IE20030531U1 - Methods and devices for placing a fistula device in fluid communication with a target vessel - Google Patents

Abstract

ABSTRACT According to an aspect of the invention there is provided an apparatus for deploying a fistula device. The apparatus comprises an elongate cover member having a proximal end and a distal end, and an elongate support member within the cover member for supporting the fistula device and configured for relative movement with respect to the cover member so as to release the fistula device at a desired location.

Claims (1)

CLAIMS:

1.An apparatus for deploying a fistula device, the apparatus comprising: an elongate cover member having a proximal end and a distal end; an elongate support member deployed within said cover member for supporting said fistula device and configured for relative movement with respect to said cover member so as to release said fistula device at a desired location; optionally, wherein said apparatus deploys said fistula device in a wall of a patient’s heart to place said fistula device in communication with a heart chamber and a coronary artery; optionally, wherein said fistula device is expandable from a collapsed state to an expanded state; optionally, wherein the apparatus further comprises a removable retaining sheath overlying at least a portion of said fistula device, said fistula device transitioning from said collapsed state to said expanded state when said retaining sheath is removed; optionally, wherein said fistula device is released when said cover member is moved in a proximal direction; optionally, wherein said support member comprises: a first elongate member; and a second member, substantially shorter than said first elongate member, said first and second members forming a generally L- shaped support member; optionally, wherein said member urges said fistula device through said wall when said support member is pulled in a proximal direction; optionally, wherein the apparatus comprises a penetrating tip coupled to said fistula device for penetrating said wall to facilitate passage of said fistula device therethrough; optionally, wherein the apparatus further comprises a rod coupled to said second member for extending at least partially into said fistula device; optionally, wherein said cover member is tubular; optionally, wherein said support member is tubular; optionally, wherein said support member includes a chambered edge to protect said penetrating tip; optionally, wherein said fistula device comprises anchoring means to prevent said fistula device from being displaced when said retaining sheath is removed; optionally, wherein said fistula device is self-expanding; optionally, wherein said fistula device is balloon expandable; optionally, wherein said fistula device is heat-expanded; optionally, wherein said fistula device is released when said cover member is moved in a distal direction; optionally, wherein said cover member has an opening therein through which said fistula device exits when said cover member is moved distally; 17 optionally, wherein the apparatus further comprises a pull-wire coupled to said retaining sheath for removing said retaining sheath in a proximal direction; optionally, wherein the apparatus further comprises a rip—chord coupled to said retaining sheath for ripping said retaining sheath to release said fistula device; optionally, wherein said retaining sheath is bio-resorbable; optionally, wherein the apparatus further comprises a push—rod coupled to said fistula device for maintaining said fistula device in position when said retaining sheath is removed; and optionally, wherein the apparatus further comprises a penetrating tip coupled to said fistula device for penetrating said wall to facilitate passage of said fistula device therethrough. An apparatus for deploying a fistula device, the apparatus comprising: an elongate outer tube having a proximal end and a distal end; an inner support tube positioned within said outer tube for supporting said fistula device and configured for relative movement with respect to said outer tube such that said fistula device is moveable between a storage position where said fistula device resides adjacent an inner surface of said outer tube, and a delivery position which is achieved by moving said outer tube in a proximal direction; optionally, wherein said fistula device is expandable from a collapsed state to an expanded state; optionally, wherein the apparatus further comprises a removable retaining sheath overlying at least a portion of said fistula device, said fistula device transitioning from said collapsed state to said expanded state when said retaining sheath is removed; optionally, wherein said support tube comprises an L-shaped member at its distal end, said member having a short leg that abuts a distal end of said fistula device; optionally, wherein said short leg urges said fistula device through human tissue when said inner support tube is pulled in a proximal direction; optionally, wherein the apparatus further comprises a penetrating tip coupled to said fistula device for penetrating said tissue to facilitate passage of said fistula therethrough; optionally, wherein the apparatus further comprises a rod coupled to said short leg for extending at least partially into said fistula device; optionally, wherein said support tube includes a chambered edge for protecting said penetrating tip; optionally, wherein said fistula device comprises anchoring means to prevent said fistula device from being displaced when said retaining sheath is removed; optionally, wherein said fistula device is self-expanding; optionally, wherein said fistula device is balloon expandable; optionally, wherein said fistula device is heat-expanded; and optionally, wherein said retaining sheath is bio-resorbable. A delivery apparatus for delivering a fistula device into a wall of a patient’s heart to place the fistula device in communication with a heart chamber, the apparatus comprising an elongate cover member having a proximal end and a distal end; an elongate support member provided inside the elongate cover member with the elongate cover member and the elongate support member being moveable with respect to each other; and a fistula device supported by the support member, wherein, in use, the elongate cover member is pulled in a proximal direction to allow the fistula device to be released from the delivery apparatus and to deliver the fistula device at a desired location in the wall of the heart; optionally, wherein the delivery apparatus comprises a retaining sheath overlying at least a portion of the fistula device, the sheath being moveable to expose the portion of the fistula device covered by the sheath; optionally, wherein the fistula device comprises a stent which is moveable between a collapsed condition when covered by the retaining sheath and an expanded condition when the sheath is removed; optionally, wherein the delivery apparatus includes means for urging the fistula device through the wall of the heart; optionally, wherein the elongate support member is substantially straight over its length; optionally, wherein the elongate support member conveniently includes a short limb and a long limb defining a generally L-shaped member at the distal end of the elongate support member; optionally, wherein the short limb of the generally L-shaped member abuts the fistula device at the distal end of the fistula device; optionally, wherein the means for urging the fistula device through the wall of the heart comprises the short limb of the L—shaped member; optionally, wherein the delivery apparatus also includes an inner rod connected to the short limb of the L—shaped member, the inner rod extending into the fistula device for at least a portion of its length; optionally, wherein the sheath includes a penetrating tip for penetrating through the wall of the heart and facilitating passage of the conduit into and through the heart wall; optionally, wherein the elongate cover member comprises an outer tube which covers the elongate support member and the latter is in the form of an inner tube; and optionally, wherein the fistula device is moveable between a storage mode in which the fistula device is contained inside the delivery apparatus, with the fistula device lying alongside the elongate cover member at one elongate side of the fistula device and with the elongate support member at the other elongate side of fistula device; and a delivery mode in which the elongate cover member is moved in a proximal direction to release the conduit from the delivery apparatus. A method of deploying an expandable fistula device between an artery and a heart chamber, the method comprising: mounting the fistula on a longitudinal support member; placing the support member within a longitudinal cover member having proximal and distal ends to envelope the fistula between the support member and the cover member; 21 positioning the enveloped fistula at a target location; pulling the cover member in a proximal direction to expose the fistula; 5 optionally, wherein the method further comprises: compressing the expandable fistula; and enclosing the compressed fistula in a retaining sheath to maintain the 10 fistula in a compressed state until the fistula is deployed; and optionally, wherein the method fiirther comprises: pulling the support member proximally to urge the exposed fistula 15 through a coronary wall; and releasing the fistula from said retaining sheath to allow the fistula to expand; 20 optionally, wherein the step of releasing comprises moving the support member distally after the fistula is deployed in the coronary wall; optionally, wherein the step of releasing comprises: 25 attaching a pull wire to the restraining sheath; and advancing the pull wire distally to remove the restraining sheath allowing the fistula to expand; and 30 optionally, wherein the method further comprises the step of maintaining said fistula in position while the restraining sheath is removed. 22 An apparatus for deploying a fistula device substantially as herein described with reference to and as shown in the accompanying drawings. MACLACHLAN & DONALDSON Applicants’ Agents 47 Merrion Square