Bifurcated stent for percutaneous arterialization of the coronary sinus and retrograde perfusion of the myocardium

• US 20030130719A1
• Filed: 01/07/2002
• Published: 07/10/2003
• Est. Priority Date: 01/07/2002
• Status: Active Grant

• Current Assignee: Eric C. Martin
• Original Assignee: Eric C. Martin
• Inventors: Martin, Eric C.
• Granted Patent: US 7,037,329 B2
• Time in Patent Office: Days
• US Class Current: 623/1.13
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/2493 Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2002/072 Encapsulated stents, e.g. wire or whole stent embedded in lining
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2250/0037 differing in height or in length
• CPC Class Codes: A61F 2250/0039 differing in diameter

Abstract

The present invention provides a novel bifurcated stent for providing retrograde flow of oxygenated blood from the left ventricle to the myocardium via the coronary sinus without a significant or deleterious left-to-right shunt. The present invention includes a main covered stent and a side limb, generally contemplating a Y or a T shaped bifurcated stent.

Claims

1. A bifurcated stent for facilitating retrograde supply of oxygenated blood to heart tissue through a coronary sinus comprising:

a main covered stent having a main stent covered by a graft and defining an opening, and having a leading end, and a trailing end; and

a side limb having a side stent, wherein said side limb is in contact with said main covered stent about said opening.

2. The bifurcated stent according to claim 1, wherein said side stent is not attached to said main stent of said main covered stent.

3. The bifurcated stent according to claim 1, wherein said side limb further has a cuff that is attached to said graft of said main covered stent.

4. The bifurcated stent according to claim 3, wherein said cuff is attached by being connected to said graft.

5. The bifurcated stent according to claim 3, wherein said cuff is attached by being continuous with said graft.

6. The bifurcated stent according to claim 3, wherein said side stent is not attached to said main stent of said main covered stent.

7. The bifurcated stent according to claim 1, wherein said side stent is attached to said main stent of said main covered stent.

8. The bifurcated stent according to claim 7, wherein said side stent is attached by being connected to said main stent.

9. The bifurcated stent according to claim 7, wherein said side stent is attached by being continuous with said main stent.

10. The bifurcated stent according to claim 1, wherein cross section of said main covered stent varies along its extent.

11. The bifurcated stent according to claim 10, wherein said cross section of said main covered stent tapers toward said leading end and said trailing end.

12. The bifurcated stent according to claim 10, wherein said main covered stent exhibits a constriction near said leading end and a constriction near said trailing end.

13. The bifurcated stent according to claim 1, wherein said main covered stent has a constant cross section.

14. The bifurcated stent according to claim 1, wherein said side limb and said opening have similar cross section.

15. The bifurcated stent according to claim 1, wherein a cross section of said leading end is appropriately sized to control blood flow from said left ventricle into said main covered stent.

16. The bifurcated stent according to claim 1, wherein a cross section of said trailing end is appropriately sized to control blood flow into a right atrium.

17. The bifurcated stent according to claim 1, wherein cross section of said opening and said side limb are appropriately sized to control the amount of blood flowing into the retrograde portion of the coronary sinus.

18. The bifurcated stent according to claim 1, wherein cross section of said trailing end, said leading end, said opening, and said side limb are appropriately sized to prevent pressure level within said coronary sinus from rising above about 50 mm Hg.

19. The bifurcated stent according to claim 1, wherein cross section of said trailing end, said leading end, said opening, and said side limb are appropriately sized to prevent pressure level within the coronary sinus from rising above about half systemic pressure.

20. The bifurcated stent according to claim 1, wherein said trailing end, said leading end, said opening, and said side limb are each from about 1 mm to about 6 mm in diameter.

21. The bifurcated stent according to claim 20, wherein said trailing end, said leading end, said opening, and said side limb are each from about 2 mm to about 5 mm in diameter.

22. The bifurcated stent according to claim 1, wherein said side limb and said opening have similar cross section.

23. The bifurcated stent according to claim 1, wherein cross section of said side limb varies along its extent.

24. The bifurcated stent according to claim 1, wherein said side limb is from about 1 mm to about 6 mm in diameter.

25. The bifurcated stent according to claim 1, wherein said main covered stent and said side limb allow compression and expansion.

26. The bifurcated stent according to claim 1, wherein said main covered stent and said side limb are flexible.

27. The bifurcated stent according to claim 1, wherein said main covered stent and said side stent are of mesh construction.

28. The bifurcated stent according to claim 1, wherein said main covered stent and said side stent are of coiled construction.

29. The bifurcated stent according to claim 1, wherein said main covered stent does not exceed from about 6 mm to about 12 mm in diameter.

30. The bifurcated stent according to claim 1, wherein said graft is inside said main stent.

31. The bifurcated stent according to claim 1, wherein said graft is outside said main stent.

32. The bifurcated stent according to claim 1, wherein said main stent is sandwiched between an inside graft and an outside graft.

33. The bifurcated stent according to claim 1, wherein said main covered stent expands and forms a friction fit.

34. The bifurcated stent according to claim 1, wherein a portion of said main stent near said trailing end is not covered by said graft.

35. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising:

puncturing a hole through said coronary sinus and a wall of said left ventricle,

delivering a bifurcated stent having a main covered stent with a main stent covered by a graft and having a leading end and a trailing end; and

a side limb having a side stent, wherein said side limb is in contact with said main covered stent about an opening in said main covered stent,

wherein said opening is substantially aligned with a retrograde portion of said coronary sinus.

36. The method according to claim 35, wherein said leading end is positioned within said left ventricle.

37. The method according to claim 35, wherein an extension stent is used to reach said left ventricle.

38. The method according to claim 35, wherein said trailing end is positioned near a coronary ostium.

39. The method according to claim 35, wherein said trailing end is positioned in a right atrium.

40. The method according to claim 35, wherein said side limb is positioned toward a retrograde portion of said coronary sinus.

41. The method according to claim 35, wherein said main covered stent tapers cross sectionally toward the leading end and the trailing end.

42. The method according to claim 35, wherein said main covered stent expands to make a friction fit within said coronary sinus.

43. The method according to claim 42, wherein said friction fit prevents axial rotation and migration.

44. The bifurcated stent according to claim 35, wherein cross section of said trailing end, said leading end, said opening, and said side limb are appropriately sized to prevent pressure level within the coronary sinus from rising above about 50 mm Hg.

45. The bifurcated stent according to claim 35, wherein the cross section of said trailing end, said leading end, said opening, and said side limb are appropriately sized to prevent pressure level within the coronary sinus from rising above about half systemic pressure.

46. The bifurcated stent according to claim 35, wherein said side stent is attached to said main stent.

47. The bifurcated stent according to claim 35, wherein said side stent is not attached to said main stent, and said side stent is delivered after delivery of the main covered stent.

48. The bifurcated stent according to claim 35, wherein said bifurcated stent is delivered percutaneously.

49. A bifurcated stent for facilitating retrograde supply of oxygenated blood to heart tissue through a coronary sinus comprising:

a main covered stent having a main stent covered by a graft and defining an opening, and having a leading end and a trailing end, wherein said main covered stent tapers in cross sectionally toward said leading end and toward said trailing end, and

a side limb comprising a side stent, wherein said side limb is in contact with said main covered stent about said opening.