Methods and devices for improving cardiac output

Claim 2

1 . A method of improving cardiac output of a patient's heart, comprising: forming at least one opening through a wall of the heart substantially at the apex; forming at least one opening through a wall of the aorta by means of an instrument delivered endovascularly through the aorta; establishing a fluid communication pathway between the apical opening and the aortic opening; and performing each of the above steps while the heart is beating.

Claim 3

2 . The method of claim 1 , wherein forming the apical opening is performed from outside of the patient's heart.

Claim 4

3 . The method of claim 1 , wherein forming the apical opening is performed from inside of the left ventricle.

Claim 5

4 . The method of claim 1 wherein establishing a fluid communication pathway comprises implanting a conduit between said apical opening and said aortic opening.

Claim 6

5 . The method of claim 4 wherein said conduit comprises a valve.

Claim 7

6 . The method of claim 1 further comprising implanting a valve in at least one of the group consisting of the fluid communication pathway, substantially adjacent the apical opening, substantially adjacent the aortic opening and the aorta.

Claim 8

7 . The method of claim 1 wherein said apical opening is formed in the left ventricle and the aortic opening is formed in the descending aorta.

Claim 9

8 . A method of improving cardiac output of a patient's heart, comprising: forming an opening through the left ventricular wall at the apex of the heart; forming an opening through a wall of the descending aorta by means of an instrument delivered endovascularly through the aorta; implanting a conduit between the left ventricular opening and the aortic opening; and performing each of the above steps while the heart is beating.

Claim 10

8 . A method of improving cardiac output of a patient's heart, comprising: forming an opening through the left ventricular wall at the apex of the heart; forming an opening through a wall of the descending aorta by means of an instrument delivered endovascularly through the aorta; implanting a conduit between the left ventricular opening and the aortic opening; and performing each of the above steps while the heart is beating.

Claim 11

9 . The method of claim 8 wherein said forming the aortic opening is done under fluoroscopic visualization.

Claim 12

10 . The method of claim 8 wherein said forming the ventricular opening is performed under endoscopic visualization.

Claim 13

11 . A method of improving cardiac output of a patient's heart, comprising: providing a conduit having an upstream end and a downstream end; delivering the conduit to a location external to the heart between the left ventricle and the descending aorta; selecting a downstream conduit attachment site within the wall of the descending aorta; occluding blood flow through the descending aorta at the downstream conduit attachment site; forming an opening in the descending aorta at the downstream conduit attachment site; selecting an upstream conduit attachment site within the wall of the left ventricle; attaching the upstream end of the conduit to the upstream conduit attachment site; accessing said upstream attachment site through the conduit; and forming an upstream opening in the left ventricular wall at the upstream conduit attachment site.

Claim 14

11 . A method of improving cardiac output of a patient's heart, comprising: providing a conduit having an upstream end and a downstream end; delivering the conduit to a location external to the heart between the left ventricle and the descending aorta; selecting a downstream conduit attachment site within the wall of the descending aorta; occluding blood flow through the descending aorta at the downstream conduit attachment site; forming an opening in the descending aorta at the downstream conduit attachment site; selecting an upstream conduit attachment site within the wall of the left ventricle; attaching the upstream end of the conduit to the upstream conduit attachment site; accessing said upstream attachment site through the conduit; and forming an upstream opening in the left ventricular wall at the upstream conduit attachment site.

Claim 15

12 . The method of claim 11 further comprising preventing the escape of blood from the open upstream attachment site while forming the upstream opening therein.

Claim 16

13 . The method of claim 12 wherein said preventing the escape of blood comprises sealing the upstream opening from inside the left ventricle.

Claim 17

14 . The method of claim 13 wherein said sealing comprises inflating a balloon.

Claim 18

15 . The method of claim 14 wherein said sealing comprises expanding a mesh.

Claim 19

16 . The method of claim 12 wherein said preventing comprises occluding the conduit adjacent the upstream opening.

Claim 20

17 . The method of claim 11 wherein said accessing the upstream attachment site through the conduit comprises accessing the conduit through the downstream end of the conduit.

Claim 21

18 . The method of claim 11 wherein said accessing the upstream attachment site through the conduit comprises accessing the conduit through a port within a side wall of the conduit.

Claim 22

19 . The method of claim 18 wherein said port is sealable.

Claim 23

20 . The method of claim 11 further comprising attaching the downstream end of the conduit to the downstream conduit attachment site.

Claim 24

21 . The method of claim 11 further comprising inserting a valve into the conduit.

Claim 25

22 . The method of claim 11 further comprising implanting a valve within the descending aorta.

Claim 26

23 . The method of claim 11 wherein the occluding blood flow through the descending aorta comprises inflating at least one balloon within the descending aorta.