Methods of providing direct blood flow between a heart chamber and a coronary vessel

• US 7,294,115 B1
• Filed: 03/24/2000
• Issued: 11/13/2007
• Est. Priority Date: 01/30/1998
• Status: Expired due to Fees

• Current Assignee: Horizon Technology Funding Co. LLC (Horizon Technology Finance Management LLC)
• Original Assignee: Percardia, Inc.
• Inventors: Wilk, Peter J.
• Primary Examiner(s): Bianco; Patricia
• Application Number:
  US09/534,038
• Time in Patent Office: 2,790 Days
• Field of Search: 604/8, 604/22, 604/500, 604506- 8, 604/510, 604/96.01, 604158- 59, 60416401-16402, 604/164, 604/164.06, 604/164.09, 604/164.12, 604/165, 604/171, 60416501-16504, 604/528, 604/107, 604/108, 604/264, 604/523, 607/88, 607/89, 606/7, 606 12- 18, 606/33, 606/41, 606 45- 48, 606/50, 606/108, 606/119, 606/120, 606139-144, 606/148, 606/151, 606/153, 606/155, 606157- 59, 606/170, 606/171, 606/180, 606/185, 606/190, 606/192, 606194- 95, 606/198, 606/213, 606/220, 128/898, 623/1.1, 623/1.11, 623/3.11, 623/3.26, 623/8
• US Class Current: 604/8
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• 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 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00654 entirely comprised between the two sides of the opening
• 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 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/6862 Stents
• CPC Class Codes: A61B 5/6876 Blood vessel
• 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 2/2493 Transmyocardial revascularisation [TMR] devices
• 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 2002/8486 : provided on at least one of the ends
• CPC Class Codes: A61F 2002/91508 : the meander having a difference in amplitude along the band
• CPC Class Codes: A61F 2002/91516 : the meander having a change in frequency along the band
• CPC Class Codes: A61F 2002/91525 : within the whole structure different bands showing different meander characteristics, e.g. frequency or amplitude
• CPC Class Codes: A61F 2002/91533 : characterised by the phase between adjacent bands
• CPC Class Codes: A61F 2002/91575 : connected peak to trough
• 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 2250/0002 : for data transfer
• CPC Class Codes: A61F 2250/0039 : differing in diameter
• CPC Class Codes: A61F 2250/0067 : Means for introducing or releasing pharmaceutical products into the body
• CPC Class Codes: A61M 27/002 : Implant devices for drainage of body fluids from one part of the body to another intraocular A61F9/00781; middle ear A61F11/202

Abstract

Methodology and related medical devices for effectively bypassing a blocked or partially blocked coronary artery and providing oxygenated blood to the myocardium. A coronary artery bypass method utilizes a shunt member. An upstream end portion of the shunt member is disposed in the myocardium of a patient'"'"'s heart so that the upstream end portion communicates with the left ventricle of the patient'"'"'s heart. An opposite or downstream end portion of the shunt member is placed in communication with a coronary artery of the patient downstream of a blockage in the coronary artery. The shunt member extends into the coronary artery from the myocardium either directly or indirectly with an intermediate or middle portion of the shunt member being disposed in an intrapericardial space of the patient, outside of the myocardium and outside of the coronary artery. In a method for performing a myocardial revascularization a passageway is formed at least partially through a myocardium of a patient from an outer surface of the patient'"'"'s heart, with a surgical operation being performed at an outer end of the passageway to permanently close the passageway at the outer end. The passageway may extend though a posterior wall of a coronary artery and is produced by forming an aperture in an anterior wall of the coronary artery and forming the passageway in substantial alignment with the aperture. The closure of the passageway is effectuated particularly by closing the aperture in the anterior wall of the coronary artery.

Claims

1. A method of providing direct blood flow between a heart chamber and a coronary vessel, the method comprising the steps of:

inserting an instrument through an anterior wall of the coronary vessel;

further inserting the instrument through a posterior wall of the coronary vessel and a heart wall between the heart chamber and the coronary vessel to form a passageway in the heart wall; and

radially expanding an implant within the passageway.

2. The method of claim 1, further comprising advancing the implant past the posterior wall of the coronary vessel and into the passageway.

3. The method of claim 2, further comprising advancing the implant past the anterior wall of the coronary vessel.

4. The method of claim 1, further comprising inserting the implant in the passageway via a catheter.

5. The method of claim 4, further comprising advancing the catheter to the passageway via the heart chamber.

6. The method of claim 1, wherein expanding the implant includes expanding an implant carrying a substance for delivery to the heart wall.

7. The method of claim 6, wherein the substance is chosen from angiogenesis factors and nucleic acid instructions for angiogensis factors.

8. The method of claim 6, wherein the substance is for at least one of generating, stimulating, and enhancing blood vessel formation.

9. The method of claim 1, wherein the implant includes a stent.

10. The method of claim 1, wherein expanding the implant includes expanding the implant from a collapsed configuration.

11. The method of claim 1, wherein the passageway in the heart wall is formed via one of lasing, drilling, and boring.

12. The method of claim 1, wherein inserting the instrument includes inserting an incising instrument.

13. The method of claim 1, further comprising removing the instrument from the heart wall prior to expanding the implant in the passageway.

14. The method of claim 1, wherein the implant does not extend substantially along an axial direction of the vessel.