Mesh tip myocardial implant

• US 6,361,519 B1
• Filed: 04/13/2000
• Issued: 03/26/2002
• Est. Priority Date: 08/13/1996
• Status: Expired due to Fees

• Current Assignee: WILK Patent Development Corporation
• Original Assignee: Heartstent Corp.
• Inventors: Knudson, Mark B., Giese, William L.
• Primary Examiner(s): McDermott, Corrine
• Assistant Examiner(s): Koh, Choon P.
• Application Number:
  US09/548,175
• Time in Patent Office: 712 Days
• Field of Search: 604/8, 606/151, 623/1.1, 623/1.12, 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 Y-shaped blood vessel prostheses A61F2002/065
• 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 coronary vessel disposed lying at an exterior of a heart wall, the apparatus comprising;

a hollows blood flow conduit having a first end sized for being inserted into and retained within the cart wall of a heart chamber containing oxygenated blood with said first end sized to span a thickness of the heart wall with an opening of the first end in blood-flow communication with blood contained within the chamber, said first end having sufficient radial rigidity to resist collapse of said first end in response to contraction of said heart;

the conduit having a second end sized for being inserted within the coronary vessel with an opening of the second end in blood flow communication with a lumen of the coronary vessel, said second end having an open cell structure within said vessel; and

the conduit defining a blood flow path between the openings of the first and second ends.

2. An apparatus according to claim 1 wherein the conduit is a substantially L-shaped tube.

3. An apparatus according to claim 1 wherein the conduit is a substantially T-shaped tube.

4. An apparatus according to claim 1, wherein the first end of the conduit protrudes beyond an interior surface of the heart wall.

5. An apparatus according to claim 1 wherein the blood flow path closes at least once during a cycle of the heart.

6. An apparatus according to claim 5 wherein the conduit includes a valve to close during diastole.

7. An apparatus according to claim 1 wherein the second end is radially expandable within the vessel.

8. An apparatus according to claim 7 wherein the first end is radially expandable within the heart wall.

9. An apparatus for use in a coronary artery bypass procedure at a coronary vessel disposed lying at an exterior of a heart wall, the apparatus comprising;

a hollow blood flow conduit having a first end sized for being inserted into and retained within the heart wall of a heart chamber containing oxygenated blood with said first end sized to span a thickness of the heart wall with an opening of the first end in blood flow communication with blood contained within the chamber, said firs end having sufficient radial rigidity to resist collapse of said first end in response to contraction of said heart;

the conduit having a second end sized for being inserted within the coronary vessel with an opening of the second end in blood flow communication with a lumen of the coronary vessel, said second end having an open cell structure within said vessel; and

the conduit defining a blood flow path between the openings of the first and second ends, wherein the conduit includes a reservoir for accumulating blood from the conduit during periods of high blood pressure and for discharging accumulated blood into the conduit during periods of low blood pressure.

10. An apparatus according to claim 9, wherein the first end of the conduit protrudes beyond an interior surface of the heart wall.

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

A. selecting a hollow blood flow conduit having;

a. a first end sized for being inserted into and retained within the heart wall of a heart chamber containing oxyenated blood with an opening of the first end in blood-flow communication with blood contained within the chamber;

b. the conduit having a second end sized for being inserted into the coronary vessel with an opening of the second end in blood flow communication with a lumen of the coronary vessel, said second end having an open cell structure within said vessel; and

c. the conduit defining a blood flow path between the openings of the first and second ends,

B. inserting the first end of the conduit through the heart wall with the first end in blood flow communication with the heart chamber;

C. placing the second end of the conduit into the vessel with openings of the open cell structure opposing an interior wall of the vessel.

12. A method according to claim 11 wherein the blood flow path is formed by placing the conduit through a deep wall of the coronary vessel.

13. A method according to claim 11 wherein the coronary vessel is a coronary artery.

14. A method according to claim 11 comprising closing the blood flow path once per cycle of the heart.

15. A method according to claim 11 wherein the blood flow path is closed during diastole.

16. A method according to claim 11 Wherein the second end is radially expanded within the vessel.

17. A method according to claim 16 wherein the first end is radially expanded within the heart wall.

18. The method of claim 11, wherein the heart is a human heart.

19. The method of claim 11, wherein the conduit remains in the heart.

20. The method of claim 11 further comprising the steps of:

closing an incision made during insertion of the conduit and leaving the conduit in the heart.

21. The method of claim 11 further comprising the steps of:

withdrawing a catheter used to deliver the conduit and leaving the conduit in the heart.

22. An apparatus for use in a coronary artery bypass procedure at a coronary vessel disposed lying at an exterior of a heart wall, the apparatus comprising;

a blood flow conduit having a first end sized for being inserted into and retained within the heart wall of a heart chamber containing oxygenated blood with said first end sized to span a thickness of the heart wall with an opening of the first end in blood-flow communication with blood contained within the chamber, said first end having a solid wall construction within said heart wall and sufficient radial rigidity to resist collapse of said first end in response to contraction of said heart;

the conduit having a second end sized for being inserted within the coronary vessel with an openig of the second end in blood flow communication with a lumen of the coronary vessel, said second end having an open cell structure within said vessel; and

tile conduit defining a blood flow path between the openings of the first and second ends.

23. An apparatus according to claim 22, wherein the first end of the conduit protrudes beyond an interior surface of the heart wall.

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

A. selecting a hollow blood flow conduit having;

a. a first end adapted to be inserted into and retained within the heart wall of a heart chamber containing oxygenated blood with an opening of the first end in blood flow communication with blood contained within the chamber, said first end having a sufficient radial rigidity to resist collapse of said first end in response to contraction of said heart, wherein said first end remains open during both systole and diastole;

b. the conduit having a second end sized to be inserted into the coronary vessel with an opening of the second end in blood flow communication with a lumen of the coronary vessel, said second end having an open cell structure within said vessel; and

c. the conduit defining a blood flow path between the openings of the first and second ends;

B. inserting the first end of the conduit through the heart wall with the first end in blood flow communication with the heart chamber;

C. placing the second end of the conduit into the vessel with openings of the open cell structure opposing an interior wall of the vessel.

25. The method of claim 24, wherein the heart is a human heart.

26. The method of claim 24, wherein the conduit remains in the heart.

27. The method of claim 24 further comprising the steps of closing an incision made during insertion of the conduit and leaving the conduit in the heart.

28. The method of claim 24 further comprising the steps of:

withdrawing a catheter used to deliver the conduit and leaving the conduit in the heart.