Transmyocardial implant with improved flow

Abstract

A method and apparatus for performing coronary artery bypass surgery establishes a channel leading directly from a chamber of a heart into a coronary artery with said channel retained open during both diastole and systole. The coronary artery bypass procedure may be performed with or without cardiopulmonary bypass.

What is claimed is:  
     
         1 . A transmyocardial implant providing blood flow between a heart chamber and a coronary vessel, the implant comprising: 
 an open first end, an open second end and a hollow conduit connecting the first end and the second end;    the conduit adjacent the first end defining a myocardial portion sized to extend through a myocardium between the heart chamber and the coronary vessel, the myocardial portion defining a first axis;    the conduit adjacent the second end defining a vessel portion sized to lie at least partially within a lumen of the coronary vessel, the vessel portion defining a second axis;    the lumen of the coronary vessel defining a flow axis and a flow direction, the flow axis of the vessel substantially the same as the second axis; and    the first axis at a non-orthogonal angle to the second axis so that when the implant is positioned within the myocardium conduit provides fluid communication between the heart chamber and the lumen of the coronary vessel and blood flowing from the myocardial portion into the vessel portion is biased in the flow direction.    
     
     
         2 . The transmyocardial implant of  claim 1 , wherein the heart is a human heart.  
     
     
         3 . The transmyocardial implant of  claim 2 , wherein the heart chamber is the left ventricle.  
     
     
         4 . The transmyocardial implant of  claim 1 , wherein the heart chamber contains oxygenated blood.  
     
     
         5 . The transmyocardial implant of  claim 1 , wherein the coronary vessel is a coronary artery.  
     
     
         6 . The transmyocardial implant of  claim 1 , wherein the myocardial portion of the implant is rigid enough to remain open during systole and diastole when placed within the myocardium.  
     
     
         7 . The transmyocardial implant of  claim 1 , wherein the implant is sized so that the first end extends into the heart chamber beyond an inner wall of the myocardium.  
     
     
         8 . A method of providing blood flow from a heart chamber into a coronary vessel comprising the steps of: 
 placing an implant within a myocardium between the heart chamber and the coronary vessel, the implant including an open first end, an open second end and a hollow conduit connecting the first and second ends, the conduit defining an axis;    positioning the implant with the first end extending to the heart chamber and the second end extending to a lumen of the coronary vessel, the lumen of the coronary vessel defining a flow axis and a flow direction;    establishing fluid communication between the heart chamber and the lumen of the coronary vessel through the conduit with the axis of the conduit at an nonorthogonal angle to the flow axis of the lumen so that blood flowing from the second end into the lumen of the coronary vessel is biased in the flow direction.    
     
     
         9 . The method of  claim 8 , wherein the heart is a human heart.  
     
     
         10 . The method of  claim 9 , wherein the heart chamber is the left ventricle.  
     
     
         11 . The method of  claim 8 , wherein the heart chamber contains oxygenated blood.  
     
     
         12 . The method of  claim 8 , further comprising the step of maintaining the implant open during systole and diastole.  
     
     
         13 . The method of  claim 8 , wherein the coronary vessel is a coronary artery and the heart chamber contains oxygenated blood.  
     
     
         14 . The method of  claim 13 , wherein the coronary vessel includes an occlusion and the second end extends to the lumen of the coronary vessel at a point distal to the occlusion in the flow direction.  
     
     
         15 . The method of  claim 8 , wherein the second end of the implant is positioned within the heart chamber extending beyond an inner wall of the myocardium.  
     
     
         16 . The method of  claim 8 , wherein the first end is parallel to the flow axis.  
     
     
         17 . The method of  claim 8 , wherein the second end is parallel to the flow axis.  
     
     
         18 . The method of  claim 8 , wherein the first end is orthogonal to the axis of the conduit.  
     
     
         19 . The method of  claim 8 , wherein the second end is orthogonal to the flow axis.