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 installed at the operative site primarily by providing at least one graft location with instrumentation inserted through the patient's existing tubular body organ structure. Assistance in installing the new tubing may be provided by minimally invasive surgical access openings in the patient's chest. The tubing may be delivered through the patient's existing tubular body structure or, alternatively, through the surgical access openings.

Abstract: A medical graft assembly for connecting an end of a tubular graft conduit to a side wall of a patient's existing tubular body conduit via an aperture in the side wall thereof with a connector. The connector has a first plurality of fingers configured to engage an interior surface of the side wall of the existing conduit. A second plurality of fingers is configured to engage an exterior surface of the side wall of the existing conduit. A third plurality of fingers is received in an interior lumen of the graft conduit, and a fourth plurality of fingers is configured to pierce the graft conduit. The connector is radially deformable between a first size and a second size.

Abstract: A bypass graft conduit is installed in the circulatory system of a patient using apparatus which facilitates performing most or all of the necessary work intraluminally (i.e., via lumens of the patient's circulatory system). A guide structure such as a wire is installed in the patient via circulatory system lumens so that a portion of the guide structure extends along the desired path of the bypass conduit, which bypass conduit path is outside the circulatory system as it exists prior to installation of the bypass graft. The bypass graft is then introduced into the patient along the guide structure and connected at each of its ends to the circulatory system using connectors that form fluid-tight annular openings from the bypass graft lumen into the adjacent circulatory system lumens. The guide structure is then pulled out of the patient.

Abstract: Connector structures are provided for attaching elongated flexible tubular grafts to the body organ tubing of a patient. The connector structures are formed from wire. A first set of connector wires may be disposed around the periphery of one end of an elongated flexible tubular graft. A second set can be disposed around the periphery of the elongated flexible tubular graft spaced sufficiently from the first set of connector wires to define a gap. The portion of body organ tubing to which the elongated flexible tubular graft is to be attached is received in the gap and engaged by the first and second sets of connector wires. The wires may be formed in the shape of loops. If desired, hooks may be provided on the ends of the wires. The wires may be curved to accommodate attachment of the graft to tubular body organ tubing. The wires may also be formed in annular shapes. The connector structures may be formed as stand-alone ring-shaped connectors.

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 connector for use in providing an anastomotic connection between two tubular body fluid conduits in a patient. The connector is preferably a single, integral, plastically deformable structure that can be cut from a tube. The connector has axial spaced portions that include members that are radially outwardly deflectable from other portions of the connector. The connector is annularly enlargeable so that it can be initially delivered and installed in the patient in a relatively small annular size and then annularly enlarged to provide the completed anastomosis. The radially outwardly deflected members of the first and second portions respectively engage the two body fluid conduits connected at the anastomosis and hold those two conduits together in fluid-tight engagement. Apparatus for use in delivering and deploying a connector is also disclosed.

Abstract: A catheter-based system for accessing specific body cavities percutaneously and minimizing patient trauma is provided. In the preferred embodiment, in order to create an aperture at an access site in a patient's existing tubular body organ structure, a delivery sheath is passed axially along the interior of a portion of the existing tubular body organ structure to place a distal end of the delivery sheath near the access site. A centering wire is passed axially along the interior of the delivery sheath, piercing through from inside to outside of the patient's existing tubular body organ structure at the access site by causing an end portion of the centering wire to emerge from the distal end of the delivery sheath. A cutting catheter is passed substantially coaxially over the centering wire and axially along the interior of the delivery sheath.

Abstract: A medical graft connector or plug is made, for example, by cutting end portions of a tube of highly elastic material axially at numerous locations spaced circumferentially around the tube to produce a plurality of fingers which extend axially from each end of an uncut medial portion of the tube. The fingers are deflected radially outwardly from the medial portion and set in that condition. For a graft connector, the medial portion is coaxially connected to an end portion of a tubular graft. The connector is then installed through an aperture in the side wall of a patient's tubular body conduit, for example, by using a delivery tube in which the fingers are elastically deflected back to approximately their initial positions. When the delivery conduit is withdrawn from the connector, the fingers spring out to engage the inner and outer surfaces of the body conduit wall.

Abstract: A connector for use in providing an anastomotic connection between two tubular body fluid conduits in a patient. The connector is preferably a single, integral, plastically deformable structure that can be cut from a tube. The connector has axial spaced portions that include members that are radially outwardly deflectable from other portions of the connector. The connector is annularly enlargeable so that it can be initially delivered and installed in the patient in a relatively small annular size and then annularly enlarged to provide the completed anastomosis. The radially outwardly deflected members of the first and second portions respectively engage the two body fluid conduits connected at the anastomosis and hold those two conduits together in fluid-tight engagement. Apparatus for use in delivering and deploying a connector is also disclosed.

Abstract: A medical graft connector or plug is made, for example, by cutting end portions of a tube of highly elastic material axially at numerous locations spaced circumferentially around the tube to produce a plurality of fingers which extend axially from each end of an uncut medial portion of the tube. The fingers are deflected radially outwardly from the medial portion and set in that condition. For a graft connector, the medial portion is coaxially connected to an end portion of a tubular graft. The connector is then installed through an aperture in the side wall of a patient's tubular body conduit, for example, by using a delivery tube in which the fingers are elastically deflected back to approximately their initial positions. When the delivery conduit is withdrawn from the connector, the fingers spring out to engage the inner and outer surfaces of the body conduit wall.

Abstract: A distensible artificial tubular graft structure is provided that has a compliance gradient. The graft may be used to repair a patient's body organ tubing. For example, the graft may be used to replace or supplement portions of a patient's vascular system. The ends of the graft structure may have compliances that are matched to the compliances of the body organ tubing to which they are attached. Distensible compliance-matched connector structures may be used to attach the graft to the body organ tubing.

Abstract: A connector for use in providing an anastomotic connection between two tubular body fluid conduits in a patient. The connector is preferably a single, integral, plastically deformable structure that can be cut from a tube. The connector has axial spaced portions that include members that are radially outwardly deflectable from other portions of the connector. The connector is annularly enlargeable so that it can be initially delivered and installed in the patient in a relatively small annular size and then annularly enlarged to provide the completed anastomosis. The radially outwardly deflected members of the first and second portions respectively engage the two body fluid conduits connected at the anastomosis and hold those two conduits together in fluid-tight engagement. Apparatus for use in delivering and deploying a connector is also disclosed.

Abstract: A distensible artificial tubular graft structure is provided that has a compliance gradient. The graft may be used to repair a patient's body organ tubing. For example, the graft may be used to replace or supplement portions of a patient's vascular system. The ends of the graft structure may have compliances that are matched to the compliances of the body organ tubing to which they are attached. Distensible compliance-matched connector structures may be used to attach the graft to the body organ tubing.

Abstract: A connector for use in providing an anastomotic connection between two tubular body fluid conduits in a patient. The connector is preferably a single, integral, plastically deformable structure that can be cut from a tube. The connector has axial spaced portions that include members that are radially outwardly deflectable from other portions of the connector. The connector is annularly enlargeable so that it can be initially delivered and installed in the patient in a relatively small annular size and then annularly enlarged to provide the completed anastomosis. The radially outwardly deflected members of the first and second portions respectively engage the two body fluid conduits connected at the anastomosis and hold those two conduits together in fluid-tight engagement. Apparatus for use in delivering and deploying a connector is also disclosed.

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 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: To facilitate subsequent location of a point along a patient's tubular body structure (e.g., a circulatory system vessel), a marker structure is inserted into and along the lumen of that tubular body structure. At the desired point along the lumen, a distal portion of the marker structure is made to pass out through a side wall of the tubular body structure so that it projects from that side wall and visibly and/or radiologically marks the desired point along the tubular body structure. The marker structure may also be used as an anchor for other instrumentation brought up to the outside of the tubular body structure (e.g., for use in further treatment of the tubular body structure).

Abstract: A graft for use in vascular anastomosis is provided. The graft includes a cylindrical metal braided frame and suture retention structures at the ends of the braided frame which provide suture sites for anastomosis.

Abstract: A micro-catheter including an inner primary liner and a plurality of concatenated tubes is provided. The primary liner extends substantially from the proximal end to the distal end of the catheter. Each of the tubes has a respective inner surface that is fused to the outer surface of the primary liner. For each and every pair of tubes, the outer diameter of the more proximally located tube is equal to or greater than the outer diameter of the more distally located tube. Each of the tubes may have different physical properties and dimensions for making customized micro-catheter profiles.

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.