Apparatus and method for connecting a conduit to a hollow organ

• US 20100010500A1
• Filed: 02/17/2009
• Published: 01/14/2010
• Est. Priority Date: 03/23/2004
• Status: Active Grant

• Current Assignee: Correx, Inc.
• Original Assignee: Correx, Inc.
• Inventors: Crunkleton, James Alan, Beane, Richard M., Smith, Joseph L. JR., Gammie, James S., Brown, John W.
• Granted Patent: US 8,226,670 B2
• Time in Patent Office: Days
• US Class Current: 606/108
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• 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 2017/00247 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 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0237 for heart surgery endoscopic heart surgery A61B2017/00243; endoscopic access devices, i.e. trocars, A61B17/34
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61F 2/064 with special features to facilitate anastomotic coupling anastomosis of natural blood vessels A61B17/11

Abstract

An apparatus and method for connecting a first conduit to the heart without the need for cardiopulmonary bypass. The first conduit may then be attached to a second conduit that has a prosthetic device interposed. The second conduit may then be connected to the aorta. The prosthetic device may be a prosthetic valve or a pump, for example. The apparatus of the present invention includes an implantable connector with first conduit component, a retractor expansion component, a coring component, and a pushing component. The retractor expansion component is slide-ably coupled to the coring component. The retractor expansion component serves to seat against and separate the inside apical wall of the left ventricle so that the coring component may cut cleanly through the myocardium to form a tissue plug without leaving any hanging attachments to the inside walls. By remaining seated against the inside wall, the retractor expansion component follows the tissue plug into the coring component. The surgeon applies force and rotary motion to the pushing component sufficient to cut the tissue plug and implant the prosthetic component.

Claims

1. An applicator for forming a hole in a wall of a hollow organ and for inserting a connector conduit into the hole to facilitate connection of the connector conduit to the hollow organ, said applicator comprising:

a hole forming element for forming a hole in the wall of the organ, said hole forming element having a cutting element on a distal end thereof and being adapted for coupling with the connector conduit, with a distal end of said connector conduit being adjacent said cutting element during a procedure for implanting the connector conduit within the organ wall;

positioning means coupled to said hole forming element for positioning said hole forming element;

a retractor element operatively coupled to said positioning means; and

sequencing means for coordinating the relative movement of said retractor element with respect to said hole forming element in a sequential manner to thereby carry out a procedure for forming a hole in the wall of the hollow organ and inserting the connector conduit in the hole.

2-69. -69. (canceled)

70. A connector conduit adapted to be connected to a hollow organ by having a portion thereof inserted into a hole formed in a wall of the hollow organ, said connector conduit comprising:

a substantially rigid portion defining a first end and having a tapered leading edge to facilitate insertion through a wall of an organ;

a flexible portion defining a second end, said flexible portion being collapsible to permit clamping to occlude blood flow through said connector conduit during a procedure.

71-96. -96. (canceled)

97. A method for using an applicator to form a hole in a wall of a hollow organ and insert a connector conduit into the hole, said applicator comprising a hole forming element having a cutting element on a distal end thereof and being coupled to the connector conduit with a distal end of said connector conduit being adjacent said cutting element, a retractor element having an expansion element, and sequencing means for coordinating the relative movement of said retractor element with respect to said hole forming element, said method comprising:

a) inserting a distal end of the retractor element through a slit formed in the wall of the organ while the retractor element is locked in a fully extended position relative to the hole forming element and the expansion element is in an unexpanded state

b) expanding the expansion element to a fully expanded state and moving the expansion element toward the hole forming element;

c) forming the hole with the cutting element and inserting the connector conduit into the hole by manipulating the hole forming element while the expansion element presses the tissue toward the cutting element;

d) decreasing the size of the expansion element to a partially expanded state and moving the expansion element to be at least partially disposed in the hole forming element; and

e) decoupling the applicator from the connector conduit to remove the applicator while the connector conduit remains in the hole.

98-110. -110. (canceled)

111. A connector conduit in combination with an applicator for forming a hole in a wall of a hollow organ and for inserting the connector conduit into the hole to facilitate connection of the connector conduit to the hollow organ, said combination comprising;

a hole forming element adapted to form a hole in the wall of the organ, said hole forming element including a cutting element on a distal end thereof;

a retractor element disposed at least partially within said hole forming element, said retractor element comprising a tip at a distal end thereof adapted to penetrate the wall of the organ, and an expansion element positioned near the distal end, said expansion element having a plurality of expansion states;

wherein the relative rotational position of the expansion element and the hole forming element are fixed while the hole is formed by said hole forming element;

a mounting element coupled to said hole forming element, said mounting element being configured to support a connector conduit, and

a connector conduit supported on said mounting element,

whereby said connector conduit is positioned relative to said cutting element such that, when the hole is formed in the wall of the hollow organ, said connector conduit is inserted through the wall of the hollow organ, thereby facilitating connection of said connector conduit to the hollow organ.

112. An applicator for forming a hole in a wall of a hollow organ and for inserting a connector conduit into the hole to facilitate connection of the connector conduit to the hollow organ, said applicator comprising:

a hole forming element adapted to form a hole in the wall of the organ, said hole forming element including a cutting element on a distal end thereof;

a retractor element disposed at least partially within said hole forming element, said retractor element comprising a tip at a distal end thereof adapted to penetrate the wall of the organ, and an expansion element positioned near the distal end, said expansion element having a plurality of expansion states;

wherein the relative rotational position of the expansion element and the hole forming element are fixed while the hole is formed by said hole forming element; and

a mounting element coupled to said hole forming element, said mounting element being configured to support a connector conduit, and

whereby when the connector conduit is supported by the mounting element, the connector conduit is positioned relative to said cutting element such that, when the hole is formed in the wall of the hollow organ, the connector conduit is inserted through the wall of the hollow organ, thereby facilitating connection of the connector conduit to the hollow organ.

113. A method for using an applicator to form a hole in a wall of a hollow organ and insert a connector conduit into the hole, said applicator comprising a hole forming element having a cutting element on a distal end thereof and being coupled to the connector conduit with a distal end of said connector conduit being adjacent said cutting element, and a retractor element having an expansion element, wherein the relative rotational position of the expansion element and the hole forming element are fixed while the hole is formed by the hole forming element, said method comprising:

a) inserting a distal end of the retractor element through a slit formed in the wall of the organ while the retractor element is locked in a fully extended position relative to the hole forming element and the expansion element is in an unexpanded state;

b) expanding the expansion element to a fully expanded state and moving the expansion element toward the hole forming element;

c) forming the hole with the cutting element and inserting the connector conduit into the hole by manipulating the hole forming element while the expansion element presses the tissue toward the cutting element;

d) decreasing the size of the expansion element to a partially expanded state and moving the expansion element to be at least partially disposed in the hole forming element; and

e) decoupling the applicator from the connector conduit to remove the applicator while the connector conduit remains in the hole.