Abstract: An insertion tool facilitates insertion of a vessel end of a transmyocardial implant into a coronary vessel. The insertion tool has a hollow sheath and mating dilator. The sheath has an external dimension sized for the sheath to be received within a lumen of an expanded size of the coronary vessel. A tapered portion extends from the dilator coaxially with an axis of the sheath. The tapered portion narrows from a cylindrical body portion to a leading tip of the tapered portion. The leading tip of the tapered portion is sized to be received within the lumen of a constricted size of the coronary vessel. The tapered portion and body portion are retractable from the sheath. After such retraction, the leading end of the implant is placed within the sheath. The sheath is split at a part-line such that the sheath can be pulled rearwardly from the vessel without disrupting the coronary vessel following placement of the implant within the sheath.

Abstract: A blood flow path is formed from a heart chamber to a coronary vessel on an exterior surface of a heart wall. A hollow conduit has a vessel portion and a myocardial portion. The vessel portion has an open leading end sized to be inserted into the coronary vessel. The myocardial portion has an open leading end and the myocardium portion is sized to extend through a thickness of the heart wall. The myocardial portion is placed in the heart wall with the open leading end of the myocardial portion protruding into the heart chamber. Blood flow through the conduit from the heart chamber is at least partially blocked. The leading end of the vessel portion is placed in the coronary vessel. Blood flow through the conduit from the heart chamber and into the vessel is then opened.

Abstract: A blood flow path is formed from a heart chamber to a coronary vessel on an exterior surface of a heart wall. A hollow conduit has a vessel portion and a myocardial portion. The vessel portion has an open leading end sized to be inserted into the coronary vessel. The myocardial portion has an open leading end and the myocardium portion is sized to extend through a thickness of the heart wall. The myocardial portion is placed in the heart wall with the open leading end of the myocardial portion protruding into the heart chamber. Blood flow through the conduit from the heart chamber is at least partially blocked. The leading end of the vessel portion is placed in the coronary vessel. Blood flow through the conduit from the heart chamber and into the vessel is then opened.

Abstract: A device for engaging a heart valve prosthesis during implantation includes a hanger and a holder. The holder includes a distal engaging surface adapted for engaging the heart valve prosthesis. The hanger is used to suspend the prosthesis in packaging and may be used to manipulate the prosthesis during implantation.

Abstract: A transmyocardial implant includes a hollow conduit having a first portion and a second portion. The first portion is received within the lumen. The first portion has an axial dimension aligned with an axis of the vessel. The second portion is sized to extend from the vessel through the myocardium into the heart chamber. The conduit has open first and second ends on axial ends of respective ones of the first and second portions to define a blood flow pathway within an interior of the conduit between the first and second ends. A collar surrounds an exterior of the artery overlying the first portion at the first open end.

Abstract: An insertion tool facilitates insertion of a vessel end of a transmyocardial implant into a coronary vessel. The insertion tool has a hollow sheath and mating dilator. The sheath has an external dimension sized for the sheath to be received within a lumen of an expanded size of the coronary vessel. A tapered portion extends from the dilator coaxially with an axis of the sheath. The tapered portion narrows from a cylindrical body portion to a leading tip of the tapered portion. The leading tip of the tapered portion is sized to be received within the lumen of a constricted size of the coronary vessel. The tapered portion and body portion are retractable from the sheath. After such retraction, the leading end of the implant is placed within the sheath. The sheath is split at a part-line such that the sheath can be pulled rearwardly from the vessel without disrupting the coronary vessel following placement of the implant within the sheath.

Abstract: A blood flow path is formed from a heart chamber to a coronary vessel. The coronary vessel has a predetermined diameter. A hollow conduit is selected having a vessel portion and a myocardial portion. The vessel portion has an open leading end sized to be inserted into the coronary vessel. The myocardial portion has an open leading end and the myocardium portion is sized to extend through a thickness of the heart wall. The conduit is selected with the vessel portion sized to be inserted within the vessel without dilating the vessel to such a degree that the vessel is incapable of further dilation in response to blood flow in the vessel. The myocardial portion is placed in the heart wall with the open leading end of the myocardial portion protruding into the heart chamber. The leading end of the vessel portion is placed in the coronary vessel.

Abstract: An apparatus controls a direction of formation of a hole through a myocardium for subsequent placement into the hole of a myocardial portion of a transmyocardial implant. The implant also includes a coronary portion having a coronary axis set at an implant angle to a myocardial axis of the myocardial portion. The apparatus includes a base member having base surface for placement against an epicardial surface of a heart adjacent a coronary vessel having a vessel axis. The base member has a determinable base axis for placement of the base surface on the epicardial surface with the base axis parallel with the vessel axis. A support member supports a myocardial penetrator for movement along a support axis in a line of travel parallel to the support axis and substantially restricting the myocardial penetrator from movement transverse to the support axis. The support member is secure to the base member with the support axis and base axis defining a support angle.

Abstract: A transmyocardial implant establishes a blood flow path through a myocardium between a heart chamber and a lumen of a coronary vessel residing on an exterior of the heart. The implant includes a coronary portion sized to be received with the vessel. A myocardial portion is sized to pass through the myocardium into the heart chamber. A transition portion connecting the coronary and myocardial portion for directing blood flow from the myocardial portion and into the coronary portion. The transition portion is an arcuate bend and at least a portion of the arcuate bend terminates at the vessel opening at a point of tangency of the arcuate bend.

Abstract: The transmyocardial implant for establishing blood flow through the myocardium between a heart chamber and a lumen of a coronary vessel includes a hollow rigid conduit extending between the lumen and the heart chamber. The conduit includes a first portion for placement in the vessel. The first portion includes an attachment location spaced from an open end for securing a suture around the vessel overlying the first portion at the attachment location. The conduit is formed of a rigid material to resist deformation in response to contraction of the myocardium and the conduit is resistant to thrombus. A tissue growth-inducing material is secured to an exterior of the first portion at the attachment location.

Abstract: A transmyocardial implant includes a hollow conduit inserted through a heart wall. The conduit defines a blood flow path between a heart chamber opening and a vessel opening. The heart chamber opening of the conduit is placed in communication with a chamber of the heart. A coronary vessel on an exterior of the heart wall is severed into a proximal portion and a distal portion. The distal portion of the vessel is placed into the vessel opening of the conduit. An alternative embodiment places the vessel flush with the vessel opening of the conduit.

Abstract: A blood flow path is formed from a heart chamber to a coronary vessel on an exterior surface of a heart wall. A hollow conduit has a vessel portion and a myocardial portion. The vessel portion has an open leading end sized to be inserted into the coronary vessel. The myocardial portion has an open leading end and the myocardium portion is sized to extend through a thickness of the heart wall. The myocardial portion is placed in the heart wall with the open leading end of the myocardial portion protruding into the heart chamber. Blood flow through the conduit from the heart chamber is at least partially blocked. The leading end of the vessel portion is placed in the coronary vessel. Blood flow through the conduit from the heart chamber and into the vessel is then opened.

Abstract: A heart valve prosthesis having a valve housing providing a lumen therethrough. The valve housing has a first annulus on one end and a second annulus on the other end spaced apart from the first annulus. A suture cuff is used for attaching the valve housing to heart tissue of a patient. The cuff is attached between the first annulus and the second annulus. The cuff is positioned such that prosthesis is attached in a supra-annular position relative to a tissue annulus of the heart. The design allows for an increased valve lumen.

Abstract: The transmyocardial implant for establishing blood flow through the myocardium between a heart chamber and a lumen of a coronary vasculature includes a hollow rigid conduit extending between the lumen and the heart chamber. The conduit is formed of a rigid material to resist deformation in response to contraction of the myocardium and the conduit is resistant to thrombus. A tissue growth-inducing material is secured to an exterior of the conduit. The tissue growth-inducing material is positioned to discourage tissue growth over openings of the implant.

Abstract: A device for engaging a heart valve prosthesis during implantation includes a mechanism for attaching the device to the heart valve prosthesis. The heart valve prosthesis includes a circular valve body having an annulus with a substantially annular aperture therein. At least one movable occluder is carried in the aperture and is movable between an open position and a closed position. The attachment mechanism includes a member which couples to the circular valve body thereby affixing the device to the heart valve prosthesis. The thickness of the device which extends in a direction above the heart valve prosthesis is reduced. The device is selectively removable from the heart valve prosthesis following implantation of the prosthesis in the heart tissue annulus of a patient.

Abstract: A holder for engaging a heart valve prosthesis during implantation includes a mechanism for attaching the holder to the heart valve prosthesis. The heart valve prosthesis includes a circular valve body having an annulus with a substantially annular aperture therein. At least one movable occluder is carried in the aperture and is movable between an open position and a closed position. The attachment mechanism attaches to the occluder thereby securing the holder to the heart valve prosthesis.

Abstract: The invention provides a sewing cuff assembly for mounting to the body of a heart valve prosthesis. The sewing cuff assembly comprises a resiliently deformed spring for exerting a force directed toward the orifice structure. When a torque is applied to the valve, the force results in a rotation-resisting torque sufficient to resist rotation during normal operation of the valve after implantation but low enough to permit assisted rotation, as during surgery.

Abstract: An annuloplasty prosthesis ring for implantation proximate a heart valve orifice includes a core having a size and shape to generally conform to the heart valve orifice. A sheath formed about the core is adapted for receiving a suture therethrough to attach the annuloplasty ring to the heart valve orifice. The suture is knotted on a knot surface of the sheath to form a suture knot thereon. A moveable suture guard is provided which is moveable between an open position in which the knot surface and suture knot are exposed and a closed position in which the knot surface and the suture knot carried on the knot surface are covered.

Abstract: An apparatus for manipulating an annuloplasty ring implantation device during implantation includes an elongated handle having a proximal end for grasping by a surgeon and a distal end. A locking surface is provided adjacent the distal end of the elongated handle. The elongated handle carries an engaging tip which extends distally from the locking surface. A locking key extends radially from the engaging tip. The annuloplasty ring implantation device includes an engaging tip opening formed therein adapted for receiving the engaging tip. A key slot is defined in the implantation device and extends radially from the engaging tip opening. The engaging tip and locking key may be inserted into the device at the engaging tip opening and key slot. The elongated handle is locked to the device by inserting the engaging tip and rotating the handle relative to the device such that the locking key and key slot are not aligned. This causes the device to be locked between the locking key and the locking surface.

Abstract: A heart valve prosthesis for use in a heart includes an orifice defining a lumen therethrough for blood flow. An occluder is carried in the orifice and is movable between an open position which allows blood flow through the lumen and a closed position in which flow through the lumen is blocked. A suture cuff coupled to the orifice extends around an outer circumference of the orifice and is used for attaching the heart valve to a heart tissue annulus using sutures. The sutures are knotted proximate the suture cuff to secure the cuff to the annulus. A suture guard is coupled to the suture cuff and is movable between an open position in which the suture knot is exposed and a closed position in which the suture, suture knot and suture cuff are covered.