Apparatus and methods for off-pump cardiac surgery

Abstract

The invention provides an apparatus for performing surgery on a heart of a patient comprising a first arm, a second arm and an actuator, the actuator moving the first arm relative to the second arm. The apparatus further includes a first blade on the first arm and a second blade on the second arm, the first and second blades having first and second surfaces facing away from each other, the first and second surfaces being adapted to atraumatically engage tissue or bone for the retraction thereof. The apparatus also includes a stabilizer adapted to be mounted to one of the first and second arms and having a foot, the foot being configured to atraumatically engage the surface of the heart. In a various embodiments, the apparatus includes removable blades mounted to the arms, suture stays removably mounted to the arms, and multiple rails for mounting the stabilizer in various positions.

What is claimed is:  
     
         1 . Apparatus for performing surgery on a heart of a patient, comprising: 
 a first arm, a second arm and an actuator, the actuator moving the first arm relative to the second arm;    a first blade on the first arm and a second blade on the second arm, the first and second blades having first and second surfaces facing away from each other, the first and second surfaces being adapted to atraumatically engage tissue or bone for the retraction thereof; and    a stabilizer adapted to be mounted to one of the first and second arms and having a foot, the foot being configured to atraumatically engage the surface of the heart;    wherein the first and second blades are removably coupled to the first and second arms whereby the first and second blades may be removed and replaced with alternate blades.    
     
     
         2 . Apparatus for performing surgery on a heart of a patient, comprising: 
 a first arm, a second arm and an actuator, the actuator moving the first arm relative to the second arm, at least one of the first and second arms having a receptacle thereon;    a first blade on the first arm and a second blade on the second arm, the first and second blades having first and second surfaces facing away from each other, the first and second surfaces being adapted to atraumatically engage tissue or bone for the retraction thereof;    a stabilizer adapted to be coupled to one of the first and second arms and having a foot, the foot being configured to atraumatically engage the surface of the heart; and    a suture stay removably mounted to the receptacle.    
     
     
         3 . The apparatus of  claim 2  wherein the first and second arms are metal.  
     
     
         4 . The apparatus of  claim 3  wherein the suture stay is plastic.  
     
     
         5 . The apparatus of  claim 2  wherein suture stay is contained in a sterile package separate from the first and second arms and the first and second blades.  
     
     
         6 . Apparatus for performing surgery on a heart of a patient, comprising: 
 a rack;    a first arm and a second arm mounted to the rack, the first arm being movable relative to the rack and relative to the other arm;    a first blade on the first arm and a second blade on the second arm, the first and second blades having first and second surfaces facing away from each other, the first and second surfaces being adapted to atraumatically engage tissue or bone for the retraction thereof;    a first rail on the first arm, a second rail on the second arm, and a third rail on the rack; and 
 a stabilizer adapted to be coupled to any one of the first rail, second rail or third rail, the stabilizer having a foot, the foot being configured to atraumatically engage the surface of the heart.  
   
     
     
         7 . A stabilizing device for stabilizing a site on an outer surface of a patient's heart to facilitate surgery thereon, comprising: 
 a shaft;    a foot coupled to the shaft having a contact surface for atraumatically engaging the outer surface of the heart; and    a mount having a first coupling for attachment to a chest retractor, a second coupling for attachment to the shaft, a first movable joint interconnected between the first and second couplings, and a second movable joint interconnected between the first joint and the second coupling;    wherein the each of the first and second joints is movable about at least two axes of rotation.    
     
     
         8 . The stabilizing device of  claim 7  wherein the first and second joints are spherical joints.  
     
     
         9 . The stabilizing device of  claim 7  wherein the first joint comprises a first hemispherical member centered on a first axis and the second joint comprises a second hemispherical member centered on a second axis, the first and second axes being generally perpendicular.  
     
     
         10 . A suture stay for use with a surgical retractor having a pair of blades, comprising: 
 a body having an inner edge and an outer edge;    retention structure on the body for retaining the body on a blade of the surgical retractor;    at least one channel extending through the body from the inner edge to the outer edge, the channel being adapted to removably receive a suture therein; and    a clamp coupled to the body adjacent to the channel and adapted to releasably retain the suture in the channel.