Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures

• US 6,616,675 B1
• Filed: 03/17/1999
• Issued: 09/09/2003
• Est. Priority Date: 02/02/1996
• Status: Expired due to Term

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: TransVascular, Inc. (Medtronic Plc)
• Inventors: Flaherty, J. C., Machold, Timothy R., Makower, Joshua, Macaulay, Patrick E., Roth, Alex T., Whitt, Jason B., Evard, Philip C., Garibotto, John T.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US09/117,520
• Time in Patent Office: 1,637 Days
• Field of Search: 606/1, 606/108, 606/194, 606/195, 606/198, 606/200, 606/153-156, 623/1, 623/12, 623/1.15, 623/1.22, 623/1.2
• US Class Current: 606/155
• CPC Class Codes: A61B 1/3137 for examination of the interior of blood vessels
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 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 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/00504 Tissue welding
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22077 : with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00404 : Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00869 : Phase
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/1475 : Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 2090/3925 : ultrasonic
• CPC Class Codes: A61B 2090/3929 : Active markers
• CPC Class Codes: A61B 2090/3958 : emitting a signal
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/40 : Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
• CPC Class Codes: A61F 2/07 : Stent-grafts
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2/90 : characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/95 : Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/958 : Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/30079 : magnetic
• CPC Class Codes: A61F 2002/8486 : provided on at least one of the ends
• CPC Class Codes: A61F 2210/009 : magnetic
• CPC Class Codes: A61F 2230/001 : Figure-8-shaped, e.g. hourglass-shaped
• CPC Class Codes: A61M 2025/0076 : Unidirectional valves
• CPC Class Codes: A61M 2025/0096 : being laterally outward extensions or tools, e.g. hooks or fibres
• CPC Class Codes: A61M 2025/1052 : for temporarily occluding a vessel for isolating a sector

Abstract

Anastomotic connectors and apparatus for forming and/or maintaining connections between openings formed in anatomical structures, such as blood vessels. The apparatus is initially deployed in a first configuration which is sufficiently compact to be delivered through the lumen of a catheter or cannula. Thereafter, the device is expanded to a second configuration whereby it engages the anatomical structures and forms or maintains the desired connection between openings in the anatomical structures.

Claims

1. An apparatus for connecting a first opening formed in a first anatomical structure to a second opening formed in a second anatomical structure, said first anatomical structure having a wall and an inner space defined at least in part by an inner surface of the first anatomical structure'"'"'s wall and said second anatomical structure having a wall and an inner space defined at least in part by an inner surface of the second anatomical structure'"'"'s wall, said apparatus being initially disposable in radially collapsed configuration wherein it may be transluminally delivered to an intended implantation site and subsequently transitionable to a radially expanded configuration, said apparatus being formed of plastic and, when implanted in its radially expanded configuration, comprising:

a) a first engagement portion which engages the wall of the first anatomical structure adjacent to the perimeter of the first opening formed therein;

b) a second engagement portion which engages the wall of the second anatomical structure adjacent to the perimeter of the second opening formed therein; and

,

c) a tube connecting the first engagement portion to the second engagement portion, said tube being configured to define a flow channel through which fluid may flow from the inner space of the first anatomical structure, through the first opening, through the second opening and into the inner space of the second anatomical structure, wherein said first and second engagement portions comprise projections extending laterally outward from opposite ends of the tube.

2. The apparatus of claim 1 wherein said tube comprises a frame which will maintain an open passageway through surrounding tissue.

3. The apparatus of claim 1 wherein said tube is a mesh tube.

4. The apparatus of claim 1 wherein the projection of said second engagement member is a splayable member initially maintained in a non-splayed configuration and, after being positioned adjacent the second opening formed in the second anatomical structure, is convertible to a splayed configuration wherein the projection engages the inner wall of the second anatomical structure adjacent the second opening formed therein.

5. The apparatus of claim 4 wherein the projection of said first engagement member is self-splaying and resiliently biased to its splayed configuration.

6. The apparatus of claim 1 wherein said apparatus is initially deployable in a radially compact configuration, said apparatus being subsequently radially expandable to an operative configuration wherein at least said first and second engagement portions will abut against and engage the adjacent surfaces of the first and second anatomical structures.

7. The apparatus of claim 6 wherein said apparatus is self-expanding and resiliently biased to its operative configuration.

8. The apparatus of claim 6 wherein said apparatus is plastically formable and is initially formed in its radially compact configuration, and is subsequently deformable to its operative configuration by exertion of radial pressure upon said apparatus.

9. The apparatus of claim 1 wherein said apparatus is a hyperboloidal helical coil.

10. The apparatus of claim 9 wherein said hyperboloidal helical coil is formed of a multiplicity of adjacent convolutions of wire, and wherein at least some of said adjacent convolutions are fused to one another.

11. The apparatus of claim 1 wherein said first and second engagement portions comprise frusto-conical helical coils having outer and inner ends, the outer ends of said helical coils being larger in diameter than the inner ends thereof.

12. The apparatus of claim 1 wherein said tube has inwardly arched side walls such that the ends of the tube are of larger diameter than the middle of the tube.

13. The apparatus of claim 12 wherein said tube is a solid tube.

14. The apparatus of claim 12 wherein said tube is mesh tube.

15. The apparatus of claim 12 wherein said tube is formed of a material selected from the group of materials consisting of:

a helical wire coil;

a helical filament coil;

wire mesh;

a shape memory alloy;

plastic;

metal;

woven fabric;

elastic material; and

,

elastomeric material.

16. The apparatus of claim 12 wherein at least one of the projections is splayable.

17. The apparatus of claim 16 wherein the at least one splayable projection is self-splaying and resiliently biased to an outwardly splayed configuration.

18. The apparatus of claim 16 wherein the at least one splayable projection is plastically deformable, and initially formed in a non-splayed configuration but subsequently deformable by exertion of outwardly directed pressure thereagainst.

19. The apparatus of claim 1 wherein said connector apparatus is a flanged tube connector wherein said connecting portion comprises a tube, and wherein said first and second engagement portions comprise semi-cylindrically shaped flanges which extend laterally outward from opposite ends of the said tube.

20. The apparatus of claim 19 wherein said flanged tube connector is formed by a method comprising the steps of:

a) providing a tube having a longitudinal axis, a cylindrical side wall disposed about said longitudinal axis, first and second ends, and a hollow lumen extending longitudinally therethrough;

b) forming first and second rectangular notches at directly opposite locations in the first end of said tube, said rectangular notches having side edges which are parallel to said longitudinal axis, and an end which is perpendicular to said longitudinal axis;

c) forming third and fourth rectangular notches at directly opposite locations in the second end of said tube, said rectangular notches having side edges which are parallel to said longitudinal axis, and an end which is perpendicular to said longitudinal axis;

d) forming first and second generally arcuate notches at directly opposite locations in the cylindrical side wall of the tube, in alignment with the ends of the first and second rectangular notches;

e) forming third and fourth generally arcuate notches at directly opposite locations in the cylindrical side wall of the tube, in alignment with the ends of the third and fourth rectangular notches; and

,

f) outwardly bending the remaining cylindrical side walls of the tube adjacent said rectangular notches such that said generally arcuate notches become substantially closed, and said outwardly bent portions of the side wall form semi-cylindrical flanges which protrude outwardly from opposite ends of the remaining mid-portion of the tube, generally perpendicular to said longitudinal axis.

21. The apparatus of claim 1 wherein said tube is configured to extend through and reside within a passageway formed between said first and second openings.

22. The apparatus of claim 1 wherein said tube is constructed to penetrate through tissue and is positioned to reside within surrounding tissue and outboard of a passageway which has been formed between the first and second openings.

23. The apparatus of claim 1 wherein said apparatus is adapted to transmit energy to tissue with which the apparatus comes into contact, thereby providing an energy-mediated treatment to said tissue.

24. The apparatus of claim 1 wherein said first and second engagement portions comprise annular members, and wherein said connecting portion comprises:

at least one connector member formed on said first engagement portion and adapted to insert into an engaged said second engagement portion when said first and second engagement portions are moved toward one another.

25. The apparatus of claim 24 wherein said connector portion comprises at least one elongate member.

26. The connector apparatus of claim 1 wherein said apparatus further comprises at least one magnet to facilitate connection of the first engagement portion to the second engagement portion.

27. The connector apparatus of claim 1 wherein said tube comprises scaffolding to deter ingrowth into the flow channel formed between the first and second anatomical structures.

28. The connector apparatus of claim 1 wherein said connector apparatus has a leading edge adapted to sever tissue as said connector apparatus is advanced.

29. The connector apparatus of claim 1 wherein said connector apparatus has an outer covering which is selected from the group of outer coverings consisting of:

a synthetic tube graft;

a natural tube graft;

a chemical coating;

an antithrombogenic coating; and

,

an antimicrobial coating.

30. The connector apparatus of claim 1 wherein said connector apparatus further comprises at least one radioactive material to deter tissue ingrowth following implantation.

31. The connector apparatus of claim 1 wherein said connecting portion includes adjusting structure adapted to pull said first and second engagement portions toward one another.

32. The connector apparatus of claim 31 wherein said adjusting structure enables the connector apparatus to form connections between anatomical structures which are separated by varying distances, and is selected from the group consisting of:

telescoping structure and

distendable structure.

33. The connector apparatus of claim 31 wherein said adjusting structure is elastic, and serves to minimize the length of the channel wherein the connector apparatus is implanted.

34. The apparatus of claim 1 wherein the projection of said first engagement portion is a splayable member which is initially maintained in a non-splayed configuration and, after being positioned adjacent the first opening formed in the first anatomical structure, is convertible to a splayed configuration wherein said first engagement member engages the inner wall of the first anatomical structure adjacent the first opening.

35. The apparatus of claim 34 wherein the projection of said first engagement member is self-splaying and resiliently biased to its splayed configuration.

36. The apparatus of claim 34 wherein the projection of said first engagement portion is plastically deformable and is initially formed in its non-splayed configuration, and is subsequently deformable to its splayed configuration by exertion of pressure against said engagement member.

37. An apparatus for connecting a first opening formed in a first anatomical structure to a second opening formed in a second anatomical structure, said first anatomical structure having a wall and an inner space defined at least in part by an inner surface of the first anatomical structure'"'"'s wall and said second anatomical structure having a wall and an inner space defined at least in part by an inner surface of the second anatomical structure'"'"'s wall, said apparatus being initially disposable in radially collapsed configuration wherein it may be transluminally delivered to an intended implantation site and subsequently transitionable to a radially expanded configuration, said apparatus comprising an elongate wire member having a series of sinusoidal bends formed therein, and first and second ends, the first and second ends of said wire member being joined to one another to form a ring wherein, when said apparatus is implanted in its radially expanded configuration:

a) a first portion of at least some of said sinusoidal bends turns outwardly to form projections engaging the wall of the first anatomical structure adjacent to the perimeter of the first opening formed therein;

b) a second portion of at least some of said sinusoidal bends turns outwardly to form projections engaging the wall of the second anatomical structure adjacent to the perimeter of the second opening formed therein; and

c) the ring defines a flow channel through which fluid may flow from the inner space of the first anatomical structure, through the first opening, through the second opening and into the inner space of the second anatomical structure;

wherein at least one of the first and second portions is configured to self-expand from a radially constrained, non-splayed initial configuration to a splayed configuration such that the projections engage the wall of the first or second anatomical structure after being positioned adjacent the first or second opening and relieved of radial restraint.

38. The apparatus of claim 37, wherein said sinusoidal bends include a plurality of first sinusoidal bends of a first amplitude, and a plurality of second sinusoidal bends of a second amplitude, said second amplitude being larger than said first amplitude, said second sinusoidal bends of said second amplitude being bent outwardly to form said projections, and said first sinusoidal bends of said first amplitude remaining without outward bending so as to form said ring.

39. The apparatus of claim 37 wherein said ring is configured to extend through and reside within a passageway formed between said first and second openings.

40. The apparatus of claim 37 wherein said ring is constructed to penetrate through tissue and is positioned to reside within surrounding tissue and outboard of a passageway formed between said first and second openings.

41. The apparatus of claim 37 wherein said apparatus is adapted to transmit energy to tissue with which the apparatus comes into contact, thereby providing an energy mediated treatment to said tissue.

42. The apparatus of claim 37 wherein said apparatus comprises scaffolding to deter ingrowth into the flow channel formed between the first and second anatomical structures.

43. The apparatus of claim 37 wherein said apparatus has a leading edge, and wherein said leading edge is adapted to sever tissue as said apparatus is advanced.

44. The apparatus of claim 37 wherein said apparatus has an outer covering which is selected from the group of outer coverings consisting of:

a synthetic tube graft;

a natural tube graft;

a chemical coating;

an anti-thrombogenic coating; and

an anti-microbial coating.

45. The apparatus of claim 37 wherein said apparatus further comprises at least one radioactive material to deter tissue ingrowth following implantation.

46. An apparatus for connecting a first opening formed in a first anatomical structure to a second opening formed in a second anatomical structure, said first anatomical structure having a wall and an inner space defined at least in part by an inner surface of the first anatomical structure'"'"'s wall, and said anatomical structure having a wall and an inner space defined at least in part by an inner surface of the second anatomical structure'"'"'s wall, said apparatus being initially disposable in a radially collapsed configuration wherein it may be transluminally delivered to an intended implantation site and subsequently transitionable to a radially expanded configuration, said apparatus when implanted in its radially expanded configuration comprising:

a) a first engagement portion which engages the wall of the first anatomical structure adjacent to the perimeter of the first opening formed therein;

b) a second engagement portion which engages the wall of the second anatomical structure adjacent to the perimeter of the second opening formed therein;

c) a connecting portion connecting the first engagement portion to the second engagement portion, said connecting portion being configured to define a flow channel through which fluid may flow from the inner space of the first anatomical structure, through the first opening, through the second opening and into the inner space of the second anatomical structure; and

d) a leading edge adapted to sever tissue as said apparatus is advanced.

47. The apparatus of claim 46 wherein said connecting portion is a tubular member.

48. The apparatus of claim 46 wherein said connecting portion is a wire member.

49. The apparatus of claim 46 wherein said connecting portion comprises a frame which will maintain an open passageway through surrounding tissue.

50. The apparatus of claim 46 wherein said connecting portion is a mesh tube.

51. The apparatus of claim 46 wherein said first engagement portion is a splayable member which is initially maintained in a non-splayed configuration and, after being positioned adjacent the first opening formed in the first anatomical structure, is convertible to a splayed configuration wherein said first engagement member will engage the inner wall of the first anatomical structure adjacent the first opening formed therein.

52. The apparatus of claim 51 wherein said first engagement member is self-splaying and resiliently biased to its splayed configuration.

53. The apparatus of claim 51 wherein said first engagement portion is plastically deformable and is initially formed in its non-splayed configuration, and is subsequently deformable to its splayed configuration by exertion of pressure against said engagement member.

54. The apparatus of claim 46 wherein said second engagement portion is a splayable member which is initially maintained in a non-splayed configuration and, after being positioned adjacent the second opening formed in the second anatomical structure, is convertible to a splayed configuration wherein said second engagement member will engage the inner wall of the second anatomical structure adjacent the second opening formed therein.

55. The apparatus of claim 54 wherein said second engagement member is self-splaying and resiliently biased to its splayed configuration.

56. The apparatus of claim 54 wherein said second engagement portion is plastically deformable and is initially formed in its non-splayed configuration, and is subsequently deformable to its splayed configuration by exertion of pressure against said engagement member.

57. The apparatus of claim 46 wherein said apparatus is initially deployable in a radially compact configuration, said apparatus being subsequently radially expandable to an operative configuration wherein at least said first and second engagement portions will abut against and engage the adjacent surfaces of the first and second anatomical structures.

58. The apparatus of claim 57 wherein said apparatus is self-expanding and resiliently biased to its operative configuration.

59. The apparatus of claim 57 wherein said apparatus is plastically deformable and is initially formed in its radially compact configuration, and is subsequently deformable to its operative configuration by exertion of radial pressure upon said apparatus.

60. The apparatus of claim 46 wherein said apparatus is a hyperboloidal helical coil.

61. The apparatus of claim 60 wherein said hyperboloidal helical coil is formed of a multiplicity of adjacent convolutions of wire, and wherein at least some of said adjacent convolutions are fused to one another.

62. The apparatus of claim 46 wherein said first and second engagement portions comprise frusto-conical helical coils having outer and inner ends, the outer ends of said helical coils being larger in diameter than the inner ends thereof.

63. The apparatus of claim 62 wherein said connecting portion of said apparatus comprises a tubular member mounted between and connecting the inner ends of said frusto-conical helical coils.

64. The apparatus of claim 46 wherein said apparatus is a tube having inwardly arched side walls such that the ends of the tube are of larger diameter than the middle of the tube, said ends of the tube thereby forming said first and second engagement portions, and said middle of the tube thereby forming said connecting portion.

65. The apparatus of claim 64 further comprising at least one splayable engagement member formed on each end of the tube.

66. The apparatus of claim 65 wherein said at least one splayable engagement member is self-splaying and resiliently biased to an outwardly splayed configuration.

67. The apparatus of claim 65 wherein said at least one engagement member is plastically deformable, and initially formed in a non-splayed configuration but subsequently deformable by exertion of outwardly directed pressure thereagainst.

68. The apparatus of claim 64 wherein said tube is a solid tube.

69. The apparatus of claim 64 wherein said tube is a mesh tube.

70. The apparatus of claim 64 wherein said tube is formed of a material selected from the group of materials consisting of:

a helical wire coil;

a helical filament coil;

wire mesh;

a shape memory alloy;

plastic;

metal;

woven fabric;

elastic material; and

elastomeric material.

71. The apparatus of claim 46 wherein said apparatus comprises a plastic structure wherein the connecting portion comprises a tube, and wherein the first and second engagement portions comprise projections which extend laterally outwardly from opposite ends of said tube.

72. The apparatus of claim 46 wherein said apparatus comprises a wire clip, wherein said first and second engagement portions comprise wire projections which extend laterally outward form the center of the clip, and wherein said connecting portion comprises traversing segments of wire which extend between said projections.

73. The apparatus of claim 46 wherein said apparatus comprises an elongate wire member having a series of generally sinusoidal bends formed therein, and first and second ends, the first and second ends of said wire member being joined to one another to form a ring, and at least some of said sinusoidal bends being turned outwardly therefrom to form projections which extend outwardly from said ring, said projections thereby forming said first and second engagement portions, and said ring thereby forming said connecting portion.

74. The apparatus of claim 73 wherein said sinusoidal bends include a plurality of first sinusoidal bends of a first amplitude,and a plurality of second sinusoidal bends of a second amplitude, said second amplitude being larger than said first amplitude, said second sinusoidal bends of said second amplitude being bent outwardly to form said projections, and said first sinusoidal bends of said first amplitude remaining without outward bending so as to form said ring.

75. The apparatus of claim 46 wherein said apparatus comprises a triplet coil connector comprising:

a first helical coil having a first longitudinal axis, a second helical coil having a second longitudinal axis which is not parallel to the first longitudinal axis, and a third helical coil having a third longitudinal axis, said third longitudinal axis being perpendicular to said second longitudinal axis but spaced apart from said first longitudinal axis;

said triplet coil connector being thereby implantable within the body such that the first helical coil is within the inner space of the first anatomical structure, said third helical coil is within the inner space of the second anatomical structure, and said second helical coil extends between said first and second openings in said first and second anatomical structures.

76. The apparatus of claim 75 wherein said first, second, and third coil members are formed of helically wound wire.

77. The apparatus of claim 75 wherein said first, second, and third coil members are formed of helically wound filament.

78. The apparatus of claim 46 wherein said connecting portion comprises a tube, and wherein said first and second engagement portions comprises semi-cylindrically shaped flanges which extend laterally outward from opposite ends of said tube.

79. The apparatus of claim 78 wherein said flanged tube connector is formed by a method comprising the steps of:

a) providing a tube having a longitudinal axis, a cylindrical side wall disposed about said longitudinal axis, first and second ends, and a hollow lumen extending longitudinally therethrough;

b) forming first and second rectangular notches at directly opposite locations in the first end of said tube, said rectangular notches having side edges which are parallel to said longitudinal axis, and an end which is perpendicular to said longitudinal axis;

c) forming third and fourth rectangular notches at directly opposite locations in the second end of said tube, said rectangular notched having side edges which are parallel to said longitudinal axis, and an end which is perpendicular to said longitudinal axis;

d) forming first and second generally arcuate notches at directly opposite locations in the cylindrical side wall of the tube, in alignment with the ends of the first and second rectangular notches;

e) forming third and fourth generally arcuate notches at directly opposite locations in the cylindrical side wall of the tube, in alignment with the ends of the third and fourth rectangular notches; and

f) outwardly bending the remaining cylindrical side walls of the tube adjacent said rectangular notches such that said generally arcuate notches become substantially closed, and said outwardly bent portions of the side wall form semi-cylindrical flanges which protrude outwardly from opposite ends of the remaining mid-portion of the tube, generally perpendicular to said longitudinal axis.

80. The apparatus of claim 46 wherein said connecting portion is configured to extend through and reside within a passageway formed between said first and second openings.

81. The apparatus of claim 46 wherein said tube is constructed to penetrate through tissue and is positioned to reside within surrounding tissue and outboard of a passageway which has been formed between the first and second openings.

82. The apparatus of claim 46 wherein said apparatus is adapted to transmit energy to tissue with which the apparatus is adapted to transmit energy to tissue with which the apparatus comes into contact, thereby providing an energy-mediated treatment to said tissue.

83. The apparatus of claim 46 wherein said first and second engagement portions comprise annular members, and wherein said connecting portion comprises:

at least one connector member formed on said first engagement portion and adapted to insert into said second engagement portion when said first and second engagement portions are moved toward one another.

84. The apparatus of claim 83 wherein said connecting portion comprises at least one elongate member.

85. The apparatus of claim 46 wherein said apparatus further comprises at least one magnet to facilitate connection of the first engagement portion to the second engagement portion.

86. The apparatus of claim 46 wherein said connecting portion comprises scaffolding to deter ingrowth into the flow channel formed between the first and second anatomical structures.

87. The apparatus of claim 46 wherein said apparatus has an outer covering which is selected from the group of outer coverings consisting of:

a synthetic tube graft;

a natural tube graft;

a chemical coating;

an antithrombogenic coating; and

,

an antimicrobial coating.

88. The apparatus of claim 46 wherein said connector apparatus further comprises at least one radioactive material to deter tissue ingrowth following implantation.

89. The apparatus of claim 46 wherein said connecting portion is constructed to pull said first and second engagement portions toward one another.

90. The apparatus of claim 89 wherein said pulling of the first and second engagement members toward one another enables the connector apparatus to form connection between anatomical structures which are separated by varying distances.

91. The apparatus of claim 89 wherein said pulling of the first and second engagement members toward one another serves to minimize the length of the channel wherein the connector apparatus is implanted.