Attachment Method

Abstract

Preparing the heart for connection with a ventricular assist device (VAD) can include attaching an attachment ring to a ventricular apex of the heart. The attachment ring optionally includes a seal or a valve to allow the procedure to be performed with or without a heart-lung bypass. A valve can be temporarily attached to the attachment ring. Tissue is removed from the ventricular apex through the attachment ring to form a hole through which an inflow conduit of the VAD can be inserted. A slit can first be made in the ventricular apex to facilitate removal of the tissue. A clamp can be closed around the attachment ring to secure the inflow conduit.

1 . A method of preparing a heart for connection with a ventricular assist device, the method comprising:
 attaching an attachment ring to a ventricular apex of the heart, the attachment ring including a seal or a valve and configured to receive an inflow conduit;   removing tissue, through the attachment ring, from the heart to form a hole in the ventricular apex; and   closing a clamp around the attachment ring to secure an inflow conduit, inserted through the attachment ring, against the attachment ring, wherein the inflow conduit is configured to attach to or form a part of the ventricular assist device.   
     
     
         2 . The method of  claim 1 , further comprising, before the closing of the clamp, inserting the inflow conduit through the attachment ring and the hole in the ventricular apex. 
     
     
         3 . The method of  claim 1 , wherein the removing of the tissue from the heart includes inserting a coring knife into the attachment ring. 
     
     
         4 . The method of  claim 1 , further comprising, before the removing of the tissue, making a slit through the ventricular apex, wherein the making of the slit includes inserting a slitting tool into the attachment ring. 
     
     
         5 . The method of  claim 4 , wherein the slitting tool is aligned relative to the attachment ring by twisting the slitting tool until a feature on the slitting tool aligns with or is received within an alignment feature, the alignment feature being part of the attachment ring or a valvular structure connected to the attachment ring. 
     
     
         6 . The method of  claim 1 , wherein a valvular structure is either an integral part of or is removably attached to the attachment ring. 
     
     
         7 . A method of preparing a heart for connection with a ventricular assist device, the method comprising:
 attaching an attachment ring to a ventricular apex of the heart, the attachment ring including a valve or a seal;   forming a slit in the ventricular apex, the forming of the slit performed with use of a slitting tool aligned relative to and passed through the attachment ring; and   removing tissue around the slit to form a hole in the ventricular apex, the removing of the tissue performed through the attachment ring.   
     
     
         8 . The method of  claim 7 , wherein the slitting tool is aligned relative to the attachment ring by twisting the slitting tool until a feature on the slitting tool aligns with or is received within an alignment feature, the alignment feature being part of the attachment ring or a valvular structure connected to the attachment ring. 
     
     
         9 . The method of  claim 8 , wherein the feature on the slitting tool is a protrusion on a housing of the slitting tool, and the alignment feature is an indentation configured to receive the protrusion. 
     
     
         10 . The method of  claim 7 , further comprising:
 inserting an inflow conduit through the attachment ring and the hole in the ventricular apex; and   closing a clamp around the attachment ring to secure the inflow conduit to the attachment ring, wherein the inflow conduit is attached to or forms a part of the ventricular assist device.   
     
     
         11 . The method of  claim 7 , wherein the removing of the tissue from the heart includes inserting a coring knife into the attachment ring. 
     
     
         12 . The method of  claim 11 , wherein the inserting of the coring knife includes forming a substantially fluid-tight seal between the attachment ring and an exterior surface of the coring knife. 
     
     
         13 . The method of  claim 11 , wherein the removing of the tissue from the heart includes aligning a feature on an external surface of the coring knife with an alignment feature, the alignment feature being part of the attachment ring or a valvular structure connected to the attachment ring. 
     
     
         14 . The method of  claim 13 , wherein the feature on the external surface of the corning knife is a protrusion, and the alignment feature is an indentation configured to receive the protrusion. 
     
     
         15 . A method of preparing a heart for connection with a ventricular assist device, the method comprising:
 attaching an attachment ring to a left ventricular apex of the heart; and   attaching a valvular structure to the attachment ring using a clamp device, wherein a valvular structure has a closed position, and when in the closed position blood from an aperture in the left ventricular apex is substantially prevented from flowing out of the valvular structure.   
     
     
         16 . The method of  claim 15 , further comprising closing a ring clamp around the attachment ring to secure an inflow conduit to the attachment ring, wherein the inflow conduit is attached to or forms a part of the ventricular assist device. 
     
     
         17 . The method of  claim 15 , further comprising removing tissue from the heart to form a hole in the left ventricular apex, wherein the removing of the tissue includes:
 inserting a coring knife into the valvular structure and the attachment ring; and   pulling the coring knife, with the removed tissue, out of the valvular structure and the attachment ring, wherein the valvular structure moves to the closed position after the coring knife is pulled out.   
     
     
         18 . The method of  claim 17 , wherein the removing of the tissue includes aligning a feature on an external surface of the coring knife with an alignment feature, the alignment feature being part of the attachment ring or the valvular structure. 
     
     
         19 . The method of  claim 17 , further comprising, before the removing of the tissue, making a slit through the left ventricular apex, wherein the making of the slit includes:
 inserting a slitting tool into the valvular structure and the attachment ring to make the slit; and   pulling the slitting tool out of the valvular structure and the attachment ring after the slit is made, wherein the valvular structure moves to the closed position after the slitting tool is pulled out.   
     
     
         20 . The method of  claim 19 , wherein the making of the slit includes twisting the slitting tool until a feature on the slitting tool aligns with or is received within an alignment feature, the alignment feature being part of the attachment ring or the valvular structure. 
     
     
         21 . The method of  claim 15 , wherein the valvular structure includes a housing first portion and a housing second portion that are configured to be selectively locked together and moved apart from each other, the first housing portion connected to the second housing portion by a slide member configured to lock the housing first portion and the housing second portion together.