Methods and conduits for flowing blood from a heart chamber to a blood vessel

Abstract

Disclosed is a conduit that provides a bypass around an occlusion or stenosis in a coronary artery. The conduit is a tube adapted to be positioned in the heart wall to provide a passage for blood to flow between a heart chamber and a coronary artery, at a site distal to the occlusion or stenosis. The conduit has a section of blood vessel attached to its interior lumen which preferably includes at least one naturally occurring one-way valve positioned therein. The valve prevents the backflow of blood from the coronary artery into the heart chamber.

1 - 34 . (canceled) 
     
     
         35 . An implantable prosthesis, comprising:
 an expandable stent having a first end and a second end forming a continuous, substantially linear conduit therebetween, the conduit configured for passage of blood from a left ventricle to a blood vessel upon implantation of the stent adjacent the left ventricle; and   a tissue valve attached to an interior surface of the stent, the valve configured to permit blood flow from the left ventricle to the blood vessel and to restrict blood flow from the blood vessel to the left ventricle,   wherein the stent comprises a metal or metal alloy; and   wherein at least a portion of the first end of the stent extends into the left ventricle.   
     
     
         36 . The implantable prosthesis of  claim 35 , wherein the blood vessel includes an artery. 
     
     
         37 . The implantable prosthesis of  claim 35 , wherein the artery comprises stenosed tissue. 
     
     
         38 . The implantable prosthesis of  claim 35 , configured to improve a flow of oxygenated blood from the left ventricle through the blood vessel. 
     
     
         39 . The implantable prosthesis of  claim 35 , wherein the stent is self-expandable. 
     
     
         40 . The implantable prosthesis of  claim 35 , wherein the stent is balloon-expandable. 
     
     
         41 . The implantable prosthesis of  claim 35 , wherein the metal or metal alloy comprises stainless steel, nitinol, titanium, titanium alloy, nickel, nickel alloy, or cobalt alloy. 
     
     
         42 . The implantable prosthesis of  claim 35 , wherein the stent comprises at least one attachment mechanism to maintain a position of the stent relative to the left ventricle. 
     
     
         43 . The implantable prosthesis of  claim 42 , wherein the at least one attachment mechanism is configured to inhibit migration of the stent relative to the left ventricle. 
     
     
         44 . The implantable prosthesis of  claim 42 , wherein the at least one attachment mechanism is disposed on a body of the stent. 
     
     
         45 . The implantable prosthesis of  claim 44 , wherein the at least one attachment mechanism is disposed at the first end or the second end. 
     
     
         46 . The implantable prosthesis of  claim 42 , wherein the at least one attachment mechanism includes one or more hooks, barbs, collars, or flanges. 
     
     
         47 . The implantable prosthesis of  claim 46 , wherein the at least one attachment mechanism includes a sealing collar to prevent blood from flowing around an exterior surface of the stent upon implantation. 
     
     
         48 . The implantable prosthesis of  claim 35 , wherein the portion of the stent extending into the left ventricle is flared radially outward to prevent migration of the stent relative to the left ventricle. 
     
     
         49 . The implantable prosthesis of  claim 35 , wherein at least a portion of the second end of the stent extends into the blood vessel. 
     
     
         50 . The implantable prosthesis of  claim 35 , wherein the tissue valve includes tissue from a heart. 
     
     
         51 . The implantable prosthesis of  claim 35 , wherein the tissue valve includes animal tissue. 
     
     
         52 . The implantable prosthesis of  claim 51 , wherein the tissue valve includes animal tissue treated with glutaraldehyde. 
     
     
         53 . The implantable prosthesis of  claim 35 , wherein the stent includes a single integral conduit. 
     
     
         54 . The implantable prosthesis of  claim 35 , wherein the stent includes at least two parts joined to form the conduit. 
     
     
         55 . An implantable prosthesis, comprising:
 an expandable stent having a first end and a second end forming a continuous, substantially linear conduit therebetween, the conduit configured for passage of blood from a left ventricle to a blood vessel upon implantation of the stent adjacent the left ventricle; and   a tissue valve attached to an interior surface of the stent, the valve configured to permit blood flow from the left ventricle to the blood vessel and to restrict blood flow from the blood vessel to the left ventricle,   wherein the stent comprises a metal or metal alloy; and   wherein at least a portion of the stent extends radially outward to maintain a position of the stent relative to the left ventricle.   
     
     
         56 . The implantable prosthesis of  claim 55 , wherein at least a portion of the first end of the stent extends into the left ventricle. 
     
     
         57 . The implantable prosthesis of  claim 55 , wherein two portions of the stent extend radially outward to maintain the position of the stent relative to the left ventricle. 
     
     
         58 . The implantable prosthesis of  claim 55 , wherein the first end is positioned closer to the left ventricle than the second end, and wherein the portion of the stent extending radially outward to maintain the position of the stent relative to the left ventricle includes the first end of the stent. 
     
     
         59 . The implantable prosthesis of  claim 55 , wherein the first end is positioned closer to the left ventricle than the second end, and wherein the portion of the stent extending radially outward to maintain the position of the stent relative to the left ventricle includes the second end of the stent. 
     
     
         60 . The implantable prosthesis of  claim 55 , wherein the first end is positioned closer to the left ventricle than the second end, and wherein the first end of the stent is configured to prevent blood from flowing around an exterior surface of the stent upon implantation. 
     
     
         61 . A method of controlling a flow of blood from a heart to a remainder of a body of the patient, the method comprising:
 introducing a catheter into a left ventricle of the heart, wherein the catheter is coupled to a prosthesis, the prosthesis comprising:
 an expandable stent having a first end and a second end forming a continuous, substantially linear conduit therebetween; and 
 a valve comprising animal tissue attached to an interior surface of the stent, the valve configured to permit blood to flow from the left ventricle through the conduit and to restrict blood flow through the conduit into the left ventricle; 
   positioning the catheter in a passage leading from the left ventricle to an arterial blood-containing vessel; and   releasing the prosthesis from the catheter to implant the prosthesis in the passage wherein, upon implantation, at least a portion of the first end of the stent extends into the left ventricle.   
     
     
         62 . The method of  claim 61 , wherein the arterial blood-containing vessel includes stenosed tissue. 
     
     
         63 . The method of  claim 61 , wherein the stent is self-expandable. 
     
     
         64 . The method of  claim 61 , wherein the stent is balloon-expandable. 
     
     
         65 . The method of  claim 61 , further comprising positioning the prosthesis relative to the left ventricle before releasing the prosthesis from the catheter. 
     
     
         66 . The method of  claim 61 , wherein releasing the prosthesis from the catheter includes withdrawing a sheath of the catheter to allow the stent to expand. 
     
     
         67 . The method of  claim 61 , wherein the patient has aortic insufficiency. 
     
     
         68 . The method of  claim 61 , wherein the method increases blood flow to the remainder of the body of the patient via the arterial blood-containing vessel.