Method and apparatus for providing an anastomosis

#This invention relates generally to a method and apparatus for providing an anastomosis, and, more particularly, to an improved portal-caval shunt and to an improved method of relieving portal hypertension.

#It is sometimes desired to relieve a condition known as portal hypertension. This condition is characterized by the pressure of blood in the portal vein being substantially greater than its normal pressure. In some cases, this condition is relieved surgically, with the surgeon first making a major incision in the body, then making an opening between proximate portions of the vena cava and portal vein, and thereafter suturing marginal portions of such vessels together about the surgically-formed opening. The intent here is to provide a shunt to relieve excess pressure in the portal vein to the patient's vena cava. This technique, while effective, requires major surgery.

#Accordingly, there is believed to be a need for an improved device that would permit the provision of a anastomotic shunt, for example to relieve portal hypertension, without the need for major surgery.

#FIG. 1 is a fragmentary longitudinal vertical sectional view of one form of the improved shunt, showing the male and female sections as being operatively coupled together with the spokes extending generally radially outwardly from the axis of the shunt to embrace marginal portions of the portal vein and vena cava about the opening to provide an anastomosis therebetween.

#FIG. 2 is a left end elevation of the leftward male section, this view showing the spokes as extending outwardly from the male section.

#FIG. 3 is a fragmentary transverse vertical sectional view thereof, taken generally on line 3--3 of FIG. 1, showing the manner by which the spokes are pivotally connected to the female section.

#At the outset, it should be clearly understood that like reference numerals are intended to identify the same structural elements, portions or surfaces consistently throughout the several drawing figures, as such elements, portions or surfaces may be further described or explained by the entire written specification of which this detailed description is an integral part. Unless otherwise indicated, the drawings are intended to be read (e.g., arrangement of parts, mounting, etc.) together with the specification, and are to be considered a portion of the entire written description of this invention. As used in the following description, the terms "horizontal", "vertical", "left", "right", "up" and "down", as well as adjectival and adverbial derivatives thereof (e.g., "horizontally", "rightwardly", "upwardly", etc.) simply refer to the orientation of the illustrated structure as the particular drawing figure faces the reader. Unless otherwise indicated, the terms "inwardly" and "outwardly" refer to the orientation of a surface relative to its axis of elongation, or axis or rotation, as appropriate.

#Referring now to the drawings, and, more particularly, to FIGS. 1-8 thereof, this invention broadly provides an improved shunt, of which a presently-preferred embodiment is generally indicated at 20, for providing an anastomosis (i.e., a surgical joining of two hollow blood vessels or other tubular organs). The invention is deemed to have particular utility to provide an anastomotic shunt between a patient's vena cava and his portal vein, so as to relieve an excess pressure condition within the portal vein (i.e., portal hypertension). Thus, in FIG. 1, the improved shunt is shown as being provided within aligned openings 21,22 provided in the patient's vena cava 23 and portal vein 24, respectively. However, the invention is not limited to this particular end use, and possesses general utility to provide a shunt or anastomosis between other blood vessels (i.e., both venous and arterial), ducts, and passageways as well. Thus, while the invention will now be described in the environment of relieving portal hypertension, it should be clearly understood that the scope of the appended claims are not limited to this particular use, unless an explicit limitation to that effect appears therein.

#The illustrated form 20 of the improved shunt is shown as including a leftward male section 25 and a rightward female section 26. Male section 25 is shown as being a thin-walled cylindrical tube having a horizontal axis x--x. The male section has an annular vertical left end face 28, an annular vertical right end face 29, and inwardly -and outwardly-facing horizontal cylindrical surfaces 30,31, respectively, extending between end faces 28,29. As best shown in FIGS. 4 and 6, four blind tapped holes, severally indicated at 32, extended horizontally into the male section from its right end face 29. These four holes are spaced from one another by equal arc distances of 90.degree.. In FIG. 4, these four holes are specifically shown as being arranged at the 1:30, 4:30, 7:30 and 10:30 o'clock positions.