Methods and devices for placing a conduit in fluid communication with a target vessel

• US 7,578,828 B2
• Filed: 05/19/2003
• Issued: 08/25/2009
• Est. Priority Date: 01/15/1999
• Status: Expired due to Fees

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Cole, David H., Carson, Dean F., Lepulu, Keke, Gittings, Darin C., Sharkawy, Adam, Laroya, Gilbert S., Rapacki, Alan R., Buch, Wally S.
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): Araj; Michael J
• Application Number:
  US10/441,256
• Publication Number:
  US 20040097988A1
• Time in Patent Office: 2,290 Days
• Field of Search: 606/153, 606/151, 606/194, 606/167, 606/170, 623/1.11, 623/1.12
• US Class Current: 606/153
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 2017/00243 cardiac
• 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 2017/00867 shape memory effect for prostheses A61F2210/0014
• 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 2017/1205 Introduction devices
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• 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 2/86 Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
• 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 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/9517 handle assemblies therefor
• 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 2002/91541 Adjacent bands are arranged out of phase
• CPC Class Codes: A61F 2002/91558 connected peak to peak
• CPC Class Codes: A61F 2220/0008 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/005 : using adhesives
• CPC Class Codes: A61F 2220/0058 : soldered or brazed or welded
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0054 : V-shaped

Abstract

Methods and devices for placing a conduit in fluid communication with a target vessel and a source of blood, such as the aorta or a heart chamber. The device may be actuated using one hand to place the conduit. The invention allows air in the conduit to be removed prior to placement of the conduit. The invention deploys the conduit in the target vessel by moving a sheath in a distal direction and then in a proximal direction. A conduit is provided with a reinforcing member to prevent kinking of the conduit, and a structure for preventing blockage of the conduit by tissue. A vessel coupling may be used to secure a conduit to a target vessel so as to preserve native blood flow through the vessel, and the conduit may be placed in fluid communication with a target vessel via a laparoscopic or endoscopic procedure.

Claims

1. A device for placing an implantable fluid conduit comprising a stent in fluid communication with a lumen of a target vessel of a body, the device comprising:

a handle;

a support member having a distal end and a proximal end upon which at least a portion of the length of the implantable fluid conduit can be mounted, wherein the support member comprises a bore extending through its length, wherein the proximal end is fixed to the handle and the distal end comprises a conduit stop member for maintaining the conduit in position on the support member;

a shaft comprising a proximal end and a distal end, wherein the shaft is movably received by the bore of the support member, wherein the shaft comprises a bore extending through its length;

a conduit retention device provided at the distal end of the shaft, wherein the conduit retention device comprises a sheath portion with a cavity having an open end that is configured and sized to be placed over at least an end portion of the conduit comprising the stent when the conduit is mounted on the support member;

a dilator provided at the distal end of the shaft distal the conduit retention device for introducing the device into the lumen of the target vessel, wherein the dilator comprises at least one tapered surface;

an incising member comprising a sharpened tip for penetrating a wall of the target vessel, wherein the incising member is movably received by the bore of the shaft;

an actuator assembly coupled to the handle for moving the conduit retention device distally relative to the support member by way of the shaft, so as to permit removal of the cavity of the sheath portion from the end portion of the conduit, wherein the actuator assembly comprises a rack and pinion mechanism; and

a retention device withdrawal member that is movably supported relative to the support member and configured to substantially engage the sheath portion at the open end so as to provide a substantially smooth outer profile for withdrawal of the conduit retention device from the lumen of the target vessel.

2. The device of claim 1, wherein the actuator assembly comprises a lever coupled to the shaft for moving the conduit retention device with respect to the support member, wherein the proximal end of the shaft comprises a rack having teeth and the lever comprises a pinion having teeth, wherein the teeth of the rack engages the teeth of the pinion, wherein movement of the lever creates movement of the shaft.

3. The device of claim 2, wherein the lever is pivotally coupled to the handle such that moving the lever with respect to the handle moves the conduit retention device away from the handle.

4. The device of claim 2, further comprising a lock for fixing the position of the lever with respect to the handle.

5. The device of claim 1, wherein the retention device withdrawal member is slidably connected to the support member so that movement of the retention device withdrawal member toward the distal end of the support member causes relative movement of the retention device withdrawal member toward the sheath portion of the conduit retention device.

6. The device of claim 5, wherein the actuator and retention device withdrawal member are operable using one hand.

7. The device of claim 1, in combination with the implantable fluid conduit, wherein the conduit has a first end, a second end and a lumen, and wherein at least a portion of the conduit is supported on the support member.

8. The device of claim 7, wherein the first end and second end of the conduit are supported on the support member.

9. The device of claim 7, wherein the first end of the conduit is supported on the support member and the support member passes through an opening in a side wall of the conduit so that the second end of the conduit is not supported on the support member.