Devices, systems, and methods for revascularization of the myocardium
Devices, systems, and methods for revascularization of the myocardium are disclosed, such as an intravascular medical device for shunting and selectively regulating anatomical fluid flow. A tubular shunt is configured for deployment in a passageway between a first organ and a second adjacent organ and to bridge a first cavity in the first organ and a second cavity in the second organ. A stabilizer is configured to stabilize the tubular shunt in the passageway. A flow deflector extends from the tubular shunt and has a surface for deflecting flow in the second cavity.
1 . An intravascular retrograde blood flow device, comprising:
a catheter;
an expandable shunt compressed within the catheter and configured to bridge an opening between a first cavity of a first organ and a second cavity of a second organ;
an expandable flow deflector compressed within the catheter and configured to:
deflect flow in a first direction in the second cavity; and
at least partially occlude flow in a second direction in the second cavity; and
a flexible hinge interconnecting the expandable shunt and the expandable flow deflector, wherein the flexible hinge is configured to bend such that when the expandable shunt is positioned in the opening and the expandable flow deflector is positioned in the second cavity, the flexible hinge is bendable such that the expandable flow deflector is movable relative to the expandable shunt.
2 . The device of claim 1 , wherein the expandable flow deflector includes an expandable frame covered by a flexible flow-deflecting cover, and wherein the expandable frame is configured to fixate, upon expansion, against a wall of the second cavity, such that the fixation aids in stabilizing the expandable shunt in the opening.
3 . The device of claim 2 , wherein in an expanded configuration, the expandable frame includes a cylindrical portion and wherein the flow deflecting cover extends over the cylindrical portion in a manner forming a drum-like planar flow deflecting surface.
4 . The device of claim 2 , wherein in an expanded configuration, the expandable frame includes a deflector support and wherein the flow deflecting cover extends over the deflector support in a manner forming a concave flow deflecting surface.
5 . The device of claim 2 , wherein in an expanded configuration, the expandable frame includes a concave portion and wherein the flow-deflecting cover extends over the concave portion in a manner forming a scoop-shaped flow deflecting surface.
6 . The device of claim 2 , wherein in an expanded configuration, the expandable frame includes an extension extending from the expandable frame beyond an intersection of a first axis with a wall of the second cavity, and wherein the extension engages the wall of the second cavity.
7 . The device of claim 6 , wherein the extension extends in a direction contrary to a normal direction of fluid flow.
8 . The device of claim 2 , wherein the flexible flow-deflecting cover is substantially impermeable to blood.
9 . The device of claim 2 , wherein the flexible flow-deflecting cover includes a tool passage configured to minimize blood flow therethrough.
10 . The device of claim 2 , wherein the flexible flow-deflecting cover includes at least one of a mesh, a fabric, a polymer coating, or a synthetic material coating.
11 . The device of claim 1 , further including a first stabilizer extending from a distal end of the expandable shunt, opposite the hinge, for engaging with an inner wall of the first cavity to maintain the expandable shunt in the opening.
12 . The device of claim 11 , further including a second stabilizer comprising a flange region extending from a proximal end of the expandable shunt into the second cavity for engaging with an inner wall of the second cavity to maintain the expandable shunt in the opening.
13 . The device of claim 12 , wherein at least one of the first stabilizer and the second stabilizer comprises a plurality of prongs having inequivalent lengths.
14 . The device of claim 11 , wherein the first stabilizer includes a plurality of outwardly extending prongs, each prong having a distal end curved in a direction facing an inner wall of the first cavity.
15 . The device of claim 1 , wherein the expandable shunt includes a tubular scaffold, and wherein the flexible flow-deflecting cover extends over the tubular scaffold.
16 . The device of claim 2 , wherein the flexible flow-deflecting cover is further configured to permit at least some non-retrograde blood flow in the second cavity.
17 . The device of claim 1 , wherein the expandable flow deflector includes a lip for engaging with a wall of the second cavity to aid in forming a seal against the wall of the second cavity.
18 . The device of claim 1 , wherein the expandable flow deflector includes a frame configured to initially maintain a compressed form following ejection from the catheter, and wherein the device further comprises a release mechanism for enabling selective expansion of the expandable flow deflector following expansion of the expandable shunt.
19 . The device of claim 1 , wherein the expandable flow deflector is partially connected to a perimeter edge of the expandable shunt via the flexible hinge.
20 . The device of claim 1 , wherein the flexible hinge includes a tether.
21 . The device of claim 20 , wherein the tether has an undulating shape.
22 . The device of claim 2 , wherein the expandable frame is configured such that when the catheter is removed in a first direction to cause release of the expandable flow deflector, the expandable frame is configured to expand in a second direction different from the first direction.
23 . The device of claim 2 , wherein the one or more flexible hinges include two flexible hinges extending from opposing sides of the shunt circumference.
24 . A method for directing intravascular retrograde blood flow, the method comprising:
puncturing an opening between a first cavity and a second cavity;
advancing a catheter into the opening between the first cavity and the second cavity;
expelling, from the catheter in the opening, an expandable shunt compressed within the catheter;
expelling from the catheter an expandable flow deflector connected to the expandable shunt by a flexible hinge configured to bend such that when the expandable shunt is positioned in the opening and the expandable flow deflector is positioned in the second cavity, the flexible hinge is bendable such that the expandable flow deflector is movable relative to the expandable shunt; and
fixating the expandable flow deflector in the second cavity,
wherein the expandable flow deflector is configured to:
deflect flow in a first direction in the second cavity; and
at least partially occlude flow in a second direction in the second cavity.