US 10,537,430 B2 · Sizing methods for a valved conduit graft

Abstract

A sizing tool for use in implanting a composite valved conduit having a prosthetic heart valve on a distal end attached to a conduit graft that extends to a proximal end. The tool includes a proximal handle and a distal shaft, a prosthetic heart valve sizer having an axis affixed to a distal end of the shaft, and a conduit graft replica having an axis mounted on the shaft proximal to the heart valve sizer. A method of securing a composite valved conduit includes introducing to an excised ascending aorta the sizing tool, measuring the aortic annulus with the prosthetic heart valve sizer, and determining whether the coronary arteries have sufficient length or whether an additional tubular coronary extension segment is required to add to one or both of the ends of the coronary arteries by extending the coronary arteries toward the conduit graft replica.

Claims20

Dependent claims

A method of sizing a patient's aortic valve annulus and two coronary arteries for implant of a composite valved conduit having a prosthetic heart valve on a distal end attached to a conduit graft that extends to a proximal end, comprising:

obtaining a sizing tool having a proximal handle and a shaft extending distally therefrom, a heart valve sizer defining an axis and affixed to a distal end of the shaft, and a conduit graft replica defining an axis and mounted on the shaft proximal to the heart valve sizer;
accessing the patient's heart;
severing the two coronary arteries from the patient's ascending aorta;
resecting a section of the ascending aorta from a location adjacent to the aortic valve annulus to leave a remaining portion;
advancing the heart valve sizer of the sizing tool to the aortic valve annulus;
determining the diameter of the aortic valve annulus by inserting the heart valve sizer into the aortic valve annulus;
assessing whether the severed coronary arteries are long enough to reach the conduit graft replica;
adding a tubular coronary extension segment to either of the severed coronary arteries that are not long enough to reach the conduit graft replica;
preparing the composite valved conduit for implant;
attaching the composite valved conduit between the aortic valve annulus and the remaining portion of the ascending aorta;
and
forming anastomotic connections between the coronary arteries and the conduit graft.

9 more elements

obtaining a sizing tool having a distal heart valve sizer defining an axis and a conduit graft replica defining an axis and located proximal to the heart valve sizer;
accessing the patient's heart;
severing the two coronary arteries from the patient's ascending aorta;
resecting a section of the ascending aorta from a location adjacent to the aortic valve annulus to leave a remaining portion;
spacing the conduit graft replica proximally away from the heart valve sizer;
advancing the heart valve sizer of the sizing tool to the aortic valve annulus;
determining the diameter of the aortic valve annulus by inserting the heart valve sizer into the aortic valve annulus;
sliding the conduit graft replica into contact with the heart valve sizer and then assessing whether the severed coronary arteries are long enough to reach the conduit graft replica;
adding a tubular coronary extension segment to either of the severed coronary arteries that are not long enough to reach the conduit graft replica;
preparing the composite valved conduit for implant;
attaching the composite valved conduit between the aortic valve annulus and the remaining portion of the ascending aorta;
and
forming anastomotic connections between the coronary arteries and the conduit graft.

10 more elements

obtaining a sizing tool having a heart valve sizer on a distal end with a diameter that corresponds to a labeled size of the prosthetic heart valve, and a conduit graft replica located proximal to the heart valve sizer having an outwardly-bulged portion with a diameter that is larger than the heart valve sizer diameter;
accessing the patient's heart;
severing the two coronary arteries from the patient's ascending aorta;
resecting a section of the ascending aorta from a location adjacent to the aortic valve annulus to leave a remaining portion;
advancing the heart valve sizer of the sizing tool to the aortic valve annulus;
determining the diameter of the aortic valve annulus by inserting the heart valve sizer into the aortic valve annulus;
assessing whether the severed coronary arteries are long enough to reach respective target locations on the outwardly-bulged portion of the conduit graft replica;
adding a tubular coronary extension segment to either of the severed coronary arteries that are not long enough to reach the respective target location;
preparing the composite valved conduit for implant;
attaching the composite valved conduit between the aortic valve annulus and the remaining portion of the ascending aorta;
and
forming anastomotic connections between the coronary arteries and the conduit graft.

9 more elements

Dependencies are inferred from the claim text.

Sizing methods for a valved conduit graft

Life of this patent

Sizing methods for a valved conduit graft

Life of this patent

Abstract

Claims20