Abstract: A system and method for end-to-side anastomosis to an anatomical passageway is disclosed. The system and method are particularly useful in coupling an LVAD pump to an aorta. The system and method include using a tubular graft member having a skirt flange that engages the side of the aorta, a seating assembly and a flanged stent for securing the tubular graft to the side of the anatomical passageway. An assembly for creating an opening in the side of the anatomical passageway and an assembly for delivering the tubular graft is also disclosed.

Abstract: A transvaginal occluder includes an elongated housing having proximal and distal portions and an internal cavity defined therebetween configured for selective receipt of a surgical instrument therethrough. The elongated housing includes a first material having a first durometer extending between the proximal and distal portions and defining the internal cavity, the first material including one or more recesses defined therein along the internal cavity. The elongated housing also includes a second material having a second, lower durometer and that extends between the proximal and distal portions, the second material encapsulating a portion of the first material and configured to engage vaginal tissue. The elongated housing also includes a third material having a third, lowest durometer disposed within the one or more recesses that is configured to engage a shaft of the surgical instrument in a fluid tight manner.

Abstract: To percutaneously deliver a replacement tricuspid valve, a cable is percutaneously positioned with a first end extending out of the venous vasculature at the neck, and a second end extending out of a femoral access point. An eyehook device is positioned over the first end. A tricuspid valve delivery device (TVDD) is advanced over the second end, and then advanced through an IVC into a right atrium. The eyehook device is advanced into the right ventricle, drawing an intermediate portion of the cable into the right ventricle. Contact between the distal end of the eyehook device and the right ventricle is maintained while the TVDD is pushed from the femoral vein. The intermediate portion of cable applies a force to a distal nose of the TVDD that causes the distal nose to be steered into a tricuspid valve annulus as the TVDD is advanced.

Abstract: Devices, systems, and methods to improve both the reliability of soft tissue repair procedures and the speed at which the procedures are completed are provided. The devices and systems include one or more tissue augmentation constructs, which include constructs that are configured to increase a footprint across which suture applied force to tissue when the suture is tied down onto the tissue. The tissue augmentation constructs can be quickly and easily associated with the repair suture, and can be useful in many different tissue repair procedures that are disclosed in the application. Tissue augmentation constructs can include various blocks and scaffolds, among other formations. The present disclosure includes, among other disclosures, methods for using tissue augmentation scaffolds, including folding scaffolds, and descriptions and methods associated with extra-wide tissue augmentation blocks.

Abstract: A system comprising a handpiece and drive system configured to removably couple to a proximal end of a housing. A scalpet assembly is configured to removeably couple to the housing, and includes a scalpet array comprising at least one scalpet configured for rotation. The scalpet array is configured to harvest dermal plugs via fractional resection. A collection chamber is configured to collect the dermal plugs, and to house formation of an injectable filler by mincing the dermal plugs, and mixing the dermal plugs with a carrier. The injectable filler is configured for bulk fill. The collection chamber includes a loading port, and a cannular syringe is configured to mate with the loading port to receive the injectable filler, and to deliver the injectable filler for the bulk fill.

Abstract: Devices, systems, and methods to improve both the reliability of soft tissue repair procedures and the speed at which the procedures are completed are provided. The devices and systems include one or more tissue augmentation constructs, which include constructs that are configured to increase a footprint across which suture applied force to tissue when the suture is tied down onto the tissue. The tissue augmentation constructs can be quickly and easily associated with the repair suture, and can be useful in many different tissue repair procedures that are disclosed in the application. In one exemplary embodiment, one or more constructs are disposed on a suture threader, which can be used to associate the construct(s) with a repair suture(s) being used to repair the soft tissue. Tissue augmentation constructs can include various blocks and patches, among other formations. Exemplary methods for manufacturing the tissue augmentation constructs are also provided.

Abstract: Collapsible branched anastomosis devices allow for the formation of percutaneous vascular anastomoses using a Seldinger wire technique. This minimally invasive approach eliminates the need for a large surgical incision and also avoids the use of time consuming hand-suturing. The devices collapse to a fraction of their expanded volume and are configured to fit within a delivery sheath for over the wire delivery through a small incision in a blood vessel.

Abstract: A blood flow reducing assembly includes a catheter shaft and an expandable occlusion member assembled with the catheter shaft. The expandable occlusion member includes foldable protrusions. One or more manipulation members are connected to the foldable protrusions and operative to move the foldable protrusions closer to or further away from one other. Movement of the foldable protrusions modifies occlusion ability of the foldable protrusions.

Abstract: Disclosed are devices and methods for providing simple, fast, effective, and repeatable anastomotic graft connections, which can reduce (or eliminate) risks associated with graft anastomoses, thus improving patient outcomes. An example embodiment is an anastomotic graft connection device that includes a connector and a cuff. The connector includes a first flared end and a second flared end. The first flared end is configured to be inserted into a vessel (e.g., blood vessel). At least the second flared end is configured to be attached to a graft. The cuff includes an inner ring and an outer ring. The inner ring is configured to secure the graft to at least the second flared end of the connector, and the outer ring is configured to exert force on the vessel to seal the first flared end of the connector against an inner wall of the vessel.

Abstract: A dilator includes a tubular member composed of a flexible material, the tubular member forming a channel; wires extending inwardly from an interior of the tubular member into the channel; a string attached to the wires and extending through the channel; and a handle attached to the string; pulling the handle applies force to the string; force to the string causes the string to disengage from the wires such that the wires recoil against the interior of the tubular member such that the tubular member takes on a diameter of a predetermined dimension; and the tubular member in a recoiled state provides for dilation of a canal.

Abstract: A delivery system and method for delivering a prosthetic heart valve to the aortic valve annulus via a transaortic approach. The system includes a balloon catheter for delivering a balloon-expandable prosthetic heart valve through an introducer from an approach from outside the patient, through a minimally-invasive opening in the chest cavity through an incision in the aorta, and into the aorta and aortic annulus. The balloon catheter includes a flexible, tapered tip just distal of the balloon to facilitate positioning of the prosthetic heart valve in the proper orientation within the aortic annulus. The prosthetic heart valve may be installed over the existing calcified leaflets, and a pre-dilation valvuloplasty procedure may also be utilized.

Abstract: A method and apparatus for securing separate loops of suture with a coaxial mechanical fastener. Separate loops of suture extend from opposite ends of the mechanical fastener. A wire snare facilitates pulling the suture through the fastener. A suturing instrument provides for the infusion of pressurized physiologic solutions into the left ventricle so that the proper replacement suture length can be demonstrated real time prior to crimping the fastener. The instrument incorporates a slotted release site so that the fastener and suture can be released from the device tip once the fastener is secured. A method of securing suture coming from cardiac valve leaflets and or other structures like papillary muscles permits a more atraumatic orientation of the fastener coaxial with the suture strands.

Abstract: Various systems and techniques for inserting an intraocular lens are disclosed. In particular implementations, a system and a technique for inserting an intraocular lens may include the ability to move, in response to a force being applied in a first direction along a longitudinal axis, a first plunger tip along the longitudinal axis and into a delivery cartridge to fold an intraocular lens and move in a second direction along the longitudinal axis in response to the applied force being reduced. The system and the technique may also include the ability to engage a second plunger tip and move, in response to a force being applied in the first direction along the longitudinal axis, the second plunger tip along the longitudinal axis and into the delivery cartridge to insert the intraocular lens.

Abstract: A trans-atrial septal catheter system for delivery of a steerable sheath into the left atrium contains three components. The first component is a three-segmented needle-guide wire composed of a distal needle designed to flex sharply in relation to the conjoined looped guide wire segment after fossa ovalis puncture and needle advancement. The distal guide wire loops are advanced into the left atrium maintaining the angled needle in a central location relevant to the loops for preserving an atraumatic position while stabilizing the loops in the left atrium. The elongated proximal extra stiff guide wire segment is conjoined to the looped segment which crosses the fossa ovalis and extends proximally to become externalized to the femoral vein. This segment is extra stiff and significantly elongated to permit catheter and device exchanges. The guide wire serves as a support rail over which the dilator and sheath can be advanced into the left atrium.

Abstract: Vascular closure devices and methods for closing a blood vessel puncture site disposed at a distal end of a tissue tract are described. A combination of the body's own natural mechanism with chemical and/or biological agents is relied upon to accelerate the hemostatic process. Included are steps of introducing a closure device through the tissue tract and deploying an expansible member at a distal end of the device within the blood vessel to occlude the puncture site. A sealing member disposed proximal the expansible member is then displaced by retracting and tensioning a coil spring so as to expose a chemical and/or biological region or release region of the device. The retraction and tensioning of the coil spring is limited by a coupling member. Exposure of blood and tissue to the chemical and/or biological sealing member promotes the clotting processing to accelerate the occlusion process in the tract.

Abstract: Subcutaneous implantation tools and methods of implanting a subcutaneous device using the same. The tool may include a tool body having a longitudinally extending recess having a distal opening and having a tunneler at a distal end of the tool body extending from the distal opening of the recess. The tool may include a plunger slidably fitting within at least a portion of the tool body recess. The recess may be configured to receive an implantable device and the tunneler preferably extends distally from the recess at a position laterally displaced from the device when the device is so located in the recess. Movement of the plunger distally within the recess advances the device distally out of the recess and alongside of and exterior to the tunneler.

Abstract: An adjustable loop ring stripper for stretching an arterial wall outwardly as plaque is excavated inwardly.

Abstract: A self-expandable double-sided surgical implant including a peripheral pocket receiving an expansion ring. The surgical implant may be used for the correction of congenital diaphragmatic hernias.

Abstract: The present embodiments provide delivery systems for facilitating orientation of a prosthesis in a bodily passage. In one example, a system comprises an inner cannula having proximal and distal regions, and further comprises an atraumatic tip having a proximal end, a distal end, and a central region disposed therebetween. At least a portion of the atraumatic tip may be coupled to the proximal region of the inner cannula. A plurality of orientation struts are provided having a retracted delivery state, an expanded deployed state, and a retracted withdrawal state. The plurality of orientation struts each have apices that are oriented proximally relative to the atraumatic tip in the retracted delivery state, are oriented radially outward relative to the atraumatic tip in the expanded deployed state, and are oriented distally relative to the atraumatic tip in the retracted withdrawal state.

Abstract: Subcutaneous implantation tools and methods of implanting a subcutaneous device using the same. The tool may include a tool body having a longitudinally extending recess having a distal opening and having a tunneler at a distal end of the tool body extending from the distal opening of the recess. The tool may include a plunger slidably fitting within at least a portion of the tool body recess. The recess may be configured to receive an implantable device and the tunneler preferably extends distally from the recess at a position laterally displaced from the device when the device is so located in the recess. Movement of the plunger distally within the recess advances the device distally out of the recess and alongside of and exterior to the tunneler.