Abstract: A balloon catheter includes a balloon coupled to a shaft. The shaft includes a proximal perfusion portion disposed proximal of the balloon and a distal perfusion portion disposed distal of the balloon. The proximal and distal perfusion portions each are formed by a respective plurality of wire members woven together to form a respective proximal and distal braided shafts. The plurality of wire members are woven together such that a plurality of perfusion openings are formed between the wire members. The plurality of perfusion openings extend from an outer surface of the respective proximal or distal braided shaft to a lumen of the respective proximal or distal braided shaft. A perfusion lumen extends between the proximal perfusion portion and the distal perfusion portion.

Abstract: A system for fracturing a frame of a deployed prosthesis with ultrasonic vibration includes a shaft, a tip assembly, an ultrasonic electric generator, and an ultrasonic transducer. The shaft includes a proximal portion and a distal portion. The tip assembly is coupled to the distal portion of the shaft. The tip assembly includes a cutting edge. The ultrasonic transducer is electrically coupled to the ultrasonic generator. Ultrasonic vibration generated by the ultrasonic transducer is translated to the tip assembly. The cutting edge of the tip assembly is configured to focus the vibration of the tip assembly onto a frame of a deployed prosthesis to fracture the frame of the prosthesis. The ultrasonic transducer may be coupled to the proximal portion or the distal portion of the shaft.

Abstract: In some examples, a catheter may include an elongate body and a push assembly. The elongate body may include an inner liner defining an entry port into a lumen defined by the elongate body, and an outer jacket. The push assembly may an anchor member positioned at a distal end of an elongate member. Distal to a proximal end of the elongate body, a first portion of the push assembly, comprising the anchor member, may be positioned between a portion of the inner liner and a portion of the outer jacket. The anchor member may extend only partially around an outer perimeter of the inner liner when the catheter is assembled. Proximal to the proximal end of the elongate body, a second portion of the push assembly, proximal to the first portion, may be positioned outside of the outer jacket and the inner liner.

Abstract: A prosthetic assembly configured for endovascular placement within an aortic arch and method of use thereof. The prosthetic assembly includes a proximal aortic stent-graft prosthesis configured to be positioned within a proximal portion of the aortic arch adjacent to the brachiocephalic artery, a distal aortic stent-graft prosthesis configured to be positioned within a distal portion of the aortic arch adjacent to the left subclavian artery, a first branch stent-graft prosthesis configured to be positioned within the brachiocephalic artery and a second branch stent-graft prosthesis configured to be positioned in one of the left common carotid and the left subclavian artery. When deployed, a proximal end of the first branch stent-graft prosthesis is disposed within a lumen of the proximal aortic stent-graft prosthesis to proximally displace the ostium of the brachiocephalic artery.

Abstract: A tool for use in loading a transcatheter valve prosthesis within a delivery catheter includes a body portion, a pivotable element and a biasing element. The body portion includes a central passageway extending form a proximal end to a distal end of the body portion. The central passageway is configured to receive a distal portion of a delivery catheter therethrough. The pivotable element is attached to the body portion and is configured to secure a tether during loading of a transcatheter valve prosthesis within the delivery catheter. The biasing element compresses the pivotable element against the body portion such that the pivotable element holds a second end against the delivery catheter and secures the tether thereto. The pivotable element may be two or more pivotable elements.

Abstract: Biodegradable magnesium alloy implantable medical devices are protected to delay onset of corrosion, and thus biodegradability, or to corrode more uniformly. The protection allows for extended effective use of the devices while maintaining biodegradability. Examples of protective coatings include conversion coatings that at least partially remove exposed second phases from a surface of the magnesium alloy and coatings that provide a barrier between water and the surface of the magnesium alloy.

Abstract: A stent graft includes a main body extending along a longitudinal axis when in a preinstalled configuration prior to insertion into a body of a patient. The stent graft also includes a mobile external coupling extending away from the main body and configured to align with a secondary blood vessel within the body to provide access thereto. The main body includes a plurality of stents extending thereabout. The stents include a first bracketing stent extending about a proximal side of the mobile external coupling, and a second bracketing stent located adjacent the first bracketing stent and extending about a distal side of the mobile external coupling. The first bracketing stent includes peaks that are aligned along a first axis, and the second bracketing stent includes peaks that are aligned along a second axis that diverges from the first axis relative to a circumferential direction toward the mobile external coupling.

Abstract: In some examples, the disclosure describes an annuloplasty device that comprises a tube-like structure configured to extend around at least part of a circumference of an annulus of a cardiac or vascular valve of a patient, and at least one anchor configured to anchor the tube-like structure to the annulus. The tube-like structure is configured to decrease a distance between valve leaflets that extend from the annulus.

Abstract: An expandable introducer sheath provided with a steering mechanism is disclosed. The introducer sheath is configured for providing a prosthesis delivery system percutaneous access to a patient's vasculature. The introducer sheath includes a sheath component defining a central lumen and having a longitudinally-extending, radially-expandable portion. The sheath component also includes a steering wire slidably disposed within a wall thereof that longitudinally extends along the radially-expandable portion. When the steering wire is in a slackened configuration, the steering wire permits a width of the radially-expandable portion to increase. When the steering wire is in a taut configuration, the steering wire permits a distal portion of the sheath component to be manipulated or bent in order to align a distal port of the introducer sheath, for instance, with an ostium of a branch vessel.

Abstract: A steerable catheter device including a catheter, first and second steering wires, and a steering control unit. The steering wires are connected to and extend from the catheter. The steering control unit includes a first actuator member, a first output member, a second actuator member, and a second output member. The first output member is threadably connected to the first actuator member. The second output member is threadably connected to the second actuator member. A portion of the first actuator member is disposed within the second actuator member. The first output member translates with rotation of the first actuator member and the second output member translates with rotation of the second actuator member. The first steering wire is attached to the first output member and the second steering wire is attached to the second output member. Tension in the steering wires can be independently adjusted.

Abstract: A delivery device for percutaneously delivering a stented prosthetic heart includes a sheath, a handle, and adjustment device including a fine adjustment mechanism, and an outer stability shaft. The sheath defines a lumen and is configured to compressively constrain the stented prosthetic heart valve. The handle is coupled to the proximal portion of the sheath and includes an actuator mechanism coupled to a proximal portion of the sheath that is configured to selectively move the sheath relative to the housing to release the stented prosthetic heat valve. The adjustment device is coupled to the handle and includes an adjustment lumen through which the sheath and the handle slidably extend. The outer stability shaft is coupled to the adjustment device. The fine adjustment mechanism is configured to selectively move the handle and the sheath relative to the adjustment device and the outer stability shaft.

Abstract: A polymer coating/ring is employed to aid in the sealing and connection of modular elements used in body flow lumens for the exclusion and bypass of diseased regions of the flow lumen, such as where aneurysm occurs adjacent to branching blood vessels.

Abstract: In some examples, a package includes a package body enclosing a medical supply. The package body defines a window. The package includes a breathable membrane adjacent the package body and extending across the window. The package includes a moisture oxygen scavenger adjacent the package body and extending across the breathable membrane. The package includes an adhesive layer configured to hold the moisture oxygen scavenger adjacent the breathable membrane. In some examples, a technique includes sterilizing a package precursor including the package body and the breathable membrane, and after the sterilizing, adhering the moisture oxygen scavenger to the package body to form the package.

Abstract: The disclosure relates to transcatheter stented prosthesis delivery devices including a handle assembly connected to a shaft assembly on which a stented prosthesis is loaded and compressively retained with a plurality of elongate tension members. The delivery devices include a cutting assembly that can sever the elongate tension members after the stented prosthesis is expanded at a target site so that the delivery device can be withdrawn from the patient. Certain embodiments position the cutting assembly at least within the shaft assembly and others position the cutting assembly over the shaft assembly. Various disclosed cutting assemblies are actuated with the handle assembly or the like, which draw the tension members across the blade or vice versa.

Abstract: Delivery devices for delivery of a stented prosthetic heart valve. Various delivery devices include an outer sheath assembly including an outer sheath connected to a capsule that is advanced proximally to retain the prosthetic valve, which is secured over an inner shaft assembly of the delivery device. The delivery device further includes a bumper to provide a smooth transition of the capsule over the prosthetic valve during loading and recapture procedures. The bumper is expandable from a first position to a second position in which a distal end of the bumper is expanded to increase its diameter. The bumper can be biased in the second, expanded position so that the bumper automatically transitions to the expanded position upon retraction of the outer sheath.

Abstract: Stented prosthetic heart valves including a stent frame having a plurality of stent frame support structures collectively defining an interior surface, an exterior surface and a plurality of cells. The stented prosthetic heart valve further including a valve structure including valve leaflets disposed within and secured to the stent frame and defining a margin of attachment. The stented prosthetic heart valve including one or both of an outer paravalvular leakage prevention wrap and an inner skirt for supporting the valve leaflets. In various embodiments, the outer wrap is positioned entirely on one side of the margin of attachment. In embodiments including an inner skirt, the outer wrap and the inner skirt are on opposite sides of the margin of attachment such that the inner skirt and the outer wrap do not overlap. In other embodiments, the outer wrap includes a plurality of zones having varying thickness.

Abstract: The techniques of this disclosure generally relate to a modular assembly including first and second stent-grafts. The first stent-graft includes a body portion having a first diameter and a waist portion having a second diameter less than the first diameter. The waist portion is at a distal end of the first stent-graft. The second stent-graft includes a captured proximal portion configured to be located within the first stent-graft. The captured proximal portion includes a seated portion configured to be located proximal to the waist portion. The seated portion has a third diameter greater than the second diameter to form a mechanical interlock between the first stent-graft and the second stent-graft.

Abstract: Embodiments hereof relate to methods of delivering a valve prosthesis to an annulus of a native valve of a heart, the native valve having chordae tendineae. A chordae management catheter is positioned within a ventricle of the heart, the chordae management catheter having a displacement component at a distal end thereof. The displacement component has an annular shape and defines a central lumen therethrough. The displacement component is radially expanded to push chordae tendineae within the ventricle radially outward. A valve delivery system is introduced into the ventricle of the heart via a ventricular wall of the heart. The valve delivery system has the valve prosthesis at a distal portion thereof. The valve delivery system is advanced through the central lumen of the radially expanded displacement component towards the annulus of the native valve of the heart. The valve prosthesis is deployed into apposition with the annulus of the native valve.

Abstract: In some examples, the disclosure describes a medical assembly that includes a stent including a primary electrode, where the stent is configured to expand from a collapsed configuration to an expanded configuration, a secondary electrode, and an energy source configured to deliver an electrical signal between the primary electrode and the secondary electrode through a fluid in contact with the primary electrode to cause the fluid to undergo cavitation to generate a pressure pulse wave within the fluid.

Abstract: The disclosure describes an annuloplasty device that includes a wire configured to extend around at least part of an annulus of a cardiac or vascular valve, such as at least partially around a circumference of the annulus, and a plurality of anchors. The anchors of the plurality of anchors are configured to engage the wire and anchor the wire to the annulus. The wire is configured to urge at least some anchors of the plurality of anchors toward each other in a radially inward direction to decrease a distance between valve leaflets that extend from the annulus.