Prosthesis (i.e. – artificial body members) – parts thereof – or ai – Arterial prosthesis – Stent structure
Reexamination Certificate
1998-01-20
2001-04-10
Milano, Michael J. (Department: 3738)
Prosthesis (i.e., artificial body members), parts thereof, or ai
Arterial prosthesis
Stent structure
C623S001100, C623S001240
Reexamination Certificate
active
06214041
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention pertains to an implant for passing blood flow directly between a chamber of the heart and a coronary vessel. More particularly, this invention pertains to such an implant with an enhance design for providing blood flow to septal perfusing and branching arteries.
2. Description of the Prior Art
Commonly assigned and co-pending U.S. patent application Ser. No. 08/882,397 filed Jun. 25, 1997, now U.S. Pat. No. 5,944,019, entitled “Method and Apparatus for Performing Coronary Bypass Surgery”, and filed in the name of inventors Mark B. Knudson and William L. Giese, teaches an implant for defining a blood flow conduit directly from a chamber of the heart to a lumen of a coronary vessel. An embodiment disclosed in the aforementioned application teaches an L-shaped implant in the form of a rigid conduit having one leg sized to be received within a lumen of a coronary artery and a second leg sized to pass through the myocardium and extend into the left ventricle of the heart. As disclosed in the above-referenced application, the conduit is rigid and remains open for blood flow to pass through the conduit during both systole and diastole. The conduit penetrates into the left ventricle in order to prevent tissue growth and occlusions over an opening of the conduit.
Commonly assigned and co-pending U.S. patent application Ser. No. 08/944,313 filed Oct. 6, 1997, now U.S. Pat. No. 5,984,956, entitled “Transmyocardial Implant”, and filed in the name of inventors Katherine S. Tweden, Guy P. Vanney and Thomas L. Odland, teaches an implant such as that shown in the aforementioned '397 application with an enhanced fixation structure. The enhanced fixation structure includes a fabric surrounding at least a portion of the conduit to facilitate tissue growth on the exterior of the implant.
Implants such as those shown in the aforementioned applications include a portion to be placed within a coronary vessel and a portion to be placed within the myocardium. When placing a portion of the implant in the coronary vessel, the vessel is axially incised a length sufficient to insert the implant. When placed within the coronary vessel, the implant discharges flow axially into the vessel. The vessel may have multiple branching vessels. For example, in the case of a coronary artery, numerous septal perfusing arteries may branch off of the coronary artery to provide blood to the septal wall. The septal perfusing arteries branch off of the floor of the coronary artery. In addition to these, additional small arteries may branch off of the sides of the coronary artery. Due to the axial length of the implant within the vessel, the wall of the implant may block blood flow to these branching arteries resulting in localized ischemia.
SUMMARY OF THE INVENTION
According to a preferred embodiment of the present invention, a transmyocardial implant is disclosed for establishing a blood flow path through a myocardium between a heart chamber and a lumen of a coronary vessel residing on an exterior of the heart. The implant includes a hollow rigid conduit having a first portion and a second portion. The first portion is sized to be received within the lumen. The first portion has an axial dimension aligned with an axis of the vessel. The second portion is sized to extend from the vessel through the myocardium into the heart chamber. The conduit has open first and second ends on axial ends of respective ones of the first and second portions to define a blood flow pathway within an interior of the conduit between the first and second ends. The first portion has at least one radial opening formed therethrough for blood to flow radially outward of the first portion proximally to the first end.
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U.S. application No. 08/882,397, filed Jun. 25, 1997.
U.S. application No. 08/944,313, filed Oct. 6, 1997.
Goldman, A. et al., “Experimental Methods for Producing a Collateral Circulation to the Heart Directly From the Left Ventricle”,J. Thoracic Surg.,31(3):364-374 (Mar. 1956).
Massimo, C. et al., “Myocardial Revascularization by a New Method of Carrying Blood Directly From the Left Ventricular Cavity into the Coronary Circulation”,J. Thoracic Surg.,34(2):257-264 (Aug. 1957).
Munro, I. et al., “The possibility of myocardial revascularization by creation of a left ventriculocoronary artery fistula”,Thoracic and Cardiovascular Surgery,58:(1)25-32 (Jul. 1969).
Conrad Timothy R.
Tweden Katherine S.
Heartstent Corporation
Merchant & Gould P.C.
Milano Michael J.
Phan Hieu
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