Methods and devices for cardiac surgery

Abstract

Methods for performing minimally invasive heart surgery include accessing a heart of a patient through a first incision on the left thorax of the patient, contacting the heart through the incision with a heart stabilizing device and/or a heart positioning device, introducing at least one coupling device through a second incision on the patient located apart from the first incision, coupling the coupling device with the heart stabilizing device or the heart positioning device, and performing a surgical procedure on the heart. Systems may include a retractor device, a heart stabilizing device, and a coupling device, for enhancing cardiac surgery. Any suitable heart surgery may be performed using methods, devices or systems of the present invention. In one embodiment, a CABG procedure is performed.

What is claimed is: 
     
         1 . A method for performing minimally invasive heart surgery in a patient, the method comprising:
 introducing a heart stabilizing device through a first incision on the patient, the heart stabilizing device comprising a tissue contacting surface;   introducing a first coupling device through a second incision on the patient, the first coupling device comprising a flexible, rigidifying portion having a plurality of pieces and a wire that when tightened locks the pieces of the rigidifying portion;   coupling the first coupling device with the heart stabilizing device;   introducing a heart positioning device through the first incision on the patient, the heart stabilizing device comprising a tissue contacting surface;   introducing a second coupling device through a third incision on the patient; and   coupling the second coupling device with the heart positioning device.   
     
     
         2 . The method according to  claim 1 , further comprising coupling the first coupling device with a stable object. 
     
     
         3 . The method according to  claim 2 , wherein the stable object comprises at least one part of an operating room table. 
     
     
         4 . The method according to  claim 2 , comprising rigidifying the flexible, rigidifying portion of the first coupling device after coupling the first coupling device with the stable object. 
     
     
         5 . The method according to  claim 1 , wherein the heart stabilizing device comprises a suction aperture adjacent the tissue contacting surface, the method further comprising providing a vacuum at the suction aperture of the heart stabilizing device. 
     
     
         6 . The method according to  claim 1 , wherein the heart positioning device comprises a suction aperture adjacent the tissue contacting surface, the method further comprising providing a vacuum at the suction aperture of the heart positioning device. 
     
     
         7 . The method according to  claim 1 , further comprising contacting heart tissue of the patient with the tissue contacting surface of the heart stabilizing device. 
     
     
         8 . The method according to  claim 1 , further comprising contacting heart tissue of the patient with the tissue contacting surface of the heart positioning device. 
     
     
         9 . The method according to  claim 1 , wherein the second coupling device comprises a flexible, rigidifying portion having a plurality of pieces and a wire that when tightened locks the pieces of the rigidifying portion into place. 
     
     
         10 . The method according to  claim 1 , wherein the heart stabilizing device comprises a ball, wherein the first coupling device comprises a collet or socket, and wherein coupling the first coupling device with the heart stabilizing device comprises coupling the ball with the collet or socket. 
     
     
         11 . The method according to  claim 10 , comprising tightening the collet or socket around the ball using a tightening device. 
     
     
         12 . The method according to  claim 1 , wherein the heart positioning device comprises a ball, wherein the second coupling device comprises a collet or socket, and wherein coupling the second coupling device with the heart positioning device comprises coupling the ball with the collet or socket. 
     
     
         13 . The method according to  claim 12 , comprising tightening the collet or socket around the ball using a tightening device. 
     
     
         14 . The method according to  claim 1 , wherein the heart stabilizing device comprises a surface feature, wherein the first coupling device comprises a slot, and wherein coupling the first coupling device with the heart stabilizing device comprises coupling the slot with the surface feature. 
     
     
         15 . The method according to  claim 1 , wherein the heart positioning device comprises a surface feature, wherein the second coupling device comprises a slot, and wherein coupling the second coupling device with the heart positioning device comprises coupling the slot with the surface feature. 
     
     
         16 . The method according to  claim 1 , wherein the first coupling device comprises threads, wherein the heart stabilizing device comprises complementary threads, and wherein coupling the first coupling device with the heart stabilizing device comprises coupling the threads with the complementary threads. 
     
     
         17 . The method according to  claim 1 , wherein the second coupling device comprises threads, wherein the heart positioning device comprises complementary threads, and wherein coupling the second coupling device with the heart positioning device comprises coupling the threads with the complementary threads. 
     
     
         18 . The method according to  claim 1 , wherein the first coupling device comprises a clamp, and wherein coupling the first coupling device with the heart stabilizing device comprises coupling the clamp with the heart stabilizing device. 
     
     
         19 . The method according to  claim 1 , wherein the second coupling device comprises a clamp, and wherein coupling the second coupling device with the heart positioning device comprises coupling the clamp with the heart positioning device. 
     
     
         20 . A method for performing minimally invasive heart surgery in a patient, the method comprising:
 introducing a heart stabilizing device through a first incision on the patient, the heart stabilizing device comprising a tissue contacting surface;   introducing a first coupling device through a second incision on the patient, the first coupling device comprising a flexible, rigidifying portion having a plurality of pieces and a wire that when tightened locks the pieces of the rigidifying portion; and   coupling the first coupling device with the heart stabilizing device.   
     
     
         21 . The method according to  claim 20 , further comprising coupling the first coupling device with a stable object. 
     
     
         22 . The method according to  claim 21 , wherein the stable object comprises at least one part of an operating room table. 
     
     
         23 . The method according to  claim 21 , comprising rigidifying the flexible, rigidifying portion of the first coupling device after coupling the first coupling device with the stable object. 
     
     
         24 . The method according to  claim 20 , wherein coupling the first coupling device with the heart stabilizing device comprises coupling a first flexible arm with the first coupling device and with the heart stabilizing device. 
     
     
         25 . The method according to  claim 20 , wherein the plurality of pieces comprises a plurality of beads. 
     
     
         26 . A method for performing minimally invasive heart surgery in a patient, the method comprising:
 introducing a heart stabilizing device through a first incision on the patient, the heart stabilizing device comprising a tissue contacting surface;   introducing a first coupling device through a second incision on the patient, the first coupling device comprising a flexible, rigidifying portion having a plurality of pieces and a wire that when tightened locks the pieces of the rigidifying portion; and   coupling the first coupling device with the heart stabilizing device with a distal coupling means.   
     
     
         27 . The method according to  claim 26 , comprising tightening or loosening the distal coupling means with an actuation device.