Abstract: Left ventricular conduits and related methods are disclosed for achieving bypass of a partially or completely occluded coronary artery. More broadly, conduits for allowing communication of bodily fluids from one portion of a patient's body to another and related methods are disclosed, including conduits for forming a blood flow path from a chamber of the heart to a vessel or from one vessel to another. In other embodiments, the conduits achieve a coronary artery bypass by allowing blood communication between the left ventricle and the coronary artery or between a proximal portion of the coronary artery and a distal portion of the coronary artery. The conduits may be placed completely through the heart wall or extend only partially therein. Conduits may take on a variety of configurations for allowing the control of blood flow therethrough, including curved or tapered shapes.

Abstract: A method for revascularizing a coronary vessel with a conduit through the heart wall having a diameter transition in the myocardial leg, wherein blood flow is in the direction of transition from larger to smaller diameter. A method for revascularizing a coronary vessel using an implant with a myocardial leg having a maximum cross-sectional area proximate a first end, and inserting the first end through the myocardium into a heart chamber so that the implant directs blood flow into the coronary vessel. A transmyocardial implant with a myocardial leg including point of minimum diameter and a first end with a larger diameter, and a vessel leg in fluid communication with the myocardial leg.

Abstract: Conduits are provided to direct blood flow from the left ventricle to a coronary artery at a location distal to a blockage in the coronary artery. Threaded and nonthreaded conduits are delivered using a guidewire delivered through the posterior and anterior walls of a coronary artery and into the heart wall. A dilator may be provided over the guidewire into the heart wall, and the conduit delivered over the dilator. An introducer sleeve may be provided over the dilator into the heart wall, the dilator removed, and the conduit delivered through the introducer sleeve. A hollow needle also may be inserted into the posterior and anterior walls of the coronary artery prior to inserting the guidewire. A depth measuring tool may determine the appropriate length of the conduit prior to delivery.

Abstract: A method for revascularizing a coronary vessel with a conduit through the heart wall having a diameter transition in the myocardial leg, wherein blood flow is in the direction of transition from larger to smaller diameter. A method for revascularizing a coronary vessel using an implant with a myocardial leg having a maximum cross-sectional area proximate a first end, and inserting the first end through the myocardium into a heart chamber so that the implant directs blood flow into the coronary vessel. A transmyocardial implant with a myocardial leg including point of minimum diameter and a first end with a larger diameter, and a vessel leg in fluid communication with the myocardial leg.

Abstract: Described herein are various methods and apparatuses for delivering stents or conduits and other devices into the myocardium of a patient. One preferred stent delivery system provides access to the insertion site in the myocardium by advancing a delivery catheter through a blockage in a coronary artery, or around the blockage through a coronary vein or through a channel or tunnel formed around the blockage. In one embodiment, once the distal end of the delivery catheter is adjacent the myocardium, an angled bend is created in the catheter by actuating expandable steering guides mounted to the catheter which cooperate with the walls of the blood vessel to cause the catheter to turn. Then, a guidewire is advanced through the delivery catheter and into the myocardium. In another embodiment, a tip-deflecting pull wire extends from the distal end of the delivery catheter which may be actuated to turn towards and then inserted into the myocardium.

Abstract: Improved methods of treatment of diseased or occluded vascular grafts in patients having undergone coronary artery bypass or other bypass surgery are disclosed. Deployment of a conduit in the myocardium at a site distal to the site of attachment of the coronary artery bypass graft allows oxygenated blood to flow from a chamber in the heart directly into the coronary artery, bypassing blockages in the coronary artery and the graft originally used to bypass the coronary artery. To ensure proper positioning, the conduit is delivered through the graft to the myocardium. A new lining for the existing vein graft and methods of delivery are also disclosed.

Abstract: Disclosed is a conduit that provides a bypass around a stenosis or occlusion in a coronary artery. The conduit is adapted to be positioned in the myocardium to provide a passage for blood to flow from a heart chamber to a coronary artery, at a site distal to the blockage or stenosis in the coronary artery. The conduit has a one-way valve positioned therein to prevent the backflow of blood from the coronary artery into the heart chamber.

Abstract: Described herein is a catheter system for delivering an L-shaped conduit into the body of a patient between the left ventricle and coronary artery. A shunt preferably made of semirigid material is inserted into the lumen of a delivery catheter. The delivery catheter is advanced within the patient until its distal end is located adjacent to the desired insertion site, which is preferably the junction between a coronary artery and passageway formed in the myocardium between the left ventricle and coronary artery. A proximal section of the shunt is first advanced out of the delivery catheter into the myocardial passageway. A distal section of the shunt is advanced into the coronary artery, preferably by advancing the distal section of the shunt into the myocardial passageway and then. pulling the distal section back into the coronary artery, or by pushing the distal section of the shunt in a folded configuration out of the delivery catheter into the coronary artery.

Abstract: Disclosed is a conduit that provides a bypass around a stenosis or occlusion in a coronary artery. The conduit is adapted to be positioned in the myocardium to provide a passage for blood to flow from a heart chamber to a coronary artery, at a site distal to the blockage or stenosis in the coronary artery. The conduit has a one-way valve positioned therein to prevent the backflow of blood from the coronary artery into the heart chamber.

Abstract: A bypass conduit and related methods include implanting a bypass in the heart between a heart chamber and an at least partially occluded artery to directly flow blood from the chamber to the artery. The bypass conduit is configured to have a higher resistance to blood flow in a first direction than in a second direction without any active flow control mechanism. The bypass conduit may have a first end defining a first opening and a second end defining a second opening and a wall extending between the two ends that defines a lumen extending between the two openings. The ends and the wall of the conduit are configured to have a higher resistance to blood flow in a first direction than in a second direction.

Abstract: Conduits are provided to direct blood flow from the left ventricle to a coronary artery at a location distal to a blockage in the coronary artery. Threaded and nonthreaded conduits are delivered using a guidewire delivered through the posterior and anterior walls of a coronary artery and into the heart wall. A dilator may be provided over the guidewire into the heart wall, and the conduit delivered over the dilator. An introducer sleeve may be provided over the dilator into the heart wall, the dilator removed, and the conduit delivered through the introducer sleeve. A hollow needle also may be inserted into the posterior and anterior walls of the coronary artery prior to inserting the guidewire. A depth measuring tool may determine the appropriate length of the conduit prior to delivery.

Abstract: A conduit is provided to provide a bypass around a blockage in the coronary artery. The conduit is adapted to be positioned in the myocardium or heart wall to provide a passage for blood to flow between a chamber of the heart such as the left ventricle and the coronary artery, distal to the blockage. The stent is self-expanding or uses a balloon to expand the stent in the heart wall. Various attachment means are provided to anchor the stent and prevent its migration.

Abstract: A bypass conduit and related methods include implanting a bypass in the heart between a heart chamber and an at least partially occluded artery to directly flow blood from the chamber to the artery. The bypass conduit is configured to have a higher resistance to blood flow in a first direction than in a second direction without any active flow control mechanism. The bypass conduit may have a first end defining a first opening and a second end defining a second opening and a wall extending between the two ends that defines a lumen extending between the two openings. The ends and the wall of the conduit are configured to have a higher resistance to blood flow in a first direction than in a second direction.

Abstract: Improved methods of treatment of diseased or occluded vascular grafts in patients having undergone coronary artery bypass or other bypass surgery are disclosed. Deployment of a conduit in the myocardium at a site distal to the site of attachment of the coronary artery bypass graft allows oxygenated blood to flow from a chamber in the heart directly into the coronary artery, bypassing blockages in the coronary artery and the graft originally used to bypass the coronary artery. To ensure proper positioning, the conduit is delivered through the graft to the myocardium. A new lining for the existing vein graft and methods of delivery are also disclosed.

Abstract: Described herein is a catheter system for delivering an L-shaped conduit into the body of a patient between the left ventricle and coronary artery. A shunt preferably made of semirigid material is inserted into the lumen of a delivery catheter. The delivery catheter is advanced within the patient until its distal end is located adjacent to the desired insertion site, which is preferably the junction between a coronary artery and passageway formed in the myocardium between the left ventricle and coronary artery. A proximal section of the shunt is first advanced out of the delivery catheter into the myocardial passageway. A distal section of the shunt is advanced into the coronary artery, preferably by advancing the distal section of the shunt into the myocardial passageway and then pulling the distal section back into the coronary artery, or by pushing the distal section of the shunt in a folded configuration out of the delivery catheter into the coronary artery.

Abstract: A conduit is provided to provide a bypass around a blockage in the coronary artery. The conduit is adapted to be positioned in the myocardium or heart wall to provide a passage for blood to flow between a chamber of the heart such as the left ventricle and the coronary artery, distal to the blockage. The stent is self-expanding or uses a balloon to expand the stent in the heart wall. Various attachment means are provided to anchor the stent and prevent its migration.

Abstract: Left ventricular conduits and related methods are disclosed for achieving bypass of a partially or completely occluded coronary artery. More broadly, conduits for allowing communication of bodily fluids from one portion of a patient's body to another and related methods are disclosed, including conduits for forming a blood flow path from a chamber of the heart to a vessel or from one vessel to another. In other embodiments, the conduits achieve a coronary artery bypass by allowing blood communication between the left ventricle and the coronary artery or between a proximal portion of the coronary artery and a distal portion of the coronary artery. The conduits may be placed completely through the heart wall or extend only partially therein. Conduits may take on a variety of configurations for allowing the control of blood flow therethrough, including curved or tapered shapes.

Abstract: Left ventricular conduits and related methods are disclosed for achieving bypass of a partially or completely occluded coronary artery. More broadly, conduits for allowing communication of bodily fluids from one portion of a patient's body to another and related methods are disclosed, including conduits for forming a blood flow path from a chamber of the heart to a vessel or from one vessel to another. In other embodiments, the conduits achieve a coronary artery bypass by allowing blood communication between the left ventricle and the coronary artery or between a proximal portion of the coronary artery and a distal portion of the coronary artery. The conduits may be placed completely through the heart wall or extend only partially therein. Conduits may take on a variety of configurations for allowing the control of blood flow therethrough, including curved or tapered shapes.

Abstract: Described herein are various methods and apparatuses for delivering stents and other devices into the myocardium of a patient. One preferred stent delivery system provides access to the insertion site in the myocardium by advancing a delivery catheter through a blockage in a coronary artery, or around the blockage through a coronary vein or through a channel or tunnel formed around the blockage. In one embodiment, once the distal end of the delivery catheter is adjacent the myocardium, an angled bend is created in the catheter by actuating expandable steering guides mounted to the catheter which cooperate with the walls of the blood vessel to cause the catheter to turn. Then, a guidewire is advanced through the delivery catheter and into the myocardium. In another embodiment, a tip-deflecting pull wire extends from the distal end of the delivery catheter which may be actuated to turn towards and then inserted into the myocardium.

Abstract: A conduit is provided to provide a bypass around a blockage in the coronary artery. The conduit is adapted to be positioned in the myocardium or heart wall to provide a passage for blood to flow between a chamber of the heart such as the left ventricle and the coronary artery, distal to the blockage. The stent is self-expanding or uses a balloon to expand the stent in the heart wall. Various attachment means are provided to anchor the stent and prevent its migration. In one embodiment, a conduit is provided having a distal top which is more preferably a ball top, wire top, flare top or flip-down top. These top configurations anchor the shunt at one end in the coronary artery.