US3630207A - Pericardial catheter - Google Patents

Pericardial catheter Download PDF

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Publication number
US3630207A
US3630207A US3630207DA US3630207A US 3630207 A US3630207 A US 3630207A US 3630207D A US3630207D A US 3630207DA US 3630207 A US3630207 A US 3630207A
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Prior art keywords
catheter
tube
flat
plurality
bottom wall
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Expired - Lifetime
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Paul Kahn
Mogens L Bramson
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Cutter Laboratories Inc
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Cutter Laboratories Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M27/00Drainage appliances for wounds or the like, i.e. wound drains, implanted drains
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621Extra-corporeal blood circuits
    • A61M1/3653Interfaces between patient blood circulation and extra-corporal blood circuit
    • A61M1/3659Cannulae pertaining to extracorporeal circulation

Abstract

The pericardial catheter has a main tube, flat in cross section, open at one end and closed at the other. The top wall is flat and the bottom wall is generally flat, having a plurality of openings near to but spaced from the closed end. A plurality of lengthwise extending ridges lie between successive openings and on each end of them. A round collapse-prevention member is inside the main tube and has an outer diameter at least as great as the inner distance between the top and bottom walls.

Description

United States Patent mi 3,630,207

[72] Inventors Paul Kalm; 1,596,754 8/1926 Moschelle 128/350 Mogens L. Bramson, both of San Francisco, 3,136,316 6/ 1 964 Beall 128/350 Calif. 3,430,631 3/1969 Abramson 128/350 21 AppLNo. 848,510 OTHERREFERENCES Edted t d 1 9 7 1 Miller et a1.- .lour. Thorac. & Card. Surg., Vol. 56 No. 4. a en e Oct. 68, pp. 607- 608 [73] Assignee Cutter Laboratories,lnc.

Berkeley, Calif. Primary Examiner Dalton L. Truluck Attorneys-Bertram Bradley and Owen, Wickersham &

Erickson [54] PERICARDIAL CATHETER 7 Claims, 4 Drawing Figs.

ABSTRACT: The pericardial catheter has a main tube, flat in ...A6ll2I:/1;3?0R0 cross Secfion open at one end and closed at he Omen The mp 501 Field tar 55H. Ins/348451 is and is having a rality of openings near to but spaced from the closed end. A plurality of lengthwise extending ridges lie between successive [56] References Cited openings and on each end of them A round col1apse preven UNITED STATES PATENTS lion member is inside the main tube and has an outer diameter 204,905 6/1878 L k 12 /349 at least as great as the inner distance between the top and bot- 1,045,326 11/1912 Ruflin 128/349 m ll PERICARDIAL CATHETER This invention relates'to animproved pericardial catheter or drainage tube. v v

Among the serious problems that remain in the field of surgery requiring extracorporeal circulation are intraoperative hemolysis and postoperative tamponade.

While there are many possible causes of hemolysis, it has been found that one of the major causes relates to blood lying in extracardiac spaces (pericardial or pleural) for prolonged periods of time before being returned to the pump oxygenator. As this blood pools, it is contaminated by tissue fluid and fat droplets, and drying occurs at the blood-air-mernbrane junction. Further, cell tra'uma'has been found to occur when this mixture is returned to the venous reservoirby a suction source that mixes great amounts of air with the blood. Together, these factors app'earto'be a major source of hemolysis, at least in some systems of extracorporeal circulation. I

It has been found that these. factors can be largely eliminated by the continuous evacuation of the pericardial space by means of a gentle source of suction, thereby reducing to a minimum the time for tissue fluid to mix with'the blood, for drying to occur, and for the blood and air to mix in .the cardiotomy suction. In considering these problems of intraoperative hemolysis and postoperative tamponade, it became apposition in the pericardium would effectively remove the blood during the procedure and could be placed or left in place postoperatively as a means of dependent pericardial drainage, so longas it would not cause cardiac irritability or otherwise interfere with cardiac contraction. However, fora tube to be suitable for this use, there must be means to insure against its collapse, because if it should collapse, or if anything should rest on it, serious problems might result.

l have found that these problems can be solved by employing a tube or catheter which israther flat in shape, is quite flexible, and is kept open at all times by means of a small.

round inner tube of substantially the same material and about the same .diameter, or slightly larger in minimum exterior diameter than the smallest interior dimension of the flat tube to be used The inner tube included in the lumen of the catheter prevents collapse even when bending occurs. Another feature of the tube or catheter of my invention is that the surface of the dependent end of the tube, which lies against the pericardium, has smooth, interrupted ridges; these serveto prevent the suction opening from being drawn against .the pericardium, and they also provide multiple channels for the progression of the blood into the catheter. The tube or catheter is provided with a pair of generally rectangular entrance openings on the surface having the ridges.

Further objects and advantages of the invention will appear from the following description of the preferred embodiment.

ln the drawings: FIG. 1 is a bottom plan view'of a tube or catheter embodying the principles of the invention.

FIG. 2 is a view in section taken along the line 2-2 in FIG. I.

FIG. 3 is a view in section taken along the line 3-3 in FIG. 1.

FIG. 4 is a view in section taken along the line 44 in F IG. 1.

A catheter l embodying the. principles of the invention is shown in the drawings; typically, the catheter it) may be approximately l2 inches long, three-fourths of an inch wide, and

one-fourth of an inch thick. It comprises a flattened flexible tube 11 made from a suitable plastic, such as a silicone which does not introduce problems of infection. It should be, in

other words, inert, so far as the body fluids are concerned. The tube 11 has a generally flat top surface 12 and rather shallow sidewalls l3 and 14. The largest proportion of its bottom surface 15 comprises a flat portion 16, but adjacent the dependent end 17 of the tube 11 there is a plurality of ridges 20, 21, and 22 of about the proportion shown in the drawings. Between the ridges 20 and 21 there is an entrance opening 23, and between the ridges 20 and 22 there is an entrance opening parent that a drainage or catheter tube placed in a dependent 2s 24. These entrance openings 23-and 24 are preferably approximately rectangular and serve to take in the fluid. The smooth ridges 20, 21, and 22 prevent the suction openings 23 and 24 from being drawn against the pericardium and at the same time they provide between them multiple channels 25, 26, 27, 28, 29, and 30 for the progression of the blood into the openings 23' and 24.

The interior or lumen 31 of the tube ll is quite flat in cross section as shown in FIGS. 3 and 4 and is featured by containing an interior collapse-preventing tube 32 which is nominally round'in cross section and is preferably slightly larger in outer diameter than the interior diameter of the lumen 31 in its narrowest direction. This tube 32 need not be cemented in place if so made slightly larger, for it will then be held by the natural elasticity ofthe outer flat tube 11, slightly compressing the walls of the round tube 32, and making the-lumen 3i seek to regain its shaped and thus hold the tube 32 in place. ln place of the tube 32, a rod may be used, but a tube is better because it distorts more easily and therefore is more easily retained in place; moreover a tube 32 provides an additional lumen for suction. Cement or welding may be used to hold the tube 32 in place, but as stated, this is usually unnecessary.

Wherever bending should occur, the tube 32 prevents collapse of the tube 1] and even substantial weights do not collapse the tube 11 made in this manner.

The relationship of the heart to the pericardial space is such that if approached by way of a median sternotomy, the oblique sinus is slightly cephalad to the angle formed by the diaphragmatic and posterior parietal pericardium. This anatomic feature thus necessitates only a very slight bend in the catheter 10 for the lowermost hole 24 to be in its dependent position. In clinical use, it has appeared to work best if it enters the pericardial space by a stab wound in the right subcostal space just lateral to the lower end of the median sternotomy skin incision.

in clinical use, the catheter 10 is placed just as bypass is instituted and is connected by a wired connector to a cardiotomy suction source. At the completion of bypass it is connected to the usual chest suction and remains so during postoperative period, until drainage has ceased. it is removed in the same way as any other chest tube.

The catheter 10 has been used on many patients without any ill effects. So long as used in the described manner, the catheter 10 does not interfere with operative manipulations and has been noted to keep the pericardium free of blood. In the postoperative period, there has been no evidence of cardiac irritability, the tube 11 is drained well, and the milking of the tube 11 by the left venticular action prevents clotting. Frequently, the blood level will be seen moving back and forth with the heart action.

To those skilled in the art to which this invention relates, many changesin construction and widely differing embodiments and applications of the invention will suggest them- Selves without departing from the spirit and scope of the invention. The disclosures and the description herein-are purely illustrative and are not intended to be in any sense limiting.

We claim:

l. A pericardial catheter, including in combination, a main tube of flexible plastic flat in cross section open at one end and closed at the other and having a flat top wall, a generally flat bottom wall, and shallow sidewalls, said bottom wall having entrance opening means. spaced from the closed end of the tube, said bottom wall also having a plurality of lengthwise extending ridges adjacent the longitudinal ends of said opening means, and

a collapse-prevention member, round in cross section, in-

side said main tube along the longitudinal centerline thereof and having an outer diameter at least as great as the inner distance between said top and bottom walls.

2. The catheter of claim I having a plurality of entrance I opening means spaced apart from each other by a plurality of and slightly larger in outer diameter than the inner distance between said top and bottom walls.

5. The catheter of claim 4 wherein said entrance openings are generally rectangular.

6. The catheter of claim 5 wherein there are two said entrance openings and wherein there are three said ridges in each location of said ridges.

7. The catheter of claim 6 wherein said entrance openings are approximately as wide as the width across said ridges.

Claims (7)

1. A pericardial catheter, including in combination, a main tube of flexible plastic, flat in cross section open at one end and closed at the other and having a flat top wall, a generally flat bottom wall, and shallow sidewalls, said bottom wall having entrance opening means spaced from the closed end of the tube, said bottom wall also having a plurality of lengthwise extending ridges adjacent the longitudinal ends of said opening means, and a collapse-prevention member, round in cross section, inside said main tube along the longitudinal centerline thereof and having an outer diameter at least as great as the inner distance between said top and bottom walls.
2. The catheter of claim 1 having a plurality of entrance opening means spaced apart from each other by a plurality of lengthwise extending ridges.
3. The catheter of claim 1 wherein said collapse-prevention member is a hollow tube.
4. A pericardial catheter, including in combination, a main flexible plastic tube, flat in cross section open at one end and closed at the other and having a generally flat bottom wall, a flat top wall, and shallow sidewalls, said bottom wall having a plurality of entrance openings spaced from each other and from the closed end of the tube, said bottom wall also having a plurality of lengthwise extending ridges between said openings and adjacent their distal ends, and a collapse-prevention tube, round in cross section inside said main tube along the longitudinal outerline thereof and slightly larger in outer diameter than the inner distance between said top and bottom walls.
5. The catheter of claim 4 wherein said entrance openings are generally rectangular.
6. The catheter of claim 5 wherein there are two said entrance openings and wherein there are three said ridges in each location of said ridges.
7. The catheter of claim 6 wherein said entrance openings are approximately as wide as the width across said ridges.
US3630207A 1969-08-08 1969-08-08 Pericardial catheter Expired - Lifetime US3630207A (en)

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Cited By (41)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4317452A (en) * 1980-02-04 1982-03-02 C. R. Bard, Inc. Body fluid drain
EP0101890A1 (en) * 1982-07-30 1984-03-07 Karl Dr. Aigner Double lumen catheter for a device for in-vivo cleansing of the blood
US4465481A (en) * 1981-02-26 1984-08-14 Innovative Surgical Products, Inc. Single piece wound drain catheter
US4688568A (en) * 1985-02-20 1987-08-25 Michael Frass Respiratory tube or airway
US4863441A (en) * 1987-07-17 1989-09-05 Minnesota Mining And Manufacturing Company Venous return catheter
US5041084A (en) * 1990-08-09 1991-08-20 Dlp, Inc. Single stage venous catheter
WO1993007931A1 (en) * 1991-10-24 1993-04-29 Georgetown University Pericardial access via the right auricle
US5389091A (en) * 1991-03-07 1995-02-14 C. R. Bard, Inc. Site-selective durability-enhanced catheter and methods of manufacturing and using same
US5641458A (en) * 1995-06-15 1997-06-24 Shockley, Jr.; H. David Flow through cell assembly
US5968010A (en) * 1997-04-30 1999-10-19 Beth Israel Deaconess Medical Center, Inc. Method for transvenously accessing the pericardial space via the right atrium
EP0956094A1 (en) * 1995-06-07 1999-11-17 Cormedics Corp. Method and apparatus for accessing the pericardial space
US6200303B1 (en) 1997-04-30 2001-03-13 Beth Israel Deaconess Medical Center, Inc. Method and kit for transvenously accessing the pericardial space via the right atrium
US6478789B1 (en) 1999-11-15 2002-11-12 Allegiance Corporation Wound drain with portals to enable uniform suction
US6517536B2 (en) 2000-04-27 2003-02-11 Atricure, Inc. Transmural ablation device and method
US20040215168A1 (en) * 1997-04-30 2004-10-28 Beth Israel Deaconess Medical Center Kit for transvenously accessing the pericardial space via the right atrium
US20040249360A1 (en) * 1999-03-22 2004-12-09 Spehalski Stephan R. Steerable wound drain device
US6889694B2 (en) 2000-04-27 2005-05-10 Atricure Inc. Transmural ablation device
US6905498B2 (en) 2000-04-27 2005-06-14 Atricure Inc. Transmural ablation device with EKG sensor and pacing electrode
US6932811B2 (en) 2000-04-27 2005-08-23 Atricure, Inc. Transmural ablation device with integral EKG sensor
US7288092B2 (en) 2003-04-23 2007-10-30 Atricure, Inc. Method and apparatus for ablating cardiac tissue with guide facility
US7291161B2 (en) 2002-10-02 2007-11-06 Atricure, Inc. Articulated clamping member
US7470272B2 (en) 1997-07-18 2008-12-30 Medtronic, Inc. Device and method for ablating tissue
US20090076482A1 (en) * 2007-09-14 2009-03-19 Avalon Laboratories, Inc. Cannula reinforcing band and method
US7507235B2 (en) 2001-01-13 2009-03-24 Medtronic, Inc. Method and system for organ positioning and stabilization
US7530980B2 (en) 2004-04-14 2009-05-12 Atricure, Inc Bipolar transmural ablation method and apparatus
US7566334B2 (en) 2004-06-02 2009-07-28 Medtronic, Inc. Ablation device with jaws
US7628780B2 (en) 2001-01-13 2009-12-08 Medtronic, Inc. Devices and methods for interstitial injection of biologic agents into tissue
US7740623B2 (en) 2001-01-13 2010-06-22 Medtronic, Inc. Devices and methods for interstitial injection of biologic agents into tissue
US20100160719A1 (en) * 2006-06-30 2010-06-24 Kassab Ghassan S Devices, systems, and methods for pericardial access
US7744562B2 (en) 2003-01-14 2010-06-29 Medtronics, Inc. Devices and methods for interstitial injection of biologic agents into tissue
US20100168791A1 (en) * 2006-06-30 2010-07-01 Cvdevices, Llc (A California Limited Liability Company) Systems and methods for closing a hole in cardiac tissue
US20100185140A1 (en) * 2006-06-30 2010-07-22 Kassab Ghassan S Devices, systems, and methods for promotion of infarct healing and reinforcement of border zone
US20100228221A1 (en) * 2006-06-30 2010-09-09 Kassab Ghassan S Devices, systems, and methods for obtaining biopsy tissue samples
US20100312256A1 (en) * 2006-06-30 2010-12-09 Cvdevices, Llc Devices, systems, and methods for lead delivery
US20110060182A1 (en) * 2007-04-27 2011-03-10 Cvdevices, Llc Systems for engaging a bodily tissue and methods of using the same
US20110144572A1 (en) * 2007-04-27 2011-06-16 Kassab Ghassan S Steering engagement catheter devices, systems, and methods
US7967816B2 (en) 2002-01-25 2011-06-28 Medtronic, Inc. Fluid-assisted electrosurgical instrument with shapeable electrode
US20110224720A1 (en) * 2010-03-11 2011-09-15 Cvdevices, Llc Devices, systems, and methods for closing a hole in cardiac tissue
US20120089164A1 (en) * 2010-10-12 2012-04-12 Seiko Epson Corporation Fluid ejection device and medical instrument
US8540674B2 (en) 2007-04-27 2013-09-24 Cvdevices, Llc Devices, systems, and methods for transeptal atrial puncture using an engagement catheter platform
EP2708257A1 (en) * 2012-09-12 2014-03-19 Chi Mei Medical Center Tracheal tube for secretion removal

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Cited By (100)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4317452A (en) * 1980-02-04 1982-03-02 C. R. Bard, Inc. Body fluid drain
US4465481A (en) * 1981-02-26 1984-08-14 Innovative Surgical Products, Inc. Single piece wound drain catheter
EP0101890A1 (en) * 1982-07-30 1984-03-07 Karl Dr. Aigner Double lumen catheter for a device for in-vivo cleansing of the blood
US4688568A (en) * 1985-02-20 1987-08-25 Michael Frass Respiratory tube or airway
US4863441A (en) * 1987-07-17 1989-09-05 Minnesota Mining And Manufacturing Company Venous return catheter
US5041084A (en) * 1990-08-09 1991-08-20 Dlp, Inc. Single stage venous catheter
US5389091A (en) * 1991-03-07 1995-02-14 C. R. Bard, Inc. Site-selective durability-enhanced catheter and methods of manufacturing and using same
WO1993007931A1 (en) * 1991-10-24 1993-04-29 Georgetown University Pericardial access via the right auricle
US5269326A (en) * 1991-10-24 1993-12-14 Georgetown University Method for transvenously accessing the pericardial space via the right auricle for medical procedures
EP0956094A4 (en) * 1995-06-07 2009-09-02 Cormedics Corp Method and apparatus for accessing the pericardial space
EP0956094A1 (en) * 1995-06-07 1999-11-17 Cormedics Corp. Method and apparatus for accessing the pericardial space
US6666844B1 (en) * 1995-06-07 2003-12-23 Stephen R. Igo Method and apparatus for accessing the pericardial space
US5641458A (en) * 1995-06-15 1997-06-24 Shockley, Jr.; H. David Flow through cell assembly
US5968010A (en) * 1997-04-30 1999-10-19 Beth Israel Deaconess Medical Center, Inc. Method for transvenously accessing the pericardial space via the right atrium
US20040215168A1 (en) * 1997-04-30 2004-10-28 Beth Israel Deaconess Medical Center Kit for transvenously accessing the pericardial space via the right atrium
US6200303B1 (en) 1997-04-30 2001-03-13 Beth Israel Deaconess Medical Center, Inc. Method and kit for transvenously accessing the pericardial space via the right atrium
US7678111B2 (en) 1997-07-18 2010-03-16 Medtronic, Inc. Device and method for ablating tissue
US7470272B2 (en) 1997-07-18 2008-12-30 Medtronic, Inc. Device and method for ablating tissue
US20100198171A1 (en) * 1999-03-22 2010-08-05 Spehalski Stephan R Steerable wound drain device
US20040249360A1 (en) * 1999-03-22 2004-12-09 Spehalski Stephan R. Steerable wound drain device
US8834453B2 (en) 1999-03-22 2014-09-16 Allegiance Corporation Steerable wound drain device
US7658735B2 (en) 1999-03-22 2010-02-09 Spehalski Stephan R Steerable wound drain device
US8545481B2 (en) 1999-03-22 2013-10-01 Allegiance Corporation Steerable wound drain device
US6478789B1 (en) 1999-11-15 2002-11-12 Allegiance Corporation Wound drain with portals to enable uniform suction
US6896673B2 (en) 2000-04-27 2005-05-24 Atricure, Inc. Method for transmural ablation
US6974454B2 (en) 2000-04-27 2005-12-13 Atricure, Inc. Transmural ablation device with thermocouple for measuring tissue temperature
US6984233B2 (en) 2000-04-27 2006-01-10 Atricure, Inc. Transmural ablation device with parallel electrodes
US6932811B2 (en) 2000-04-27 2005-08-23 Atricure, Inc. Transmural ablation device with integral EKG sensor
US7113831B2 (en) 2000-04-27 2006-09-26 Atricure, Inc. Transmural ablation device
US7241292B2 (en) 2000-04-27 2007-07-10 Atricure, Inc. Cardiac ablation device with movable hinge
US6923806B2 (en) 2000-04-27 2005-08-02 Atricure Inc. Transmural ablation device with spring loaded jaws
US6905498B2 (en) 2000-04-27 2005-06-14 Atricure Inc. Transmural ablation device with EKG sensor and pacing electrode
US7393353B2 (en) 2000-04-27 2008-07-01 Atricure, Inc. Transmural ablation device with temperature sensor
US7468061B2 (en) 2000-04-27 2008-12-23 Atricure, Inc. Transmural ablation device with integral EKG sensor
US6899710B2 (en) 2000-04-27 2005-05-31 Atricure Inc. Combination ablation and visualization apparatus for ablating cardiac tissue
US7487780B2 (en) 2000-04-27 2009-02-10 Atricure, Inc. Sub-xyphoid method for ablating cardiac tissue
US6889694B2 (en) 2000-04-27 2005-05-10 Atricure Inc. Transmural ablation device
US6546935B2 (en) 2000-04-27 2003-04-15 Atricure, Inc. Method for transmural ablation
US6517536B2 (en) 2000-04-27 2003-02-11 Atricure, Inc. Transmural ablation device and method
US7543589B2 (en) 2000-04-27 2009-06-09 Atricure, Inc. Method for ablating cardiac tissue
US7001415B2 (en) 2000-04-27 2006-02-21 Atricure, Inc. Transmural ablation device
US7604634B2 (en) 2000-04-27 2009-10-20 Atricure, Inc. Transmural ablation device
US7628780B2 (en) 2001-01-13 2009-12-08 Medtronic, Inc. Devices and methods for interstitial injection of biologic agents into tissue
US7507235B2 (en) 2001-01-13 2009-03-24 Medtronic, Inc. Method and system for organ positioning and stabilization
US7740623B2 (en) 2001-01-13 2010-06-22 Medtronic, Inc. Devices and methods for interstitial injection of biologic agents into tissue
US7967816B2 (en) 2002-01-25 2011-06-28 Medtronic, Inc. Fluid-assisted electrosurgical instrument with shapeable electrode
US7291161B2 (en) 2002-10-02 2007-11-06 Atricure, Inc. Articulated clamping member
US7744562B2 (en) 2003-01-14 2010-06-29 Medtronics, Inc. Devices and methods for interstitial injection of biologic agents into tissue
US8273072B2 (en) 2003-01-14 2012-09-25 Medtronic, Inc. Devices and methods for interstitial injection of biologic agents into tissue
US7288092B2 (en) 2003-04-23 2007-10-30 Atricure, Inc. Method and apparatus for ablating cardiac tissue with guide facility
US7530980B2 (en) 2004-04-14 2009-05-12 Atricure, Inc Bipolar transmural ablation method and apparatus
US20090270857A1 (en) * 2004-06-02 2009-10-29 Christian Steven C Ablation Device with Jaws
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