Coronary artery by-pass method and associated catheter

• US 5,287,861 A
• Filed: 10/30/1992
• Issued: 02/22/1994
• Est. Priority Date: 10/30/1992
• Status: Expired due to Term

• Current Assignee: Peter J. Wilk
• Original Assignee: Peter J. Wilk
• Inventors: Wilk, Peter J.
• Primary Examiner(s): Sykes, Angela D.
• Application Number:
  US07/969,747
• Time in Patent Office: 480 Days
• Field of Search: 128/897-898, 128/673, 128/672, 128/748, 128/772, 128/774, 600/16-18, 606/7, 604/96, 604/100, 604/104
• US Class Current: 128/898
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2/06 Blood vessels
• CPC Class Codes: A61F 2/2493 Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2/94 Stents retaining their form, i.e. not being deformable, after placement in the predetermined place

Abstract

A coronary-bypass method uses a collapsible stent made of a biocompatible material and having an inherent spring bias tending to form the stent into a substantially tubular opened configuration. The stent is disposed in a wall of a patient'"'"'s heart so that the stent extends between the left ventricle of the heart and a coronary artery. Upon placement, the stent opens and allows blood to flow from the left ventricle into the coronary artery during diastole and is closed by heart contraction during systole.

Claims

1. A surgical method comprising the steps of:

providing a collapsible stent made of a biocompatible material and having an inherent spring bias tending to form the stent into a substantially tubular opened configuration; and

disposing said stent in a wall of a patient'"'"'s heart so that said stent extends between the left ventricle of the heart and a coronary artery, whereupon the stent opens and allows blood to flow from said left ventricle into the coronary artery during diastole and is closed by heart contraction during systole, said stent being essentially coextensive with said wall upon disposition of said stent in said wall, said stent adapted to extend only within said wall and not extend into the left ventricle or the coronary artery.

2. The method defined in claim 1 wherein said step of disposing includes the steps of inserting a catheter into the coronary artery and ejecting said stent from a distal end of said catheter into said wall.

3. The method defined in claim 2 wherein said step of disposing further includes the step of forming a perforation in said wall prior to said step of ejecting.

4. The method defined in claim 3 wherein said step of disposing also includes the steps of ejecting a collapsed inflatable balloon with said stent into said wall from said distal end of said catheter, said stent surrounding said balloon, and inflating said balloon and expanding said stent upon ejection of said balloon and said stent into said wall.

5. The method defined in claim 4 wherein said steps of inflating and expanding are performed during diastole.

6. The method defined in claim 4 wherein said balloon and said stent are inserted into said wall over a guide wire, further including the step of inserting said guide wire into said perforation prior to the ejection of said collapsed balloon and said stent from said distal end of said catheter.

7. The method defined in claim 3, further comprising the steps of inserting a distal end portion of said catheter into said perforation prior to said step of ejecting, sensing pressure on said catheter along said distal end portion, thereby determining a thickness of said heart wall at said perforation, and cutting said stent from a piece of stent material so that said stent has a length corresponding to the thickness of said heart wall at said perforation.

8. The method defined in claim 3 wherein said step of forming includes the step of ejecting a needle into said wall from said distal end of said catheter.

9. The method defined in claim 3 wherein said step of forming includes the steps of pushing a drill head into said wall from said distal end of said catheter and rotating said drill head during said step of pushing.

10. The method defined in claim 3 wherein said steps of forming and ejecting are implemented during diastole.

11. The method defined in claim 3, further comprising the step of operating a computer to synchronize said steps of forming and ejecting with the rhythm of said heart.

13. The method defined in claim 11 wherein said stent is made of a biocompatible material and has an inherent spring bias tending to form said stent into a substantially tubular opened configuration, said step of expanding including the step of expanding said stent under the action of said inherent spring bias, said step of closing including the step of collapsing said stent in response to cardiac contraction during systole.

12. A method for supplying blood to the heart, comprising the steps of:

during diastole, expanding a stent in a wall of the heart between the left ventricle of the heart and a coronary artery to thereby form an opening directly from said left ventricle into said coronary artery through said wall and allowing blood to flow from said left ventricle into said coronary artery through said wall; and

during systole, collapsing said stent and thereby closing said opening to block direct communication from said left ventricle into said coronary artery through said wall.

14. An angioplastic surgical method comprising the steps of:

providing an intravascular measurement device;

inserting said device into a vascular system of a patient;

moving said device through the patient'"'"'s vascular system to the patient'"'"'s heart;

operating said device to measure a thickness of a wall of the patient'"'"'s heart;

upon determining the wall thickness, providing a collapsible stent having a length at least approximately equal to said thickness;

inserting said stent into the patient'"'"'s vascular system;

moving said stent through the patient'"'"'s vascular system to the patient'"'"'s heart; and

disposing said stent in the wall of patient'"'"'s heart so that said stent is essentially coextensive with said wall.

15. The method defined in claim 14 wherein said device includes a catheter with steering means connected to said catheter for enabling an operator to control, from outside a patient'"'"'s body, an orientation of a distal tip of said catheter upon insertion of said catheter into the patient, said step of moving said device including the step of actuating said steering means to turn the distal tip of said catheter upon insertion thereof into the patient'"'"'s vascular system.

16. The method defined in claim 15 wherein said device further includes pressure sensor means operatively connected to said catheter for measuring length of a portion of said catheter at a distal end thereof which is subjected to increased compressive pressure, said step of operating said device including the step of operating said pressure sensor means to measure the length of a portion of said catheter at a distal end thereof which is subjected to increased compressive pressure.

17. The method defined in claim 14 wherein said step of providing includes the step of selecting said stent from among a plurality of stents of different sizes.