Method and apparatus for performing coronary artery bypass surgery

• US 5,755,682 A
• Filed: 08/13/1996
• Issued: 05/26/1998
• Est. Priority Date: 08/13/1996
• Status: Expired due to Fees

• Current Assignee: Horizon Technology Funding Co. LLC (Horizon Technology Finance Management LLC)
• Original Assignee: Heartstent Corp.
• Inventors: Knudson, Mark B., Giese, William L.
• Primary Examiner(s): Clarke, Robert A.
• Assistant Examiner(s): Black, John M.
• Application Number:
  US08/689,773
• Time in Patent Office: 651 Days
• Field of Search: 604/7, 604/8, 604/9, 623/1, 623/12, 128/898, 600/16
• US Class Current: 604/8
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12131 characterised by the type of occluding device
• CPC Class Codes: A61B 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• 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 2017/12127 Double occlusion, e.g. for creating blood-free anastomosis site
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• 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 2/07 Stent-grafts
• CPC Class Codes: A61F 2/2493 Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2/856 Single tubular stent with a side portal passage
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/061 : provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2002/065 : Y-shaped blood vessels
• CPC Class Codes: A61F 2002/068 : Modifying the blood flow model, e.g. by diffuser or deflector
• CPC Class Codes: A61F 2002/821 : Ostial stents
• CPC Class Codes: A61F 2240/008 : Means for testing implantable prostheses
• CPC Class Codes: Y10S 623/903 : Blood vessel

Abstract

A method and apparatus for performing coronary artery bypass surgery establishes a channel leading directly from a chamber of a heart into a coronary artery. The coronary artery bypass procedure may be performed with or without cardiopulmonary bypass.

Claims

1. An apparatus for use in a coronary artery bypass procedure at a human coronary artery on an exterior of a human heart wall, said apparatus comprising:

a. A hollow blood flow conduit having a first end dimensioned for insertion into and retention within said human heart wall of a left ventricle containing oxygenated blood with an opening of said first end for providing blood flow communication with blood contained within said left ventricle;

b. said conduit having a second end, said conduit further dimensioned for said second end to be positioned and retained within said human coronary artery with an opening of said second end positioned and dimensioned for providing blood flow communication with a lumen of said human coronary artery when said first end is within said human heart wall;

c. Said conduit capable of defining a continuously open blood flow path between said openings of said first and second ends, said conduit being sufficiently rigid such that when placed within said human heart wall said blood flow path remains open during both diastole and systole;

d. said conduit configured to substantially block flow from leaving said conduit other than through said first and second ends; and

e. said conduit includes a reservoir for accumulating blood from said conduit during periods of high blood pressure and for discharging accumulated blood into said conduit during periods of low blood pressure.

2. An apparatus for use in a coronary bypass procedure at a human coronary vessel disposed lying on an exterior of a human heart wall, the apparatus comprising:

a hollow blood flow conduit having a first end dimensioned for insertion into and retention within the human heart wall of a heart chamber containing oxygenated blood with an opening of the first end for providing blood-flow communication with blood contained within the chamber;

the conduit having a second end disposed at an angle to the first end, the second end dimensioned for insertion into and retention within said human coronary vessel with an opening of the second end positioned and dimensioned for providing blood flow communication with a lumen of the human coronary vessel such that the second end can be substantially axially aligned with the human coronary vessel;

the conduit capable of defining a continuously open blood flow path during both diastole and systole between the openings of the first and second ends and at least a portion of the conduit being sufficiently rigid such that when placed within said human heart wall said conduit remains open in response to contraction and relaxation of musculature of the human heart wall and;

the conduit has a portion to block flow out of the conduit in a direction axially opposite the second end.

3. An apparatus according to claim 2 wherein the conduit is a substantially L-shaped, rigid tube.

4. A method for performing a coronary bypass procedure at a coronary vessel disposed lying on an exterior of a heart wall, the method comprising:

inserting a hollow conduit through the heart wall where the conduit defines a blood flow path between a heart chamber opening and a vessel opening and with the conduit selected so as to maintain the blood flow path open during both systole and diastole and with the heart chamber opening of the conduit in blood flow communication with the heart chamber;

placing the vessel opening of the conduit within the vessel to direct blood to flow from the blood flow path into the vessel in a flow direction generally parallel with an axis of the vessel.

5. A method according to claim 4 further comprising placing the vessel opening facing away from an obstruction which at least partially obstructs blood flow through the vessel.

6. A method according to claim 4 wherein the blood flow path is formed by placing the conduit through a deep wall of the coronary vessel.

7. A method according to claim 4 wherein the coronary vessel is a coronary artery.

8. A method for performing a coronary bypass procedure at a coronary artery of a heart where the coronary artery has an obstruction at least partially obstructing flow of oxygenated blood through the coronary artery, the method comprising:

selecting a site in the coronary artery distal to the obstruction;

forming a blood flow path directly from a left ventricle of the heart into the coronary artery at the site distal to the obstruction with the blood flow path being open during both systole and diastole.

9. A method according to claim 8 wherein the obstruction is, at least in part, artificially formed by placement of a conduit from the left ventricle to the coronary artery where the conduit has an opening discharging into the coronary artery and where the obstruction includes a portion of the conduit proximal to the opening.