US20140187853A1 - Devices, methods and systems for counterpulsation and blood flow conduit connection - Google Patents

Devices, methods and systems for counterpulsation and blood flow conduit connection Download PDF

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Publication number
US20140187853A1
US20140187853A1 US14/234,239 US201214234239A US2014187853A1 US 20140187853 A1 US20140187853 A1 US 20140187853A1 US 201214234239 A US201214234239 A US 201214234239A US 2014187853 A1 US2014187853 A1 US 2014187853A1
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conduit
blood flow
blood
flow conduit
tip portion
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Abandoned
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US14/234,239
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Paul A. Spence
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Individual
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Individual
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    • A61M1/1008—
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • 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
    • A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
    • 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
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
    • A61M1/3655—Arterio-venous shunts or fistulae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
    • A61M25/0071—Multiple separate lumens
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0074—Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/10—Location thereof with respect to the patient's body
    • A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
    • A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
    • A61M60/148—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/10—Location thereof with respect to the patient's body
    • A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
    • A61M60/165—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable in, on, or around the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/20—Type thereof
    • A61M60/247—Positive displacement blood pumps
    • A61M60/253—Positive displacement blood pumps including a displacement member directly acting on the blood
    • A61M60/268—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/20—Type thereof
    • A61M60/247—Positive displacement blood pumps
    • A61M60/253—Positive displacement blood pumps including a displacement member directly acting on the blood
    • A61M60/268—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders
    • A61M60/274—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders the inlet and outlet being the same, e.g. para-aortic counter-pulsation blood pumps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/40—Details relating to driving
    • A61M60/403—Details relating to driving for non-positive displacement blood pumps
    • A61M60/405—Details relating to driving for non-positive displacement blood pumps the force acting on the blood contacting member being hydraulic or pneumatic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/40—Details relating to driving
    • A61M60/424—Details relating to driving for positive displacement blood pumps
    • A61M60/427—Details relating to driving for positive displacement blood pumps the force acting on the blood contacting member being hydraulic or pneumatic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/80—Constructional details other than related to driving
    • A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
    • A61M60/857—Implantable blood tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00884—Material properties enhancing wound closure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1135—End-to-side connections, e.g. T- or Y-connections
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0026—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in surface structures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M2025/006—Catheters; Hollow probes characterised by structural features having a special surface topography or special surface properties, e.g. roughened or knurled surface
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2206/00—Characteristics of a physical parameter; associated device therefor
    • A61M2206/10—Flow characteristics

Definitions

  • IABP Intra Aortic Balloon Pump
  • the balloon is timed to empty very quickly as the heart beats, which lowers the pressure inside the aorta and makes it easy for the heart to eject blood.
  • the balloon fills and blood is pushed through the arteries of the heart and the rest of the body.
  • the combination of reduced work for the heart and improved blood flow to the heart have a very salutary effect on cardiac function.
  • the catheter is inserted in the groin and he or she must remain supine in bed. This condition cannot be maintained indefinitely as the patient becomes weak from immobility. Also, infection sometimes travels up the catheter and into the blood stream, causing a serious condition.
  • a blood flow conduit comprises a first conduit portion defining a first portion of a lumen and a second conduit portion defining a second portion of a lumen. At least one of the first or second conduit portions includes a tip portion and the other of the first or second conduit portions includes an enlarged area. The tip portion extends at least partially into the enlarged area in a manner designed to prevent contact between the tip portion and an inner wall of the enlarged area as blood flows through the lumen.
  • the tip portion can include an inner wall with a surface roughness less than a surface roughness of the inner wall of the enlarged area.
  • the tip portion can be formed from at least one material selected from the group consisting of metals or polymers, and the enlarged area can be formed from a material that promotes tissue or cell ingrowth.
  • the tip portion can be formed at least partially from silicone, and the enlarged area can be formed from a fabric or textile.
  • the enlarged area can be formed in at least two pieces adapted to be affixed together during a surgical procedure.
  • the tip portion can be part of a blood pump.
  • the first and second conduit portions can be configured to be affixed together during a surgical procedure.
  • the first and second conduit portions can be configured to be affixed to a pump during a surgical procedure.
  • a washer can be affixed around the tip portion.
  • a blood flow assist system comprises a blood pump and a blood flow conduit as set forth in any of the preceding discussion.
  • FIG. 1 is a schematic drawing of a patient with a counterpulsation system constructed in accordance with one embodiment of the invention.
  • FIG. 2 is a perspective view illustrating a graft element of FIG. 1 being directed toward an artery for attachment purposes.
  • FIG. 3 is a perspective view similar to FIG. 2 and illustrating the graft element being sewn to the artery.
  • FIG. 4 is a perspective view similar to FIGS. 2 and 3 , and further illustrating a blood flow conduit being attached to the graft element.
  • FIG. 5 is a perspective view similar to FIGS. 2 through 4 , and further illustrating the blood flow conduit attached to the graft element.
  • FIG. 6A is a cross-sectional view illustrating the blood flow conduit being attached to the graft element.
  • FIG. 6B is a cross-sectional view illustrating the blood flow conduit attached to the graft element.
  • FIG. 7 is a cross-sectional view of another embodiment of the invention illustrating a graft element attached to a blood flow conduit and an artery.
  • FIG. 8 is a cross-sectional view of another embodiment of the invention illustrating a graft element attached to a blood flow conduit and an artery.
  • FIG. 9 is a cross-sectional view of another embodiment of the invention illustrating a graft element attached to a blood flow conduit and an artery.
  • FIG. 10A is a disassembled view, in partial cross-section, illustrating the graft element of FIG. 9 and a blood pump.
  • FIG. 10B is an assembled view, in partial cross-section, illustrating the graft element of FIG. 9 and a blood pump.
  • a pump 10 is implanted in a pacemaker pocket on the patient's right side. Blood fills the pump 10 on one side and air or other fluid fills a sac or bladder (not shown) on the other side of the pump 10 .
  • An air drive line 12 is tunneled from the pacemaker pocket to a skin exit site 14 , so the entire pump 10 is under the skin and can remain there chronically. After the driveline 12 exits the skin, it is attached to a small air drive unit 16 that controls shuttling of pressurized air in and out of the pump 10 .
  • a void in the pump 10 may be formed with the sac or bladder.
  • the void fills with air as the heart beats (less cardiac work in ejecting blood) and empties to return blood into the circulation (more flow to the patient).
  • the pump 10 is attached to the circulation with a conduit 20 .
  • the conduit 20 shuttles blood between the patient's circulatory system and the pump 10 . This situation allows a patient to have chronic counterpulsation with full mobility. For a patient with severe and potentially non-reversible cardiac dysfunction, this is a great advantage as it is possible to live a relatively normal life—apart from the need to carry a small battery powered drive console 16 .
  • the blood is shuttled in and out of the pump 10 with a conduit 20 which is connected to the circulation.
  • this conduit 20 There are a number of considerations related to implantation and use of this conduit 20 .
  • a second potential difficulty with a conduit in this situation is that it will typically be sewn to the subclavian artery 22 or axillary artery which is located beneath the clavicle and often quite deep, so it is technically difficult for a surgeon to suture the end of the conduit 20 to the artery 22 .
  • the problem of a conduit with bidirectional flow relates to the responses of blood and tissues to the interfaces with synthetic materials and the response is dependent on the direction of flood flow.
  • Many medical devices such as blood pumps, are connected to the patient's circulation with artificial graft material such as polyester materials like Dacron® or expanded, porous Teflon® (ePTFE) that will promote tissue or cell ingrowth.
  • graft material such as polyester materials like Dacron® or expanded, porous Teflon® (ePTFE) that will promote tissue or cell ingrowth.
  • the inside of blood pumps are generally smooth and composed of metals or plastics. When blood flows from a smooth metal or plastic blood pump into a synthetic graft (such as polyester), the interface where the pump meets the conduit (plastic or metal to synthetic graft) is a stable junction and there tends to be little problem when blood flows forward through this junction.
  • FIG. 8 shows one potential solution in a cross-sectional view.
  • the subclavian artery 22 is shown at the top of the figure.
  • a “bubble” or enlarged area 24 of Dacron®, Teflon® or other material is sewn to the artery 22 .
  • a silicone or other smooth material conduit portion 26 is connected to the other side of the enlarged area 24 . Rather than a direct junction, a special interface is created.
  • the smooth silicone surface portion 26 extends with a tip portion 26 a several millimeters inside the enlarged area 24 of fabric or other material.
  • the walls of the silicone tip portion 26 a do not contact the fabric or material of the enlarged area or bubble 24 . This avoids a silicone-to-fabric (or smooth-to-rough) point of contact.
  • Heart valves have been constructed with arrangements to avoid tissue ingrowth into the valve by creating an elevation—so that there is not a continuous connection between the fabric surface and the smooth surface. This elevation prevents tissue from growing over into junction point and creating a point where platelets and fibrin are deposited.
  • the use of a small washer of material may also be of use.
  • FIG. 8 shows a small washer 28 around the base of the tip 26 a that may help arrest the attachment of blood elements.
  • FIG. 9 shows that this arrangement of the “bubble” or enlarged area 24 a of graft material is located away from the anastomosis. Specifically, enlarged area 24 a is coupled to or includes an extension 24 b that is anastomosed to the artery 22 . Other features may be as described previously.
  • FIGS. 10A and 10B show a similar arrangement can be made at the junction of the pump 10 .
  • the plastic, metal or other smooth surfaced junction or tip portion 10 a of the pump 10 is separated from the rough surface of the enlarged graft material by a bubble interface 24 a.
  • An extension 24 b of the graft material is sewn to the artery 22 ( FIG. 9 ) as previously described.
  • Another extension 24 c on the opposite end may facilitate connection to the pump interface or tip portion 10 a, along with a suitable connector 28 .
  • the junction or interface 10 a which serves as an inlet/outlet port that extends into, but does normally not contact, the graft material 24 a in use.
  • FIGS. 2 and 3 Such a solution is shown in FIGS. 2 and 3 .
  • a graft element form from material such as described above is sewn to the artery.
  • the graft element 30 has a flange 32 at one end.
  • the element 30 is small and easy to move around, so does not obscure the view of the surgeon.
  • FIG. 3 shows that it is easy to sew this element 30 around an opening 22 a on the artery 22 .
  • FIG. 4 shows how a junction between the silicone material portion 26 of the conduit 20 and the graft element 30 is recreated when a rim or flange 34 of sewing material or graft material, for example, of the conduit portion 26 is affixed to the flange 32 on the element 30 previously anastomosed to the artery 22 .
  • FIG. 5 shows how the two flanges 32 , 34 are sewn together. This is a very easy anastomosis to perform.
  • flanges 32 , 34 could be joined not just by sutures but by staples, clips, glues, clamps etc.
  • FIG. 6A shows a side cross sectional view of the two flanges 32 , 34 coming together.
  • FIG. 6B shows how the bubble or enlarged connector 30 does not have to be flat—it could be beveled. Also the connector 30 does not have to be a generally spherical bubble as shown elsewhere herein. The key is only that the enlarged area keeps the silicone and graft surfaces (that is, smooth and rough flow surfaces) from direct contact at their junction during use.
  • the bubble or enlarged area 36 is quite useful as it allows the graft to move or “swivel” inside the bubble 36 and still not contact the wall of the bubble 36 .
  • FIG. 6B also shows clips or staples 38 attaching the connector 30 to the artery 22 and attaching the flanges 32 , 34 together.
  • the conduit portion 26 does not have to be entirely silicone. It could have any inner core that presents a compatible surface to the exposed blood.
  • the inside could be metal, have a metal spiral re-inforcement, etc. It could also have graft material inside like ePTFE or other polyester.
  • the smooth surface does not have to be silicone. This is used as representative of a smooth surface.
  • the surface could be a metal or plastic (such as in the pump connection shown in FIGS. 10A and 10B .)
  • FIG. 7 shows a bubble or enlarged area 40 constructed by “splitting” the bubble in the middle of the hemisphere. It could be equally possible to form the junction 42 anywhere in this arrangement; the location at the hemisphere is merely an example.
  • the terms used are basically smooth (silicone, plastics, metals) and rough or textured surfaces (Dacron, Teflon, ePTFE). It is also possible to have a tightly woven or knitted material that is typically called a textile, but could function as a smooth surface.
  • conduits may also be important to prevent these conduits from collapsing as they can be located below the skin and could be crushed by a patient lying on them. Reinforcement of the conduits with plastic or wire spirals or rings can be used here. In addition, extra thicknesses of polymer or plastic could be added make them stronger.
US14/234,239 2011-08-11 2012-08-09 Devices, methods and systems for counterpulsation and blood flow conduit connection Abandoned US20140187853A1 (en)

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US14/234,239 US20140187853A1 (en) 2011-08-11 2012-08-09 Devices, methods and systems for counterpulsation and blood flow conduit connection

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US201161522401P 2011-08-11 2011-08-11
US14/234,239 US20140187853A1 (en) 2011-08-11 2012-08-09 Devices, methods and systems for counterpulsation and blood flow conduit connection
PCT/US2012/050050 WO2013023009A1 (en) 2011-08-11 2012-08-09 Devices, methods and systems for counterpulsation and blood flow conduit connection

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US14/234,239 Abandoned US20140187853A1 (en) 2011-08-11 2012-08-09 Devices, methods and systems for counterpulsation and blood flow conduit connection
US14/522,383 Active US9440013B2 (en) 2011-08-11 2014-10-23 Devices, methods and systems for counterpulsation and blood flow conduit connection
US15/241,590 Active US9919086B2 (en) 2011-08-11 2016-08-19 Devices, methods and systems for counterpulsation and blood flow conduit connection

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US15/241,590 Active US9919086B2 (en) 2011-08-11 2016-08-19 Devices, methods and systems for counterpulsation and blood flow conduit connection

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US (3) US20140187853A1 (ja)
EP (2) EP2741807B1 (ja)
JP (2) JP6099647B2 (ja)
AU (1) AU2012312957A1 (ja)
CA (2) CA3040534C (ja)
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JP2014528762A (ja) 2014-10-30
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CA2844744A1 (en) 2013-03-28
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CA2844744C (en) 2020-01-07
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US20160354524A1 (en) 2016-12-08
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