Shunt for redistributing atrial blood volume
Systems and methods for implanting a shunt for regulating blood pressure between a patient's left and right atria are provided. The shunt comprises an anchor having a neck region, first and second end regions, and a conduit affixed with the anchor formed of a biocompatible material that is resistant to transmural and translation tissue ingrowth and that reduces a risk of paradoxical embolism. The shunt may be advanced through the sheath until the first region protrudes from the sheath and self-expands within the left atrium. The shunt and the sheath may then be retracted until the first region contacts the left side of the atrial septum. The sheath may further be retracted until the counterforce exerted by shunt tension on the atrial septum overcomes the friction of the retained portions of the shunt such that the second region is exposed from the sheath and self-expands within the second atrium.
1. An interatrial shunt for regulating blood volume distribution configured for placement in an interatrial septum between a patient's left atrium and the patient's right atrium, the interatrial shunt comprising:
an hourglass-shaped anchor having a first region, a second region, a neck region joining the first region to the second region, the hourglass-shaped anchor configured to transition from a collapsed delivery state to an expanded deployed state in which the first region extends into the patient's left atrium, the second region extends into the patient's right atrium, and the neck region is disposed at the interatrial septum, the expanded deployed state exhibiting the hourglass-shape; and
an expanded-polytetrafluoroethylene (ePTFE) conduit affixed to the hourglass-shaped anchor and defining a lumen that permits blood to flow across the interatrial septum via the interatrial shunt, wherein the lumen at a narrow portion of the neck region has a diameter of 4-6 mm in the expanded deployed state, and wherein the first region is configured to protrude 2.5-7 mm into the left atrium and the second region is configured to protrude 5-9 mm into the right atrium in the expanded deployed state.
2. The interatrial shunt of claim 1 , wherein the lumen of the interatrial shunt is sized and shaped to permit an amount of blood to flow across the interatrial septum to treat the patient's heart failure.
3. The interatrial shunt of claim 1 , wherein the lumen of the interatrial shunt is sized and shaped to permit an amount of blood to flow across the interatrial septum to treat the patient's pulmonary hypertension.
4. The interatrial shunt of claim 1 , wherein the lumen of the interatrial shunt is sized and shaped to permit an amount of blood to flow across the interatrial septum while preventing right ventricle (RV) overload.
5. The interatrial shunt of claim 1 , wherein the lumen of the interatrial shunt is sized and shaped to permit an amount of blood to flow across the interatrial septum to lower blood pressure in the left atrium.
6. The interatrial shunt of claim 1 , wherein the hourglass-shaped anchor is configured to self-expand to the expanded deployed state.
7. The interatrial shunt of claim 1 , wherein the hourglass-shaped anchor is formed of superelastic material.
8. The interatrial shunt of claim 1 , wherein the hourglass-shaped anchor is formed of nitinol.
9. The interatrial shunt of claim 1 , wherein the hourglass-shaped anchor is laser cut from a single tube of nitinol.
10. The interatrial shunt of claim 1 , wherein the hourglass-shaped anchor is a diabolo-shaped body.
11. The interatrial shunt of claim 1 , wherein the interatrial shunt is configured for percutaneous delivery to the interatrial septum through a sheath while in the collapsed delivery state.
12. The interatrial shunt of claim 11 , wherein the interatrial shunt is configured to be pushed through, and out of, the sheath via a delivery catheter.
13. The interatrial shunt of claim 1 , wherein the diameter is 4-5.5 mm.
14. The interatrial shunt of claim 1 , wherein the interatrial shunt has a length of 10-20 mm.
15. The interatrial shunt of claim 1 , wherein the interatrial shunt has a length of 10-18 mm in the collapsed delivery state.
16. The interatrial shunt of claim 1 , wherein the first and second regions have a maximal diameter of 10-16 mm in the expanded deployed state.
17. The interatrial shunt of claim 1 , further comprising a valve for controlling flow through the interatrial shunt.
18. The interatrial shunt of claim 1 , wherein the interatrial shunt remains patent post-implantation.
19. The interatrial shunt of claim 1 , wherein the ePTFE conduit defines a lumen wall that is resistant to transmural and translational tissue growth.
20. The interatrial shunt of claim 1 , wherein the ePTFE conduit has a first end that is configured to extend from the neck region a first distance of at least 3 mm into the patient's left atrium and a second end that is configured to extend from the neck region a second distance of at least 3 mm into the patient's right atrium, thereby preventing pannus formation from narrowing the lumen in the neck region.
21. The interatrial shunt of claim 20 , wherein the ePTFE conduit is configured so that when implanted the second end of the ePTFE conduit is located out of a natural circulation flow path of blood entering into the patient's right atrium from an inferior vena cava, thereby reducing a risk of emboli entrained in flow from the inferior vena cava being directed into the second end of the ePTFE conduit.
22. The interatrial shunt of claim 1 , wherein the hourglass-shaped anchor comprises a plurality of circumferential sinusoidal struts interconnecting longitudinal struts.
23. The interatrial shunt of claim 1 , wherein the ePTFE conduit encapsulates the hourglass-shaped anchor except for a portion defining cutouts adjacent to an end of the ePTFE conduit.
24. The interatrial shunt of claim 1 , wherein the ePTFE conduit has an exterior surface that is impermeable to transmural tissue growth and resistant to translational tissue growth.
25. The interatrial shunt of claim 1 , wherein the hourglass-shaped anchor, in the expanded deployed state, forms a filter that prevents emboli from entering an end of the ePTFE conduit.
26. A method for regulating blood volume distribution between a patient's left atrium and the patient's right atrium, the method comprising:
implanting an interatrial shunt to treat a heart condition, the interatrial shunt comprising:
an hourglass-shaped anchor having a first region, a second region, a neck region joining the first region to the second region, the hourglass-shaped anchor configured to transition from a collapsed delivery state to an expanded deployed state in which the first region extends into the patient's left atrium, the second region extends into the patient's right atrium, and the neck region is disposed at the interatrial septum, the expanded deployed state exhibiting the hourglass-shape; and
an expanded-polytetrafluoroethylene (ePTFE) conduit affixed to the hourglass-shaped anchor and defining a lumen that permits blood to flow across the interatrial septum via the interatrial shunt, wherein the lumen at a narrow portion of the neck region has a diameter of 4-6 mm in the expanded deployed state, and wherein the first region is configured to protrude 2.5-7 mm into the left atrium and the second region is configured to protrude 5-9 mm into the right atrium in the expanded deployed state.