Percutaneous artery to artery bypass using heart tissue as a portion of a bypass conduit

• US 6,213,126 B1
• Filed: 06/19/1997
• Issued: 04/10/2001
• Est. Priority Date: 06/19/1997
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: LaFontaine, Daniel M., Hektner, Thomas R., Harrison, Kent D.
• Primary Examiner(s): Nguyen, Dinh X.
• Assistant Examiner(s): O'Hara, Kelly
• Application Number:
  US08/878,933
• Time in Patent Office: 1,391 Days
• Field of Search: 128/898, 623/1, 623/21, 623/66, 623/11, 604/2, 604/4, 604/5, 604/96-103, 604/18, 604/49, 600/18, 600/201, 600/204, 606/49
• US Class Current: 128/898
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• 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 Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61F 2/064 with special features to facilitate anastomotic coupling anastomosis of natural blood vessels A61B17/11
• CPC Class Codes: A61F 2/2481 Devices outside the heart wall, e.g. bags, strips or bands
• CPC Class Codes: A61F 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2210/0014 using shape memory or superelastic materials, e.g. nitinol

Abstract

A restriction in a restricted vessel lying closely proximate the heart is bypassed. An aperture is formed in a supply vessel suitable for providing a blood supply. An aperture is formed in the restricted vessel distal of the restriction. Heart tissue is removed from the surface of the heart to form a channel in the heart tissue between the aperture in the supply vessel and the aperture in the restricted vessel distal of the restriction. The channel is covered to form a conduit to conduct blood from the supply vessel to the restricted vessel distal of the restriction.

Claims

1. A method of bypassing a restriction in a restricted vessel, the restricted vessel lying closely proximate heart tissue, the method comprising:

forming an aperture in a supply vessel suitable for providing a blood supply;

forming an aperture in the restricted vessel distal of the restriction in the restricted vessel;

removing heart tissue from the surface of the heart to form a channel in the surface of the heart tissue between the aperture in the supply vessel and the aperture in the restricted vessel distal of the restriction; and

covering the channel to form a conduit to conduct blood from the supply vessel to the restricted vessel distal of the restriction.

2. The method of claim 1 wherein forming an aperture in a supply vessel, comprises:

forming the aperture in a region of the restricted vessel proximal of the restriction.

3. The method of claim 1 wherein the supply vessel comprises a neighboring vessel residing proximate the restricted vessel and wherein forming an aperture in a supply vessel, comprises:

forming an aperture in the neighboring vessel proximate the restricted vessel.

4. The method of claim 3 wherein the neighboring vessel comprises a parent vessel of the restricted vessel, and wherein forming an aperture in the neighboring vessel, comprises:

forming an aperture in the parent vessel proximate the restricted vessel.

5. The method of claim 3 wherein the neighboring vessel comprises a branching vessel branching from a region of the restricted vessel proximal of the restriction, and wherein forming an aperture in the neighboring vessel, comprises:

forming an aperture in the branching vessel proximate the restricted vessel.

6. The method of claim 1 wherein covering the channel comprises:

applying a patch over the channel.

7. The method of claim 6 wherein applying a patch comprises:

adhering the patch to heart tissue proximate the channel.

8. The method of claim 6 wherein applying a patch comprises:

delivering the patch, intravascularly, in a first configuration;

deploying the patch into a second configuration, larger than the first configuration, to cover the channel; and

connecting the patch to heart tissue to form the conduit.

9. The method of claim 8 wherein deploying the patch includes allowing the patch to assume the second configuration under the influence of a superelastic material.

10. The method of claim 8 wherein deploying the patch comprises:

expanding the patch in axial and longitudinal directions relative to the first configuration.

11. The method of claim 8 wherein deploying the patch comprises:

unrolling the patch from a coiled configuration to an expanded, uncoiled configuration.

12. The method of claim 1 and further comprising:

delivering a substance to the channel to enhance endothelialization of the heart tissue.

13. The method of claim 12 wherein delivering a substance comprises:

accessing the channel with a catheter; and

injecting, through the catheter, the substance.

14. The method of claim 12 wherein delivering a substance comprises:

delivering endothelial cells to the channel.

15. The method of claim 12 wherein delivering a substance comprises:

delivering a growth factor to the channel.

16. The method of claim 1 wherein covering the channel comprises:

delivering the patch, intravascularly, in a first configuration;

allowing the patch to assume a second configuration, larger than the first configuration, under the influence of a shape memory material; and

connecting the patch to heart tissue to form the conduit.

17. A method of bypassing a restriction in a restricted vessel, the method comprising:

accessing a region in a supply vessel proximate the restricted vessel and closely proximate heart tissue and suitable for providing a blood supply;

forming an aperture in the supply vessel;

accessing a region of the restricted vessel closely proximate heart tissue and distal of the restriction;

forming an aperture in the restricted vessel distal of the restriction;

creating a channel in heart tissue between the aperture in the supply vessel and the aperture in the restricted vessel; and

covering the channel to form a conduit.

18. A method of bypassing a restriction in a restricted coronary artery, the method comprising:

forming an aperture in a supply coronary artery proximate the restricted coronary artery;

forming an aperture in the restricted coronary artery distal of the restriction;

removing heart tissue from the surface of the heart to form a channel in the surface of the heart tissue between the aperture in the supply coronary artery and the aperture in the restricted coronary artery distal of the restriction; and

covering the channel to form a conduit to conduct blood from the supply coronary artery to the restricted coronary artery distal of the restriction.

19. The method of claim 18 wherein forming an aperture in the supply coronary artery, comprises:

forming the aperture in a region of the restricted coronary artery proximal of the restriction.

20. The method of claim 18 wherein the supply coronary artery comprises a neighboring coronary artery residing proximate the restricted vessel and wherein forming an aperture in the supply coronary artery, comprises:

forming an aperture in the neighboring coronary artery proximate the restricted coronary artery.

21. The method of claim 18 wherein covering the channel comprises:

applying a patch over the channel.

22. The method of claim 21 wherein applying a patch comprises:

adhering the patch to heart tissue proximate, the channel.