Vascular and aortic connectors with robotic delivery and deployment methods thereof
A deployment tool and associated method are disclosed for implanting a vascular connector in a patient. The vascular connector deployment tool has a housing, an inner sheath extending distally from the housing, a floating mandrel, a vascular connector disposed coaxially about the mandrel, and an outer sheath telescopically deployed over an inner sheath. The outer sheath constrains the vascular connector around the mandrel in an insertion profile when the outer sheath is disposed over the vascular connector. The inner sheath may be rotated to cause the outer sheath to retract relative to the floating mandrel and expose sequential portions of the vascular connector. A drive disposed within the housing and coupled to a proximal end of the outer sheath translates rotational motion of the inner sheath into longitudinal motion of the outer sheath.
1 . A vascular connector deployment tool, comprising:
a housing;
an inner sheath extending distally from the housing, wherein the inner sheath is rotatable with respect to the housing;
a floating mandrel;
a connector coupling the floating mandrel to a distal end of the inner sheath such that the inner sheath is capable of rotation with respect to the floating mandrel;
a vascular connector disposed coaxially about the floating mandrel;
an outer sheath telescopically deployed over the inner sheath, wherein the outer sheath is configured to constrain the vascular connector around the floating mandrel in an insertion profile when the outer sheath is disposed over the vascular connector; and
a drive disposed within the housing that is coupled to a proximal end of the outer sheath and is configured to translate a rotational motion of the inner sheath into a longitudinal motion of the outer sheath.
2 . The vascular connector deployment tool of claim 1 , wherein the drive is coaxially disposed over a proximal portion of the inner sheath and engages external threads on the proximal portion of the inner sheath.
3 . The vascular connector deployment tool of claim 2 , wherein the drive travels along guides in the housing that permit longitudinal motion and resist rotational motion.
4 . The vascular connector deployment tool of claim 2 , wherein the drive is configured to translate a first predetermined amount of rotation of the inner sheath into a first known amount of longitudinal motion of the outer sheath.
5 . The vascular connector deployment tool of claim 4 , wherein the first known amount of longitudinal motion exposes a distal portion of the vascular connector.
6 . The vascular connector deployment tool of claim 5 , wherein the drive is configured to translate a second predetermined amount of rotation of the inner sheath into a second known amount of longitudinal motion of the outer sheath and wherein the second known amount of longitudinal motion exposes a proximal portion of the vascular connector.
7 . The vascular connector deployment tool of claim 4 , wherein the inner sheath has an interface that extends from a proximal end of the housing and is configured to rotate the inner sheath.
8 . The vascular connector deployment tool of claim 1 , wherein the floating mandrel comprises a shoulder configured to engage and resist proximal longitudinal motion of the vascular connector when the outer sheath is retracted.
9 . The vascular connector deployment tool of claim 1 , wherein the vascular connector is visible through the outer sheath.
10 . The vascular connector deployment tool of claim 1 , wherein the outer sheath comprises a marker configured to indicate a position of the vascular connector prior to retraction of the outer sheath.
11 . The vascular connector deployment tool of claim 1 , wherein the vascular connector is a self-expanding connector and is able to maintain radial force at a temperature in a range of 19° C. to 37° C.
12 . The vascular connector deployment tool of claim 1 , wherein the floating mandrel and the inner sheath comprise a guidewire lumen.
13 . A method for implanting a vascular connector in a patient, comprising: providing a vascular connector deployment tool including a housing, an inner sheath extending distally from the housing, wherein the inner sheath is rotatable with respect to the housing, a floating mandrel, a connector coupling the floating mandrel to a distal end of the inner sheath such that the inner sheath is capable of rotation with respect to the floating mandrel, a vascular connector disposed coaxially about the floating mandrel, an outer sheath telescopically deployed over the inner sheath, wherein the outer sheath is configured to constrain the vascular connector around the floating mandrel in an insertion profile when the outer sheath is disposed over the vascular connector, and a drive disposed within the housing that is coupled to a proximal end of the outer sheath and is configured to translate a rotational motion of the inner sheath into a longitudinal motion of the outer sheath; positioning at least a distal portion of the vascular connector within a first lumen for conducting blood of the patient, the vascular connector being constrained around the floating mandrel in an insertion profile; rotating the inner sheath to cause the drive to translate the rotational movement of the inner sheath to longitudinal movement of the outer sheath to cause the outer sheath to retract longitudinally relative to the floating mandrel and expose a distal portion of the vascular connector; and
securing the distal portion of the vascular connector within the first lumen by expansion of the portion of the vascular connector from the insertion profile.
14 . The method of claim 13 , wherein rotating the inner sheath comprises imparting a first predetermined amount of rotation to cause a first known amount of longitudinal motion of the outer sheath, such that the first known amount of longitudinal motion exposes the distal portion of the vascular connector.
15 . The method of claim 14 , further comprising: advancing a second lumen for conducting blood of the patient coaxially over the deployment tool until an end of the second lumen is adjacent the opening of the first lumen; further rotating the inner sheath to cause the outer sheath to retract relative to the floating mandrel and expose a remaining portion of the vascular connector; and securing the remaining portion of the vascular connector within the second lumen by expansion of the remaining portion of the vascular connector from the insertion profile.
16 . The method of claim 15 , wherein further rotating the inner sheath comprises imparting a second predetermined amount of rotation of the inner sheath to cause a second known amount of longitudinal motion of the outer sheath, such that the second known amount of longitudinal motion exposes the remaining portion of the vascular connector, wherein the remaining portion of the vascular connector comprises a proximal portion of the vascular connector.
17 . The method of claim 15 , wherein the first lumen is a blood vessel and the second lumen is a graft.
18 . The method of claim 13 , wherein positioning at least the distal portion of the vascular connector within the first lumen comprises visualizing the vascular connector through the outer sheath.
19 . The method of claim 13 , wherein positioning at least the distal portion of the vascular connector within the first lumen comprises using a marker that indicates a position of the vascular connector prior to retraction of the outer sheath.