US6206912B1
Expired / Lapsed
US
⏱️ 0.0 years remaining
Medical grafting methods and apparatus
Assignee: St Jude Medical ATG Inc
•
Filing: 1999-08-04
•
Granted: 2001-03-27
•
Expires: 2019-08-04
Abstract
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.
Inventors
- 👤 David S. Goldsteen
- 👤 Thomas J. Bachinski
- 👤 Rudy Mazzocchi
- 👤 Daniel J. Sullivan
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-24 10:47
CPC Classifications
A; A61; A61B; A61B1/00; A61B1/005; A61B1/0058; A61B17/00; A61B17/22; A61B17/221; A61B17/32; A61B17/3205; A61B17/32056; A61F; A61F2/00; A61F2/02; A61F2/04; A61F2/06; A61F2/064; A61F2/07; A61F2/95; A61F2/954; A61F2/958; A61M; A61M25/00; A61M25/0021; A61M25/0041; A61M25/01; A61M25/0105; A61M25/0133; A61M25/0147; A61M25/0152; A61B17/0057; A61B17/11; A61B17/1114; A61B17/00234; A61B2017/00292; A61B2017/003; A61B2017/1107; A61B2017/1135; A61B2017/1139; A61B2017/2212; A61B17/28; A61B17/29; A61B2017/2926; A61B2017/2932; A61B2017/2939; A61B90/00; A61B90/30; A61B2090/306; A61B90/36; A61B90/361; A61B2090/3614; A61F2/82; A61F2/86; A61F2/90; A61F2002/061; A61F2002/065; A61F2/30; A61F2002/30001; A61F2002/30003; A61F2002/3006; A61F2002/3008; A61F2002/30092; A61F2002/826; A61F2/848; A61F2002/8486; A61F2210/00; A61F2210/0014; A61F2240/00; A61F2240/001; A61F2250/00; A61F2250/0058; A61F2250/0096; A61F2250/0098; A61M25/02; A61M2025/0293; A61M25/10; A61M2025/1043; A61M2025/1052; A61M25/0108; A61M25/04; A61M25/09; A61M25/09016; A61M25/09025; Y; Y10; Y10S; Y10S623/00; Y10S623/902; Y10S623/903
Claims Analysis
Total Claims: 45
Claim 1
Independent Claim
152 words
Apparatus for making a new tubular connection between first and second sections of a patient's existing tubular body organ structure comprising: first elongated instrumentation insertable axially into and along the interior of a portion of said existing structure to said first section where said first instrumentation produces an aperture through a first section to the outside of said patient's existing structure; and second elongated instrumentation insertable axially into and along the interior of a part of said existing structure for conveying said new length of tubing to and partly through said aperture in said first section and then outside of said existing structure to an aperture in said second section so that said new length of tubing attaches to said second section via said aperture in said second section and also attaches to said first section via said aperture in said first section, wherein said second elongated instrumentation is a catheter-type member.
Claim 2
Dependent Claim
152 words
Apparatus for making a new tubular connection between first and second sections of a patient's existing tubular body organ structure comprising: first elongated instrumentation insertable axially into and along the interior of a portion of said existing structure to said first section where said first instrumentation produces an aperture through a first section to the outside of said patient's existing structure; and second elongated instrumentation insertable axially into and along the interior of a part of said existing structure for conveying said new length of tubing to and partly through said aperture in said first section and then outside of said existing structure to an aperture in said second section so that said new length of tubing attaches to said second section via said aperture in said second section and also attaches to said first section via said aperture in said first section, wherein said second elongated instrumentation is a catheter-type member.
Claim 3
Dependent Claim
21 words
The apparatus defined in claim 1 wherein said first and second instrumentation is substantially entirely controlled from outside of said patient.
Claim 4
Dependent Claim
47 words
The apparatus defined in claim 1 further comprising: third elongated instrumentation insertable axially into and along the interior of a length of said existing structure to said second section where said third instrumentation produces said aperture through said second section to the outside of said existing structure.
Claim 5
Dependent Claim
19 words
The apparatus defined in claim 3 wherein said third instrumentation is substantially entirely controlled from outside of said patient.
Claim 6
Dependent Claim
58 words
The apparatus defined in claim 1 wherein said first instrumentation comprises: a first tubular structure insertable into and along the interior of said portion of said existing structure; and a first longitudinal structure insertable longitudinally into and along said first tubular structure and having a distal portion which is adapted for producing said aperture through said first section.
Claim 7
Dependent Claim
20 words
The apparatus defined in claim 5 wherein said second instrumentation is insertable longitudinally into and along said first tubular structure.
Claim 8
Dependent Claim
19 words
The apparatus defined in claim 6 wherein said second instrumentation is extendable through said aperture in said first section.
Claim 9
Dependent Claim
35 words
The apparatus defined in claim 5 wherein a distal portion of said first tubular structure is adapted for passage through said aperture in said first section after said first longitudinal structure has produced said aperture.
Claim 10
Dependent Claim
37 words
The apparatus defined in claim 8 wherein said distal portion of said first tubular structure includes an anchor structure for releasably securing said distal portion of said first tubular structure through said aperture in said first section.
Claim 11
Dependent Claim
76 words
The apparatus defined in claim 9 wherein said anchor structure comprises two axially spaced, annular, inflatable members on said distal portion, one of said inflatable members being inside said first section and the other of said inflatable members being outside of said first section when said distal portion is disposed through said aperture in said first section, each of said inflatable members being too large when inflated to pass through said aperture in said first section.
Claim 12
Dependent Claim
40 words
The apparatus defined in claim 8 wherein said distal portion of said first tubular structure includes a seal structure for providing a fluid-tight seal around said distal portion where said distal portion passes through said aperture in said first section.
Claim 13
Dependent Claim
78 words
The apparatus defined in claim 11 wherein said seal structure comprises two axially spaced, annular, inflatable members on said distal portion, one of said inflatable members being inside said first section and the other of said inflatable members being outside of said first section when said distal portion is disposed through said aperture in said first section, each of said inflatable members resiliently bearing on said first section annularly around said aperture when said inflatable members are inflated.
Claim 14
Dependent Claim
57 words
The apparatus defined in claim 1 wherein said second instrumentation comprises: a second tubular structure insertable into and along the interior of said part of said existing structure; and a second longitudinal structure insertable longitudinally into and along said second tubular structure and having a distal portion on which said new length of tubing is releasably disposed.
Claim 15
Dependent Claim
57 words
The apparatus defined in claim 1 wherein said new length of tubing includes selectively operable fasteners where said new length of tubing is to attach to said second section, and wherein said second instrumentation operates said fasteners to engage said second section when said new length of tubing is properly positioned for attachment to said second section.
Claim 16
Dependent Claim
56 words
The apparatus defined in claim 1 wherein said new length of tubing includes selectively operable fasteners where said new length of tubing is to attach to said first section, and wherein said second instrumentation operates said fasteners to engage said first section when said new length of tubing is to be attached to said first section.
Claim 17
Dependent Claim
49 words
The apparatus defined in claim 13 wherein said new length of tubing includes selectively operable fasteners where said new length of tubing is to attach to said second section, and wherein said second longitudinal structure comprises: a circumferentially expandable structure for operating said fasteners to engage said second section.
Claim 18
Dependent Claim
15 words
The apparatus defined in claim 16 wherein said circumferentially expandable structure comprises an inflatable balloon.
Claim 19
Dependent Claim
49 words
The apparatus defined in claim 13 wherein said new length of tubing includes selectively operable fasteners where said new length of tubing is to attach to said first section, and wherein said second longitudinal structure comprises: a circumferentially expandable structure for operating said fasteners to engage said first section.
Claim 20
Dependent Claim
15 words
The apparatus defined in claim 18 wherein said circumferentially expandable structure comprises an inflatable balloon.
Claim 21
Dependent Claim
99 words
The apparatus defined in claim 3 wherein said first instrumentation includes a first longitudinal structure having a distal portion which is axially extendable from the remainder of said first instrumentation through the aperture in said first section to the outside of said existing structure, and wherein said third instrumentation includes a second longitudinal structure having a distal portion which is axially extendable from the remainder of said third instrumentation through the aperture in said second section to the outside of said existing structure for interengagement with said distal portion of said first longitudinal structure outside of said existing structure.
Claim 22
Dependent Claim
68 words
The apparatus defined in claim 20 wherein one of said first and third instrumentations further includes an endoscope having a distal portion which is axially extendable to the outside of said existing structure through the aperture in the one of the first and second sections that is associated with said one of said instrumentations for facilitating interengagement between said distal portions of said first and second longitudinal structures.
Claim 23
Dependent Claim
22 words
The apparatus defined in claim 21 wherein said distal portion of said endoscope is laterally steerable from endoscope controls outside said patient.
Claim 24
Dependent Claim
27 words
The apparatus defined in claim 21 wherein said endoscope includes an illumination source for illuminating the interior of the patient adjacent said distal portion of said endoscope.
Claim 25
Dependent Claim
38 words
The apparatus defined in claim 21 wherein said endoscope transmits image information regarding the appearance of the interior of the patient adjacent the distal portion of said endoscope to a viewing location which is outside of said patient.
Claim 26
Dependent Claim
13 words
The apparatus defined in claim 21 wherein said endoscope is a video endoscope.
Claim 27
Dependent Claim
71 words
The apparatus defined in claim 21 wherein the distal portion of the one of said first and second longitudinal structures that is associated with said one of said first and third instrumentations that includes said endoscope is mounted relative to said distal portion of said endoscope so that said distal portion of said one of said first and second longitudinal structures can be moved with said distal portion of said endoscope.
Claim 28
Dependent Claim
54 words
The apparatus defined in claim 26 wherein, when said distal portion of said one of said first and second longitudinal structures is being moved with said distal portion of said endoscope, said distal portion of said one of said first and second longitudinal structures is also within the field of view of said endoscope.
Claim 29
Dependent Claim
41 words
The apparatus defined in claim 20 wherein the distal portion of one of said first and second longitudinal structures comprises: a selectively closable snare for selectively closing around the distal portion of the other of said first and second longitudinal structures.
Claim 30
Dependent Claim
114 words
The apparatus defined in claim 28 wherein said snare comprises: a tube having a distal end; and a longitudinal member axially reciprocable within said tube and having a distal loop which is resiliently biased to open when said loop is distal of said distal end of said tube and which is closed by proximal retraction of said loop into said tube, said loop being large enough when open for the distal portion of the other of said first and second longitudinal structures to enter said loop, and said loop being small enough when closed to engage the distal portion of said other of said first and second longitudinal structures which has entered said loop.
Claim 31
Dependent Claim
38 words
The apparatus defined in claim 29 wherein said tube is large enough to receive both said loop and the distal portion of said other of said first and second longitudinal structures which has been engaged by said loop.
Claim 32
Dependent Claim
55 words
The apparatus defined in claim 20 wherein said first and third instrumentations permit said first and second longitudinal structures after interengagement to be shifted axially as a unit relative to said first and third instrumentations until one of said first and second longitudinal structures extends continuously between said apertures in said first and second sections.
Claim 33
Dependent Claim
68 words
The apparatus defined in claim 31 wherein said first and third instrumentations additionally permit said first and second longitudinal structures after interengagement to be shifted axially as a unit relative to said first and third instrumentations until only one of said first and second longitudinal structures extends continuously from outside said patient, through both of said first and third instrumentations, and then back out of said patient again.
Claim 34
Dependent Claim
60 words
The apparatus defined in claim 20 wherein said second instrumentation is adapted to travel axially along at least one of said first and second longitudinal structures after interengagement of those structures in order to enable a distal portion of said second instrumentation to find its way from the aperture in said first section to said aperture in said second section.
Claim 35
Dependent Claim
32 words
The apparatus defined in claim 33 wherein said new length of tubing is disposed substantially coaxially around said at least one of said first and second longitudinal structures in said third instrumentation.
Claim 36
Dependent Claim
41 words
The apparatus defined in claim 33 wherein said second instrumentation includes a distal portion which is adapted to enlarge the aperture in said second section to facilitate attachment of said new length of tubing to said second section via said aperture.
Claim 37
Dependent Claim
43 words
The apparatus defined in claim 34 wherein said second instrumentation comprises: a delivery tube disposed substantially concentrically around said new length of tubing for facilitating entry of a distal portion of said new length of tubing into the aperture in said second section.
Claim 38
Dependent Claim
55 words
The apparatus defined in claim 36 wherein said new length of tubing includes selectively operable fasteners, and wherein said fasteners are rendered operable to attach said new length of tubing by proximal retraction of said delivery tube relative to said new length of tubing so that said fasteners are no longer within said delivery tube.
Claim 39
Dependent Claim
25 words
The apparatus defined in claim 37 wherein said fasteners are radially outwardly expandable to engage said second section around said aperture in said second section.
Claim 40
Dependent Claim
34 words
The apparatus defined in claim 38 wherein said second instrumentation includes a selectively circumferentially expandable structure disposed adjacent said fasteners for radially outwardly expanding said fasteners when said circumferentially expandable structure is circumferentially expanded.
Claim 41
Dependent Claim
15 words
The apparatus defined in claim 39 wherein said circumferentially expandable structure is an inflatable balloon.
Claim 42
Dependent Claim
25 words
The apparatus defined in claim 37 wherein said fasteners are radially outwardly expandable to engage said first section around said aperture in said first section.
Claim 43
Dependent Claim
34 words
The apparatus defined in claim 41 wherein said second instrumentation includes a selectively circumferentially expandable structure disposed adjacent said fasteners for radially outwardly expanding said fasteners when said circumferentially expandable structure is circumferentially expanded.
Claim 44
Dependent Claim
15 words
The apparatus defined in claim 42 wherein said circumferentially expandable structure is an inflatable balloon.
Claim 45
Dependent Claim
42 words
The apparatus defined in claim 20 wherein at least one of said longitudinal structures includes a plurality of longitudinally spaced radiologic markers for helping to measure path length outside of said existing structure between said apertures in said first and second sections.
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USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 2004-03-26 | 2004-09-25 | 2005-03-27 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2008-03-26 | 2008-09-25 | 2009-03-27 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2012-03-26 | 2012-09-25 | 2013-03-27 | $7700.00 | Window Closed / Lapsed |