This invention relates to devices and methods for creating and maintaining a fluid conduit to establish fluid communication between opposing surfaces of a tissue wall.
Construction of an alternative conduit between the left ventricle and the aorta (an apicoaortic conduit, or AAC) to create a double-outlet left ventricle (LV) has been successfully employed to treat a variety of complex congenital LV outflow obstruction (fibrous tunnel obstruction, aortic annular hypoplasia, tubular hypoplasia of the ascending aorta, and patients with diffuse septal thickening, severe LV hypertrophy and a small LV cavity) as well as adult-onset aortic stenosis in patients with complicating preoperative conditions (previous failed annular augmentation procedures, previous infection, previous CABG with patent anterior internal mammary artery grafts, and a porcelain ascending aorta).
However, the AAC insertion procedure has been poorly accepted, primarily because of early valve failures using first-generation bioprostheses as well as the success of direct LVOTO repair and aortic valve replacement. In the United States, despite an aging population, the unadjusted mortality for isolated aortic valve operations in 2001 remained under 4%. Further, the AAC insertion operation, with or without cardiopulmonary bypass, has not been as technically straightforward as direct aortic valve replacement. For most surgeons, AAC insertion is not a familiar operation and is of historical interest only.
Nonetheless, several studies have demonstrated that AAC insertion successfully lessens the LV-aortic pressure gradient, preserves or improves ventricular function and maintains normally distributed blood flow through the systemic and coronary circulation. While there have been several techniques described, the most commonly employed method is the lateral thoracotomy approach with placement of the AAC to the descending aorta. Other techniques include a median sternotomy approach with insertion of the distal limb of the AAC to the ascending aorta, to the transverse part of the aortic arch, or to the intra-abdominal supraceliac aorta.
In general, the thoracic aorta and the left ventricle apex are exposed through a left lateral thoracotomy, and a needle is passed through the apex and into the left ventricle. While the connector is still spaced apart from the apex, the sutures that will fix the connector to the apex are threaded through a cuff on the connector and through the apex in a matching pattern. The cuff is set back from the end of the connector by 1-2 centimeters to allow the end of the connector to extend through the heart muscle and into the left ventricle. Once the sutures are in place, a ventricular coring device is used to remove a core of ventricular muscle, and the pre-threaded sutures are then pulled to draw the connector into the opening until the cuff comes to rest: on the apex. The sutures are tied off, and additional sutures may be added. Either before or after this procedure, the opposite end of the connector is attached to a valved conduit which terminates at the aorta.
The current techniques and technology available to perform AAC insertion were originally designed to be performed on-pump; either with an arrested or fibrillating heart. While off-pump cases have been described, they can be technically difficult due to the shortcomings of presently available conduits and systems for installing such conduits. For example, because existing conduits require the use of sutures to reliably secure the connector in place, it is often difficult for surgeons or other clinicians to insert such sutures reliably in active cardiac and/or vascular tissue.
Some devices and methods have been devised to install an AAC conduit, such as those described generally in U.S. patent application Ser. No. 11/251,100, filed on Oct. 14, 2005, and U.S. patent application Ser. No. 10/915,691, filed on Aug. 11, 2004, both of which are hereby incorporated herein in their entirety by reference. However, these AAC conduit devices and installation systems rely on the use of a flexible flange that is inserted through a pre-defined aperture in the ventricular apex. Thus, such methods require the use of a hemostatic device (such as an occlusion balloon and/or “umbrella” device) to prevent blood loss from the aperture during installation of the AAC conduit.
Various embodiments of the present invention provide an improved system and method for the insertion of a conduit (such as an AAC conduit) that will significantly simplify the in vivo insertion of a graft into the beating cardiac apex or other tissue walls (such as other areas of the heart including the anterior, lateral, posterior walls of the left or right ventricle, the left or right atrium, the aortic wall, ascending, transverse, or descending, or other blood vessel walls), such that vascular conduit insertions (including AAC procedures) may be rendered far more attractive to clinicians. Because vascular conduits and systems of the present invention may be used to create alternate outflow tracts in “off-pump” procedures, the embodiments of the present invention may effectively reduce and/or negate the detrimental effects of both cardio-pulmonary by-pass (CPB) and global cardiac ischemia. Additionally, because some conduit embodiments of the present invention (for AAC procedures, for example) may be inserted into a ventricular or atrial free wall or cardiac apex, the conduction system of the heart may be avoided, along with the native coronary arteries and grafts from previous surgical revascularization. In some embodiments of the present invention, wherein the system is used to implant an AAC, a small size valve (19 to 21 mm for typical adult body surface areas) is usually adequate; as the effective postoperative orifice is the sum of the native and prosthetic aortic valves. Further, the present invention provides vascular conduits that may be compatible with newer generation biologic valves, such that valved conduit failure is far less likely. Various embodiments of the present invention may also provide general conduit devices (and systems for implanting) suitable for establishing fluid communication between opposing surfaces of tissue walls in a variety of applications, including the establishment of a fluid conduit through the tissue wall of a mammalian urinary bladder.
In one exemplary embodiment, a system is provided for implanting a conduit device (such as an AAC component) in a tissue wall having a first surface and an opposing second surface. According to some embodiments, the system comprises an outer tube defining a guide aperture extending axially through the outer tube and an attaching device extending from a distal end of said outer tube. The attaching device is configured for advancing along a helical path at least partially through the tissue wall such that at least a portion of the attaching device becomes disposed substantially between the first surface and the opposing second surface of the tissue wall when the outer tube is rotated relative to the first surface of the tissue wall. The attaching device, in some system embodiments, comprises at least one of a helical static coil and a helical elastic spring having a sharpened distal end adapted for piercing the tissue wall as the outer tube is rotated relative to the first surface of the tissue wall. According to some such embodiments, the attaching device may define a radially-expanding helix as the attaching device extends away from the distal end of the outer tube.
In some embodiments, the system also comprises a ring operably engaged about an outer surface of the outer tube and configured for cooperating with the attaching device such that at least a portion of the tissue wall is secured between the attaching device and the ring so as to operably engage said outer tube with the tissue wall. According to some such embodiments, the system may further comprise a plurality of ridges disposed on the outer surface of the outer tube. In such embodiments, the ring comprises at least one deformable pawl member operably engaged therewith for releasably engaging the plurality of ridges on the outer surface of the outer tube. In some other embodiments, the system may comprise threading on at least a portion of the outside surface of the outer tube and corresponding threading on at least a portion of an inside surface of the ring. The threading may thus be configured to cooperate for axially securing the ring relative to the outer tube. Furthermore, some system embodiments may further comprise a nut operably engaged about an outer surface of the outer tube and proximal to the ring. The nut may comprise threading on at least a portion on an inside surface thereof, wherein the threading may be configured for cooperating with the threading on at least a portion of the outside surface of the outer tube. Furthermore, the nut may be configured for cooperating with the ring to advance the ring towards the distal end of the outer tube.
In some embodiments, various system components, such as the outer tube and the ring, may be configured to conform to and/or establish a substantially fluid-tight seal with at least a portion a surface of the tissue wall. For example, in some embodiments, the system may comprise a sealing member operably engaged with a distal end of the ring. According to such embodiments, the sealing member may be configured for establishing a substantially fluid tight seal between the ring and the first surface of the tissue wall. In some embodiments, the system may be configured to cooperate and/or operably engage a tissue wall comprising a substantially curved tissue wall. According to some such embodiments, the ring may comprise a frusto-conical assembly configured for receiving at least a portion of the substantially curved tissue wall so as to form a substantially fluid-tight seal between the frusto-conical assembly and the tissue wall.
In some embodiments, the system further comprises an inner tube configured for insertion into the guide aperture defined by the outer tube. According to such embodiments, the inner tube defines a conduit aperture extending axially therethrough. Furthermore, in some such embodiments, the outer tube may comprise a first securing device operably engaged with a proximal end of the outer tube and the inner tube may comprise a complementary second securing device operably engaged with a proximal end of said inner tube. Thus, according to such embodiments, the second securing device may be configured for selectively operably engaging the first securing device so as to operably engage the inner tube with the outer tube to install and maintain the conduit.
In some embodiments, the system may also comprise a coring device configured for advancing through the conduit aperture defined by the inner tube and through the tissue wall to define an aperture therein by removing a tissue core. The coring device may be further configured for carrying the inner tube through the aperture such that the inner tube extends at least partially through the aperture so as to establish fluid communication between the first and second surfaces of the tissue wall. The coring device may define a coring bore extending axially therethrough and configured for receiving the tissue core removed by the coring device. In some embodiments, the coring device may further comprise a piercing rod slidably advancable and retractable within the coring bore. The piercing rod may further comprise a retrieval device operably engaged with a distal end thereof and configured for axially retaining the tissue core removed by the coring device. Thus, in some embodiments, the piercing rod may be configured for advancing so as to pierce the tissue wall prior to removal of the tissue core and/or retracting after removal of the tissue core such that the tissue core is retrievable via a proximal end of the coring device. In some such embodiments, the coring device may further comprise a handle operably engaged with the proximal end of the coring device. The handle may define a tissue core chamber in communication with the coring bore, the tissue core chamber configured for receiving the tissue core retrieved by the retraction of the piercing rod. Furthermore, in some such embodiments, at least a portion of the handle may comprise a transparent material such that the tissue core received therein is visible from a position outside the handle.
The various embodiments of the present invention may thus be configured for implanting a conduit device that is adapted for providing a conduit for a medical procedure. Such procedures may include, but are not limited to: bypass; cardiac valve repair or replacement; attachment of a ventricular assist device; establishment of an apicoaortic conduit (AAC) and combinations of such procedures.
Use of this new conduit device, system, and method will significantly improve the ease and safety of conduit insertion (such as the implantation of AAC devices, for example). For example, various embodiments of the present invention may allow the outer tube to be securely operably engaged with the tissue wall (due at least in part to the cooperation of the attaching device and the ring) prior to the removal of a tissue core to define an aperture in the tissue wall. Thus, portions of the system disclosed herein may define a guide aperture extending axially through the outer tube for receiving a coring device that may be configured to be capable of efficiently removing and retrieving a tissue core while substantially simultaneously operably engaging a inner tube in the guide aperture so as to establish fluid communication between first and second opposing surfaces of the tissue wall. As persons of ordinary skill in the art will readily appreciate, the various embodiments of the present invention may also be used in a minimally invasive, endoscopically assisted approach.
Having thus described various embodiments of the invention in general terms, reference will now be made to the accompanying drawings, which are not necessarily drawn to scale, and wherein:
The present inventions now will be described more fully hereinafter with reference to the accompanying drawings, in which some, but not all embodiments of the inventions are shown. Indeed, these inventions may be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements Like numbers refer to like elements throughout. The singular forms “a,” “an,” and “the” include plural referents unless the context clearly dictates otherwise.
Although some embodiments of the invention described herein are directed to a conduit device 1 (see
It should be further understood that various embodiments of the conduit device 1 described herein may also be utilized to establish fluid communication between opposing surfaces of a variety of tissue walls and/or anatomical structures. For example, in some embodiments, the conduit device 1 and system for implanting described herein may be used to establish a conduit (and consequently fluid communication) between opposing surfaces of a wall of an anatomical structure that may include, but is not limited to: a urinary bladder; a gall bladder; a diaphragm; a thoracic cavity; an abdominal cavity; an intestinal structure; a cecal cavity; and other tissue wall structures.
It should be understood that the various conduit device 1 components described herein (see, for example, the components shown in
The attaching device 15 may comprise, in some embodiments, a helical static coil having a sharpened distal end adapted for piercing the tissue wall 850 as the outer tube 10 is rotated relative to the first surface 855 of the tissue wall 850. In other embodiments, the attaching device 15 may comprise a helical elastic spring having a sharpened end adapted for piercing the tissue wall 850 as the outer tube 10 is rotated relative to the first surface 855 of the tissue wall 850. In some embodiments, as shown in
In other embodiments, as shown generally in
As described herein, the system may further comprise a ring 30 operably engaged about an outer surface of the outer tube 10. As shown generally in
In order to ensure that the ring 30 forms a substantially fluid-tight seal with the first surface 855 of the tissue wall 850 about the aperture defined therein, some embodiments (as shown in
In some embodiments, the seal testing aperture 36 may also serve an alternative function for rotationally securing the ring 30 relative to and the first surface 855 of the tissue wall 850. For example, a clinician may insert a needle and/or other elongate spike through the seal testing aperture 36 defined in the ring 30 and substantially into the tissue wall 850. The interaction of the needle and/or spike with the ring 30 (via the seal testing aperture 36) and the tissue wall 850 may thus reduce a chance that the ring 30 (and the helical attaching device 15 extending from the outer tube 10) are rotatable relative to the tissue wall 850 such that the ring 30 and the helical attaching device 15 may be less prone to “backing out” of the tissue wall 850 once the seal is established between the ring 30 and the first surface 855 of the tissue wall 850.
In some additional embodiments, as shown generally in
Referring to
As shown generally in
As shown in
In some embodiments, wherein the attaching device comprises a conical and/or “radially-expanding” helix, the attaching device 15 may act to compress at least a portion of the tissue wall 850 radially inward and towards an outer surface of the inner tube 40 so as to establish a substantially fluid-tight seal between the outer surface of the inner tube 40 and the portion of the tissue wall 850 that has been urged radially inward by the conical and/or radially-expanding helix of the attaching device 15. Furthermore, in embodiments wherein the attaching device 15 comprises a conical and/or “radially-expanding” helix, the attaching device 15 may act to compress at least a portion of the tissue wall 850 radially inward such that the portion of the tissue wall 850 may be more readily received by ring 30 (which may comprise a frusto-conical structure configured for receiving the compressed portion of the tissue wall 850). As shown in
As shown in
As shown in
Referring again to
As described generally herein with regard to the various system embodiments of the present invention, the conduit device 1 installation process may advantageously allow a clinician to visually confirm that the tissue core 850a removed by the coring cylinder 65 has been completely and cleanly removed from the aperture defined in the tissue wall 850. For example, in some embodiments, at least a portion of the handle 63 may comprise a transparent material such that the tissue core 850a received within the tissue core chamber 62 may be directly visible by a clinician and/or an endoscopic imaging device from a position substantially outside the handle 63. As shown in
Many modifications and other embodiments of the inventions set forth herein will come to mind to one skilled in the art to which these inventions pertain having the benefit of the teachings presented in the foregoing descriptions and the associated drawings. Therefore, it is to be understood that the inventions are not to be limited to the specific embodiments disclosed and that modifications and other embodiments are intended to be included within the scope of the appended claims. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation.
The present application is a continuation of co-pending U.S. patent application Ser. No. 15/058,703, filed on Mar. 2, 2016, which is a continuation of U.S. patent application Ser. No. 14/475,068, now U.S. Pat. No. 9,308,015, which is a continuation of U.S. patent application Ser. No. 13/845,960, filed on Mar. 18, 2013, now U.S. Pat. No. 8,858,489, which is a continuation of U.S. patent application No. Ser. No. 12/901,810, filed on Oct. 11, 2010, now U.S. Pat. No. 8,430,836 issued on Apr. 30, 2013, which is a continuation of U.S. patent application Ser. No. 11/739,151, filed on Apr. 24, 2007, now U.S. Pat. No. 7,846,123 issued on Dec. 7, 2010, which are hereby incorporated by reference in their entireties herein.
Number | Name | Date | Kind |
---|---|---|---|
3512519 | Hall | May 1970 | A |
3540451 | Zeman | Nov 1970 | A |
3856021 | McIntosh | Dec 1974 | A |
4204541 | Kapitanov | May 1980 | A |
4366819 | Kaster | Jan 1983 | A |
4769031 | McGough et al. | Sep 1988 | A |
4904264 | Scheunemann | Feb 1990 | A |
4955856 | Phillips | Sep 1990 | A |
5098369 | Heilman et al. | Mar 1992 | A |
5129913 | Ruppert | Jul 1992 | A |
5139517 | Corral | Aug 1992 | A |
5158563 | Cosman | Oct 1992 | A |
5222980 | Gealow | Jun 1993 | A |
5256160 | Clement | Oct 1993 | A |
5290639 | Mallory | Mar 1994 | A |
5291179 | Ooe et al. | Mar 1994 | A |
5387193 | Miraki | Feb 1995 | A |
5447533 | Vachon et al. | Sep 1995 | A |
5456714 | Owen | Oct 1995 | A |
5488958 | Topel | Feb 1996 | A |
5562729 | Purdy et al. | Oct 1996 | A |
5577993 | Zhu et al. | Nov 1996 | A |
5582616 | Bolduc et al. | Dec 1996 | A |
5695504 | Gifford et al. | Dec 1997 | A |
5728116 | Rosenman | Mar 1998 | A |
5738680 | Mueller et al. | Apr 1998 | A |
5755697 | Jones et al. | May 1998 | A |
5782844 | Yoon et al. | Jul 1998 | A |
5797933 | Snow et al. | Aug 1998 | A |
5810836 | Hussein et al. | Sep 1998 | A |
5810851 | Yoon | Sep 1998 | A |
5814005 | Barra et al. | Sep 1998 | A |
5824070 | Jarvik | Oct 1998 | A |
5824071 | Nelson et al. | Oct 1998 | A |
5827316 | Young et al. | Oct 1998 | A |
5833698 | Hinchliffe et al. | Nov 1998 | A |
5843088 | Barra et al. | Dec 1998 | A |
5865791 | Whayne et al. | Feb 1999 | A |
5893369 | LeMole | Apr 1999 | A |
5910153 | Mayengerger | Jun 1999 | A |
5924424 | Stevens et al. | Jul 1999 | A |
5944730 | Nobles et al. | Aug 1999 | A |
5976174 | Ruiz | Nov 1999 | A |
5984956 | Tweden et al. | Nov 1999 | A |
5989278 | Mueller | Nov 1999 | A |
6001056 | Jassawalla et al. | Dec 1999 | A |
6007576 | McClellan | Dec 1999 | A |
6022324 | Skinner | Feb 2000 | A |
6022367 | Sherts | Feb 2000 | A |
6024755 | Addis | Feb 2000 | A |
6039748 | Savage et al. | Mar 2000 | A |
6066085 | Heilman et al. | May 2000 | A |
6079414 | Roth | Jun 2000 | A |
6080173 | Williamson et al. | Jun 2000 | A |
6080176 | Young | Jun 2000 | A |
6113611 | Allen et al. | Sep 2000 | A |
6146325 | Lewis et al. | Nov 2000 | A |
6241743 | Levin et al. | Jun 2001 | B1 |
6254564 | Wilk et al. | Jul 2001 | B1 |
6267732 | Heneveld et al. | Jul 2001 | B1 |
6273862 | Privitera et al. | Aug 2001 | B1 |
6290728 | Phelps et al. | Sep 2001 | B1 |
6346071 | Mussivand | Feb 2002 | B1 |
6390976 | Spence et al. | May 2002 | B1 |
6401720 | Stevens et al. | Jun 2002 | B1 |
6409739 | Nobles et al. | Jun 2002 | B1 |
6443957 | Addis | Sep 2002 | B1 |
6458140 | Akin et al. | Oct 2002 | B2 |
6506197 | Rollero et al. | Jan 2003 | B1 |
6537300 | Girton | Mar 2003 | B2 |
6551319 | Lieberman | Apr 2003 | B2 |
6551322 | Lieberman | Apr 2003 | B1 |
6551332 | Nguyen et al. | Apr 2003 | B1 |
6582400 | Hawk | Jun 2003 | B1 |
6589277 | Fabiani et al. | Jul 2003 | B1 |
6607541 | Gardiner et al. | Aug 2003 | B1 |
6638237 | Guiles et al. | Oct 2003 | B1 |
6651670 | Rapacki et al. | Nov 2003 | B2 |
6663633 | Pierson, III | Dec 2003 | B1 |
6669708 | Nissenbaum et al. | Dec 2003 | B1 |
6673043 | Landesberg | Jan 2004 | B1 |
6676678 | Gifford et al. | Jan 2004 | B2 |
6689147 | Koster, Jr. | Feb 2004 | B1 |
6695859 | Golden et al. | Feb 2004 | B1 |
6699256 | Logan et al. | Mar 2004 | B1 |
6705988 | Spence et al. | Mar 2004 | B2 |
6726648 | Kaplon et al. | Apr 2004 | B2 |
6732501 | Yu et al. | May 2004 | B2 |
6740101 | Houser et al. | May 2004 | B2 |
6776787 | Phung et al. | Aug 2004 | B2 |
6802806 | McCarthy et al. | Oct 2004 | B2 |
6808498 | Laroya et al. | Oct 2004 | B2 |
6824071 | McMichael | Nov 2004 | B1 |
6827683 | Otawara | Dec 2004 | B2 |
6863677 | Breznock | Mar 2005 | B2 |
6869437 | Hausen et al. | Mar 2005 | B1 |
6942672 | Heilman et al. | Sep 2005 | B2 |
6978176 | Lattouf | Dec 2005 | B2 |
6984241 | Lubbers et al. | Jan 2006 | B2 |
6994666 | Shannon et al. | Feb 2006 | B2 |
7018384 | Skakoon | Mar 2006 | B2 |
7033372 | Cahalan | Apr 2006 | B1 |
7048681 | Tsubouchi et al. | May 2006 | B2 |
7056286 | Ravenscroft et al. | Jun 2006 | B2 |
7077801 | Haverich | Jul 2006 | B2 |
7083631 | Houser et al. | Aug 2006 | B2 |
7163525 | Franer | Jan 2007 | B2 |
7182771 | Houser et al. | Feb 2007 | B1 |
7214234 | Rapacki et al. | May 2007 | B2 |
7232421 | Gambale et al. | Jun 2007 | B1 |
7258694 | Choi et al. | Aug 2007 | B1 |
7309343 | Vargas et al. | Dec 2007 | B2 |
7331956 | Hovda et al. | Feb 2008 | B2 |
7404792 | Spence et al. | Jul 2008 | B2 |
7510561 | Beane et al. | Mar 2009 | B2 |
7637919 | Ishikawa et al. | Dec 2009 | B2 |
7717844 | Cohn | May 2010 | B2 |
7744527 | Cohn | Jun 2010 | B2 |
7766811 | Haverich | Aug 2010 | B2 |
7799041 | Beane et al. | Sep 2010 | B2 |
7842068 | Ginn | Nov 2010 | B2 |
7846123 | Vassiliades et al. | Dec 2010 | B2 |
7846179 | Belef et al. | Dec 2010 | B2 |
7931581 | Cohn | Apr 2011 | B2 |
7942805 | Shambaugh, Jr. | May 2011 | B2 |
7993392 | Righini et al. | Aug 2011 | B2 |
8226670 | Beane et al. | Jul 2012 | B2 |
8430836 | Vassiliades et al. | Apr 2013 | B2 |
8556930 | Ellingwood | Oct 2013 | B2 |
8579790 | Jeffery et al. | Nov 2013 | B2 |
8764795 | Whitman et al. | Jul 2014 | B2 |
8840538 | Jeffery et al. | Sep 2014 | B2 |
8858489 | Vassiliades et al. | Oct 2014 | B2 |
20010051809 | Houser et al. | Dec 2001 | A1 |
20020019623 | Altman et al. | Feb 2002 | A1 |
20020019643 | Gifford et al. | Feb 2002 | A1 |
20020032462 | Houser et al. | Mar 2002 | A1 |
20020038127 | Blatter et al. | Mar 2002 | A1 |
20020045846 | Kaplon et al. | Apr 2002 | A1 |
20020055737 | Lieberman | May 2002 | A1 |
20020055738 | Lieberman | May 2002 | A1 |
20020055739 | Lieberman | May 2002 | A1 |
20020055740 | Lieberman | May 2002 | A1 |
20020055742 | Lieberman | May 2002 | A1 |
20020058958 | Walen | May 2002 | A1 |
20020095210 | Finnegan et al. | Jul 2002 | A1 |
20020099394 | Houser et al. | Jul 2002 | A1 |
20020116018 | Stevens et al. | Aug 2002 | A1 |
20020177865 | McIntosh | Nov 2002 | A1 |
20020183786 | Girton | Dec 2002 | A1 |
20020193806 | Moenning et al. | Dec 2002 | A1 |
20030014064 | Blatter | Jan 2003 | A1 |
20030023255 | Miles et al. | Jan 2003 | A1 |
20030032979 | Mortier et al. | Feb 2003 | A1 |
20030040765 | Breznock | Feb 2003 | A1 |
20030045834 | Wing et al. | Mar 2003 | A1 |
20030078592 | Heilman et al. | Apr 2003 | A1 |
20030078597 | Blatter | Apr 2003 | A1 |
20030130668 | Nieman et al. | Jul 2003 | A1 |
20030181843 | Bibber et al. | Sep 2003 | A1 |
20030181913 | Lieberman | Sep 2003 | A1 |
20040002624 | Yu et al. | Jan 2004 | A1 |
20040050393 | Golden et al. | Mar 2004 | A1 |
20040068299 | Laske et al. | Apr 2004 | A1 |
20040073216 | Lieberman | Apr 2004 | A1 |
20040077989 | Goode et al. | Apr 2004 | A1 |
20040092858 | Wilson et al. | May 2004 | A1 |
20040097973 | Loshakove et al. | May 2004 | A1 |
20040097993 | Whayne | May 2004 | A1 |
20040098011 | Vargas et al. | May 2004 | A1 |
20040133155 | Varner et al. | Jul 2004 | A1 |
20040138701 | Peartree et al. | Jul 2004 | A1 |
20040153112 | Nissenbaum et al. | Aug 2004 | A1 |
20040158308 | Hogendijk et al. | Aug 2004 | A1 |
20040162608 | Haverich | Aug 2004 | A1 |
20040167547 | Beane et al. | Aug 2004 | A1 |
20040167551 | Gifford, III et al. | Aug 2004 | A1 |
20040171905 | Yu et al. | Sep 2004 | A1 |
20040186490 | Gifford et al. | Sep 2004 | A1 |
20040225306 | Blatter et al. | Nov 2004 | A1 |
20040236170 | Kim | Nov 2004 | A1 |
20050033107 | Tsubouchi | Feb 2005 | A1 |
20050043781 | Foley | Feb 2005 | A1 |
20050075656 | Beaupre | Apr 2005 | A1 |
20050085883 | Ollivier | Apr 2005 | A1 |
20050101982 | Ravenscroft et al. | May 2005 | A1 |
20050101983 | Loshakove et al. | May 2005 | A1 |
20050131451 | Kleshinski et al. | Jun 2005 | A1 |
20050137609 | Guiraudon | Jun 2005 | A1 |
20050149093 | Pokorney | Jul 2005 | A1 |
20050154411 | Breznock et al. | Jul 2005 | A1 |
20050171479 | Hruska et al. | Aug 2005 | A1 |
20050177180 | Kaganov | Aug 2005 | A1 |
20050187568 | Klenk et al. | Aug 2005 | A1 |
20050192604 | Carson et al. | Sep 2005 | A1 |
20050209502 | Schmid et al. | Sep 2005 | A1 |
20050222582 | Wenchell | Oct 2005 | A1 |
20050250987 | Ewers | Nov 2005 | A1 |
20050251187 | Beane et al. | Nov 2005 | A1 |
20050256368 | Klenk et al. | Nov 2005 | A1 |
20050267495 | Ginn et al. | Dec 2005 | A1 |
20060020326 | Bolduc et al. | Jan 2006 | A9 |
20060036313 | Vassiliades et al. | Feb 2006 | A1 |
20060074484 | Huber | Apr 2006 | A1 |
20060089707 | Vassiliades et al. | Apr 2006 | A1 |
20060099716 | Tipler et al. | May 2006 | A1 |
20060142634 | Anstadt et al. | Jun 2006 | A1 |
20060161193 | Beane et al. | Jul 2006 | A1 |
20060167333 | Moore et al. | Jul 2006 | A1 |
20060178675 | Hamman | Aug 2006 | A1 |
20060241659 | Tulleken et al. | Oct 2006 | A1 |
20060259050 | De Winter | Nov 2006 | A1 |
20070010834 | Sharkawy et al. | Jan 2007 | A1 |
20070055357 | Pokorney et al. | Mar 2007 | A1 |
20070060952 | Roby et al. | Mar 2007 | A1 |
20070066943 | Prasad et al. | Mar 2007 | A1 |
20070088375 | Beane et al. | Apr 2007 | A1 |
20070100363 | Dollar et al. | May 2007 | A1 |
20070106315 | Gregoric et al. | May 2007 | A1 |
20070106328 | Wardle et al. | May 2007 | A1 |
20070112361 | Schonholz et al. | May 2007 | A1 |
20070142849 | Ewers | Jun 2007 | A1 |
20070167968 | Pandey | Jul 2007 | A1 |
20070167969 | Pandey | Jul 2007 | A1 |
20070173879 | Pandey | Jul 2007 | A1 |
20070197856 | Gellman et al. | Aug 2007 | A1 |
20070208214 | Hjelle et al. | Sep 2007 | A1 |
20070265643 | Beane et al. | Nov 2007 | A1 |
20080004640 | Ellingwood | Jan 2008 | A1 |
20080009668 | Cohn | Jan 2008 | A1 |
20080009887 | Cohn | Jan 2008 | A1 |
20080009891 | Cohn | Jan 2008 | A1 |
20080039883 | Nohilly | Feb 2008 | A1 |
20080058846 | Vosough | Mar 2008 | A1 |
20080076959 | Farnan et al. | Mar 2008 | A1 |
20080161826 | Guiraudon | Jul 2008 | A1 |
20080177301 | Svensson | Jul 2008 | A1 |
20080255597 | Pravong et al. | Oct 2008 | A1 |
20090012552 | Pandey et al. | Jan 2009 | A1 |
20090012557 | Osypka | Jan 2009 | A1 |
20090082778 | Beane et al. | Mar 2009 | A1 |
20090112062 | Bakos | Apr 2009 | A1 |
20090203957 | LaRose et al. | Aug 2009 | A1 |
20090204206 | Parquet et al. | Aug 2009 | A1 |
20090240264 | Tuval et al. | Sep 2009 | A1 |
20100004739 | Vesely | Jan 2010 | A1 |
20100010500 | Beane et al. | Jan 2010 | A1 |
20100010616 | Drews et al. | Jan 2010 | A1 |
20100049225 | To et al. | Feb 2010 | A1 |
20100087907 | Lattouf | Apr 2010 | A1 |
20100160847 | Braido et al. | Jun 2010 | A1 |
20100161040 | Braido et al. | Jun 2010 | A1 |
20100168778 | Braido | Jul 2010 | A1 |
20110092766 | Almog et al. | Apr 2011 | A1 |
20110106116 | Ducharme et al. | May 2011 | A1 |
20110118766 | Reichenbach et al. | May 2011 | A1 |
20110118770 | Pokorney et al. | May 2011 | A1 |
20110118833 | Reichenbach et al. | May 2011 | A1 |
20110144680 | Nguyen et al. | Jun 2011 | A1 |
20110160850 | Bourque | Jun 2011 | A1 |
20110190811 | Shanley | Aug 2011 | A1 |
20110196190 | Farnan et al. | Aug 2011 | A1 |
20110224785 | Hacohen | Sep 2011 | A1 |
20110251450 | Pagani et al. | Oct 2011 | A1 |
20120059212 | LaRose et al. | Mar 2012 | A1 |
20120059457 | Leinsing et al. | Mar 2012 | A1 |
20120089181 | Shanley et al. | Apr 2012 | A1 |
20120123452 | Asfora et al. | May 2012 | A1 |
20120123461 | Gillies et al. | May 2012 | A1 |
20120226096 | Callaway et al. | Sep 2012 | A1 |
20120253386 | Rowe et al. | Oct 2012 | A1 |
20120296151 | Curtis et al. | Nov 2012 | A1 |
20120296358 | Nguyen et al. | Nov 2012 | A1 |
20130012761 | Gregoric et al. | Jan 2013 | A1 |
20130110228 | Braido | May 2013 | A1 |
20130116728 | Litvack et al. | May 2013 | A1 |
20130150654 | Stanfield et al. | Jun 2013 | A1 |
20130218169 | Vassiliades et al. | Aug 2013 | A1 |
20130253641 | Lattouf | Sep 2013 | A1 |
20140039375 | Jimenez et al. | Feb 2014 | A1 |
20140067057 | Callaway et al. | Mar 2014 | A1 |
20140100430 | Beane et al. | Apr 2014 | A1 |
20140148786 | Milo | May 2014 | A1 |
20140194833 | Andrus | Jul 2014 | A1 |
20140214159 | Vidlund et al. | Jul 2014 | A1 |
20140378772 | Sundt, III et al. | Dec 2014 | A1 |
20140379074 | Spence et al. | Dec 2014 | A1 |
20150032153 | Quadri et al. | Jan 2015 | A1 |
20150038770 | Colella | Feb 2015 | A1 |
20150112120 | Andrus | Apr 2015 | A1 |
20150196321 | Gregory et al. | Jul 2015 | A1 |
20150359952 | Andrus et al. | Dec 2015 | A1 |
20160095705 | Keranen et al. | Apr 2016 | A1 |
Number | Date | Country |
---|---|---|
2 526 920 | Feb 2009 | CA |
1842354 | Oct 2006 | CN |
1 669 042 | Jun 2006 | EP |
1 691 884 | Mar 2011 | EP |
1 628 702 | May 2013 | EP |
1 706 168 | Nov 2013 | EP |
HI 1-500642 | Jan 1999 | JP |
2002-518082 | Jun 2002 | JP |
2006-514569 | May 2006 | JP |
2006-518624 | Aug 2006 | JP |
2007-510522 | Apr 2007 | JP |
WO 9325148 | Dec 1993 | WO |
WO 9625886 | Aug 1996 | WO |
WO 9713463 | Apr 1997 | WO |
WO 9965409 | Dec 1999 | WO |
WO 0000193 | Jan 2000 | WO |
WO 0015147 | Mar 2000 | WO |
WO 0015149 | Mar 2000 | WO |
WO 0041759 | Jul 2000 | WO |
WO 0074747 | Dec 2000 | WO |
WO 03001980 | Jan 2003 | WO |
WO 2004026147 | Apr 2004 | WO |
WO 2004096059 | Nov 2004 | WO |
WO 2004096337 | Nov 2004 | WO |
WO 2005046783 | May 2005 | WO |
WO 2006019755 | Feb 2006 | WO |
WO 2006020651 | Feb 2006 | WO |
WO 2006093970 | Sep 2006 | WO |
2007047933 | Apr 2007 | WO |
WO 2007038109 | Apr 2007 | WO |
WO 2007047212 | Apr 2007 | WO |
WO 2007117612 | Oct 2007 | WO |
WO 2008131453 | Oct 2008 | WO |
WO 2008153872 | Dec 2008 | WO |
WO 2009100198 | Aug 2009 | WO |
WO 2009117435 | Sep 2009 | WO |
2012025927 | Mar 2012 | WO |
WO 2012040233 | Mar 2012 | WO |
WO-2012106422 | Aug 2012 | WO |
WO 2013064529 | May 2013 | WO |
2013189620 | Dec 2013 | WO |
2015109328 | Jul 2015 | WO |
Entry |
---|
International Search Report and Written Opinion for International Patent Application No. PCT/US2008/061404, dated Aug. 19, 2008. |
International Preliminary Report on Patentability for International Patent Application No. PCT/US2008/061404, dated Oct. 27, 2009. |
Office Action for European Patent Application No. 08 799 829.0, dated Apr. 19, 2012. |
Office Action for European Patent Application No. 08 799 829.0, dated Nov. 2, 2012. |
Office Action for Japanese Patent Application No. 2010-606491, dated Nov. 13, 2012. |
Office Action for European Patent Application No. 08 799 829.0, dated May 27, 2013. |
Office Action for Japanese Patent Application No. 2010-606491, dated Jul. 5, 2013. |
Extended European Search Report for European Patent Application No. 13 186 508.1, dated Feb. 6, 2014. |
Office Action or European Patent Application No. 13 186 508.1, dated Mar. 17, 2014. |
Office Action for Canadian Patent Application No. 2,719,951, dated Apr. 30, 2014. |
English Translation of Office Action for Japanese Patent Application No. 2013-175430, dated Jul. 11, 2014. |
Notice of Allowance for Canadian Patent Application No. 2,719,951, dated Feb. 5, 2015. |
English Translation of Office Action for Japanese Patent Application No. 2013-175430, dated May 19, 2015. |
Office Action for Japanese Patent Application No. 2013-175430, dated Jan. 5, 2016. |
Number | Date | Country | |
---|---|---|---|
20180200492 A1 | Jul 2018 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 15058703 | Mar 2016 | US |
Child | 15919975 | US | |
Parent | 14475068 | Sep 2014 | US |
Child | 15058703 | US | |
Parent | 13845960 | Mar 2013 | US |
Child | 14475068 | US | |
Parent | 12901810 | Oct 2010 | US |
Child | 13845960 | US | |
Parent | 11739151 | Apr 2007 | US |
Child | 12901810 | US |