Abstract: An apparatus for sealing a passage through tissue includes an elongate shaft and a cylindrical plug disposed on a distal end of the shaft, the plug including a helical thread on its outer surface. Intestinal submucosa may be secured to the plug, e.g., in a cavity in its distal end, that may be delivered into the passage. Alternatively, the plug may be formed from a bioabsorbable material and may be released from the shaft within the passage. The plug is threaded into the passage, thereby engaging the tissue to seal the passage. The shaft is rotated until it engages a blood vessel within the tissue while monitoring blood flow through the vessel. The shaft is rotated to thread the plug into the passage until blood flow ceases through the vessel, whereupon rotation of the shaft is reversed to back the plug until blood flow through the vessel resumes.

Abstract: A device for closing a septal defect, such as a patent foramen ovale, includes a clip formed from a superelastic material that is inserted into a septum wall of a heart. The clip is advanced through a patient's vasculature, e.g., within a delivery apparatus, until the clip is disposed within a first chamber adjacent the septal defect. Tines of the clip are directed through a flap of tissue of the septal defect until the tines of the clip are disposed within a second opposing chamber. The clip then transforms into its relaxed state, wherein the tines of the clip engage with a surface of the second chamber, thereby substantially closing the septal opening.

Abstract: A lung-assist apparatus includes a tubular housing, a tubular nozzle therein, and a first valve disposed between the housing and nozzle. The housing is implanted across a bifurcation such that the nozzle extends from a first branch communicating with a healthy region of a lung towards a main passage, and terminates proximate a lateral opening in the housing that is disposed within a second branch communicating with a damaged region of the lung. During inhalation, the first valve opens to allow air flow into the first branch, and closes during exhalation to force air through the nozzle, thereby inducing a vacuum for drawing air from the damaged region. A second valve in the second branch opens during exhalation to draw air from the diseased region, and closes during inhalation to prevent air from being drawn into the damaged region.

Abstract: A band of biocompatible and/or bioabsorbable material is provided including threads on one or both of its ends. An area adjacent a spinal disc is accessed, and the band of material is wrapped around the disc to stabilize the disc and/or to facilitate healing. An elongate member is inserted around a posterior region of the disc, e.g., through tubular guide members. An end of the band is connected to a distal end of the elongate member, and the elongate member is pulled back around the disc to direct the band around the disc. The band is secured around the disc overlapping vertebrae adjacent the disc. Optionally, a relative location of the vertebrae is adjusted relative to the disc before wrapping the band around the disc, for example, using a fork member or traction. Energy may also be applied to the disc to enhance healing.

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

Abstract: An apparatus for sealing a passage through tissue includes a bioabsorbable body disposed on a distal end of a handle device. The plug member includes a helical thread on its outer surface and the plug member and handle device include cooperating lumens communicating with a distal port. A sealing member is disposed within the plug member lumen. An obturator is inserted through the lumens until its distal tip extends beyond the plug member, the distal tip including a bleed back port. The plug member is threaded into a passage towards a blood vessel until the bleed back indicator identifies the location of the vessel with respect to the plug member. The plug member is released from the handle device, the handle device and obturator are withdrawn, and the sealing member seals the lumen. The plug member is left within the passage to seal the passage until the tissue heals.

Abstract: Apparatus and methods are provided for reducing the volume of a lung using a clip including a plurality of tines. The clip is advanced along an interior of a bronchial passage to a predetermined location with the tines in a contracted condition. The tines are expanded outwardly to engage surrounding tissue, and then collapsed towards the contracted condition, thereby drawing the surrounding tissue inwardly to substantially close the bronchial passage from air flow therethrough. Optionally, electrical energy may be applied to the surrounding tissue after collapsing the tines to the contracted condition, thereby fusing the surrounding tissue together. The clip is then released within or removed from the passage.

Abstract: An apparatus for sealing a passage through tissue communicating with a blood vessel includes a bioabsorbable plug member coupled to the distal end of a carrier member. The plug member includes a lumen extending therethrough that communicates with a lumen extending through the carrier member. A sealing member is disposed in the plug member lumen for sealing the lumen. A guide member is slidable into the lumen such that edges of a groove extending between proximal and distal portions of the guide member engage a wall of the lumen to define a bleed back lumen. The guide member is inserted into the passage until the distal portion enters the vessel. The plug member is advanced over the guide member until the plug member enters the vessel, whereupon blood enters the bleed back lumen to identify the location of the vessel relative to the plug member.

Abstract: An apparatus for sealing a passage through tissue communicating with a blood vessel includes a bioabsorbable plug member coupled to the distal end of a carrier member. The plug member includes a lumen extending therethrough that communicates with a lumen extending through the carrier member. A sealing member is disposed in the plug member lumen for sealing the lumen. A guide member is slidable into the lumen such that edges of a groove extending between proximal and distal portions of the guide member engage a wall of the lumen to define a bleed back lumen. The guide member is inserted into the passage until the distal portion enters the vessel. The plug member is advanced over the guide member until the plug member enters the vessel, whereupon blood enters the bleed back lumen to identify the location of the vessel relative to the plug member.

Abstract: The invention adapts the pericardium for use as a pump bladder having a pump cavity formed by at least a portion of the pericardial space between the parietal pericardium and the visceral pericardium. The pump bladder is inflated to provide a compressive pressure on the heart and deflated to relieve the pressure. The pericardium is modified under conditions to improve the pumping characteristics of the pericardium as a pump bladder. A portion of the parietal pericardium may be attached to a portion of the visceral pericardium to isolate a portion of the pericardial space to form the pump cavity. The pericardium may be treated by stiffening, strengthening, tightening, shrinking, reshaping, or reducing the compliance or elasticity of the pericardium, or any combination thereof. The treatment may be carried out by heating the pericardium, applying a chemical to the pericardium, plicating the pericardium, or any combination thereof.

Abstract: An apparatus for sealing a passage through tissue includes a bioabsorbable, threaded plug carried by a delivery device. A guide wire is receivable through lumens in the plug and delivery device that includes wings on a bioabsorbable distal portion. With the wings collapsed, the guide wire is advanced through the passage into a blood vessel, the wings expanding once located within the vessel, and the guide wire is withdrawn until the wings contact the vessel wall. The plug is threaded into the passage over the guide wire until the plug is disposed adjacent the wings. The distal portion of the guide wire is secured to the plug, e.g., by compressing a collet within the plug lumen that seals the lumen, and is severed from a proximal portion thereof. Thus, the plug and distal portion are deployed with the plug sealing the passage.

Abstract: An apparatus for sealing a passage through tissue includes a plug including external threads, a lumen extending between its proximal and distal ends, and an annular collet slidably disposed within the lumen. The plug is carried on a distal end of a handle device that includes an inner member with a distal end that is slidable axially within the lumen of the body for moving the collet into a reduced cross-sectional region of the lumen, thereby compressing the collet to seal the lumen, and for deploying the plug from the handle device. During use, the plug is threaded into a passage through tissue over a guide wire. Once a desired location is reached, the plug is deployed from the handle device, thereby compressing the collet and sealing the lumen. The guide wire and handle device are removed, leaving the plug to seal the passage.

Abstract: An apparatus for sealing a passage through tissue includes a threaded plug detachably carried on a distal end of a delivery device. A guide wire element is receivable through the lumens extending through the plug and delivery device that includes expandable wings adjacent its distal end, and markers adjacent its proximal end. During use, the guide wire element is advanced through a passage through tissue into a blood vessel. The wings on the distal end are expanded within the vessel, and the guide wire element withdrawn until the wings contact a wall of the vessel. The plug is threaded into the passage over the guide wire element until the markers appear from the delivery device, and released from the delivery device, thereby deploying the plug member adjacent the vessel to seal the passage.

Abstract: The invention modifies the pericardium to treat patients suffering from or at risk of heart failure of the type wherein constraining forces of the pericardium around the heart are inadequate to prevent remodeling of the heart. The pericardium is enhanced by restoring, increasing, or improving its ability to restrain the heart and prevent dilation of the chambers of the heart. Methods and apparatus are provided for stiffening, strengthening, tightening, reshaping, and/or shrinking the pericardium to enhance the restraining and supporting capability of the pericardium around the heart. Specific embodiments enhance the pericardium by heating the pericardial tissue using radiofrequency energy and the like, treating the pericardium with a chemical such as glutaraldehyde, plicating the pericardium, or some combination of the above.