Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
  • A61F2/06—Blood vessels
  • A61F2/064—Blood vessels with special features to facilitate anastomotic coupling
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
  • A61F2/2493—Transmyocardial revascularisation [TMR] devices
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
  • A61F2/88—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure the wire-like elements formed as helical or spiral coils
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
  • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure

Definitions

• the invention relates to treating heart disease, and more particularly systems, devices and methods for reestablishing or improving blood flow to the myocardium.
• the invention provides a device and method for engaging tissue of a coronary vessel or heart wall during a cardiovascular procedure.
• a device constructed according to this embodiment includes first and second members coupled together so as to permit relative movement.
• a tissue engaging mechanism is coupled to the first and second members and moves between first and second positions. In the preferred embodiment, the first and second positions are collapsed and expanded orientations.
• the tissue engaging mechanism includes at least one tissue engaging member that contacts engage body tissue when in the expanded orientation.
• a method carried out according to this embodiment includes steps of providing a tissue support device having a tissue engaging mechanism configured to assume an expanded, tissue supporting orientation, positioning the tissue support device through the wall of a patient's heart and locating the tissue engaging mechanism adjacent tissue, and placing the tissue engaging mechanism in the expanded, tissue supporting orientation in engagement with the tissue.
• the invention provides a device and method for supporting a wall of a vascular structure in order to access the lumen of the vascular structure.
• a device constructed according to this embodiment includes a support structure adapted to be positioned in the lumen of a vascular structure, the support structure comprising a plurality of support elements coupled together so as to be movable relative to each other. The support elements move relative to each other to move the support structure from a collapsed orientation to an expanded orientation in order to support a wall of a vascular structure, and are sized and configured so that when the support structure is in the expanded orientation the support elements engage the wall of the vascular structure to prevent the wall from collapsing.
• Another device constructed according to this embodiment includes an introducer having a hollow interior and an elongated support member configured to be generally coiled when in an unbiased orientation and generally straight when in a biased orientation.
• the interior of the introducer is sized and configured to receive the elongated support member and hold the support member in the generally straight, biased orientation.
• the elongated support member is moved from the straight, biased orientation within the interior of the introducer to the coiled, unbiased orientation upon entering the interior of the vascular structure to support the vascular structure.
• a method carried out according to this embodiment includes steps of positioning a support within an interior of a vascular structure such that the support contacts and supports a wall of the vascular structure, and introducing a medical device into the interior of the vascular structure by passing the device through the wall of the vascular structure and through the support.
• the invention provides a device and method for stabilizing an area of a patient's heart adjacent a coronary vessel.
• a device constructed according to this embodiment includes a base configured to be positioned adjacent a coronary vessel of a patient's heart, the base having at least one opening for accessing the coronary vessel.
• At least one tissue engaging element is coupled to the base so as to be movable with respect to the base, the tissue engaging element having a portion configured to securely engage the wall of a patient's heart in order to stabilize the wall of the heart upon moving the tissue engaging element with respect to the base.
• An actuator is provided for imparting relative movement to the base and the tissue engaging element in order to stabilize the heart while accessing the coronary vessel through the opening in the base.
• the invention provides a conduit for placing a coronary vessel of a patient's heart in communication with a heart chamber.
• the conduit is in the form of a tubular element including first and second portions having different cross-sectional sizes and a bore defining a blood flow path.
• the cross-section of the first portion of the tubular element is larger than the cross-section of the second portion such that the tubular element is generally funnel-shaped, and the first and second portions of the tubular element are generally aligned so that the bore defines a generally straight blood flow path.
• the invention provides a conduit for communicating a chamber of a patient's heart with a coronary vessel.
• the conduit is in the form of an expandable stent including first and second portions having different cross- sectional sizes when the stent is expanded.
• Each of the first and second portions of the stent includes strut members disposed along a first direction when the stent is unexpended and along a second direction when the stent is expanded, the second direction being transverse to the first direction.
• the strut members of the first portion are longer than the strut members of the second portion so that the stent is generally funnel-shaped when expanded.
• the invention provides a conduit is in the form of an expandable tubular element having first and second portions with different cross- sectional sizes.
• This tubular element is preferably a coronary stent constructed so that the first and second portions are disposed in an orientation that provides the stent with maximum radial strength when expanded.
• the invention provides a conduit for placing a coronary vessel in communication with a heart chamber, the conduit including a vessel support mechanism configured to contact and support the vessel wall when the conduit is positioned in the heart wall.
• Fig. 1 is a schematic view of a patient prepared to undergo a cardiovascular surgical procedure, the patient's heart being exposed via a retractor positioned in a thoracotomy formed in the patient's chest;
• Fig. 2 is a perspective view of the heart shown in Fig. 1, wherein a portion of the heart wall is broken away for clarity;
• FIG. 2 A is an enlarged view of a portion of Fig. 2;
• Figs. 3A-3B are perspective views showing a tissue engaging device constructed according to one embodiment of the invention, the device being shown in collapsed and expanded orientations, respectively;
• Figs. 4A-4B are elevation views, in section, illustrating one preferred construction of a tissue engaging device according to the embodiment of Figs. 3A-3B, wherein the device is shown being used to engage the heart wall shown in Figs. 2-2A;
• Figs. 5A-5B are elevation views, in section, illustrating another preferred construction of a tissue engaging device according to the embodiment of Figs. 3A-3B, wherein the device is shown being used to engage the heart wall shown in Figs. 2-2A;
• Figs. 6A-6C are elevation views, in section, sequentially illustrating a vessel support device constructed according to another embodiment of the invention being used to support the wall of a vascular structure;
• Fig. 7 is a perspective view of a vessel support device constructed according to an alternative embodiment of the invention, the device being shown positioned in the interior of a vascular structure;
• Figs. 8A-8B are elevation views, in section, sequentially illustrating the device shown in Fig. 7 being used to support a coronary artery of the heart shown in Figs. 2-2A;
• Fig. 9 is a perspective view of a vessel support device constructed according to another alternative embodiment of the invention, the device being shown positioned in the interior of a vascular structure;
• Fig. 13 is an elevation view, in section, of an alternative tissue engaging device constructed according to the embodiment shown in Figs. 12A-12B;
• Figs. 15A-15B are elevation views of an expandable conduit mounted on the tapered balloon shown in Figs. 14A-14B, the conduit being shown in its collapsed and expanded orientations, respectively;
• FIGs. 17A-17B are elevation views showing a conduit constructed according to still another embodiment of the invention, wherein the conduit has a cross- sectional size that varies over its length;
• Fig. 18 is a perspective view of another embodiment of the invention providing a conduit for placing a coronary vessel in communication with a heart chamber while internally supporting the interior of the vessel;
• FIGS. 19A-19C are schematic representations of a preferred application for the conduit shown in Fig. 18;
• Fig. 20 is a perspective view of an alternative embodiment of a conduit for placing a coronary vessel in communication with a heart chamber while internally supporting the interior of the vessel;
• Fig. 22 is a perspective view of yet another alternative embodiment of a conduit for placing a coronary vessel in communication with a heart chamber while internally supporting the interior of the vessel.
• Fig. 1 is a schematic view of a patient prepared to undergo a cardiovascular surgical procedure, the patient's heart being exposed via a retractor positioned in a thoracotomy formed in the patient's chest;
• Fig. 2 is a perspective view of the heart shown in Fig. 1, wherein a portion of the heart wall is broken away for clarity;
• FIG. 2A is an enlarged view of a portion of Fig. 2;
• Figs. 3A-3B are perspective views showing a tissue engaging device constructed according to one embodiment of the invention, the device being shown in collapsed and expanded orientations, respectively;
• Figs. 8A-8B are elevation views, in section, sequentially illustrating the device shown in Fig. 7 being used to support a coronary artery of the heart shown in Figs. 2-2A;
• Fig. 9 is a perspective view of a vessel support device constructed according to another alternative embodiment of the invention, the device being shown positioned in the interior of a vascular structure;
• Figs. 10A-10B are elevation views, in section, sequentially illustrating the device shown in Fig. 9 being used to support a coronary artery of the heart shown in Figs. 2-2A;
• Figs. 12A-12B are elevation views, in section, taken along lines A-A in Figs. 11 A-l IB;
• Fig. 13 is an elevation view, in section, of an alternative tissue engaging device constructed according to the embodiment shown in Figs. 12A-12B;
• Figs. 14A-14B are elevation views of a tapered balloon forming part of another embodiment of the invention, wherein the balloon is shown in its collapsed and expanded orientations, respectively;
• Figs. 15A-15B are elevation views of an expandable conduit mounted on the tapered balloon shown in Figs. 14A-14B, the conduit being shown in its collapsed and expanded orientations, respectively;
• Fig. 16 is an elevation view, in section, of a portion of a heart wall and coronary vessel in which the conduit shown in Fig. 15A-15B has been positioned;
• FIGs. 17A-17B are elevation views showing a conduit constructed according to still another embodiment of the invention, wherein the conduit has a cross- sectional size that varies over its length;
• Fig. 18 is a perspective view of another embodiment of the invention providing a conduit for placing a coronary vessel in communication with a heart chamber while internally supporting the interior of the vessel;
• Figs. 19A-19C are schematic representations of a preferred application for the conduit shown in Fig. 18;
• Fig. 20 is a perspective view of an alternative embodiment of a conduit for placing a coronary vessel in communication with a heart chamber while internally supporting the interior of the vessel;
• Fig. 21 is a perspective view of another alternative embodiment of a conduit for placing a coronary vessel in communication with a heart chamber while internally supporting the interior of the vessel;

Landscapes

• Health & Medical Sciences (AREA)
• Cardiology (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Transplantation (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Vascular Medicine (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Gastroenterology & Hepatology (AREA)
• Pulmonology (AREA)
• Prostheses (AREA)
• Surgical Instruments (AREA)

Applications Claiming Priority (3)

Publications (1)

Family

ID=22626353

Family Applications (1)

Country Status (5)

Families Citing this family (18)

Family Cites Families (6)

• 1999
  • 1999-10-12 EP EP99953035A patent/EP1121067A1/de not_active Withdrawn
  • 1999-10-12 JP JP2000575445A patent/JP2002527141A/ja not_active Withdrawn
  • 1999-10-12 CA CA002347457A patent/CA2347457A1/en not_active Abandoned
  • 1999-10-12 WO PCT/US1999/022954 patent/WO2000021463A1/en not_active Application Discontinuation
  • 1999-10-12 AU AU65067/99A patent/AU6506799A/en not_active Abandoned
• 2003
  • 2003-08-14 AU AU2003234967A patent/AU2003234967A1/en not_active Abandoned

Non-Patent Citations (1)

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