Claims
- 1. A method for accessing an interior chamber of a beating heart, said method comprising:
forming a penetration through a muscular wall of the heart into the interior chamber; positioning a distal end of a tubular access device having an inner lumen through the penetration; and forming a hemostatic seal between the device and the penetration to inhibit blood loss through the penetration.
- 2. A method as in claim 1 wherein the interior chamber is selected from a right atrium, a right ventricle, and a left atrium.
- 3. A method as in claim 2, wherein a proximal end of the tubular access device is open to the exterior and wherein blood flow through the inner lumen is prevented by the pressure head of blood within the inner lumen.
- 4. A method as in claim 3, wherein a lateral side of the patient is disposed upward to permit vertical entry of the tubular access device into the interior chamber from a lateral portion of the chest.
- 5. A method as in claim 1, wherein the tubular access device is introduced percutaneously through an intercostal space.
- 6. A method as in claim 5, wherein the tubular access device is passed percutaneously through an intercostal space selected from the second, third, fourth, fifth, sixth or seventh intercostal space.
- 7. A method as in claim 1, wherein a lung is collapsed to provide a working space between the ribs and the pericardium.
- 8. A method as in claim 7, further comprising percutaneously introducing a viewing scope into the working space and viewing the heart while forming the penetration and positioning the distal end of the access device.
- 9. A method as in claim 8, wherein the heart is viewed by viewing a video image obtained from a camera mounted to the viewing scope.
- 10. A method as in claim 8, wherein the heart is directly viewed through an optical passage in the viewing scope.
- 11. A method as in claim 1, wherein the hemostatic seal is formed by expanding a balloon around the access device to occlude the penetration.
- 12. A method as in claim 1, wherein the hemostatic seal is formed by radially expanding the access device.
- 13. A method as in claim 1, wherein the hemostatic seal is formed by tightening a purse-string suture in the heart wall around the penetration.
- 14. A method as in claim 1, further comprising performing a procedure on the heart using one or more instruments introduced through the inner lumen of the access device.
- 15. A method for closing a cardiac septal defect in a heart, said method comprising:
positioning a tubular access device percutaneously through an intercostal space and through a penetration in a muscular wall of the heart; and passing one or more instruments from a proximal end of the access device, through an inner lumen of the access device, and out of a distal end of the access device into a cardiac chamber in the heart, wherein the one or more instruments are used to close the septal defect.
- 16. A method as in claim 15, wherein the cardiac septal defect is closed by applying at least one suture to the cardiac septum using a suturing instrument introduced into the cardiac chamber through the inner lumen of the access device.
- 17. A method as in claim 16, wherein the step of applying at least one suture comprises:
inserting through the defect a plurality of needles connected by at least one length of suture, the needles being inserted while in a retracted position; repositioning the needles to a radially expanded position; drawing the needles through the cardiac septum while in the radially expanded position to position the length of suture across the defect; and tensioning the length of suture to close the defect.
- 18. An improved method for closing a cardiac septal defect of the type in which a patch of material is secured over the defect, wherein the improvement comprises introducing and securing the patch through an inner lumen of a tubular access device positioned through a muscular wall of the heart.
- 19. An improved method for closing a cardiac septal defect of the type in which a pericardium patch is secured over the defect, wherein the improvement comprises harvesting the pericardium patch using instruments introduced through one or more intercostal spaces, and introducing and securing the patch in the heart through an inner lumen of a tubular access device positioned through a muscular wall of the heart.
- 20. An improved method for closing a cardiac septal defect of the type in which the defect is sutured closed, wherein the improvement comprises suturing the defect using an instrument introduced through an inner lumen of a tubular access device positioned through a muscular wall of the heart.
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of application Ser. No. 09/411,095, filed Oct. 4, 1999, which is a continuation of application Ser. No. 08/643,898, filed May 7, 1996, now issued as U.S. Pat. No. 6,079,414, which is a divisional of application Ser. No. 08/425,179, filed Apr. 20, 1995, now issued as U.S. Pat. No. 5,797,960, which is a continuation-in-part of application Ser. No. 08/163,241, filed Dec. 6, 1993, now issued as U.S. Pat. No. 5,571,215, which is a continuation-in-part of application Ser. No. 08/023,778, filed Feb. 22, 1993, now issued as U.S. Pat. No. 5,452,733. The complete disclosures of these applications are hereby incorporated herein by reference for all purposes.
Divisions (2)
|
Number |
Date |
Country |
Parent |
09411095 |
Oct 1999 |
US |
Child |
10098838 |
Mar 2002 |
US |
Parent |
08425179 |
Apr 1995 |
US |
Child |
08643898 |
May 1996 |
US |
Continuations (1)
|
Number |
Date |
Country |
Parent |
08643898 |
May 1996 |
US |
Child |
09411095 |
Oct 1999 |
US |
Continuation in Parts (2)
|
Number |
Date |
Country |
Parent |
08163241 |
Dec 1993 |
US |
Child |
08425179 |
Apr 1995 |
US |
Parent |
08023778 |
Feb 1993 |
US |
Child |
08163241 |
Dec 1993 |
US |