Abstract: A suture for use in cardiac valve repair comprises a flexible rod of ePTFE (expanded polytetrafluoroethylene) formed with end sections of a first diameter and a center section of a second diameter, the second diameter being greater than the first diameter, and the end sections having a length sufficient to enable one to be fastened to the other. In one embodiment, the first diameter is about 1-1.6 mm and the second diameter is between about 1.8-4 mm. The center section can be about 2-9 cm in length. Surgical needles are preferably provided attached to the distal ends of the end sections. The center section has a density less than the end sections, the density of the center section being chosen to promote tissue ingrowth following implantation in heart tissue. Representative density range for the center section is 0.25-0.35 g/cm3.

Abstract: A band forming apparatus for banding an internal body part and method of using same. The band forming apparatus is initially supplied as a relatively straight structure so that it can be, for example, inserted through a catheter or narrow incision such as when using endoscopic or robotic surgery techniques. Alternatively, the band forming apparatus may be used or inserted using conventional surgical techniques. In use, the initially straight assembly can be formed into a loop or band around an internal body part. Embodiments of the band forming apparatus include a compressible tube having first and second tube ends and an orifice in the tube wall between the first and second tube ends. A string is received in the tube, the string having a first end extending out of the first end of the tube and a second end extending out of the orifice. Alternatively the second string end may extend out of the second tube end.

Abstract: A surgical thoracic retractor has retraction members that grip the anterior and posterior surfaces of the ribs between vice-like jaws to prevent a crushing or other force being applied to the intercostal nerves, thus minimizing the patient's post-operative pain.

Abstract: A suture retainer for use with a surgical instrument comprises a slot defined in the surgical instrument, the slot having a bottom and lateral slot ends. A retainer block comprises a bottom and lateral block ends. The lateral block ends and the lateral slot ends are configured to matingly engage to define a v-shaped gap adjacent a lateral slot end near a mouth of the slot.

Abstract: A band forming apparatus for banding an internal body part and method of using same. The band forming apparatus is initially supplied as a relatively straight structure so that it can be, for example, inserted through a catheter or narrow incision such as when using endoscopic or robotic surgery techniques. Alternatively, the band forming apparatus may be used or inserted using conventional surgical techniques. In use, the initially straight assembly can be formed into a loop or band around an internal body part. Embodiments of the band forming apparatus include a compressible tube having first and second tube ends and an orifice in the tube wall between the first and second tube ends. A string is received in the tube, the string having a first end extending out of the first end of the tube and a second end extending out of the orifice. Alternatively the second string end may extend out of the second tube end.

Abstract: An apparatus implantable in a heart ventricle includes a frame configured to engage an inner circumferential periphery of the ventricle and to expand and contract between an expanded state corresponding to a desired end diastolic diameter of the ventricle and a contracted state corresponding to a desired end systolic diameter of the ventricle. A bistable structure is operatively associated with the frame. The bistable structure mechanically assists movement of the ventricle toward both an end systolic diameter during systole and an end diastolic diameter during diastole. The bistable structure may be integrally formed of the frame. A method of implanting the apparatus in a heart ventricle includes surgically accessing a ventricle, inserting the apparatus in the ventricle and attaching the device to a portion of myocardium defining an inner circumferential periphery of the ventricle.

Abstract: An annuloplasty ring holder including a head having an upper surface and an annuloplasty ring receiving surface facing opposite the upper surface. The annuloplasty ring holder also includes means for attaching an annuloplasty ring to the annuloplasty ring receiving surface. The means for attaching an annuloplasty ring to the annuloplasty ring receiving surface may include one or more suture guides operatively associated with the head and configured to position one or more sutures to removably associate an annuloplasty ring with the annuloplasty ring receiving surface. The head may include a central hub and more than one spoke radiating out from the central hub. If the head is thus configured, each spoke will include a portion of the annuloplasty ring receiving surface.

Abstract: An annuloplasty ring comprising an elongate tube of suturable material formed into a ring. A stiffener configured to prevent axial compression and radial deformation of the ring is received in the tube in a first circumferential segment of the ring. An axial support configured to prevent axial compression of the ring and to permit radial deformation of the ring is received in the tube in a second circumferential segment of the ring. The first circumferential segment of the ring may correspond to a posterior portion of a mitral valve annulus with the first circumferential portion configured to extend between the right and the left fibrous trigones of the mitral valve annulus upon installation. The second circumferential segment of the ring may correspond to an anterior portion of a mitral valve annulus and the second circumferential segment is configured to extend between the right and left fibrous trigones of the mitral valve annulus upon installation.

Abstract: An annuloplasty ring holder including a head having an upper surface and an annuloplasty ring receiving surface facing opposite the upper surface. The annuloplasty ring holder also includes means for attaching an annuloplasty ring to the annuloplasty ring receiving surface. The means for attaching an annuloplasty ring to the annuloplasty ring receiving surface may include one or more suture guides operatively associated with the head and configured to position one or more sutures to removably associate an annuloplasty ring with the annuloplasty ring receiving surface. The head may include a central hub and more than one spoke radiating out from the central hub. If the head is thus configured, each spoke will include a portion of the annuloplasty ring receiving surface.

Abstract: An epicardial stabilizer foot comprises a frame configured to reside adjacent to a target portion of a beating heart and a number of self-retaining flexible suction cups attached to the frame for adhering the frame to the surface of the beating heart adjacent the target portion. The frame may be configured to partially surround the target portion with the associated suction cups surrounding the target portion as well. A method for stabilizing a target portion of a beating heart comprises pressing the suction cups of the suction cup stabilizer foot adjacent the target portion of a beating heart to form a partial vacuum attachment therebetween and fixing the position of the frame to prevent motion of the frame relative to the beating heart.

Abstract: A cardiac apical suction device (CASD) for supporting an apical region of a beating heart during off-pump, beating heart surgery. The apparatus consists of an outer frame configured to fit over the apical region of the heart having a flexible inner member. The inner member has an inner surface defining a cavity of select volume sized to receive the apical region of a heart. The inner member further has a peripheral lip sized to make sealing engagement along a contour of the surface of the heart. The inner member and outer frame are connected by an actuation member operative to selectively increasing the volume of the inner cavity. The CASD may be placed over the apical region of a heart such that the peripheral lip forms a sealing engagement with the surface of the heart. Upon operation of the actuation member, the increase in the volume of the inner cavity causes a decrease in the pressure within the inner member, resulting in suction adhesion between the CASD and the surface of the heart.

Abstract: A device for capping a severed sternum. The device comprises an end wall configured to extend along a length of severed sternum. A gasket is attached to the end wall configured to abut at least part of the length of a severed sternum when deployed thereon.

Abstract: An apparatus implantable in a heart ventricle includes a frame configured to engage an inner circumferential periphery of the ventricle and to expand and contract between an expanded state corresponding to a desired end diastolic diameter of the ventricle and a contracted state corresponding to a desired end systolic diameter of the ventricle. Assisting means are operatively associated with the frame for mechanically assisting movement of the ventricle toward at least one of an end systolic diameter during systole and an end diastolic diameter during diastole. The assisting means may be integrally formed of the frame. The frame may be configured to have expanded and contracted bistable states for assisting both systole and diastole. A method of implanting the apparatus in a heart ventricle includes surgically accessing a ventricle, inserting the apparatus in the ventricle and attaching the device to a portion of myocardium defining an inner circumferential periphery of the ventricle.

Abstract: A method and apparatus is disclosed that allows a cardiac surgeon to temporarily and controllably dilate the aortic root using a thin walled spiral cylinder that is irreversibly dilated by an expansion apparatus. Following removal of the reversible expansive apparatus the irreversible dilation member temporarily remains in the expanded aortic root during aortic valve prosthesis placement with the irreversible dilation member at the level of the aortic annulus. Implantation sutures that had been previously placed are tied following the removal of the irreversible dilation member. The apparatus and method may be used to place a sub aortic stent for the treatment of sub aortic stenosis.

Abstract: An implantable annuloplasty suture guide is intended to lie against at least a portion of an annulus surrounding a human heart. The implantable annuloplasty suture guide is made of an elongated ribbon of braided, heat setable material. The braided, heat-setable material is heat-set in a curved lengthwise configuration corresponding to at least a portion of the annulus of the human heart valve. A method of making an implantable annuloplasty suture guide configured to lie against at least a portion of an annulus defined by tissue surrounding a human heart. The method includes the steps of providing an elongate biocompatible ribbon comprising a braided, heat setable material. A fixture is provided, with the fixture comprising a heat conducting material defining an elongate cavity having a curved length-wise configuration corresponding to at least a portion of the annulus defined by the tissue surrounding the human heart.

Abstract: An annuloplasty ring holder including a head having an upper surface and an annuloplasty ring receiving surface facing opposite the upper surface. The annuloplasty ring holder also includes means for attaching an annuloplasty ring to the annuloplasty ring receiving surface. The means for attaching an annuloplasty ring to the annuloplasty ring receiving surface may include one or more suture guides operatively associated with the head and configured to position one or more sutures to removably associate an annuloplasty ring with the annuloplasty ring receiving surface. The head may include a central hub and more than one spoke radiating out from the central hub. If the head is thus configured, each spoke will include a portion of the annuloplasty ring receiving surface.

Abstract: A support arm assembly for assisting in the performance of cardiac surgery has an articulated arm movable axially of a support base and rotatable relative to the support base. A distal end of the articulated arm receives a contact member and the contact member is moveable relative to the distal end. A surgeon may configure the support arm assembly to contact a desired portion of a heart and fix the articulated arm, its axial position, its rotated position and the orientation of the contact member with a single control.

Abstract: A suture retainer for use with a surgical instrument comprises a slot defined in the surgical instrument, the slot having a bottom and lateral slot ends. A retainer block comprises a bottom and lateral block ends. The lateral block ends and the lateral slot ends are configured to matingly engage to define a v-shaped gap adjacent a lateral slot end near a mouth of the slot.

Abstract: A retractor system that is easily and quickly attached to the operating room table utilizing low profile retractor blades which minimize obstruction of the surgeons view and access to the surgical field. Retraction is accomplished quickly and simply with virtually infinite variability using a single or dual generally linear ratcheting system that gently and controllably elevates one side of an incision and moves it away from the other side of the incision.

Abstract: A device and method for temporarily immobilizing a small segment of the surface of the heart during coronary artery bypass grafting for obviating the necessity for placing the patient on cardiopulmonary bypass are disclosed.