Delivery methods for left ventricular conduit

A method for delivering a conduit into a heart wall to bypass a blockage formed in a coronary artery, comprising:

• creating a channel from a position proximal to the blockage in the coronary artery to a position distal to the blockage in the coronary artery;
• advancing a guidewire through the channel until a distal end of the guidewire is adjacent the heart wall;
• inserting the guidewire into the heart wall;
• and
• advancing a conduit over the guidewire into the heart wall.

A method for creating a bypass around a blockage in a coronary artery, adjacent a heart wall, comprising:

• inserting a needle into a patient into the heart wall, the needle having a lumen extending therethrough;
• advancing the needle through the heart wall and into the coronary artery distal to the blockage;
• advancing a guidewire through the lumen in the needle, the guidewire once advanced extending through the coronary artery proximal to the blockage, through the heart wall, and into the coronary artery distal to the blockage;
• removing the needle from the patient while leaving the guidewire in place;
• advancing a shunt over the guidewire, the shunt once advanced having a distal end in the coronary artery distal to the blockage.

A method for creating a bypass through the heart wall of a patient to bypass a blockage formed in a coronary artery, comprising:

• creating a first tunnel through the heart wall having a proximal end and a distal end, the proximal end opening into the coronary artery proximal to the blockage, and the distal end positioned within the heart wall;
• creating a second tunnel through the heart wall, the second tunnel having a first branch extending from the distal end of the first tunnel and opening into the coronary artery at a position distal to the blockage, and a second branch extending from the distal end of the first channel and opening into a heart chamber;
• and
• disposing a conduit in the second tunnel to provide a passageway therethrough.

A delivery catheter, comprising:

• an elongate tubular body having a proximal end and a distal end and a lumen extending therethrough;
• a first steering member mounted on the distal end of the tubular body;
• and
• a second steering member mounted on the distal end of the tubular body at a position distal to that of the anchoring member.

A method for delivering a medical device to a delivery site within a patient comprising:

• providing a delivery catheter having a proximal end and a distal end and a lumen extending therethrough into a body lumen of the patient;
• securing the delivery catheter within the body lumen;
• turning the distal end of the catheter by actuating a steering member mounted on the distal end of the catheter which pushes off against a wall of the body lumen;
• and
• advancing the medical device through the lumen of the delivery catheter and out the distal end.

A method for delivering a conduit into the heart wall of a patient, comprising:

• advancing a delivery catheter into the vasculature of the patient, the delivery catheter having a proximal end and a distal end and a lumen extending therethreough, until the distal end is adjacent the heart wall;
• actuating a pull wire extending from the distal end of the delivery catheter to turn the pull wire toward the heart wall;
• advancing the pull wire from the distal end of the delivery catheter into the heart wall;
• and
• delivering the conduit over the pull wire into the heart wall.

A method for delivering a conduit into the heart wall of a patient, comprising:

• advancing a delivery catheter into the vasculature of the patient, the catheter having a proximal end and a distal end and a lumen extending from the proximal end to a side port near the distal end, until the side port faces the heart wall;
• inserting a guidewire having a proximal end and a distal end into the lumen;
• advancing the distal end of the guidewire through the lumen and out the side port;
• advancing the guidewire into the heart wall;
• and
• delivering the conduit over the guidewire into the heart wall.

A method for delivering a conduit into the heart wall of a patient, comprising:

• advancing a delivery catheter into the vasculature of a patient, the catheter having a proximal end and a distal end, until the distal end is adjacent the heart wall;
• expanding an anchoring member mounted on the distal end of the catheter to secure the delivery catheter within the vasculature;
• inserting a guidewire having a proximal end and a distal end through a lumen in the expanded anchoring member, the lumen extending from a proximal end of the anchoring member to a side port facing the heart wall, so that the distal end of the guidewire exits through the side port;
• advancing the guidewire into the heart wall;
• and
• advancing the conduit over the guidewire into the heart wall.

A delivery catheter, comprising:

• an elongate body having a proximal end and a distal end;
• an expandable member mounted on the distal end of the tubular body, the expandable member having a proximal end and a distal end and an exterior surface;
• and
• a guide lumen extending from the proximal end of the expandable member to a side port on the exterior surface of the expandable member for directing a medical device therethrough.

A method for treating an aneurysm, comprising:

• advancing a catheter having a proximal end and a distal end to the site of the aneurysm;
• actuating an expandable member mounted on the distal end of the catheter to substantially enclose the aneurysm;
• and
• inserting an embolic element into the aneurysm.

An assembly for delivering a medical device into a heart wall of a patient, comprising:

• an insertion tube having a proximal end and a distal end and a delivery channel extending therethrough;
• a tubular member having a proximal end and a distal end and a lumen extending therethrough, the tubular member having a distal portion provided with an internal spring bias tending to form said distal portion into an arcuate configuration in the absence of an external straightening force on said distal portion, the tubular member being longitudinally slidable in said delivery channel, and wherein said distal portion may be alternately maintained in a relatively straightened configuration in the distal end of said channel and moved outside of said channel to assume said arcuate configuration;
• and
• a guidewire longitudinally slidable within the lumen of the tubular member.

A method for delivering a guidewire at an angle into a desired insertion site in the body, the method comprising:

• delivering an insertion tube into the vasculature of a patient, the insertion tube having a delivery channel extending therethrough and once delivered having a proximal end located outside of the patient and a distal end located adjacent a desired insertion site;
• delivering a delivery catheter through the delivery channel, the delivery catheter having a guidewire lumen extending therethrough, the delivery catheter once delivered having a proximal end outside of the patient and a distal end within the delivery channel;
• ejecting the distal end of the delivery catheter out of the delivery channel at the distal end of the insertion tube, the ejection of the delivery catheter from the delivery channel causing the distal end of the delivery catheter to turn toward the insertion site;
• and
• advancing a guidewire through the guidewire lumen into the insertion site.

A method for delivering a guidewire into the heart wall, comprising:

• inserting a guidewire into a lumen of a delivery catheter, the guidewire having a proximal section and a distal section, the distal section of the guidewire being folded back over the proximal section while inside the delivery catheter lumen;
• delivering the delivery catheter into a patient, the delivery catheter once delivered having a proximal end outside of the patient and a distal end adjacent a desired insertion site in the heart wall;
• ejecting the distal section of the guidewire out of the lumen of the delivery catheter at its distal end;
• and
• pulling proximally on the guidewire such that the distal section punctures into the heart wall at an obtuse angle relative to the direction that the guidewire is ejected out of the lumen of the delivery catheter at its distal end.

A method for delivering a guidewire into an insertion site in the body, comprising:

• advancing a delivery catheter having a proximal end and a distal end and a lumen extending therethrough into the body, the distal end of the delivery catheter once advanced being located adjacent the insertion site;
• turning the distal end of the delivery catheter toward the insertion site;
• and
• advancing a guidewire through the lumen in the delivery catheter from the proximal end toward the distal end;
• and
• guiding the guidewire out the distal end and into the insertion site through a narrowing passageway formed in the lumen.

A method for delivering a medical device into a body tissue of a patient comprising:

• inserting a guidewire having a proximal end and a distal end into the heart wall from a coronary blood vessel;
• anchoring the guidewire to the body tissue;
• pushing the medical device over the guidewire into the body tissue;
• and
• pulling on the proximal end of the guidewire while advancing the medical device through the body tissue.

A delivery system for directing a medical treatment at least partially into the heart wall, comprising:

• a guidewire having a proximal end and a distal end;
• means for turning the distal end of the guidewire toward the heart wall;
• means for anchoring the guidewire to the heart wall;
• and
• a catheter carrying the medical treatment having a lumen extending therethrough for receiving the guidewire and advancing the catheter into the heart wall.

A method for delivering a conduit into the heart wall of a patient to bypass a blockage formed in a coronary artery, comprising:

• advancing a catheter having a proximal end and a distal end and a lumen extending at least partially therethrough from the proximal end to a distal opening through the coronary artery of the patient until the distal opening is past the blockage;
• turning the catheter so that the distal opening faces the heart wall;
• extending a wire having a proximal end and a distal end through the distal opening such that the distal end punctures into the heart wall;
• anchoring the distal end of the wire to the heart wall;
• delivering a dilation catheter over the wire, the catheter carrying a dilation balloon on a distal end thereof, until the balloon is within the heart wall;
• inflating the dilation balloon to create an opening in the heart wall;
• deflating the dilation balloon and removing the dilation catheter from the wire;
• delivering a conduit introducer catheter over the wire, the conduit introducer catheter carrying a conduit on a distal end thereof, until the conduit is located within the opening in the heart wall, and
• deploying the conduit within the opening in the heart wall.

A method for delivering medical treatment into the heart wall of a patient, comprising:

• delivering a tubular wire having a lumen extending therethrough into the patient, the wire once delivered having a proximal end extending out of the patient and a distal end positioned adjacent the heart wall;
• providing a means for turning the distal end of the wire towards the heart wall;
• inserting the distal end of the wire into the heart wall;
• and
• delivering the medical treatment through the lumen in the wire into the heart wall.