Methods and devices for bypassing an obstructed target vessel by placing the vessel in communication with a heart chamber containing blood
First Claim
1. A method for performing bypass on a vessel by placing the vessel in fluid communication with a heart chamber containing blood, the method comprising steps of:
- (a) providing a first vessel having a lumen, the first vessel being sized and configured for being joined to a second vessel having a lumen that is at least partially obstructed;
(b) placing at least a portion of the first vessel adjacent the lumen of the second vessel downstream of the obstruction so as to place the lumens of the first and second vessels in fluid communication;
(c) fixing the first vessel in position with respect to the lumen of the second vessel without using suture to form a substantially suture-free anastomosis between the first and second vessels; and
(d) placing the first vessel in fluid communication with a heart chamber containing blood so as to deliver blood from the heart chamber to the lumen of the second vessel.
1 Assignment
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Accused Products
Abstract
Methods and devices for forming an anastomosis during a bypass procedure utilize a graft vessel secured to a vessel coupling adapted to be fixed to a target vessel without using suture. The graft vessel is placed in fluid communication with a heart chamber containing blood. The vessel coupling may be collapsed for introduction into the target vessel and then expanded to fix the coupling thereto. The vessel coupling may be a stent with the graft vessel secured thereto to form a stent-graft assembly. The anastomosis is carried out to place the graft and target vessels in fluid communication while preserving native proximal flow through the target vessel, which may be a coronary artery. As a result, blood flowing from the aorta and past an obstruction in the coronary artery is not blocked by formation of the anastomosis; rather, such proximal blood flow is free to move past the vessel coupling and the anastomosis.
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Citations
37 Claims
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1. A method for performing bypass on a vessel by placing the vessel in fluid communication with a heart chamber containing blood, the method comprising steps of:
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(a) providing a first vessel having a lumen, the first vessel being sized and configured for being joined to a second vessel having a lumen that is at least partially obstructed;
(b) placing at least a portion of the first vessel adjacent the lumen of the second vessel downstream of the obstruction so as to place the lumens of the first and second vessels in fluid communication;
(c) fixing the first vessel in position with respect to the lumen of the second vessel without using suture to form a substantially suture-free anastomosis between the first and second vessels; and
(d) placing the first vessel in fluid communication with a heart chamber containing blood so as to deliver blood from the heart chamber to the lumen of the second vessel. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A method for bypassing an obstruction in a coronary artery by placing the coronary artery in fluid communication with a heart chamber containing blood, the method comprising steps of:
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(a) providing a stent-graft assembly including a stent movable between expanded and non-expanded orientations and a graft vessel attached to the stent, wherein the graft vessel has a lumen in fluid communication with the stent;
(b) forming an opening in the wall of the coronary artery that is sized to allow at least a portion of the stent to be positioned in the lumen of the coronary artery when the stent is in the non-expanded orientation;
(c) positioning at least a portion of the stent in the lumen of the coronary artery and expanding the stent into contact with the coronary artery to form a substantially suture-free anastomosis between the graft vessel and the coronary artery; and
(d) placing the graft vessel in communication with a heart chamber containing blood. - View Dependent Claims (10, 11, 13, 14, 15, 16, 17, 18, 19)
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12. A device for forming an anastomosis between a graft vessel and a target vessel during a bypass procedure in which the target vessel is placed in fluid communication with a heart chamber containing blood, the device comprising:
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a vessel coupling configured to secure a graft vessel to a target vessel, the vessel coupling having a lumen and being movable between expanded and non-expanded orientations;
a graft vessel secured to the vessel coupling with the lumens of the graft vessel and the vessel coupling in fluid communication, a portion of the graft vessel being adapted to be placed in fluid communication with a heart chamber containing blood;
an expansion mechanism for expanding the vessel coupling to the expanded orientation in order to form an anastomosis between the vessel coupling and the target vessel without using suture;
wherein the vessel coupling is sized and configured to fit at least partially within the lumen of a coronary artery in said non-expanded orientation and to engage the coronary artery in said expanded orientation.
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20. A device for performing a bypass procedure in which a suture-free anastomosis is formed between a graft vessel and a coronary artery, and wherein the graft vessel is placed in communication with a heart chamber containing blood to deliver blood from the heart chamber to the coronary artery, the device comprising:
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a stent-graft assembly including a stent movable between collapsed and expanded orientations and a graft vessel having a lumen, wherein the stent is secured to the graft vessel with the lumen of the graft vessel is in fluid communication with the stent; and
an expansion mechanism for expanding the stent to the expanded orientation once the stent has been at least partially positioned in the lumen of a coronary artery;
wherein the stent and graft vessel are sized and configured to be collapsed for placement in the lumen of the coronary artery and then expanded to cause the stent to engage the wall of the coronary artery to anastomose the stent-graft assembly to the coronary artery without suture. - View Dependent Claims (21)
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22. A method for placing a target vessel in fluid communication with a heart chamber containing blood while preserving native blood flow through the target vessel, the method comprising steps of:
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(a) providing a graft vessel selected from the group consisting of tissue grafts, synthetic grafts, and grafts formed of both tissue and synthetic material, wherein the graft vessel has a lumen and is adapted to be secured to a target vessel having a lumen;
(b) fixing at least a portion of the graft vessel to the target vessel without using suture to form a substantially suture-free anastomosis between the graft and target vessels that is distal to the obstruction in the target vessel;
(c) placing the graft vessel in fluid communication with a heart chamber containing blood; and
(d) allowing any native blood flow in the target vessel to move past the site of the anastomosis. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29)
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30. A device for performing a bypass procedure in which a target vessel is placed in communication with a heart chamber containing blood and an anastomosis is formed between a graft vessel and the target vessel that allows native blood flow through the target vessel, the device comprising:
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a graft vessel adapted to be anastomosed to a target vessel and placed in communication with a heart chamber containing blood;
a vessel coupling secured to the graft vessel, wherein the vessel coupling has a lumen and is configured to be anastomosed to the target vessel to place the graft and target vessels in fluid communication; and
wherein the vessel coupling is secured to the graft vessel so as to allow blood flow through the target vessel to move past the site of the anastomosis. - View Dependent Claims (31, 32, 33, 34, 35, 37)
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36. A device for use in performing a bypass procedure in which a first vessel is placed in fluid communication with a heart chamber containing blood and anastomosed to a second vessel with a lumen containing an obstruction, the device comprising:
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a vessel coupling including first and second portions for forming an anastomosis between a first vessel and a second vessel;
wherein the first portion of the vessel coupling is configured to be coupled to a first vessel that is in fluid communication with a heart chamber containing blood so that blood flows from the heart chamber and through the coupling; and
wherein the second portion of the vessel coupling is configured to be secured to a second vessel without using suture to form a substantially suture-free anastomosis that allows native blood flow through the second vessel to move past the site of the anastomosis.
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Specification