Vascular graft and blood supply method

• US 4,601,718 A
• Filed: 07/13/1984
• Issued: 07/22/1986
• Est. Priority Date: 12/13/1982
• Status: Expired due to Term

• Current Assignee: Medrad Incorporated (Bayer AG)
• Original Assignee: Possis Medical, Inc. (Bayer AG)
• Inventors: Nicoloff, Demetre M., Possis, Zinon C.
• Primary Examiner(s): Apley, Richard J.
• Assistant Examiner(s): NOT, DEFINED
• Application Number:
  US06/630,838
• Time in Patent Office: 739 Days
• Field of Search: 3/1.4, 3/1.7, 128/325, 128/334 R, 128/334 C, 128/325, 623/1, 623/12, 623/66 B, 623/66 C
• US Class Current: 623/1.26
• CPC Class Codes: A61F 2/06 Blood vessels
• CPC Class Codes: Y10S 623/903 Blood vessel

Abstract

A graft is used to supply blood to one or more coronary artery branches. The graft is also usable as a peripheral revascularization and inter position prosthesis to supply blood to desired blood vessels. The graft has an elongated U-shaped tubular body providing a continuous passage for carrying blood from a high pressure blood supply to a blood receiver. One or more openings in the body allow blood to flow into the coronary artery branches. The flow and pressure of the blood in the passage is controlled by a restriction providing a restricted passage located remote from the inlet end of the tubular body. In one embodiment, the restriction is reinforced with a sleeve to maintain a desired cross sectional area and length of the restricted passage. The pressure differential between the blood supply and blood receiver maintains continuous and adequate blood flow at a desired pressure in the continuous passage and provides a continual supply of blood for the coronary artery branches.

Claims

1. A graft for supplying blood to one or more coronary arteries of a primate heart having a right atrium, pulmonary artery, and an aorta joined to the heart to receive blood therefrom comprising:

an elongated biocompatible means having a cylindrical wall having an inside cylindrical surface surrounding a continuous passage for carrying blood, said means having an inlet end attachable to the aorta whereby blood under pressure flows from the aorta into said passage, and an outlet end attachable to the heart to discharge blood into the right atrium, said wall being provided with one or more openings and being attachable to one or more coronary arteries whereby blood flows from said passage through said openings into one or more of said coronary arteries, and means for restricting the flow of blood and sustaining the pressure of the blood in said passage located remote from the inlet end and between the outlet end and said openings thereby maintaining a continuous flowing supply of blood to said coronary arteries and into the right atrium, said means for restricting the flow of blood in said passage comprises a section of said cylindrical wall having an inside cross sectional area smaller than the cross sectional area of said passage thereby providing said passage with a throat, said cylindrical wall having an outlet end portion connected to said section, said outlet end portion having an outlet passage for carrying blood from the throat to the atrium, said outlet passage having a cross sectional area larger than the cross sectional area of the throat.

2. The graft of claim 1 wherein:

said elongated means has a generally U-shaped tubular body.

3. The graft of claim 1 wherein:

said elongated means and means for restricting the flow of blood comprises a synthetic tube.

4. The graft of claim 1 wherein:

said elongated means and means for restricting the flow of blood comprises an umbilical cord.

5. The graft of claim 4 wherein:

the umbilical cord has a distal end section, said distal end section having a throat passage smaller in size than the passage in the elongated means to sustain the pressure of the blood in the passage of the elongated means and restrict the amount of blood that flows through said passage in the elongated means.

6. The graft of claim 5 wherein:

said throat passage is spaced upstream from the distal end of the umbilical cord.

7. The graft of claim 4 including means located about a distal end section of the cord for reducing the cross sectional area of the passage of the cord to restrict the amount of blood that flows through said passage of the cord.

8. The graft of claim 7 wherein:

the means located about a distal end section of the cord comprises clamp means engageable with the cord.

9. The graft of claim 8 wherein:

said clamp means includes means for adjusting the cross sectional area of the throat passage.

10. The graft of claim 1 wherein:

said elongated means is saphenous vein, and the means for restricting the flow of blood is attached to the outlet end of the saphenous vein.

11. The graft of claim 10 wherein:

said means for restricting the flow of blood comprises tubular means having a throat passage with a cross sectional area smaller than the cross sectional area of the passage of the saphenous vein to restrict the flow of blood therein.

12. The graft of claim 11 wherein:

the cross sectional area of the throat passage is less than one-half of the cross sectional area of the passage of the saphenous vein.

13. The graft of claim 1 wherein:

said inside cylindrical surface has a generally uniform diameter.

14. The graft of claim 1 wherein:

said outlet end portion has a length of less than 10 cm.

15. The graft of claim 1 wherein:

said cylindrical wall has a generally U-shape.

16. The graft of claim 1 wherein:

said passage has a diameter of about 5 mm and the throat has a diameter of about 2 mm.

17. The graft of claim 1 wherein:

said throat has a cross sectional area that is less than one-half the cross sectional area of the passage.

22. The graft of claim 1 wherein:

said means for restricting the flow of blood comprises tubular means having converging, linear, and diverging tubular sections providing a restricted passage with a decreasing cross sectional area, a cross sectional area smaller than the cross sectional area of the continuous passage and an increasing cross sectional area to restrict the flow of blood through the restricted passage.

23. the graft of claim 22 wherein:

said elongated means and means for restricting the flow of blood comprises a synthetic tube having a restricted section providing a restricted passage.

24. The graft of claim 22 wherein:

said elongated means, and means for restricting the flow of blood comprises an unbilical cord having a restricted section providing a restricted passage.

26. The graft of claim 1 wherein:

said elongated means comprises a synthetic tube having a restricted section providing a restricted passage, said restricted section having enlarged wall thickness to reinforce the restricted section.

57. The graft of claim 1 wherein:

said outlet end portion has a tubular wall surrounding said throat, a converging wall joined to the inlet of the tubular wall, and a diverging wall joined to the outlet end of the tubular wall, said outlet end portion having a tubular member joined to said diverging wall.

58. The graft of claim 57 including:

tubular sleeve means surrounding the tubular wall, converging wall, and diverging wall to reinforce said walls and maintain the cross sectional size of the restricted passage.

18. A graft for supplying blood to one or more coronary arteries of a primate heart having a right atrium, pulmonary artery, and an aorta joined to the heart to receive blood therefrom comprising:

an elongated biocompatible means having a continuous passage for carrying blood, said means having an inlet end attachable to the aorta whereby blood under pressure flows from the aorta into said passage, and an outlet end attachable to the heart to discharge blood into the right atrium, said means being provided with one or more openings and being attachable to one or more coronary arteries whereby blood flows from said passage through said openings into one or more of said coronary arteries, and means for restricting the flow of blood and sustaining the pressure of the blood in said passage located remote from the inlet end and between the outlet end and said openings thereby maintaining a continuous flowing supply the blood to said coronary arteries and into the right atrium, and means for reinforcing the means for restricting the flow of blood to maintain the size and shape thereof.

19. The graft of claim 18 wherein:

said means for reinforcing the means for restricting the flow of blood comprises an annular sleeve.

20. The graft of claim 19 wherein:

the sleeve comprises fiber means providing a reinforcement.

21. The graft of claim 20 wherein:

the fiber means comprise a plurality of substantially non-elastic strands.

25. The graft of claim 18 wherein:

said means for restricting the flow of blood and sustaining the pressure of the blood in said passage comprises a tubular wall joined to a converging wall and a diverging wall providing a restricted passage having a decreasing cross sectional area, a cross sectional area smaller than the continous passage, and an increasing cross sectional area, said means for reinforcing the means for restricting the flow of blood comprising a tubular sleeve surrounding and mounted on the tubular wall, converging wall, and diverging wall.

27. A graft for supplying blood to one or more blood vessels comprising:

a tubular body having an inlet end adapted to be connected to means providing a supply of blood under pressure, said tubular body having a first passage open to the inlet end adapted to be provided with one or more openings which are connected to at least one blood vessel for supplying blood to said vessel, said tubular body also having a restricted second passage and an outlet end joined to said body remote from said inlet end said restricted second passage being between said one or more openings and said outlet end and acting to control the flow of blood through the first passage and sustain the pressure of blood in the first passage in order to continuously supply blood to said vessel, said outlet end having a third passage with a cross sectional area larger than the cross sectional area of said restricted second passage said third passage being open to the restricted second passage adapted to be connected to a receiver of blood having blood pressure lower than the pressure of the supply of blood thereby maintaining a continuous supply of blood to said vessel and a continuous flow of blood through said first passage, second passage and third passage into the receiver of blood.

28. The graft of claim 27 wherein:

said body has a generally U-shape.

29. The graft of claim 27 wherein:

said body means having a restricted second passage and an outlet end comprise a synthetic tube.

30. The graft of claim 27 wherein:

said body means having a restricted second passage and an outlet, and said body including an umbilical cord.

31. The graft of claim 27 wherein:

said body is a saphenous vein, and the means for controlling the flow of blood through the first passage is attached to the outlet end of the saphenous vein.

32. The graft of claim 31 wherein:

said means for controlling the flow of blood comprises a body having said restricted second passage, and means connectable to the saphenous vein.

33. The graft of claim 27 wherein:

said means having a restricted second passage is located adjacent said outlet end.

34. The graft of claim 33 wherein:

said means having a restricted second passage is located within 10 cm of said outlet end.

35. The graft of claim 27 wherein:

said means having a restricted second passage includes clamp means located about a distal section of said body for reducing the size of said distal section thereby providing said second passage.

36. The graft of claim 35 wherein:

said clamp means includes means for adjusting the clamp means to vary the size of said distal section thereby adjusting the size of said second passage.

37. The graft of claim 27 wherein:

said second passage has a cross sectional area that is less than one-half the cross sectional area of the first passage.

38. A graft for supplying blood to one or more blood vessels comprising:

a tubular body having an inlet end adapted to be connected to means providing a supply of blood under pressure, said tubular body having a first passage open to the inlet end adapted to be provided with one or more openings and connected to at least one blood vessel for supplying blood to said vessel, means having a restricted second passage and an outlet end joined to said body remote from said inlet end between said one or more openings and said outlet end to control the flow of blood through the first passage and sustained the pressure of the blood in the first passage to continuously supply blood to said vessel, said outlet end open to the restricted second passage adapted to be connected to a receiver of blood having blood pressure lower than the supply of blood thereby maintaining a continuous supply of blood to said vessel and flow of blood through said first and second passages into the receiver of blood, and reinforcing means cooperating with the means having a restricted second passage to maintain the size and shape of said restricted second passage.

39. The graft of claim 38 wherein:

the reinforcing means comprises a sleeve located about said means having a restricted second passage.

40. The graft of claim 38 wherein:

the means having a restricted passage comprises a tubular wall joined to a converging wall and a diverging wall, said restricted passage being a continuation of the first passage, said restricted passage having a decreasing cross sectionsl area, a cross sectional area smaller than the continuous passage, and an increasing cross sectional area, said reinforcing means comprising a sleeve surrounding and mounted on the tubular wall, converging wall, and diverging wall.

41. The graft of claim 38 wherein:

the means having a restricted passage comprises a synthetic tube, said reinforcing means including enlarged wall thickness of said tube to maintain the size and shape of said restricted passage.

42. A graft for supplying blood to one or more blood vessels comprising:

an elongated tubular means for carrying blood from a supply of blood under pressure to one or more blood vessels, said tubular means having body means providing a first passage for carrying blood, said body means being provided with one or more openings which are connectible to at least one blood vessel for supplying blood through said opening to said blood vessel, said tubular means also having inlet end means adapted to be connected to the supply of blood under pressure whereby blood flows into said first passage and from said first passage into said blood vessel, means having a restricted second passage joined to said body means remote from said inlet end means to control the flow of blood through the first passage and sustaining the pressure of the blood in the first passage, and an outlet end means having a third passage larger than said second passage joined to the means having the restricted second passage adapted to be connected to means for receiving blood having blood pressure lower than the pressure of the supply of blood whereby blood continuously flows to said blood vessel and continuously flows through the first passage, second passage and third passage into the means for receiving blood.

43. The graft of claim 42 wherein:

said body means has a U-shape.

44. The graft of claim 42 wherein:

said elongated means is a synthetic tube.

45. The graft of claim 42 wherein:

said elongated means is an umbilical cord.

46. The graft of claim 42 wherein:

said body means and inlet end means comprises a saphenous vein, and said means having a restricted second passage comprises a tubular member having said second passage, and means connectable to said saphenous vein.

47. The graft of claim 42 wherein:

said means having a restricted second passage includes clamp means located about a distal section thereby adjusting the size of said second passage.

48. The graft of claim 47 wherein:

said clamp means includes means for adjusting the clamp means to vary the size of said distal section thereby adjusting the size of said second passage.

52. The graft of claim 42 wherein:

the means having a restricted second passage has a tubular wall surrounding said restricted passage, said restricted passage having a cross section smaller than said first passage, a converging wall joining the inlet of the tubular wall to the body means, and a diverging wall joining the outlet of the tubular wall to said outlet end means.

53. The graft of claim 52 wherein:

said third passage of the outlet end means has a cross section larger than the cross section of the restricted passage.

54. The graft of claim 52 including:

tabular sleeve means surrounding the tubular wall, converging wall, and diverging wall to reinforce said walls and maintain the cross sectional size of the restricted passage.

49. A graft for supplying blood to one or more blood vessels comprising:

an elongated tubular means for carrying blood from a supply of blood under pressure to one or more blood vessels, said tubular means having body means providing a first passage for carrying blood, said body means provided with one or more openings and connectible to at least one blood vessel for supplying blood through said one opening to said blood vessel, inlet end means adapted to be connected to the supply of blood under pressure whereby blood flows into said first passage and from said first passage into said blood vessel, means having a restricted second passage joined to said body means remote from said inlet end means to control the flow of blood through said first passage and to sustain the pressure of blood in the first passage, an outlet end means having a third passage joined to the means having the restricted second passage adapted to be connected to means for receiving blood having blood pressure lower than the pressure of the supply of blood whereby the blood continuously flows through said blood vessel and into the means for receiving blood, and reinforcing means cooperating with the means having a restricted second passage to maintain the size and shape of said restricted second passage.

50. The graft of claim 49 wherein:

the reinforcing means comprises a sleeve located about said means having a restricted second passage.

51. The graft of claim 49 wherein:

the means having a restricted passage comprises a synthetic tube, said reinforcing means including an enlarged wall thickness of said tube to maintain the size and shape of said restricted passage.

55. A graft for supplying blood to one or more blood vessels comprising:

a tubular body having an inlet end adapted to be connected to means providing a supply of blood under pressure, said tubular body having a first passage open to the inlet end adapted to be provided with one or more openings and connected to at least one blood vessel for supplying blood to said vessel, means having a restricted second passage and an outlet end joined to said body remote from said inlet end between said one or more openings and said outlet end to control the flow of blood through the first passage and sustain the pressure of blood in the first passage to continuously supply blood to said vessel, said outlet end open to the restricted second passage adapted to be connected to a receiver of blood having blood pressure lower than the supply of blood thereby maintaining a continuous supply of blood to said vessel and flow of blood through said first passage and said second passage into the receiver of blood, and means having a restricted second passage comprises an outlet end section of the tubular body, said end section having a tubular wall surrounding a restricted passage smaller in cross sectional area than said first passage, a converging wall joining the inlet of the tubular wall to said body, and a diverging wall joined to the outlet of the tubular wall.

56. The graft of claim 55 including:

tubular sleeve means surrounding the tubular wall, converging wall, and diverging wall to reinforce said walls and maintain the cross sectional size of the restricted passage.

59. A graft for supplying blood to one or more coronary arteries of a primate heart having a right atrium, and an aorta joined to the heart to receive blood therefrom comprising:

a single elongated tubular member having a single passage, an inlet end attachable to the aorta whereby blood under pressure flows from the aorta into said passage, an outlet end attachable to the heart to direct blood into the right atrium, said tubular member having one or more openings and being attachable to one or more coronary arteries to align the opening with said arteries whereby blood flows from said passage through said openings into one or more of said coronary arteries, said tubular member having a restricted section between said openings and the outlet end, said section having a tubular wall surrounding a restricted passage small in cross section than said single passage, a converging annular wall on the inlet side of the tubular wall, and a diverging annular wall on the outlet side of the tubular wall, said converging wall providing a passage decreasing in cross sectional area to the restricted passage, and said diverging annular wall providing a passage increasing in cross sectional area from the restricted passage, said restricted passage limiting the flow of blood and sustaining the pressure of the blood in said single passage to maintain continuous flow of blood in said single passage to perfuse said coronary arteries and discharge blood to the right atrium.

60. The graft of claim 59 including:

sleeve means surrounding the tubular wall, converging wall, and diverging wall to reinforce said walls and maintain the cross sectional size of the restricted passage.

61. The graft of claim 59 including:

an end tubular section joined to the diverging wall, said tubular section having a passage with a cross sectional larger than the cross sectional area of the restricted passage.