Designs for left ventricular conduit

• US 7,101,402 B2
• Filed: 06/09/2003
• Issued: 09/05/2006
• Est. Priority Date: 09/10/1998
• Status: Expired due to Fees

• Current Assignee: Horizon Technology Funding Co. LLC (Horizon Technology Finance Management LLC)
• Original Assignee: Percardia, Inc.
• Inventors: Hall, Todd, Wolf, Scott, Phelps, David, Wilk, Peter, Furnish, Greg
• Primary Examiner(s): GHERBI, SUZETTE JAIME J
• Application Number:
  US10/456,488
• Publication Number:
  US 20030195458A1
• Time in Patent Office: 1,184 Days
• Field of Search: 623 115- 116, 623/23.7, 623/903, 604/8, 606/108
• US Class Current: 623/23.7
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• 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 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61F 2/2493 Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61F 2/91 made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
• CPC Class Codes: A61F 2/915 with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2/94 Stents retaining their form, i.e. not being deformable, after placement in the predetermined place
• 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 2002/826 more than one stent being applied sequentially
• CPC Class Codes: A61F 2002/91541 Adjacent bands are arranged out of phase
• CPC Class Codes: A61F 2220/0008 Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2230/005 Rosette-shaped, e.g. star-shaped
• CPC Class Codes: A61F 2230/006 Y-shaped
• CPC Class Codes: A61F 2250/0067 Means for introducing or releasing pharmaceutical products into the body
• CPC Class Codes: Y10S 623/903 Blood vessel

Abstract

A conduit is provided to provide a bypass around a blockage in the coronary artery. The conduit is adapted to be positioned in the myocardium or heart wall to provide a passage for blood to flow between a chamber of the heart such as the left ventricle and the coronary artery, distal to the blockage. The stent is self-expanding or uses a balloon to expand the stent in the heart wall. Various attachment means are provided to anchor the stent and prevent its migration.

Claims

1. A method for treating a heart, the method comprising:

delivering a conduit in a contracted configuration to a heart wall, the conduit including a plurality of units;

expanding the conduit in a passage in the heart wall between a heart chamber and a coronary vessel; and

sizing the conduit so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber,

wherein sizing the conduit includes adjusting a length of the conduit.

2. The method of claim 1, further comprising adjusting a position of the conduit within the heart wall.

3. The method of claim 1, wherein sizing the conduit includes cutting the conduit.

4. The method of claim 1, wherein delivering the plurality of units includes delivering the plurality of units in an aligned configuration.

5. The method of claim 1, wherein the plurality of units are connected.

6. The method of claim 5, wherein the plurality of units are connected by a wire.

7. The method of claim 5, wherein the plurality of units are interconnected.

8. The method of claim 1, wherein delivering the plurality of units includes delivering the plurality of units one at a time.

9. The method of claim 8, wherein delivering the plurality of units one at a time includes depressing a mechanism on a handle.

10. The method of claim 1, wherein the plurality of units comprise a plurality of ring-like elements.

11. The method of claim 10, wherein the ring-like elements are connected to each other.

12. The method of claim 10, wherein the ring-like elements are interconnected.

13. The method of claim 10, wherein the ring-like elements form a coil.

14. The method of claim 1, wherein delivering the plurality of units includes expanding the plurality of units from a delivered configuration within a delivery catheter to an expanded configuration in the heart wall.

15. The method of claim 1, wherein the coronary vessel is a coronary artery and the heart chamber is a left ventricle.

16. The method of claim 1, wherein the plurality of units includes at least one flange.

17. The method of claim 1, wherein the conduit is configured to place the heart chamber and the coronary vessel in flow communication with each other.

18. The method of claim 1, further comprising securing the conduit within the passage.

19. The method of claim 18, wherein securing the conduit includes attaching at least a portion of the conduit to the heart wall.

20. The method of claim 18, wherein securing the conduit includes attaching at least one of the plurality of units to the heart wall.

21. The method of claim 18, wherein securing the conduit includes deploying an attachment portion of the conduit within the passage.

22. The method of claim 1, further comprising delivering at least one agent to the heart wall via the conduit.

23. The method of claim 22, wherein the at least one agent is chosen from drugs, genes, angiogenesis factors, and growth factors.

24. A method for treating a heart, method comprising:

delivering a conduit in a contracted configuration to a heart wall, the conduit including a plurality of units;

expanding the conduit in a passage in the heart wall between a heart chamber and a coronary vessel; and

sizing the conduit so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber,

wherein sizing the conduit includes shortening the conduit.

25. A method for treating a heart, the method comprising:

delivering a conduit in a contracted configuration to a heart wall, the conduit including a plurality of units;

expanding the conduit in a passage in the heart wall between a heart chamber and a coronary vessel;

sizing the conduit so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber; and

adjusting a position of the conduit within the heart wall, wherein the adjusting the position is performed after the delivering of the conduit.

26. A method for treating a heart, the method comprising:

delivering a conduit in a contracted configuration to a heart wall, the conduit including a plurality of units;

expanding the conduit in a passage in the heart wall between a heart chamber and a coronary vessel; and

sizing the conduit so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber,

wherein the plurality of units are connected by a suture.

27. A method for treating a heart, the method comprising:

delivering a conduit in a contracted configuration to a heart wall, the conduit including a plurality of units;

expanding the conduit in a passage in the heart wall between a heart chamber and a coronary vessel; and

sizing the conduit so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber,

wherein the plurality of units comprise a plurality of ring-like elements,

wherein the ring-like elements are separable from each other.

28. A method for treating a heart, the method comprising:

delivering a conduit in a contracted configuration to a heart wall, the conduit including a plurality of units;

expanding the conduit in a passage in the heart wall between a heart chamber and a coronary vessel; and

sizing the conduit so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber,

wherein the plurality of units are not connected.

29. A method for treating a heart, the method comprising:

delivering a conduit in a contracted configuration to a heart wall, the conduit including a plurality of units;

expanding the conduit in a passage in the heart wall between a heart chamber and a coronary vessel; and

sizing the conduit so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber,

wherein the plurality of units includes at least one flange,

wherein delivering the plurality of units includes extending the at least one flange outward.

30. A method of treating a heart, the method comprising:

providing a plurality of units in a delivery device; and

deploying each of the plurality of units one at a time in a passage in a heart wall between a heart chamber and a coronary vessel to form a conduit that is sized so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber,

wherein deploying the plurality of units includes expanding the plurality of units from a delivered configuration within the delivery device to an expanded configuration in the heart wall.

31. The method of claim 30, wherein deploying the plurality of units includes deploying the plurality of units in an aligned configuration.

32. The method of claim 30, wherein the plurality of units are connected.

33. The method of claim 32, wherein the plurality of units are connected by a wire.

34. The method of claim 30, wherein deploying the plurality of units one at a time includes depressing a mechanism on a handle of the delivery device.

35. The method of claim 30, wherein the plurality of units comprise a plurality of ring-like elements.

36. The method of claim 35, wherein the ring-like elements are connected to each other.

37. The method of claim 30, wherein the coronary vessel is a coronary artery and the heart chamber is a left ventricle.

38. The method of claim 30, wherein the plurality of units includes at least one flange.

39. The method of claim 30, wherein the conduit is configured to place the heart chamber and the coronary vessel in flow communication with each other.

40. The method of claim 30, further comprising securing the conduit within the passage.

41. The method of claim 40, wherein securing the conduit includes attaching at least a portion of the conduit to the heart wall.

42. The method of claim 40, wherein securing the conduit includes attaching at least one of the plurality of units to the heart wall.

43. The method of claim 40, wherein securing the conduit includes deploying an attachment portion of the conduit within the passage.

44. The method of claim 30, further comprising inserting the delivery device into the heart wall percutaneously.

45. The method of claim 30, further comprising inserting the delivery device into the heart wall over a wire.

46. The method of claim 30, wherein deploying the plurality of units includes retracting the delivery device from the heart wall.

47. The method of claim 30, wherein the delivery device includes a catheter.

48. The method of claim 30, further comprising delivering at least one agent to the heart wall via the plurality of units.

49. The method of claim 48, wherein the at least one agent is chosen from drugs, genes, angiogenesis factors, and growth factors.

51. The method of claim 32, wherein the plurality of units are interconnected.

50. A method of treating a heart, the method comprising:

providing a plurality of units in a delivery device; and

deploying each of the plurality of units one at a time in a passage in a heart wall between a heart chamber and a coronary vessel to form a conduit that is sized so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber,

wherein the plurality of units are connected by a suture.

52. A method of treating a heart, the method comprising:

providing a plurality of units in a delivery device; and

deploying each of the plurality of units one at a time in a passage in a heart wall between a heart chamber and a coronary vessel to form a conduit that is sized so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber,

wherein the plurality of units comprise a plurality of ring-like elements,

wherein the ring-like elements are separable from each other.

53. A method of treating a heart, the method comprising:

providing a plurality of units in a delivery device; and

deploying each of the plurality of units one at a time in a passage in a heart wall between a heart chamber and a coronary vessel to form a conduit that is sized so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamberm,

wherein the plurality of units are not connected.

54. A method of treating a heart, the method comprising:

providing a plurality of units in a delivery device; and

deploying each of the plurality of units one at a time in a passage in a heart wall between a heart chamber and a coronary vessel to form a conduit that is sized so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber,

wherein the plurality of units includes at least one flange,

wherein deploying the plurality of units includes extending the at least one flange outward.

55. A method for treating a heart, the method comprising:

providing a conduit comprising a plurality of unconnected units;

delivering the conduit to a passage in a heart wall between a heart chamber and a coronary vessel; and

sizing the conduit so that a first end of the conduit is positioned proximate the coronary vessel and a second end of the conduit is positioned proximate the heart chamber.

56. The method of claim 55, wherein delivering the conduit includes deploying the plurality of unconnected units in an aligned configuration.

57. The method of claim 55, wherein delivering the conduit includes depressing a mechanism on a handle of the delivery device.

58. The method of claim 55, wherein the plurality of unconnected units comprise a plurality of ring-like elements.

59. The method of claim 55, wherein delivering the conduit includes expanding the plurality of unconnected units from a delivered configuration within a delivery device to an expanded configuration in the heart wall.

60. The method of claim 55, wherein the coronary vessel is a coronary artery and the heart chamber is a left ventricle.

61. The method of claim 55, wherein the conduit includes at least one flange.

62. The method of claim 61, wherein delivering the conduit includes extending the at least one flange outward.

63. The method of claim 55, wherein the conduit is configured to place the heart chamber and the coronary vessel in flow communication with each other.

64. The method of claim 55, further comprising securing the conduit within the passage.

65. The method of claim 64, wherein securing the conduit includes attaching at least a portion of the conduit to the heart wall.

66. The method of claim 64, wherein securing the conduit includes attaching at least one of the plurality of unconnected units to the heart wall.

67. The method of claim 64, wherein securing the conduit includes deploying an attachment portion of the conduit within the passage.

68. The method of claim 55, further comprising delivering at least one agent to the heart wall via the conduit.

69. The method of claim 68, wherein the at least one agent is chosen from drugs, genes, angiogenesis factors, and growth factors.