УСТРОЙСТВО ДЛЯ ВНУТРИСЕРДЕЧНОЙ И ВНУТРИСОСУДИСТОЙ ХИРУРГИЧЕСКОЙ ПРОЦЕДУРЫ, СОДЕРЖАЩЕЕ ЭНДОЛЮМИНАЛЬНЫЙ УЛЬТРАЗВУКОВОЙ ЗОНД

Изобретение относится к медицинской технике, а именно к средствам для внутрисердечной и внутрисосудистой хирургической процедуры. Устройство содержит хирургический эндолюминальный ультразвуковой зонд, содержащий гибкую трубку, имеющую продольную полость, которая образует рабочий канал для приема и направления транскатетерных устройств или инструментов для хирургической процедуры, закрывающую дверцу, трехмерный ультразвуковой датчик и один или более встроенный движущий трос, вставленный в указанные отверстия для осевого ориентирования дистального конца гибкой трубки, причем гибкая трубка имеет выходное отверстие рабочего канала на дистальном конце гибкой трубки, закрывающая дверца присоединена к дистальному концу гибкой трубки посредством шарнира для открывания и закрывания выходного отверстия рабочего канала и ультразвуковой датчик расположен на указанной закрывающей дверце. Дистальная часть гибкой трубки содержит кольцеобразные элементы, расположенные последовательно вдоль гибкой трубки ...

УСТРОЙСТВО ДЛЯ ЗАЖИМА КЛАПАНА

Группа изобретений относится к медицинской технике, а именно к устройству для зажима клапана и системе для зажима клапана, в частности, к устройству для зажима клапана и системе для зажима клапана при лечении регургитации сердечного клапана. Устройство для зажима клапана для лечения митральной регургитации содержит первый зажимной компонент, второй зажимной компонент и фиксирующий компонент для фиксации первого зажимного компонента и второго зажимного компонента. Первый зажимной компонент содержит по меньшей мере два первых зажимных рычага. Второй зажимной компонент содержит соответствующее количество вторых зажимных рычагов. Каждый первый зажимной рычаг и соответствующий второй зажимной рычаг объединены в пару зажимов. Дистальные концы по меньшей мере одной части первых зажимных рычагов снаружи имеют первые выступы и внутри имеют вторые выступы вдоль направления зажима первых зажимных рычагов. Первые зажимные рычаги и вторые зажимные рычаги, соответственно, имеют зажимные зубцы, ответные ...

УСТРОЙСТВО И СПОСОБ ДЛЯ БЕЗОПАСНОГО ПОЗИЦИОНИРОВАНИЯ КОРОНАРНОГО СТЕНТА В КОРОНАРНЫХ АРТЕРИЯХ

КРЮЧКИ ДЛЯ ФИКСАЦИИ МЕДИЦИНСКОГО УСТРОЙСТВА

... 1. Имплантируемое медицинское устройство, содержащеекаркас, имеющий, по меньшей мере, один продолговатый элемент, ификсирующий элемент, содержащий первую манжету, вторую манжету, зацепляющийся с тканью элемент, конфигурация которого обеспечивает крепление к ткани на участке имплантации для удержания имплантируемого медицинского устройства в положении, которое находится на участке имплантации, и соединяющий манжеты элемент, имеющий дуговую форму и соединенный у первого края с первой манжетой, а у второго края со второй манжетой,отличающееся тем, чтопервая манжета окружает периметр первого участка, по меньшей мере, одного продолговатого элемента, вторая манжета окружает периметр второго участка, по меньшей мере, одного продолговатого элемента, а соединяющий манжеты элемент не окружает периметр ни одного участка, по меньшей мере, одного продолговатого элемента.2. Имплантируемое медицинское устройство по п. 1, отличающееся тем, что зацепляющийся с тканью элемент имеет конфигурацию, обеспечивающую ...

УСТРОЙСТВО ЗАХВАТА СТВОРКИ КЛАПАНА СЕРДЦА

КАТЕТЕР ДЛЯ ИЗМЕРЕНИЯ ЭЛЕКТРИЧЕСКОГО ПОТЕНЦИАЛА

... 1. Катетер для измерения электрического потенциала, содержащий:стержень, имеющий электроды для измерения электрического потенциала, металлическую часть длиной 2 мм или более и просвет, проходящий через него от проксимального конца к дистальному концу в продольном направлении; иметаллическую проволоку, вставленную через указанный просвет и соединенную с указанной металлической частью.2. Катетер для измерения электрического потенциала по п.1,в котором указанные электроды для измерения электрического потенциала прикреплены к дистальной стороне в продольном направлении указанного стержня, иуказанная металлическая часть расположена дистально относительно положения указанных электродов для измерения электрического потенциала в продольном направлении указанного стержня.3. Катетер для измерения электрического потенциала по п.1 или 2, в котором длина указанной металлической части составляет от 2 до 50 мм.4. Катетер для измерения электрического потенциала согласно любому одному из пп.1 или 2, в котором ...

ШОВНЫЕ НИТИ С ЗАЗУБРИНАМИ И СТОПОРАМИ ДЛЯ ТАМПОНОВ И СПОСОБЫ ИХ ПРИМЕНЕНИЯ

... 1. Хирургическая шовная нить, содержащая:удлиненный сердечник, содержащий первое плечо и второе плечо; истопор, выступающий из упомянутого удлиненного сердечника между упомянутыми первым и вторым плечами.2. Хирургическая шовная нить по п.1, дополнительно содержащая:первый набор зазубрин, выступающих из упомянутого первого плеча упомянутого удлиненного сердечника; ивторой набор зазубрин, выступающих из упомянутого второго плеча упомянутого удлиненного сердечника, причем упомянутый стопор выступает из центральной области упомянутого удлиненного сердечника, находящейся между упомянутыми первым и вторым наборами зазубрин.3. Хирургическая шовная нить по п.2, в которой упомянутый первый набор зазубрин выступает в первом направлении, а упомянутый второй набор зазубрин выступает во втором направлении, противоположном первому направлению.4. Хирургическая шовная нить по п.2, в которой упомянутые первый и второй наборы зазубрин являются гибкими, и при этом упомянутый стопор является менее гибким, ...

УСТРОЙСТВА ДЛЯ ТЕРАПИИ НАРУШЕНИЙ ФУНКЦИИ СЕРДЦА

KATHETER

Reparaturvorrichtungen und -verfahren für körpereigene Klappen

Ein System zum Implantieren einer Reparaturvorrichtung an einer körpereigenen Klappe eines natürlichen Herzens, um die körpereigene Klappe eines Patienten während eines nicht am offenen Herzen erfolgenden Eingriffs zu reparieren. Das System umfasst ein chirurgisches Zuführinstrument, eine Klappenreparaturvorrichtung und einen Paddelsteuerungsmechanismus. Das chirurgische Zuführinstrument weist zumindest ein Lumen auf. Die Klappenreparaturvorrichtung ist dafür ausgelegt, durch das Lumen des chirurgischen Zuführinstruments hindurch zugeführt zu werden und an einer körpereigenen Klappe eines Patienten angebracht zu werden. Die Klappenreparaturvorrichtung umfasst ein erstes Paddel, ein zweites Paddel und ein Paar von Greifelementen. Das erste und das zweite Paddel sind zwischen einer offenen Stellung und einer geschlossenen Stellung beweglich. Die Paddel und die Greifelemente sind dafür ausgelegt, an der körpereigenen Klappe des Patienten angebracht zu werden. Der Paddelsteuerungsmechanismus ...

KLAPPENREPARATURSYSTEM

Klappenreparatursystem (600) zum Reparieren einer körpereigenen Klappe eines Patienten während eines nicht am offenen Herzen erfolgenden Eingriffs, wobei das Klappenreparatursystem umfasst:eine Klappenreparaturvorrichtung (602) zur Anbringung an einer körpereigenen Klappe eines Patienten, wobei die Klappenreparaturvorrichtung umfasst:eine Basisanordnung (604), welche umfasst:einen ersten Schaft (603a);einen zweiten Schaft (603b);ein erstes Verbindungsstück (605a), das entlang des ersten Schafts beweglich ist; undein zweites Verbindungsstück (605b), das entlang des zweiten Schafts beweglich ist;ein erstes Paddel (606a) und ein zweites Paddel (606b), wobei das erste Paddel (606a) schwenkbar an dem ersten Verbindungsstück (605a) angebracht ist und das zweite Paddel (606b) schwenkbar an dem zweiten Verbindungsstück (605b) angebracht ist; undein Paar von Greifelementen (608), die an der Basisanordnung (604) angebracht sind, wobei die Paddel (606a, 606b) und die Greifelemente (608) so angeordnet ...

TRANSVENOES EINFUEHRBARE KNOPFARTIGE VORRICHTUNG ZUM SCHLIESSEN EINES HERZGEWEBEDEFEKTES.

IMPLANTIERBARE GEHIRNSCHUTZVORRICHTUNG SOWIE ANWENDUNGSVERFAHREN

Medizinisches Instrument

Es wird ein medizinisches Instrument (1) bereitgestellt, das umfasst: einen länglichen Einführungsabschnitt (2), der Flexibilität aufweist und in einen lebendigen Körper einführbar ist; einen Saugfixierungsabschnitt (4), der an einer Außenumfangsoberfläche des Einführungsabschnitts (2) in einer Zwischenposition in einer Längsrichtung des Einführungsabschnitts (2) vorgesehen ist und eine Saugöffnung (4a) an einer Außenseite in einer radialen Richtung relativ zu dem Einführungsabschnitt (2) aufweist, die sich in der radialen Richtung öffnet und Gewebe in dem lebendigen Körper durch Saugen fixiert; und einen Drehmechanismus (5), der den Saugfixierungsabschnitt (4) derart an dem Einführungsabschnitt (2) fixiert, dass er um eine Achse (A) in einer Richtung drehbar ist, die im Wesentlichen identisch mit der radialen Richtung ist.

VORRICHTUNG ZUR PRÄVENTION DER BILDUNG VON THROMBEN IM LINKEN VORHOFANHANG

Vorrichtung zur Unterstützung chirurgischer Maßnahmen innerhalb eines Gefäßes, insbesondere zur minimalinvasiven Explantation und Implantation von Herzklappen

Vorrichtung zur Unterstützung chirurgischer Maßnahmen innerhalb eines Gefäßes, insbesondere zur minimalinvasiven Explantation und Implantation von Herzklappen, mit einem innerhalb des Gefäßes implantierbaren Arbeitsgerüst, das lösbar fest an die Innenwand des Gefäßes fügbar ist, dadurch gekennzeichnet, dass das Arbeitsgerüst auffalt- oder auswickelbar ausgebildet ist und im aufgefalteten oder ausgewickelten Zustand die Form eines Zylinders annimmt, dessen Zylinderdurchmesser kleiner als der Gefäßdurchmesser ist, dass das als Zylinder ausgebildete Arbeitsgerüst eine innere Oberfläche aufweist, an der die Anschluß- und/oder Auflagestruktur vorgesehen ist, und dass die Anschlußstruktur als Steck- oder Bajonettverschluß ausgebildet ist, um an diesem weitere chirurgische Instrumente zu fixieren oder zu verbinden oder mindestens ein weiteres Arbeitsgerüst zu verbinden.

Chirurgische Instrumente und Verfahren zur Stabilisierung der Herzschlagbewegung während einer koronaren Arterienbypassimplantation

Gewebestabilisierungsvorrichtung zur Verwendung in der Chirurgie

Reparaturvorrichtungen und -verfahren für körpereigene Klappen

Ein System zum Implantieren einer Reparaturvorrichtung an einer körpereigenen Klappe eines natürlichen Herzens, um die körpereigene Klappe eines Patienten während eines nicht am offenen Herzen erfolgenden Eingriffs zu reparieren. Das System umfasst eine Basisanordnung mit einer Mehrzahl von Schwenkgliedern, ein Paar von an der Basisanordnung angebrachten Paddeln, ein Paar von an der Basisanordnung angebrachten Greifelementen und zumindest ein zwischen dem Paar von Greifelementen angeordnetes Koaptations- oder Abstandselement. Eine Bewegung der Schwenkglieder der Basisanordnung bewirkt, dass sich die Paddel zwischen einer offenen Stellung und einer geschlossenen Stellung bewegen. Die Paddel und die Greifelemente sind dafür ausgelegt, an Klappensegeln des Patienten angebracht zu werden. Das Koaptations- oder Abstandselement ist dafür ausgelegt, zumindest einen Abschnitt des Spalts zwischen den Klappensegeln des Patienten auszufüllen.

BALLONVERANKERUNGSDRAHT

VORRICHTUNG ZUR ERLEICHTERUNG EINER TERMINOLATERALEN ANASTOMOSE-OPERATION

VORRICHTUNG ZUM ABDICHTEN EINER ÖFFNUNG IN EINEM HOHLEN ODER ROHRFÖRMIGEN ORGAN

SCHRITTMACHER ZUR ERHÖHUNG DES HERZZEITVOLUMENS

Chirurgisches Stabilisierungsinstrument mit fernbetätigten Füssen

AUSSCHLUSSVORRICHTUNG FÜR DAS LINKE HERZOHR

Medical device for fixing of mitral valve tissue of human patient, has absorption device for absorption of tissue, fixing device for fixing tissue and comprising retainer for surgical wire, and guiding device flexibly retaining anchor wire

The device (1) has an absorption device (5) for absorption of a tissue (3). A fixing device (7) is provided for fixing the tissue and comprises a retainer for a surgical wire (9). A guiding device flexibly retains an anchor wire (11) e.g. barbed hook, in the device. A wire guide guides the wire to an outer circumferential region or to an inner section of the guiding device. A tipping device is provided for curving the anchor wire with respect to a longitudinal axis of the guiding device from a position to another position.

Apparatus for use in coronary artery bypass surgery

The apparatus comprises a blood flow conduit 10 of T- or L-shape having a first end for insertion into and retention within a wall of a heart chamber 44 containing oxygenated blood and a second end for retention within a coronary artery 30, the conduit defining an open flow blood path during both systole and diastole. The conduit may be such as to bias forward flow of blood from the first towards the second end while not blocking reverse flow and may comprise a deflection surface for blocking flow through the conduit from impinging directly upon the coronary artery. Means may be provided in the conduit for reducing but not blocking blood flow during diastole.

Heart valve repair

Device for heart repair

Device for heart repair

Device and method for safely positioning a coronary stent in the coronary arteries

Device and method for safely positioning a coronary stent in the coronary arteries

Device for heart repair

DIVERSON DEVICE FOR THE INCREASE OF THE BRAIN BLOOD CIRCULATION

DEVICES TO THE HEART FLAP TREATING

SWIVELLING LINE IMPORTER

HEART DEVICES FOR THE PERCUTANEOUS REPAIR OF ATRIOVENTRIKULÄREN FLAPS

ATRIALE ANNULUS ABLATION DEVICE

POINT WITH VARIABLE FORM FOR CRYOABLATIONSGERÄT

EQUIPMENT FOR THE ELECTRIC INSULATION OF A HERZKAMMER BY ULTRASONIC

DEVICE FOR THE ATTACHMENT OF A CONTAINER ANASTOMOSIS

SEWING SYSTEM

KRYOGENI DEVICE

EVALUATION AND FORECAST OF THE ABLATION OF HEART FABRIC

EQUIPMENT FOR THE REGULATION OF THE CARDIAC OUTPUT

PACESETTER FOR THE INCREASE OF THE CARDIAC OUTPUT

DEVICE FOR THE REDUCTION OF THE HEART WALL TENSION

DEVICES FOR THE INTERSTITIAL INJECTION OF BIOLOGICAL MEANS IN FABRICS

EQUIPMENT FOR FABRIC TREATMENT

EXCLUSION DEVICE FOR THE LEFT HERZOHR

SURGICAL CLAMP WITH TREATMENT ELEMENTS

CATHETER WITH BEND-CASH POINT

VERSCHLUSSVORRICHTUNG TO THE BACKTACKING MECHANISM

FILTERABGABEUND - BACK BRINGING DEVICE

ARTERIAL KANÜLE WITH AN INTRODUCTION MEANS WITH A CUTTING ELEMENT

ENTRANCE OPENING WITH KLIP AND USE PROCEDURE

DEVICE FOR THE ATTACHMENT OF CONTAINER ANASTOMOSES

REAL TIME MONITORING AND MAPPING OF ABLATION LESION FIGURATION IN THE HEART

INSTRUMENT FOR THE DETERMINATION OF THE RECEPTION POINT A KORONAREN ARTERIEN BYPASSIMPLANTATS

STABILIZATION OF THE HEART FLAPPING DURING A KORONAREN ARTERIENBYPASSIMPLANTATION

MECHANISM FOR THE TEMPORARY IMMOBILIZATION OF LOCALLY DELIMITATION FABRIC AREAS

PERCUTANEOUS CATHETER AND GUIDANCE WIRE FOR FILTERING DURING THAT MYOKARDIALEN OR VASKULAREN FABRIC ABLATION

VERSCHLUSSVORRICHTUNGEN AND TOOLS

SYSTEM FOR THE EXECUTION OF KARDIAKVERFAHREN

MULTIPLE SENSOR FOR THE ANNOUNCEMENT OF ELECTRICAL SIGNALS IN BLOOD VESSELS

SYSTEM FOR INTRAVASKULÄREN THE TREATMENT OF ARRHYTHMIEN

SYSTEM F�R INTERSTITIAL ONE TRANSVASKUL�RE SURGICAL INTERFERENCES

LOCALLY FLEXIBLE ONE DILATORHÜLSE

HÄMOSTATI ENTRANCE DEVICE FOR BLOOD VESSELS

AORTALE BALLONOCCLUSIONSKANÜLE

DEVICE FOR ELECTRICALPHYSIOLOGICAL TREATMENTS OF THE HEART

FLEXIBLE ELECTRODE STRUCTURE

LIQUID-COOLED SURGICAL EQUIPMENT

Wire fasteners for use in minimally invasive surgery and methods

Suturing device for minimally invasive surgery and needles and methods thereof

A suturing device for minimally invasive surgery is disclosed. The suturing device has a head defining one or more ferrule holders and a tissue bite area. The device also has a first needle comprising a flywheel portion and one or more curved arms extending from the flywheel portion, each of the one or more curved arms comprising a ferrule engaging tip, wherein the first needle is pivotably coupled to the head. The suturing device further has a first actuator coupled to the first needle and configured to rotate it from a retracted position, where the ferrule engaging tip of each of the one or more curved arms starts away from the one or more ferrule holders, through the tissue bite area, and to an engaged position where the ferrule engaging tip of each of the one or more curved arms is operationally aligned with the one or more ferrule holders.

Implantable medical device deployment system

Various aspects of the present disclosure are directed toward apparatuses, systems (200), and methods for deploying a medical device (202). In certain instances, the medical device (202) may be a shunt device. In addition, the apparatuses, systems (200), and methods may include one or more constraining lines (212) arranged through a portion of the implantable medical device (202) and one or more release lines (216) configured to engage the one or more constraining lines (212).

Methods and devices for catheter advancement and delivery of substances therethrough

Methods and devices for successively advancing a plurality of catheters over a guide element to a body tissue are described. In some of the methods, the guide element may be attached to the body tissue, which may be accessible minimally invasively. In certain variations, the guide element may not be detached from the body tissue after the catheters have been advanced over the guide element. The methods may further comprise deploying at least one implant from at least one of the plurality of catheters. In some variations, a method may comprise advancing a first delivery catheter to a first region of a body tissue, deploying a first anchor from the first delivery catheter, where the first anchor is attached to a guide element, proximally withdrawing the first delivery catheter, advancing a second delivery catheter over the guide element, and deploying a second anchor from the second delivery catheter. 420 FIG. 4G 420 422 FIG. 4H ...

Valve docking devices, systems and methods

MITRAL VALVE DOCKING DEVICES, SYSTEMS AND METHODS A helical anchor (72) for docking a mitral valve prosthesis (120), the helical anchor (72) adapted to be received in and delivered from a coil guide catheter (68), and comprising: a plurality of coils (104, 108) having a preformed, coiled configuration after being delivered from the coil guide catheter (68) and adapted to support the prosthetic mitral valve upon being fully delivered from the coil guide catheter (68) and implanted with respective coil portions above and below the mitral valve annulus, wherein the helical anchor (72) includes a distal end portion and the distal end portion is formed to extend downward and radially outward relative to a next adjacent coil such that the distal end portion is spaced from the next adjacent coil and is configured to be delivered between the commissures of the native mitral valve (44).

Suction stabilized epicardial ablation devices

Body lumen shaping device with cardiac leads

Apparatus and method for mitral valve repair without cardiopulmonary bypass, including transmural techniques

Treatments for a patient with congestive heart failure

Heart valve repair

Device and method for establishing an artificial arterio-venous fistula

CARDIAC DEVICES AND METHODS FOR MINIMALLY INVASIVE REPAIR OF ISCHEMIC MITRAL REGURGITATION

Minimially invasive repair of a valve leaflet in a beating heart

CARDIAC HARNESS DELIVERY DEVICE

BIOLOGICALLY IMPLANTABLE PROSTHESIS AND METHODS OF USING THE SAME

Post-operative adjustment tool, minimally invasive attachment apparatus, and adjustable tricuspid ring

An implantable device system for controlling the dimensions of internal anatomic passages corrects physiologic dysfunctions resulting from a structural lumen which is either too large or too small. Implantable devices are disclosed which employ various mechanisms for adjusting and maintaining the size of an orifice to which they are attached. Systems permit the implants to be implanted using minimally invasive procedures and permit final adjustments to the dimensions of the implants after the resumption of normal flow of anatomic fluids in situ.

Methods and devices for accessing and delivering devices to a heart

Described here are devices, methods, and systems for accessing and delivering devices to a heart. Systems used to provide access to the heart via the left atrial appendage comprise a first access element with a first alignment member, a second access element with a second alignment member, a piercing element, an exchange element and may further comprise a left atrial appendage stabilization device. Methods of accessing and delivering devices to the heart via the left atrial appendage may comprise advancing a first access element into the left atrial appendage by an intravascular pathway and advancing a second access element towards the left atrial appendage through the pericardial space. The first and second alignment members form an attachment through the wall of the left atrial appendage so that the first and second access elements are aligned.

Methods and devices for treating atrial fibrillation

Described here are systems and methods for affecting tissue within a body to form a lesion. Some systems comprise tissue-affecting devices, devices that guide the advancement of the tissue-affecting elements to a target tissue region, devices that locate and secure tissue, and devices that help position the tissue-affecting devices along the target tissue. The methods described here comprise advancing a first tissue-affecting device to a first surface of a target tissue, advancing a second tissue-affecting device to a second surface of the target tissue, and positioning the first and second devices so that a lesion may be formed in the tissue between them. In some variations, the devices, systems, and methods described here are used to treat atrial fibrillation by ablating fibrillating tissue from an endocardial surface and an epicardial surface of a heart. Methods of closing, occluding, and/or removing the left atrial appendage are also described.

Ablation catheter for vein anatomies

A catheter adapted for simultaneous tissue contact with two opposing ring electrodes carried on a generally linear portion of an electrode assembly is adapted to straddle an ostium for ablating two lesions along a chord of the ostium, wherein the generally linear portion is stabilized on the ostium to ensure proper tissue contact when a force is applied down the length of the catheter body.

Tissue ligation devices and tensioning devices therefor

Described here are closure devices and methods for ligating tissue, such as the left atrial appendage, and tensioning devices and mechanism for actuating these devices. The tensioning mechanisms and devices may allow a user to apply one or more predetermined forces to a suture or other portion of the closure devices. The closure devices may comprise a suture loop releasably attached to a snare loop assembly, and a tensioning mechanism or device may be configured to tighten the suture loop and/or release the suture loop from the snare loop assembly ...

System for providing surgical access

One embodiment is directed to a system for providing surgical access across a wall of a tissue structure, comprising a delivery member ( 14 ), a first helical member ( 66 ), an anchor member ( 54 ) removably coupled to the helical member distal end, and a suture member ( 52 ) coupled distally to a portion of the anchor member and extending proximally to a position wherein at least a portion of it may be freely manipulated by an operator; wherein upon rotation of the delivery member in a first direction, the first helical member and coupled anchor member are advanced across at least a portion of the wall of the tissue structure, pulling along the distal portion of the suture member in a deployed suture pattern which remains coupled to the anchor member, the deployed suture pattern being characterized in that it is substantially helical with between about one and three helical loops.

Heart occlusion devices

The present invention is specifically directed to a heart occlusion device with a self-centering mechanism. The heart occlusion device includes two separate uniquely shaped wires (12, 14, 12A, 14A) each forming shapes that mirror the respective wire's shapes. Each wire forms half-discs or quarter-discs (12B, 12B', 14B, 14B') that together form a distal disc (16) and a proximal disc (18). In other versions, the device includes four separate wires, each mirroring its neighboring wire and forming a proximal and a distal quarter-disc. In the versions with four wires, the quarter-discs of each wire together form proximal and distal discs. The distal disc and proximal disc are separated by a self-centering waist (12C,14C). The proximal disc is attached to a hub (30) comprising a screw mechanism. A similar hub is optional on the distal disc. The discs further include coverings which form a sealant to occlude an aperture in a tissue. The wires forming the discs have a shape-memory capability such ...

A maneuverable electrophysiology catheter for percutaneous orintraoperative ablation of cardiac arrhythmias

Method of laser surgery

Graft fixation device

VASCULAR OCCLUSION DEVICE

Energy based devices and methods for treatment of patent foramen ovale

Methods and apparatus for treatment of patent foramen ovale (PFO) provide for applying energy to tissues adjacent the PFO with a catheter device to substantially close the PFO acutely. Apparatus generally includes a catheter device having at least one energy transmission member at or near its distal end configured to apply energy to PFO tissues to acutely, substantially close the PFO. Applied energy may be monopolar or bipolar radiofrequency energy or any other suitable energy, such as laser, microwave, ultrasound, resistive heating or the like. Some embodiments of a catheter device fuirther include one or more tissue apposition members near the distal end for helping bring PFO tissues together, such as a PFO covering member, a vacuum applying member and/or the like. PFO closure via energy-based approaches of the invention may help prevent stroke, treat migraine headache, and possibly treat or prevent other medical conditions.

Method and Apparatus for Delivering a Lead to a Heart

A method and apparatus for creating and accessing an anatomic space between a heart and a pericardial sac. The apparatus includes a catheter having a cryoadhesion member situated on the distal tip of the catheter. The cryoadhesion member is utilized to adhere to the pericardial sac and to retract the sac to create a tent like structure. The catheter allows introduction of an instrument to access the pericardial sac by puncture. The access to the pericardial sac allows delivery of a device, a drug, a biologic or other substance to the heart or the space around the heart.

System and method for manipulating insertion pathways for accessing target sites

A method for accessing a target site in the body by transferring a guidewire from an initial insertion site on the body to a different insertion site on the body is provided. In one aspect, a method for transferring a medical device or component, such as a sensor lead, from an initial insertion site to another insertion site is also provided. A guidewire of sufficient length, pliancy and deformability to perform a transfer from one insertion site to another insertion site is provided. In one aspect, the guidewire comprises a removable core mandrel to increase rigidity, facilitate insertion and/or improve steerability. A kit or system, comprising introducers, guidewires and catheters for performing a guidewire or device transfer is also provided.

Pericardial Devices, Systems and Methods For Occluding An Atrial Appendage

Disclosed are devices for pericardial access to the heart, including direct access to the left atrium. In certain embodiments, the device may comprise a device and/or an atrial appendage (AA) portal having a configuration such that the distal end of the device and/or the portal can access an atrial appendage while the proximal end of the device and/or portal can extend to outside of the subject. The devices and methods may also include a pericardial portal for emplacement of the device and/or the AA portal. Also, methods for using such devices and/or AA portals and pericardial portals to perform surgery on the heart, and systems (e.g., kits) comprising these devices and/or portals in combination with other therapeutic devices are disclosed.

Truncated Cone Heart Valve Stent

A heart valve stent having a section with a heart valve implant and several proximally disposed tissue anchors, also comprising a plurality of anchoring threats, each with a proximate end fastened to the stent or valve and a distal end attached to tissue within a heart chamber to provide tension between the heart chamber tissue and the stent.

Needle Apparatus for Closing Septal Defects and Methods for Using Such Apparatus

Apparatus and methods for closing a septal defect including a flap of tissue partially detached from a septum of a heart. A needle is advanced through a patient's vasculature within a delivery apparatus until the needle is disposed within a first chamber adjacent the septum. The needle is directed through the flap of tissue until the needle is disposed within a second chamber opposite the septum. A filament attached to an intermediate region of the needle is pulled, thereby causing the needle to pivot about the intermediate region such that the ends of the needle straddle the septal opening. A locking element is secured to the filament to secure the flap of tissue against the septum, and the filament is cut. Alternatively, the filament is biased to coil to engage the flap of tissue and secure the needle against the septum to close the opening.

Navigation System for Cardiac Therapies

An image guided navigation system for navigating a region of a subject includes an imaging device, a tracking device, a controller, and a display. The imaging device generates images of the region of the subject. The tracking device tracks the location of the instrument in the subject. The controller superimposes an icon representative of the instrument onto the images generated from the imaging device based upon the tracked location of the instrument. The display displays the image with the superimposed instrument.

Devices and Methods for Heart Valve Treatment

Devices and methods for treating heart valves include members that assist the valve in closing during at least a portion of the cardiac cycle. Such devices include members configured to alter the shape of a valve annulus, reposition at least one papillary muscle, and/or plug an orifice of the valve so as to provide a coaptation surface for the valve leaflets.

Method for providing surgical access

One embodiment is directed to a method for providing surgical access across a wall of a tissue structure, comprising: measuring a thickness of the wall of the tissue structure at a targeted entry location; and providing a helical needle having a helical needle pitch selected to pull an intercoupled suture member across the wall with a distal portion of the needle such that a deployed suture pattern is formed, the deployed suture pattern being characterized in that it is substantially helical and represents a number of helical loops substantially encapsulated by the wall of the tissue structure that is greater than about one helical loop, and is less than about three helical loops.

Method and apparatus for performing transesophageal cardiovascular procedures

An apparatus for performing a transesophageal cardiovascular procedure includes an elongated tubular main access device having a first lumen with an open proximal end and a distal side opening, and a second lumen with a rigid outer wall and a collapsible inner wall. The second lumen is adapted to receive an elongated probe or surgical device. The apparatus further includes an inflatable sealing means on the outside of the main access device above and below the side opening, and a first fluid conduit extending along the main access device for inflating the sealing means so that when the main access device is inserted into a patient's esophagus and the sealing means are inflated. The portion of the esophagus opposite the side opening is isolated from the remainder of the esophagus above and below the side opening.

Suture system

A suture system includes a plurality of double-stranded needles connected in sequence with a single-stranded needle at each end. The double-stranded suture needles incorporates two suture strands into a single needle. The suture system of the present invention facilitates the implantation of valve prostheses.

Method and apparatus for circulatory valve repair

An apparatus for the repair of a cardiovascular valve has leaflets comprising a grasper capable of grabbing and co-apting the leaflets of the valve. In a preferred embodiment, the grasper has jaws that grasp and immobilize the leaflets, and then a fastener is inserted to co-apt the leaflets. The apparatus is particularly useful for repairing mitral valves to cure mitral regurgitation.

Heart Valve Implant

A method according to one embodiment may include providing a heart valve implant including an anchor capable of engaging coronary tissue, a shaft coupled to said anchor, and a valve body coupled to said shaft. The method may further include at least partially collapsing the heart valve implant and percutaneously inserting the heart valve implant into a heart. The percutaneously inserted implant may be secured within the heart and may then be expanded. Of course, many alternatives, variations, and modifications are possible without departing from this embodiment.

System for controlling tissue ablation using temperature sensors

Body tissue ablation is carried out by inserting a probe into a body of a living subject, urging the probe into contact with a tissue in the body, generating energy at a power output level, and transmitting the generated energy into the tissue via the probe. While transmitting the generated energy the ablation is further carried out by determining a measured temperature of the tissue and a measured power level of the transmitted energy, and controlling the power output level responsively to a function of the measured temperature and the measured power level. Related apparatus for carrying out the ablation is also described.

Devices, systems and methods for tissue repair

Devices, systems and methods are disclosed for repairing soft tissue. The surgical system allows for the creation of tissue repair by grasping, aligning and sewing or fixing tissue. For example, this system may be used for clipping together excessive capsular tissue and reducing the overall capsular volume. The deployment device includes a central grasping mechanism and an outer clip delivery system. The clip embodiments may be single or multi-component (penetration and locking base components) that penetrate tissue layers and deploy or lock to clip the tissue together. An example of the system is used to reduce the joint capsule tissue laxity and reduces the potential for subluxation or dislocation of the joint by either restricting inferior laxity (anterior or posterior) and resolving or eliminating pathologic anterior or posterior translation.

Angiography catheter

Embolic protection devices and methods for capturing embolic debris. An embolic protection device includes a pigtail catheter having a lumen for housing a guidewire. The distal portion of the catheter has one or more apertures in fluid communication with the lumen and one or more radiopaque markers on the distal-most section. The device includes a self-expanding filter coupled to a side of the catheter and a movable outer sheath surrounding the catheter. The outer sheath holds the filter in a collapsed configuration when surrounding the filter. The outer sheath is proximally retracted to deploy the filter. A method of capturing embolic debris includes inserting a guidewire into a body lumen, tracking the device over the guidewire, retracting the guidewire, positioning the device using the radiopaque marker, retracting the outer sheath and deploying the filter, performing a procedure, and advancing the outer sheath to recapture the filter.

Device and method for temporary or permanent suspension of an implantable scaffolding containing an orifice for placement of a prosthetic or bio-prosthetic valve

In a surgical method for improving cardiac function, an implantable scaffold Or valve support device is inserted inside a patient's heart and attached to the heart in a region adjacent to a natural mitral or other heart valve. The scaffold or valve support device defines an orifice and, after the attaching of the scaffold or valve support device to the heart, or temporary support while native valve leaflets and/or subvalvular structures are captured, a prosthetic or bio-prosthetic valve seated in the orifice, and the native valve may be retracted into the scaffold/replacement assembly to create a gasket for sealing the complex.

Integrated medical apparatus for non-traumatic grasping, manipulating and closure of tissue

The integrated medical apparatus includes an operator handle end and a multi-prong grasping member positioned within and movable relative to a grasper lumen that extends from the handle end, wherein the grasping prongs are moved between an open and closed position by relative axial movement between the prongs of the grasping member and the grasper lumen. The medical apparatus includes a contractible snare and a plurality of axially moveable snare pushing arms. At least two of the snare pushing arms include a snare holding and release mechanism, wherein the snare pushing arms are configured to advance the snare in an open, encircling position to a final deployed position where the snare can be released through the activation of the holding and release mechanism of the pushing arms, and finally tightened in a conventional fashion, such as pulling on an end of the snare at the handle end.

Apical puncture access and closure system

A device, system, and method for providing access to, and sealing of, a body organ includes an implant device. An implant device has a main body having an internal access lumen, with a plurality of prongs extending from a distal end of the main body. The main body can include two lumens, one slidable within the other, to form a single continuous lumen with an adjustable length. The main body has an expanded configuration with an expanded diameter, and an unexpanded configuration with an unexpanded diameter. The prongs have a generally straight configuration where they extend distally of the distal end of the main body, and a bent configuration where the prongs bend around so that their tips extend proximally of the distal end of the main body. The device may include a hemostatic barrier to prevent fluid leakage therethrough when the main body is in the unexpanded configuration.

Apparatus and Method for Ablating Tissue

A control system alters one or more characteristics of an ablating element to ablate tissue. In one aspect, the control system delivers energy nearer to the surface of the tissue by changing the frequency or power. In another aspect, the ablating element delivers focused ultrasound which is focused in at least one dimension. The ablating device may also have a number of ablating elements with different characteristics such as focal length.

Systems and methods for engaging heart tissue

A system for engaging heart tissue includes an engagement catheter defining a first lumen therethrough and having a suction port at or near a distal end and a vacuum port at or near a proximal end, a delivery catheter defining a delivery catheter lumen therethrough and configured for slidable insertion into the first lumen of the engagement catheter, and an implantable device capable of insertion into the delivery catheter lumen such that at least part of the implantable device extends from a delivery catheter distal end upon implantation into a patient, where the suction port is operable to removably attach to a targeted tissue on an interior wall of a heart of the patient after the engagement catheter has been advanced through a blood vessel and into the heart, thereby forming a reversible seal with the targeted tissue when a vacuum source is operatively coupled to the vacuum port.

Positioning Cage

A positioning device and method of using are provided herein. The positioning device includes an expandable cage through which blood can flow. The expandable cage is insertable into a bodily organ, for example a heart, and expanded to temporarily secure the positioning device within the organ. Then, the cage can be used to steady the implantation of an annuloplasty device, for example. Alternatively, the expanded cage can be used to locate a desired area or feature of the body organ in which it is inserted by way of fluoroscopy.

Systems and methods for determining location of an access needle in a subject

Systems and methods for epicardial electrophysiology and other procedures are provided in which the location of an access needle may be inferred according to the detection of different pressure frequencies in separate organs, or different locations, in the body of a subject. Methods may include inserting a needle including a first sensor into a body of a subject, and receiving pressure frequency information from the first sensor. A second sensor may be used to provide cardiac waveform information of the subject. A current location of the needle may be distinguished from another location based on an algorithm including the pressure frequency information and the cardiac waveform information.

Optical fiber instrument system for dynamic recalibration

An instrument system that includes an elongate body, an optical fiber and a controller is provided. The optical fiber is at least partially separate from the elongate body. The controller is operatively coupled to the elongate body and to the optical fiber and the controller is adapted to receive a signal from the optical fiber, detect movement of the optical fiber based on the signal; and update a position of the elongate body relative to the optical fiber based on the detected movement.

Systems and methods for vacuum-assisted regeneration of damaged tissue

A system and method for regenerating damaged or necrosed tissue. Negative or vacuum pressure is applied to a surface of the damaged tissue to stimulate the revascularization of the area and/or increased blood flow to the area, which encourages the regeneration of the damaged tissue. A negative pressure device is provided that is capable of providing a sequenced vacuum treatment regimen to damaged tissue.

Minimally invasive repair of heart valve leaflets

A method of repairing a heart valve provides intravascular access for repair of a heart valve through a ventricular trans-septal approach. An external guide catheter can be inserted through a vein of a patient into the right ventricle via the right atrium. An internal guide catheter can be inserted through the external guide and can provide access to the septum for a puncture tool to create an opening through the septum to the left ventricle. The internal guide can then be advanced into the left ventricle and used to guide a deployment catheter that deploys a repair device onto the heart valve.

Cardiac Electrosurgery

Devices and methods are disclosed for providing access to the pericardial cavity while reducing risk of myocardial damage. The methods include maintaining the positions of a puncture device and of a portion of a parietal pericardium relative to one other while delivering energy from the puncture device to create a channel through the pericardium. Additional embodiments disclosed include delivering a pulse or pulses of energy to the parietal pericardium and attempting to advance the puncture device through the parietal pericardium between deliveries of energy pulses.

Device and method for replacing mitral valve

A prosthetic mitral valve assembly is disclosed. The assembly comprises a radially-expandable stent including a lower portion sized for deployment between leaflets of a native mitral valve and an upper portion having a flared end. The upper portion is sized for deployment within the annulus of the mitral valve and the flared end is configured to extend above the annulus. The stent is formed with a substantially D-shape cross-section for conforming to the native mitral valve. The D-shape cross-section includes a substantially straight portion for extending along an anterior side of the native mitral valve and a substantially curved portion for extending along a posterior side of the native mitral valve. The assembly further includes a valve portion formed of pericardial tissue and mounted within an interior portion of the stent for occluding blood flow in one direction.

Trans-catheter ventricular reconstruction structures, methods, and systems for treatment of congestive heart failure and other conditions

Embodiments described herein include devices, systems, and methods for reducing the distance between two locations in tissue. In one embodiment, an anchor may reside within the right ventricle in engagement with the septum. A tension member may extend from that anchor through the septum and an exterior wall of the left ventricle to a second anchor disposed along a surface of the heart. Perforating the exterior wall and the septum from an epicardial approach can provide control over the reshaping of the ventricular chamber. Guiding deployment of the implant from along the epicardial access path and another access path into and through the right ventricle provides control over the movement of the anchor within the ventricle. The joined epicardial pathway and right atrial pathway allows the tension member to be advanced into the heart through the right atrium and pulled into engagement along the epicardial access path.

Over-the-wire cardiac implant delivery system for treatment of chf and other conditions

Medical devices, systems, and methods reduce the distance between two locations in tissue in a minimally invasive manner, often for treatment of congestive heart failure. In one embodiment, an anchor of an implant system may, when the implant system is fully deployed, reside within the right ventricle in engagement with the ventricular septum. A tension member may extend from that anchor through the septum and an exterior wall of the left ventricle to a second anchor disposed along an epicardial surface of the heart. Deployment of the anchor within the right ventricle may be performed by inserting a guidewire through the septal wall into the right ventricle. The anchor may be inserted into the right ventricle over the guidewire and through a lumen of a delivery catheter. Delivering the anchor over the guidewire may provide improved control in the delivery and placement of the anchor within the right ventricle.

Apparatus and method for guide-wire based advancement of a rotation assembly

Apparatus is provided, comprising (1) a guide member, (2) a tissue-adjustment mechanism having (a) an upper surface and a lower surface, (b) at least one first opening at the upper surface, (c) at least one second opening at the lower surface, and (4) a channel extending between the first and second openings, the channel facilitating advancement of the tissue-adjustment mechanism along the guide member; and (3) at least one repair chord coupled at a first portion thereof to the tissue-adjustment mechanism and having at least a first end that is configured to be coupled to a portion of tissue of a patient, the repair chord being configured to adjust a distance between the portion of tissue and the tissue-adjustment mechanism, in response to adjustment of the repair chord by the tissue-adjustment mechanism. Other embodiments are also described.

Method and apparatus for performing transesophageal cardiovascular procedures

An apparatus for performing a transesophageal cardiovascular procedure includes an elongated tubular main access device having a first lumen with an open proximal end and a distal side opening, and a second lumen with a rigid outer wall and a collapsible inner wall. The second lumen is adapted to receive an elongated probe or surgical device. The apparatus further includes an inflatable sealing means on the outside of the main access device above and below the side opening, and a first fluid conduit extending along the main access device for inflating the sealing means so that when the main access device is inserted into a patient's esophagus and the sealing means are inflated. The portion of the esophagus opposite the side opening is isolated from the remainder of the esophagus above and below the side opening.

Pfo closing device

A PFO closing device for bringing the septum primum and the septum secundum into contact with each other and joining them together includes a clamping mechanism and energy supplying device. The clamping mechanism includes a needle part for puncturing the septum primum, and a clamping member for cooperating with the needle part in clamping therebetween tissue of the septum primum and the septum secundum. The energy supplying device supplies energy for joining the tissues clamped by the needle part and the clamping member. The clamping mechanism is mounted in a catheter so as to be protrudable from and retractable into the catheter.

Catheter-based annuloplasty using ventricularly positioned catheter

The present invention relates to a minimally invasive method of performing annuloplasty. According to one aspect of the present invention, a method for performing annuloplasty includes accessing a left ventricle of a heart to provide a discrete plication element to the left ventricle, and engaging the plication element to tissue near a mitral valve of the heart. Engaging the plication element includes causing the plication element to gather a portion of the tissue to create a plication. In one embodiment, accessing the left ventricle of the heart to provide the plication element includes accessing the left ventricle of the heart using a catheter arrangement.

Treatment instrument

Provided is a treatment instrument including a guide member with a tip surface to be pressed against an outer surface of a pericardium; a pericardium fixing member including at least one needle-shaped portion having a sharp pointed end extending diagonally forward along a circumferential direction at a tip of a cylinder-shaped body rotatable around the axis thereof; a perforating member for forming a through-hole for a guide wire in the pericardium to which the pericardium fixing member is fixed; and a pointed end position restricting portion for restricting the position of the pointed end in a direction of the axis relative to the tip surface of the guide member at a location where the pointed end of the pericardium fixing member does not reach the outer surface of a heart while the tip surface of the guide member is pressed against the outer surface of the pericardium.

Electrophysiological endocardiology tool

Apparatus and methods for pacing the heart. The apparatus may include, and the methods may involve, an elongated member having: a delivery lumen that is configured to traverse the heart wall, the lumen having a proximal opening for receiving the instrument and a distal opening for deploying the instrument; and an electrically conductive member that is configured to deliver to the heart wall a current that modifies a contraction frequency. The apparatus may include an access opening closure device that has: a distal end that is configured to be disposed interior the heart and contact endocardial tissue adjacent the access opening; and a proximal end that is configured to be disposed exterior the heart and contact heart tissue adjacent the access opening; and an electrode that is configured to discharge electrical energy into the heart wall to change the frequency. The apparatus may include an injectable needle pacing electrode.

Minimally invasive surgical techniques

Apparatus and methods are described including a trocar ( 40 ) that defines a lumen therethrough, configured to provide a passage through skin of a subject into a body of the subject. A cannula ( 60 ) is configured to be placed into the subject's body via the passage provided by the trocar, the cannula being configured to be slidable with respect to the trocar. The cannula includes an outer tube ( 64 ) having a first expandable element ( 77 ) disposed at a distal end thereof, and an inner tube ( 62 ) having a second expandable element ( 72 ) disposed at a distal end thereof, the inner tube being configured to be slidable with respect to the outer tube. A vacuum port ( 61 ) applied vacuum pressure to the first expandable element via a space ( 65 ) between the inner and outer tubes of the cannula. Other applications are also described.

Method and apparatus for repairing a mitral valve

A method for repairing a mitral valve, the method comprising: positioning a crossing guidewire across the mitral valve, the crossing guidewire passing through the annulus of the mitral valve at a first location and passing through the annulus of the mitral valve at a second location; using the crossing guidewire to position a spanning implant across the mitral valve, with the spanning implant extending from the first location to the second location; anchoring the spanning implant at the first location; tensioning the spanning implant so as to draw the first location and the second location together; and anchoring the spanning implant at the second location.

Cryotreatment device and method

Devices and methods for cooling vessel walls to inhibit restenosis in conjunction with medical procedures such as coronary artery angioplasty. One catheter device includes a distal tube region having coolant delivery holes radially and longitudinally distributed along the distal region. In some devices, holes spray coolant directly onto the vessel walls. In other embodiments, a balloon or envelope is interposed between the coolant and the vessel walls and the coolant returned out of the catheter through a coolant return lumen. Some direct spray devices include an occlusion device to restrict blood flow past the region being cooled. Pressure, temperature, and ultrasonic probes are included in some cooling catheters. Some cooling catheters are coiled perfusion catheters supporting longer cooling periods by allowing perfusing blood flow simultaneously with vessel wall cooling.

Apparatus and methods for coronary sinus access

Apparatus and methods for locating features within a body cavity using a catheter including proximal and distal ends, a transparent balloon carried on the distal end, and an optical imaging assembly carried on the distal end for imaging through the balloon. The balloon includes a channel extending therethrough to a lumen extending through the catheter. A guidewire or other localization member is received in the lumen that is extendable through the channel. During use, the catheter is inserted into a right atrium of a heart, and the balloon is expanded and placed against the wall of the heart to locate the coronary sinus. Sufficient force is applied to clear blood between the surface and the wall and clear the field of view of the imaging assembly. The catheter is manipulated to locate the coronary sinus, whereupon the localization member is advanced into the coronary sinus.

Apex closure device

Wound closure devices, systems, and methods may be used to close an opening, such as a puncture wound or incision, formed in tissue, such as heart tissue. A wound closure device may be configured and adapted to be placed within the puncture wound or incision to close and/or seal the puncture wound or incision. A bioadhesive may be used to strengthen the closure and/or seal of the puncture wound after placement of the wound closure device relative to the puncture wound.

Systems and methods for making a laminar ventricular partitioning device

Described herein are systems and methods for securing a polymeric sheet to rib components of a frame structure, wherein the rib components are jointed at a hub to form an expandable and collapsible implant. In general, the method may include the steps of decreasing a diameter of the frame structure; placing the frame structure into an assembly fixture, wherein the assembly fixture is configured to hold the frame structure in a loaded configuration with a decreased diameter; placing a polymeric sheet into the assembly fixture; and heating the assembly under pressure to fuse the sheet to the frame structure. In general, a fixture may include a first and second platen having a shaping portion and a rim portion positioned around the periphery of the platen, wherein the shaping portions are configured to hold the rib components of the frame structure in a loaded configuration with a decreased diameter.

Devices and methods for delivering an endocardial device

Described herein are devices, systems and methods for delivering an endocardial device. The systems for delivering the device transvascularly may generally include an elongate guide catheter having a proximal end and a distal end; a conical dilator at the distal end of the elongate guide catheter, the conical dilator being removable to enable delivery of the ventricular portioning device; a delivery catheter having a proximal and distal end; an expansion member near the distal end of the delivery catheter and configured to expand a plurality of struts of the partitioning device; and a coupling element configured to deployably secure to a hub of the partitioning device. The systems for delivering the device transapically may generally include an elongate access sheath; an elongate delivery catheter; an expansion member; and a coupling element proximal to the expansion member and configured to deployably secure to a hub of the partitioning device.

Coupling System Useful in the Placement of Implants

A coupling system is disposed at the distal end of an interventional delivery system for coupling to an implant. The coupling device has a first and second prong connected at one end. The other end of the prongs open or close to release or trap an object, e.g., a bead tethered from an implant. A slot at the distal end of the coupling device allows extra degrees of flexibility for the coupling device.

Post-operative adjustment tool, minimally invasive attachment apparatus, and adjustable tricuspid ring

An implantable device system for controlling the dimensions of internal anatomic passages corrects physiologic dysfunctions resulting from a structural lumen which is either too large or too small. Implantable devices are disclosed which employ various mechanisms for adjusting and maintaining the size of an orifice to which they are attached. Systems permit the implants to be implanted using minimally invasive procedures and permit final adjustments to the dimensions of the implants after the resumption of normal flow of anatomic fluids in situ.

Bifurcated catheter

Systems and methods are disclosed for a bifurcated catheter, and more particularly, to denervation of arterial nerves using a bifurcated catheter. In embodiments, the catheter comprises, for example, a catheter shaft bifurcated into a first catheter energy member and a second catheter energy member, wherein the first catheter energy member comprises a first transducer and the second catheter energy member comprises a second transducer, and wherein the first and second transducers are configured to cause denervation of an arterial nerve of the patient.

Method and Apparatus for a Right-Sided Short Sheath

An introducer sheath comprising a curved shape that follows the right sided vasculature when introduced through the right side subclavian vein and which stops far short of the coronary ostium in the right atrium. No attempt is made to access the coronary sinus through the sheath. The sheath establishes a fulcrum point on the upper lateral wall of the superior vena cava and comprises the ability to be removed from the implanted pacemaker lead without flipping the distal end of the sheath to cause a pull back of the pacemaker lead. The more proximal portions of the sheath extend through the superior vena cava and provide a force which biases the sheath against the lateral wall of the lower portion of the superior vena cava to establish a fulcrum or pivot point which positions the distal end of sheath at the desired location.

Therapeutic methods and devices following myocardial infarction

Described herein are methods of treating a patient to prevent or correct cardiac remodeling following myocardial infarction. In general these methods may include inserting or implanting a device in a heart chamber to support the affected region within 72 hours after myocardial infarction. The device may be a support device (e.g., a resilient frame) and/or a partitioning device.

Closure device

A closure device for closing a bodily passageway is provided. The device includes first and second frames and first and second crossbars. A sheet of biocompatible material is attached to one or more of the frames. The first crossbar extends across the first frame and has terminal crossbar ends connectively linked to separate sites on the first frame; the second crossbar is similarly linked to the second frame. The crossbars are attached to each other at a connection point, and they are each configured to bend away from the connection point when the closure device is deployed to close a bodily passageway. A method of making the closure device is provided, as well as a method for closing a bodily passageway using such a device. Further, a closure device assembly is provided, including a closure device, a delivery catheter housing, and a delivery release member.

Tissue anchors, systems and methods, and devices

Systems, devices and methods for securing tissue including the annulus of a mitral valve. The systems, devices and methods may employ catheter based techniques and devices to plicate tissue and perform an annuloplasty.

System and method for transapical access and closure

Embodiments are described for creating and closing tissue access ports, such as transapical access ports, which involve placement of an introducer across the subject tissue structure, and deployment of a controllable port closure device assembly configured to remain in place with a ratcheting mechanism, and to hold the tissue surrounding the previous access port location closed against a sealing disc with proximal and distal strut assemblies, after the introducer has been removed.

Device for sealing perforations and sustaining flow

A device for sealing perforations and sustaining a flow of liquids as well as a method of using the same are disclosed. The device can be beneficially employed in emergency trauma care or for performing a rapid aortic cannulation procedure or other catheterizations. The device includes a catheter member, a mandrel member, a cannula member and a sealing element.

Intra-Operative Heart Size Measuring Tool

A heart size measuring tool includes a tubular body, a flexible measuring cord having length indicia, a measuring cord support mechanism movable between retracted and extended states with respect to the body, and an actuating mechanism to move the measuring cord support mechanism. When in the retracted state the measuring cord support mechanism is positioned within the tubular body with the measuring cord in a collapsed position. When the measuring cord support mechanism is in the extended state the measuring cord extends around a portion of a heart to be measured. A scale on the body can be used in connection with the indicia on the measurement cord to provide a reading of the heart size. 1inserting into a patient's body through a minimally invasive access port a heart measurement tool having a measurement device movable between extended and retracted states;positioning a distal end portion of the heart measurement tool adjacent to an apex of the patient's heart while the measurement device is in the retracted state;actuating the measurement tool to move the measurement device to the extended state around at least a portion of the patient's heart;determining the heart size measurement using the measurement device in the extended state; andactuating the measurement tool to move the measurement device to the retracted state; withdrawing the measurement tool from the patient's body.. A method for measuring a size of a patient's heart in connection with the implantation of a therapeutic device surrounding at least a portion of the heart, including: This application is a continuation of U.S. patent application Ser. No. 15/223,973 filed Jul. 29, 2016, which is a continuation of U.S. patent application Ser. No. 14/698,689 filed Apr. 28, 2015 (now U.S. Pat. No. 9,427,318 issued Aug. 30, 2016), which is a continuation of U.S. application Ser. No. 13/261,173, filed on Jun. 29, 2012 (now U.S. Pat. No. 9,044,169 issued Jun. 2, 2015), which is a United States national stage ...

METHODS AND DEVICES FOR TRANSXIPHOID ACCESS TO THE MAMMARY ARTERIES

A trans-xiphoid procedure for gaining entry to the chest cavity of a patient, sometimes also referred to herein as a “TRAX” procedure. The procedure may be used for, among other things, mobilization of the mammary arteries and performing coronary artery bypass surgery in which the mammary artery of the patient or other conduit is joined to a coronary artery of the patient, such as the left anterior descending (LAD) coronary artery. 1. An exposure device useful for providing surgical access to the mammary arteries of a subject , the device comprising:an elongate body member having a proximal end, a distal end configured for internal placement in a subject, a bottom portion, and a pair of opposing side wall portions, the bottom and side wall portions together having a top surface portion forming an elongate access channel open through at least the proximal end;the body member configured for insertion of the distal end into the chest cavity of a subject through the subject's upper abdomen and diaphragm into a position overlying the subject's heart and underlying the subject's sternum, with both the right and left mammary arteries of the subject positioned above and accessible through the access channel.2. The exposure device of claim 1 , further comprising a mounting member connected to the top surface portion claim 1 , the mounting member configured for retaining and positioning an endoscope such that claim 1 , in use claim 1 , an endoscope extends from the proximal end to the distal end through the access channel claim 1 , and into the subject.3. The exposure device of claim 1 , further comprising an at least one a camera and/or light source mounted on the exposure device other than an endoscope camera.4. The exposure device of claim 1 , further comprising at least one stationary anchor member connected to the body member and configured for securing an elastic mammary artery retractor band thereto and arranged proximally to distally on the top surface portion).5. The ...

Apparatus and Method for Cardiac Tissue Modulation by Topical Application of Vacuum to Minimize Cell Death and Damage

A method and apparatus are provided for treating cardiac tissue to modulate ischemic heart tissue with topical sub-atmospheric pressure to minimize cell death and damage.

GRIPPER PUSHER MECHANISM FOR TISSUE APPOSITION SYSTEMS

The invention provides devices, systems and methods for tissue approximation and repair at treatment sites. The devices, systems and methods of the invention will find use in a variety of therapeutic procedures, including endovascular, minimally-invasive, and open surgical procedures, and can be used in various anatomical regions, including the abdomen, thorax, cardiovascular system, heart, intestinal tract, stomach, urinary tract, bladder, lung, and other organs, vessels, and tissues. The invention is particularly useful in those procedures requiring minimally-invasive or endovascular access to remote tissue locations, where the instruments utilized must negotiate long, narrow, and tortuous pathways to the treatment site. In addition, many of the devices and systems of the invention are adapted to be reversible and removable from the patient at any point without interference with or trauma to internal tissues. 1. A system for fixation of leaflets of a heart valve comprising: a first arm and a second arm,', 'a first proximal element moveable relative to the first arm between a first position and a second position, and', 'a second proximal element moveable relative to the second arm between a first position and a second position; and, 'an implantable fixation device comprising'} a delivery catheter having a proximal end portion and a distal end portion, the delivery catheter defining at least one lumen extending between the proximal end portion and the distal end portion,', 'a first proximal element line extending through the at least one lumen, the first proximal element line releasably coupled to the first proximal element and actuatable to move the first proximal element between the first position and the second position,', 'a second proximal element line extending through the at least one lumen, the second proximal element line releasably coupled to the second proximal element and actuatable to move the second proximal element between the first position and the ...

Diaphragm entry for posterior surgical access

Methods and devices described herein facilitate diaphragm entry for posterior access of body organs.

Device and Method for Transcatheter Heart Valve Repair under Triangular Resection Technique

Medical device for transcatheter heart valve repair comprising a grasping tweezer () and a plicating tweezer (), said grasping tweezer () being adapted to grasp a leaflet rim () and said plicating tweezer () comprising two rotatable flaps () and a central shaft () around which said flaps () may rotate in a “butterfly manner”, in such a way that the plicating tweezer () may adopt a closed or an open configuration. The invention also relates to a method for using this medical device. 112-. (canceled)13: A medical device for transcatheter heart valve repair comprising:a grasping tweezer configured to grasp a leaflet rim; anda plicating tweezer including two rotatable flaps and a central shaft around which the two rotatable flaps are configured to rotate in a butterfly manner such that the plicating tweezer can adopt a closed configuration or an open configuration.14: The medical device according to claim 13 , wherein each flap has a substantially triangular shape.15: The medical device according to claim 14 , wherein a first side of a triangle that forms the triangular shape is mainly defined by the central shaft claim 14 , and a second side is located on a proximal end of the plicating tweezer claim 14 , and a third side is located on a distal end of the plicating tweezer.16: The medical device according to claim 15 , wherein the central shaft and the third side form an angle between 0° and 90°.17: The medical device according to claim 16 , wherein the angle is between 15° and 35°18: The medical device according to claim 13 , wherein each flap is includes a plurality of segments.19: The medical device according to claim 18 , wherein the plurality of segments are covered by a mesh.20: The medical device according to claim 13 , wherein at least one flap includes a releasable tissue fixing means.21: The medical device according to claim 13 , wherein at least one flap includes a tissue-cutting device.22: The medical device according to claim 13 , wherein the central shaft ...

SYSTEM FOR OCCLUSION OF LEFT ATRIAL APPENDAGE

A device for occluding an atrial appendage includes a catheter-deliverable epicardial implant that is detachably secured to a delivery device. The implant includes an inflatable cuff that is positionable about the atrial appendage to an extent that, when adjustably inflated, the cuff physiologically occludes the atrial appendage. Such occlusion addresses health risks associated with atrial fibrillation and cardiac rhythm disorder. 1. An epicardial implant , comprising:a positioning device defining an open interior, wherein the positioning device is configured to be detachably coupled with an implant delivery device such that the positioning device may be detached from the implant delivery device after the epicardial implant is in place about the atrial appendage; andat least one expandable cuff coupled with the positioning device;wherein the positioning device is configured to selectively move the expandable cuff toward and away from an atrial appendage to position the expandable cuff in a desired position relative to the atrial appendage;wherein the at least one expandable cuff is expandable into at least a portion of the open interior of the positioning device following placement of the expandable cuff into the desired position; andwherein the at least one expandable cuff is configured to physically occlude a base of the atrial appendage when expanded.2. The epicardial implant of claim 1 , wherein:the positioning device comprises a first prong that is coupled with a second prong at a hinge that is configured to adjust a distance between the first prong and the second prong, wherein a space between the first prong and the second prong defines the open interior of the positioning device.3. The epicardial implant of claim 1 , wherein:the at least one expandable cuff comprises a plurality of distinct chambers that are sequentially or simultaneously filled with a fluid to expand the at least one expandable cuff.4. The epicardial implant of claim 3 , wherein:the fluid ...

MEDICAL DEVICE FOR MODIFICATION OF LEFT ATRIAL APPENDAGE AND RELATED SYSTEMS AND METHODS

Several embodiments are set forth of devices, systems and methods for modifying an atrial appendage such as a left atrial appendage (LAA). In one embodiment, a medical device includes a frame member and a tissue growth member. The frame member includes a unitary, seamless central portion having a plurality of struts defining a multi-cellular structure and an anchoring system, the plurality of struts extending between and configured to self-expand and directly bias the anchor system to anchor the frame member at least partially within the LAA. With this arrangement, the tissue growth member is attached to the frame member to occlude the LAA. 1. A medical device configured to be positioned within a left atrial appendage of a heart , the medical device comprising:a tissue in-growth portion with a central hub coupled to the tissue in-growth portion, the tissue in-growth portion sized and configured to be positioned against tissue adjacent an opening of the left atrial appendage; anda multi-arm anchor portion including a base arm portion and arms, the base arm portion being coupled to the central hub and extending distally from the central hub to a distal most end thereof such that the arms of the multi-arm anchor portion extend radially outward at the distal most end in a curved manner so that the arms extend proximally toward the cover portion.2. The medical device of claim 1 , wherein the tissue in-growth portion comprises a tissue-ingrowth material configured to promote tissue growth therein.3. The medical device of claim 1 , wherein the arms are configured to self-expand from a constricted position to an expanded position.4. The medical device of claim 1 , wherein the arms of the multi-arm anchor portion are each configured to independently expand and bias against tissue within the left atrial appendage.5. The medical device of claim 1 , wherein the arms extend proximally from the distal most end of the multi-arm anchor portion in a separate and independent manner.6 ...

SUTURE-SECURING FOR CARDIAC VALVE REPAIR

Apparatus is provided that includes a casing, shaped to define a cavity, and one or more openings in the casing, in which openings one or more sutures are disposable; and a core, disposed in the cavity, and shaped to define a lumen in which the sutures are disposable. The apparatus has an unlocked configuration in which the sutures are disposable within and slidable through the openings and the lumen, and a locking configuration in which the sutures are inhibited from sliding through the openings and the lumen. The apparatus is movable from the unlocked configuration to the locking configuration, and is configured such that, when the sutures are disposed within the openings and the lumen, and the apparatus moves from the unlocked configuration to the locking configuration, the apparatus cuts the sutures at a cutting site, and becomes coupled to the sutures at a coupling site. 174-. (canceled)75. Apparatus for use with one or more sutures , the apparatus comprising:a casing, shaped to define a cavity, and one or more openings in the casing, in which openings the sutures are disposable; anda core, disposed in the cavity, and shaped to define a lumen in which the sutures are disposable, having an unlocked configuration in which the sutures are disposable within and slidable through the openings and the lumen, and a locking configuration in which the sutures are inhibited from sliding through the openings and the lumen,', 'being movable from the unlocked configuration to the locking configuration, and', 'being configured such that, when the sutures are disposed within the openings and the lumen, and the apparatus moves from the unlocked configuration to the locking configuration, the apparatus (1) cuts the sutures at a cutting site of the apparatus, and (2) becomes coupled to the sutures at a coupling site of the apparatus., 'the apparatus76. The apparatus according to claim 75 , wherein:the casing defines two or more openings, the openings being provided along a ...

DEVICES AND METHODS FOR IMAGE-GUIDED PERCUTANEOUS CARDIAC VALVE IMPLANTATION AND REPAIR

Devices and methods for ultrasound image-guided percutaneous cardiac valve implantation and repair comprise, in combination, a plurality of devices including but not limited to an ultrasound-image guided catheter, a pericardial sheath, a cardiac valve delivery system and an ascending aortic filter. An image-guided catheter is utilized to introduce via an introducer needle and a guide wire a pericardium portal for permitting entry from the chest wall to inside the pericardial space between the pericardial outer lining and inner lining. The pericardium portal permits the use of ultrasound vision to locate a site proximate the left ventricular apex for introduction of a sheath via a myocardium needle into the left ventricular space at an angle and avoiding any coronaries or vessels. A first delivery system permits placement of at least one aortic filter which collects any emboli, particulate matter, plaque and prevents such matter travelling via the ascending aorta to the brain, causing a stroke. A second delivery system permits placement of an aortic and/or mitral valve replacement or repair using several types of repair tools. 1. Apparatus for ultrasound image guided percutaneous cardiac valve replacement or repair comprising in combination:an image guided catheter for entry via an incision in the chest wall and by ultrasound vision guidance to a site proximate the left ventricular apex of a heart myocardium,a guide wire for introduction via the image guided catheter into the pericardial space,a sheath for entry via the guide wire through the chest wall to pass through and into the pericardial space,a pericardium portal introduced through the sheath into the pericardial space replacing the guide wire.a pericardium ultrasound transducer deployable from the pericardium portal having an imaging zone of the left ventricle and the ascending aorta,a myocardial needle delivery system comprising a bendable portion of the pericardium portal and a myocardial needle for ...

CATHETER WITH MECHANICALLY EXPANDABLE ELEMENT HAVING FLEX CIRCUIT

An apparatus includes a catheter and an end effector. At least a portion of the catheter is sized and configured to fit within a lumen of a human cardiovascular system. The end effector is positioned at a distal end of the catheter. The end effector includes an expandable assembly and at least one flex circuit. The expandable assembly is configured to transition between a non-expanded state and an expanded state. The expandable assembly includes at least one deformable strut or cage. Each flex circuit includes a flexible substrate secured, without an adhesive, to the expandable assembly and an electrode secured to the flexible substrate. The expandable assembly in the expanded state is configured to urge the electrode into contact with tissue. The electrode has a fishbone-like configuration that defines a longitudinally elongated portion and a plurality of fingers extending transversely from the longitudinally elongated portion. 1. An apparatus comprising:(a) a catheter, wherein at least a portion of the catheter is sized and configured to fit within a lumen of a human cardiovascular system; and (i) an expandable assembly, wherein the expandable assembly is configured to transition between a non-expanded state and an expanded state, wherein the expandable assembly comprises at least one deformable strut or cage, and', (A) a flexible substrate secured to the expandable assembly without adhesive, and', '(B) an electrode secured to the flexible substrate, wherein the expandable assembly in the expanded state is configured to urge the electrode into contact with tissue, the electrode having a fishbone-like configuration that defines a longitudinally elongated portion and a plurality of fingers extending transversely from the longitudinally elongated portion., '(ii) at least one flex circuit, wherein each flex circuit of the at least one flex circuit comprises], '(b) an end effector positioned at a distal end of the catheter, wherein the end effector comprises2. The ...

Truncated Cone Heart Valve Stent

A heart valve stent having a section with a heart valve implant and several proximally disposed tissue anchors, also comprising a plurality of anchoring threats, each with a proximate end fastened to the stent or valve and a distal end attached to tissue within a heart chamber to provide tension between the heart chamber tissue and the stent. 1. (canceled)2. A prosthetic mitral valve comprising:a self-expanding stent having a proximal atrial section and a distal body section;a prosthetic valve assembly disposed within the body section of the stent; anda cloth member positioned on an exterior surface of the atrial section of the stent;wherein the atrial section of the stent includes a first tissue anchor connected to, and flaring radially outward from, a first end of the body section, the first tissue anchor including a plurality of circumferentially arranged expandable stent cells adapted to anchor to a first tissue area on an atrial side of a native mitral valve annulus; andwherein the body section of the stent includes a plurality of second tissue anchors extending therefrom adapted to anchor to a second tissue area disposed distally to the first tissue area.3. The prosthetic mitral valve of claim 2 , wherein the prosthetic valve assembly is directly coupled to the body section of the stent.4. The prosthetic mitral valve of claim 2 , wherein the cloth member is formed of a material selected from the group consisting of synthetics claim 2 , pericardium claim 2 , and polytetrafluoroethylene.5. The prosthetic mitral valve of claim 2 , wherein the cloth member is also positioned on an exterior surface of the body section of the stent.6. The prosthetic mitral valve of claim 2 , wherein the plurality of second tissue anchors includes a plurality of anchoring sutures.7. The prosthetic mitral valve of claim 2 , wherein the body section of the stent has a shape of a truncated cone.8. The prosthetic mitral valve of claim 2 , wherein one side of the body section is flattened ...

Devices and Methods for Stabilizing Tissue

The devices and methods relate to devices for stabilizing and/or positioning tissue (e.g., heart) within a surgical area. The device may include an articulating arm and a tissue stabilizing member. The device may include one or more stabilizing segments disposed along at least a portion of the length of the articulating arm. Each stabilizing segment may be configured to compress and expand with respect to an internal channel of the arm. The articulating arm may be configured to move between a fixed state and movable state based on a state of the one or more stabilizing segments. In the fixed state, the one or more stabilizing segments may be compressed against the internal channel. In the movable state, the one or more stabilizing segments may be expanded with respect to the internal channel. 1. A device for stabilizing tissue , comprising:an articulating arm having a first end, a second end, and a length there between;one or more channels disposed along at least the length of the articulating arm, the one or more channels including an internal channel disposed along at least the length of the articulating arm;one or more stabilizing segments disposed along at least a portion of the length of the articulating arm, each stabilizing segment being configured to compress and expand with respect to the internal channel;a plurality of ports disposed on the internal channel within each stabilizing segment; anda tissue stabilizing member disposed at the second end of the articulating arm, the articulating arm is configured to move between a fixed state and movable state based on a state of the one or more stabilizing segments;', 'in the fixed state, the one or more stabilizing segments is compressed against the internal channel, and', 'in the movable state, the one or more stabilizing segments are expanded with respect to the internal channel., 'wherein2. The device according to claim 1 , further comprising:a plurality of stabilizing particles disposed within each ...

Device for treating regurgitation of tricuspid and implantation method therefor

A device for treating regurgitation of a tricuspid valve (4) is disclosed. The device comprises a tricuspid valve plug (21) capable of compressing and expanding and a tricuspid valve plug fixing device used for anchoring the tricuspid valve-in-plug (21) to an orifice of the tricuspid valve (4). The tricuspid valve plug (21) is provided with an inflow end (42, 52) and an opposite outflow end (47, 57), and a prosthetic valve (50, 70) capable of being opened and closed is disposed in the tricuspid valve plug (21). When the tricuspid valve (4) is dosed, the prosthetic valve (50, 70) is automatically closed, and when the tricuspid valve (4) is opened, the prosthetic valve (50, 70) is automatically opened.

Heart Ventricle Remodeling

The ventricle of a heart can be reshaped by passing a plurality of catheters from inside the ventricle to outside the ventricle through holes in the ventricle wall. Fluid-tight bags are then delivered through the catheters and expanded outside the ventricle to a diameter that is larger than the holes. A fluid substance is introduced into the bags, and the fluid substance is configured to solidify into solid pads that are also larger than the holes. The solid pads are then pulled towards each other and locked in position in order to reshape the ventricle. 1. An apparatus for reshaping a ventricle of a heart , the ventricle having a first wall section and a second wall section that is disposed opposite to the first wall section , the apparatus comprising:a first fluid-tight bag having a first inlet that is configured to accept a fluid and a distal end that is configured to pass through a first hole in the first wall section and extend outside the ventricle, wherein the first fluid-tight bag is configured so that when the distal end has passed through the first hole and has been extended outside the ventricle, at least a portion of the distal end that extends outside the ventricle has a diameter that is larger than the first hole;a first solid filler material disposed outside the ventricle in the distal end of the first fluid tight bag, the first solid filler material having diameter that is larger than the first hole, wherein the first solid filler material is formed by introducing at least one fluid substance into the first fluid tight bag via the first inlet after the distal end of the first fluid tight bag has passed through the first hole and has been extended outside the ventricle, wherein the at least one fluid substance is configured to solidify after being introduced into the first fluid tight bag;a second fluid-tight bag having a second inlet that is configured to accept a fluid and a distal end that is configured to pass through a second hole in the second ...

Heart valve sealing devices and delivery devices therefor

An exemplary implantable prosthetic device has a paddle frame, an inner paddle, and an outer paddle. The outer paddle is connected to the inner paddle. The inner and outer paddles are connected to the paddle frame at a connection between the inner paddle and the outer paddle. The paddle frame can be positioned inside the inner paddle, outside the outer paddle, or between the inner and outer paddles.

Medical securing device for securing a cardiac implant device with a securing member

A medical securing, such as a suturing device (100) for securing a cardiac implant device (400A, 400B) with a securing member (102), like a suture. The medical securing device comprises an elongated sheath (101) extending in a longitudinal direction and having proximal (101A) and distal (101B) ends. The distal end of the elongated sheath has a support portion (101C) to support the elongated sheath to the cardiac implant device and/or to the tissue (20). The medical securing device comprises also a securing member introduction device (103) extending from the sheath (101) and having proximal (103A) and distal (103B) ends. The distal end (103B) of the securing member introduction device (103) is configured to deliver the securing member (102) to the cardiac implant device and to secure the cardiac implant device to the annulus (20) of the valve with the securing member (102).

Cannula for minimally invasive surgical tricuspid valve repair

A cannula for minimally invasive surgical tricuspid valve repair, constituted by two coaxial tubes—an outer short one () and an inner long one (), of which the inner long tube () is slidably movable relative to the outer short tube (), and its proximal end is constituted by a head () which in the folded position has a cone shape with an axial inlet hole () in the axis of the upper base, while in the unfolded position, with the outer short tube () slid off in the distal direction, the head () has the shape of a cup extending outwardly. The outer edge of the cup has a diameter about three times the inner diameter of the cannula (). The outer short tube () is equipped with at least one rigid tie rod () the free end of which extends along the inner wall of the inner long tube () beyond its distal end. 11233245241283. A cannula for minimally invasive surgical tricuspid valve repair , which is constituted by at least one flexible tube equipped with a connector , characterised in that the cannula () is formed by two coaxial tubes—an outer short one () and an inner long one () , of which the inner long tube () is slidably movable relative to the outer short tube () , and its proximal distal end is constituted by a head () which in the folded position has a cone shape with an axial inlet hole () in the axis of the upper base , while in the unfolded position , with the outer short tube () slid off in the proximaldistal direction , the head () has the shape of a cup extending outwardly the outer edge of which has a diameter about three times the inner diameter of the cannula () , and the outer short tube () is equipped with at least one rigid tie rod () the free end of which extends along the inner wall of the inner long tube () beyond its distal proximal end.241. The cannula according to claim 1 , characterised in that the head () of the cannula () is made of a resilient and stretchable material.341. The cannula according to claim 2 , characterised in that the head () of the ...

INTERATRIAL SHUNTS HAVING BIODEGRADABLE MATERIAL, AND METHODS OF MAKING AND USING SAME

A device for regulating blood pressure between a patient's left atrium and right atrium comprises an hourglass-shaped stent comprising a neck region and first and second flared end regions, the neck region disposed between the first and second end regions and configured to engage the fossa ovalis of the patient's atrial septum, and a drug-eluting biodegradable material that biodegrades over time to release a drug that limits tissue overgrowth. The inventive device also may include a biodegradable material that biodegrades to offset flow changes caused by tissue overgrowth. The inventive device may reduce left atrial pressure and left ventricular end diastolic pressure, and may increase cardiac output, increase ejection fraction, relieve pulmonary congestion, and lower pulmonary artery pressure, among other benefits. 1. A device for regulating blood flow in a patient to treat a condition , the device comprising:a stent comprising a first flared end region, a second flared end region, a neck region disposed between the first and second flared end regions, and a passageway extending through the first flared end region through the neck region and through the second flared end region, the stent configured to shunt blood between body cavities;a biocompatible material disposed on the stent to define a sheath that channels blood flow through the passageway; anda biodegradable material disposed on an inner surface of the biocompatible material at the neck region, the biodegradable material configured to inhibit tissue overgrowth across the biodegradable material within the passageway of the stent.2. The device of claim 1 , wherein the stent comprises a plurality of rings interconnected by a plurality of longitudinally extending struts.3. The device of claim 1 , wherein the biocompatible material is disposed in the neck region claim 1 , the second flared end region claim 1 , and a portion of the first flared end region of the stent.4. The device of claim 1 , wherein the ...

ATRIAL-APPENDAGE LIGATION TREATMENT TOOL

An atrial-appendage ligation treatment tool including: a shaft provided with a lumen having, at a distal end thereof, an opening having an opening diameter that allows passage of a thread of a ligation loop formed in a ring shape, which can be tightened, by connecting an end of the thread at an intermediate position by means of a knot and that does not allow passage of the knot; and a cutting part that is provided at a distal end of the shaft and that cuts, at an inner side of the opening and in the vicinity of the opening, the thread passing through the lumen. 1. An atrial-appendage ligation treatment tool comprising:a shaft provided with a lumen having, at a distal end thereof, an opening having an opening diameter that allows passage of a thread of a ligation loop formed in a ring shape, which can be tightened, by connecting an end of the thread at an intermediate position by means of a knot, and that does not allow passage of the knot; anda cutting part that is provided at a distal end of the shaft and that cuts, at an inner side of the opening and in the vicinity of the opening, the thread passing through the lumen.2. An atrial-appendage ligation treatment tool according to claim 1 , further comprising an accommodating portion that accommodates the knot claim 1 , at the outer side of the opening in the lumen.3. An atrial-appendage ligation treatment tool according to claim 1 , wherein the cutting part comprises an energy supply part that supplies energy to the thread for cutting the thread.4. An atrial-appendage ligation treatment tool according to claim 3 , wherein the energy supply part is a heater that supplies heat claim 3 , an ultrasonic vibrator that supplies ultrasonic waves claim 3 , or an electrode that supplies high-frequency current.5. An atrial-appendage ligation treatment tool according to claim 1 , wherein the cutting part is a cutter provided with a blade portion that moves in a direction that intersect the thread.6. An atrial-appendage ligation ...

FLANGED OCCLUSION DEVICES AND METHODS

Implantable occlusion devices that include one or more flanges extending from a tubular body are disclosed. The flange or flanges may assist in retention of the device within a vessel, cavity, appendage, etc. At least one flange on the occlusion device may include a concave surface proximate one end of a body. Because of the shape of the flange, e.g., its concavity, the occlusion device may resist dislocation due to e.g., the forces generated within the left atrial appendage during atrial filbrillation. 117-. (canceled)18. A medical device for deployment in a body , wherein the device comprises:a tubular body comprising a first end and a second end, the body defining a longitudinal axis extending between the first end and the second end, the body comprising a body width measured transverse to the longitudinal axis when the device is in a relaxed configuration; andonly one flange attached to the body proximate the second end of the body, the only one flange comprising a flange width transverse to the longitudinal axis and a concave outer surface facing the first end of the body when the device is in the relaxed configuration,wherein the width of the body proximate the only one flange is less than the width of the flange when the device is in the relaxed configuration.19. The medical device of claim 18 , wherein the concave outer surface is linear in one or more directions.20. The medical device of claim 18 , wherein the concave outer surface is formed from a plurality of flat surfaces joined together.21. The medical device of claim 18 , wherein the flange comprises a convex outer surface facing the second end of the body.22. The medical device of claim 21 , wherein the convex surface faces away from the first end of the body when the device is in the relaxed configuration.23. The medical device of claim 18 , wherein the device comprises a collapsed configuration in which a distance between the first end and the second end is increased such that the body width and the ...

System and Method for Monitoring the Movement of a Medical Instrument in the Body of a Subject

This system comprises means ( 9 ) for determining a position of a first portion of a medical instrument in the body of a subject at a determination time, and means ( 11 ) for displaying an image of the first portion in the determined position. The determination means ( 9 ) comprise an imaging module ( 15 ) that is capable of acquiring, at an acquisition time that precedes said determination time, a position of the first portion, a detection module ( 17 ) for detecting a movement of a second portion of the medical instrument between said acquisition and determination times, and a determination module ( 19 ) for determining the position of the first portion ( 3 d ) at said determination time, from said position of the first portion at said acquisition time and from said movement of the second portion.

APPARATUS AND METHOD FOR HEART VALVE REPAIR

A device for repairing mitral valve leaflets includes a jaw mechanism that may be positioned adjacent a mitral valve leaflet . The jaw mechanism may move between an open position and a closed position by pivoting a first jaw relative to a second jaw . The first jaw may include a rivet that may move from a stored position to an application position projecting away from the first jaw when the jaw mechanism is moved from the closed to the open position. Closing the jaws about a valve leaflet causes the rivet to pierce the leaflet. The jaw mechanism may then be rotated to wind the leaflet thereabout and again pierce the leaflet. The rivet may then be released from the jaw mechanism and the device removed from the patient. 1. A method of repairing a heart valve leaflet in a patient , the method comprising:positioning a jaw mechanism adjacent the heart valve leaflet, the jaw mechanism including a first jaw, a second jaw, and a rivet mounted to the first jaw in a stored position, the rivet having a sharp free end;moving the jaw mechanism to an open position to create a receiving space between the first jaw and the second jaw;moving the rivet from the stored position to an application position in which the sharp free end of the rivet projects away from the first jaw toward the second jaw;capturing the heart valve leaflet in the receiving space;moving the jaw mechanism to a closed position in which the second jaw confronts the first jaw, whereby the sharp free end of the rivet pierces the heart valve leaflet at a first location and the heart valve leaflet is clamped between the first jaw and the second jaw;rotating the jaw mechanism so that the heart valve leaflet winds around the jaw mechanism;piercing the sharpened tip of the rivet through the heart valve leaflet at a second location different from the first location; andreleasing the rivet from the first jaw.2. The method of claim 1 , wherein moving the jaw mechanism to the open position includes pivoting the second jaw ...

METHOD AND APPARATUS FOR PERCUTANEOUS DELIVERY AND DEPLOYMENT OF A CARDIOVASCULAR PROSTHESIS

Catheter apparatuses and methods are provided for repairing heart valves, particularly mitral valves. The method includes providing a catheter having an elongate, flexible body, with a proximal end and a distal end. The distal end can be transluminally advanced from the left atrium through the mitral valve and along the left ventricular outflow tract into the ascending aorta. A valve repair device is deployed to permanently connect leaflets at a mid-section of a mitral valve while permitting medial and lateral portions of the natural leaflets to open and close. The valve repair device detachably connects the distal and proximal ends of the catheter. 1. A method of performing a procedure in the heart , comprising:providing a catheter having an elongate flexible body, a proximal end, a distal end, and a procedure zone, spaced proximally apart from the distal end, proximal and distal portion of the catheter being separable from the procedure zone;advancing the catheter antegrade through the mitral valve, through the aortic valve and into the aorta, such that the procedure zone is positioned upstream from the aortic valve;performing a procedure from the procedure zone;separating at least one of the proximal portion and the distal portion from the procedure zone; andseparately removing the proximal and distal ends of the catheter from the patient.2. (canceled)3. (canceled)4. A method of performing a procedure in the heart as in claim 1 , wherein the procedure zone comprises a fastening device configured to opening carried by the catheter.5. A method of performing a procedure in the heart as in claim 4 , wherein the fastening device is configured to capture adjacent edges of the valve to create a double orifice in the valve.6. A method of performing a procedure in the heart as in claim 5 , wherein the fastening device comprises a clip having proximal and distal portions detachably coupled to the proximal and distal portions of the catheter.7. A method of performing a ...

MULTIPLE ANCHOR DELIVERY TOOL

An anchor deployment tool is provided that includes a flexible tube, which defines an anchor storage area in which tissue anchors are stored before deployment, and a distal anchor manipulation area that has a length of at least 3 cm. The tool also includes a rotating deployment element, which is positioned within the flexible tube, and is configured to, while the distal anchor manipulation area is disposed within a lumen defined by a wall of a sleeve, (i) directly engage the anchors in the anchor storage area a single one at a time, (ii) advance each of the anchors, while thus directly engaged, in a distal direction into the anchor manipulation area, and (iii) anchor the sleeve to tissue of a subject by deploying each of the tissue anchors through a distal end of the flexible tube, through the wall of the sleeve, and into the tissue. 159-. (canceled)60. Apparatus comprising:an implantable sleeve having a wall that is shaped to define a lumen;a plurality of tissue anchors; and [ (i) an anchor storage area in which the plurality of tissue anchors are stored before deployment thereof, and', '(ii) a distal anchor manipulation area, which (A) is disposed between the anchor storage area and the distal tube end, (B) has a length of at least 3 cm, and (C) is removably positionable within the lumen of the sleeve; and, '(a) a flexible tube, which has a distal tube end, and which defines, (i) directly engage the tissue anchors in the anchor storage area a single one at a time,', '(ii) advance each of the tissue anchors, while thus directly engaged, in a distal direction into the anchor manipulation area, and', '(iii) anchor the sleeve to tissue of a subject by deploying each of the tissue anchors through the distal tube end, through the wall of the sleeve, and into the tissue,, '(b) a rotating deployment element, which is positioned within the flexible tube, and is configured to, while the distal anchor manipulation area is disposed within the lumen of the sleeve], 'an anchor ...

Devices and methods for closure of transvascular or transcameral access ports

The present disclosure provides a variety of prostheses, delivery systems and techniques to facilitate closure of transvascular or transcameral access ports. Various embodiments of prostheses are provided including a plurality of radially expandable discs that can be filled with material to facilitate coagulation and to reduce or stop leakage from punctures in vessel walls.

BIO-ABSORBABLE WOUND CLOSURE DEVICE AND METHOD

A wound closure device comprises a first frame and a flexible tubular section connected to the first frame, the first frame implantable through a wound in a patient's skin into a lumen of a blood vessel with a portion of the tubular section extending out through the skin. The tubular section has a first portion and a second portion, a wall of the tubular section defining a coaxial inner bore. Twisting the first portion relative to the second portion of the tubular section closes the bore is closed in an area of the tubular section between the first and second portions, thereby closing the wound. Also disclosed is an embodiment for closing an opening in a heart, as well as a delivery device, systems, and methods. 1. A device for closing a wound , the device comprising an implant having a first end , a second end , and a longitudinal axis extending between the first end and the second end , the implant comprising:a first frame at the first end; anda flexible tubular section connected to the first frame and extending along the longitudinal axis, the tubular section having a first portion and a second portion;wherein a wall of the tubular section defines a coaxial inner bore, and wherein the device is adjustable to a first position where the first portion and the second portion of the tubular section are rotated circumferentially around the longitudinal axis in a first direction relative to one another, such that the bore is closed in an area of the tubular section between the first and second portions.2. The device of claim 1 , wherein the device is adjustable to a second position where the first portion and the second portion of the tubular section are rotated circumferentially in a direction opposite to the first direction relative to one another claim 1 , such that the bore is open between the first and second portions claim 1 , and wherein a length of the implant from the first end to the second end is longer in the second position than in the first position.3. The ...

TISSUE COMPRESSION DEVICE WITH TENSION LIMITING STRAP RETAINER

Tissue compression devices having a tension limiting strap retainer and methods of using the same. The tissue compression devices described herein may include a strap retainer that is attached to a base by an elastic member that is configured to draw the strap retainer towards the base. The tissue compression devices described herein may also include a tension indicator that extends between the base of the tissue compression device and strap retainer. The tension indicator may be configured to limit the travel distance of the strap retainer away from the base in response to forces acting on the strap retainer. The tension indicator may also provide visual feedback to a user of the tension force in a strap to attach the tissue compression device to a patient. 115-. (canceled)16. A method of attaching a tissue compression device to a patient , the method comprising:positioning a base of a tissue compression device such that a pressure apparatus attached to the base is located over selected tissue at a selected location, wherein the base comprises a first side and a strap retainer attached to a second side of the base, wherein the strap retainer is attached to the second side of the base by an elastic member;connecting a free end of a strap to the strap retainer, wherein a fixed end of the strap is attached to the base, and wherein the strap and the base are configured to encircle a limb when the free end of the strap is connected to the strap retainer;stretching the elastic member by moving the strap retainer away from the base, wherein the stretching elongates the elastic member so that the strap retainer is moved from a retracted position to an extended position, and wherein the elastic member applies a tension force on the strap through the strap retainer when the strap retainer is in the extended position.17. A method according to claim 16 , wherein the method comprises providing a visual indication of the tension force applied to the strap using a tension ...

METHODS AND DEVICES FOR DIASTOLIC ASSIST

The devices and method described herein allow for therapeutic damage to increase volume in these hyperdynamic hearts to allow improved physiology and ventricular filling and to reduce diastolic filling pressure by making the ventricle less stiff. 1a handle comprising a handle body and an actuating member;a flexible shaft having a near end coupled to the handle body and a far end, the flexible shaft;an atraumatic tip located at the far end;a cutting member pivotally secured within the flexible shaft and having a cutting edge; anda linking member coupling the actuating member of the handle to the cutting member,. A medical device for creating elongated incisions within soft tissue, the device comprising: This application is a continuation of U.S. application Ser. No. 15/085,509 filed Mar. 30, 2016, which is a continuation of International Application No. PCT/US2014/058438 filed Sep. 30, 2014, which claims the benefit of priority to U.S. Provisional Patent Application Nos. 61/884,332 filed Sep. 30, 2013, 61/911,456 filed Dec. 3, 2013, and 62/046,863 filed Sep. 5, 2014. PCT/US2014/058438 filed Sep. 30, 2014 is also a continuation-in-part of U.S. patent application Ser. No. 14/152,189 filed Jan. 10, 2014, the contents of which are incorporated herein by reference in their entiretiesCongestive heart failure (CHF) in the United States has a prevalence of approximately 5.8 million people and an incidence of approximately 550,000 people annually. CHF is a rapidly growing medical problem. CHF can be categorized as either systolic heart failure (SHF) or diastolic heart failure (DHF). The estimated direct and indirect cost of CHF in the United States for 2009 is $37.2 billion. CHF is the primary reason for 12-15 million office visits and 6.5 million hospital days each year. CHF is also thought to be the cause of at least 20 percent of all hospital admissions among patients older than 65. Over the past decade, the rate of hospitalizations for heart failure has increased by 159 ...

Dissection tip and introducer for surgical instrument

A surgical fastener applying apparatus includes an elongate body portion having proximal and distal ends, an end effector including a first movably coupled to a second jaw that is positioned at the distal end of the elongate body portion, and an introducer member. The introducer member has proximal and distal portions, and is configured and dimensioned for releasable connection with the end effector. The introducer member is at least partially formed from a flexible material, and is configured and dimensioned to separate target tissue from collateral tissue prior to positioning of the target tissue between the first and second jaws of the end effector.

Full eversion anastomosis juncture formation and suturing

Disclosed embodiments include apparatuses, systems, and methods for facilitating anastomosis between bodily passages. In an illustrative embodiment, an eversion mechanism is configured to engage a first external surface of a receiving passage adjacent a first opening in the receiving passage in order to create a receiving flange presenting a first interior face. A donor support mechanism is configured to support a donor passage with an opening in an end in an everted position that forms a donor flange presenting a second interior face. The donor support mechanism is further configured to present the second interior face of the donor flange against the first interior face of the receiving flange to present a passage juncture. A suturing mechanism is configured to motivate a filament through a helical path around the passage juncture to suture the second interior face of the donor passage to the first interior face of the receiving passage.

System(s), method(s) and device(s) for the prevention of esophageal fistula during catheter ablation

The present invention is directed to systems, devices and methods for trans-septally delivering carbon dioxide through a minimally invasive catheter to create a gaseous pocket or emphysema between the posterior wall of the left atrium and the esophagus during cardiac ablation of the left atrium. This pocket of gas expanded tissue serves to thermally insulate and separate the esophagus from the left atrium during ablation to prevent the formation of an atrial-esophageal fistula. The system comprises a control system to precisely deliver the gas to a desired location through a needle-based catheter assembly.

Percutaneous repair of mitral prolapse

A mitral valve leaflet repair system may include a delivery catheter having at least one lumen extending proximally from a distal end of the delivery catheter, a plurality of anchor elements disposed within the at least one lumen, each of the plurality of anchor elements being configured to extend through one layer of mitral valve leaflet tissue, and a securing element configured to secure at least two of the plurality of anchor elements together on one side of the mitral valve leaflet tissue. The at least one lumen may include a suction lumen configured to grasp a mitral valve leaflet prior to extending the plurality of anchor elements through one layer of mitral valve leaflet tissue.

Electrosurgical Pericaridial Puncture

Devices and methods for providing access to the pericardial cavity while reducing risk of myocardial damage. One method includes using an apparatus to apply pressure to a parietal pericardium, retracting the apparatus, and puncturing the parietal pericardium by delivering electrical energy using a puncture device. Another method includes moving a portion of parietal pericardium away from a surface of myocardium of the heart and puncturing the parietal pericardium by delivering electrical energy using a puncture device. The methods may include a step of confirming that the puncture device is at least partially within the parietal cavity by injecting or aspirating fluid through a lumen in the puncture device or measuring the pressure or electrical impedance at the distal end of the puncture device. 121.-. (canceled)22. A method of accessing a pericardial cavity of a heart comprising:a. using an apparatus to apply pressure to a parietal pericardium;b. retracting the apparatus; andc. puncturing the parietal pericardium by delivering electrical energy using a puncture device.23. The method of claim 22 , further comprising the step of advancing the puncture device through the apparatus.24. The method of claim 22 , further comprising a step of confirming that the puncture device is at least partially within the pericardial cavity.25. The method of claim 24 , wherein the step of confirming that the puncture device is at least partially within the pericardial cavity comprises injecting a contrast fluid into the pericardial cavity through a lumen of the puncture device.26. The method of claim 24 , wherein the step of confirming that the puncture device is at least partially within the pericardial cavity comprises aspirating fluid from the pericardial cavity through a lumen of the puncture device.27. The method of claim 24 , wherein the step of confirming that the puncture device is at least partially within the pericardial cavity comprises measuring electrical impedance at a ...

METHOD AND APPARATUS FOR PERCUTANEOUS DELIVERY AND DEPLOYMENT OF A CARDIOVASCULAR PROSTHESIS

Catheter apparatuses and methods are provided for repairing heart valves, particularly mitral valves. The method includes providing a catheter having an elongate, flexible body, with a proximal end and a distal end. The distal end can be transluminally advanced from the left atrium through the mitral valve and along the left ventricular outflow tract into the ascending aorta. A valve repair device is deployed to permanently connect leaflets at a mid-section of a mitral valve while permitting medial and lateral portions of the natural leaflets to open and close. The valve repair device detachably connects the distal and proximal ends of the catheter. 119.-. (canceled)20. A mitral valve prosthesis , comprising:an elongate arcuate body having a proximal end and a distal end;a base disposed between the proximal and distal ends of the elongate body;an arcuate anterior leaflet grasping element articulated at the distal end of the elongate body, the arcuate anterior leaflet grasping element being movable between an open position and a closed position; andan arcuate posterior leaflet grasping element articulated at the distal end of the elongate body, the arcuate posterior leaflet grasping element being movable between an open position and a closed position.21. The mitral valve prosthesis of claim 20 , wherein when the posterior leaflet grasping element is in the closed position the posterior leaflet grasping element is received in a space at least partially bounded by the base.22. The mitral valve prosthesis of claim 21 , wherein a flush surface is provided between the base and side surfaces of at least one of the anterior and poster leaflet grasping elements.23. The mitral valve prosthesis of claim 20 , wherein a lumen and a pneumatic actuator are disposed in the base for actuating at least one of the anterior and poster leaflet grasping elements.24. The mitral valve prosthesis of claim 23 , wherein a first lumen and a first pneumatic actuator is disposed in the base for ...

MEDICAL DEVICE, KIT AND METHOD FOR CONSTRICTING TISSUE OR A BODILY ORIFICE, FOR EXAMPLE, A MITRAL VALVE

A device, kit and method may employ an implantable device (e.g., annuloplasty implant) and a tool to implant such. The implantable device is positionable in a cavity of a bodily organ (e.g., a heart) and operable to constrict a bodily orifice (e.g., a mitral valve). Tissue anchors are guided into precise position by an intravascularly deployed anchor guide frame and embedded in an annulus. Constriction of the orifice may be accomplished via a variety of structures, for example by cinching a flexible cable or anchored annuloplasty ring, the cable or ring attached to the tissue anchors. The annuloplasty ring may be delivered in a generally elongated configuration, and implanted in an anchored generally arch, arcuate or annular configuration. Such may move a posterior leaflet anteriorly and an anterior leaflet posteriorly, improving leaflet coaptation to eliminate mitral regurgitation. 1. (canceled)2. An implant system comprising:a helical tissue anchor comprising a plurality of helically arranged coils, the helical tissue anchor configured to be implanted into bodily tissue within a body; andan anchor guide member configured to position the helical tissue anchor at least proximate a tissue insertion location within the body during an implant procedure, the anchor guide member including a first portion and a second portion, the first portion of the anchor guide member located within multiple coils of the plurality of helically arranged coils of the helical tissue anchor at least in a first configuration of the implant system, and the second portion of the anchor guide member extending radially outward beyond the helical tissue anchor at least in the first configuration of the implant system,wherein, at least in the first configuration, the helical tissue anchor is configured to rotate relative to both the first portion of the anchor guide member and the second portion of the anchor guide member, andwherein the first configuration of the implant system is configured to ...

HEART VALVE SEALING DEVICES AND DELIVERY DEVICES THEREFOR

An exemplary valve repair device for repairing a native valve of a patient includes a coaption element and a pair of paddles. The coaption element and/or the pair of paddles can be made from a fabric, such as a braided metal fabric. The pair of paddles are connected to the coaption element. The paddles are movable between an open position and a closed position. The valve repair device is configured to attach to the native valve of the patient. 1. A valve repair device for repairing a native valve of a patient , the valve repair device comprising:a coaption element made from a fabric;a pair of paddles connected to the coaption element, wherein the paddles are movable between an open position and a closed position;wherein the paddles are configured to attach to the native valve of the patient.2. The valve repair device of claim 1 , wherein the fabric comprises metal strands that are woven together.3. The valve repair device of claim 1 , wherein the fabric comprises an electrospun material.4. The valve repair device of claim 1 , wherein the metal fabric material comprises electrospun metal fibers.5. The valve repair device of claim 1 , wherein the paddles are connected to the coaption element by connecting fabric.6. The valve repair device of claim 5 , wherein the connecting fabric comprises metal strands that are woven together.7. The valve repair device of claim 5 , wherein the connecting fabric comprises an electrospun material.8. The valve repair device of claim 1 , wherein the paddles are made from a fabric.9. The valve repair device of claim 8 , wherein the fabric that the paddles are made of comprises metal strands that are woven together.10. The valve repair device of claim 8 , wherein the fabric that the paddles are made from comprises an electrospun material.11. The valve repair device of claim 1 , wherein the paddles comprise an inner paddle portion and an outer paddle portion.12. The valve repair device of claim 11 , wherein the inner paddle portion is made ...

HEART VALVE SEALING DEVICES AND DELIVERY DEVICES THEREFOR

An exemplary implantable prosthetic device has a coaption element and a pair of paddles. The coaption element has a first end portion and a second end portion. The pair of paddles is connected to the second end portion of the coaption element. The coaption element narrows as the copation element extends from the first end portion to the second end portion. The paddles are movable between an open position and a closed position. The paddles are configured to attach to the native valve of the patient. 1. A valve repair device for repairing a native valve of a patient , the valve repair device comprising:a coaption element having a first end portion and a second end portion; anda pair of paddles connected to the second end portion of the coaption element;wherein the coaption element narrows as the copation element extends from the first end portion to the second end portion;wherein the paddles are movable between an open position and a closed position; andwherein the paddles are configured to attach to the native valve of the patient.2. The valve repair device of claim 1 , wherein the coaption element is symmetrical about a plane that bisects the coaption element and the paddles.3. The valve repair device of claim 1 , wherein the coaption element is symmetrical about a plane that bisects the coaption element and that is between the paddles.4. The valve repair device of claim 1 , wherein the coaption element narrows as the copation element extends from the first end portion to the second end portion when the valve repair device is viewed from a side of the valve repair device.5. The valve repair device of claim 1 , wherein the coaption element narrows as the copation element extends from the first end portion to the second end portion when the valve repair device is viewed from a front of the valve repair device.6. The valve repair device of claim 1 , wherein the coaption element narrows as the copation element extends from the first end portion to the second end portion ...

PERICARDIAL ACCESS

Medical devices and instruments, particularly pericardial access systems and devices and related methods are disclosed. Some example pericardial access devices may include a distally located, expandable skirt configured to engage the pericardium. When extended, the skirt may be wider than the tubular body of the device. Some example pericardial access devices may include an at least partially transparent, repositionable tip. 1. A surgical device for accessing a pericardial space of a patient , comprising:an elongated, generally tubular body including a proximal end and a distal end, the tubular body including at least one longitudinal channel extending from the proximal end to the distal end, the at least one longitudinal channel being capable of selectively accepting an obturator and a needle guide system therein;a handle disposed at the proximal end of the tubular body; anda selectively deployable suction skirt movable between a retracted configuration in which the skirt is radially contracted and an extended configuration in which the skirt is radially expanded and includes a distal edge defining a distal opening;wherein, in the extended configuration, the distal edge of the skirt is configured to sealingly engage a surface of a tissue layer, the distal opening of the skirt is diametrically wider than the distal end of the tubular body, and the skirt is configured to accept a portion of the tissue layer proximally therein when suction is applied to the skirt via the tubular body.2. The device of claim 1 ,wherein, in the retracted configuration, the skirt is at least partially within the tubular body; andwherein, in the extended configuration, the skirt extends distally beyond the distal end of the tubular body.3. The device of claim 1 , wherein claim 1 , in the extended configuration claim 1 , the skirt is generally frustoconical.4. The device of claim 1 , wherein the skirt includes at least one positioner operatively coupled an actuator disposed on the handle ...

ABLATION AND OCCLUSIVE SYSTEM

An example medical system for ablating and occluding the left atrial appendage is disclosed. The example system includes a catheter sized and shaped for vascular access and including an elongate body extending between a proximal end and a distal end. A first expandable member may be positioned near the distal end of the elongate body and have a first region configured to permeate a liquid therethrough. A first set of one or more electrodes may be arranged within the first expandable member and may be configured to deliver energy to the tissue region. An occlusive implant may be releasably secured to the distal end of the elongate body. 1. An ablation and implant system , the system comprising:a catheter sized and shaped for vascular access and including an elongate body extending between a proximal end and a distal end;a first expandable member positioned near the distal end of the elongate body and having a first region configured to permeate a liquid therethrough;a first set of one or more electrodes arranged within the first expandable member and configured to deliver energy to the tissue region; andan occlusive implant releasably secured to the distal end of the elongate body.2. The system of claim 1 , further comprising:a second expandable member and having a first region configured to permeate a liquid therethrough and positioned between the first expandable member and the occlusive implant; anda second set of one or more electrodes arranged within the second expandable member.3. The system of claim 1 , wherein the first region of the first expandable member is configured to transfer energy from the first set of one more electrodes to the tissue region.4. The system of claim 1 , further comprising a direct current source electrically coupled to the first set of one or more electrodes.5. The system of claim 1 , wherein the direct current source is configured to deliver pulses of voltage in the range of about 1000 to about 5000 volts.6. The system of claim 4 , ...

EXPANSION DEVICE FOR OPENING VALVE PERIMETER IN CARDIAC SURGERY

A tissue expander/retractor tool works within a narrow cavity/tunnel to access a deeper structure (e.g., the mitral valve) without consuming a significant amount of space either within the small through-hole or in the vicinity of the entrance to the port. The tool provides the user with direct control of the expansion and separation of a target area. The moving parts of the tool have a closed configuration with a narrow profile for insertion/removal and an open configuration obtained using a remotely-controlled, compact pivot mechanism that provides a broad enlargement capability for the retraction jaws. A pantograph mechanism with input pivots and output pivots is coupled between the retraction jaws and a compound cable (e.g., Bowden cable). A handle is coupled to the other end of the compound cable for displacing the inner wire along the outer tube. 1. An expander/retractor device for minimally invasive cardiac surgery comprising:a pantograph mechanism with first and second input pivots and first and second output pivots;first and second retraction jaws extending from the first and second output pivots, respectively;a compound cable with an outer tube fixed to the first input pivot and an inner wire fixed to the second input pivot; anda handle for displacing the inner wire along the outer tube.2. The device of wherein the retraction jaws have adjustable shapes.3. The device of wherein the adjustable shapes of the retraction jaws includes pivoting from within a plane defined by the pantograph mechanism to an orientation transverse to the plane.4. The device of wherein the retraction jaws are comprised of malleable wires bent according to a desired retraction surface shape.5. The device of wherein the malleable wires forming the retraction jaws further form linkages between the input and output pivots of the pantograph mechanism.6. The device of wherein the pantograph mechanism is further comprised of linkages joining the first input pivot to the first and second ...

PERCUTANEOUS PAPILLARY MUSCLE RELOCATION

A system for treating mitral regurgitation may include an outer sheath having a lumen extending to a distal end of the outer sheath, an intermediate sheath slidably disposed within the lumen of the outer sheath, the intermediate sheath having a lumen extending to a distal end of the intermediate sheath, and an inner sheath slidably disposed within the lumen of the intermediate sheath, wherein the inner sheath includes a first anchor disposed within a lumen of the inner sheath, the first anchor being configured to penetrate and secure to a first papillary muscle. The intermediate sheath may include a tissue grasping mechanism at the distal end of the intermediate sheath, the tissue grasping mechanism being configured to hold and stabilize the first papillary muscle for penetration and securement of the first anchor to the first papillary muscle. 1. A method for treating mitral regurgitation , comprising:advancing a distal end of an outer sheath intravascularly to a left ventricle of a heart, the outer sheath having a lumen extending to the distal end of the outer sheath;wherein an intermediate sheath is slidably disposed within the lumen of the outer sheath, the intermediate sheath having a lumen extending to a distal end of the intermediate sheath and a tissue grasping mechanism disposed at the distal end of the intermediate sheath; andwherein an inner sheath is slidably disposed within the lumen of the intermediate sheath;grasping a first papillary muscle of the left ventricle using the tissue grasping mechanism, the tissue grasping mechanism being configured to hold and stabilize the first papillary muscle for penetration of a first anchor into the first papillary muscle from the inner sheath;advancing the first anchor into the first papillary muscle from within a lumen of the inner sheath, the first anchor being configured to penetrate and secure to the first papillary muscle of the left ventricle;grasping a second papillary muscle of the left ventricle using the ...

SURGICAL TOOL

A medical instrument including a first joint including a first member and a second member, the first member configured to be repositionable with respect to the second member in a first degree of freedom, a second joint operatively coupled to the first joint, the second joint including a third member and a fourth member, the third member configured to be repositionable with respect to the fourth member in a second degree of freedom, a pair of repositionable jaws operatively coupled to the first joint and the second joint, an open-ended occlusion clip detachably mounted to the pair of repositionable jaws, and a controller operatively coupled to the first joint, the second joint, and the pair of repositionable jaws, the controller including a control with a line operatively coupled to the first and second jaws in at least a gun tackle pulley configuration. 1. A medical instrument comprising:a first joint comprising a first member and a second member, the first member configured to be repositionable with respect to the second member in a first degree of freedom;a second joint operatively coupled to the first joint, the second joint comprising a third member and a fourth member, the third member configured to be repositionable with respect to the fourth member in a second degree of freedom;a pair of repositionable jaws operatively coupled to the first joint and the second joint;an open-ended occlusion clip detachably mounted to the pair of repositionable jaws; and,a controller operatively coupled to the first joint, the second joint, and the pair of repositionable jaws, the controller including a first control configured to direct repositioning of at least one of the first member and the second member, and a second control configured to direct repositioning of at least one of the third member and the fourth member, and a third control configured to direct repositioning of the pair of repositionable jaws, the third control including a line operatively coupled to the first ...

SURGICAL TOOL

A medical instrument comprising: (a) a first joint comprising a first member and a second member, the first member configured to be repositionable with respect to the second member in a first degree of freedom; (b) a second joint operatively coupled to the first joint, the second joint comprising a third member and a fourth member, the third member configured to be repositionable with respect to the fourth member in a second degree of freedom; (c) a pair of repositionable jaws operatively coupled to the first joint and the second joint; (d) an open-ended occlusion clip detachably mounted to the pair of repositionable jaws; and, (e) a controller operatively coupled to the first joint, the second joint, and the pair of repositionable jaws, the controller including a first control configured to direct repositioning of at least one of the first member and the second member, and a second control configured to direct repositioning of at least one of the third member and the fourth member, and a third control configured to direct repositioning of the pair of repositionable jaws, the third control including a line operatively coupled to the first and second jaws in at least a gun tackle pulley configuration 133-. (canceled)34. A method of controlling an end effector of a medical instrument that includes a first jaw and a second jaw , the medical instrument including a hand-held device operatively coupled to the end effector , comprising:providing a first control of the hand-held device configured to direct repositioning of at least one of a first member and a second member of a first joint of the end effector, the first member and second member being repositionable with respect to one another in a first degree of freedom;providing a second control of the hand-held device configured to direct repositioning of at least one of a third member and a fourth member of a second joint of the end effector, the third member and fourth member being repositionable with respect to one ...

SURGICAL TOOL

A medical instrument comprising: (a) a first joint comprising a first member and a second member, the first member configured to be repositionable with respect to the second member in a first degree of freedom; (b) a second joint operatively coupled to the first joint, the second joint comprising a third member and a fourth member, the third member configured to be repositionable with respect to the fourth member in a second degree of freedom; (c) a pair of repositionable jaws operatively coupled to the first joint and the second joint; (d) an occlusion clip detachably mounted to the pair of repositionable jaws; and, (e) a controller operatively coupled to the first joint, the second joint, and the pair of repositionable jaws, the controller including a first control configured to direct repositioning of at least one of the first member and the second member, and a second control configured to direct repositioning of at least one of the third member and the fourth member, and a third control configured to direct repositioning of the pair of repositionable jaws. 1. A medical instrument comprising:a first joint comprising a first member and a second member, the first member configured to be repositionable with respect to the second member in a first degree of freedom;a second joint operatively coupled to the first joint, the second joint comprising a third member and a fourth member, the third member configured to be repositionable with respect to the fourth member in a second degree of freedom;a pair of repositionable jaws operatively coupled to the first joint and the second joint, the pair of repositionable jaws coupled to a repositionable support that interposes the pair of repositionable jaws and the second joint, the repositionable support maintaining the pair of jaws in a parallel orientation across a range of motion;an occlusion clip detachably mounted to the pair of repositionable jaws; and,a controller operatively coupled to the first joint, the second joint ...

Transcatheter insertion device and method

The present invention relates to a transcatheter method for providing fluid communication between two anatomical compartments. The present invention also relates to a transcatheter system comprising an intracorporeal connector for fluid communication between two anatomical compartments through at least one anatomical wall, wherein said connector is adapted to receive a flow regulating device, a connector, a flow regulating device and an insertion device.

VALVE PROSTHESIS CONFIGURED FOR DEPLOYMENT IN ANNULAR SPACER

Embodiments of the present disclosure are directed to prosthetic heart valves and methods of use thereof. In one implementation, a prosthetic heart valve may include an annular spacer having a spacer opening therein and a disc-shaped wall configured to obstruct blood flow. The annular spacer may be configured for engaging with a native heart valve opening, such as the orifice of a mitral valve. The spacer opening may be sized to be smaller than the native heart valve opening. The prosthetic heart valve may also include a central valve section configured for disposal within the spacer opening. The central valve section may be separate from the annular spacer and may include one or more prosthetic valve leaflets. 163-. (canceled)64. A prosthetic heart valve , comprising:an annular spacer having a spacer opening therein and a disc-shaped wall configured to obstruct blood flow, wherein the annular spacer is configured for engaging with a native heart valve opening and wherein the spacer opening is sized to be smaller than the native heart valve opening; anda central valve section configured for disposal within the spacer opening, wherein the central valve section is separable from the annular spacer.65. The prosthetic heart valve of claim 64 , wherein the annular spacer is configured for engaging with a heart valve annulus and wherein the spacer opening is sized to be smaller than the heart valve annulus.66. The prosthetic heart valve of claim 64 , wherein an outer diameter of the central valve section is smaller than a diameter of a heart valve annulus.67. The prosthetic heart valve of claim 64 , wherein the central valve section is configured for implantation after implantation of the annular spacer.68. The prosthetic heart valve of claim 64 , wherein the annular spacer is configured to provide coupling between the central valve section and a heart valve annulus.69. The prosthetic heart valve of claim 64 , wherein the disc-shaped wall includes a support stent having a ...

APPARATUS FOR MANUALLY MANIPULATING HOLLOW ORGANS

An apparatus for mechanically manipulating hollow organs within the body of a subject, or an organ manipulation apparatus, includes a manipulation section. The manipulation section may include a substantially two-dimensional element, which may have a width that exceeds a distance across a portion of the interior of a hollow organ within which the manipulation section is to be positioned. The manipulation section is configured to manipulate at least a portion of a hollow organ from within, which may modify at least one of a shape, orientation, or location of at least part of the hollow organ. Methods for manipulating hollow organs are also disclosed, as are operating techniques, such as left atrial ablation, in which the shapes, orientations, and/or locations of hollow organs are manipulated to move the hollow organs away from the site of the medical procedure, reducing the potential for damage to the hollow organs. 1. An apparatus for manipulating an esophagus , comprising: a distal end;', 'a proximal end opposite from the distal end;', 'a proximal portion adjacent to the proximal end, the proximal portion being substantially linear or substantially curvilinear; and', 'a distal portion adjacent to the distal end, a manipulation section of the distal portion having a substantially two-dimensional configuration defined by a series of bends, the substantially two-dimensional configuration having a width of more than 14 mm., 'an elongate element consisting of2. The apparatus of claim 1 , wherein the elongate element has a substantially solid structure.3. The apparatus of claim 1 , wherein the elongate element is radiopaque.4. The apparatus of claim 1 , wherein the elongate element is a wire.5. The apparatus of claim 1 , wherein the elongate element has a diameter of about 0.035 inch to about 0.038 inch.6. The apparatus of claim 1 , wherein the manipulation section is made of a shape memory alloy.7. The apparatus of claim 1 , wherein the series of bends in the distal ...