Crystalline Forms of N-[3-fluoro-4-(oxy)phenyl]-N'-(4-fluorophenyl)cyclopropane-1,1-dicarboxamide

This invention relates to three crystalline forms of N—[3-fluoro-4-((6-(methyloxy)-7-[(3-morpholin-4-ylpropyl)oxy]quinolin-4-yl|oxy)phenyl]—N′—(4-fluorophenyl)cyclopropane-1,1-dicarboxamide. Compound (I), designated as Form A, Form B, and Form C. The invention provides methods for treatment of cancer by exploiting the modulation of protein kinase activity. The invention also provides pharmaceutical compositions containing a crystalline form of Compound (I) and a pharmaceutically acceptable excipient. 1. A crystalline form of N—[3-fluoro-4-({6-(methyloxy)-7-[(3-morpholin-4-ylpropyl)oxy]quinolin-4-yl}oxy)phenyl]—N′—(4-fluorophenyl)cyclopropane-1 ,1-dicarboxamide characterized by having at least one of:{'sup': '13', 'a solid state C NMR spectrum with peaks at 161.2, 158.6, 153.3, 146.5, 136.0, 132.6, 128.6, 127.4, and 124.9 ppm±0.2 ppm;'}{'sup': '19', 'sub': '3', 'a solid state F NMR spectrum with peaks at −116.8 and −128.6 ppm±0.2 ppm relative to CFCl; and'}an X-ray powder diffraction pattern with peaks at 7.2, 7.7, 12.5, 15.5, 16.5, 17.1, and 19.1 °2θ±0.7°2θ.2. A crystalline form of N—[3-fluoro-4-({6-(methyloxy)-7-[(3-morpholin-4-ylpropyl)oxy]quinolin-4-yl}oxy)phenyl]—N′—(4-fluorophenyl)cyclopropane-1 claim 1 ,1-dicarboxamide according to characterized by at least two of:an X-ray powder diffraction pattern with peaks at 7.2, 7.7, 12.5, 15.5, 16.5, 17.1, and 19.1 °2θ±0.2°2θ:{'sup': '13', 'a solid state C NMR spectrum with peaks at 161.2, 158.6, 153.3, 146.5, 136.0, 132.6, 128.6, 127.4, and 124.9 ppm±0.2 ppm; and'}{'sup': '19', 'sub': '3', 'a solid state F NMR spectrum with peaks at −116.8 and −128.6 ppm±0.2 ppm relative to CFCl.'}3. A crystalline form of N—[3-fluoro-4-({6-(methyloxy)-7-[(3-morpholin-4-ylpropyl)oxy]quinolin-4-yl}oxy)phenyl]—N′—(4-fluorophenyl)cyclopropane-1 claim 1 ,1-dicarboxamide characterized by having at least one of:{'sup': '13', 'a solid state C NMR spectrum with peaks at 162.7, 160.5, 147.4, 137.9, 133.5, 131.4, 126.1, and 122.7 ppm±0.2 ppm;'}{' ...

Detachable aneurysm neck bridge

In one embodiment, a neck bridge for bridging the neck of an aneurysm includes a junction region, a number of radially extending array elements attached to the junction region, and a cover attached to one or both of the junction region and an array element. The array elements are configured to be positioned within the aneurysm after the neck bridge is deployed from a delivery device. In a second embodiment, the neck bridge includes a junction region and a braided or mesh-like structure secured to the junction region. The braided or mesh-like structure is made from an elastic material.

DELIVERY SYSTEMS FOR PROSTHETIC HEART VALVE

Described herein are systems and methods from delivering prosthetic devices, such as prosthetic heart valves, through the body and into the heart for implantation therein. The prosthetic devices delivered with the delivery systems disclosed herein are, for example, radially expandable from a radially compressed state mounted on the delivery system to a radially expanded state for implantation using an inflatable balloon of the delivery system. Exemplary delivery routes through the body and into the heart include transfemoral routes, transapical routes, and transaortic routes, among others. 1. A method of implanting a radially compressible and expandable prosthetic heart valve in a native heart valve of the heart , the method comprising:introducing a delivery device into the body of a patient, the delivery device comprising a handle portion, an elongated shaft extending from the handle portion, the shaft having a distal end portion mounting an inflatable balloon and a prosthetic heart valve in a radially compressed state;advancing the distal end portion of the delivery device toward the native heart valve until the prosthetic valve is within or adjacent the annulus of the native heart valve;positioning the prosthetic heart valve at a desired implantation position within the annulus of the native by rotating an adjustment device coupled to the handle portion and the shaft to cause the shaft and the prosthetic valve to move distally and/or proximally relative to the handle portion until the prosthetic heart valve is at the desired implantation position; andafter the prosthetic heart valve has been moved to the desired implantation position, inflating the balloon to cause the prosthetic heart valve to radially expand and engage the annulus of the native heart valve.2. The method of claim 1 , wherein prior to positioning the prosthetic heart valve at a desired implantation position claim 1 , activating a shaft engagement member that frictionally engages an outer surface ...

SYSTEM AND METHOD FOR CRIMPING A PROSTHETIC VALVE

An exemplary system for crimping a prosthetic valve comprises a radially expandable and compressible prosthetic valve, a crimping device positioned around the valve and configured to reduce the diameter of the valve to a delivery configuration, and a sterile package enclosing the valve and the crimping device. The valve can be pre-assembled in a partially crimped configuration within the crimping device. After removing the sterile packaging, the crimping device can be used to crimp the valve from the partially crimped configuration to the delivery configuration, such as by twisting a knob on the crimping device. The system can further comprise at least a portion of a delivery catheter within the sterile package, wherein the valve is pre-mounted on or adjacent to an inflatable balloon of the delivery catheter, such that the valve can be crimped onto the delivery catheter using the crimping device. 1. A system comprising:a radially expandable and compressible prosthetic valve;a crimping device positioned around the valve, the crimping device being configured to reduce the diameter of the valve to a delivery configuration; anda sterile package enclosing the valve and the crimping device.2. The system of claim 1 , wherein the valve is in a partially crimped configuration within the crimping device and within the sterile package.3. The system of claim 2 , wherein the crimping device is configured to crimp the valve from the partially crimped configuration to the delivery configuration.4. The system of claim 1 , further comprising at least a portion of a delivery catheter within the sterile package claim 1 , wherein the valve is pre-mounted on or adjacent a balloon of the delivery catheter.5. The system of claim 1 , wherein the crimping device comprises:a radially compressible collet positioned around the valve; anda rotatable knob coupled to the collet, wherein rotation of the knob causes radial compression of the collet and crimping of the valve.6. The system of claim 1 ...

DETACHABLE ANEURYSM NECK BRIDGE

A device for bridging a neck of an aneurysm, comprises a junction region, one or more radially extending array elements secured to the junction region, each array element having an unfolded shape and a delivery shape; and a cover attached to the junction region, and extending over the delivery shape of the array elements, wherein each array element is attached at one end to the junction region and the array elements are constructed and arranged to unfold the cover when assuming their unfolded shape, and wherein the device further comprises a tip, and each array element is attached at another end to the tip, the tip comprising an opening through which a vaso-occlusive device or occlusion fluid may be delivered. 1. An aneurysm retainer assembly for bridging a neck of an aneurysm , comprising:an elongated tubular member defining a lumen; a first collar and a second collar, wherein the first and second collars are slidably disposed on, and detachably coupled to, the elongated tubular member,', 'a plurality of radially extending array elements, each array element having a first end and a second end, the respective array element first ends attached to the first collar and the respective array element second ends attached to the second collar, each array element having an unfolded shape and a delivery shape, and', 'a cover attached to each of the first and second collars and extending over the array elements., 'a neck bridge mounted on a distal end of the elongated tubular member, the neck bridge configured for placement over or across the neck of the aneurysm, and comprising'}2. The aneurysm retainer assembly of claim 1 , further comprising a first control wire detachably coupled to the first collar claim 1 , and a second control wire detachably coupled to the second collar.3. The aneurysm retainer assembly of claim 2 , wherein the second control wire is configured to move the second collar relative to the first collar along the tubular member.4. The aneurysm retainer ...

VASO-OCCLUSIVE DEVICES HAVING EXPANDABLE FIBERS

This is a device for occluding a space, for example an aneurysm, within the body. In particular, the device comprising a metallic vaso-occlusive device and expandable fibrous elements. The devices may be placed in a desired site within a mammal. 119.-. (canceled)20. An occlusive device comprising an expandable fiber wound helically about at least a portion of the device.21. The device of claim 20 , wherein the fiber comprises at least one monofilament.22. The device of claim 20 , wherein the fiber comprises at least one multifilament.23. The device of claim 20 , wherein the fiber contacts the device in two or more places.24. The device of claim 20 , wherein the device is an embolic coil claim 20 , the embolic coil comprising a metal selected from the group consisting of nickel claim 20 , titanium claim 20 , platinum claim 20 , gold claim 20 , tungsten claim 20 , iridium and alloys or combinations thereof.25. The device of claim 24 , wherein the metal is nitinol or platinum.26. The device of claim 20 , wherein the device includes a tubular braid.27. The device of claim 20 , further comprising at least one bioactive material.28. An occlusive device having an expandable mesh disposed about a portion of the device.29. The device of claim 28 , wherein the mesh includes at least one monofilament.30. The device of claim 28 , wherein the mesh includes at least one multifilament.31. The device of claim 28 , wherein the mesh contacts the device in two or more places.32. The device of claim 28 , wherein the device is an embolic coil claim 28 , the embolic coil comprising a metal selected from the group consisting of nickel claim 28 , titanium claim 28 , platinum claim 28 , gold claim 28 , tungsten claim 28 , iridium and alloys or combinations thereof.33. The device of claim 32 , wherein the metal is nitinol or platinum.34. The device of claim 28 , wherein the device includes a tubular braid.35. The device of claim 28 , further comprising at least one bioactive material. ...

INTRA-ANEURYSM DEVICES

Devices for occluding an aneurysm are provided. In particular, the device include an upper member that sits against the dome of the aneurysm, a lower member that sits in the neck of the aneurysm, and a means of adjusting the overall dimensions of the device. Also provided are methods of making and using these devices. 1. A vaso-occlusive device for placement within an aneurysm having a neck and a sac , the device comprising:a self-expanding resilient body having a linear configuration prior to deployment and a deployed expanded configuration, wherein the deployed configuration bridges the neck of the aneurysm and occludes the aneurysm sac when the device is placed within the aneurysm;central member having a undeployed, linear configuration, and an expanded deployed configuration, wherein the central member is disposed within the self-expanding resilient body, and is configured to adjust an overall dimensions of the device.2. The vaso-occlusive device of claim 1 , wherein the central member comprises a proximal end that is coupled to a proximal end of the self-expanding resilient body.3. The vaso-occlusive device of claim 1 , wherein the self-expanding resilient body comprises a plurality of wires extending through the central member claim 1 , each wire comprising a proximal end and a distal end.4. The vaso-occlusive device of claim 3 , wherein the proximal ends of the wires are coupled to the central member.5. The vaso-occlusive device of claim 3 , wherein the distal ends of the wires are coupled to the central member.6. The vaso-occlusive device of claim 1 , wherein the self-expanding resilient body and central member each comprises a mesh or braided structure.7. The vaso-occlusive of claim 1 , further comprising a detachment junction claim 1 , the detachment junction comprising an electrolytically detachable end or a mechanically detachable end.8. The vaso-occlusive device of claim 7 , wherein the detachment junction is disposed between the self-expanding ...

STEERABLE CATHETER WITH MULTIPLE PULL WIRES

In one representative embodiment, a steerable catheter device comprises a shaft comprising a proximal portion and a distal portion, and first and second pull wires having respective proximal portions and respective distal portions. The proximal portions of the first and second pull wires extend through the proximal portion of the shaft in close proximity to each other. The distal portions of the first and second pull wires extend through the distal portion of the shaft in close proximity to each other over a first distance defining a primary flexing section, diverge away from each other over a second distance, and then extend parallel to each other at angularly spaced locations over a third distance defining a secondary flexing section. 1. A steerable catheter device , comprising:a shaft having a proximal portion and a distal portion; andfirst and second pull wires having respective proximal portions and respective distal portions, the proximal portions of the first and second pull wires extending through the proximal portion of the shaft in close proximity to each other, and the distal portions of the first and second pull wires extending through the distal portion of the shaft in close proximity to each other over a first distance defining a primary flexing section, diverging away from each other over a second distance, and then extending parallel to each other at angularly spaced locations over a third distance defining a secondary flexing section;wherein tension applied to the first pull wire and/or the second pull wire is effective to flex the distal portion of the shaft away from a central axis of the proximal portion of the shaft, wherein the direction of flexion is determined by the relative tensions in the pull wires.2. The catheter device of claim 1 , wherein the shaft comprising a main pull-wire lumen extending through the proximal portion of the shaft and first and second distal pull-wire lumens extending from the main pull-wire lumen claim 1 , the ...

SYSTEM AND METHOD FOR CRIMPING A PROSTHETIC VALVE

An exemplary system for crimping a prosthetic valve comprises a radially expandable and compressible prosthetic valve, a crimping device positioned around the valve and configured to reduce the diameter of the valve to a delivery configuration, and a sterile package enclosing the valve and the crimping device. The valve can be pre-assembled in a partially crimped configuration within the crimping device. After removing the sterile packaging, the crimping device can be used to crimp the valve from the partially crimped configuration to the delivery configuration, such as by twisting a knob on the crimping device. The system can further comprise at least a portion of a delivery catheter within the sterile package, wherein the valve is pre-mounted on or adjacent to an inflatable balloon of the delivery catheter, such that the valve can be crimped onto the delivery catheter using the crimping device. 124-. (canceled)25. A crimping device for crimping a radially expandable and compressible prosthetic valve , the crimping device comprising: 'a longitudinal opening extending between the proximal end and the distal end;', 'a coiled wire frame comprising a first end, a second end, a proximal end, a distal end, and'}a first member coupled to the first end of the coiled wire frame; anda second member coupled to the second end of the coiled wire frame, the second member movable relative to the first member,whereinthe coiled wire frame has a first state and a second state, the opening of the coiled wire frame having a first diameter in the first state and a second diameter in the second state, the first diameter greater than the second diameter, the first diameter dimensioned to receive a prosthetic valve in an expanded or partially crimped configuration, the second diameter dimensioned to receive the prosthetic valve in a crimped configuration, andthe first member is operably movable relative to the second member to convert the coiled wire frame from the first state to the ...

STEERABLE CATHETER WITH PULL WIRE

In one representative embodiment, a steerable catheter device comprises a shaft comprising a proximal portion, a distal portion, and a pull-wire lumen that extends at least partially through the proximal and distal portions. A pull wire extends through the pull-wire lumen and has a proximal end portion and a distal end portion, wherein the distal end portion of pull wire is fixed to the distal end portion of the shaft. An adjustment mechanism is operatively connected to the proximal end portion of the pull wire and configured to increase and decrease tension in the pull wire to adjust the curvature of the distal portion of the shaft. An axially non-compressible pull-wire sleeve extends co-axially through the pull-wire lumen and over the pull wire. 1. A method comprising:providing a catheter device having a shaft, a pull wire extending through the shaft, and an axially non-compressible pull-wire sleeve, the pull wire extending at least partially through the pull-wire sleeve, the pull wire and the pull-wire sleeve being radially offset from a central axis of the shaft, wherein the shaft comprises a proximal portion and a distal portion;inserting the catheter device into the body of a patient; andapplying tension to the pull wire to adjust the curvature of the distal portion of the shaft.2. The method of claim 1 , further comprising torqueing the shaft to rotate the distal portion of the shaft after inserting the catheter device into the body and adjusting the curvature of the distal portion of the shaft.3. The method of claim 1 , further comprising mounting a prosthetic valve in a radially compressed state on the catheter device claim 1 , inserting the prosthetic valve into the body of the patient when inserting the catheter device into the body claim 1 , and deploying the prosthetic valve within the body.4. The method of claim 1 , wherein applying tension to the pull wire to adjust the curvature of the distal portion of the shaft causes the pull-wire sleeve to move ...

VASO-OCCLUSIVE DEVICES HAVING EXPANDABLE FIBERS

This is a device for occluding a space, for example an aneurysm, within the body. In particular, the device comprising a metallic vaso-occlusive device and expandable fibrous elements. The devices may be placed in a desired site within a mammal. 119-. (canceled)20. An occlusive device having a single expandable material disposed about a portion of the occlusive device.21. The occlusive device of claim 20 , wherein the expandable material is loosely wrapped about a portion of the occlusive device.22. The occlusive device of claim 20 , wherein a portion of the expandable material is interlaced between adjacent windings of the occlusive device.23. The occlusive device of claim 20 , wherein the expandable material contacts the occlusive device in two or more places.24. The occlusive device of claim 20 , wherein the occlusive device is an embolic coil claim 20 , the embolic coil comprising a metal selected from the group consisting of nickel claim 20 , titanium claim 20 , platinum claim 20 , gold claim 20 , tungsten claim 20 , iridium and alloys or combinations thereof.25. The occlusive device of claim 24 , wherein the metal is nitinol or platinum.26. The occlusive device of claim 20 , wherein the occlusive device includes a tubular braid.27. The occlusive device of claim 20 , further comprising at least one bioactive material.28. An occlusive device having an expandable monofilament disposed about an exterior surface of the occlusive device.29. The occlusive device of claim 28 , wherein the expandable monofilament is loosely wrapped about a portion of the occlusive device.30. The occlusive device of claim 28 , wherein a portion of the expandable monofilament is interlaced between adjacent windings of the occlusive device.31. The occlusive device of claim 28 , wherein the expandable material contacts the occlusive device in two or more places.32. The occlusive device of claim 28 , wherein the occlusive device is an embolic coil claim 28 , the embolic coil comprising a ...

Delivery systems for prosthetic heart valve

A delivery apparatus for a prosthetic heart valve includes a shaft, an inner balloon, and an outer balloon. The shaft has a lumen extending from a proximal end portion to a distal end portion and a plurality of openings formed in the distal end portion. The shaft is configured such that a fluid can flow through the lumen and the openings. The inner balloon has end portions and a center portion disposed between the end portions. The inner balloon is mounted on the distal end portion of the shaft and is in fluid communication with the openings of the shaft. When the inner balloon is inflated with the fluid, the end portions expand farther radially outwardly than the center portion. The outer balloon is mounted to the shaft and disposed over the inner balloon. The outer balloon is configured to fully expand after the inner balloon at least partially expands.

CARDIAC VALVE REPAIR DEVICES CONFIGURED FOR PERCUTANEOUS DELIVERY

Certain aspects of the disclosure concern a device for repairing or replacing a native heart valve. The device can include a frame including a first set of struts intersecting with a second set of struts at a plurality of strut connection points. The frame can be radially expandable from a radially collapsed state to a radially expanded state. The device can include at least one expansion feature including a screw head and a screw shaft connected to the screw head. The screw shaft can extend through a first strut connection point and a second strut connection point. The device can further include a plurality of penetrating members extending from a first end of the frame. Rotating the screw shaft in a first direction can radially expand the frame from the radially collapsed state to the radially expanded state.

INTRA-ANEURYSM DEVICES

Devices for occluding an aneurysm are provided. In particular, the device include an upper member that sits against the dome of the aneurysm, a lower member that sits in the neck of the aneurysm, and a means of adjusting the overall dimensions of the device. Also provided are methods of making and using these devices. 1. A vaso-occlusive device for placement within an aneurysm having a neck and a sac , the device comprising:a plurality of inter-woven wires having a compressed delivery configuration for passage through a delivery catheter, and an expanded deployed configuration,wherein, when the device is positioned within the aneurysm in the expanded deployed configuration, the plurality of inter-woven wires are configured to bridge the neck of the aneurysm and occlude the aneurysm sac, respectively, andwherein, in the expanded deployed configuration, first ends of the wires form an external concavity in a first end portion of the device, and second ends of the wires form an external concavity in a second end portion of the device.2. The vaso-occlusive device of claim 1 , wherein in the expanded deployed configuration claim 1 , the plurality of inter-woven wires define a cylindrical middle body portion having a first end that transitions into the first end portion claim 1 , and a second end that transitions into the second end portion.3. The vaso-occlusive device of claim 1 , wherein in the expanded deployed configuration claim 1 , the plurality of inter-woven wires define a substantially spherical interior region.4. The vaso-occlusive device of claim 1 , wherein the device is self-expanding.5. The vaso-occlusive of claim 1 , further comprising a mechanical or electrolytic detachment junction.6. The vaso-occlusive device of claim 3 , wherein the detachment junction is disposed between the plurality of inter-woven wires and a pusher wire slidably disposed within a delivery catheter.7. The vaso-occlusive device of claim 1 , wherein the device is made from a ...

SYSTEMS, DEVICES, AND METHODS FOR TREATING HEART VALVES

Systems, assemblies, and methods for treating valve regurgitation and other valve problems are described. Prosthetic valves can have integrated coverings or flanges. Prosthetic valves can have a flange attached to the inflow end of the annular frame and designed to extend outwardly therefrom. Docking devices can be used to repair or reshape native heart valves and to secure prosthetic heart valves at a specific location and position relative to a native heart valve. Delivery systems can be used to deploy a docking device into the heart, including a lubricous sleeve in the delivery system. Packaging and storage systems suitable for the delivery systems are described. 1. A delivery system for delivering a docking device to a native valve annulus of a patient's heart , comprising:an outer shaft; a distal section configured to cover the docking device; and', 'a proximal section including a tubular portion and a cut portion, the cut portion having an open cross-section; and, 'a sleeve shaft at least partially arranged within the outer shaft, the sleeve shaft comprising a main tube arranged interior to, in a radial direction that is relative to a central longitudinal axis of the delivery system, the sleeve shaft;', 'an annular shell surrounding a proximal end portion of the main tube and spaced away from, in the radial direction, an outer surface of the main tube; and', 'a proximal extension connected to and extending proximally from a proximal end of the main tube, the proximal extension extending along a portion of an inner surface of the cut portion of the proximal section of the sleeve shaft., 'a pusher shaft at least partially arranged within the outer shaft, the pusher shaft comprising2. The delivery system of claim 1 , wherein the pusher shaft further comprises an annular plug arranged within the annular shell claim 1 , at a proximal end of the shell claim 1 , and surrounding the main tube claim 1 , wherein the plug includes a crescent-shaped portion extending ...

LOW PROFILE DELIVERY SYSTEM FOR TRANSCATHETER HEART VALVE

A method of delivery a prosthetic heart valve includes inserting a delivery apparatus and a prosthetic heart valve into a patient's vasculature. The delivery apparatus includes a steerable guide catheter, a balloon catheter, and a flex indicator. The balloon catheter extends coaxially through the guide catheter, the prosthetic heart valve is mounted on a distal end portion of the balloon catheter, and the flex indicator is movably coupled to a handle of the guide catheter. The method further includes adjusting flexion of a steerable section of the guide catheter to position the prosthetic heart valve. The flex indicator moves relative to the handle of the guide catheter as the flexion of the steerable section is adjusted, and the handle comprises one or more visual indicators adjacent the flex indicator to provide visual indication of an amount of flexion of the steerable section of the guide catheter. 1. A delivery apparatus , comprising:a handle;a first shaft extending distally from the handle;an inflatable balloon disposed on a distal end portion of the first shaft;a second shaft extending distally from the handle over at least a portion of the first shaft; andthe second shaft comprising an expandable distal end portion extending over a portion of the balloon;wherein the distal end portion of the second shaft is configured to expand radially when the balloon is inflated from an uninflated state to an inflated state.2. The delivery apparatus of claim 1 , wherein the distal end portion of the second shaft comprises a plurality of longitudinally extending slots defining a plurality of circumferentially spaced deflectable sections that can deflect radially outwardly from one another when the balloon is inflated.3. The delivery apparatus of claim 2 , wherein the plurality of deflectable sections comprise a plurality of metal sections.4. The delivery apparatus of claim 3 , wherein the distal end portion of the second shaft further comprises a further material layer ...

DELIVERY SYSTEMS FOR PROSTHETIC HEART VALVE

A delivery apparatus for a prosthetic heart valve includes a shaft, an inner balloon, and an outer balloon. The shaft has a lumen extending from a proximal end portion to a distal end portion and a plurality of openings formed in the distal end portion. The shaft is configured such that a fluid can flow through the lumen and the openings. The inner balloon has end portions and a center portion disposed between the end portions. The inner balloon is mounted on the distal end portion of the shaft and is in fluid communication with the openings of the shaft. When the inner balloon is inflated with the fluid, the end portions expand farther radially outwardly than the center portion. The outer balloon is mounted to the shaft and disposed over the inner balloon. The outer balloon is configured to fully expand after the inner balloon at least partially expands. 1. A method of positioning a prosthetic heart valve , comprising:inserting a distal end portion of a delivery apparatus into a patient's vasculature, wherein the distal end portion comprises a prosthetic heart valve mounted thereon;advancing the distal end portion of the delivery apparatus and the prosthetic heart valve to an implantation location;partially inflating an inner balloon of the delivery apparatus disposed at the distal end portion of the delivery apparatus with a fluid, wherein partially inflating the inner balloon results in end portions of the inner balloon expanding radially outwardly farther than at a center portion of the inner balloon, and wherein partially inflating the inner balloon results in partial expansion of the prosthetic heart valve; andafter partially inflating the inner balloon, fully inflating an outer balloon of the delivery apparatus disposed at the distal end portion of the delivery apparatus with the fluid, wherein the fluid flows from within the inner balloon, through openings in the inner balloon, and into the outer balloon, wherein the outer balloon is sealed so as to prevent ...

LOW PROFILE DELIVERY SYSTEM FOR TRANSCATHETER HEART VALVE

An apparatus for delivering a prosthetic heart valve includes a steerable guide catheter, a balloon catheter, and a flex indicator. The guide catheter has a handle and a guide tube extending from the handle. The guide tube has a distal end portion comprising a steerable section. The guide catheter further includes an adjustment mechanism on the handle and a pull wire connecting the adjustment mechanism to the steerable section for changing flexion of the steerable section. The balloon catheter includes a shaft extending coaxially through the guide tube. The shaft includes a proximal end portion and a distal end portion. The balloon catheter further includes a balloon mounted on the distal end portion of the shaft. The flex indicator moves relative to the handle upon adjustment of the adjustment mechanism. The handle includes visual indicia adjacent the flex indicator to provide visual indication of the flexion of the steerable section. 1. An apparatus for delivering a prosthetic heart valve to a patient's native aortic valve , the apparatus comprising:a steerable guide catheter having a handle portion and an elongated guide tube extending from the handle portion, the elongated guide tube having a distal end portion comprising a steerable section, the guide catheter further comprising an adjustment mechanism on the handle portion and a pull wire operatively connecting the adjustment mechanism to the steerable section for changing flexion of the steerable section via manual adjustment of the adjustment mechanism;a balloon catheter comprising an elongated shaft extending coaxially through the guide tube, the shaft comprising a proximal end portion and a distal end portion, the balloon catheter further comprising an inflatable balloon mounted on the distal end portion of the shaft; anda flex indicator that moves relative to the handle portion upon manual adjustment of the adjustment mechanism,wherein the handle portion comprises visual indicia adjacent the flex ...

LOW PROFILE DELIVERY SYSTEM FOR TRANSCATHETER HEART VALVE

A method of delivery a prosthetic heart valve includes inserting a delivery apparatus and a prosthetic heart valve into a patient's vasculature. The delivery apparatus includes a steerable guide catheter, a balloon catheter, and a flex indicator. The balloon catheter extends coaxially through the guide catheter, the prosthetic heart valve is mounted on a distal end portion of the balloon catheter, and the flex indicator is movably coupled to a handle of the guide catheter. The method further includes adjusting flexion of a steerable section of the guide catheter to position the prosthetic heart valve. The flex indicator moves relative to the handle of the guide catheter as the flexion of the steerable section is adjusted, and the handle comprises one or more visual indicators adjacent the flex indicator to provide visual indication of an amount of flexion of the steerable section of the guide catheter. 1. A method of delivery a prosthetic heart valve comprising:inserting a delivery apparatus and a prosthetic heart valve into a patient's vasculature, wherein the delivery apparatus comprises a steerable guide catheter, a balloon catheter, and a flex indicator, wherein the balloon catheter extends coaxially through the guide catheter, wherein the prosthetic heart valve is mounted on a distal end portion of the balloon catheter, and wherein the flex indicator is movably coupled to a handle of the guide catheter;adjusting flexion of a steerable section of the guide catheter to position the prosthetic heart valve relative to the patient's native aortic valve, wherein the flex indicator moves relative to the handle of the guide catheter as the flexion of the steerable section is adjusted, and wherein the handle comprises one or more visual indicators adjacent the flex indicator to provide visual indication of an amount of flexion of the steerable section of the guide catheter; andexpanding the prosthetic heart valve into contact with the patient's native aortic valve by ...

VALVE ANCHOR AND INSTALLATION METHOD

Anchor devices and methods used to secure a prosthetic valve to a native valve annulus are described. The anchor device can be a separate expandable element from the prosthetic valve that is first advanced to the annulus and deployed, after which an expandable prosthetic valve is advanced to within the annulus and deployed. The combination of the two elements can apply a clamping force to the valve leaflets which holds the prosthetic valve in place. The anchor device can have a lower or ventricular portion and an upper or atrial portion. The anchor device can include one or more leaflet clamping portions. One, two, or more upstanding vertical posts between the clamping portions can extend upward at the valve commissures and support the upper portion, which can include one or more structures for leak prevention. 128-. (canceled)29. A system for securing a prosthetic valve at a native valve , comprising:an expandable/collapsible anchor device having a lower portion below an upper portion, the lower portion having an expandable tubular body about a vertical axis and comprising undulating struts, the tubular body defining a leaflet clamping portion defined by at least one peak extending upward,wherein there is a downward valley on the lower portion adjacent the at least one leaflet clamping portion, the device further including an upstanding vertical post commencing at the downward valley and extending upward beyond a maximum height of the at least one peak of the leaflet clamping portion and terminating in the upper portion.30. The system of claim 29 , further comprising a second leaflet clamping portion defined by at least one peak extending upward.31. The system of claim 30 , wherein the clamping portions each include at least two peaks and one valley therebetween.32. The system of claim 29 , wherein the clamping portion is covered with fabric.33. The system of claim 29 , wherein each undulating strut has an S-shape and terminates in an asymptotic manner at each end ...

INCREMENTAL SIMPLIFICATION AND OPTIMIZATION OF COMPLEX QUERIES USING DYNAMIC RESULT FEEDBACK

Techniques for improving complex database queries are provided. A determination is made whether to adopt a static or dynamic query execution plan for a received database query based on metrics. When a dynamic query execution plan is adopted, the database query is separated into query fragments. A plan fragment is generated for each query fragment and executed to generate feedback for the plan fragment. The feedback from the execution of each plan fragment is used to initiate query rewrite rules to simplify the corresponding query fragments. The rewritten query fragments are combined to generate the dynamic query plan. 1. A method implemented and programmed within a non-transitory computer-readable storage medium and processed by a processor , the processor configured to execute the method , comprising:determining, at the processor, whether to execute a received database query via a static query plan or a dynamic query plan;fragmenting, at the processor, the database query into query fragments when the dynamic query plan is selected, each query fragment comprising one or more query blocks; generating, by said processor, a plan fragment for the query fragment;', 'executing, by said processor, the plan fragment to generate feedback for the plan fragment; and', 'performing an incremental query rewrite on the query fragment with feedback applied to said plan fragment to produce a rewritten query fragment;, 'for each query fragmentcombining, by said processor, said rewritten query fragments to generate said dynamic query plan; andexecuting said query in accordance with said dynamic query plan.2. The method of claim 1 , wherein selecting a dynamic plan for execution of said query comprises determining whether said query includes at least one of the following:a noncorrelated scalar subquery which returns a single row with a single field;a single-row relation, where a field is defined as unique;a noncorrelated subquery with small enough results which can be processed as an ...

Occlusive cinching devices and methods of use

Methods and devices for blocking orifices and occluding cavities within a patient are provided. The device in one variation comprises first and second tubular members attached to a collapsible sealing element. The device can be placed through an orifice and the collapsible sealing element can be collapsed to seal the orifice. An embolic may be introduced distal to the sealing element to occlude a cavity. The device may incorporate a locking mechanism which can be engaged to lock the sealing element into the collapsed position. The device may incorporate a valve to prevent flow through the tubular members, for example to prevent egress of the embolic from a cavity. The device can be detached to provide a permanent seal of the orifice, and can retain the embolic within the cavity. The device may be used in conjunction with a stent or other retention device to assist the sealing element in maintaining the seal.

APPARATUS FOR THE INTRODUCTION AND MANIPULATION OF MULTIPLE TELESCOPING CATHETERS

A delivery apparatus includes a steerable shaft having a proximal portion, a distal portion, and a pull-wire conduit that extends through the proximal and distal portions. A pull wire extends through the conduit and has a distal portion that is fixed to the shaft. An adjustment mechanism is connected to the proximal end portion of the pull wire and configured to increase and decrease tension in the pull wire to adjust the curvature of the shaft. The distal portion of the shaft has a steerable portion including one or more layers. A compression-resistance portion is incorporated into a layer of the steerable portion, and extends angularly along a portion of a cross-section of the layer. The layer of the steerable portion into which the compression-resistance portion is incorporated has a first hardness, and the compression-resistance portion has a second hardness that is greater than the first hardness. 1. A delivery apparatus , comprising:a steerable shaft comprising a proximal portion, a distal portion, and a pull-wire conduit that extends at least partially through the proximal and distal portions of the shaft;a pull wire extending through the pull-wire conduit and having a proximal end portion and a distal end portion, wherein the distal end portion of the pull wire is fixed to the distal portion of the shaft; andan adjustment mechanism operatively connected to the proximal end portion of the pull wire and configured to increase and decrease tension in the pull wire to adjust the curvature of the distal portion of the shaft;wherein the distal portion of the shaft comprises a steerable portion having one or more layers, the steerable portion including a compression-resistance portion incorporated into a respective layer of the steerable portion and extending angularly along a portion of a cross-section of the layer, the layer of the steerable portion into which the compression-resistance portion is incorporated having a first hardness, the compression-resistance ...

STEERABLE CATHETER WITH PULL WIRE

In one representative embodiment, a steerable catheter device comprises a shaft comprising a proximal portion, a distal portion, and a pull-wire lumen that extends at least partially through the proximal and distal portions. A pull wire extends through the pull-wire lumen and has a proximal end portion and a distal end portion, wherein the distal end portion of pull wire is fixed to the distal end portion of the shaft. An adjustment mechanism is operatively connected to the proximal end portion of the pull wire and configured to increase and decrease tension in the pull wire to adjust the curvature of the distal portion of the shaft. An axially non-compressible pull-wire sleeve extends co-axially through the pull-wire lumen and over the pull wire. 1. A steerable catheter device , comprising:a shaft comprising a proximal portion, a distal portion, and a pull-wire lumen that extends at least partially through the proximal and distal portions;a pull wire extending through the pull-wire lumen and having a proximal end portion and a distal end portion, wherein the distal end portion of pull wire is fixed to the distal portion of the shaft;an adjustment mechanism operatively connected to the proximal end portion of the pull wire and configured to increase and decrease tension in the pull wire to adjust the curvature of the distal portion of the shaft; andan axially non-compressible pull-wire sleeve extending co-axially through the pull-wire lumen and over the pull wire.2. The catheter device of claim 1 , wherein the pull-wire sleeve comprises a closed-pitch coil.3. The catheter device of claim 1 , wherein the pull-wire sleeve is free-floating within the pull-wire lumen.4. The catheter device of claim 1 , wherein the pull-wire sleeve comprises a proximal end portion that extends outside of and alongside the shaft and the pull wire extends proximally past the proximal end portion of the pull-wire sleeve.5. The catheter device of claim 4 , further comprising a handle and a ...

Facial treatment systems and methods

A method for applying an emollient fluid to the skin includes cooling an emollient fluid and applying the cooled fluid to the skin. The emollient fluid may be made from a powdered plant product mixed into an aqueous medium. The fluid may be cooled to form a solid which is applied to the skin. Optionally, the solid is formed on an applicator which serves as a handle for the user. A kit which includes a mold, an applicator and a supply of emollient product is provided. The powdered plant product may be made from a powdered plant, powdered fruit or powdered extract of any one or more of pineapple, pumpkin, rice, banana, oats, cucumber, strawberry, lemon peel, watermelon, guava, mango avocado, tomato, blueberries, pomegranate, green tea (matcha), spirulina, dragon fruit, and beet.

SYSTEM AND METHOD FOR CRIMPING A PROSTHETIC HEART VALVE

A device for crimping a radially expandable and collapsible prosthetic valve comprises a coiled wire frame having a longitudinal opening extending from a proximal end to a distal end thereof. The opening has a first state and a second state, the opening in the first state having a first diameter dimensioned to receive the prosthetic valve in an expanded or partially crimped configuration therein, and the opening in the second state having a second diameter dimensioned to receive the prosthetic valve in a crimped configuration. The coiled wire frame has a first end coupled to a first member and a second end coupled to a second member. The first member is movable relative to the second member to convert the coiled wire frame from the first state to the second state. 1. (canceled)2. A crimping device for crimping a radially expandable and compressible prosthetic valve , the crimping device comprising:a housing member configured to receive a prosthetic valve in a radially expanded state; anda rotatable knob rotatably coupled to the housing member, wherein rotation of the knob relative to the housing member causes radial crimping of the prosthetic valve.3. The crimping device of claim 2 , wherein rotation of the knob causes axial movement of the prosthetic valve through the housing member.4. The crimping device of claim 2 , wherein rotation of the knob causes the knob to move axially over the housing member.5. The crimping device of claim 2 , wherein the housing member comprises an internally tapered surface and further wherein rotation of the knob causes relative axial movement between the tapered surface and the prosthetic valve.6. The crimping device of claim 2 , wherein the knob is threadably engaged to the housing member.7. The crimping device of claim 6 , wherein the knob has internal threads that engage external threads of the housing member.8. A method for crimping a prosthetic valve claim 6 , the method comprising:rotating a rotatable knob of a crimping device ...

HEART VALVE DOCKING DEVICES AND SYSTEMS

Docking devices for docking a prosthetic valve at a native valve of a heart can include a coiled docking anchor and a retrieval suture. The docking device and retrieval suture can be configured for improved retention and retrieval of the docking device after deployment. The docking devices can have an end portion with a central axis. The retrieval suture can be connected to the end portion such that a line of force applied by applying tension to the retrieval suture is substantially aligned with the central axis. 1. A system for implanting a docking device at a native valve , the system comprising:a delivery catheter;an elongated coiled docking device having an end portion;a pusher device having a central lumen, wherein the pusher device is disposed in the delivery catheter;a retrieval line that extends through the central lumen of the delivery catheter and is coupled to the end portion of the coiled docking device;wherein the system is configured such that pulling the retrieval line pulls the end portion of the coiled anchor against the pusher device; andwherein the end portion and retrieval line are configured and coupled such that a tension force from the pulling is biased to be substantially aligned with a central axis of the end portion of the coiled docking device.2. The system of claim 1 , wherein the end portion is configured to align at least a lengthwise portion of the retrieval line along the central axis.3. The system of claim 1 , wherein the retrieval line extends through a central passage at a tip of the end portion of the docking device claim 1 , and wherein the central passage is aligned with the central axis.4. The system of claim 1 , wherein the docking device further comprises a spherical tip.5. The system of claim 4 , wherein the spherical tip receives the retrieval line through a passage that is aligned with central axis of the end portion of the coiled docking device.6. The system of claim 5 , wherein the spherical proximal tip comprises an ...

SYSTEM AND METHOD FOR CRIMPING A PROSTHETIC HEART VALVE

A device for crimping a radially expandable and collapsible prosthetic valve comprises a coiled wire frame having a longitudinal opening extending from a proximal end to a distal end thereof The opening has a first state and a second state, the opening in the first state having a first diameter dimensioned to receive the prosthetic valve in an expanded or partially crimped configuration therein, and the opening in the second state having a second diameter dimensioned to receive the prosthetic valve in a crimped configuration. The coiled wire frame has a first end coupled to a first member and a second end coupled to a second member. The first member is movable relative to the second member to convert the coiled wire frame from the first state to the second state. 1. A crimping device for crimping a radially expandable and compressible prosthetic valve , the crimping device comprising:a coiled wire frame comprising a first end, a second end, a proximal end, a distal end, and a longitudinal opening extending between the proximal end and the distal end;a first member coupled to the first end of the coiled wire frame; anda second member coupled to the second end of the coiled wire frame, the second member movable relative to the first member, the coiled wire frame has a first state and a second state, the opening of the coiled wire frame having a first diameter in the first state and a second diameter in the second state, the first diameter greater than the second diameter, the first diameter dimensioned to receive a prosthetic valve in an expanded or partially crimped configuration, the second diameter dimensioned to receive the prosthetic valve in a crimped configuration, and', 'the first member is operably movable relative to the second member to convert the coiled wire frame from the first state to the second state., 'wherein'}2. The crimping device of claim 1 , further comprising a housing claim 1 , the housing enclosing the coiled wire frame claim 1 , the first ...

STABILITY DEVICE FOR USE WITH PERCUTANEOUS DELIVERY SYSTEMS

A delivery system for stabilizing a catheter shaft across an aortic arch can include one or more stabilizing members configured to fix or stabilize the position of the catheter relative to the aortic arch of a patient. 1. A prosthetic heart valve delivery device , comprising:an elongate catheter tube having a first end portion, a second end portion, a first lumen, a second lumen, and a third lumen, wherein the first lumen is radially centrally disposed, the second lumen is disposed radially outwardly from the first lumen, and the third lumen is disposed radially outwardly from the first lumen and circumferentially spaced relative to the second lumen;an elongate flexible member disposed in the second lumen of the catheter tube; andan elongate stability member disposed in and axially moveable relative to the third lumen of the catheter tube and the flexible member, wherein the stability member comprises a C-shape and is relatively stiffer than the catheter tube and the flexible member.2. The device of claim 1 , wherein the second lumen of the catheter tube is diametrically opposed to the third lumen of the catheter tube.3. The device of claim 1 , wherein the first end portion of the catheter tube is a distal end portion claim 1 , the second end portion of the catheter tube is a proximal end portion claim 1 , and the stability member is disposed near the distal end portion of the catheter tube and is axially movable in the third lumen of the catheter tube between a first position and a second position proximal relative to the first position.4. The device of claim 3 , wherein the flexible member and the stability member are configured such that the flexible member and the stability member are axially overlapped relative to each other with the stability member in the first position and are axially offset relative to each other with the stability member in the second position claim 3 , and wherein the catheter tube is relatively straighter with the stability member in the ...

MOISTURE INDICATOR FOR WOOD SUBSTRATES

A moisture content indicator for visually indicating the moisture content of a wood substrate and methods of making the moisture content indicator are provided. 1. A moisture content indicator for visually determining the moisture content of a wood substrate , the moisture content indicator comprising a transition layer composition comprising an opaque polymer , a surfactant , and a binding agent.2. The moisture content indicator of claim 1 , wherein the binding agent of the transition layer is at least one of an alkyd resin claim 1 , an aqueous latex claim 1 , and a polymeric or oligomeric dispersion.3. The moisture content indicator of claim 1 , wherein the opaque polymer is a styrene-acrylic microsphere dispersion and the microsphere has a hollow core.4. The moisture content indicator of claim 1 , wherein the surfactant of the transition layer composition is a polymeric surfactant.5. The moisture content indicator of claim 4 , wherein the polymeric surfactant is a polymer with multiple carboxylic functional groups that have been neutralized with a base compound.6. The moisture content indicator of claim 5 , wherein the polymeric surfactant is a salt of an anionic polysaccharide.7. The moisture content indicator of claim 6 , wherein the anionic polysaccharide is alginic acid.8. The moisture content indicator of claim 1 , wherein the transition layer composition further comprises a wetting agent.9. The moisture content indicator of claim 8 , wherein the wetting agent is selected from the group consisting of an alkyd resin claim 8 , an acrylic resin claim 8 , and a polyester resin.10. The moisture content indicator of claim 1 , wherein the moisture content indicator transitions between a transparent appearance and an opaque white appearance when the moisture content of the wood substrate is from about 9% to about 10%.11. The moisture content indicator of claim 10 , wherein the moisture content indicator exhibits a white/opaque appearance when the moisture content of ...

CARDIAC VALVE REPAIR DEVICES CONFIGURED FOR PERCUTANEOUS DELIVERY

Disclosed herein are devices for improving coaption of the mitral valve leaflets to reduce or eliminate mitral valve regurgitation. The devices may be used to perform mitral valve annuloplasty, or to serve as a docking station for a transcatheter prosthetic heart valve. The various embodiments of devices are configured for percutaneous and, in some cases, transvascular delivery. Delivery systems useful for routing the devices to the mitral valve are also disclosed, including catheters, balloons and/or mechanical expansion systems. The devices themselves include at least one tissue penetrating member. Methods of delivery include partially embedding the devices in the mitral valve annulus via at least one tissue penetrating member. Tissue penetrating members may be embedded into the tissue in a simultaneous or a nearly simultaneous fashion. Upon embedding, the devices employ various expansion and/or contraction features to adjust the mitral valve diameter. Adjustments may continue until the leaflets fully coapt and the problem of mitral regurgitation is reduced or eliminated. 1. A method for replacing a native mitral valve , comprising:advancing an expandable ring toward the mitral valve, the ring comprising a collapsible and expandable frame comprising a plurality of tissue penetrating members disposed along an exterior surface and a plurality of protrusions along an inner surface;expanding the ring such that the tissue penetrating members penetrate surrounding tissue within the mitral valve;advancing a prosthetic valve toward the mitral valve, the prosthetic valve comprising a collapsible and expandable tubular stent formed with intercrossing bars and a valvular structure mounted within the tubular stent; andradially expanding the prosthetic valve within the ring;wherein the protrusions on the inner surface of the ring extend between intercrossing bars of the tubular stent and secure the prosthetic valve to the ring, thereby anchoring the prosthetic valve within the ...

Delivery systems for prosthetic heart valve

Described herein are systems and methods from delivering prosthetic devices, such as prosthetic heart valves, through the body and into the heart for implantation therein. The prosthetic devices delivered with the delivery systems disclosed herein are, for example, radially expandable from a radially compressed state mounted on the delivery system to a radially expanded state for implantation using an inflatable balloon of the delivery system. Exemplary delivery routes through the body and into the heart include transfemoral routes, transapical routes, and transaortic routes, among others.

JACK AND DOLLY ASSEMBLY AND METHOD OF OPERATION

A jack and dolly assembly provides power-assisted lifting and moving capabilities using a single power source, according to an embodiment. In some embodiments a first shaft is used for lifting and lowering an object, and a second shaft is used for causing the jack and dolly assembly to move on a generally horizontal surface. In some embodiments the first and second shafts may selectively move or rotate independently from one another while being powered by the single power source. In some embodiments an inner and outer shaft arrangement is provided, so that the outer shaft has a hollow interior and at least a portion of the inner shaft is positioned within the hollow interior. 1. A jack and dolly assembly comprising:a driving unit and at least one wheel;a differential gear assembly configured to receive a driving force from the driving unit and to generate at least two outputs;a first shaft coupled to a first one of the at least two outputs for rotation of the first shaft; 'wherein the differential gear assembly is further configured to rotate the first shaft during a time that external resistance is applied to the second shaft and to rotate the second shaft during a time that external resistance is applied to the first shaft; and', 'a second shaft coupled to a second one of the at least two outputs for rotation of the second shaft,'}a brake mechanism having a state of engagement or non-engagement with each of the first shaft and the second shaft to selectively interrupt the rotation of one of the first and second shafts during the time that the differential gear assembly is receiving the driving force,wherein the one of the first and second shafts comprises a lead screw for use in translating rotation of the lead screw into a generally linear motion for extending or retracting the at least one wheel, and wherein the other of the first and second shafts comprises at least a portion of a drive train for rotating the at least one wheel.2. The jack and dolly assembly of ...

LOW PROFILE DELIVERY SYSTEM FOR TRANSCATHETER HEART VALVE

A heart valve delivery apparatus includes a valve carrying member. A prosthetic valve is crimped onto the valve carrying member at a location that is distal or proximal to the balloon member, thereby providing a smaller profile delivery apparatus. 1. An apparatus for delivering a prosthetic valve through the vasculature of a patient comprising:a steerable guide catheter having a handle portion and an elongated guide tube extending from the handle portion, the elongated guide tube having a distal end portion comprising a steerable section, the guide catheter further comprising a first adjustment mechanism on the handle portion and a pull wire operatively connecting the first adjustment mechanism to the steerable section for changing the curvature of the steerable section via manual adjustment of the first adjustment mechanism, the guide catheter further comprising a second adjustment mechanism coupled to the handle portion, the second adjustment mechanism comprising a securement mechanism; anda balloon catheter sized to slidably extend through the guide catheter, the balloon catheter comprising an elongated shaft extending coaxially through the guide tube and the handle portion, the shaft comprising a proximal end portion and a distal end portion, the balloon catheter further comprising an inflatable balloon mounted on the distal end portion of the shaft;wherein the securement mechanism is configured to selectively retain the shaft of the balloon catheter to prevent longitudinal sliding movement of the shaft relative to the second adjustment mechanism and release the shaft to permit longitudinal sliding movement of the shaft relative to the second adjustment mechanism;wherein the second adjustment mechanism is configured to produce longitudinal movement of the shaft of the balloon catheter relative to the guide tube via manual adjustment of the second adjustment mechanism relative to the handle portion when the securement mechanism is activated to retain the shaft ...

SYSTEM AND METHOD FOR CRIMPING A PROSTHETIC VALVE

A device for crimping a radially expandable and collapsible prosthetic valve comprises a crimping loop having a first end portion, a second end portion, and a loop portion extending between the first and second end portions and defining an opening configured to receive the prosthetic valve. The crimping loop is movable between a first state in which the opening has a first diameter and a second state in which the opening has a second diameter smaller than the first diameter such that when the prosthetic valve is positioned within the loop portion, movement of the crimping loop from the first state to the second state is effective to reduce a diameter of the prosthetic valve. A method for crimping a prosthetic valve comprises reducing a diameter of an opening of a crimping loop, thereby radially compressing an at least partially expanded prosthetic valve disposed within the opening. 1. A crimping device for crimping a radially expandable and compressible prosthetic valve , comprising:a crimping loop having a first end portion, a second end portion and a loop portion extending between the first and second end portions and defining an opening configured to receive the prosthetic valve,wherein the crimping loop is movable between a first state in which the opening has a first diameter and a second state in which the opening has a second diameter smaller than the first diameter such that when the prosthetic valve is positioned within the loop portion, movement of the crimping loop from the first state to the second state is effective to reduce a diameter of the prosthetic valve.2. The crimping device of claim 1 , wherein the crimping loop is configured to move between the first state and the second state when the first end portion is moved relative to the second end portion.3. The crimping device of claim 1 , wherein the crimping loop is configured to move between the first state and the second state when the first end portion is moved relative to the second end portion ...

APPARATUS FOR THE INTRODUCTION AND MANIPULATION OF MULTIPLE TELESCOPING CATHETERS

A delivery apparatus includes a steerable shaft having a pull-wire conduit. A pull wire extends through the pull-wire conduit. The steerable shaft includes one or more layers. A compression-resistance portion is incorporated into at least one of the one or more layers. A cross-section of the compression-resistance portion has an arcuate shape that extends along a portion of a cross-section of the steerable shaft. The compression-resistance portion has a hardness that is greater than a hardness of the one or more layers that the compression-resistance portion is incorporated into. 1. A delivery apparatus , comprising:a steerable shaft having a pull-wire conduit;a pull wire extending through the pull-wire conduit;wherein the steerable shaft has one or more layers;wherein the steerable shaft includes a compression-resistance portion incorporated into at least one of the one or more layers of the steerable portion;wherein a cross-section of the compression-resistance portion has an arcuate shape that extends along a portion of a cross-section of the steerable shaft; andwherein the compression-resistance portion has a hardness that is greater than a hardness of the one or more layers that the compression-resistance portion is incorporated into.2. The delivery apparatus of claim 1 , further comprising an adjustment mechanism operatively connected to a proximal end portion of the pull wire and configured to increase and decrease tension in the pull wire to adjust the curvature of a distal portion of the steerable shaft.3. The delivery apparatus of claim 1 , wherein the compression-resistance portion is located opposite the pull-wire conduit.4. The delivery apparatus of claim 1 , wherein the compression-resistance portion extends from 10 degrees to 180 degrees along the cross-section of the steerable shaft.5. The delivery apparatus of claim 4 , wherein the compression-resistance portion extends about 60 degrees along the cross-section of the steerable shaft.6. The delivery ...

INTRA-ANEURYSM DEVICES

Devices for occluding an aneurysm are provided. In particular, the device include an upper member that sits against the dome of the aneurysm, a lower member that sits in the neck of the aneurysm, and a means of adjusting the overall dimensions of the device. Also provided are methods of making and using these devices. 1. A vaso-occlusive device for placement within an aneurysm having a neck and a sac , the device comprising:a plurality of inter-woven wires having a compressed delivery configuration for passage through a delivery catheter, and an expanded deployed configuration,wherein, when the device is positioned within the aneurysm in the expanded deployed configuration, the plurality of inter-woven wires are configured to bridge the neck of the aneurysm and occlude the aneurysm sac, respectively, andwherein, in the expanded deployed configuration, first ends of the wires form an external concavity in a first end portion of the device, and second ends of the wires form an external concavity in a second end portion of the device.2. The vaso-occlusive device of claim 1 , wherein in the expanded deployed configuration claim 1 , the plurality of inter-woven wires define a cylindrical middle body portion having a first end that transitions into the first end portion claim 1 , and a second end that transitions into the second end portion.3. The vaso-occlusive device of claim 1 , wherein in the expanded deployed configuration claim 1 , the plurality of inter-woven wires define a substantially spherical interior region.4. The vaso-occlusive device of claim 1 , wherein the device is self-expanding.5. The vaso-occlusive of claim 1 , further comprising a mechanical or electrolytic detachment junction.6. The vaso-occlusive device of claim 3 , wherein the detachment junction is disposed between the plurality of inter-woven wires and a pusher wire slidably disposed within a delivery catheter.7. The vaso-occlusive device of claim 1 , wherein the device is made from a ...

STABILITY DEVICE FOR USE WITH PERCUTANEOUS DELIVERY SYSTEMS

A method of implanting a prosthetic heart valve includes advancing a distal end portion of a catheter shaft through a patient's vasculature. The distal end portion of the catheter shaft includes an expansion device. A prosthetic heart valve is mounted on the expansion device with the expansion device and the prosthetic heart valve in a compressed configuration. The method further includes positioning the distal end portion of the catheter shaft and the prosthetic heart valve to an implantation location, and expanding the prosthetic heart valve and the expansion device from the compressed configuration to an expanded configuration. The expansion device includes an inner expandable member and a plurality of outer expandable members. The outer expandable members are distributed such that there are gaps providing perfusion passageways between the expansion device and the prosthetic heart valve when the expansion device is in the expanded configuration. 1. A method of implanting a prosthetic heart valve , the method comprising:advancing a distal end portion of a catheter shaft through a patient's vasculature, wherein the distal end portion of the catheter shaft comprises an expansion device, and wherein a prosthetic heart valve is mounted on the expansion device, the expansion device and the prosthetic heart valve being in a compressed configuration;positioning the distal end portion of the catheter shaft and the prosthetic heart valve at or adjacent an implantation location; andexpanding the prosthetic heart valve and the expansion device from the compressed configuration to an expanded configuration, wherein the expansion device comprises an inner expandable member and a plurality of outer expandable members, wherein the outer expandable members are distributed circumferentially around the inner expandable member and are circumferentially spaced apart relative to each such that there are gaps between adjacent outer expandable members providing perfusion passageways ...

DEPLOYMENT SYSTEMS, TOOLS, AND METHODS FOR DELIVERING AN ANCHORING DEVICE FOR A PROSTHETIC VALVE

A delivery catheter is in various embodiments configured to deliver an anchoring device to a native valve annulus of a patient's heart, where the anchoring device can better secure a prosthesis at the native annulus. The delivery catheter can includes a distal section that includes one or more spines or is laser cut to assume a particular shape for better facilitating delivery of the anchoring device at the implant site and can include a flexible tube, a first pull wire, and a second pull wire. The flexible tube can comprise a bore extending between the first end and the second end sized for passing the anchoring device therethrough. The distal portion can comprise a first flexing section and a second flexing section. Actuation of the first pull wire and the second pull wire can cause the flexible tube to move from a first configuration to a second configuration. 1. A method of using a delivery catheter to deliver an anchoring device to a native valve of a patient's heart , the method comprising:advancing the delivery catheter into a chamber of the heart;creating a first curved portion in a first flexing section of the delivery catheter;creating a curved planar portion in a second flexing section of the delivery catheter;positioning a distal opening of the delivery catheter to deliver the anchoring device in a direction of a commissure of the native valve;delivering the anchoring device at the native valve through the delivery catheter.2. The method according to claim 1 , further comprising adjusting at least one of a height or an angle of the distal opening of the delivery catheter such that at least a portion of the delivery catheter is substantially parallel to a plane of an annulus of the native valve.3. The method according to claim 1 , further comprising advancing at least part of the distal opening of the delivery catheter through the commissure of the native valve and into ventricle second chamber of the heart.4. The method according to claim 1 , wherein the ...

CARDIAC VALVE REPAIR DEVICES CONFIGURED FOR PERCUTANEOUS DELIVERY

Disclosed herein are devices for improving coaption of the mitral valve leaflets to reduce or eliminate mitral valve regurgitation. The devices may be used to perform mitral valve annuloplasty, or to serve as a docking station for a transcatheter prosthetic heart valve. The various embodiments of devices are configured for percutaneous and, in some cases, transvascular delivery. Delivery systems useful for routing the devices to the mitral valve are also disclosed, including catheters, balloons and/or mechanical expansion systems. The devices themselves include at least one tissue penetrating member. Methods of delivery include partially embedding the devices in the mitral valve annulus via at least one tissue penetrating member. Tissue penetrating members may be embedded into the tissue in a simultaneous or a nearly simultaneous fashion. Upon embedding, the devices employ various expansion and/or contraction features to adjust the mitral valve diameter. Adjustments may continue until the leaflets fully coapt and the problem of mitral regurgitation is reduced or eliminated. 1. A device for improving function of a cardiac valve , comprising:a frame configured to fit within a cardiac valve, the frame comprising a proximal portion, a distal portion, and an opening extending therebetween; anda pair of tissue penetrating members extending from the proximal portion of the frame, the tissue penetrating members each comprising an end having a penetrating surface configured to penetrate tissue,wherein the frame is collapsible to a first position and expandable to a second position;wherein in the first position, the penetrating members are positioned such that the penetrating surfaces of each pair of tissue penetrating members abut one another to form a blunt end; andwherein in the second position, the penetrating members of each pair of tissue penetrating members are spaced apart such that their respective penetrating surfaces are exposed.2. The device of claim 1 , wherein ...

HEART VALVE DOCKING DEVICES AND SYSTEMS

Docking devices for docking a prosthetic valve at a native valve of a heart can include a coiled docking anchor and a retrieval suture. The docking device and retrieval suture can be configured for improved retention and retrieval of the docking device after deployment. The docking devices can have an end portion with a central axis. The retrieval suture can be connected to the end portion such that a line of force applied by applying tension to the retrieval suture is substantially aligned with the central axis. 1. A docking device for docking a prosthetic valve at a native valve of a heart , comprising: the central region possesses a plurality of turns having substantially equal inner diameters;', 'the leading turn extends from a first end of the central region and has a diameter greater than the diameter of the central region; and', 'the stabilization turn extends from a second end of the central region and has a diameter greater than the diameter of the central region; and, 'a coil extending along a central axis from a proximal end portion to a distal end portion, including a leading turn, a central region, and a stabilization turn, whereina proximal connection end disposed at the proximal end portion of the coil, the proximal connection end having an opening formed therein, the opening configured to receive a retrieval line of a delivery catheter.2. The docking device of claim 1 , wherein an outer width of a portion of the proximal connection end comprising the opening is greater than a thickness of the proximal end portion of the coil claim 1 , the outer width and thickness measured in a direction perpendicular to the central axis of the coil.3. The docking device of claim 1 , wherein the opening is formed in a curved portion of the proximal connection end and wherein the proximal connection end includes a narrower claim 1 , neck portion arranged distal to the curved portion.4. The docking device of claim 1 , wherein the proximal connection end is a cap ...

Fabricating solid carbon porous electrodes from powders

Fabrication of conductive solid porous carbon electrodes for use in batteries, double layer capacitors, fuel cells, capacitive dionization, and waste treatment. Electrodes fabricated from low surface area (<50 m 2 /gm) graphite and cokes exhibit excellent reversible lithium intercalation characteristics, making them ideal for use as anodes in high voltage lithium insertion (lithium-ion) batteries. Electrodes having a higher surface area, fabricated from powdered carbon blacks, such as carbon aerogel powder, carbon aerogel microspheres, activated carbons, etc. yield high conductivity carbon compositives with excellent double layer capacity, and can be used in double layer capacitors, or for capacitive deionization and/or waste treatment of liquid streams. By adding metallic catalysts to be high surface area carbons, fuel cell electrodes can be produced.

Low profile delivery system for transcatheter heart valve

A heart valve delivery apparatus includes a valve carrying member. A prosthetic valve is crimped onto the valve carrying member at a location that is distal or proximal to the balloon member, thereby providing a smaller profile delivery apparatus.

System and method for crimping a prosthetic valve

An exemplary system for crimping a prosthetic valve comprises a radially expandable and compressible prosthetic valve, a crimping device positioned around the valve and configured to reduce the diameter of the valve to a delivery configuration, and a sterile package enclosing the valve and the crimping device. The valve can be pre-assembled in a partially crimped configuration within the crimping device. After removing the sterile packaging, the crimping device can be used to crimp the valve from the partially crimped configuration to the delivery configuration, such as by twisting a knob on the crimping device. The system can further comprise at least a portion of a delivery catheter within the sterile package, wherein the valve is pre-mounted on or adjacent to an inflatable balloon of the delivery catheter, such that the valve can be crimped onto the delivery catheter using the crimping device.

Valve anchor and installation method

Delivery systems for prosthetic heart valve

Described herein are systems and methods from delivering prosthetic devices, such as prosthetic heart valves, through the body and into the heart for implantation therein. The prosthetic devices delivered with the delivery systems disclosed herein are, for example, radially expandable from a radially compressed state mounted on the delivery system to a radially expanded state for implantation using an inflatable balloon of the delivery system. Exemplary delivery routes through the body and into the heart include transfemoral routes, transapical routes, and transaortic routes, among others.

Heart valve docking devices and systems

Docking devices for docking a prosthetic valve at a native valve of a heart can include a coiled docking anchor and a retrieval suture. The docking device and retrieval suture can be configured for improved retention and retrieval of the docking device after deployment. The docking devices can have an end portion with a central axis. The retrieval suture can be connected to the end portion such that a line of force applied by applying tension to the retrieval suture is substantially aligned with the central axis.

Deployment systems, tools, and methods for delivering an anchoring device for a prosthetic valve

A delivery catheter is in various embodiments configured to deliver an anchoring device to a native valve annulus of a patient' s heart, where the anchoring device can better secure a prosthesis at the native annulus. The delivery catheter can includes a distal section that includes one or more spines or is laser cut to assume a particular shape for better facilitating delivery of the anchoring device at the implant site and can include a flexible tube, a first pull wire, and a second pull wire. The flexible tube can comprise a bore extending between the first end and the second end sized for passing the anchoring device therethrough. The distal portion can comprise a first flexing section and a second flexing section. Actuation of the first pull wire and the second pull wire can cause the flexible tube to move from a first configuration to a second configuration.

Cardiac valve repair devices configured for percutaneous delivery

Disclosed herein are devices for improving coaption of the mitral valve leaflets to reduce or eliminate mitral valve regurgitation. The devices may be used to perform mitral valve annuloplasty, or to serve as a docking station for a transcatheter prosthetic heart valve. The various embodiments of devices are configured for percutaneous and, in some cases, transvascular delivery. Delivery systems useful for routing the devices to the mitral valve are also disclosed, including catheters, balloons and/or mechanical expansion systems. The devices themselves include at least one tissue penetrating member. Methods of delivery include partially embedding the devices in the mitral valve annulus via at least one tissue penetrating member. Tissue penetrating members may be embedded into the tissue in a simultaneous or a nearly simultaneous fashion. Upon embedding, the devices employ various expansion and/or contraction features to adjust the mitral valve diameter. Adjustments may continue until the leaflets fully coapt and the problem of mitral regurgitation is reduced or eliminated.

Low profile delivery system for transcatheter heart valve

A heart valve delivery apparatus includes a valve carrying member. A prosthetic valve is crimped onto the valve carrying member at a location that is distal or proximal to the balloon member, thereby providing a smaller profile delivery apparatus.

Delivery system for artificial heart valve

【課題】本発明は、人工心臓弁を植え込むための送達システムに関する。【解決手段】人工心臓弁などの人工器官を内部に植え込むために身体を通じて心臓の中に送達するシステムおよび方法が、本明細書に記載されている。本明細書に開示した送達システムを用いて送達される人工器官は、例えば、送達システムに取り付けられた半径方向に圧縮された状態から送達システムの膨張可能バルーンを用いて植え込みのために半径方向に拡張した状態へ半径方向に拡張可能である。例示的な身体を通じて心臓の中に送達する送達ルートは、数ある中でも、経大腿ルート、経心尖ルート、および経大動脈ルートが挙げられる。【選択図】図１

BUCCAL CONFORMER

ORTHODONTIC DEVICE

L'invention concerne un dispositif orthodontique 10.Il comprend une coquille 16, destinée à être placée dans la cavité buccale intra-maxillaire d'un sujet, ladite coquille 16 comportant une partie antérieure 20d destinée à être placée à proximité des maxillaires du sujet, et un embout de succion 18 solidaire de la coquille 16 et s'étendant d'une face interne de la partie antérieure de la coquille vers une partie postérieure de la coquille, caractérisé en ce que ledit dispositif est conformé pour ne pas empêcher l'occlusion dentaire ou maxillaire du sujet. The invention relates to an orthodontic device 10.It comprises a shell 16, intended to be placed in the intra-maxillary oral cavity of a subject, said shell 16 comprising an anterior part 20d intended to be placed close to the jaws of the subject, and a suction tip 18 secured to the shell 16 and extending from an inner face of the front portion of the shell to a posterior portion of the shell, characterized in that said device is shaped not to prevent occlusion dental or maxillary subject.

Stability device for use with percutaneous delivery systems

A delivery system for stabilizing a catheter shaft across an aortic arch can include one or more stabilizing members configured to fix or stabilize the position of the catheter relative to the aortic arch of a patient.

Valve anchor and installation method

Anchor devices and methods used to secure a prosthetic valve to a native valve annulus are described. The anchor device can be a separate expandable element from the prosthetic valve that is first advanced to the annulus and deployed, after which an expandable prosthetic valve is advanced to within the annulus and deployed. The combination of the two elements can apply a clamping force to the valve leaflets which holds the prosthetic valve in place. The anchor device can have a lower or ventricular portion and an upper or atrial portion. The anchor device can include one or more leaflet clamping portions. One, two, or more upstanding vertical posts between the clamping portions can extend upward at the valve commissures and support the upper portion, which can include one or more structures for leak prevention.

Deployment systems, tools, and methods for delivering an anchoring device for a prosthetic valve

A delivery catheter is in various embodiments configured to deliver an anchoring device to a native valve annulus of a patient' s heart, where the anchoring device can better secure a prosthesis at the native annulus. The delivery catheter can includes a distal section that includes one or more spines or is laser cut to assume a particular shape for better facilitating delivery of the anchoring device at the implant site and can include a flexible tube, a first pull wire, and a second pull wire. The flexible tube can comprise a bore extending between the first end and the second end sized for passing the anchoring device therethrough. The distal portion can comprise a first flexing section and a second flexing section. Actuation of the first pull wire and the second pull wire can cause the flexible tube to move from a first configuration to a second configuration.

Apparatus for introduction and manipulation of multiple telescoping catheters

【課題】改善された操縦可能なシャフトを備えた送達装置を提供する。【解決手段】送達装置が、近位部分と、遠位部分と、近位部分および遠位部分を通って伸びるプルワイヤ導管と、を有する操縦可能なシャフトを含む。プルワイヤが、導管を通って伸び、シャフトに固定された遠位部分を有する。調整機構が、プルワイヤの近位端部分に接続され、シャフトの湾曲を調整するためにプルワイヤの張力を増減するように構成される。シャフトの遠位部分は、１つまたは複数の層を含む操縦可能な部分を有する。圧縮抵抗部分が、操縦可能な部分の層に組み込まれ、層の断面の一部に沿って角度方向に広がる。圧縮抵抗部分が組み込まれている操縦可能な部分の層は、第１の硬度を有し、圧縮抵抗部分は、第１の硬度よりも大きい第２の硬度を有する。【選択図】図６

Fluid line removal device for removing a fluid line from a body and related methods

A fluid line device is for removing a fluid line from a body and may include a handle and a cutting head having a proximal end carried by the handle, and a distal end spaced apart from the proximal end. A fluid line channel may extend through the cutting head between the proximal end and the distal end for receiving the fluid line. The cutting head may also include a guide carried within the fluid line channel for supporting the fluid line therein during manipulation of the handle so that the cutting edge cuts body tissue away from the fluid line for removal thereof from the body.

Crystalline forms of n-[3-fluoro-4-([6-(methyloxy)-7-[(morpholin-4ylpropyl)oxy}]-quinolin-4-yl}oxy)phenyl]-n'-(4-fluorophenyl)cyclopropane-1, 1-dicarboxamide

Stability device for use with percutaneous delivery systems

Low profile delivery system for transcatheter heart valve

A heart valve delivery apparatus (10) includes a valve carrying member (58). A prosthetic valve (12) is crimped onto the valve carrying member at a location that is distal or proximal to the balloon member (28), thereby providing a smaller profile delivery apparatus.

Heart valve docking devices and systems.

Los dispositivos de acoplamiento para acoplar una válvula protésica en una válvula nativa de un corazón pueden incluir un anclaje de acoplamiento en espiral y una sutura de recuperación. El dispositivo de acoplamiento y sutura de recuperación pueden ser configurados para mejorar la retención y recuperación del dispositivo de acoplamiento después del despliegue. Los dispositivos de acoplamiento pueden tener una porción extrema con un eje central. La sutura de recuperación se puede conectar a la porción extrema, de tal manera que una línea de fuerza aplicada por aplicación de tensión a la sutura de recuperación es alineada sustancialmente con el eje central.

Low profile delivery system for transcatheter heart valve

Histogram interval selection

A database system may include an array of storage devices configured to store a plurality of database tables and a plurality of histograms. Each histogram may correspond to one or more columns of a database table. The database system may further include a processor in communication with the storage device. The processor may receive an indication that a histogram is to be rebuilt, wherein the histogram has a first number of intervals. The processor may determine at least one condition associated with a distribution of column values of at least one column in the histogram. The processor may determine a second number of histogram intervals based on the at least one condition. The processor may rebuild the histogram to include the second number of intervals. A method and computer-readable medium may also be implemented.

Low profile delivery system for transcatheter heart valve

A delivery system for delivering a prosthetic aortic heart valve to a patient's native aortic valve, comprising a balloon catheter comprising an elongated shaft and an inflatable balloon mounted at a distal end of the elongated shaft, and a flex indicating device wherein the handle portion comprises a flex activating member, the flex activating member being coupled to the at least one pull wire such that manual adjustment of the flex activating member causes the distal end portion of the elongated guide tube to flex.

Low profile delivery system for transcatheter heart valve

System and method for crimping a prosthetic valve

A device for crimping a radially expandable and collapsible prosthetic valve comprises a coiled wire frame having a longitudinal opening extending from a proximal end to a distal end thereof. The opening has a first state and a second state, the opening in the first state having a first diameter dimensioned to receive the prosthetic valve in an expanded or partially crimped configuration therein, and the opening in the second state having a second diameter dimensioned to receive the prosthetic valve in a crimped configuration. The coiled wire frame has a first end coupled to a first member and a second end coupled to a second member. The first member is movable relative to the second member to convert the coiled wire frame from the first state to the second state.

Heart valve docking devices and systems

Docking devices for docking a prosthetic valve at a native valve of a heart can include a coiled docking anchor and a retrieval suture. The docking device and retrieval suture can be configured for improved retention and retrieval of the docking device after deployment. The docking devices can have an end portion with a central axis. The retrieval suture can be connected to the end portion such that a line of force applied by applying tension to the retrieval suture is substantially aligned with the central axis.

Occlusive cinching devices and methods of use

Methods and devices for blocking orifices and occluding cavities within a patient are provided. The device in one variation comprises first and second tubular members attached to a collapsible sealing element. The device can be placed through an orifice and the collapsible sealing element can be collapsed to seal the orifice. An embolic may be introduced distal to the sealing element to occlude a cavity. The device may incorporate a locking mechanism which can be engaged to lock the sealing element into the collapsed position. The device may incorporate a valve to prevent flow through the tubular members, for example to prevent egress of the embolic from a cavity. The device can be detached to provide a permanent seal of the orifice, and can retain the embolic within the cavity. The device may be used in conjunction with a stent or other retention device to assist the sealing element in maintaining the seal.

Solid state laser with beam path conditioning

A solid state laser system having at least one gas injector is disclosed. The gas injector may be configured to so as cause gas flow in a path of the laser beam in order to mitigate distortion of the laser beam due to optical path difference. Each gas injector may be configured so as to cause gas flow proximate at least one optical surface of a solid state gain element of the laser beam system. In this manner gain uniformity may be enhanced so as to facilitate use of the laser system in a variety of military and commercial applications.

Method for fabricating a pixelized phosphor

A process for making a pixelized phosphor structure involves the steps of forming an integral, non-layered mold by creating a plurality of openings in a substrate, and depositing a phosphor into the openings of the mold, thereby filling each of the openings of the mold with phosphor, and thereby forming a pixelized phosphor structure comprising an array of discrete phosphor elements. A second process for making a pixelized phosphor structure involves the steps of forming a first integral, non-layered mold by creating a plurality of first openings in a substrate, forming a series of one or more generations of replicas of the master mold, each of the one or more generations of replicas having a plurality of second openings, depositing a phosphor into the second openings of one of the one or more generations of replicas, thereby filling each of the second openings of the one of the one or more generations of replicas with phosphor, and thereby forming a pixelized phosphor structure comprising an array of discrete phosphor elements. A third process for making a pixelized phosphor structure involves the steps of providing a sheet of a first phosphor, creating a plurality of discrete holes in the first phosphor, each of the discrete holes extending through the first phosphor and having two openings, and depositing a second phosphor onto the first phosphor to form a pixelized phosphor structure, at least a portion of the second phosphor being deposited into the plurality of discrete holes in the first phosphor.

Heart valve docking devices and systems

Docking devices for docking a prosthetic valve at a native valve of a heart can include a coiled docking anchor and a retrieval suture. The docking device and retrieval suture can be configured for improved retention and retrieval of the docking device after deployment. The docking devices can have an end portion with a central axis. The retrieval suture can be connected to the end portion such that a line of force applied by applying tension to the retrieval suture is substantially aligned with the central axis.

Radiation detector and fabrication method

A solid state radiation detector provides a plurality of modules disposed adjacent one another in a two-dimensional array. Each of the modules includes an array of thin film transistors. A continuous radiation detecting layer, such as a photoconductor layer, is disposed over the modules. The radiation detecting layer generates electrical charge representative of a pattern of radiation. The thin film transistors are used to sense the electrical charge on a pixel-by-pixel basis to form a representation of an image. A continuous insulating layer can be disposed between the radiation detecting layer and a continuous conducting layer.

Low profile delivery system for transcatheter heart valve

Low profile delivery system for transcatheter heart valve

An apparatus for delivering a prosthetic valve through the vasculature of a patient comprising a steerable guide catheter and a balloon catheter sized to slidably extend through the guide catheter, wherein a securement mechanism of a second adjustment mechanism in the steerable guide catheter is configured to selectively retain the shaft of the balloon catheter to prevent longitudinal sliding movement of the shaft relative to the second adjustment mechanism and release the shaft to permit longitudinal sliding movement of the shaft relative to the second adjustment mechanism, and wherein the second adjustment mechanism is configured to produce longitudinal movement of the shaft of the balloon catheter relative to the guide tube of the steerable guide catheter via manual adjustment of the second adjustment mechanism relative to the handle portion of the steerable guide catheter when the securement mechanism is activated to retain the shaft relative to the second adjustment mechanism.

Low profile delivery system for transcatheter heart valve

A delivery system for delivering a prosthetic aortic heart valve to a patient's native aortic valve, comprising a balloon catheter comprising an elongated shaft and an inflatable balloon mounted at a distal end of the elongated shaft, and a flex indicating device wherein the handle portion comprises a flex activating member, the flex activating member being coupled to the at least one pull wire such that manual adjustment of the flex activating member causes the distal end portion of the elongated guide tube to flex.

Detachable aneurysm neck bridge

In one embodiment, a neck bridge for bridging the neck of an aneurysm includes a junction region, a number of radially extending array elements attached to the junction region, and a cover attached to one or both of the junction region and an array element. The array elements are configured to be positioned within the aneurysm after the neck bridge is deployed from a delivery device. In a second embodiment, the neck bridge includes a junction region and a braided or mesh-like structure secured to the junction region. The braided or mesh-like structure is made from an elastic material.

Buccal corrector

The present invention relates to a buccal corrector intended to be placed in the buccal cavity of the jaw of a patient in order to correct a condition in which the lower jaw (3) is posterior in relation to the upper jaw (4), consisting of a shell (5) which is open at least on its rear and lower parts and of which the upper part is intended to be applied against the roof of the mouth, characterized in that the shape of the shell (5) is such that, when the corrector is in position in said buccal cavity, it is free of any contact with the teeth (1, 1') of the lower jaw (3), at least one area of its lower part (6a) bears on the gums (7) of the inner part of the lower jaw (3), and it is free of any contact with the gums (7) of the inner part of the upper jaw (4).

Valve anchor and installation method

Anchor devices and methods used to secure a prosthetic valve to a native valve annulus are described. The anchor device can be a separate expandable element from the prosthetic valve that is first advanced to the annulus and deployed, after which an expandable prosthetic valve is advanced to within the annulus and deployed. The combination of the two elements can apply a clamping force to the valve leaflets which holds the prosthetic valve in place. The anchor device can have a lower or ventricular portion and an upper or atrial portion. The anchor device can include one or more leaflet clamping portions. One, two, or more upstanding vertical posts between the clamping portions can extend upward at the valve commissures and support the upper portion, which can include one or more structures for leak prevention.

Apparatus for the introduction and manipulation of multiple telescoping catheters

A delivery apparatus includes a steerable shaft having a pull-wire conduit. A pull wire extends through the pull-wire conduit. The steerable shaft includes one or more layers. A compression-resistance portion is incorporated into at least one of the one or more layers. A cross-section of the compression-resistance portion has an arcuate shape that extends along a portion of a cross-section of the steerable shaft. The compression-resistance portion has a hardness that is greater than a hardness of the one or more layers that the compression-resistance portion is incorporated into.

Cardiac valve repair devices configured for percutaneous delivery

Apparatus for the introduction and manipulation of multiple telescoping catheters

Crystalline Forms on N-[3-fluoro-4-({6-(methyloxy)-7-[(3-morpholin-4-ylpropyl)oxy]-quinolin-4-yl}oxy)phenyl]-N′-(4-fluorophenyl)cyclopropane-1,1-dicarboxamide

This invention relates to three crystalline forms of N-[3-fluoro-4-((6-(methyloxy)-7-[(3-morpholin-4-ylpropyl)oxy]quinolin-4-yl|oxy)phenyl]-N′-(4-fluorophenyl)cyclopropane-1,1-dicarboxamide. Compound (I), designated as Form A, Form B, and Form C. The invention provides methods for treatment of cancer by exploiting the modulation of protein kinase activity. The invention also provides pharmaceutical compositions containing a crystalline form of Compound (I) and a pharmaceutically acceptable excipient.

Detachable aneurysm neck bridge

In one embodiment, a neck bridge for bridging the neck of an aneurysm includes a junction region, a number of radially extending array elements attached to the junction region, and a cover attached to one or both of the junction region and an array element. The array elements are configured to be positioned within the aneurysm after the neck bridge is deployed from a delivery device. In a second embodiment, the neck bridge includes a junction region and a braided or mesh-like structure secured to the junction region. The braided or mesh-like structure is made from an elastic material.

Delivery systems for prosthetic heart valve

Described herein are systems and methods from delivering prosthetic devices, such as prosthetic heart valves, through the body and into the heart for implantation therein. The prosthetic devices delivered with the delivery systems disclosed herein are, for example, radially expandable from a radially compressed state mounted on the delivery system to a radially expanded state for implantation using an inflatable balloon of the delivery system. Exemplary delivery routes through the body and into the heart include transfemoral routes, transapical routes, and transaortic routes, among others.

Radiation detector

ABSTRACT OF THE DISCLOSURE A radiation detector containing: (a) a fiber optic network; (b) an array of pixelized phosphors on the X-ray incidence side of the fiber optic network; and (c) an array of pixelized sensors optically coupled to the other side of thefiber optic network, wherein: (i) the ratio of the surface area of a phosphor pixel to the surface area of a sensor pixel is in the range of about 1:1 to 1:64, and (ii) the ratio of the surface area of the core of each individual optical fiber of the fiber optic network to the surface area of a phosphor pixel is in the range of about 1:4 to 1:160.

Stability device for use with percutaneous delivery systems

A delivery system for stabilizing a catheter shaft across an aortic arch can include one or more stabilizing members configured to fix or stabilize the position of the catheter relative to the aortic arch of a patient.

Buccal conformator for dento maxillo facial field, has shell shaped so that shell is disengaged from teeth and gingiva of lower and upper maxillae and shell`s lower part is supported on lower maxilla`s gingiva when conformator is in cavity

The conformator (5) has a shell with an upper part applied against a bony palate, where the conformator is made of a flexible material. The shape of the shell is such that the shell is disengaged from teeth (1, 2) of a lower maxilla (3) and from gingiva (7) of an internal part of an upper maxilla (4), and a lower part (6a) of the shell is supported on the gingiva of an internal part of the lower maxilla when the conformator is placed in a buccal cavity. The shell has a lip inclined with respect to the periphery of the shell. An independent claim is also included for a method for fabricating a buccal conformator.

Stability device for use with percutaneous delivery systems

A delivery system for stabilizing a catheter shaft across an aortic arch can include one or more stabilizing members configured to fix or stabilize the position of the catheter relative to the aortic arch of a patient.

Polysilicon thin film transistor

A process for producing a polysilicon thin film transistor includes hydrogenating the thin film transistor and depositing an atomic hydrogen-containing layer on the thin film transistor. The thin film transistor is characterized by leakage current rates as low as 10-13A.

Vaso-occlusive devices with textured surfaces

Disclosed herein are vaso-occlusive devices for forming occluding the vasculature of a patient. More particularly, disclosed herein are vaso-occlusive devices having a textured outer surface for promoting tissue in-growth.

Process for Forming a Phosphor

A process for forming a phosphor comprising the steps of: (a) providing a substrate for deposition and growth of an alkali halide phosphor, (b) forming a patterned surface on the substrate comprising a plurality of mesas, each of the mesas having an incline, a decline, and a horizontal surface, the mesas being separated from one another by horizontal segments of the substrate and wherein: (i) the ratio of the height of each of the mesas to the width of the horizontal segments is in the range of about 1:20 to 1:4; (ii) the ratio of the width of each of the mesas to the width of the horizontal segments is in the ratio of about 1:30 to 1:4; and (iii) the angles of incline and decline of each of the mesas are between about 5° to 85°; and (c) depositing an alkali halide phosphor on the patterned surface of the substrate of step (b), thereby forming cracks, in the deposited phosphor, originating from the inclines and/or declines of each of the mesas.

Vaso-occlusive devices with textured surfaces

Disclosed herein are vaso-occlusive devices for forming occluding the vasculature of a patient. More particularly, disclosed herein are vaso-occlusive devices having a textured outer surface for promoting tissue in-growth.

Delivery systems for prosthetic heart valve

Low profile delivery system for transcatheter heart valve

A heart valve delivery apparatus (10) includes a valve carrying member (58). A prosthetic valve (12) is crimped onto the valve carrying member at a location that is distal or proximal to the balloon member (28), thereby providing a smaller profile delivery apparatus.

Low profile delivery system for transcatheter heart valve

SSTL pull-up pre-driver design using regulated power supply

A SSTL memory interface pre-driver stage that uses a voltage regulator to generate a ‘virtual’ ground reference voltage is provided. The ‘virtual’ ground voltage reference, being greater than a zero volt ground voltage, allows low voltage transistors to be used, thereby improving interface performance and decreasing system power consumption. The pre-driver stage uses a biasing circuit to bias the voltage regulator, formed by a transistor arranged in a source follower configuration, to generate the ‘virtual’ ground reference voltage off which a voltage translator stage of the pre-driver stage operates to generate an output of the pre-driver stage.

Low profile delivery system for transcatheter heart valve

An apparatus for delivering a prosthetic valve through the vasculature of a patient comprising a steerable guide catheter and a balloon catheter sized to slidably extend through the guide catheter, wherein a securement mechanism of a second adjustment mechanism in the steerable guide catheter is configured to selectively retain the shaft of the balloon catheter to prevent longitudinal sliding movement of the shaft relative to the second adjustment mechanism and release the shaft to permit longitudinal sliding movement of the shaft relative to the second adjustment mechanism, and wherein the second adjustment mechanism is configured to produce longitudinal movement of the shaft of the balloon catheter relative to the guide tube of the steerable guide catheter via manual adjustment of the second adjustment mechanism relative to the handle portion of the steerable guide catheter when the securement mechanism is activated to retain the shaft relative to the second adjustment mechanism.

n- [3-fluoro-4 - ({6- (methyloxy) -7 - [(3-morpholin-4-ylpropyl) oxy] -quinolin-4-yl} oxy) phenyl] -n '- () 4-Fluorphenyl) cyclopropane-1,1-dicarboxamide, pharmaceutical composition with them, methods of preparing them and treating cancer

Low profile delivery system for transcatheter heart valve

A heart valve delivery apparatus (10) includes a valve carrying member (58). A prosthetic valve (12) is crimped onto the valve carrying member at a location that is distal or proximal to the balloon member (28), thereby providing a smaller profile delivery apparatus.