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Device for facilitating end-to-side anastomosis

机译:促进端侧吻合的装置

摘要

The present invention provides a device and method for creating a seal around the inner wall of an incision in a blood vessel. The device is particularly adapted to create an anastomosis site for coronary artery bypass grafts to a patient's aorta without obstructing the flow of blood in the aorta. The device comprises an extruded tube with a translatable shaft positioned therein. One end of the shaft is coupled to a handle of the device which allows a practitioner to advance and withdraw the shaft relative to the tube. The other end of the shaft is connected to a flexible inverting member which is attached to the distal end of the tube. By manipulating the handle, the practitioner can remotely deform the inverting member between two configurations: an elongated, narrow configuration in which the inverting member is adapted to be inserted through a small incision, and an inverted configuration in which the inverting member forms an expanded, inward-facing cup. In operation, the medical practitioner inserts the inverting member into the blood vessel through an incision while the inverting member is maintained in its elongated, narrow configuration, and then manipulates the handle to cause the inverting member to assume its inverted configuration. A seal is then formed by applying a proximal force to the device to cause a rim of the cup to form a seal against an inner wall of the blood vessel. This prevents blood from flowing out of the incision and creates a working area for performing an end-to-side anastomosis. The working area is formed without interrupting the flow of blood through the vessel. The device preferably includes a hole punch device slidably mounted to the tube for allowing the practitioner to create an anastomosis hole once the seal has been formed.
机译:本发明提供了一种用于在血管中的切口的内壁周围形成密封的装置和方法。该装置特别适于在不阻碍主动脉中的血流的情况下为患者的主动脉创建用于冠状动脉旁路移植物的吻合部位。该装置包括其中具有可平移轴的挤压管。轴的一端连接到装置的手柄,该手柄允许从业者相对于管前进和缩回轴。轴的另一端连接到柔性反转构件,该柔性反转构件附接到管的远端。通过操纵手柄,从业人员可以在两种配置之间使转换构件远程变形:细长的狭窄配置,其中转换构件适合通过小切口插入;以及反转配置,其中转换构件形成展开状态,向内杯。在操作中,医生将倒转构件通过切口插入血管中,同时将倒转构件保持在其细长的狭窄构型,然后操纵手柄以使倒转构件采取其倒转构型。然后通过向该装置施加近侧力以使杯子的边缘形成抵靠血管的内壁的密封来形成密封。这防止了血液从切口流出,并形成了用于进行端对侧吻合的工作区域。在不中断通过血管的血液流动的情况下形成工作区域。该装置优选地包括可滑动地安装到管上的打孔装置,以允许从业者一旦形成密封件就形成吻合孔。

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