Coronary bypass implant

• US 6,454,794 B1
• Filed: 06/07/1999
• Issued: 09/24/2002
• 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): Isabella, David J.
• Application Number:
  US09/326,819
• Time in Patent Office: 1,205 Days
• Field of Search: 128/898, 606/153-156, 606/159, 606/192, 606/194, 606/195, 606/198, 600/16-18, 623/11.11, 623/23.64, 623/23.68, 623/23.7, 623/1.13, 623/1.24, 623/1.3, 623/1.31, 623/1.32, 623/1.49, 623/2.1, 623/1.1
• US Class Current: 623/1.1
• 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 with said channel retained open during both diastole and systole. The coronary artery bypass procedure may be performed with or without cardiopulmonary bypass.

Claims

1. An apparatus for use in a coronary bypass procedure at a human coronary vessel on a human heart wall, the apparatus comprising:

a. a blood flow conduit having a rigid first portion 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;

b. the conduit having a flexible second portion having a second end with an outer diameter sized to approximate a diameter of a lumen of the coronary vessel with an opening of the second end positioned for providing blood flow communication with the lumen of the coronary vessel, the flexible second portion extending exterior of the heart wall to the coronary vessel; and

c. the rigid first portion of the conduit being sufficiently rigid such than when placed through the heart wall the conduit defines a blood flow path open during at least systole.

2. An apparatus according to claim 1 wherein the conduit has a cross-sectional area sufficient to pass blood at a volumetric flow rate to supply blood to cardiac musculature served by the coronary vessel in an amount to reduce signs and symptoms of reduced coronary blood flow.

3. An apparatus according to claim 1 wherein the conduit has a geometry selected to bias forward flow of blood from the first end toward the second end while inhibiting blood flow from the second end toward the first end.

4. An apparatus according to claim 1 wherein the second end is sized to be connected to a T-shaped conduit inserted into and retained within the coronary vessel on a downstream side of a predetermined obstruction site.

5. An apparatus according to claim 1 comprising a deflection surface for blocking blood flow through the conduit from impinging directly upon the coronary vessel.

6. An apparatus according to claim 1 wherein the conduit is sized to extend through the heart chamber wall and a lower wall of said coronary vessel.

7. An apparatus according to claim 1 wherein the conduit includes a biasing feature to provide a net volumetric blood flow from the first end toward the second end.

8. An apparatus according to claims 1, 2, 4, 5, or 6 wherein the apparatus is constructed for connection with a coronary artery.

9. An apparatus according to claim 1 wherein the rigid first portion of the conduit is sufficiently rigid such that when placed within the heart wall the conduit defines the open blood flow path during both diastole and systole.

14. An apparatus according to claim 1, wherein the first end of the rigid first portion protrudes into the heart chamber beyond an interior surface of the heart wall.

16. An apparatus according to claim 1 wherein the second end of the flexible second portion includes a connector having portions that project outwardly from opposite sides of the flexible second portion.

10. An apparatus for use in a coronary bypass procedure at a human coronary vessel on a human heart wall, the apparatus comprising:

a. a blood flow conduit having a rigid first portion 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;

b. the conduit having a second portion having a second end dimensioned for connection to the coronary vessel with an opening of the second end positioned for providing blood flow communication with a lumen of the coronary vessel, the second portion extending exterior of the heart wall to the coronary vessel; and

c. a deflection surface for deflecting blood flowing from the heart chamber to the vessel for the blood to be deflected into the vessel without substantial impingement of the blood on a wall of the vessel when the conduit is placed within the heart wall.

11. An apparatus according to claim 10 wherein the first portion of the conduit is sufficiently radially rigid such that when placed within the heart wall the conduit defines the open blood flow path during both diastole and systole.

12. An apparatus according to claim 10 wherein the rigid first portion of the conduit is sufficiently rigid such than when placed within the heart wall the conduit defines an open blood flow path at least during systole and, when so placed, the first end protrudes into the heart chamber beyond an interior surface of the heart wall.

13. An apparatus according to claims 10, 11 or 12 wherein the apparatus is constructed for connection with a coronary artery.

15. An apparatus for use in a coronary bypass procedure at a human coronary vessel on a human heart wall, the apparatus comprising:

a. a blood flow conduit having a rigid first portion 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 provisind blood-flow communication with blood contained within the chamber;

b. the conduit having a flexible second portion having a second end dimensioned for connection to the coronary vessel with an opening of the second end positioned for providing blood floww communication with a lumen of the coronary vessel, the flexible second portion extending exterior of the heart wall to the coronary vessel;

c. the rigid first portion of the conduit being sufficiently rigid such that when placed through the heart wall the conduit defines a blood flow path open during at least systole; and

d. the second end of the flexible second portion of the conduit having an outer diameter between 1.0 mm and 4 mm.