Patent•
Prevention of myocardial infarction induced ventricular expansion and remodeling
25 Apr 2002-
TL;DR: In this article, a method for direct therapeutic treatment of myocardial tissue in a localized region of a heart having a pathological condition is described, which includes identifying a target region of the myocardium and applying material directly and substantially only to at least a portion of the tissue of the target region.
Abstract: A method for direct therapeutic treatment of myocardial tissue in a localized region of a heart having a pathological condition. The method includes identifying a target region of the myocardium and applying material directly and substantially only to at least a portion of the myocardial tissue of the target region. The material applied results in a physically modification the mechanical properties, including stiffness, of said tissue. Various devices and modes of practicing the method are disclosed for stiffening, restraining and constraining myocardial tissue for the treatment of conditions including myocardial infarction or mitral valve regurgitation.
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Patent•
14 Jun 2016
TL;DR: Newness and distinctiveness is claimed in the features of ornamentation as shown inside the broken line circle in the accompanying representation as discussed by the authors, which is the basis for the representation presented in this paper.
Abstract: Newness and distinctiveness is claimed in the features of ornamentation as shown inside the broken line circle in the accompanying representation.
1,500 citations
Patent•
21 Apr 2011TL;DR: In this paper, a surgical instrument can comprise a channel configured to support a staple cartridge and, in addition, an anvil pivotable between open and closed positions relative to the channel.
Abstract: A surgical instrument can comprise a channel configured to support a staple cartridge and, in addition, an anvil pivotable between open and closed positions relative to the channel. The surgical instrument can further comprise a cutting member configured to incise tissue positioned captured between the staple cartridge and the anvil and, in addition, means for stopping the cutting member prior to a distal end datum, wherein the distal end datum can be defined by the distal-most staple cavity in the staple cartridge. In such embodiments, the incision within the tissue may not extend beyond the portion of the tissue that has been stapled.
1,498 citations
Patent•
20 Sep 2016TL;DR: In this article, an E-beam firing bar is used to drive staples on each side of the cut in a surgical severing and stapling instrument, which is suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil.
Abstract: A surgical severing and stapling instrument, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil. An E-beam firing bar moves distally through the clamped end effector to sever tissue and to drive staples on each side of the cut. The E-beam firing bar affirmatively spaces the anvil from the elongate channel to assure properly formed closed staples, especially when an amount of tissue is clamped that is inadequate to space the end effector. In particular, an upper pin of the firing bar longitudinally moves through an anvil slot and a channel slot is captured between a lower cap and a middle pin of the firing bar to assure a minimum spacing. Forming the E-beam from a thickened distal portion and a thinned proximal strip enhances manufacturability and facilitates use in such articulating surgical instruments.
1,384 citations
Patent•
27 Oct 2008
TL;DR: In this paper, a handle assembly, a first endoscopic portion, a motor, and a first effector are described, and the first end effector is configured to perform a first stapling function.
Abstract: A surgical instrument including a handle assembly, a first endoscopic portion, a motor, and a first end effector is disclosed. The first endoscopic portion is selectively connectable to a distal portion of the handle assembly and defines a longitudinal axis. The first endoscopic portion includes a housing adjacent its proximal portion and includes an actuation member. The motor is disposed in mechanical cooperation with the housing of the first endoscopic portion and is operatively connected to the actuation member for moving the actuation member substantially along the longitudinal axis. The first end effector is selectively connectable to a distal portion of the first endoscopic portion and is configured to perform a first stapling function.
1,339 citations
Patent•
30 Jan 2007TL;DR: In this article, a surgical cutting and fastening instrument is described, which includes an end effector comprising an elongate channel, a clamping member pivotably connected to the channel, and a moveable cutting instrument for traversing the channel to cut an object clamped in the end-effector by the clamped member when the member is in a clamped position.
Abstract: A surgical cutting and fastening instrument is disclosed. According to various embodiments, the instrument includes an end effector comprising an elongate channel, a clamping member pivotably connected to the channel, and a moveable cutting instrument for traversing the channel to cut an object clamped in the end effector by the clamping member when the clamping member is in a clamped position. The instrument may also comprise a main drive shaft assembly for actuating the cutting instrument in the end effector, a gear drive train connected to the main drive shaft assembly, and a motor for actuating the gear drive train. The instrument may also includes a closure trigger and a firing trigger, separate from the closure trigger, for actuating the motor when the firing trigger is retracted. Also, the instrument may comprise a mechanical closure system connected to the closure trigger and to the clamping member for causing the clamping member to pivot to the clamped position when the closure trigger is retracted.
1,317 citations
References
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TL;DR: Left ventricular end-diastolic and end-systolic volume and ejection fraction data provide support for the beneficial effects of therapeutic agents such as angiotensin-converting enzyme (ACE) inhibitors and beta-adrenergic blocking agents on the remodeling process.
2,215 citations
TL;DR: The results document the presence of a subepicardial zone of ischemic but viable myocardium which is available for pharmacologic or surgical salvage for at least three and perhaps six hours following circumflex occlusion in the dog.
Abstract: Irreversible ischemic myocardial cell injury developes in an increasing number of cells as the duration of coronary occlusion is prolonged. The present study quantitates myocardial necrosis produced by 40 minutes, 3 hours, or 6 hours of temporary circumflex coronary occlusion (CO) followed by 2 to 4 days of reperfusion, or by 24 or 96 hours of permanent circumflex ligation in pentobarbital anesthetized open chest dogs. After 40 minutes of ischemia, myocyte necrosis was subendocardial but with increasing duration of coronary occlusion, irreversible injury progressed as a wavefront toward the subepicardium. Transmural necrosis was 38 +/- 4% after 40 min, 57 +/- 7% after 3 hours, 71 +/- 7% after 6 hours and 85 +/- 2% after 24 hours of ischemic injury. These results document the presence of a subepicardial zone of ischemic but viable myocardium which is available for pharmacologic or surgical salvage for at least three and perhaps six hours following circumflex occlusion in the dog.
1,968 citations
Patent•
05 Jan 1990
TL;DR: In this article, an elongate steerable implement (10, 45, 60, 76) is dislcosed, which may be either a steerable guidewire or catheter for coronary angioplasty applications.
Abstract: An elongate steerable implement (10, 45, 60, 76) is dislcosed, which may be either a steerable guidewire or catheter for coronary angioplasty applications. A floppy steerable tip on a steering region (16) at the distal end (14) of the implement (10) and a control device (18) at the proximal end (12) are connected by means of a plurality of axially movable deflection wires (28) extending throughout the implement. Manipulation of the control (18) permits deflection of the steering region (16) throughout a full 360° range of motion about the axis of the implement, without axial rotation or ''torquing'' thereof.
1,283 citations
TL;DR: BMCs cultured with 5-aza differentiated into cardiac-like muscle cells in culture and in vivo in ventricular scar tissue and improved myocardial function.
Abstract: Background—Autologous bone marrow cells (BMCs) transplanted into ventricular scar tissue may differentiate into cardiomyocytes and restore myocardial function. This study evaluated cardiomyogenic differentiation of BMCs, their survival in myocardial scar tissue, and the effect of the implanted cells on heart function. Methods and Results—In vitro studies: BMCs from adult rats were cultured in cell culture medium (control) and medium with 5-azacytidine (5-aza, 10 μmol/L), TGFβ1 (10ng/mL), or insulin (1 nmol/L) (n=6, each group). Only BMCs cultured with 5-aza formed myotubules which stained positively for troponin I and myosin heavy chain. In vivo studies: a cryoinjury-derived scar was formed in the left ventricular free wall. At 3 weeks after injury, fresh BMCs (n=9), cultured BMCs (n=9), 5-aza–induced BMCs (n=12), and medium (control, n=12) were autologously transplanted into the scar. Heart function was measured at 8 weeks after myocardial injury. Cardiac-like muscle cells which stained positively for my...
1,100 citations
TL;DR: The eccentric exercise gives rise to muscles soreness and influences, on mechanical basis and selectively with regard to fiber type, the fine structure of the contractile apparatus.
Abstract: Muscle soreness that has a delayed onset is a common feature among both athletes and untrained individuals who engage in unusual exercises. This study was designed to provide additional morphological data to assess the relevance and significance of our previous findings that the sore muscles contain fibers with disorganized myofibrillar material. Muscle biopsies were obtained from 12 males (mean age 25 +/- 7 years), who suffered from severe soreness in their thigh muscles 18--72 h following eccentric bicycle exercise. Their strength performance were tested in parallel. Knee extensor strength was decreased at all angular velocities soon after exercise but gradually increased over the subsequent days although slower at the fastest contractions. Disturbances of the cross-striated band pattern were constantly observed. They originated from the myofibrillar Z-band, which showed marked streaming, broadening and, at places, total disruption. The disturbances were found in every second to every third fiber up to 3 days after exercise and in one tenth of the fibers 6 days following the exercise. Type 2 fibers were predominantly affected. Thus, the eccentric exercise gives rise to muscles soreness and influences, on mechanical basis and selectively with regard to fiber type, the fine structure of the contractile apparatus.
1,019 citations