platform may be ratcheted relative to the port body and the feet may be ratcheted relative to the platform to permit rapid adjustment of the port relative to the patient.

Abstract: A port device includes tubular body with a distal swivel, a platform movable along the length of the port body, and preferably three legs movable relative to the platform. The tubular body is inserted through the chest wall, and the platform is then positioned over the proximal end of the tubular body and adjusted such that feet on the legs contact the chest wall and clamp the chest wall between the feet and the swivel. The legs may be individually adjusted to provide the tubular body at a desired angle relative to the chest wall. According to preferred aspects of the port device, the platform may be ratcheted relative to the port body and the feet may be ratcheted relative to the platform to permit rapid adjustment of the port relative to the patient.

Abstract: A first catheter surrounds a guidewire, with the first catheter and guidewire each having a distal portion emplaced in the cardiovascular system of a patient. By this invention, the first catheter may be removed without displacing the guidewire. To accomplish this, one may advance an exchange catheter into the patient to a desired position where the exchange catheter completely surrounds the guidewire distal end and, in turn, is surrounded along part of its length by the first catheter. One causes a proximal end portion of the guidewire to project outwardly through a longitudinal slit of the exchange catheter, so that the proximal end of the guidewire may be grasped. By this means the guidewire may be retained in the desired position as the exchange catheter is advanced into its position within the first catheter and surrounding the guidewire. One then withdraws the first catheter from the patient, while causing the exchange catheter to be held relatively stationary.

Abstract: An intravascular catheter comprises a flexible tubular catheter body having a guidewire lumen. A pull cord extends through the catheter from a first position adjacent the proximal end of the lumen to an end position of the lumen remote from the proximal end, typically adjacent the distal end, where the pull cord is attached to the catheter body. The pull cord defines at least one loop extending about the guidewire lumen. The pull cord is longitudinally movable relative to the catheter body except where it is attached thereto. Thus, pulling the cord from the first position can cause the pull cord loop to straighten and trap a guidewire occupying the lumen, to suppress longitudinal motion of the guidewire.

Abstract: A first catheter surrounds a guidewire, with the first catheter and guidewire each having a distal portion emplaced in the cardiovascular system of a patient. By this invention, the first catheter may be removed without displacing the guidewire. To accomplish this, one may advance an exchange catheter into the patient to a desired position. The exchange catheter surrounds the guidewire and, in turn, is surrounded by the first catheter. One causes a proximal end portion of the guidewire to project outwardly through a longitudinal slit of the exchange catheter, so that the proximal end of the guidewire may be grasped. By this means the guidewire may be retained in the desired position as the exchange catheter is advanced into its position within the first catheter and surrounding the guidewire. One then withdraws the first catheter from the patient, while causing the exchange catheter to be held relatively stationary.

Abstract: An intravascular catheter comprises a proximal portion and a distal portion. The proximal portion has greater torsional stiffness than the distal portion, while the distal portion has greater dependability than the proximal portion. In accordance with this invention the distal portion carries a helical wire support member embedded therein, the helical support member being essentially free of crossing wires, to provide kink-resistance upon bending to the distal portion.

Abstract: A flexible plastic catheter defines a flexible, distal tip. In accordance with this invention, the distal tip comprises a plastic formulation containing sufficient radiopaque agent to be substantially more radiopaque and preferably softer than portions of the catheter proximal to the tip. Thus, the distal tip area of the catheter can be flexible to avoid possible tissue damage as the catheter is advanced, but is still readily visible by x-ray. At the same time, the majority of the catheter may be of normal flexibility and strength.

Abstract: A flexible plastic catheter defines a flexible, distal tip. In accordance with this invention, the distal tip comprises a plastic formulation containing sufficient radiopaque agent to be substantially more radiopaque and preferably softer than portions of the catheter proximal to the tip. Thus, the distal tip area of the catheter can be flexible to avoid possible tissue damage as the catheter is advanced, but is still readily visible by x-ray. At the same time, the majority of the catheter may be of normal flexibility and strength.