65 results about "Bypass grafts" patented technology

A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being. The system comprises an atherectomy catheter having a working head, e.g., a rotary impacting impeller, and a debris extraction sub-system. The atherectomy catheter is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head and withdraws that liquid and some blood at a second and higher flow rate, through the guide catheter to create a differential flow adjacent the working head, whereupon the debris is withdrawn in the infusate liquid and blood for collection outside the being's body. The introduction of the infusate liquid may also be used to establish an unbalanced flow adjacent the working head to enable the atherectomy catheter to be steered hydrodynamically. A guide wire having an inflatable balloon on its distal end may be used with the atherectomy catheter to block the flow of debris distally, while enabling distal tissues to be perfused with an oxygenating liquid. At least one flow control port may be provided in the guide catheter to prevent collapse of the vessel being revascularized. A cradle is provided to fix the guide catheter and guide wire in position within the body of the being while enabling the atherectomy catheter to be advanced along the guide wire and through the guide catheter. The guide catheter includes a wear resistant coating and is constructed so that its distal end includes plural sections of different outside diameters, with the distal most section being of the smallest outside diameter. A control console is provided to establish various modes of operation of the system based on manual inputs via switches or voice commands via voice recognition circuitry. A video panel displays the various modes of operation and instructions to the operator.

A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being. The system comprises an atherectomy catheter having a working head, e.g., a rotary impacting impeller, and a debris extraction sub-system. The atherectomy catheter is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head and withdraws that liquid and some blood at a second and higher flow rate, through the guide catheter to create a differential flow adjacent the working head, whereupon the debris is withdrawn in the infusate liquid and blood for collection outside the being's body. The introduction of the infusate liquid may also be used to establish an unbalanced flow adjacent the working head to enable the atherectomy catheter to be steered hydrodynamically. A guide wire having an inflatable balloon on its distal end may be used with the atherectomy catheter to block the flow of debris distally, while enabling distal tissues to be perfused with an oxygenating liquid. At least one flow control port may be provided in the guide catheter to prevent collapse of the vessel being revascularized. A cradle is provided to fix the guide catheter and guide wire in position within the body of the being while enabling the atherectomy catheter to be advanced along the guide wire and through the guide catheter.

A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being. The system comprises an atherectomy catheter having a working head, e.g., a rotary impacting impeller, and a debris extraction sub-system. The atherectomy catheter is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head and withdraws that liquid and some blood at a second and higher flow rate, through the guide catheter to create a differential flow adjacent the working head, whereupon the debris is withdrawn in the infusate liquid and blood for collection outside the being's body. The introduction of the infusate liquid may also be used to establish an unbalanced flow adjacent the working head to enable the atherectomy catheter to be steered hydrodynamically. A guide wire having an inflatable balloon on its distal end may be used with the atherectomy catheter to block the flow of debris distally, while enabling distal tissues to be perfused with an oxygenating liquid. At least one flow control port may be provided in the guide catheter to prevent collapse of the vessel being revascularized. A cradle is provided to fix the guide catheter and guide wire in position within the body of the being while enabling the atherectomy catheter to be advanced along the guide wire and through the guide catheter.

Anastomosis systems include fittings and compression mechanisms for effecting end-end or end-side couplings of biological or synthetic bypass grafts to vessel locations. The fittings are tubular and surround end regions of the graft. In some applications an end region of the graft is everted and surrounds an exterior of the fitting, in which case the preferred compression mechanism is a retaining ring. A tool is used to evert the graft end region. In other applications, the fitting has an interior groove that receives an expandable retaining ring that urges the graft end region radially outwardly against the fitting. A graft deploying and securing system includes a needle for puncturing vessel tissue, a dilator, and a sheath adapted for containing a graft / fitting combination and guiding the combination into the vessel through an opening formed by the needle and dilator.

Surgical methods and instruments are disclosed for performing port-access or closed-chest coronary artery bypass (CABG) surgery in multivessel coronary artery disease. In contrast to standard open-chest CABG surgery, which requires a median sternotomy or other gross thoracotomy to expose the patient's heart, post-access CABG surgery is performed through small incisions or access ports made through the intercostal spaces between the patient's ribs, resulting in greatly reduced pain and morbidity to the patient. In situ arterial bypass grafts, such as the internal mammary arteries and / or the right gastroepiploic artery, are prepared for grafting by thoracoscopic or laparoscopic takedown techniques. Free grafts, such as a saphenous vein graft or a free arterial graft, can be used to augment the in situ arterial grafts. The graft vessels are anastomosed to the coronary arteries under direct visualization through a cardioscopic microscope inserted through an intercostal access port. Retraction instruments are provided to manipulate the heart within the closed chest of the patient to expose each of the coronary arteries for visualization and anastomosis. Disclosed are a tunneler and an articulated tunneling grasper for rerouting the graft vessels, and a finger-like retractor, a suction cup retractor, a snare retractor and a loop retractor for manipulating the heart. Also disclosed is a port-access topical cooling device for improving myocardial protection during the port-access CABG procedure. An alternate surgical approach using an anterior mediastinotomy is also described.

A vascular connector includes a main tube having a channel for fluid flow therethrough and opposed ends adapted to be connected to a vascular structure; and at least one inlet tube having a channel for fluid flow therethrough, a proximal end intersecting the main tube, and a distal end adapted to be connected to a vascular structure.

A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being's vascular system. The system introduces an infusate liquid at a first flow rate to the occluded portion of the blood vessel, and withdraws that liquid and some blood at a second and higher flow rate. This action creates a differential flow in the occluded blood vessel portion and thereby prevent particles of occlusive material from flowing into any upstream blood vessel or downstream blood vessel in said living being's vascular system.

A bypass graft includes a tubular portion having an internal tubular diameter and a first end and a second end. The tubular portion has a central axis. A flared portion has an adjoining end, wherein the adjoining end of the flared portion is integrally formed on and is substantially concentric with the second end of the tubular portion, and a flared end, wherein the flared end has a flared end internal diameter, such that the internal flared end diameter is greater than the internal tubular diameter. The flared portion includes a circumferential skirt for surgical attachment of the graft to a patient's blood vessel. A method for manufacturing a bypass graft, includes the steps of providing a mandrel having a tubular portion and a flared end with a flared end central axis; forming a layer of polyurethane over the mandrel; drying the layer of polyurethane on the mandrel; forming a skirt edge around the flared end of the mandrel to form an opening at a predetermined angle to the flared end central axis; forming a second edge around the tubular portion of the mandrel, and removing the graft from the mandrel.

This invention relates to an implant, implant tools, and an implant technique for the interposition of an extracardiac conduit between the left ventricle of a beating heart and the aorta to form an alternative one-way blood pathway thereby bypassing the native diseased aortic valve. The implant consists of a hollow conduit having a first end opening, a second end opening, and a one-way valve located between the end openings. The valve is biased to allow one-way flow from the second end opening to the first end opening. A first slit opening is located between the first end opening and the valve and a second slit opening is located between the second end opening and the heart valve. The implant tools consist of a vessel wall cutting tool and a heart wall piercing and dilating tool. The vessel wall cutting tool is sized to closely fit through the implant's first slit opening and the first end opening. The heart wall piercing and dilating tool is sized to closely fit through the implant's second slit opening and the second end opening. The implant technique allows the surgeon to safely connect the implant between a heart chamber and a blood vessel without stopping the heart or impeding flow in the blood vessel.

A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being. The system comprises an atherectomy catheter having a working head, e.g., a rotary impacting impeller, and a debris extraction sub-system. The atherectomy catheter is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head and withdraws that liquid and some blood at a second and higher flow rate, through the guide catheter to create a differential flow adjacent the working head, whereupon the debris is withdrawn in the infusate liquid and blood for collection outside the being's body. The introduction of the infusate liquid may also be used to establish an unbalanced flow adjacent the working head to enable the atherectomy catheter to be steered hydrodynamically. A guide wire having an inflatable balloon on its distal end may be used with the atherectomy catheter to block the flow of debris distally, while enabling distal tissues to be perfused with an oxygenating liquid. At least one flow control port may be provided in the guide catheter to prevent collapse of the vessel being revascularized. A cradle is provided to fix the guide catheter and guide wire in position within the body of the being while enabling the atherectomy catheter to be advanced along the guide wire and through the guide catheter.

A bilateral intra-aortic bypass graft and method and apparatus for repairing an abdominal aortic aneurysm includes two tubular grafts which are intraluminally delivered to the aorta and secured to the aorta by the expansion and deformation of two expandable and deformable tubular members.

A vessel harvesting system that is suitable for harvesting target vessels such as the saphenous vein or radial artery for cardiac artery bypass graft surgery. The system includes a vessel harvesting tool with an elongated cannula and a plurality of surgical instruments therein for separating the target vessels from the surrounding tissue and side branches. The harvesting tool includes a modular handle unit with a base attached to the elongated cannula and a sled that can adapt the base to various types of vessel severing / securing tools, such as tissue welders, bipolar scissors, and bipolar bisectors. The handle unit may be relatively rigid and integrated with the various tool movement controls to facilitate one-handed operation by a user. A severing / securing tool rotation mechanism may be incorporated within the handle and operated by a thumbwheel or other such mechanism. The vessel harvesting system may also provide distal CO2 insufflation for enhanced maintenance of the operating cavity.

A method for inhibiting hyperplasia at an anastomotic junction of a vascular fistula or vascular graft comprises exposing the anastomotic junction to vibrational energy at a mechanical index and for a time sufficient to inhibit hyperplasia. Kits are described comprising the catheter or a probe suitable for performing the methods together with instructions for use setting forth the methods. The methods and kits are particularly suitable for treating anastomotic junctions formed to provide vascular access for hemodialysis, hemofiltration, and the like. The methods and kits are also suitable for treating other vascular grafts, such as those formed during cardiac bypass graft surgery, vascular repair, and the like.

A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being's vascular system. The system introduces an infusate liquid at a first flow rate to the occluded portion of the blood vessel, and withdraws that liquid and some blood at a second and higher flow rate. This action creates a differential flow in the occluded blood vessel portion and thereby prevent particles of occlusive material from flowing into any upstream blood vessel or downstream blood vessel in said living being's vascular system.

Devices and methods for sealingly joining a graft vessel, such as a coronary bypass graft, to the side wall of a target vessel, such as the aorta or a coronary artery, in an anastomosis.

A system for performing an end-to-side vascular anastomosis including an anastomosis device, an application instrument and methods for performing a vascular anastomosis. The system is applicable for performing an anastomosis between a vascular graft and the ascending aorta in coronary artery bypass surgery, particularly in port-access CABG surgery. A first aspect of the invention includes a vascular anastomosis staple. A first configuration has two parts: an anchor member, forming the attachment with the target vessel wall and a coupling member, forming the attachment with the bypass graft vessel. The anastomosis is completed by inserting the coupling member, with the graft vessel attached, into the anchor member. A second configuration combines the functions of the anchor member and the coupling member into a one-piece anastomosis staple. A second aspect of the invention includes an anastomotic fitting, having an inner flange over which the graft vessel is everted and an outer flange which contacts the exterior surface of the target vessel. A tailored amount of compression applied by the inner and outer flanges grips the target vessel wall and creates a leak-proof seal between the graft vessel and the target vessel. A third aspect of the invention has a flange to which the graft vessel attaches, by everting the graft vessel over the flange, and a plurality of staple-like members which attach the flange and the everted end of the graft vessel to the wall of the target vessel to form the anastomosis

The invention relates to a hemodynamic fast planning method for personalized coronary artery bypass graft surgery. According to the method, a personalized coronary artery lumped parameter model is built according to information of a patient, the coronary artery fractional flow reserve for reflecting coronary artery functional diseases is calculated, the surgery indication is evaluated, and in combination with SYNTAX grading of anatomic disease extension, the evaluation is used as the comprehensive evaluation basis for selecting a coronary artery bypass graft surgery strategy. A bypass graft scheme is selected on the premise of adaptation and involves the bypass graft blood vessel number, the bypass graft position, the transfer catheter type and the like. The personalized lumped parameter model is calculated, and postoperative coronary artery flow and pressure changes and postoperative bypass graft blood vessel parameters are obtained. According to the average wall shear stress, the wall shear stress oscillation index and the competitive flow degree, the long-term permeability of the transfer catheter of the scheme is analyzed. The long-term permeability of transfer catheters in different bypass graft schemes is compared, and the best bypass graft scheme is obtained. The hemodynamic fast planning method solves the problems that an existing method is invasive, indirect, long in consumed time and the like.

A vessel harvesting system that is suitable for harvesting target vessels such as the saphenous vein or radial artery for cardiac artery bypass graft surgery. The system includes a vessel harvesting tool with an elongated cannula and a plurality of surgical instruments therein for separating the target vessels from the surrounding tissue and side branches. The harvesting tool includes a modular handle unit with a base attached to the elongated cannula and a sled that can adapt the base to various types of vessel severing / securing tools, such as tissue welders, bipolar scissors, and bipolar bisectors. The handle unit may be relatively rigid and integrated with the various tool movement controls to facilitate one-handed operation by a user. A severing / securing tool rotation mechanism may be incorporated within the handle and operated by a thumbwheel or other such mechanism. The vessel harvesting system may also provide distal CO2 insufflation for enhanced maintenance of the operating cavity.

A vessel holder supports a blood vessel during processing for use in bypass graft surgery. The holder comprises a base and a first fixture mounted on the base for holding a first end of the blood vessel. The first fixture has a fluid supply needle for inserting into the first end of the blood vessel. A second fixture is mounted on the base a predetermined distance from the first fixture for holding a second end of the blood vessel. The predetermined distance is adjustable for holding the blood vessel under tension. The device reduces labor and time for vessel preparation. With various optional features, the device obtains safer application of pressurized saline solution when testing for leaks, better visualization for inspecting the vessel for surgical use, reliable protection of the vessel from accidental damage, and convenient immersion of the vessel in a bath for preservation until needed in the surgery.

A system and method for exclusion of an aneurysm of an aortic arch region using a graft delivery system capable of maneuvering around an aortic arch, an aortic arch graft, and an occluder system for isolating an aneurysm while occluding one or more corresponding arteries, and with bypass of those arteries being performed using one or more selected bypass grafts. The graft may be branched or branchless. The graft delivery system has a flexible sheath that is manipulated manually with the aid of a guidance system. A hoist delivery system may also be provided. The occluder system may comprise independent occluders with one or more anchor members adjacent to one end. Alternatively, the occluders can be provided as part of the aortic arch graft, either as a built-in singular self-deploying occluder or as built-in multiple occluders. A kit is also provided containing a graft, stents, occluders, and optional delivery system.

Disclosed is an implantable material comprising a biocompatible matrix and cells which, when provided to a vascular access structure, can promote functionality generally. For example, implantable material of the present invention can enhance maturation of an arteriovenous native fistula as well as prolong the fistula in a mature, functional state suitable for dialysis. Additionally, the present invention can promote formation of a functional arteriovenous graft suitable for dialysis as well as promote formation of a functional peripheral bypass graft. Implantable material can be configured as a flexible planar form or a flowable composition with shape retaining properties suitable for implantation at, adjacent or in the vicinity of an anastomoses or arteriovenous graft. According to the methods disclosed herein, the implantable material is provided to an exterior surface of a blood vessel. Certain embodiments of the flexible planar form define a slot. The materials and methods of the present invention comprise cells, preferably endothelial cells or cells having an endothelial-like phenotype.

A method of yielding a functional human hybrid coronary bypass graft is provided. The method includes conditioning a hybrid synthetic tubular structure having stem cells and / or endothelial cells on at least one surface to yield the functional human hybrid coronary bypass graft. Specifically, the method includes placing the hybrid synthetic tubular structure in a system capable of producing three dimensional dynamic conditions for a sufficient time to yield said functional human hybrid coronary bypass graft.

A method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being. The method entails using an instrument to deploy the stent at occlusive material within the blood vessel to open the lumen, whereupon some debris may be produced. Operating a debris extraction system for removing debris during deployment of the stent.

The invention discloses a cardiovascular and cerebrovascular disease therapeutic apparatus capable of positioning function recovery therapy, preventing hypertension and cardiovascular and cerebrovascular diseases, and carrying out clinic therapy and first-aid, which consists of an oxygen inhalation horizontal exerciser and a massager and utilizes physical and chemical medicine combination treatment; the oxygen inhalation horizontal exerciser consists of a bed body, an oxygen inhalation device and a rotary wheel, for oxygen inhalation, respiratory administration, recovering abdominal breathing function and reducing blood pressure, which is combined with medicine oral administration, and the massager comprises medicine cloth and a massage head for medically massaging rigid muscle and activating blood, which is combined with local medicine injection; the invention is based on treatment principle and method of serious diseases, aims at the cause of hypertension and cardiovascular and cerebrovascular diseases to be function reduction and structural damage which are restricted by each other, and integrates function recovery with existing treatment of medicine, operation, and bypass grafting injury protection which can promote one another. The invention can cure cardiovascular and cerebrovascular diseases by treatment of disease cause.

A tissue punch which is configured to operate by utilizing a spring force to compress tissue between a rotatable cutter blade and a tissue piercing element. The tissue punch is configured such that once the spring force is applied, the cutter blade can be selectively rotated by the user. The rotation of the blade, assisted by the compression from the spring force, causes the cutter blade to cut through the tissue. Three different methods for creating an anastomosis for locating a bypass graft are disclosed. In each method, bypass graft material is installed on a tissue punch and then sutured. Depending on the method, the tissue is punched either before or after the suturing.

The present invention provides a system for treating heart disease as a “bridge to recovery” using cellular cardiomyoplasty. The system is particularly useful in selecting and treating patients with damaged myocardium due coronary artery disease, myocardial infarction, congestive heart failure, and ischemia. Based on various clinical criteria, a patient is selected and optionally treated using cellular cardiomyoplasty to improve the patient's cardiac function. The cardiomyoplasty may be combined with other treatments such as medications or left ventricular assist devices. Preferably, the cellular cardiomyoplasty eliminates the need for invasive surgery such as by-pass grafting or cardiac transplantation. The invention also provides kits for use in selecting and treating patients using the inventive method.