Abstract: A method for improving function of a cardiac valve in a patient, the cardiac valve having at least one leaflet that is attached to a papillary muscle: Inserting a balloon, that is in a first uninflated condition and having a first diameter, within tissue that is part of to the papillary muscle, and thereby separating tissue that was previously connected together, by a maximum amount equal to the first diameter; inflating the balloon to a second inflated condition having a second diameter greater than the first diameter, thereby permanently stretching tissue in the papillary muscle and separating the tissue from the first diameter to a maximum amount equal to the second diameter; deflating the balloon to the first uninflated condition, and thereby returning the tissue to a separation of a maximum amount substantially equal to the first diameter; and then removing the balloon from the patient.

Abstract: Various exemplary methods and devices for auto return of articulated end effectors are provided. In general, a surgical device can include an end effector configured to articulate. The device can include an actuator configured to be actuated to move the end effector from an articulated position to an unarticulated position. In at least some embodiments, the actuator can also be configured to be actuated to move the end effector from the unarticulated position to the articulated position. In at least some embodiments, the device can include the actuator and include another actuator configured to rotate the end effector about a longitudinal axis of an elongate shaft having the end effector at a distal end thereof. In at least some embodiments, the device can include the actuator and include another actuator configured to articulate the end effector from the unarticulated position to the articulated position.

Abstract: A prosthesis for repairing a hernia defect includes a patch body, a hoisting frame releasably attachable to the patch body, and a tether attached to the hoisting frame with a free end extendable through the thickness of the patch body and accessible from the side of the patch body opposite to where the hoisting frame is releasably attached. The patch body and/or the hoisting frame includes a self-expanding support member. The hoisting frame includes a frame body with an outer frame component and a force translation component for directing pulling forces on the tether across the frame body. The outer frame component has a loop configuration to generally follow the patch periphery with overlapping end portions or a gap between free ends thereof. The force translation component is separable into multiple segments to facilitate withdrawal of the hoisting frame through an opening when released from the patch.

Abstract: A new and improved pacifier provides bristle like structures which discourages continued use of the pacifier by a child of appropriate age.

Abstract: Surgical devices and methods are described herein that provide improved motor control and feedback, thereby combining advantages of manually-operated and powered surgical devices. In one embodiment, a surgical device includes a proximal handle portion that includes a motor, a distal end effector coupled to the handle portion, and a cutting element configured to cut tissue engaged by the end effector, wherein the motor is configured to supply power that moves the cutting element. The device also includes a motor control mechanism configured to cause the amount of the power to dynamically change in response to a manual user input when the cutting element is moving.

Abstract: A forceps comprising: (a) a stylet having a hollow tube having a proximal end region and a longitudinal axis; one or more assemblies that are extendable through the hollow tube, the one or more assemblies comprising: one or more support rods and one or more functional attachments; (b) a hand piece comprising: one or more housing structures defining a cavity; one or more actuating mechanisms comprising: a bearing fitting; a shuttle in communication with the bearing fitting constrained by a plurality of guide ridges; a socket housed by the shuttle; and one or more levers in communication with stylet so that movement of the one or more levers causes movement of the hollow tube and movement of the one or more assemblies; and wherein the movement of the hollow tube and the movement of the one or more assemblies are relative to each other.

Abstract: A vascular intervention device delivery system includes a catheter with a proximal end attached to a handle, and a distal carrier segment for mounting a vascular intervention device thereon. A retractable sheath is movable from a first position covering the distal carrier segment to a second position retracted proximally uncovering the distal carrier segment. A pull is attached to the retractable sheath and extends proximally from the retractable sheath toward the handle. A majority of the length of the pull has a cross sectional shape with a concave side that faces the longitudinal axis and is opposite to a convex side that faces away from the longitudinal axis. The cross sectional shape has a width that is greater than a thickness.

Abstract: Exemplary embodiments provide methods and systems for delivering a prosthesis to a target location in a lumenal system of a patient. At least one tether is secured proximate the target location to serve as a rail, and a prosthesis is advanced along the rail to the target location and secured in place. Exemplary methods and systems provide for repair of the mitral and tricuspid valves, as well as abdominal aortic aneurysms, stomach valves, fallopian tubes and the pulmonary system, among others. Also disclosed are various prostheses suitable for use with the disclosed methods and systems.

Abstract: A method of delivering a prosthetic heart valve to the aortic valve annulus while a patient's heart is beating is disclosed. The method includes accessing the left ventricle through an intercostal incision and forming a puncture in the left ventricle. A guidewire is advanced into the left ventricle and through the aortic valve. An introducer is passed over the guidewire and into the left ventricle. A valve delivery device is advanced over the guidewire and through the introducer until a prosthetic heart valve positioned thereon is located within the aortic valve. The prosthetic heart valve is then radially expanded within the aortic valve annulus for replacing the function of the native aortic valve.

Abstract: An explantation accessory includes a catheter with a steerable head carrying a tubular receptacle adapted to accommodate the proximal portion of the capsule. The explantation accessory further includes a lasso having a flexible wire extending along the catheter to and forming at its distal end a deformable loop. One end of the deformable loop is mobile so as to allow tightening of the loop under the effect of a traction exerted on the flexible wire along the catheter. The free end edge of the tubular receptacle comprises a protruding anterior portion, an axially recessed posterior portion with respect to the anterior portion and located diametrically opposite to the protruding anterior portion, and two beveled edges connecting the protruding anterior portion to the recessed posterior portion.

Abstract: A medical device includes an expandable conduit, a prosthetic heart valve and a delivery device, including a balloon catheter. The expandable conduit may include one or more inner or outer sleeves supported by a frame or stent. The sleeve(s) may be a bioprosthetic tissue wrapped, molded or sewn about the frame or stent. Coupled to an end of the expandable conduit is the prosthetic heart valve. The conduit and heart valve may be crimped on the balloon catheter for percutaneous deployment. The frame may be constructed of a balloon-expandable material for the conduit portion and a self-expandable material for the prosthetic heart valve portion. The prosthetic heart valve is anchored at the native heart valve and then the conduit to be expanded into place to protect the aorta. The self-expanding prosthetic heart valve avoids the need for balloon mounting. This provides for a smaller diameter and easier delivery.

Abstract: A system for fastening soft tissue to bone includes a bone screw having a threaded shaft and a screw head having an underside with malleable protuberances that project toward a distal end of the threaded shaft. A fixation plate is coupled with the threaded shaft. The fixation plate has a proximal face that opposes the underside of the screw head, a distal face that faces away from the underside of the screw head, an outer peripheral edge that extends between the proximal and distal faces, a central opening for receiving the threaded shaft, and protrusions spaced from one another around the outer peripheral edge that extend distally beyond the distal face of the fixation plate. The system includes an insertion tool having a handle and a tubular shaft extending distally from the handle.

Abstract: Lancet device includes a housing, a removable front cap mounted to the housing, a lancet holding member, and a trigger. A system is utilized for placing the lancet device in a trigger-set or armed position. A depth adjustment system includes a member that is at least partially rotatably mounted and that has an axis of rotation arranged substantially perpendicular to a center axis of the lancet holding member. An ejection system is utilized for at least one of preventing axial movement of the lancet holding member and removing or ejecting a lancet from the lancet holding member.

Abstract: A suture retention device is described. The suture retention device has various uses, one being for a gastropexy. A gastropexy may use a suture to hold the stomach against the abdominal wall of a patient. According to one example, a suture retention device is described that may have a shell having a thickness and an upper surface and a lower surface spaced apart by the thickness, the shell having an outer diameter that is greater than the thickness, the shell defining an internal chamber. A spring may be mounted within the internal chamber. The shell may be movable relative to a suture that passes through the shell and engages the spring.

Abstract: A surgical clip applier is provided including a housing, at least one handle pivotably connected to the housing, an outer support channel extending distally from the housing, a drive channel slidably disposed within the outer support channel, a jaw assembly including a first and second pair of jaws extending from an end of the outer support channel in a parallel configuration, and an integrated cutting mechanism disposed within a gap defined between the first and second pair of jaws. The jaw assembly is capable of effectuating formation of a pair of clips disposed within a respective first and second pair of jaws in response to movement of the at least one handle and the cutting mechanism is independently operable of the at least one handle. At least one jaw member of each of the pair or jaws includes a curved distal end. A method of operating same is also provided.

Abstract: A tissue-removing catheter for removing tissue from a body lumen includes a tissue-removing element. The tissue-removing element may be coupled to a first longitudinal body portion of the catheter body. The first longitudinal body portion may be rotatable along its length and relative to a second longitudinal body portion to adjust the angular position of the first longitudinal body portion relative to the second longitudinal body portion. An angular-positioning mechanism may be operatively connected to the tissue-removing element for rotating the tissue-removing element relative to the second longitudinal body portion about a rotational axis to adjust an angular tissue-removing position of the tissue-removing element, relative to the longitudinal axis of the body lumen, from a first angular tissue-removing position to a second angular tissue-removing position offset from the first angular tissue-removing position.

Abstract: Devices and methods for controlling blood perfusion pressure. In an exemplary device for controlling blood perfusion pressure within a vessel of the present disclosure, the device comprises an elongated body having a lumen, a proximal end configured for placement in a first area having a first blood pressure, and a distal end configured for placement in a second area having a second blood pressure, partial occluder positioned within the lumen of the elongated body between the proximal end and the distal end, the partial occluder configured so not to fully occlude a blood vessel, wherein the partial occluder is configured to equalize the first blood pressure at the first area with the second blood pressure at the second area.

Abstract: A tissue manipulation system comprises a reconfigurable hood structure with a distal end. The hood structure has a membrane extending across the hood structure distal end. The membrane includes an aperture with an aperture diameter smaller than an outer lip diameter of the hood structure in the expanded deployed configuration. The system also includes a fluid lumen in communication with the open area and an inflatable balloon member translatable through the aperture in the membrane and distal to the open area. The system also comprises an expandable stent positioned upon the balloon member. The stent has an unexpanded configuration sized to pass through the aperture in the membrane.

Abstract: The present invention relates to apparatuses and methods of using a resection line guide in various medical procedures. A resection line guide may include a first clamp member and a second clamp member configured to be positioned on a first side and a second side generally opposite that of the first side of an anatomical structure, such as, for example, a stomach. The clamp members may be configured to provide a clamping force on the stomach to secure the guide to the stomach. Further, at least one flexible member may be operatively coupled to the clamp members. The flexible member may be configured to be tensioned so as to provide at least a portion of the clamping force on the stomach.

Abstract: An arteriotomy closure device. The arteriotomy closure device includes a proximal end and a distal end designed to be inserted into an arteriotomy opening resulting from an endovascular procedure. The arteriotomy closure device provides a pair of doors operated by a door drive that stabilize the arteriotomy closure device within an artery during a closure operation. A plurality of needles with a suture attached to each penetrate the arterial wall. When the needles are engaged with a plurality of needle receptors, a cap trap is engaged with the needle receptors so that when the needles are retracted, the suture is secured in a position to close the arteriotomy opening. When the needles are retracted, the doors are lowered and the arteriotomy closure device is removed from the closure site, the suture is used to close the arteriotomy opening.