| 摘要 |
The present invention provides a device and method for creating an area of hemostasis within a blood vessel (81) without interruption the flow of blood through the vessel. The device is particularly adapted to create an anastomosis site for attaching coronary artery bypass grafts to a patient's aorta without the need to stop the patient's heart. The device comprises an extruded tube (12, 112, 160) with a shaft (11, 51, 232) positioned therein. One end of the shaft (11, 51, 232) is coupled to a handle (16, 180, 252) of the device which allows a practitioner to advance and withdraw the shaft (11, 51, 232) relative to the tube (12, 112, 160). The other end of the shaft (11, 51, 232) is connected to a flexible inverting member (14, 15, 151) which is attached to the distal end of the tube (12, 112, 160). By manipulating the handle (16, 180, 252). The practitioner can remotely deform the inverting member (14, 15, 151) between an elongated, narrow configuration in which the inverting member (14, 15, 151) is adapted to be inserted through a small incision (82) and an inverted configuration in which the inverting member (14, 15, 151) forms an expanded, inward-facing cup. In operation, the practitioner inserts the inverting member (14, 15, 151) into the blood vessel (81) through an incision (82) while the inverting member (14, 15, 151) is maintained in its elongated, narrow configuration, and then manipulates the handle (16, 180, 252) to cause the inverting member (14, 15, 151) to assume its inverted configuration. A seal is then formed by applying a proximal force to the device to cause a rim of the cup to form a seal against an inner wall of the blood vessel (81). An optional hold punch device (178) may then be slidably deployed along the cube (12, 112, 160) to form an anastomosis hole (182) within the boundaries of the seal.
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