Methods and apparatus for transmyocardial direct coronary revascularization
First Claim
1. A method for delivering blood from a chamber of the heart to a coronary blood vessel, said method comprising the steps of:
- a) advancing, into the coronary blood vessel, a catheter having side port and a tissue penetrator that is advancable out of the side port;
b) positioning the catheter such that the side port is directed toward the left ventricle;
c) advancing a tissue penetrator out of the side port, through myocardium located between the coronary blood vessel and the chamber of the heart, and into the chamber of the heart, thereby creating a passageway that extends from the coronary blood vessel to the left ventricle;
d) advancing a guidewire through the passageway;
e) advancing a passageway-modifying apparatus over the guidewire; and
f) using the passageway-modifying apparatus to modify the passageway in a manner that facilitates bloodflow from the chamber of the heart, through the passageway and into the coronary blood vessel;
wherein i) the tissue penetrator has a lumen and, in step d, the guidewire is advanced through the tissue penetrator lumen, ii) after the guidewire has been advanced through the tissue penetrator lumen, the tissue penetrator is withdrawn into the catheter and iii) after the tissue penetrator has been withdrawn into the catheter and prior to performance of step e, the catheter is removed leaving the guidewire within the passageway.
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Accused Products
Abstract
Methods and apparatus for direct coronary revascularization wherein a transmyocardial passageway is formed between a chamber of the heart and a coronary blood vessel to permit blood to flow therebetween. In some embodiments, the transmyocardial passageway is formed between a chamber of the heart and a coronary vein. The invention includes unstented transmyocardial passageways, as well as transmyocardial passageways wherein protrusive stent devices extend from the transmyocardial passageway into an adjacent coronary vessel or chamber of the heart. The apparatus of the present invention include protrusive stent devices for stenting of transmyocardial passageways, intraluminal valving devices for valving of transmyocardial passageways, intracardiac valving devices for valving of transmyocardial passageways, endogenous tissue valves for valving of transmyocardial passageways, and ancillary apparatus for use in conjunction therewith.
183 Citations
23 Claims
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1. A method for delivering blood from a chamber of the heart to a coronary blood vessel, said method comprising the steps of:
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a) advancing, into the coronary blood vessel, a catheter having side port and a tissue penetrator that is advancable out of the side port; b) positioning the catheter such that the side port is directed toward the left ventricle; c) advancing a tissue penetrator out of the side port, through myocardium located between the coronary blood vessel and the chamber of the heart, and into the chamber of the heart, thereby creating a passageway that extends from the coronary blood vessel to the left ventricle; d) advancing a guidewire through the passageway; e) advancing a passageway-modifying apparatus over the guidewire; and f) using the passageway-modifying apparatus to modify the passageway in a manner that facilitates bloodflow from the chamber of the heart, through the passageway and into the coronary blood vessel; wherein i) the tissue penetrator has a lumen and, in step d, the guidewire is advanced through the tissue penetrator lumen, ii) after the guidewire has been advanced through the tissue penetrator lumen, the tissue penetrator is withdrawn into the catheter and iii) after the tissue penetrator has been withdrawn into the catheter and prior to performance of step e, the catheter is removed leaving the guidewire within the passageway. - 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)
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Specification