CARDIOVASCULAR VALVE AND VALVE HOUSING APPARATUSES AND SYSTEMS
A cardiovascular valve assembly is disclosed including a housing assembly comprising a first portion and a second portion removably attached to the first portion. A valve may be positioned within the housing assembly. The valve, which may be a mechanical valve, a biological tissue valve, or a polymeric valve, may be structured to allow fluid to flow through the housing assembly in a single direction. In certain embodiments, the valve assembly may further include at least one coupling structure provided on the second portion and at least one aperture defined in the first portion, with the aperture structured to receive the coupling structure to couple the first portion to the second portion. Corresponding systems incorporating cardiovascular valve assemblies are also disclosed.
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This is a continuation of U.S. patent application Ser. No. 12/340,189 filed on 19 Dec. 2008, now pending, the disclosure of which is incorporated, in its entirety, by this reference.
BACKGROUNDAortic valve replacement is a cardiac surgery procedure that replaces a patient's aortic valve with a prosthetic valve. Aortic valve replacement typically requires open heart surgery, which may be risky and/or impractical for many patients. Aortic valve replacement may not be an option for patients with aortic stenosis, left ventricular outflow obstruction, a heavily calcified ascending aorta, a heavily calcified aortic root, and/or other high risk medical conditions. For example, patients with conditions that preclude a median sternotomy may not be candidates for an aortic valve replacement operation.
Apical aortic conduits may provide a less invasive alternative to aortic valve replacement. An apical aortic conduit may be connected between the apex of the heart and the aorta in a procedure similar to a coronary artery bypass graft. Apical aortic conduits may improve blood flow between the heart and the aorta by bypassing a diseased or malfunctioning aortic valve. Patients who are not eligible for aortic valve replacement may be treated by using an apical aortic conduit to bypass the valve. For example, apical aortic conduits may be used in pediatric patients. The native valve may be left in place in pediatric patients to eliminate the need for periodic valve replacements as the patient grows. Thus, the apical aortic conduit may maintain the maximum possible function of the native valve while bypassing the restricted flow to lessen stress on the heart and allow more blood flow to the body. In other words, the apical aortic conduit may bypass the native valve to allow for extra flow to the aorta while still allowing the maximum flow that the native valve can physiologically handle.
Traditional apical aortic conduits may fail or malfunction for various reasons. For example, the conduit material used in an apical aortic conduit may become blocked as a result of kinking. Traditional conduits may also become occluded and obstruct apical flow. Also, apical aortic conduits are typically sutured to the heart and the aorta, and the suturing may cause aneurisms at or near the attachment site. Apical aortic conduits may also cause gastrointestinal complications such as dysphagia and gastric erosion. Furthermore, implanting an apical aortic conduit on a beating heart may result in significant blood loss from the patient.
SUMMARYIn at least one embodiment, a cardiovascular valve assembly may comprise a housing assembly comprising a first portion and a second portion removably attached to the first portion. The cardiovascular valve assembly also may comprise a valve positioned within the housing assembly′. In certain embodiments, the valve may be structured to allow fluid to flow through the housing assembly in a single direction. The valve may comprise at least one of a mechanical valve, a biological tissue valve, and a polymeric valve.
In certain embodiments, the first portion may comprise a first connector structured to removably attach the first portion a first conduit. Similarly, the second portion may comprise a second connector structured to removably attach the second portion to a second conduit. In at least one embodiment, the valve may be a biological tissue valve comprising a cuff member positioned between the first portion and the second portion.
In certain embodiments, the cardiovascular valve assembly may further comprise at least one coupling structure provided on the second portion and at least one aperture defined in the first portion, the aperture being structured to receive the coupling structure to couple the first portion to the second portion. In addition, the coupling structure provided on the second portion may be configured to snap-fit into the aperture defined in the first portion. At least one aperture also may be defined in the valve. In this embodiment, the apertures defined in the first portion in the valve may be structured to receive the coupling structure provided on the second portion to couple the first portion and the valve to the second portion.
In an additional embodiment, the cardiovascular valve assembly may further comprise a hinged structure constructed to hingedly attach the first portion to the second portion. The valve assembly also may further comprise at least one seal member positioned between the first portion and the second portion, the seal member being configured to prevent fluid from escaping the housing assembly. In addition, when the first portion is removably attached to the second portion, the first and second portions may form a seal to prevent fluid from escaping the housing assembly.
In at least one embodiment, the cardiovascular valve assembly also may comprise at least one identifying indicia to identify a direction for fluid flow. In addition, the valve may be structured to prevent the valve from being positioned within the housing assembly in a manner that restricts fluid flow in a desired direction.
In an additional embodiment, the first portion may comprise a contoured contact surface structured to contact a contoured contact surface formed on the second portion. The cardiovascular valve assembly also may comprise a threaded end provided on the first portion and a threaded recess defined in the second portion, the threaded recess being structured to receive the threaded end to removably attach the first portion to the second portion. The cardiovascular valve assembly also may comprise a retention assembly configured to removably secure the first portion to the second portion. In addition, the valve may be sutured to at least one of the first portion and the second portion. The first portion also may be stapled to the second portion. In addition, the first portion and the second portion may comprise conical-shaped ends configured to contact at least a portion of the valve.
In an additional embodiment, a pre-assembled cardiovascular valve assembly may comprise a conduit, a housing assembly positioned within the conduit, and a valve positioned within the housing assembly. In certain embodiments, the housing assembly may be sutured to the conduit. In addition, the valve may be structured to allow fluid to flow through the housing assembly in a single direction. The valve may comprise at least one of a mechanical valve, a biological tissue valve, and a polymeric valve.
In certain embodiments, a system may comprise a first conduit dimensioned to be positioned against a first coring site of a cardiovascular organ and a valve assembly removably attached to the first conduit. The valve assembly may comprise a housing assembly comprising a first portion and a second portion removably attached to the first portion and a valve positioned within the housing assembly. The valve may be structured to allow fluid to flow through the housing assembly in a single direction. In addition, the system may comprise a second conduit removably attached to the valve assembly. The second conduit may be dimensioned to be positioned against a second coring site of a cardiovascular organ.
In at least one embodiment, a cardiovascular valve assembly may comprise a housing assembly, the housing assembly comprising a first portion comprising at least one coupling structure and a second portion comprising at least one aperture. In certain embodiments, this aperture may be structured to receive the coupling structure to removably attach the first portion to the second portion. In addition, the cardiovascular valve assembly may comprise a valve positioned within the housing assembly, at least one seal member positioned between the first portion and the second portion, and at least one identifying indicia configured to indicate a desired direction for fluid flow. In certain embodiments, the seal member may be configured to prevent fluid from escaping the housing assembly. In addition, the valve may be structured to allow fluid to flow through the housing assembly in a single direction. The valve also may be structured to prevent the valve from being positioned within the housing assembly in a manner that restricts fluid flow in a desired direction.
Features from any of the above-mentioned embodiments may be used in combination with one another in accordance with the general principles described herein. These and other embodiments, features, and advantages will be more fully understood upon reading the following detailed description in conjunction with the accompanying drawings and claims.
The accompanying drawings illustrate a number of exemplary embodiments and are a part of the specification. Together with the following description, these drawings demonstrate and explain various principles of the instant disclosure.
Throughout the drawings, identical reference characters and descriptions indicate similar, but not necessarily identical, elements. While the exemplary embodiments described herein are susceptible to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and will be described in detail herein. However, the exemplary embodiments described herein are not intended to be limited to the particular forms disclosed. Rather, the instant disclosure covers all modifications, equivalents, and alternatives falling within the scope of the appended claims.
DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTSA physician may implant a cardiovascular conduit system to circumvent a restriction in blood flow. For example, a physician may use a cardiovascular conduit system to bypass an aortic valve in a patient with aortic valve stenosis. Similarly, a cardiovascular conduit system may be used to bypass a pulmonary valve in a patient with pulmonary valve stenosis. Physicians may also use cardiovascular conduit systems to address various other problems and diseases in a patient's cardiovascular system.
Cardiovascular conduit systems may provide various advantages over prior systems. Physicians may implant a cardiovascular conduit system on a beating heart. Procedures performed on a beating heart may be referred to as off-pump procedures, and off-pump procedures may be less invasive than on-pump procedures (i.e., procedures that require cardiopulmonary bypass). In some embodiments, cardiovascular conduit systems may be used with traditional surgical techniques (e.g., on-pump procedures). In traditional surgical techniques, cardiovascular conduit systems may provide various advantages, such as reduced pump time and smaller incisions. Connectors in a cardiovascular conduit system may be designed to reduce the risk of aneurisms at the attachment site. The conduit in a cardiovascular conduit system may be kink and occlusion resistant. Cardiovascular conduit systems may also reduce the risk of gastrointestinal complications. Cardiovascular conduit systems may be implanted quickly and minimize patient blood loss. The following disclosure presents numerous other features and advantages of cardiovascular conduit systems.
The process of implanting a cardiovascular conduit system in a patient may involve a variety of steps.
After determining the size of a patient's aorta, the physician may select the appropriately sized connector, conduit, valve, coring device, tube, and/or other tools for implanting the cardiovascular conduit system.
As shown in
A physician may insert a coring device into tube 200 after attaching tube 200 to aorta 14.
A valve 210 may be positioned within tube 200. Valve 210 may be attached to tube 200. In other embodiments, valve 210 may be formed as part of tube 200. Valve 210 may be a one-way valve that allows cardiovascular coring device 220 to pass through but blocks the flow of blood out of the opening cut in aorta 14. Valve 210 may also seal cutting member 230 to tube 200 (as shown in
According to various embodiments, cutting members may be any cutting devices suitable for cutting a cardiovascular organ. A cutting member may be a mechanical coring device, as illustrated in
Connector 254 may include expandable members 256. A retractable retaining member 260 may hold expandable members 256 in a delivery position while connector 254 is being implanted into aorta 14. Retractable retaining member 260 may be attached to handles 264 and 266 to allow a physician to control retractable retaining member 260.
A distal end of cardiovascular conduit section 250 may be sealed with a clamp 270. Clamp 270 may prevent blood from flowing out of cardiovascular conduit section 250 through connector 258 after cardiovascular conduit section 250 is attached to aorta 14. Clamp 270 may be any suitable size, shape, and/or configuration.
As shown in
Connector 254 may pass through valve 210 and be partially inserted into opening 16 of aorta 14 such that expandable members 256 extend into aorta 14. A physician may then retract retaining member 260 to allow expandable members 256 to deploy and secure cardiovascular conduit system 250 to aorta 14, as shown in
A physician may use a procedure similar to or the same as the procedure for implanting conduit section 250 in aorta 14 for implanting a cardiovascular conduit section in an apex of the heart at the left ventricle. For example, a tube may be attached to an apex of the heart. Then, a cutting member may be inserted through a valve in the tube to cut out a section of the apex of the heart. After the section of the heart and the cutting member are removed from the tube, a cardiovascular conduit section may be inserted through the tube and attached to the apex of the heart. This procedure (or similar procedures) for implanting cardiovascular conduit sections may be performed on the left ventricle of the heart, the right ventricle of the heart, the pulmonary artery, or any other blood vessel or cardiovascular organ.
Cardiovascular conduit system 299 may also include cardiovascular conduit section 250, which includes connector 254, connector 258, and conduit 252. As previously noted, connector 254 may be attached to aorta 14.
Cardiovascular conduit systems, such as cardiovascular conduit system 299, may be attached between various cardiovascular organs. A cardiovascular organ may be any organ in a cardiovascular system. Cardiovascular organs include the heart and all the blood vessels (e.g., arteries and veins) in the cardiovascular system. Thus, the aorta and the pulmonary artery may be referred to as cardiovascular organs. According to some embodiments, blood vessels may also be referred to as vascular organs.
Cardiovascular valve assembly 295 generally represents any type or form of valve or valve assembly. In certain embodiments, cardiovascular valve assembly 295 may comprise a housing having a first portion 300 and a second portion 310. As will be discussed in greater detail below, first portion 300 may be removably attached to second portion 310. As illustrated in
Valve 296 generally represents any type or form of valve. Examples of valve 296 include, without limitation, a mechanical valve, a biological tissue valve, and a polymeric valve. In certain embodiments, valve 296 may be structured to allow fluid to flow through cardiovascular valve assembly 295 in a single direction. Valve 296 and cuff member 298 may be formed in any suitable shape and size and of any suitable material or combination of materials.
The first and second portions of a cardiovascular valve assembly may be removably attached in any number of ways and configurations. For example, as illustrated in
In at least one embodiment, cardiovascular valve assembly 295 may comprise at least one identifying indicia configured to identify a desired direction for fluid flow. For example, as illustrated in
As detailed above, cuff member 298 may be formed in any shape or size and of any suitable material or combination of materials. In at least one embodiment, and as illustrated in
Cardiovascular valve assembly 295 may be formed in any shape and size and of any suitable material or combination of materials. For example, as illustrated in
In an additional embodiment, as illustrated in
In certain embodiments, a first portion of a cardiovascular valve assembly may be removably attached to a second portion of a cardiovascular valve assembly by rotating the first portion relative to the second portion. For example, as illustrated in
As detailed above, a cardiovascular valve assembly may comprise any type or form of valve or valve assembly. For example, as illustrated in
The preceding description has been provided to enable others skilled in the art to best utilize various aspects of the exemplary embodiments described herein. This exemplary description is not intended to be exhaustive or to be limited to any precise form disclosed. Many modifications and variations are possible without departing from the spirit and scope of the instant disclosure. It is desired that the embodiments described herein be considered in all respects illustrative and not restrictive and that reference be made to the appended claims and their equivalents for determining the scope of the instant disclosure.
Unless otherwise noted, the terms “a” or “an,” as used in the specification and claims, are to be construed as meaning “at least one of.” In addition, for ease of use, the words “including” and “having,” as used in the specification and claims, are interchangeable with and have the same meaning as the word “comprising.”
Claims
1.-23. (canceled)
24. A cardiovascular system, comprising:
- a tube configured to connect to a tissue wall;
- a valve positioned within the tube;
- a cutting member within the tube, the cutting member being configured to cut tissue from the tissue wall to form an opening in the tissue wall;
- a tissue retraction member configured to remove the tissue cut by the cutting member from the tube; and
- an anchor extending from the tissue retraction member for anchoring to the tissue to be removed.
25. The system of claim 24, wherein the tube is configured to provide a sealed interface between the tissue wall and a cardiovascular device.
26. The system of claim 24, wherein the tube is cylindrical.
27. The system of claim 24, wherein the tube is sized and dimensioned for implanting to the tissue wall.
28. The system of claim 24, wherein the tube is elongated.
29. The system of claim 24, wherein the tube is configured to attach to the tissue wall.
30. The system of claim 29, wherein the tube is configured to attach to the tissue wall by sutures.
31. The system of claim 29, further comprising a conduit system comprising a conduit and a connector assembly, wherein the connector assembly includes expandable members configured to deploy and secure the conduit to the tissue wall.
32. The system of claim 31, wherein the conduit system further comprises a retaining member, the retaining member being configured to retain the expandable members in a delivery configuration and retract to allow the expandable members to deploy.
33. The system of claim 24, wherein the valve is a one-way valve configured to prevent blood flow in a direction away from the tissue wall.
34. The system of claim 24, wherein the valve comprises at least one of a mechanical valve, a biological tissue valve, and a polymeric valve.
35. The system of claim 24, wherein the valve is formed as part of the tube.
36. The system of claim 24, wherein the valve is configured to seal the cutting member to the tube.
37. The system of claim 24, wherein the valve is configured to allow the cutting member to pass through the valve and is configured to block blood flow through the tube from an opening cut in the tissue by the cutting member.
38. The system of claim 24, further comprising a handle, wherein the cutting member extends distally from the handle within the tube.
39. The system of claim 38, wherein the cutting member is directly connected to the handle.
40. The system of claim 24, wherein the cutting member is cylindrical with a distal cutting edge configured for coring the tissue wall.
41. The system of claim 24, wherein the tissue retraction member extends through the cutting member.
42. The system of claim 24, wherein the valve is configured to allow the anchor to pass through the valve and remove tissue cut by the cutting member.
43. The system of claim 24, wherein the anchor forms part of the tissue retraction member.
44. The system of claim 24, wherein the anchor has a corkscrew shape.
45. The system of claim 24, wherein the tissue wall is a wall of a ventricle of a heart.
46. The system of claim 24, wherein the tissue wall is one of a wall of a chamber of a heart, a pulmonary artery wall, a blood vessel wall, and a wall of a cardiovascular organ.
47. A method of accessing a cardiovascular vessel, comprising:
- determining a size of a target location of a vessel;
- selecting a size of a cutting device based on the size of the target location;
- selecting a size of a tube for attaching to the vessel based on the size of the target location;
- positioning the tube against the vessel at the target location;
- inserting the cutting device through the tube to the target location;
- anchoring a section of tissue to be removed from the vessel;
- cutting the section of tissue from a wall of the vessel using the cutting device; and
- retrieving the anchored section of tissue through the tube.
48. The method of claim 47, wherein the cutting device is a cylindrical coring blade, the cutting being performed by rotating the cutting device into the vessel or organ wall.
49. The method of claim 47, further comprising impeding flow of blood out of the vessel after removal of the cutting device.
50. The method of claim 47, further comprising suturing the tube to the vessel.
51. The method of claim 47, wherein anchoring the section of tissue comprises rotating a corkscrew anchor into the section of tissue prior to cutting the section of tissue from the wall of the vessel.
52. The method of claim 47, further comprising removing the cutting device and tube after retrieving the anchored section of tissue.
53. The method of claim 47, wherein the vessel is one of a chamber of a heart, a pulmonary artery, a blood vessel, and a cardiovascular organ.
54. The method of claim 47, wherein the anchoring is performed prior to the cutting.
55. The method of claim 47, wherein retrieving the anchored section of tissue comprises removing the section of tissue through the cutting device.
56. The method of claim 47, wherein retrieving the anchored section of tissue comprises removing the section of tissue into the tube.
Type: Application
Filed: Jan 4, 2017
Publication Date: Apr 27, 2017
Applicant: St. Jude Medical, Inc. (St. Paul, MN)
Inventors: Peter N. Braido (Linwood, MN), Yousef F. Alkhatib (Maple Grove, MN)
Application Number: 15/398,620