Direct-access, minimally invasive, beating-heart intracardial procedures have the potential to replace many traditional surgical procedures requiring cardio-pulmonary bypass as long as micro-emboli are prevented from entering the cardiovascular system. A new surgical port was developed to introduce surgical instruments into chambers of the beating heart during minimally invasive, intracardial surgical procedures without allowing the introduction of micro-emboli 0.1 mm or larger in size. The design consists of an outer port body that is secured to the heart wall using a purse string suture and a series of inner tubular sleeves that form the interface between the port and the transecting instrument. The design enables rapid tool changes and accommodates a wide variety of instruments. The port uses a fluid purging system to dislodge and remove emboli from a surgical instrument. Laboratory and clinical tests show that the port adequately seals around a surgical instrument and prevents the introduction of emboli with diameters greater than 0.1 mm into the heart while minimizing hemorrhage.

References

References
1.
Walther
,
T.
,
Simon
,
P.
,
Dewey
,
T.
,
Wimmer-Greinecker
,
G.
,
Falk
,
V.
,
Kasimir
,
M. T.
,
Doss
,
M.
,
Borger
,
M. A.
,
Schuler
,
G.
,
Glogar
,
D.
,
Fehske
,
W.
,
Wolner
,
E.
,
Mohr
,
F. W.
, and
Mack
,
M.
, 2007, “
Transapical Minimally Invasive Aortic Valve Implantation: Multicenter Experience
,”
Circulation
,
116
, pp.
I240
I245
.
2.
Bajona
,
P.
,
Katz
,
W. E.
,
Daly
,
R. C.
,
Zehr
,
K. J.
, and
Speziali
,
G.
, 2009, “
Beating-Heart, Off-Pump Mitral Valve Repair by Implantation of Artificial Chordae Tendineae: An Acute In Vivo Animal Study
,”
J. Thorac. Cardiovasc. Surg.
,
137
(
1
), pp.
188
193
.
3.
Vasilyev
,
N. V.
,
Melnychenko
,
I.
,
Kitahori
,
K.
,
Freudenthal
,
F. P.
,
Phillips
,
A.
,
Kozlik-Feldmann
,
R.
,
Salgo
,
I. S.
,
del Nido
,
P. J.
, and
Bacha
,
E. A.
, 2008, “
Beating-Heart Patch Closure of Muscular Ventricular Septal Defects Under Real-Time Three-Dimensional Echocardiographic Guidance: A Preclinical Study
,”
J. Thorac. Cardiovasc. Surg.
,
135
(
3
), pp.
603
609
.
4.
Stump
,
D. A.
,
Kon
,
N. A.
,
Rogers
,
A. T.
, and
Hammon
,
J. W.
, 1996, “
Emboli and Neuropsychological Outcome Following Cardiopulmonary Bypass
,”
Echocardiography
,
13
(
5
), pp.
555
558
.
5.
Suematsu
,
Y.
,
Marx
,
G. R.
,
Triedman
,
J. K.
,
Mihaljevic
,
T.
,
Mora
,
B. N.
,
Takamoto
,
S.
, and
del Nido
,
P. J.
, 2004, “
Three-Dimensional Echocardiography-Guided Atrial Septectomy: An Experimental Study
,”
J. Thorac. Cardiovasc. Surg.
,
128
(
1
), pp.
53
59
.
6.
Downing
,
S. W.
,
Herzog
,
W. A.
, Jr.
,
McLaughlin
,
J. S.
, and
Gilbert
,
T. P.
, 2002, “
Beating-Heart Mitral Valve Surgery: Preliminary Model and Methodology
,”
J. Thorac. Cardiovasc. Surg.
,
123
(
6
), pp.
1141
1146
.
7.
Leon
,
M. B.
,
Kodali
,
S.
,
Williams
,
M.
,
Oz
,
M.
,
Smith
,
C.
,
Stewart
,
A.
,
Schwartz
,
A.
,
Collins
,
M.
, and
Moses
,
J. W.
, 2006, “
Transcatheter Aortic Valve Replacement in Patients With Critical Aortic Stenosis: Rationale, Device Descriptions, Early Clinical Experiences, and Perspectives
,”
Semin. Thorac. Cardiovasc. Surg.
,
18
(
2
), pp.
165
174
.
8.
Roth-Isigkeit
,
A.
,
Hasselbach
,
L.
,
Ocklitz
,
E.
,
Bruckner
,
S.
,
Ros
,
A.
,
Gehring
,
H.
,
Schmucker
,
P.
,
Rink
,
L.
, and
Seyfarth
,
M.
, 2001, “
Inter-Individual Differences in Cytokine Release in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass
,”
Clin. Exp. Immunol.
,
125
(
1
), pp.
80
88
.
9.
Antonelli
,
M.
,
Testa
,
G.
,
Tritapepe
,
L.
,
D’Errico
,
R. R.
,
Costa
,
D.
,
Giovannelli
,
L.
,
Riccioni
,
L.
,
Gasparetto
,
A.
, and
Catena
,
G.
, 1999, “
IL-8, IL-6 and ICAM-1 in Serum of Paediatric Patients Undergoing Cardiopulmonary Bypass With and Without Cardiocirculatory Arrest
,”
J. Cardiovasc. Surg.
,
40
(
6
), pp.
803
809
.
10.
Graham
,
M.
,
Slocum
,
A.
, and
Sanchez
,
R.
, 2007, “
Teaching High School Students and College Freshmen Product Development by Deterministic Design With PREP
,”
J. Mech. Des.
,
129
(
7
), pp.
677
681
.
11.
White
,
J.
,
Agnihotri
,
A.
,
Latrémouille
,
C.
,
Messas
,
E.
,
Carpentier
,
A.
, and
Torchiana
,
D.
, 2005, “
A Method of Using the Pulmonary Trunk to Form a Trileaflet Valve
,”
J. Thorac. Cardiovasc. Surg.
,
129
(
3
), pp.
677
679
.
You do not currently have access to this content.