Apparatus for treatment of ischemic heart disease by providing transvenous myocardial perfusion
First Claim
1. Apparatus for use in treating ischemic heart disease by providing long-term retrograde transvenous myocardial perfusion, the apparatus comprising:
- a conduit adapted to be disposed between a patient'"'"'s left ventricle and the patient'"'"'s coronary sinus, so that blood flows through the conduit from the left ventricle to the coronary sinus during cardiac systole;
means for partially occluding the patient'"'"'s coronary ostium; and
a valve for limiting a peak pressure attained within the coronary sinus by venting blood from the conduit into the patient'"'"'s right atrium when the pressure attained within the coronary sinus exceeds a predetermined value.
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Accused Products
Abstract
Apparatus and methods are provided for use in open surgical and transluminal methods for supplying long-term retrograde perfusion of the myocardium via a conduit disposed between the left ventricle and the coronary sinus. In a first method, an opening is formed between the left ventricle and the coronary sinus, and the coronary ostium is partially occluded using a stent that prevents the pressure in the coronary sinus from exceeding a predetermined value. In an alternative method, a first end of a conduit is inserted transeptally through the right atrium and obliquely into the posterior septal endocardium of the left ventricle via the posterior pyramidal space, while a second end of the conduit is inserted into the coronary sinus via the coronary ostium. A pressure-limiting valve is included in the conduit. In either method, the outlet from the left ventricle to the coronary sinus may include a one-way valve to prevent backflow from the coronary sinus into the left ventricle during cardiac diastole.
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Citations
22 Claims
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1. Apparatus for use in treating ischemic heart disease by providing long-term retrograde transvenous myocardial perfusion, the apparatus comprising:
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a conduit adapted to be disposed between a patient'"'"'s left ventricle and the patient'"'"'s coronary sinus, so that blood flows through the conduit from the left ventricle to the coronary sinus during cardiac systole; means for partially occluding the patient'"'"'s coronary ostium; and a valve for limiting a peak pressure attained within the coronary sinus by venting blood from the conduit into the patient'"'"'s right atrium when the pressure attained within the coronary sinus exceeds a predetermined value. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A kit for use in treating ischemic heart disease by providing long-term retrograde transvenous myocardial perfusion, the kit comprising:
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means for forming a passageway having first and second ends, the first end in fluid communication with a patient'"'"'s left ventricle, the second end in fluid communication with the patient'"'"'s coronary sinus, the passageway providing a lumen for blood flow from the left ventricle to the coronary sinus and extending from an interior surface of the coronary sinus into the left ventricle, the means for forming configured for percutaneous, transluminal insertion into the coronary sinus; a plug adapted to be disposed in the patient'"'"'s coronary ostium to partially occlude the coronary ostium. - View Dependent Claims (12, 13, 14, 15, 16)
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17. Apparatus for use in treating ischemic heart disease by providing long-term retrograde transvenous myocardial perfusion, the apparatus comprising:
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a conduit having first and second ends and an intermediate portion located between the first and second ends, the first end adapted to be disposed in fluid communication with a patient'"'"'s left ventricle, the second end adapted to be disposed in the coronary ostium in fluid communication with the patient'"'"'s coronary sinus, the conduit providing a lumen for blood flow from the left ventricle to the coronary sinus during cardiac systole, a first region of the conduit near the first end adapted to be disposed in a passageway extending between the right atrial endocardium and the left ventricular septal endocardium, the intermediate portion extending into the right atrium; a valve disposed in the intermediate portion to limit a peak pressure attained within the coronary sinus, the valve venting blood from the coronary sinus into the right atrium when the pressure attained within the coronary sinus exceeds a predetermined value. - View Dependent Claims (18, 19, 20, 21, 22)
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Specification