Vascular graft bypass

Abstract

Improved methods of treatment of diseased or occluded vascular grafts in patients having undergone coronary artery bypass or other bypass surgery are disclosed. Deployment of a conduit in the myocardium at a site distal to the site of attachment of the coronary artery bypass graft allows oxygenated blood to flow from a chamber in the heart directly into the coronary artery, bypassing blockages in the coronary artery and the graft originally used to bypass the coronary artery. To ensure proper positioning, the conduit is delivered through the graft to the myocardium. A new lining for the existing vein graft and methods of delivery are also disclosed.

What is claimed is:  
     
         1 . A method for bypassing a coronary artery bypass graft in a patient, comprising: 
 delivering a hollow conduit through the coronary artery bypass graft; and    inserting the conduit in the patient's heart wall at a location distal to a site of attachment of the graft, such that the conduit allows blood to flow from a chamber in the patient's heart directly into the coronary artery.    
     
     
         2 . The method of  claim 1 , wherein the chamber is the left ventricle.  
     
     
         3 . The method of  claim 1 , wherein the conduit is mounted on the distal end of a delivery catheter prior to insertion into the patient.  
     
     
         4 . The method of  claim 1 , further comprising anchoring the conduit into position in the myocardium.  
     
     
         5 . The method of  claim 4 , wherein said anchoring comprises suturing the conduit into position.  
     
     
         6 . The method of  claim 1 , further comprising visualizing the position of the conduit in the myocardium radiographically.  
     
     
         7 . A method for improving the patency of a coronary artery bypass graft having an interior lumen in a patient, comprising: 
 inserting a lining into the lumen of said graft.    
     
     
         8 . The method of  claim 7 , further comprising harvesting a section of a blood vessel from the patient to be used as the lining and inserting the section of blood vessel into the lumen of the graft.  
     
     
         9 . The method of  claim 7 , further comprising mounting the lining over an inflatable balloon located on a distal end of a catheter, and delivering the distal end of the catheter into the lumen of the graft.  
     
     
         10 . The method of  claim 9 , further comprising inflating the balloon to expand the lumen of the graft.  
     
     
         11 . The method of  claim 9 , wherein the catheter is inserted into a lumen in a delivery catheter, and the delivery catheter and the catheter bearing the lining are delivered together into the patient.  
     
     
         12 . The method of  claim 7 , further comprising permanently attaching the lining to the lumen of the graft.  
     
     
         13 . The method of  claim 7 , wherein the method is performed percutaneously.  
     
     
         14 . A method for improving the patency of a coronary artery bypass graft having a lumen in a patient, comprising: 
 harvesting a section of vein from the patient, and    delivering the section of vein to the lumen of the graft, such that the section of vein provides a lining in the lumen of the graft.    
     
     
         15 . The method of  claim 14 , further comprising: 
 mounting the section of vein over an inflatable balloon located at a distal end of a catheter;    delivering the distal end of the catheter to the lumen of the graft;    inflating the balloon to expand the vein section and graft;    deflating the balloon; and    withdrawing the catheter from the patient.    
     
     
         16 . The method of  claim 15 , wherein the catheter is first inserted into a lumen in a delivery catheter, and the delivery catheter and the catheter bearing the vein section are delivered together into the patient.  
     
     
         17 . The method of  claim 14 , further comprising permanently attaching the vein section to the lumen of the graft.  
     
     
         18 . The method of  claim 14 , wherein the section of vein is sized so as to be approximately the same length as the graft.  
     
     
         19 . A device for improving the patency of a coronary artery bypass graft, comprising an inner lining for said graft.  
     
     
         20 . The device of  claim 19 , wherein the lining is formed from a section of blood vessel.  
     
     
         21 . The device of  claim 20 , wherein the section of blood vessel is obtained from a human.  
     
     
         22 . The device of  claim 20 , wherein the blood vessel is a vein.  
     
     
         23 . The device of  claim 19 , wherein the lining includes a one-way valve.  
     
     
         24 . The device of  claim 19 , wherein said lining is sized so as to be approximately the same length as the graft.