Apparatus and method for connecting a conduit to a hollow organ

Abstract

An apparatus and method for connecting a first conduit to the heart without cardiopulmonary bypass. The first conduit may be attached to a second conduit having a prosthetic device interposed. The second conduit may then be connected to the aorta. The prosthetic device may be a prosthetic valve (or pump). The apparatus includes an implantable connector with first conduit component, a coring component, a retractor expansion component slidably coupled to the coring component, and a pushing component. The retractor expansion component seats against and separates the inside wall of the left ventricle so that the coring component cuts cleanly through the myocardium, forming a tissue plug. By remaining seated against the inside wall, the retractor expansion component follows the tissue plug into the coring component. The surgeon applies force and rotary motion to the pushing component sufficient to cut the tissue plug and implant the prosthetic component.

1 - 96 . (canceled) 
     
     
         97 . A method for using an applicator to form a hole in a wall of a hollow organ and insert a connector conduit into the hole, said applicator comprising a hole forming element having a cutting element on a distal end thereof and being coupled to the connector conduit with a distal end of said connector conduit being adjacent said cutting element, a retractor element having an expansion element, and sequencing means for coordinating the relative movement of said retractor element with respect to said hole forming element, said method comprising:
 a) inserting a distal end of the retractor element through a slit formed in the wall of the organ while the retractor element is locked in a fully extended position relative to the hole forming element and the expansion element is in an unexpanded state   b) expanding the expansion element to a fully expanded state and moving the expansion element toward the hole forming element;   c) forming the whole with the cutting element and inserting the connector conduit into the hole by manipulating the hole forming element while the expansion element presses the tissue toward the cutting element;   d) decreasing the size of the expansion element to a partially expanded state and moving the expansion element to be at least partially disposed in the hole forming element; and   e) decoupling the applicator from the connector conduit to remove the applicator while the connector conduit remains in the hole.   
     
     
         98 . The method of  claim 97 , wherein said cutting element is a cutting blade formed on a distal portion of said hole forming element and wherein said forming step comprises pressing a cutting blade into the tissue and applying torsional force to the cutting blade. 
     
     
         99 . The method of  claim 97 , further comprising occluding blood flow through the applicator to create substantial hemostasis throughout a procedure for implanting the connector conduit within the organ wall while the organ remains at substantially normal physiological pressures. 
     
     
         100 . The method of  claim 97 , wherein said hole forming element and said connector conduit are fixed relative to one another said forming step. 
     
     
         101 . The method of  claim 97 , wherein said expansion element is a balloon. 
     
     
         102 . The method of  claim 101 , wherein said balloon is in the shape of a circular toroid. 
     
     
         103 . The method of  claim 97 , wherein said expansion element is an expandable sponge. 
     
     
         104 . The method of  claim 97 , wherein said expansion element is an umbrella mechanism. 
     
     
         105 . The method of  claim 97 , wherein said sequencing means comprises a cam mechanism. 
     
     
         106 . The method of  claim 97 , wherein said sequencing means comprises a gear mechanism. 
     
     
         108 . The method of  claim 97 , wherein said sequencing means comprises at least one servo mechanism operatively coupled to the positioning means and a controller operatively coupled to said at least one servo mechanism. 
     
     
         109 . The method of  claim 108 , wherein said controller mechanism comprises a microprocessor based device. 
     
     
         110 . The method of  claim 109 , further comprising a button operatively coupled to said sequencing means for activating said sequencing means upon depression of the button to thereby accomplish steps of a procedure for implanting the connector conduit within the organ wall.