Abstract: Methods and apparatus for delivering and installing a new length of tubing between two sections of a patient's existing body organ tubing and at least partly outside of that existing structure. For example, the new length of tubing may be for the purpose of providing the patient with a coronary bypass. The new tubing may be an artificial graft, a natural graft (harvested elsewhere from the patient), or both. The new tubing is delivered to and installed at the operative site primarily by working through the patient's existing tubular body organ structure. This avoids the need for any significant surgery on the patient.

Abstract: A two-piece graft connector having a tubular band section with its proximal end configured to attach to a tubular graft and retention loops extending from its distal end, and a tubular anchor structure configured to be placed in the patient's tubular body tissue structure is provided. In a preferred embodiment, the proximal end of the tubular band section is attached to a tubular graft. The retention loops extend from the distal end of the tubular band section of the connector, through an aperture in the side wall of a patient's tubular body tissue structure. The tubular anchor structure is placed in the patient's tubular body tissue structure, within the retention loops. Then, the tubular anchor structure is circumferentially expanded, firmly retaining the retention loops, and forming a seal between the tubular band section and the side wall of the tubular body tissue structure. Alternatively, the retention loops may be replaced by retention fingers, which form arcs.

Abstract: A body tissue graft for use in a patient includes a frame structure made of a first elastic material, a covering of a second elastic material on the frame structure, the covering substantially filling openings in the frame structure, and a connector connected to the frame structure. Projections are secured to the connector structure. The projections facilitate attachment of the tubular graft in a patient by securing the graft to the body tissue with which the graft is employed. The connector selectively circumferentially expands and the projections selectively circumferentially expand. This may be done using an inflatable balloon to circumferentially expand the projections. A restraining member may be provided to restrain the projections in a cone shape so that an end of the graft may be used to open an aperture through a side wall of existing body organ tubing and a portion of the projections may enter the aperture.

Abstract: A catheter with at least one integrated lumen and methods of its manufacture and use are provided. A method of manufacture includes: (1) covering a primary mandrel with a first layer, (2) disposing a second layer on the first layer, wherein the second layer has at least one removable secondary mandrel substantially embedded therein, (3) fusing the first layer to the second layer, (4) removing the secondary mandrel from the second layer to form a secondary lumen, and (5) removing the primary mandrel from the first layer to form a primary lumen. The method may further include forming an inflatable balloon at the surface of the second layer where the secondary lumen forms an opening. Also, auxiliary apparatus, such as snare instruments and bundles of optical fibers, may be inserted through the secondary lumen before or during use of the catheter.

Abstract: Connectors are provided for attaching flexible tubular grafts to the body organ tubing of a patient at oblique angles. The connector structures may be formed from two elongated members connected by a series of struts. Wire hooks welded to the connector may be used to engage the graft and the body organ tubing when the connector is used to attach the graft to the body organ tubing. The struts are bendable so that the elongated members can be compressed toward each other when it is desired to install a graft by placing the graft and the connector in a delivery tube. When the connector and graft are released from the delivery tube at the installation site, at least the open end of the connector adjacent to the body organ tubing has an oval shape for insertion into and attachment to an oval aperture in the body organ tubing.

Abstract: Methods and apparatus for delivering and installing a new Length of tubing between two sections of a patient's existing body organ tubing and at least partly outside of that existing structure. For example, the new length of tubing may be for the purpose of providing the patient with a coronary bypass. The new tubing may be an artificial graft, a natural graft (harvested elsewhere from the patient), or both. The new tubing is delivered to and installed at the operative site primarily by working through the patient's existing tubular body organ structure. This avoids the need for any significant surgery on the patient. The artificial grafts may have shapes other than tubular. Certain procedural and apparatus aspects of the invention have uses other than in connection with grafting in general or tubular grafting in particular.

Abstract: Connectors are provided for making connections between tubular conduits in medical procedures such as those involving treatment of a patient's circulatory system. The connectors are variously configured for making end-to-side or end-to-end connections of tubular conduits. One of the tubular conduits may be a graft conduit, which can be artificial conduit, natural conduit, or a combination of both. The connectors for making end-to-side connections can be generally T-shaped or L-shaped. Various portions of the connectors can attach to the inside or outside of the associated conduit, depending on the connector configuration that is selected.

Abstract: A tubular artificial graft for attachment to a patient's tubular body tissue has an initially radially relatively small connector structure adjacent each of its ends. The initial relatively small size of each connector structure facilitates insertion of that portion of the graft into the body tissue to which that connector structure is to make a connection. After a connector structure is properly positioned relative to the body tissue, the connector structure is radially enlarged to connect the graft to the body tissue. The connection is preferably both a mechanical and a fluid-tight connection.

Abstract: Methods and apparatus are provided for attaching grafts of tubing between sites in a patient's body via the patient's existing arteries and veins. Grafts may be held in place during graft delivery using a partially inflated proximal balloon and a partially inflated distal balloon which frictionally engage axially spaced portions of the graft (e.g., pronged attachment rings that pierce the graft adjacent its ends). After aligning the distal end of the graft with the distal attachment site, the distal balloon may be further inflated to help attach the distal end of the graft to the distal attachment site (e.g., by driving the prongs of the distal attachment ring into the distal attachment site). The proximal balloon may then be inflated to attach the proximal end of the graft to the proximal attachment site. The insertion instrument allows the distance between the distal and proximal balloons to be adjusted, thereby accommodating grafts of various lengths.

Abstract: A bodily fluid filter has an elastic tubular framework and a plurality of filter filaments extending from the surface of the tubular framework in toward the longitudinal axis to trap objects to be filtered. The elastic framework is deformable to facilitate deployment and removal, but resumes its operational shape once deployed. The filter can be installed intralumenally and/or remotely if desired.