Blood flow conduit delivery system and method of use

Abstract

Described herein is a catheter system for delivering an L-shaped conduit into the body of a patient between the left ventricle and coronary artery. A shunt preferably made of semirigid material is inserted into the lumen of a delivery catheter. The delivery catheter is advanced within the patient until its distal end is located adjacent to the desired insertion site, which is preferably the junction between a coronary artery and passageway formed in the myocardium between the left ventricle and coronary artery. A proximal section of the shunt is first advanced out of the delivery catheter into the myocardial passageway. A distal section of the shunt is advanced into the coronary artery, preferably by advancing the distal section of the shunt into the myocardial passageway and then. pulling the distal section back into the coronary artery, or by pushing the distal section of the shunt in a folded configuration out of the delivery catheter into the coronary artery. In one embodiment, the shunt is made of a collapsible material for insertion into the delivery catheter, the shunt expanding upon removal from the delivery catheter.

What is claimed is:  
     
         1 . A method of delivering a conduit into a portion of the body having a first passageway and a second passageway joined generally at an angle, comprising: 
 advancing a delivery catheter into the patient, the delivery catheter having a proximal end and a distal end and a lumen extending therethrough, the delivery catheter once advanced having a proximal end that extends outside of the patient and a distal end located substantially adjacent the location where the first passageway and the second passageway are joined;    inserting a conduit into the lumen of the delivery catheter, the conduit having a proximal section and a distal section;    advancing the proximal section of the conduit out of the lumen at the distal end of the delivery catheter into the first passageway; and    advancing the distal section of the conduit into the second passageway.    
     
     
         2 . The method of  claim 1 , wherein the first passageway is a myocardial passageway formed through the myocardium of the heart between the left ventricle and a coronary artery.  
     
     
         3 . The method of  claim 2 , wherein the second passageway is in a portion of the coronary artery downstream from the myocardial passageway.  
     
     
         4 . The method of  claim 1 , further comprising collapsing the conduit prior to inserting it into the lumen.  
     
     
         5 . The method of  claim 1 , wherein, prior to advancing the proximal section out of the delivery catheter, the delivery catheter is delivered until the lumen at the distal end faces at least partially into the first passageway.  
     
     
         6 . The method of  claim 3 , wherein the conduit is inserted into the lumen at the distal end of the delivery catheter in a substantially linear configuration, the conduit while inserted having a proximal end located nearer to the distal end of the delivery catheter and a distal end located nearer to the proximal end of the delivery catheter.  
     
     
         7 . The method of  claim 6 , further comprising, after advancing the proximal section of the conduit out of the lumen into the myocardial passageway, advancing the distal section of the conduit into the myocardial passageway such that the conduit is substantially completely outside of the lumen of the delivery catheter and the proximal end of the conduit extends into the left ventricle.  
     
     
         8 . The method of  claim 7 , wherein advancing the distal section of the conduit into the second passageway comprises moving the distal section out of the myocardial passageway and into the coronary artery.  
     
     
         9 . The method of  claim 3 , wherein the conduit is inserted into the lumen at the distal end in a folded configuration, wherein the distal section of the conduit is folded over the proximal section, the conduit having a proximal end and a distal end that both face the distal end of the delivery catheter, the proximal end of the conduit being located closer to the distal end of the delivery catheter than the distal end of the conduit is located to the distal end of the delivery catheter.  
     
     
         10 . The method of  claim 9 , wherein the proximal section of the conduit is advanced into the first passageway by pushing the conduit out of the lumen.  
     
     
         11 . The method of  claim 10 , wherein the distal section of the conduit is advanced into the second passageway by pushing the conduit out of the lumen.  
     
     
         12 . A method for creating a bypass between a chamber of the heart and a blood vessel adjacent to that chamber, the method comprising: 
 forming a passageway in a heart wall that extends between the chamber of the heart and the blood vessel, the passageway having a proximal end opening into the chamber of the heart and a distal end opening into the blood vessel;    advancing a conduit having a proximal end and a distal end through the distal end of the passageway toward its proximal end, the proximal end of the conduit once advanced extending past the heart wall into the chamber of the heart and the distal end of the conduit once advanced being located in the heart wall; and    advancing the distal end of the conduit out of the distal end of the passageway and into the blood vessel downstream of the passageway.    
     
     
         13 . The method of  claim 12 , further comprising, prior to advancing the conduit through the distal end of the passageway, inserting the conduit in a substantially linear configuration into the lumen of a delivery catheter having a proximal end and a distal end, the proximal end of the conduit being located closer the distal end of the delivery catheter and the distal end of the conduit being located closer to the proximal end of the delivery catheter.  
     
     
         14 . The method of  claim 13 , further comprising advancing the delivery catheter into the patient such that the proximal end of the delivery catheter is located outside of the patient and the distal end of the delivery catheter is located adjacent the distal end of the myocardial passageway.  
     
     
         15 . The method of  claim 14 , further comprising, prior to advancing the conduit into the passageway, releasably attaching a rod to the distal end of the conduit.  
     
     
         16 . The method of  claim 15 , wherein advancing the conduit into the passageway comprises pushing the rod distally to move the conduit out of the lumen.  
     
     
         17 . The method of  claim 16 , wherein while advancing the conduit into the passageway, the delivery catheter is positioned such that the lumen at the distal end faces into the passageway.  
     
     
         18 . The method of  claim 16 , wherein advancing the distal end of the conduit out of the distal end of the passageway comprises pushing the rod into the coronary artery.  
     
     
         19 . The method of  claim 18 , wherein while advancing the distal end of the conduit out of the distal end of the passageway, the delivery catheter is positioned such that the lumen at the distal end faces downstream into the coronary artery.  
     
     
         20 . The method of  claim 12 , wherein the distal end of the conduit is advanced into the blood vessel until the proximal end of the conduit is approximately flush with the proximal end of the passageway.  
     
     
         21 . The method of  claim 12 , wherein the conduit is made of a shape memory material having a collapsible shape when inserted into the delivery catheter and an expanded shape when advanced into the passageway and into the blood vessel.  
     
     
         22 . The method of  claim 12 , wherein the chamber of the heart is the left ventricle.  
     
     
         23 . The method of  claim 12 , wherein the blood vessel is a coronary artery.  
     
     
         24 . A method for creating a bypass between a chamber of the heart and a blood vessel adjacent to that chamber, the method comprising: 
 forming a passageway in a heart wall that extends between the chamber of the heart and the blood vessel, the passageway having a proximal end opening into the chamber of the heart and a distal end opening into the blood vessel;    folding a conduit having a proximal end and a distal end to define a proximal section and a distal section between the fold;    inserting the folded conduit into a delivery catheter having a proximal end and a distal end and a lumen extending therethrough, the conduit being inserted such that the proximal end of the conduit is nearer to the distal end of the delivery catheter than the distal end of the conduit is to the distal end of the delivery catheter, with both the proximal end and the distal end of the conduit facing toward the distal end of the delivery catheter;    advancing the delivery catheter into a patient into the blood vessel until its distal end is adjacent to the distal end of the passageway in the heart wall;    advancing the proximal section of the conduit out of the lumen at the distal end of the delivery catheter into the passageway; and    advancing the distal section of the conduit out of the lumen at the distal end into the blood vessel.    
     
     
         25 . The method of  claim 24 , wherein the proximal section of the conduit is advanced into the passageway until the proximal end of the conduit is approximately flush with the proximal end of the passageway  
     
     
         26 . The method of  claim 24 , wherein while advancing the proximal section of the conduit out of the lumen, the delivery catheter is positioned such that the lumen at the distal end faces at least partially into the passageway.  
     
     
         27 . The method of  claim 26 , wherein while advancing the proximal section of the conduit out of the lumen, the delivery catheter is turned such that proximal section of the conduit is located in a part of the lumen closest to the passageway.  
     
     
         28 . The method of  claim 24 , wherein while advancing the distal section of the conduit out of the lumen, the delivery catheter is positioned such that the lumen at the distal end faces downstream into the blood vessel.  
     
     
         29 . The method of  claim 24 , further comprising, prior to advancing the proximal section of the conduit into the passageway, releasably attaching a rod to the distal end of the conduit.  
     
     
         30 . The method of  claim 29 , wherein advancing the proximal section of the conduit into the passageway comprises pushing the rod distally to move the conduit out of the lumen.  
     
     
         31 . The method of  claim 29 , wherein advancing the distal section of the conduit into the passageway comprises pushing the rod distally to move the conduit out of the lumen.  
     
     
         32 . The method of  claim 24 , wherein the conduit is made of a shape memory material having a collapsible shape when inserted into the delivery catheter and an expanded shape when advanced into the passageway and into the blood vessel.  
     
     
         33 . The method of  claim 24 , wherein the chamber of the heart is the left ventricle.  
     
     
         34 . The method of  claim 24 , wherein the blood vessel is a coronary artery.