Apparatus and method for selectively isolating a proximal anastomosis site from blood in an aorta

Claim 1

An endolumenal aortic isolation system, comprising: an elongate body with a proximal end portion, a distal end portion, a longitudinal axis, and a flow lumen which extends between a distal port located along the distal end portion of the elongate body and a proximal port located along the proximal end portion of the elongate body, wherein the flow lumen communicates externally of the elongate body through an intermediate port located between the distal and proximal ports; a distal internal valve coupled to the flow lumen between the distal port and intermediate ports that is adjustable from an open position, wherein the flow lumen is open between the distal and first proximal ports, to a closed position, wherein the flow lumen is substantially closed between the distal and intermediate ports; a proximal internal valve coupled to the internal flow lumen between the intermediate port and the proximal port that is adjustable from an open position, wherein the flow lumen is open between the intermediate and proximal ports, to a closed position, wherein the flow lumen is substantially closed between the intermediate and proximal ports and where said proximal internal valve and said distal internal valve are independently adjustable; and an aorta isolation assembly located along the distal end portion of the elongate body with a distal portion located proximally of the distal port, a proximal portion located proximally of the distal portion and distally of the intermediate port, and an intermediate region located between the distal and proximal portions, the distal and proximal portions being adjustable between first and second collapsed positions, respectively, and first and second extended positions, also respectively, which are each adapted to circumferentially engage an aortic wall of an aorta, wherein in the respective first and second extended positions the distal and proximal portions have first and second outer diameters and the intermediate region has an intermediate outer diameter that is less than the first and second outer diameters and is insufficient to engage the aortic wall, and wherein the aorta isolation assembly is adapted to isolate a proximal anastomosis site along the aortic wall from a volume of pressurized blood at a location in the aorta either distally from the distal portion or proximally from the proximal portion of the aorta isolation assembly with respect to the elongate body by positioning the intermediate region within the aorta along a proximal anastomosis site and adjusting the distal and proximal portions to the first and second extended positions, respectively, to thereby engage the aortic wall on upstream and downstream sides of the proximal anastomosis site.

Claim 43

A method for anastomosing an arterial bypass graft to a proximal anastomosis site along an aortic wall of an aorta in a patient, comprising: endolumenally isolating a proximal anastomosis site along an aortic wall from a volume of pressurized blood in the aorta using an aorta isolation assembly provided along a distal end portion of an elongate body, said elongate body having a proximal end portion, a distal end portion, a longitudinal axis, and a flow lumen which extends between a distal port located along the distal end portion of the elongate body and a proximal port located along the proximal end portion of the elongate body, wherein the flow lumen communicates externally of the elongate body through an intermediate port located between the distal and proximal ports; while the proximal anastomosis site is isolated from the volume of pressurized blood with the aorta isolation assembly, shunting the volume of blood through said flow lumen along the elongate body from said distal port of the flow lumen positioned along an upstream region of the aorta located upstream from the proximal anastomosis site and through a proximal port of the flow lumen positioned along a downstream region of the aorta located downstream from the proximal anastomosis site; and while the volume of blood is being shunted from the upstream region to the downstream region, adjusting a distal internal valve within the flow lumen between the distal and proximal ports to an open position and adjusting a proximal internal valve within the flow lumen proximally of the intermediate port to a closed position.

Claim 44

A method for anastomosing an arterial bypass graft to a proximal anastomosis site along an aortic wall of an aorta in a patient, comprising: endolumenally isolating a proximal anastomosis site along an aortic wall from a volume of pressurized blood in the aorta using an aorta isolation assembly provided along a distal end portion of an elongate body, said elongate body having a proximal end portion, a distal end portion, a longitudinal axis, and a flow lumen which extends between a distal port located along the distal end portion of the elongate body and a proximal port located along the proximal end portion of the elongate body, wherein the flow lumen communicates externally of the elongate body through an intermediate port located between the distal and proximal ports; while the proximal anastomosis site is isolated from the volume of pressurized blood with the aorta isolation assembly, shunting the volume of blood through said flow lumen along the elongate body from said distal port of the flow lumen positioned along an upstream region of the aorta located upstream from the proximal anastomosis site and through a proximal port of the flow lumen positioned along a downstream region of the aorta located downstream from the proximal anastomosis site; and while the volume of blood is being shunted from the upstream region to the downstream region, adjusting a distal internal valve within the flow lumen between the distal and proximal ports to an open position and adjusting a proximal internal valve within the flow lumen proximally of the intermediate port to a closed position.