Surgery – Devices transferring fluids from within one area of body to...
Reexamination Certificate
2000-08-01
2003-10-28
Jacyna, J. Casimer (Department: 3751)
Surgery
Devices transferring fluids from within one area of body to...
Reexamination Certificate
active
06638237
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to an apparatus for bypassing a blocked or stenosed blood vessel segment, and, more particularly, to an apparatus and method for delivering a conduit between the coronary artery and the left ventricle of the heart.
BACKGROUND OF THE INVENTION
Coronary artery disease is a major problem in the U.S. and throughout the world. Coronary arteries as well as other blood vessels frequently become clogged with plaque which, at the very least, can reduce blood and oxygen flow to the heart muscle (myocardium), and may impair the efficiency of the heart's pumping action, and can lead to heart attack (myocardial infarction) and death. In some cases, these coronary arteries can be unblocked through non-invasive techniques such as balloon angioplasty. In more difficult cases, a surgical bypass of the blocked vessel is necessary.
In a coronary bypass operation, one or more venous segments are inserted between the aorta and the coronary artery, or, alternatively, the distal end of an internal mammary artery is anastomosed to the coronary artery at a site distal to the stenosis or occlusion. The inserted venous segments or transplants act as a bypass of the blocked portion of the coronary artery and thus provide for a free or unobstructed flow of blood to the heart. More than 500,000 bypass procedures are performed in the U.S. every year.
Such coronary artery bypass graft (CABG) surgery, however, is a very intrusive procedure which is expensive, time-consuming, and traumatic to the patient. The operation requires an incision through the patient's sternum (sternotomy), and that the patient be placed on a heart-lung bypass pump so that the heart can be operated on while not beating. A saphenous vein graft is harvested from the patient's leg, another highly invasive procedure, and a delicate surgical procedure is required to piece the bypass graft to the coronary artery (anastpmosis). Hospital stays subsequent to the surgery and convalescence are prolonged. Furthermore, many patients are poor surgical candidates due to other concomitant illnesses.
As mentioned above, another conventional treatment is percutaneous transluminal coronary angioplasty (PTCA) or other types of angioplasty. However, such vascular treatments are not always indicated due to the type or location of the blockage or stenosis, or due to the risk of emboli.
Thus, there is a need for an improved coronary bypass system which is less traumatic to the patient.
SUMMARY OF THE INVENTION
Briefly stated, the methods and apparatus described and illustrated herein generally relate to direct coronary revascularization, wherein a conduit or opening is provided from the left ventricle to the coronary artery, often times the left anterior descending (LAD), to provide blood flow directly therethrough. These methods and apparatus are particularly useful when a blockage partially or completely obstructs the coronary artery, in which case the bypass conduit or opening is positioned distal to the blockage. More preferably, conduits are provided to direct blood flow from the left ventricle to a coronary artery at a location distal to a blockage in the coronary artery. The conduits may be threaded to facilitate insertion into a patient's heart wall and to control the depth of insertion. Threaded and nonthreaded conduits are preferably delivered using a guidewire approach. In this approach, the guidewire is placed through a needle that is inserted into the left ventricle. After the guidewire is placed, the needle is removed. In one embodiment, a dilator is provided over the guidewire into the heart wall, and the conduit is delivered over the dilator. In another embodiment, an introducer sleeve is provided over the dilator into the heart wall, the dilator is removed, and the conduit is delivered through the introducer sleeve. A depth measuring tool is preferably used to determine the appropriate length of the conduit prior to delivery. In another embodiment, a feature can be included on the end of the introducer sleeve that engages with the arterial wall, and when pulled back, distends the artery. The conduit can then be advanced until the deployable flanges seat against the bottom of the artery.
REFERENCES:
patent: 3971363 (1976-07-01), Fletcher et al.
patent: 4503568 (1985-03-01), Madras
patent: 4733665 (1988-03-01), Palmaz
patent: 4769029 (1988-09-01), Patel
patent: 4995857 (1991-02-01), Arnold
patent: 5035702 (1991-07-01), Taheri
patent: 5135467 (1992-08-01), Citron
patent: 5190058 (1993-03-01), Jones et al.
patent: 5226889 (1993-07-01), Sheiban
patent: 5258008 (1993-11-01), Wilk
patent: 5287861 (1994-02-01), Wilk
patent: 5292309 (1994-03-01), Van Tassel et al.
patent: 5330486 (1994-07-01), Wilk
patent: 5344426 (1994-09-01), Lau et al.
patent: 5385541 (1995-01-01), Kirsch et al.
patent: 5409019 (1995-04-01), Wilk
patent: 5423744 (1995-06-01), Gencheff et al.
patent: 5423851 (1995-06-01), Samuels
patent: 5429144 (1995-07-01), Wilk
patent: 5443497 (1995-08-01), Venbrux
patent: 5456694 (1995-10-01), Marin et al.
patent: 5456712 (1995-10-01), Maginot
patent: 5456714 (1995-10-01), Owen
patent: 5470320 (1995-11-01), Tiefenbrun et al.
patent: 5527337 (1996-06-01), Stack et al.
patent: 5578075 (1996-11-01), Dayton
patent: 5593434 (1997-01-01), Williams
patent: 5609626 (1997-03-01), Quijano et al.
patent: 5611778 (1997-03-01), Brinon
patent: 5618299 (1997-04-01), Khosravi et al.
patent: 5643278 (1997-07-01), Wijay
patent: 5655548 (1997-08-01), Nelson et al.
patent: 5662124 (1997-09-01), Wilk
patent: 5676670 (1997-10-01), Kim
patent: 5733267 (1998-03-01), Del Toro
patent: 5755682 (1998-05-01), Knudson et al.
patent: 5758663 (1998-06-01), Wilk et al.
patent: 5787933 (1998-08-01), Russ et al.
patent: 5797920 (1998-08-01), Kim
patent: 5810836 (1998-09-01), Hussein et al.
patent: 5810871 (1998-09-01), Tuckey et al.
patent: 5824038 (1998-10-01), Wall
patent: 5824071 (1998-10-01), Nelson et al.
patent: 5830222 (1998-11-01), Makower et al.
patent: 5843163 (1998-12-01), Wall
patent: 5851232 (1998-12-01), Lois
patent: 5855597 (1999-01-01), Jayaraman
patent: 5865723 (1999-02-01), Love
patent: 5876419 (1999-03-01), Carpenter et al.
patent: 5878751 (1999-03-01), Hussein et al.
patent: 5893848 (1999-04-01), Negus et al.
patent: 5908028 (1999-06-01), Wilk
patent: 5908029 (1999-06-01), Knudson et al.
patent: 5935119 (1999-08-01), Guy et al.
patent: 5935161 (1999-08-01), Robinson et al.
patent: 5935162 (1999-08-01), Dang
patent: 5944019 (1999-08-01), Knudson et al.
patent: 5961548 (1999-10-01), Shmulewitz
patent: 5968093 (1999-10-01), Kranz
patent: 5971993 (1999-10-01), Hussein et al.
patent: 5976153 (1999-11-01), Fischell et al.
patent: 5976155 (1999-11-01), Foreman et al.
patent: 5976159 (1999-11-01), Bolduc et al.
patent: 5976169 (1999-11-01), Imran
patent: 5976178 (1999-11-01), Goldsteen et al.
patent: 5976181 (1999-11-01), Whelan et al.
patent: 5976182 (1999-11-01), Cox
patent: 5976192 (1999-11-01), McIntyre et al.
patent: 5976650 (1999-11-01), Campbell et al.
patent: 5979455 (1999-11-01), Maginot
patent: 5980530 (1999-11-01), Willard et al.
patent: 5980533 (1999-11-01), Holman
patent: 5980548 (1999-11-01), Evans et al.
patent: 5980551 (1999-11-01), Summers et al.
patent: 5980552 (1999-11-01), Pinchasik et al.
patent: 5980553 (1999-11-01), Gray et al.
patent: 5980566 (1999-11-01), Alt et al.
patent: 5984955 (1999-11-01), Wisselink
patent: 5984956 (1999-11-01), Tweden et al.
patent: 5984963 (1999-11-01), Ryan et al.
patent: 5984965 (1999-11-01), Knapp et al.
patent: 5989207 (1999-11-01), Hughes
patent: 5989263 (1999-11-01), Shmulewitz
patent: 5989287 (1999-11-01), Yang et al.
patent: 5993481 (1999-11-01), Marcade et al.
patent: 5993482 (1999-11-01), Chuter
patent: 5997563 (1999-12-01), Kretzers
patent: 5997573 (1999-12-01), Quijano et al.
patent: 6001123 (1999-12-01), Lau
patent: 6004261 (1999-12-01), Sinofsky et al.
patent: 6004347 (1999-12-01), McNamara et al.
patent: 6004348 (1999-12-01), Banas et al.
patent: 6007543 (1999-12-01), Ellis et al.
patent: 6007575 (1999-12-01), Samuels
patent: 60
Guiles Marvin
Melsky Gerald
Finnegan Henderson Farabow Garrett & Dunner LLP
Jacyna J. Casimer
Percardia Inc.
LandOfFree
Left ventricular conduits and methods for delivery does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Left ventricular conduits and methods for delivery, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Left ventricular conduits and methods for delivery will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-3150863