Methods and devices providing transmyocardial blood flow to the arterial vascular system of the heart

Abstract

This invention relates to methods and devices providing transmyocardial blood flow or coronary revascularization for the treatment of coronary atherosclerosis and resulting myocardial ischemia by increasing the flow of blood from one or more oxygenated blood sources within the patient to one or more sites selected in the arterial vascular system of the heart using a channel for maintaining and regulating blood flow therebetween. A valved conduit or a self-maintained channel is created between the left ventricle reservoir of oxygenated blood and the coronary artery distal to an area of obstruction by surgical and percutaneous methods. Preferably, the conduit or self-maintained channel integrally regulates the flow of blood between the oxygenated blood source and the site selected in the arterial vascular system of the heart wherein an increase in blood flow is desired.

What is claimed is:  
     
         1 . A method for increasing the flow of blood to a selected site in a patient's arterial vascular system of the heart, the method comprising the steps of: 
 creating a channel for blood flow from an oxygenated blood source to the selected site in the arterial vascular system of the heart;    maintaining the channel in an open position for blood flow through diastolic and systolic cycles of the heart; and    regulating the blood flow in the channel to minimize blood flow from the coronary vascular system to the blood source during diastole.    
     
     
         2 . The method of    claim 1    wherein the creating step includes perforating and dilating the tissue surrounding the blood source to create the channel therein.  
     
     
         3 . The method of    claim 1    wherein the creating step includes removing tissue to form an aperture completely through the tissue surrounding the blood source to partially create the channel therein.  
     
     
         4 . The method of    claim 1    wherein the creating step includes exposing at least a portion of the patient's heart for surgical access.  
     
     
         5 . The method of    claim 1    wherein the creating step includes advancing a delivery device to the tissue surrounding the blood source.  
     
     
         6 . The method of    claim 1    wherein the blood source is the left ventricle and the tissue surrounding the blood source is the myocardium.  
     
     
         7 . The method of    claim 1    wherein the method includes more than one blood source.  
     
     
         8 . The method of    claim 1    wherein the method includes more than one site in the arterial vascular system.  
     
     
         9 . The method of    claim 1    wherein the method includes selecting a site in the arterial vascular system distal to an obstruction therein.  
     
     
         10 . A method for performing a transmyocardial coronary revascularization procedure for the treatment of coronary atherosclerosis caused by an obstruction in the arterial vascular system, the method comprising the steps of: 
 creating a channel for blood flow from an oxygenated blood source to the arterial vascular system distal to the area of obstruction;    maintaining the channel in an open position for blood flow through the diastole and systole cycles of the heart; and    regulating the blood flow in the channel to minimize blood flow from the arterial vascular system to the blood source during the diastolic cycle of the heart.    
     
     
         11 . The method of    claim 10    wherein the creating step includes perforating and dilating the tissue surrounding the blood source to create the channel therein.  
     
     
         12 . The method of    claim 10    wherein the creating step includes removing tissue to form an aperture completely through the tissue surrounding the blood source to partially create the channel therein.  
     
     
         13 . The method of    claim 10    wherein the creating step includes exposing at least a portion of the patient's heart for surgical access.  
     
     
         14 . The method of    claim 10    wherein the creating step includes advancing a delivery device to the tissue surrounding the blood source.  
     
     
         15 . The method of    claim 10    wherein the blood source is the left ventricle and the tissue surrounding the blood source is the myocardium.  
     
     
         16 . The method of    claim 10    wherein the method includes more than one blood source.  
     
     
         17 . The method of    claim 10    wherein the method includes more than one site in the arterial vascular system.  
     
     
         18 . The method of    claim 10    wherein the method includes selecting a site in the arterial vascular system distal to an obstruction therein.  
     
     
         19 . A method for treating an obstruction in a patient's cardiovascular system using a non-expandable conduit made of biocompatible material, the method comprising the steps of: 
 inserting the conduit completely through the myocardium of the patient's heart with one end of the conduit extending into the left ventricle and the other end of the conduit extending into the arterial vascular system distal to the area of obstruction;    maintaining the conduit in an open position for blood flow through the diastolic and systolic cycles of the heart;    regulating the blood flow in the channel to minimize blood flow from the arterial vascular system to the left ventricle during the diastolic cycle of the heart.    
     
     
         20 . The method of    claim 19    wherein the inserting step includes perforating and dilating the tissue surrounding the blood source to create the channel therein.  
     
     
         21 . The method of    claim 19    wherein the inserting step includes removing tissue to form an aperture completely through the tissue surrounding the blood source to partially create the channel therein.  
     
     
         22 . The method of    claim 19    wherein the inserting step includes exposing at least a portion of the patient's heart for surgical access.  
     
     
         23 . The method of    claim 19    wherein the inserting step includes advancing a delivery device to the tissue surrounding the blood source.  
     
     
         24 . The method of    claim 19    wherein the blood source is the left ventricle and the tissue surrounding the blood source is the myocardium.  
     
     
         25 . The method of    claim 19    wherein the method includes more than one blood source.  
     
     
         26 . The method of    claim 19    wherein the method includes more than one site in the arterial vascular system.  
     
     
         27 . The method of    claim 19    wherein the method includes selecting a site in the arterial vascular system distal to an obstruction therein.  
     
     
         28 . A method for increasing the flow of blood to a selected site in a patient's arterial vascular system, the method comprising the steps of: 
 inserting one end of a conduit into the left ventricle;    inserting the second end of the conduit into the arterial vascular system at the selected site;    maintaining the conduit in an open position for blood flow through the diastolic and systolic cycles of the heart;    regulating the blood flow in the conduit to minimize blood flow from the arterial vascular system to the left ventricle during the systolic cycle of the heart.    
     
     
         29 . The method of    claim 28    wherein the method includes connecting the ends of the conduit together.  
     
     
         30 . The method of    claim 28    wherein the method includes: 
 accessing the patient's myocardium; and  
 perforating the myocardium.  
 
     
     
         31 . The method of    claim 28    wherein the inserting step includes perforating and dilating the tissue surrounding the blood source to create the channel therein.  
     
     
         32 . The method of    claim 28    wherein the inserting step includes removing tissue to form an aperture completely through the tissue surrounding the blood source to partially create the channel therein.  
     
     
         33 . The method of    claim 28    wherein the inserting step includes exposing at least a portion of the patient's heart for surgical access.  
     
     
         34 . The method of    claim 28    wherein the inserting step includes advancing a delivery device to the tissue surrounding the blood source.  
     
     
         35 . The method of    claim 28    wherein the blood source is the left ventricle and the tissue surrounding the blood source is the myocardium.  
     
     
         36 . The method of    claim 28    wherein the method includes more than one blood source.  
     
     
         37 . The method of    claim 28    wherein the method includes more than one site in the arterial vascular system.  
     
     
         38 . The method of    claim 28    wherein the method includes selecting a site in the arterial vascular system distal to an obstruction therein.