Methods and devices for improving cardiac output

• US 20040162608A1
• Filed: 02/19/2003
• Published: 08/19/2004
• Est. Priority Date: 02/19/2003
• Status: Active Grant

• Current Assignee: Corlife Gbr
• Original Assignee: Corlife Gbr
• Inventors: Haverich, Axel
• Granted Patent: US 7,077,801 B2
• Time in Patent Office: Days
• US Class Current: 623/1.26
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• 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 2/24 Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
• CPC Class Codes: A61F 2/2412 with soft flexible valve members, e.g. tissue valves shaped like natural valves check valves with flexible valve members in general F16K15/14
• CPC Class Codes: A61F 2/2475 Venous valves
• CPC Class Codes: A61M 60/867 using position detection during deployment, e.g. for blood pumps mounted on and driven through a catheter
• CPC Class Codes: A61M 60/896 having flexible or resilient parts, e.g. flap valves

Abstract

Methods and devices are provided for improving cardiac output. The methods involve establishing a fluid communication pathway between the left ventricle and another natural or prosthetic structure. In one method, a conduit is implanted between the left ventricle and the descending aorta where ventricular blood flows from the left ventricle directly into the descending aorta and bypassing the aortic valve. The devices include such conduits and valves for forming the fluid communication pathways.

Claims

1. A method of improving cardiac output of a patient'"'"'s heart, comprising:

forming at least one opening through a wall of the heart substantially at the apex;

forming at least one opening through a wall of the aorta by means of an instrument delivered endovascularly through the aorta;

establishing a fluid communication pathway between the apical opening and the aortic opening; and

performing each of the above steps while the heart is beating.

2. The method of claim 1, wherein forming the apical opening is performed from outside of the patient'"'"'s heart.

3. The method of claim 1, wherein forming the apical opening is performed from inside of the left ventricle.

4. The method of claim 1 wherein establishing a fluid communication pathway comprises implanting a conduit between said apical opening and said aortic opening.

5. The method of claim 4 wherein said conduit comprises a valve.

6. The method of claim 1 further comprising implanting a valve in at least one of the group consisting of the fluid communication pathway, substantially adjacent the apical opening, substantially adjacent the aortic opening and the aorta.

7. The method of claim 1 wherein said apical opening is formed in the left ventricle and the aortic opening is formed in the descending aorta.

8. A method of improving cardiac output of a patient'"'"'s heart, comprising:

forming an opening through the left ventricular wall at the apex of the heart;

forming an opening through a wall of the descending aorta by means of an instrument delivered endovascularly through the aorta;

implanting a conduit between the left ventricular opening and the aortic opening; and

performing each of the above steps while the heart is beating.

9. The method of claim 8 wherein said forming the aortic opening is done under fluoroscopic visualization.

10. The method of claim 8 wherein said forming the ventricular opening is performed under endoscopic visualization.

11. A method of improving cardiac output of a patient'"'"'s heart, comprising:

providing a conduit having an upstream end and a downstream end;

delivering the conduit to a location external to the heart between the left ventricle and the descending aorta;

selecting a downstream conduit attachment site within the wall of the descending aorta;

occluding blood flow through the descending aorta at the downstream conduit attachment site;

forming an opening in the descending aorta at the downstream conduit attachment site;

selecting an upstream conduit attachment site within the wall of the left ventricle;

attaching the upstream end of the conduit to the upstream conduit attachment site;

accessing said upstream attachment site through the conduit; and

forming an upstream opening in the left ventricular wall at the upstream conduit attachment site.

12. The method of claim 11 further comprising preventing the escape of blood from the open upstream attachment site while forming the upstream opening therein.

13. The method of claim 12 wherein said preventing the escape of blood comprises sealing the upstream opening from inside the left ventricle.

14. The method of claim 13 wherein said sealing comprises inflating a balloon.

15. The method of claim 14 wherein said sealing comprises expanding a mesh.

16. The method of claim 12 wherein said preventing comprises occluding the conduit adjacent the upstream opening.

17. The method of claim 11 wherein said accessing the upstream attachment site through the conduit comprises accessing the conduit through the downstream end of the conduit.

18. The method of claim 11 wherein said accessing the upstream attachment site through the conduit comprises accessing the conduit through a port within a side wall of the conduit.

19. The method of claim 18 wherein said port is sealable.

20. The method of claim 11 further comprising attaching the downstream end of the conduit to the downstream conduit attachment site.

21. The method of claim 11 further comprising inserting a valve into the conduit.

22. The method of claim 11 further comprising implanting a valve within the descending aorta.

23. The method of claim 11 wherein the occluding blood flow through the descending aorta comprises inflating at least one balloon within the descending aorta.