WO2021062565A2

WO2021062565A2 - Fluid kinetic energy redistribution system for use as hemodynamic support

Info

Publication number: WO2021062565A2
Application number: PCT/CA2020/051673
Authority: WO
Inventors: Gabriel GEORGES
Original assignee: Puzzle Medical Devices Inc.
Priority date: 2019-10-04
Filing date: 2020-12-04
Publication date: 2021-04-08
Also published as: WO2021062565A3

Abstract

Device for assisting a first fluid flow within a first conduit of a body via a second fluid flow within a second conduit of the body, comprising: Elongated housing having a first end implantable within the first conduit, a second end implantable within the second conduit. A first rotatable element disposed at the first end having a first vane structured to impart kinetic energy to the first fluid contacting the first vane when the first rotatable element rotates. A second rotatable element disposed at the second end having a second vane structured to cause the second rotatable element to rotate when a second fluid flow contacts the second vane. A driveshaft rotatably extending within the elongated housing, operatively interconnecting the second rotatable element with the first rotatable element to transmit rotational movement from one to the other to rotate the first rotatable element. An absence of an external energy source.

Description

FLUID KINETIC ENERGY REDISTRIBUTION SYSTEM FOR USE AS HEMODYNAMIC SUPPORT

CROSS-REFERENCE

[0001] The present application claims priority to United States Provisional Patent Application Serial No. 62/910,830, filed October 4, 2019, entitled “Fluid Kinetic Energy Redistribution System for Use as Hemodynamic Support”; the entirety of which is incorporated herein by reference for all purposes.

FIELD

[0002] The present disclosure relates to systems and devices for supporting fluid circulation in a patient, specifically but not exclusively to ventricular assist devices.

BACKGROUND

[0003] Fluid carrying conduits in a patient, such as blood vessels or other fluid conduits near the heart, liver or kidneys, may require fluid circulation assistance in certain medical situations.

[0004] The left heart circulation is a relatively high-pressure system compared to the right heart system.

[0005] Ventricular Assist Devices (VADs) are an example of a device which can provide fluid circulation support. VADs can be at least partially implanted or delivered to the patient’s arteries, and typically comprise a single pump which helps the flow of blood.

[0006] To this day, most ventricular assist devices (VADs) require a direct physical connection between the implanted portion of the device (the pump) and the power source (via a driveline or electric cables). Typically, a power driveline which can also include monitoring wiring is implanted with the device and linked to an external module. This involves a percutaneous exit site of the driveline through the skin. For patients, living with a wire exiting at the level of the skin results in extensive restraints in mobility, causes pain with movement, negatively impacts the quality of life in general and requires extended post-operative recuperation and wound care. It also prevents patients from being submerged in water, such as when taking a shower, bath or leisure swim. The percutaneous wire can also lead to infections at the skin exit site, referred to as driveline infections (DLIs). The infection may be limited at the skin level and cause pain and purulent smell, or extend towards the pump housing, threatening a systemic infection and possibly requiring pump removal and exchange, which have high rates of mortality. Even with advances in wound care, antibiotic therapy, driveline material (such as textured polyester) and surgical techniques (eg. greater omentum driveline wrapping) to limit infection, DLI remain the most common type of LVAD associated complications (Leuck, 2015).

[0007] To overcome these issues, alternative powering solutions based on transcutaneous energy transfer (TET) have been proposed. TET technology eliminates the need for a skin crossing point to deliver the power to the device. A transmitting coil situated outside the body is used to generate an electromagnetic field which can be transmitted through a barrier (skin) to a receiving coil inside the body (Yomtov & BATTY, 2019). Through this approach, power can be transmitted to implanted devices such as heart pumps or batteries without any power driveline entering the body through the skin. Initial designs were based on a parallel configuration of the coils, where the coils represented by disks are separated axially by the skin. Examples of devices having used this type of technology include the Arrow LionHeart™ and totally implantable artificial heart AbioCor™by Abiomed. However, the efficiency of TET based systems is extremely dependable on coil alignment. In the event where the coils may remain misaligned for a prolonged period of time, the system may fail and threaten the patient’s life. Strategies to limit relative coil movement included magnetic alignment of the two coils. However, this led to excessive compression forces applied on the skin between the two coils resulting in tissue malperfusion and necrosis. Skin adhesives were also used to align the external coil with the implanted coil, but constant removal and exchange of adhesives on the skin proved to be irritative and to damage the skin as well as being very painful to the patient. Limited energy transfer efficiency also leads to larger external battery pack requirements to maintain operation of the device for multiple hours (typically aiming for 8-16 hours of battery life to allow activities of daily living and sleep). Additionally, the TET systems may lead to skin heating and bums by heat accumulation from the coil’s electromagnetic radiation and resistance.

[0008] The use of coplanar energy transfer (CET) systems was thus proposed as a means to increase the safety and efficiency of traditional TET. Zilbershlag & al. previously described a device in which an external transmitter coil is placed externally around a part of the body (typically a thoracic belt) and transmits power to an implanted receiver coil paired to a device (Zilbershlag, 2016; Zilbershlag & Naveh, 2017; Zilbershlag & Plotkin, 2014). The coil-within- the-coil methodology is more efficient than TET and results in VAD operating time of a few hours using internal and external upholstered battery packs (Pya & al, 2019). Despite improvements in reliability and efficiency of the system, CET still requires the implantation of a receiver coil, which is highly invasive. For example, the Leviticus Cardio CET system requires implantation of the receiver coil around the entire circumference of a lung. Hence this technology may have limited applicability to the powering of the new generation of VAD, which are implanted using minimally invasive or percutaneous transcatheter techniques. Thus, there is still an unmet need for a system that does not require a wire crossing the interface of the skin and yet would be compatible with transcatheter and minimally invasive techniques.

SUMMARY

[0009] It is an obj ect of the present technology to ameliorate at least some of the inconveniences present in the prior art.

[0010] Herein is proposed a new, fully intravascular approach to VADs, wherein fluid kinetic energy can be redistributed from one vessel or from a cardiac chamber to another. Through this method, the proposed device assesses ongoing concerns related to percutaneous drivelines, including patient mobility, driveline infections and powering efficiency.

[0011] According to certain aspects and embodiments defined below and in the claims, there are provided systems and methods for fluid circulation support. In certain aspects and embodiments, the abovementioned inconveniences are ameliorated or avoided.

[0012] The present technology is at least based in part on Developers’ observations and findings that some patients who suffer from heart failure and need hemodynamic support have a relatively well-preserved left ventricular function and mostly require right heart support. Providing a system that utilises kinetic energy from the left ventricle to lessen the demand on the right ventricle may improve patient quality of life and prevent recurrent acute decompensations, hospital readmissions and death.

[0013] Furthermore, by providing a system which is fully intravascular, patient discomfort, mobility restrictions and infection risks are avoided by eliminating all percutaneous leads traditionally required for powering classic VADs. [0014] From one aspect, there is provided a system for supporting fluid circulation and deliverable to a fluid carrying conduit of a patient, the fluid circulation support system comprising: at least two fluid pump units for pumping the fluid, each fluid pump unit having a longitudinal axis; wherein at least one of the fluid pump units is found in a body conduit having a relatively higher fluid pressure (for example, in the vasculature carrying blood away from the aortic valve); wherein at least one of the pump units is found in a body conduit having a relatively lower fluid pressure (for example, the vasculature carrying blood towards the aortic valve); wherein each fluid pump units comprises an impeller and a vessel protection cage; wherein the cage around the impeller serves to prevent the impeller from making contact with the vessel wall; wherein the cage around the impeller allows for device anchoring in the vessel wall; wherein the cage can conform to a collapsed form and an expanded form; a flex-shaft connecting the at least two fluid pump units; wherein the flex shaft crosses at least two vessel walls; wherein the at least two pumps are functionally interconnected by the flex shaft; wherein the rotation of at least one of the pumps induces rotation of at least one of the other pumps; wherein no external power source other than the impellers connected to the flex-shaft are required for powering the pump units; wherein there the system is fully intravascular; wherein there are no percutaneous attached to the system. In certain embodiments, there are provided two fluid pump units. In certain embodiments, there are provided any number of fluid pump units. In certain embodiments, there are provided 3, 4, 5, 6, 7, 8, 9 or 10 fluid pump units.

[0015] In certain embodiments, one of the pump units is found in the aorta and another pump is found in the pulmonary artery.

[0016] In certain embodiments, one pump is found in the descending aorta and another pump is found in the inferior vena cava.

[0017] In certain embodiments, the fluid pump units are sized such that the diameter of the expended fluid pump units and the Hex-shaft is less than a diameter of the conduit of the patient into which the system is deliverable. In certain embodiments, the expanded fluid pump units and flex-shaft are sized such that a diameter of the assembled fluid pump units is about the same as a diameter of the conduit of the patient into which the system is deliverable. In certain embodiments, the expanded fluid pump units and flex-shaft are sized such that a diameter of the assembled fluid pump units is more than a diameter of the conduit of the patient into which the system is deliverable. In these cases, the conduit could be stretchable to accommodate the assembled system. [0018] In certain embodiments, the system features a two-part device wherein these two parts are functionally attached and physically separate from one another. The two parts each comprise a flex shaft and at least one pump unit. The two parts are operatively connected via a magnetic drive system. The two parts are separately implanted. In these embodiments, at least one vascular wall, such as the aortic wall, pulmonary artery wall or vena cava wall separates the two parts of the device.

[0019] In certain embodiments, the system further comprises a delivery sheath for housing the fluid pump units and flex-shaft in the delivery configuration and arranged to be deliverable into the conduit of the patient, the delivery sheath being arranged to be removeable.

[0020] In certain embodiments, the Hex-shaft incorporates a clutch between two pump units.

[0021] In certain embodiments, the flex-shaft incorporates a gear box between two pump units. In certain embodiments, the gear box acts as to modify the rotational ratio between the at least two pump units. In certain embodiments, the gearbox acts as to change the rotational direction of at least one impeller compared to the at least one other impeller.

[0022] In certain embodiments, the impellers of the pump units differ one from another, in features such as but not limited to total diameter, hub diameter, blade angle, number of blades and/or blade thickness. (It should be noted that in the present specification the terms “blades” and “vanes” are used interchangeably.)

[0023] In certain embodiments, the system incorporates one pump unit at each end of the flex shaft. In other embodiments, the system incorporates more than one pump unit in series on at least one end of the device.

[0024] Definitions:

[0025] It must be noted that, as used in this specification and the appended claims, the singular form “a”, “an” and “the” include plural referents unless the context clearly dictates otherwise.

[0026] As used herein, the term “about” in the context of a given value or range refers to a value or range that is within 20%, preferably within 10%, and more preferably within 5% of the given value or range. [0027] As used herein, the term “and/or” is to be taken as specific disclosure of each of the two 10 specified features or components with or without the other. For example, “A and/or B” is to be taken as specific disclosure of each of (i) A, (ii) B and (iii) A and B, just as if each is set out individually herein.

[0028] In the context of the present specification, the words “first”, “second”, “third”, etc. have been used as adjectives only for the purpose of allowing for distinction between the nouns that they modify from one another, and not for the purpose of describing any particular relationship between those nouns. Thus, for example, it should be understood that, the use of the terms “first module” and “third module” is not intended to imply any particular order, type, chronology, hierarchy or ranking (for example) of/between the module, nor is their use (by itself) intended imply that any “second module” must necessarily exist in any given situation.

[0029] Implementations of the present technology each have at least one of the above- mentioned objects and/or aspects, but do not necessarily have all of them. It should be understood that some aspects of the present technology that have resulted from attempting to attain the above-mentioned object may not satisfy this object and/or may satisfy other objects not specifically recited herein.

[0030] Additional and/or alternative features, aspects and advantages of implementations of the present technology will become apparent from the following description, the accompanying drawings and the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

[0031] For a better understanding of the present technology, as well as other aspects and further features thereof, reference is made to the following description which is to be used in conjunction with the accompanying drawings, where:

[0032] FIG. 1 illustrates an isometric view of a system comprising two pump units connected by a flex-shaft in the expanded form.

[0033] FIG. 2 illustrates a close-up view of a single pump unit connected to the flex shaft and surrounded by an expandable cage. [0034] FIG. 3 further illustrates a side view of a system comprising two pump units connected by a flex-shaft without the expandable cages to better outline the pump units. In this specific illustration the impeller shapes differ between the two pump units.

[0035] FIG. 4 illustrates a system with the flex shaft cover (also referred to as a “housing” herein) removed to better show the flex shaft (also referred to as a “driveshaft” herein.)

[0036] FIG. 5 illustrates a side view of a driveshaft according to certain embodiments of the present technology.

[0037] FIG. 5 illustrates an exploded view of the system, highlighting the functional connection between the flex shaft, the pump unit and the expandable cage.

[0038] FIG. 6 illustrates a system where a gear box is added to the flex shaft.

[0039] FIG. 7 illustrates a two-part system functionally connected by a magnetic drive.

[0040] FIG. 8 illustrates a two-part system with the flex shaft covers removed to better appreciate the magnetic drive of the system.

[0041] FIG. 9 illustrates a system with more than two pump units at one end of the flex shaft.

[0042] FIG 10. illustrates an anatomical view of the implantation site of the system in the aorta and a pulmonary artery.

[0043] FIG. 11 illustrates an anatomical view of the implantation site of the system in the aorta and the inferior vena cava.

DETAILED DESCRIPTION

[0044] The present disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The disclosure is capable of other embodiments and of being practiced or of being carried out in various ways. Also, the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of "including", "comprising", or "having", "containing", "involving" and variations thereof herein, is meant to encompass the items listed thereafter as well as, optionally, additional items. In the following description, the same numerical references refer to similar elements. [0045] Broadly, there is provided a device for enhancing fluid circulation in certain vessels of the body by transferring kinetic energy from one vessel to another through the use of functionally interdependent pump units. Such device can be used in cases where a patient would benefit from increased venous return to the right heart, such as to augment right ventricle pre load or to decrease kidney congestion. In such embodiment, the device would transfer kinetic energy from the high-pressure aortic fluid to the low-pressure vena cava fluid. Such device may also be used to decrease right ventricle after-load in right heart failure. In such embodiment, the device would transfer kinetic energy from the high-pressure aortic fluid to the relatively low- pressure pulmonary arteries.

[0046] The device does not require an external power source. This avoids the need for wires transferring energy to the device and crossing patient skin and vessel walls which leads to patient discomfort, infection and bleeding complications and constant care to change batteries or be connected to a power source.

[0047] Referring to FIG. 1, in this embodiment, the device 100 comprises axial pump units 102a, 102b, comprising an impeller 104a, 104b (respectively) and an expandable cage 106a, 106b (respectively) and a flex shaft 108 (comprising elongated housing 110 and driveshaft therein) between the pump units 102a, 102b.

[0048] Referring to FIG. 2, each expandable cage (only 106a is shown in FIG. 2) prevents contact between the impeller 104a and the vessel wall (not shown). The cage 102a may be fabricated from flexible materials such as nitinol. The impellers 204a, 204b of the pump units 202a, 202b may differ between each pump units 202a, 202b such as depicted the embodiment shown in FIG. 3. Impeller diameter could be tailored to pre-implantation patient needs in terms of required flow and pressure support.

[0049] Referring to FIG. 4, the flex shaft driveshaft 112 connects to the at least two impellers 104a, 104b at each end of the device 110. In certain embodiments, the driveshaft 112 may transfer directly one rotation of at least one impeller 104b at one end of the device and induce one rotation of at least one impeller 104a at the other end of the device 100. In certain embodiments, the flex shaft driveshaft 312 may incorporate a gear box 314 (FIG. 6) to modify the rotational ratios between the impellers 304a, 304b at each end of the device 300. In certain embodiments, the gear box 314 may allow to change the turning direction of the flex shaft driveshaft 312 portion entering the gear box 312 compared to the shaft 312 portion exiting the gear box 314.

[0050] Referring to FIG. 7, in another embodiment, the device 400 may incorporate two parts (also referred to herein as “modules” 416a, 416b. Each part 416a, 416b comprises at least one pump unit 402a, 402b (respectively) and a flex shaft 408a, 408b (respectively) (comprising elongated housing 410a, 410b (respectively) and driveshaft 412a, 412b). Each part 416a, 416b is functionally interconnected to the other via a contactless system, such as a magnetic drive (FIG. 8), having magnets 418a, 418b.

[0051] Referring to FIG. 9, in another embodiment, the device 500 may feature more than a single pump unit 502a, 502b, 502c at each end of the flex shaft 508, according to the amount of support needed by the patient.

[0052] The device is designed for percutaneous implantation. The implantation technique uses guidewires and catheters to cross vascular walls. In certain embodiments, the aortic wall is crossed. In certain embodiments, pulmonary artery or trunk wall is crossed. In certain embodiments, the vena cava wall is crossed. Once the vascular walls have been crossed and a de novo functional connection between two vessels has been established, the system is delivered in place, wherein one end of the system is implanted in one vessel and the other end in the other vessel. The flex shaft crosses the vascular wall. The system is fully implantable and endovascular, such as no wires or part of the system exits the vascular walls other than the flex shaft between the two ends of the system. Referring to FIG. 10 and 11, the device 100 can be used as a right heart support be decreasing after-load (FIG. 10) or increasing pre-load (FIG. 11) or as a kidney decongestion device 100 to increase glomerular filtration gradient in congestive states (FIG. 11).

[0053] Referring to FIG. 7 and 8, the device 400 (modules 416a, 416b) may be implanted using two distinct vascular access points. A common vascular wall is reached via the two percutaneous access sites. Each part 416a, 416b of the device 400 is then implanted such as the end opposite to the pumping unit 402, 402b of each part faces the vascular wall separating the two parts 416a, 416b. The two parts 416a, 416b are automatically functionally interconnected by a magnetic drive system 418a, 418b.

[0054] The device 100 may be retrieved by snaring one end of the device and advancing a retrieval sheath to collapse the expandable cages and explant the device. [0055] Modifications and improvements to the above-described implementations of the present technology may become apparent to those skilled in the art. The foregoing description is intended to be exemplary rather than limiting. The scope of the present technology is therefore intended to be limited solely by the scope of the appended claims.

Claims

1. A device for assisting a flow of a first fluid within a first conduit of an animal body via a flow of a second fluid within a second conduit of the animal body, the device comprising: an elongated housing, the elongated housing having a first end sized and dimensioned to be implantable within the first conduit of the animal body, a second end sized and dimensioned to be implantable within the second conduit of the animal body; a first rotatable element disposed at the first end of the elongated housing, the first rotatable element having at least one first vane structured to impart kinetic energy to a flow of the first fluid contacting the at least one first vane when the first rotatable element rotates; a second rotatable element disposed at the second end of the elongated housing, the second rotating element having at least one second vane structured to cause the second rotatable element to rotate when a flow of the second fluid contacts the at least one second vane; a driveshaft rotatably extending within the elongated housing, the driveshaft operatively interconnecting the second rotatable element with the first rotatable element to transmit rotational movement of the second rotatable element to the first rotatable element to rotate the first rotatable element; and an absence of an external energy source.

2. The device of claim 1, wherein the animal body is a human body.

3. The device of any one of claims 1 and 2, wherein the device is of a modular construction and is sized, shaped, and structured to be assemblable transcatheter.

4. The device of claim of claim 3, wherein the device comprises a first module and a second module, the first module including a first portion of the elongated housing, the first end of the elongated housing, the first rotatable element and a first portion of the driveshaft, the first portion of the driveshaft having a first connector, the second module including a second portion of the elongated housing, the second end of the elongated housing, the second rotatable element and a second portion of the driveshaft, the second portion of the driveshaft having a second connector, the first connector and the second connector each being structured to operatively interconnect with the other.

5. The device of claim 4, wherein the first module is sized and shaped to be wholly containable within the first conduit when implanted within the animal body, the second module is sized and shaped to be wholly containable within the second conduit when implanted within the animal body, the first connector and the second connector each being structured to operatively interconnect with the other without physically crossing a wall of the first conduit or of the second conduit.

6. The device of claim 5, wherein the first connector has a first magnet and the second conductor has a second magnet, the first magnet and the second magnet capable of forming an operative interconnection of the first connector with the second connector.

7. The device of any one of claims 1 to 6, wherein each of the first rotatable element and the second rotatable element are of a fixed diameter.

8. The device of any one of claims 1 to 7, wherein each of the first rotatable element and the second rotatable element are transitionable between a collapsed configuration and an expanded configuration.

9. The device of any one of claims 1 to 8, wherein the elongated housing and the driveshaft are flexible.

10. The device of any one of claims 1 to 9, wherein the driveshaft includes a gearbox for adjusting a ratio of rotation between the first rotatable element and the second rotatable element.

11. The device of any one of claims 1 to 10, wherein the driveshaft includes a clutch to operatively disconnect the first rotatable element from the second rotatable element.

12. The device of claim 11, wherein the clutch includes two operationally coupled magnets.

13. The device of claim 11, wherein the clutch is mechanical.

14. The device of any one of claims 1 to 13, further including at least one of, a first seal for sealing a wall opening in the first conduit after the first end is implanted within the first conduit, and a second seal for sealing a wall opening in the second conduit after the second end is implanted with the second conduit.

15. The device of claim 14, wherein the at least one of the first seal and the second seal includes a radially-extending portion of the elongated housing.

16. The device of claim 15, wherein the radially-extending portion includes portions that are flexible and compressible.

17. The device of claim 16, wherein the at least one of the first seal and the second seal includes an expandable balloon.

18. The device of claim 16, wherein the at least one of the first seal and the second seal includes two expandable balloons.

19. The device of any one of claims 14 to 18, wherein the at least one of the first seal and the second seal is operable to anchor the device in place.

20. The device of any one of claims 1 to 19, wherein the first rotatable element is a first impeller and the second rotatable element is a second impeller.

21. The device of claim 20, further comprising, a first self-expandable cage surrounding the first impeller; and a second self-expandable cage surrounding the second impeller.

22. The device of claim 21, wherein each of the first self-expandable cage and the second self-expandable cage comprise nitinol.

23. The device of any one of claims 21 to 22, wherein the first self-expandable cage is expandable to anchor the first end of the elongated housing within the first conduit when the first end is implanted within the first conduit, and the second self-expandable cage is expandable to anchor the second end of the elongated housing within the second conduit when the second end is implanted within the second conduit.

24. The device of any one of claims 20 to 23, wherein the first impeller and the second impeller differ in at least one physical characteristic.

25. The device of claim 24, wherein the first impeller and the second impeller differ in total diameter.

26. The device of any one of claims 24 to 25, wherein the first impeller and the second impeller differ in hub diameter.

27. The device of any one of claims 24 to 26, wherein the first impeller and the second impeller differ in vane angle.

28. The device of any one of claims 24 to 27, wherein the first impeller and the second impeller differ in a number of vanes.

29. The device of any one of claims 24 to 28, wherein the first impeller and the second impeller differ in a vane thickness.

30. The device of any one of claims 1 to 29, wherein, the first rotatable element is one of a first plurality of first rotatable elements disposed at the first end of the elongated housing, each of the first rotatable elements of the first plurality of rotatable elements having at least one first vane structured to impart kinetic energy to a flow of the first fluid contacting the at least one first vane when the first rotatable elements rotate, and the drive shaft operatively interconnects the second rotatable element with the first plurality of first rotatable elements.

31. The device of claim 30, wherein the first rotatable elements are disposed in series with respect to one another.

32. The device of claim 30, wherein the first rotatable elements are disposed in parallel with respect to one another.

33. The device of any one of claims 30 to 32, wherein, the second rotatable element is one of a second plurality of second rotatable elements disposed at the second end of the elongated housing, each of the second rotatable elements of the second plurality of rotatable elements having at least one second vane structured to impart kinetic energy to a flow of the second fluid contacting the at least one second vane when the second rotatable elements rotate, and the drive shaft operatively interconnects the second plurality of second rotatable elements with the first plurality of first rotatable elements.

34. The device of claim 33, wherein second first rotatable elements are disposed in series with respect to one another.

35. The device of claim 33, wherein the second rotatable elements are disposed in parallel with respect to one another.

36. The device of any one of claims 1 to 29, wherein, the second rotatable element is one of a second plurality of second rotatable elements disposed at the second end of the elongated housing, each of the second rotatable elements of the second plurality of rotatable elements having at least one second vane structured to impart kinetic energy to a flow of the second fluid contacting the at least one second vane when the second rotatable elements rotate, and the drive shaft operatively interconnects the second plurality of second rotatable elements with the first rotatable element.

37. The device of claim 36, wherein second rotatable elements are disposed in series with respect to one another.

38. The device of claim 36, wherein the second rotatable elements are disposed in parallel with respect to one another.

39. The device of any one of claims 1 to 38, wherein the device is entirely endovascular.

40. A method for assisting a flow of blood within a first blood vessel downstream of an aortic valve of an animal via a flow of blood within a second blood vessel upstream of the aortic valve of the animal, the method comprising: implanting the first end of a device of any one of claims 1 to 39 within the first blood vessel; and implanting the second end of the device within the second blood vessel.

41. The method of claim 40, wherein the first blood vessel is an ascending aorta.

42. The method of claim 40, wherein the first blood vessel is a descending aorta.

43. The method of any one of claims 40 to 42, wherein the second blood vessel is a pulmonary trunk.

44. The method of any one of claims 40 to 42, wherein the second blood vessel is a pulmonary artery.

45. The method of any one of claims 40 to 42, wherein the second blood vessel is an inferior vena cava.

46. The method of any one of claims 40 to 42, wherein the second blood vessel is a superior vena cava.

47. The method of any one of claims 40 to 46, wherein, implanting the first end is percutaneously implanting the first end, and implanting the second end is percutaneously implanting the second end.

48. The method of any one of claims 40 to 46, wherein, implanting the first end is endovascularly implanting the first end, and implanting the second end is endovascularly implanting the second end.

49. The method of any one of claims 40, 47 and 48, wherein at least one of implanting the first end and implanting the second end includes crossing aortic and arterial pulmonary vasculature walls.

50. The method of any one of claims 40, 47 and 48, wherein at least one of implanting the first end and implanting the second end includes crossing aortic and inferior vena cava vascular walls.

51. The method of any one of claims 40, 47 and 48, as they depend directly or indirectly from claim 5, wherein, implanting the first end of the device includes an absence of puncturing a wall of the first conduit; and implanting the second end of the device includes an absence of puncturing a wall of the second conduit.

52. The method of any one of claims 40, 47, 48 and 51, as they dependent directly or indirectly from claim 5, wherein implanting the first module and the second module are separately implanted in the animal body.

53. The method of any one of claims 40 to 52, wherein no percutaneous leads or wires remain at an end of the method.

54. A method of explanting a device any one of claims 1 to 39 having been implanted into an animal, the method comprising: collapsing at least one element of the device via a recovery sheath; and retrieving the device via the recovery sheath.