Medical grafting methods and apparatus

Abstract

Methods and apparatus for delivering and installing a new length of tubing between two sections of a patient's existing body organ tubing and at least partly outside of that existing structure. For example, the new length of tubing may be for the purpose of providing the patient with a coronary bypass. The new tubing may be an artificial graft, a natural graft (harvested elsewhere from the patient), or both. The new tubing is delivered to and installed at the operative site primarily by working through the patient's existing tubular body organ structure. This avoids the need for any significant surgery on the patient. The artificial grafts may have shapes other than tubular. Certain procedural and apparatus aspects of the invention have uses other than in connection with grafting in general or tubular grafting in particular.

The invention claimed is:  
     
         1 . A guided punch, comprising: 
 a sharp, extendible guide wire; and    a hollow punch mechanism adapted to ride on the guide wire, wherein said guide wire is adapted to extend from said punch.    
     
     
         2 . A punch according to  claim 1 , wherein said punch is a rotating punch.  
     
     
         3 . A punch according to  claim 1 , wherein said punch is an axially moving punch.  
     
     
         4 . An anastomotic connector, comprising: 
 a cylinder-like body; and    at least one set of spikes, coupled to said body by twisting joints.    
     
     
         5 . A connector according to  claim 4 , wherein said twisting joints comprise at least one torsion bar.  
     
     
         6 . A connector according to  claim 4 , wherein said twisting joints comprise at least one bend area.  
     
     
         7 . A medical graft delivery system, comprising: 
 a tubular element for delivering a graft through a bore thereof and having a delivery end, said end being prone to distortion; and    at least one collar removably encircling said delivery end, which collar prevents said distortion.    
     
     
         8 . A system according to  claim 7 , wherein said tube comprises weakened portions at or adjacent said delivery end.  
     
     
         9 . A system according to  claim 7 , comprising an anastomotic connector preloaded in said delivery end and applying outward forces against said end.  
     
     
         10 . A system according to any of claims  7 - 9 , wherein said at least one collar comprises at least two collars.  
     
     
         11 . A method of sealing an opening between two blood conduit lips, comprising: 
 providing a clip;    first retracting a first lip into said clip; and    second retracting a second lip into said clip.    
     
     
         12 . A method according to  claim 11 , comprising closing said clip to seal said opening.  
     
     
         13 . A method according to  claim 12 , wherein closing comprises releasing said clip to selfdeform.  
     
     
         14 . A method according to  claim 12 , wherein closing comprises plastically deforming said clip.  
     
     
         15 . A method according to any of claims  11 - 14 , wherein said two lips are lips of different conduits.  
     
     
         16 . A method according to any of claims  11 - 14 , wherein at least one of the conduits comprises a blood vessel.  
     
     
         17 . A reducing profile anastomotic connector, comprising: 
 a ring section;    a spikes section comprises a plurality of spikes, wherein said spikes section defines a collapsing portion, for axial collapsing of said spikes section.    
     
     
         18 . A connector according to  claim 17 , wherein said collapsing portion buckles.  
     
     
         19 . A connector according to  claim 17 , wherein said collapsing portion twists.  
     
     
         20 . A connector according to  claim 17 , wherein said collapsing portion folds out.  
     
     
         21 . A connector according to any of claims  17 - 20 , wherein said collapsing portion selfdeforms.  
     
     
         22 . A connector according to any of claims  17 - 20 , wherein said collapsing portion plastically deforms.