Transmyocardial implant with improved flow

• US 20020072699A1
• Filed: 02/15/2002
• Published: 06/13/2002
• Est. Priority Date: 08/13/1996
• Status: Abandoned Application

• Current Assignee: Heartstent Corp.
• Original Assignee: Heartstent Corp.
• Inventors: Knudson, Mark B., Giese, William L.
• Application Number:
  US10/076,735
• Publication Number:
  US 20020072699A1
• Time in Patent Office: Days
• US Class Current: 604/8
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12131 characterised by the type of occluding device
• CPC Class Codes: A61B 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2017/12127 Double occlusion, e.g. for creating blood-free anastomosis site
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61F 2/06 Blood vessels
• CPC Class Codes: A61F 2/064 with special features to facilitate anastomotic coupling anastomosis of natural blood vessels A61B17/11
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/2493 Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2/856 Single tubular stent with a side portal passage
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/061 : provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2002/065 : Y-shaped blood vessels
• CPC Class Codes: A61F 2002/068 : Modifying the blood flow model, e.g. by diffuser or deflector
• CPC Class Codes: A61F 2002/821 : Ostial stents
• CPC Class Codes: A61F 2240/008 : Means for testing implantable prostheses
• CPC Class Codes: Y10S 623/903 : Blood vessel

Abstract

A method and apparatus for performing coronary artery bypass surgery establishes a channel leading directly from a chamber of a heart into a coronary artery with said channel retained open during both diastole and systole. The coronary artery bypass procedure may be performed with or without cardiopulmonary bypass.

Claims

1. A transmyocardial implant providing blood flow between a heart chamber and a coronary vessel, the implant comprising:

an open first end, an open second end and a hollow conduit connecting the first end and the second end;

the conduit adjacent the first end defining a myocardial portion sized to extend through a myocardium between the heart chamber and the coronary vessel, the myocardial portion defining a first axis;

the conduit adjacent the second end defining a vessel portion sized to lie at least partially within a lumen of the coronary vessel, the vessel portion defining a second axis;

the lumen of the coronary vessel defining a flow axis and a flow direction, the flow axis of the vessel substantially the same as the second axis; and

the first axis at a non-orthogonal angle to the second axis so that when the implant is positioned within the myocardium conduit provides fluid communication between the heart chamber and the lumen of the coronary vessel and blood flowing from the myocardial portion into the vessel portion is biased in the flow direction.

2. The transmyocardial implant of claim 1, wherein the heart is a human heart.

3. The transmyocardial implant of claim 2, wherein the heart chamber is the left ventricle.

4. The transmyocardial implant of claim 1, wherein the heart chamber contains oxygenated blood.

5. The transmyocardial implant of claim 1, wherein the coronary vessel is a coronary artery.

6. The transmyocardial implant of claim 1, wherein the myocardial portion of the implant is rigid enough to remain open during systole and diastole when placed within the myocardium.

7. The transmyocardial implant of claim 1, wherein the implant is sized so that the first end extends into the heart chamber beyond an inner wall of the myocardium.

8. A method of providing blood flow from a heart chamber into a coronary vessel comprising the steps of:

placing an implant within a myocardium between the heart chamber and the coronary vessel, the implant including an open first end, an open second end and a hollow conduit connecting the first and second ends, the conduit defining an axis;

positioning the implant with the first end extending to the heart chamber and the second end extending to a lumen of the coronary vessel, the lumen of the coronary vessel defining a flow axis and a flow direction;

establishing fluid communication between the heart chamber and the lumen of the coronary vessel through the conduit with the axis of the conduit at an nonorthogonal angle to the flow axis of the lumen so that blood flowing from the second end into the lumen of the coronary vessel is biased in the flow direction.

9. The method of claim 8, wherein the heart is a human heart.

10. The method of claim 9, wherein the heart chamber is the left ventricle.

11. The method of claim 8, wherein the heart chamber contains oxygenated blood.

12. The method of claim 8, further comprising the step of maintaining the implant open during systole and diastole.

13. The method of claim 8, wherein the coronary vessel is a coronary artery and the heart chamber contains oxygenated blood.

14. The method of claim 13, wherein the coronary vessel includes an occlusion and the second end extends to the lumen of the coronary vessel at a point distal to the occlusion in the flow direction.

15. The method of claim 8, wherein the second end of the implant is positioned within the heart chamber extending beyond an inner wall of the myocardium.

16. The method of claim 8, wherein the first end is parallel to the flow axis.

17. The method of claim 8, wherein the second end is parallel to the flow axis.

18. The method of claim 8, wherein the first end is orthogonal to the axis of the conduit.

19. The method of claim 8, wherein the second end is orthogonal to the flow axis.