Abstract: An annuloplasty ring holder includes an angled post for improved visibility and access by the surgeon. The post may be configured to be adjusted in angle and rotation. The ring holder can include a relatively open lower template, including relatively narrow extending radial arms with short, generally arcuate ring-retaining distal portions. The invention includes placements of suture holes and cutting wells which, in combination with improved suture routing, afford the user improved access to cutting the suture that is used to retain the annuloplasty ring to the holder. Another annuloplasty ring and ring holder combination disclosed includes a generally triangular-shaped ring and a generally T-shaped holder. The ring holder has a base portion forming the top of the T shape and engaging against a first segment of the ring, with a radial arm extending from the base portion and forming the post of the T. The radial arm engages against a junction between two segments of the ring.

Abstract: An adjustable support pad for adjustably holding a tensioning line used to apply tension to a body organ. The adjustable support pad can include a locking mechanism for preventing slidable movement of the tensioning element in one or both directions. The locking mechanism may include spring-loaded locks, rotatable cam-like structures, and/or rotatable spool structures. The adjustable support pad may be formed from rigid, semi-rigid, and/or flexible materials, and may be formed to conform to the outer surface of a body organ. The adjustable support pad can be configured to adjustably hold one or more separate tensioning lines, and to provide for independent adjustment of one or more tensioning lines or groups thereof.

Abstract: An annuloplasty ring and ring holder combination includes a generally triangular-shaped ring and a generally T-shaped holder. The ring holder has a base portion forming the top of the T shape and engaging against a first segment of the ring, with a radial arm extending from the base portion and forming the post of the T. The radial arm engages against a junction between two segments of the ring. The invention includes placements of suture holes and cutting wells which, in combination with the improved ring holder shape, afford the user improved access and visibility to the surgical site, the ring, and to the suture that is used to retain the annuloplasty ring to the holder.

Abstract: This invention relates to a surgical implant system for repairing pelvic prolapse in a patient. In particular, the present invention relates to an implant, a delivery device and a method for implanting and securing the implant to tissue structures in the pelvic region of the body.

Abstract: An annuloplasty ring holder includes an angled post for improved visibility and access by the surgeon. The post may be configured to be adjusted in angle and rotation. The ring holder can include a relatively open lower template, including relatively narrow extending radial arms with short, generally arcuate ring-retaining distal portions. The invention includes placements of suture holes and cutting wells which, in combination with improved suture routing, afford the user improved access to cutting the suture that is used to retain the annuloplasty ring to the holder.

Abstract: A mesh to repair a hole in a muscle wall includes a resilient mesh body and fortifying structure such as mesh portions of thicker weave than other portions, or strengthening members that can be engaged with the mesh and then removed from the mesh once the mesh is place over the hole. The same principles can be applied to a plug that is engaged with the mesh for filling the hole.

Abstract: Annuloplasty rings optimally sized to take into account more of the common degenerative valve pathologies. Each ring has a structural ring body with a shape that complies with predicted shapes of degenerative valvular diseases, such as fibroelastic deficiency (FED), Marfan's or Barlow's. The predicted shapes are obtained through careful echocardiographic and intraoperative measurements, and often differ for different annulus orifice sizes. For instance, in mitral rings the larger rings have larger minor axis and oblique axis dimensions relative to their major axis dimensions, and are more circular as opposed to D-shaped. The rings may also be three-dimensional and the relative heights around the rings may change for different sized rings. A mitral ring may have a higher anterior saddle relative to a posterior saddle, with the relative heights varying across the ring sizes. The ring may have varying flexibility around the ring periphery which also changes for different ring sizes.

Abstract: An active annuloplasty ring holder having a template that can be folded or pivoted to the side allowing the template to align longitudinally with the handle and enter the patient's chest through a small incision. The holder may include a mechanism to remotely detach sutures fastening the ring to the holder, thereby detaching the ring while avoiding the risk associated with introducing a scalpel into the operating field. A detachment mechanism may include a movable pin actuated by a pull wire that releases a plurality of holding sutures, or a hot wire, knives, or pull wire that severs the sutures. The holder may have a built-in light source for better visualization of the ring inside the heart. The holder may also have an optical means of visualizing the inside of the heart from the proximal end of the handle.

Abstract: Devices and methods for treating mitral regurgitation by reshaping the mitral annulus in a heart. One preferred device for reshaping the mitral annulus is provided as an elongate body having dimensions as to be insertable into a coronary sinus. The elongate body includes a proximal frame having a proximal anchor and a distal frame having a distal anchor. A ratcheting strip is attached to the distal frame and an accepting member is attached to the proximal frame, wherein the accepting member is adapted for engagement with the ratcheting strip. An actuating member is provided for pulling the ratcheting strip relative to the proximal anchor after deployment in the coronary sinus. In one preferred embodiment, the ratcheting strip is pulled through the proximal anchor for pulling the proximal and distal anchors together, thereby reshaping the mitral annulus.

Abstract: A plug is closely received in the open distal end of an outer tube for natural orifice surgery and is proximally removable from the tube. Various means are provided for deforming the plug to permit the plug to be retrieved through the outer tube.

Abstract: An adjustable support pad for adjustably holding a tensioning line used to apply tension to a body organ. The adjustable support pad can include a locking mechanism for preventing slidable movement of the tensioning element in one or both directions. The locking mechanism may include spring-loaded locks, rotatable cam-like structures, and/or rotatable spool structures. The adjustable support pad may be formed from rigid, semi-rigid, and/or flexible materials, and may be formed to conform to the outer surface of a body organ. The adjustable support pad can be configured to adjustably hold one or more separate tensioning lines, and to provide for independent adjustment of one or more tensioning lines or groups thereof.

Abstract: An adjustable support pad for adjustably holding a tensioning line used to apply tension to a body organ. The adjustable support pad can include a locking mechanism for preventing slidable movement of the tensioning element in one or both directions. The locking mechanism may include spring-loaded locks, rotatable cam-like structures, and/or rotatable spool structures. The adjustable support pad may be formed from rigid, semi-rigid, and/or flexible materials, and may be formed to conform to the outer surface of a body organ. The adjustable support pad can be configured to adjustably hold one or more separate tensioning lines, and to provide for independent adjustment of one or more tensioning lines or groups thereof.

Abstract: A mitral annuloplasty ring that has a saddle shape with an upward bow in both an anterior segment and a posterior portion, with the upward bow being more pronounced in the anterior segment. The ring defines a closed ring body with a rounded isosceles triangular shape and the anterior segment along a long side. The posterior portion bulges outward to create a minor-major axis dimension ratio of between about 3.3:4 to 4:4. An inner ring body is made of a generally rigid material such as titanium that will substantially resist distortion when subjected to the stress imparted thereon after implantation in the mitral valve annulus of an operating human heart. The outward and upward posterior bow of the annuloplasty ring corrects for pathologies associated with mitral valve prolapse, as seen with Barlow's syndrome for instance, in which the leaflets tend to be elongated or floppy.

Abstract: An annuloplasty ring and ring holder combination includes a generally triangular-shaped ring and a generally T-shaped holder. The ring holder has a base portion forming the top of the T shape and engaging against a first segment of the ring, with a radial arm extending from the base portion and forming the post of the T. The radial arm engages against a junction between two segments of the ring. The invention includes placements of suture holes and cutting wells which, in combination with the improved ring holder shape, afford the user improved access and visibility to the surgical site, the ring, and to the suture that is used to retain the annuloplasty ring to the holder.

Abstract: The invention is an apparatus, system, and method for repairing heart valves. A suture line is secured to a papillary muscle, and then passed through a portion of a heart valve leaflet. A reference element is provided at a desired distance from a plane defined by the heart valve annulus. The suture line is secured to the heart valve leaflet at a position adjacent the reference element. The reference element may part of a device configured for placement on or in a heart valve annulus. The reference element may be slidingly secured to the device so that the distance of the reference element from the main body of the device can be varied by a surgeon or other user. The reference element may be a line of suture, which may be pre-installed during manufacture of the device or may be installed by the surgeon or other user.

Abstract: Devices and methods for treating mitral regurgitation by reshaping the mitral annulus in a heart. One preferred device for reshaping the mitral annulus is provided as an elongate body having dimensions as to be insertable into a coronary sinus. The elongate body includes a proximal frame having a proximal anchor and a distal frame having a distal anchor. A ratcheting strip is attached to the distal frame and an accepting member is attached to the proximal frame, wherein the accepting member is adapted for engagement with the ratcheting strip. An actuating member is provided for pulling the ratcheting strip relative to the proximal anchor after deployment in the coronary sinus. In one preferred embodiment, the ratcheting strip is pulled through the proximal anchor for pulling the proximal and distal anchors together, thereby reshaping the mitral annulus.

Abstract: Catheters adapted to exchange heat with a body fluid flowing through a body conduit employ helical elongate lumens for heat transfer with the body fluid. The helical elongate lumen of a catheter forms multiple turns extending longitudinally of a portion of the catheter with the turns each being bonded to the catheter along a fraction of the length of the turn. The length of the lumen and its orientation in each turn has the lumen otherwise displaced over a major portion of its length from the elongate body. The turns of the helical lumen can be arranged in sets having different lengths to encounter all areas of the flow. One or more infusion lumens may also extend to an infusion port or ports. The helical elongate lumen is defined by an elongate, thin-walled element. This lumen is in fluid communication with a heater/chiller supplying a working fluid for heat transfer through the wall of the elongate element defining the helical elongate lumen.

Abstract: A catheter adapted for heat exchange within a body includes a shaft with at least one input lumen and at least one output lumen in fluid communication with one or more elongate elements which each include a heat transfer lumen. The elongate element is arranged in one or more lengths which include heat transfer lumens being folded into first elongate substantially parallel and juxtaposed portions arranged either in series or parallel or both with adjacent wings. The juxtaposed portions are arranged together in planes extending radially from the center axis of the assembly and are equiangularly placed about that axis. The ends of the portions may be bonded together to create the radial plane. An infusion lumen may extend through the heat transfer assembly with an open end for infusing into the blood stream or sampling therefrom.