Method and apparatus for performing an anastamosis
First Claim
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1. A graft delivery system for using a mammary artery comprising:
- a first elongated instrument that is insertable into a patient'"'"'s vascular system, wherein said first elongated instrument comprises a mammary catheter and a mammary guide device capable of navigating said mammary catheter to said patient'"'"'s mammary artery at a pre-determined location;
a second elongated instrument that is insertable into said patient'"'"'s vascular system, wherein said second elongated instrument comprises a coronary catheter and a coronary guide device capable of navigating said coronary catheter to a coronary artery at a pre-determined location;
a retrieving device capable of retrieving said mammary guide device and said coronary guide device and extracting said mammary guide device and said coronary guide device through a thoracic aperture in said patient;
wherein one end of said retrieving device is magnetic or electrically charged having an opposite polarity than said mammary guide device, or one end of said retrieving device comprises a cone-shaped hollow device, or both;
wherein said system further comprises a third elongated instrument comprising a thoracic catheter; and
wherein said thoracic catheter in its diameter further comprises a step-off to limit forward movement of said thoracic catheter.
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Abstract
Graft delivery systems and methods for performing a cardiac by-pass procedure using a graft or a mammary artery are described. A combination of catheters and guide devices through the aorta, coronary artery, and the thoracic region can be used to accomplish these procedures.
66 Citations
49 Claims
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1. A graft delivery system for using a mammary artery comprising:
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a first elongated instrument that is insertable into a patient'"'"'s vascular system, wherein said first elongated instrument comprises a mammary catheter and a mammary guide device capable of navigating said mammary catheter to said patient'"'"'s mammary artery at a pre-determined location;
a second elongated instrument that is insertable into said patient'"'"'s vascular system, wherein said second elongated instrument comprises a coronary catheter and a coronary guide device capable of navigating said coronary catheter to a coronary artery at a pre-determined location;
a retrieving device capable of retrieving said mammary guide device and said coronary guide device and extracting said mammary guide device and said coronary guide device through a thoracic aperture in said patient;
wherein one end of said retrieving device is magnetic or electrically charged having an opposite polarity than said mammary guide device, or one end of said retrieving device comprises a cone-shaped hollow device, or both;
wherein said system further comprises a third elongated instrument comprising a thoracic catheter; and
wherein said thoracic catheter in its diameter further comprises a step-off to limit forward movement of said thoracic catheter. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30)
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31. A method for using a mammary artery as a graft using a graft delivery system comprising:
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a first elongated instrument that is insertable into a patient'"'"'s vascular system, wherein said first elongated instrument comprises a mammary catheter and a mammary guide device capable of navigating said mammary catheter to said patient'"'"'s mammary artery at a pre-determined location;
a second elongated instrument that is insertable into said patient'"'"'s vascular system, wherein said second elongated instrument comprises a coronary catheter and a coronary guide device capable of navigating said coranary catheter to a coronary artery at a pre-determined location; and
a retrieving device capable of retrieving said mammary guide device and said coronary guide device and extracting said mammary guide device and said coronary guide device through a thoracic aperture in said patient;
said method comprising;
a) creating a thoracic aperture;
b) inserting said mammary guide device into said patient'"'"'s vascular system;
c) cutting the mammary artery to create a severed end thereof;
d) navigating the distal end of said mammary guide device to protrude out of the severed end of said mammary artery;
e) inserting said second elongated instrument into said patient'"'"'s vascular system;
f) navigating said second elongated instrument to a pre-determined location in said coronary artery;
g) protruding said coronary guide device to the outside of said coronary artery, thereby creating a coronary aperture;
h) retrieving said mammary guide device and extracting said mammary guide device with said retrieving device and retrieving said coronary guide device and extracting said coronary guide device with said retrieving device and from said thoracic region of said patient to outside of said thoracic region of said patient;
i) inserting a thoracic elongated instrument into said patient by way of the thoracic aperture and navigating the distal end of the thoracic elongated instrument through the severed end of the mammary artery such that the distal end of the thoracic elongated instrument exits through the insertion point of the mammary guide device;
j) removing the mammary guide device from the patient and inserting the distal end of the coronary guide device into the proximal end of the thoracic elongated instrument and navigating the distal end of the coronary guide device such that the distal end of the coronary guide device exits out the patient through the insertion point of the mammary guide device of the patient; and
k) attaching said severed end of said mammary artery to said coronary aperture to make a fluid tight connection. - View Dependent Claims (32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49)
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Specification