Source: http://www.google.com/patents/US6712821?dq=6,970,917
Timestamp: 2017-10-22 05:00:53
Document Index: 93702611

Matched Legal Cases: ['arts 5', 'arts 62', 'arts 5', 'arts 44', 'arts 5', 'arts 5', 'arts 5', 'arts 5', 'arts 5']

Patent US6712821 - Sternum closure apparatus and method for helping maintain a space between ... - Google Patents
An apparatus (10) maintains a desired distance between two parts (5, 6) of a severed sternum of a patient. The apparatus (10) includes an elongate member (20), such as a plastic or surgical steel plate, and an element (60) for securing the elongate member (20) to each of the two parts (5, 6) of the severed...http://www.google.com/patents/US6712821?utm_source=gb-gplus-sharePatent US6712821 - Sternum closure apparatus and method for helping maintain a space between parts of the sternum
Publication number US6712821 B2
Also published as CA2489150A1, EP1521552A1, US20040010256, WO2004006783A1
Publication number 10194654, 194654, US 6712821 B2, US 6712821B2, US-B2-6712821, US6712821 B2, US6712821B2
US 6712821 B2
an elongate member having a length approximately equal to the length of the sternum, the elongate member having longitudinal edges dimensioned and configured to extend between and space apart the two parts of the severed sternum the predetermined distance; and
6. The apparatus of claim 1, the securing means further comprising a retainer having a threaded aperture dimensioned and configured for threading engagement with the at least one threaded shaft.
8. The apparatus as set forth in claim 7, further comprising a threaded shaft for interconnecting the elongate member and the disk-shaped retainer.
20. The apparatus of claim 19, the at least one shaft further comprising at least a pair of shafts, each shaft extending from the upper surface of the body portion near one of the lateral edge portions, the elongate member of the retaining element further comprising a pair of apertures extending therethrough and spaced apart from each other to facilitate receiving a pair of the shafts.
Thousands of open-heart operations are performed in the United States each year. In order to perform most of them, the chest is opened through a mid-line sternotomy (the sternum of the chest bone is longitudinally split with an electrical saw). After the procedure is complete, the sternum is closed by a conventional method such as stainless steel wire or a clamping mechanism. However, the heart and other organs often become edematous, swollen, and generally larger than their original size. As a result, while closing the sternum and after the closure, the pressure exerted by the sternum over the enlarged organs may cause post-procedure complications such as low blood pressure, arythmias, and possibly even fatality.
FIG. 1 is a schematic perspective view of an apparatus in accordance with one feature of the present invention.
FIG. 2 is schematic orthogonal view of the apparatus of FIG. 1 implanted within a patient.
FIG. 3 is a schematic sectional view taken along line 3—3 in FIG. 2.
FIG. 4 is a schematic view similar to FIG. 3 in accordance with another aspect of the present invention.
FIG. 5 is a schematic view similar to FIG. 3 in accordance with still another aspect of the present invention.
FIG. 6 is a schematic sectional view similar to FIG. 3 showing yet another aspect of the present invention.
FIG. 7 is a schematic longitudinal sectional view of one aspect of the apparatus of FIG. 1.
FIG. 8 is a schematic longitudinal sectional view of another aspect of the apparatus of FIG. 1.
FIG. 9 is a schematic longitudinal sectional view of still another aspect of the apparatus of FIG. 1.
FIG. 10 is a schematic longitudinal sectional view of yet another aspect of the apparatus of FIG. 1.
FIG. 11 is a schematic longitudinal sectional view of still another aspect of the apparatus of FIG. 1.
FIG. 12 is a schematic view showing a method of positioning the apparatus of FIG. 1 within a patient.
FIG. 13 is a schematic view of part of the apparatus of FIG. 1 in a first installation position.
FIG. 14 is a schematic view of part of the apparatus of FIG. 1 in a second installation position.
FIG. 15 is a schematic view of another aspect of part of the apparatus of FIG. 1 in a third installation position.
FIG. 16 is a schematic view of still another aspect of part of the apparatus of FIG. 1 in a fourth installation position.
FIG. 4 illustrates another aspect of the apparatus 10. The elongate member 20 is covered with a sheath 29 of natural or synthetic material, such as animal pericardium (e.g., bovine, equine, porcine) or other suitable generally flexible biocompatible material. The pericardium sheath 29, for example, such as has been fixed in a suitable glutaraldehyde solution further can be substantially detoxified tissue. Those skilled in the art will understand and appreciate that a covering of pericardium or other tissue (natural or synthetic) can be used in connection with any of the designs shown and described herein (see, e.g., FIGS. 7-11) as well as can be applied over retaining features (see, e.g., FIGS. 1-6, 13-16).
FIG. 9 illustrates an elongate member 520 with a wave-like shape and a variable thickness. FIG. 10 illustrates an elongate member 620 with a wave-like shape and a uniform thickness. FIG. 11 illustrates an elongate member 720 with a zigzag wave shape and a uniform thickness. Which of these features is utilized, and in what combination, in a particular situation may be determined by cost, desired stiffness, gap desired between the parts 5, 6 of the severed sternum, size of the patient, etc.
FIGS. 13 and 14 illustrate an example of how to position an elongate retainer 60 along the respective threaded shaft 50 according to one aspect of the present invention. The elongate retainer 60 is positioned such that the shaft 50 extends through the openings of the elongate retainer and away from the anterior surface 28 of the elongate retainer. A threaded fastener 80, such as a nut, may be threaded onto each shaft 50 so that a posterior surface of each fastener engages the anterior surface 68 of its associated elongate retainer 60. The fasteners 80 are then tightened so that the posterior surfaces 70 of the first and second lateral parts 62, 64 of each elongate retainer 60, and the triangular teeth 72, engage and penetrate the anterior surfaces 7 of the parts 5, 6 of the severed sternum. The tightening of the fasteners 80 against the anterior surface 68 of the elongate retainer 60 also forces the anterior surfaces 46 of the second parts 44 of the projections 40 against the posterior surfaces 8 of the parts 5, 6 of the severed sternum.
For example, the portions of the retainers 60, 160 that engage threads of the shaft 50 may be constructed of metal or plastic. Similarly, the shaft 50 itself may also be metal or plastic. Additionally, it may be easy to reopen the sternum as part or all of the apparatus 10 will have been absorbed and need not be removed, thus simplifying the procedure.
In view of the foregoing structural and functional aspects, those skilled in the art will understand and appreciate how the various types of apparatuses in accordance an aspect of the present invention can be utilized to help maintain a desired space between parts of a longitudinally severed sternum of a patient. By way of example, the desired space can be maintained by implanting an elongate member (e.g., the member 20, 320, 420, 520 620, 720, 820) between opposite parts 5, 6 of the longitudinally severed sternum. The member can be inserted in a manner described with respect to FIG. 12, although those skilled in the art will appreciate other ways to insert the member according to an aspect of the present invention. Once in place, the parts 5, 6 of the longitudinally severed sternum can be permitted to close toward each other, such that the opposite parts 5, 6 of the longitudinally severed sternum each engage the elongate member. At this point, the elongate member can be secured to the opposite parts 5, 6 of the severed sternum such that a lateral dimension of the elongate member 20 provides the desired post-closure space.
US5339870 Oct 9, 1992 Aug 23, 1994 United States Surgical Corporation Sternum buckle and applier
WO2015143513A1 * Mar 23, 2015 Oct 1, 2015 Coelho De Souza Eduardo Structural arrangement for heart protector
U.S. Classification 606/71, 606/213, 606/328, 606/301, 606/76
Cooperative Classification A61B17/823, A61B17/8076