Perfusion device for maintaining blood flow in a vessel while isolating an anastomosis

• US 5,925,054 A
• Filed: 01/23/1997
• Issued: 07/20/1999
• Est. Priority Date: 02/20/1996
• Status: Expired due to Term

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Cardiothoracic Systems, Inc. (Boston Scientific Corporation)
• Inventors: Sepetka, Ivan, Taylor, Charles S., Matheny, Robert G., Salahieh, Amr, Cantu, Alfredo R., Gia, Son M., Krolic, Jeff A.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): Shai, Daphna
• Application Number:
  US08/790,827
• Time in Patent Office: 908 Days
• Field of Search: 606/108, 606/153, 606/191, 606/192, 606/195, 606/198, 623/1, 623/12
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12131 characterised by the type of occluding device
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/1219 expandable in contact with liquids
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2017/12127 Double occlusion, e.g. for creating blood-free anastomosis site

Abstract

A plurality of embodiments of a distal perfusion device are disclosed, which device facilitates anastomosis constructions by maintaining a dry anastomosis site while simultaneously maintaining blood flow distally in the blood vessel to prevent ischemia and reduce overall patient trauma. The perfusion device is configured for installation into a blood vessel such as a left anterior descending coronary artery through an incision therein, to which is to be grafted a distal end of a blood vessel such as an internal mammary artery. The device includes a central member of selected configuration and material, terminating at either end thereof in respective selectively tapered end members. A lumen extending through the central member and end members, and selected perforations in the end members, maintain blood flow through the perfusion device. A selected portion or portions of the device'"'"'s outer circumference fit snugly within the artery in the regions beyond and/or at the anastomosis site, to maintain the latter free of blood. Several methods for deploying and removing respective embodiments of the device also are illustrated.

Claims

1. A distal perfusion device for maintaining flow in a vessel having an incision in said vessel comprising:

a central member containing a lumen wherein substantially the entire length of said central member is formed of first and second sheets of radially expandable material of shape-memory property laminated together, wherein the memory of the first sheet establishes a curled cross section, said central member having end members affixed thereto and perfusion openings in communication with said lumen to maintain the blood flow through said vessel, and

heating means integrally secured to said first and second sheets respectively to selectively heat the sheets in response to an electrical current to contract and expand the diameter of the central member.

2. A distal perfusion device for maintaining flow in a vessel having an incision in said vessel comprising:

a central member containing a lumen wherein said central member is formed of a radially expandable material comprising substantially the entire length of the central member and a radially flexible material at a portion of the central member, said central member having end members affixed thereto and perfusion openings in communication with said lumen to maintain the blood flow through said vessel;

a choker tube formed with the radially expandable material; and

a thread extending through the choker tube to attach to said portion of the central member, whereby the tension on the thread draws the expandable material inward to decrease the diameter of the central member.

3. A distal perfusion device for maintaining flow in a vessel having an incision in said vessel comprising:

a central member containing a lumen wherein said central member is comprised of at least one wound coil and an elastomer material disposed about the coil and extending therebetween to define the structural support means of the central member, said central member having end members affixed thereto and perfusion openings in communication with said lumen to maintain the blood flow through said vessel.

4. The device of claim 3 wherein one end of the coil extends from an anastomosis site to allow application of a pulling force to said end to unravel the coil.

5. A distal perfusion device for maintaining flow in a vessel having an incision in said vessel comprising:

a central member containing a lumen, said central member having end members affixed thereto and perfusion openings in communication with said lumen to maintain blood flow through said vessel;

wherein said central member includes a flexible, loosely wound coil of a diameter generally corresponding to the diameter of said vessel, and

means for providing an enlarged diameter of said device upon insertion of the device within said vessel, said means for providing an enlarged diameter including a coating of a flexible, fluid impervious material deposited about the coil to define a central lumen therethrough, said selectively tapered end members being comprised of coiled end portions having said coating of the flexible, fluid impervious material deposited thereon.

6. A distal perfusion device for maintaining flow in a vessel having an incision in said vessel comprising:

a central member containing a lumen, said central member having end members affixed thereto and perfusion openings in communication with said lumen to maintain blood flow through said vessel,

wherein said central member is formed in two separate portions each with respective tapered end members, and

wherein said separate portions are insertable individually into said vessel through the arteriotomy and subsequently joined together within said vessel.

7. A distal perfusion device for maintaining flow in a vessel having an incision in said vessel comprising:

a central member containing a lumen, said central member having end members affixed thereto and perfusion openings in communication with said lumen to maintain blood flow through said vessel, wherein each of said end members has a tip distal to said perfusion openings and wherein a selectively tapered end member has a guide opening in a conical wall thereof, and

a guide wire threaded through the guide opening and the end member and through the incision into said vessel;

wherein said guide wire facilitates the insertion of the device distally into said vessel.

8. A distal perfusion device for maintaining flow in a vessel having an incision in said vessel comprising:

a central member containing a lumen, said central member having end members affixed thereto and perfusion openings in communication wit said lumen to maintain blood flow through said vessel, and

wherein said central member is formed with an arcuate portion removed therefrom diametrically opposite the anastomosis site to define a necked-down section of said central member.

9. A distal perfusion device for maintaining flow in a vessel having an incision in said vessel comprising:

a central member having a diameter and containing a lumen wherein said central member is formed of a pair of coaxially spaced flexible coils said central member having end members affixed thereto and perfusion openings in communication with said lumen to maintain blood flow through said vessel;

a coating of elastomer material laminated about said coils and extending therebetween to form said central member;

a choker tube secured to the central member and extending therefrom; and

thread means secured to facing ends of the coils and extending through the choker tube, wherein force applied to the thread means axially stretches the coils to contract the shunt diameter and releasing the thread means allow the shunt diameter to expand.