Left ventricular conduits to coronary arteries and methods for coronary bypass

• US 20060122554A1
• Filed: 06/03/2005
• Published: 06/08/2006
• Est. Priority Date: 01/30/1998
• Status: Abandoned Application

• Current Assignee: Horizon Technology Funding Co. LLC (Horizon Technology Finance Management LLC)
• Original Assignee: Horizon Technology Funding Co. LLC (Horizon Technology Finance Management LLC)
• Inventors: Wilk, Peter J.
• Application Number:
  US11/143,979
• Publication Number:
  US 20060122554A1
• Time in Patent Office: Days
• US Class Current: 604/8
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• 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: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00654 entirely comprised between the two sides of the opening
• 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
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/6862 Stents
• CPC Class Codes: A61B 5/6876 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 2/2493 Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2/915 with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2/94 Stents retaining their form, i.e. not being deformable, after placement in the predetermined place
• CPC Class Codes: A61F 2002/8486 : provided on at least one of the ends
• CPC Class Codes: A61F 2002/91508 : the meander having a difference in amplitude along the band
• CPC Class Codes: A61F 2002/91516 : the meander having a change in frequency along the band
• CPC Class Codes: A61F 2002/91525 : within the whole structure different bands showing different meander characteristics, e.g. frequency or amplitude
• CPC Class Codes: A61F 2002/91533 : characterised by the phase between adjacent bands
• CPC Class Codes: A61F 2002/91575 : connected peak to trough
• CPC Class Codes: A61F 2220/0008 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/0016 : with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2250/0002 : for data transfer
• CPC Class Codes: A61F 2250/0039 : differing in diameter
• CPC Class Codes: A61F 2250/0067 : Means for introducing or releasing pharmaceutical products into the body
• CPC Class Codes: A61M 27/002 : Implant devices for drainage of body fluids from one part of the body to another intraocular A61F9/00781; middle ear A61F11/202

Abstract

Left ventricular conduits and related methods are disclosed for achieving bypass of a partially or completely occluded coronary artery. More broadly, conduits for allowing communication of bodily fluids from one portion of a patient'"'"'s body to another and related methods arc disclosed, including conduits for forming a blood flow path from a chamber of the heart to a vessel or from one vessel to another. In other embodiments, the conduits achieve a coronary artery bypass by allowing blood communication between the left ventricle and the coronary artery or between a proximal portion of the coronary artery and a distal portion of the coronary artery. The conduits may be placed completely through the heart wall or extend only partially therein. Conduits may take on a variety of configurations for allowing the control of blood flow therethrough, including curved or tapered shapes. The conduits may also follow a variety of paths, including direct transmyocardial communication between the left ventricle and the coronary artery, or through the myocardium and into the intrapericardial space and then into the coronary artery. The conduits may be implanted through a variety of methods, including minimally invasive techniques. Also disclosed arc various preferred embodiments of medical devices and related methods for implanting the conduits including rigid delivery rods for penetrating bodily tissue. The delivery rods may be solid, thus being trocar-like, or hollow to form a self-implantable conduit. Other preferred rod embodiments may have the conduits mounted thereon and take the form of a stylet or the like. The conduits may be one-piece, continuous conduits or made up of a number of plural sections joined together. Disclosures of various anastomosis devices are provided.

Claims

1-7. -7. (canceled)

8. An implant device for implantation into tissue comprising:

an implant having a first configuration with a first profile and a second configuration having a second profile that is greater than the first profile whereby surrounding tissue into which the implant is placed is stressed and irritated sufficiently to cause an injury response including thrombus formation that initiates angiogenesis; and

an angiogenic substance for promoting angiogenesis associated with the implant.

9. An implant device as defined in claim 8 wherein the implant defines a hollow interior.

10. An implant device as defined in claim 8 wherein the angiogenic substance is joined to the device by a coating.

11. An implant device as defined in claim 8 further comprising an angiogenic substance loaded onto the implant device prior to implantation of the implant device.

12. An implant device as defined in claim 8 wherein the implant is a cylinder.

13. An implant device as defined in claim 8 wherein the implant is flexible after assuming the second configuration.

14. An implant device as defined in claim 8 wherein the implant is resiliently expandable from the first configuration to the second configuration.

15. An implant device as defined in claim 14 wherein the implant is a cylinder.

16. An implant device as defined in claim 14 wherein the implant comprises an elastic material and the motivational energy to cause the implant to move from the first to the second configuration is the inherent resiliency of the material.

17. A method of promoting angiogenesis in ischemic tissue comprising the steps of:

providing an implant,

associating an angiogenic substance with the implant,

accessing the ischemic tissue,

inserting the implant into the tissue, and

orienting the implant in the tissue to place the tissue in stress by expanding the implant from a low profile first configuration to a large profile second configuration.

18. A method of promoting angiogenesis as defined in claim 17 wherein the implant comprises a body containing an angiogenic substance to promote angiogenesis.

19. A method of promoting angiogenesis in ischemic tissue as defined in claim 17 further comprising:

irritating the tissue sufficiently to cause an injury response in the tissue that includes thrombosis and initiates angiogenesis.

20. A method of promoting angiogenesis as defined in claim 19 wherein the tissue irritation is caused by the presence of the implant in the tissue.

21. A method of promoting angiogenesis as defined in claim 20 wherein the implant is implanted entirely and only within the myocardium.

22. A method of promoting angiogenesis as defined in claim 20 wherein the tissue is myocardial tissue.

23. An implant device for implantation into heart wall tissue comprising:

an implant having a first configuration with a first profile and a second configuration having a second profile that is greater than the first profile whereby surrounding heart wall tissue into which the implant is placed is stressed and irritated sufficiently to cause an injury response that initiates angiogenesis; and

an angiogenic substance for promoting angiogenesis associated with the implant.

24. The implant device of claim 23 wherein the implant defines a hollow interior.

25. The implant device of claim 23 wherein the angiogenic substance is joined to the device by the coating.

26. The implant device of claim 23 further comprising an angiogenic substance loaded onto the implant device prior to implantation of the implant device.

27. The implant device of claim 23 wherein the implant is a cylinder.

28. The implant device of claim 23 wherein the implant is resiliently expandable from the first configuration to the second configuration.

29. The implant device of claim 28 wherein the implant is a cylinder.

30. The implant device of claim 28 wherein the implant comprises an elastic material and the motivational energy to cause the implant to move from the first to the second configuration is the inherent resiliency of the material.

31. The implant device of claim 23 wherein the implant is flexible after assuming the second configuration.

32. The implant device of claim 23 wherein the injury response includes thrombus formation.

33. A method of promoting angiogenesis in heart wall tissue comprising the steps of:

providing an implant,

associating an angiogenic substance with the implant,

accessing the heart wall tissue,

inserting the implant into the heart wall tissue, and

orienting the implant in the heart wall tissue to place the heart wall tissue in stress by expanding the implant from a low profile first configuration to a large profile second configuration.

34. The method of claim 33 wherein the implant comprises a body containing an angiogenic substance to promote angiogenesis.

35. The method of claim 33 wherein providing the implant includes providing an implant defining a hollow interior.

36. The method of claim 33 wherein associating the angiogenic substance with the implant includes coating the implant with an angiogenic substance.

37. The method of claim 33 wherein associating the angiogenic substance with the implant includes loading the angiogenic substance onto the implant device prior to implantation of the implant device.

38. The method of claim 33 wherein providing the implant includes providing an implant in the form of a cylinder.

39. The method of claim 33 wherein the implant resiliently expands from the first configuration to the second configuration.

40. The method of claim 39 wherein the implant is a cylinder.

41. The method of claim 39 wherein the implant comprises an elastic material and the motivational energy to cause the implant to move from the first to the second configuration is the inherent resiliency of the material.

42. The method of claim 33 wherein the implant is flexible after assuming the second configuration.

43. A myocardial implant for implantation into the myocardium comprising:

the implant having an expandable structure having a first configuration with a first profile in which the implant may be implanted within myocardial tissue, the implant being expandable to a second configuration having a second profile that is greater than the first profile by a magnitude that, when expanded to the second profile, will cause the myocardial tissue surrounding the implant to be placed in a stress and irritated sufficiently to cause an injury response including thrombus formation that initiates angiogenesis; and

an angiogenic substance for promoting angiogenesis associated with the implant.

44. An implant as defined in claim 43 wherein the length of the implant is less than the thickness of the myocardial tissue into which it may be implanted.

45. A device as defined in claim 43 wherein the implant, at least in its second profile, defines an interior chamber in which blood may collect, coagulate and thrombose.

46. An implant as defined in claim 45 wherein the implant, when implanted in tissue, does not maintain a patent channel through the tissue.