Method and apparatus for effecting a minimally invasive distal anastomosis for an aortic valve bypass

A delivery instrument for delivering a connector for joining a first hollow structure to the side wall of a second hollow structure, the delivery instrument comprising:

• a hollow column;
• at least one traction arm pivotally mounted to the hollow column so as to selectively radially project a toe of the traction arm;
• a rod movably mounted to the hollow column and having a clamp at the distal end thereof, the rod being adapted to selectively engage the at least one traction arm so as to cause the at least one traction arm to radially project the toe of the at least one traction arm;
• and
• at least one collar actuator slidably mounted to the hollow column.

A system for joining a first hollow structure to the side wall of a second hollow structure, the system comprising:

• a connector comprising:
• a first component comprising:
• an inner collar for disposition within the interior of the second hollow structure, the inner collar having a toroidal configuration characterized by an outer perimeter and an inner perimeter, with the inner collar being flexible;
• a hollow body connected to the inner collar and upstanding therefrom, the hollow body of the inner collar being aligned with the inner perimeter of the inner collar;
• and
• a graft element mounted to the inner collar and forming a conduit extending through the hollow body and the inner perimeter of the inner collar, the graft being formed out of a fluid-retaining material;
• a second component for disposition outside the second hollow structure, the second component comprising an outer collar and a hollow body connected to the outer collar, the outer collar having a toroidal configuration characterized by an outer perimeter and an inner perimeter, with the hollow body of the outer collar being aligned with the inner perimeter of the outer collar;
• the hollow body of the second component being sized for coaxial disposition over the hollow body of the first component so that the outer collar of the second component can be adjustably positioned relative to the inner collar of the first component and so that the conduit of the graft element provides fluid communication between (i) the region beyond the inner collar, and (ii) the region beyond the hollow body of the first component;
• and
• a delivery instrument for delivering the connector to the second hollow structure, the delivery instrument comprising:
• a hollow column;
• at least one traction arm pivotally mounted to the distal end of the hollow column so as to selectively radially project a toe of the traction arm;
• a rod movably mounted to the hollow column and having a clamp at the distal end thereof, the rod being adapted to selectively engage the at least one traction arm so as to cause the at least one traction arm to radially project the toe of the at least one traction arm;
• and
• at least one collar actuator slidably mounted to the hollow column;
• the connector being mounted to the delivery tool such that the hollow body of the first component is mounted coaxially on the hollow column of the delivery instrument, and the at least one collar actuator is aligned with the hollow body of the second component.

A method for joining a first hollow structure to the side wall of a second hollow structure, the method comprising:

• providing a connector having (i) a first component comprising an inner collar and a hollow graft element mounted to the inner collar and extending therefrom, and (ii) a second component comprising an outer collar;
• forming an opening in the side wall of the second hollow structure;
• positioning the inner collar of the first component within the interior of the second hollow structure, with the graft element extending through the side wall of the second hollow structure;
• and
• advancing the outer collar of the second component toward the inner collar of the first component so as to clamp the side wall of the second hollow structure therebetween.