Abstract: Stomach tissue is manipulated to form, for example, a restored flap of a gastroesophageal flap valve. The manipulation includes gripping stomach tissue from within the stomach while the stomach is inflated to promote visualization and stabilization of the gripped stomach tissue. Once the stomach tissue is gripped, the stomach is deflated and pulled into a mold. The molded tissue is then fastened with at least one fastener. The stomach is inflated to a first pressure during visualization and then to a second higher pressure during the stomach tissue gripping.

Abstract: A vascular occlusion device for deployment within a lumen of a vessel may include a self-expanding frame configured to shift between a collapsed configuration and an expanded configuration, the self-expanding frame defining a perimeter of an interior space disposed within the self-expanding frame, and an occlusive membrane secured to the self-expanding frame. The occlusive membrane may include a suspended portion disposed within the self-expanding frame and spaced apart from the perimeter of the interior space.

Abstract: A surgical system includes: a plurality of surgical instruments each of which includes a flexible shaft provided with a surgical tool on a leading end-side portion thereof, a supporting platform that supports the plurality of surgical instruments; a medical instrument that includes a plurality of flexible inner tubes into which the flexible shafts of the surgical instruments can be inserted, and an outer tube into which the plurality of flexible inner tubes can be inserted and that is to be inserted into a body cavity; and a gripping mechanism that includes a gripping portion that grips the outer tube, and a supporting portion that includes at least one joint portion and that fixes and supports the gripping portion, the at least one joint portion making the medical instrument adjustable regarding the position and orientation thereof.

Abstract: A number of improvements to laparoscopic devices are described herein, primarily to improve the ergonomic functionality of the devices. For example, an articulating rod system is described, a gripping mechanism is described, and an end effector is described.

Abstract: An arteriovenous graft and methods of reducing the risk of graft thrombosis and extending patency of the arteriovenous graft are provided herein. The arteriovenous graft is operable for attaching to a vein at a venous anastomosis. In some aspects, the arteriovenous graft includes a plurality of grooves at a venous anastomosis end of the arteriovenous graft and the venous anastomoses may be arranged such that the arteriovenous graft and the vein meet at an angle of 30° or less.

Abstract: A method and apparatus for reattaching soft tissue to a boney structure using an expanding suture anchor. The method can include providing a suture anchor and forming a cavity in the boney structure for receipt of the suture anchor. The method can also include coupling the soft tissue to a suture and coupling the suture to the suture anchor. The method can further include deploying the suture anchor to fix the suture to the suture anchor and the suture anchor to the cavity.

Abstract: This invention is an intrasacular aneurysm occlusion device with a proximal stent which is expanded to a globular shape within an aneurysm sac and then compressed into a bowl shape which covers the aneurysm neck. The device further comprises embolic members and/or embolic material which is inserted into a distal portion of the aneurysm sac. The proximal stent component covers the aneurysm neck so as to reduce blood flow into the aneurysm sac and the accumulated embolic members and/or embolic material in the distal portion of the aneurysm sac keeps the proximal stent in place.

Abstract: A device for closing a tissue opening includes a proximal housing portion having a first portion, a second portion, a third portion, and a fourth portion. The first portion and the fourth portion extending transversely to a longitudinal axis of the proximal housing portion on opposite sides of the proximal housing portion. A distal portion extends from the proximal housing portion. At least the second portion and the third portion are configured to move toward the first portion.

Abstract: A cardiac valve annulus may be constricted by using an apparatus to deliver a cord to the annulus, affixing the cord, and subsequently tightening that cord. In some embodiments, this apparatus includes a housing, a spool, and an elongated core with lumens that run through the core. The lumens are dimensioned to slidably accommodate portions of the cord. The cord, the lumens, and the spool are configured so that after a distal loop portion of the cord is anchored to the annulus, movement of the housing in a proximal direction will (a) cause the core to progressively move in a proximal direction with respect to portions of the cord and (b) cause extension sections of the cord to progressively unwind from the spool and be progressively drawn into the lumens.

Abstract: Valve holders and introducers for delivering a prosthetic heart valve to an implant site are configured to facilitate insertion of prosthetic valves through small incisions or access sites on a patient's body. The valve holders can also be configured to reduce or eliminate the occurrence of suture looping or other damage to the prosthetic valve during implantation. A valve holder according to embodiments of the invention includes features that reduce or eliminate mistakes during implantation of the prosthetic valves, such as a handle that prevents implantation of the valve prior to proper deployment or adjustment of the holder. An introducer is provided which can facilitate temporary deformation of a nitinol prosthetic valve to pass between adjacent ribs of a patient without rib spreading. Valves are provided having a wireform and stiffener band made of materials that exhibit superelastic properties.

Abstract: A delivery system facilitating retrieval of interventional device includes a sheath, an operation handle for driving the sheath to move, and a tube axially slidably engaging with the pusher section. The sheath includes a carrier section at a proximal end for surrounding the interventional device and a pusher section connected with the carrier section. Depending on different axial positions, the tube assumes an initial configuration in which a proximal end portion thereof is at a periphery of the pusher section, and an operation configuration in which the proximal end portion is held tightly around the carrier section and limits further expansion of the carrier section. The delivery system functions to hold the support frame tightly by surrounding the sheath with the axially movable tube, retrieving the support frame and preventing the support frame from falling off from a core shaft, thereby reducing risks in surgery and the mortality rate.

Abstract: The present disclosure describes devices, systems, and methods for intravascularly delivering an implantable device at the mitral annulus. A delivery system includes a delivery member coupled to a handle assembly and extending distally from the handle assembly. The intravascular device is attached at the distal end of the delivery member, and is housed within a distal piece of an outer sheath. A steering catheter is nested within the outer sheath to bend the delivery member into position. A delivery catheter is configured to advance the intravascular device relative to the outer sheath, and a suture catheter includes sutures/tethers which may be coupled to the intravascular device prior to deployment.

Abstract: Embodiments of the present invention encompass systems and methods for delivering ligatures to anatomical features of a patient. Exemplary ligature delivery systems for use in delivering a ligature to a left atrial appendage ligature include an elongate support mechanism having a proximal portion and a distal portion, a flexible hoop assembly, and a cinchable constriction member. The flexible hoop assembly can be coupled with the distal portion of the elongate support mechanism, and can include a support body coupled with a support frame. The support frame can be biased to hold the support body in a trailing configuration, whereby a free portion of the support body is disposed proximal to the distal portion of the elongate support mechanism. The support frame of the flexible hoop assembly can be coupled with the distal portion of the elongate support mechanism. The support body can be configured to support the cinchable constriction member and a loop of the left atrial appendage ligature.

Abstract: The disclosed technology provides a device for sealing an aperture in a tissue of a body lumen. The device comprises a flexible support member having a base having (i) a central portion and (ii) one or more lateral support portions, to engage and/or hold a sealable member of the device against an interior surface of the tissue when the device is in the sealing position. The lateral support portions provide additional support surfaces to engage peripheral portions of the sealable member against the interior surface of the tissue. A cage or shoe engaged with the support member on the exterior surface of the tissue can provide additional support and assist sealing the aperture.

Abstract: A medical device, configured to perform an endovascular therapy, e.g., thrombectomy, can comprise an elongate manipulation member and an intervention member. The intervention member can comprise a proximal end portion and a mesh. The proximal end portion can be coupled with the distal end portion of the elongate manipulation member. The mesh can have a plurality of cells and, be compressible to a collapsed configuration for delivery to an endovascular treatment site through a catheter, and be self-expandable from the collapsed configuration to an expanded configuration. At least a portion of the mesh, from a first location to a second location along the mesh, can be configured such that an amount of cell deformation in response to longitudinally directed tensile forces decreases by less than 5% or increases in a distal direction along the portion of the mesh.

Abstract: A scar subcision devices comprising a first elongated element comprising a pivotal connection to a second elongated element, the first elongated element having a blunt distal end, the second elongated element having a proximal-facing cutting edge at a distal end thereof, the device having a first state wherein the cutting edge is retracted to a location within an outer perimeter of the first elongated element, and a second state wherein the cutting edge is exposed outside of the outer perimeter of the first elongated element and the device transitioning between the first state and the second state by the first elongated element and the second elongated element rotating relative to each other about the pivotal connection are disclosed. Methods are also disclosed.

Abstract: Devices, systems, and methods for performing an ophthalmic procedure in an eye are disclosed. The devices include a hand-held portion and a distal, elongate member coupled to the hand-held portion having a lumen operatively coupled to a vacuum source. A drive mechanism operatively coupled to the elongate member is configured to oscillate the elongate member. When in use, the device is configured to aspirate ocular material from the eye through the lumen. The drive mechanism retracts the elongate member with a retraction speed profile and advances the elongate member with an extension speed profile. The retraction speed profile is different from the extension speed profile.

Abstract: A left atrial appendage closure implant may include a support frame including a first bend extending from a proximal collar to a second bend, a first segment extending from the second bend to a third bend, a second segment extending from the third bend to a fourth bend, and a third segment extending from the fourth bend to a distal collar, wherein the support frame is actuatable from a first constrained position to a second flowering position to a third mid-deployment position to a fourth unconstrained position. An implant may include a self-expanding support frame having a circumference and a central longitudinal axis, a membrane disposed over at least a portion of the support frame, and a plurality of anchors arranged into a first row and a second row such that the first row and the second row form a staggered pattern about the circumference of the support frame.

Abstract: Closure devices and methods for ligating tissue, such as the left atrial appendage, generally, include an elongate body having a first lumen therethrough, a snare loop assembly, a vacuum tube, and an imaging device. The snare loop assembly may include a snare and a suture loop releasably coupled to the snare and may at least partially extend from a distal end of the elongate body. The vacuum tube may be slidably positioned within the first lumen to extend through the snare loop assembly. The imaging device may be disposed within the lumen of the vacuum tube.

Abstract: Embodiments of systems and methods for fixing soft tissue are disclosed herein. In some embodiments, soft tissue may be fixed to an attachment surface (such as bone, other soft tissue, other implants, or allograft or xenograft materials) by providing a helical suture in the soft tissue, wherein the soft tissue has a longitudinal axis along which the soft tissue undergoes tension under normal physiological conditions, and wherein a longitudinal axis of the helical suture in the soft tissue is oriented parallel to the longitudinal axis of the soft tissue; and securing the helical suture to an attachment surface.