Abstract: Multilayer structures including a porous layer and a non-porous layer are useful as buttresses when associated with a surgical stapling apparatus.

Abstract: Described here are devices, methods, and kits for the deployment of tissue anchors. In some variations, the devices may comprise a shaft defining a lumen for housing at least one anchor therein and a mechanism for deploying the anchor distally from the lumen. In certain variations, the devices may comprise one or more stop elements. For example, a device may comprise a stop element that limits the advancement of the device through an opening in a wall portion or at the distal end of another device.

Abstract: An elongate rigid suture anchor is provided which is driven and impacted directly into bone. It has two ends: a distal end, which forms a hole in the bone, and a proximal end that penetrates the sidewall of the bone hole as the anchor is displaced proximally in the hole. A proximal force is applied to the suture anchor to displace the anchor proximally and cause tilting of the anchor. As the anchor is displaced proximally, the proximal end of the anchor enters obliquely into the sidewall of the hole.

Abstract: An insertion instrument is configured to eject one or more of anchor bodies across an anatomical gap so as to approximate the gap. The insertion instrument can include a single cannula that retains the pair of anchor bodies in a stacked relationship, or a pair of adjacent cannulas that each retains respective anchor bodies. The insertion instrument can be actuated so as to eject the anchor bodies into respective target anatomical locations.

Abstract: A surgical device of suturing vascular vessels is described, as well as methods for suturing tissue employing the surgical device. In one form the device includes a distal member that contains a suture and needle engaging fitting. A needle is advanced through tissue adjacent the puncture wound and into the needle engaging fitting to draw lengths of suture material which can then be used to close the puncture wound. In another form the device includes a needle advanceable through tissue and into a needle capture element within a distal end of the surgical device to draw lengths of suture material which can then be used to close various puncture wounds. In still another form the device includes at least one needle advanceable to draw lengths of suture material to close various puncture wounds. A foot is pivotal between a non-deployed and a deployed position.

Abstract: A mechanical system for rotatably, sequentially securing opposing sides of a tissue wound with a fastener. An applicator apparatus is capable of imparting rotatable motion to a falcate tissue penetrator that sequentially pierces and carries a fastener into a first side and a second side of the tissue wound. The first side and second side of tissue can be simultaneously captured and positioned with respect to a tissue definition member or alternatively, the first tissue side and second tissue side can be individually, sequentially captured and positioned relative to the tissue definition member. The applicator apparatus can comprise a single fastener for small tissue wounds or resections or alternatively, the applicator can comprise a plurality of staged fasteners for use in closing a larger wounds or wounds with increased tension.

Abstract: Embodiments of the invention are directed to apparatuses for securing and sealing apertures in tissue and related methods of use. An exemplary apparatus for collapsing an aperture in a wall of tissue can include a base biased to collapse into a collapsed state from an expanded state. The apparatus can also include a plurality of collapsible fingers extending from the base, wherein the collapsible fingers can be configured to collapse about tissue adjacent to and defining the aperture so as to close the aperture in the wall of tissue.

Abstract: A method of diverting fluid flow from a first vessel including an occlusion to a second vessel includes deploying a prosthesis at least partially in a fistula and making valves in the second vessel incompetent. Making the valves in the second vessel incompetent includes at least one of using a reverse valvulotome to cut the valves, inflating a balloon, expanding a stent, and lining the second vessel with a stent.

Abstract: A heart valve delivery system is provided wherein a prosthetic valve is carried on a valve catheter inside a delivery sleeve. A step balloon protrudes from the delivery sleeve and provides a tapered surface for facilitating advancement through a body vessel. The step balloon also aids in crossing the leaflets of a native valve. After the prosthetic valve is positioned within the native valve, the delivery sleeve is retracted to expose the prosthetic valve. If necessary, the step balloon may be expanded to securely seat the prosthetic valve at the site of the native valve. The prosthetic valve is preferably coupled to the valve catheter by a plurality of flexible extension arms which allow the prosthetic valve to be collapsed after initial deployment such that the prosthetic valve may be repositioned if necessary.

Abstract: Methods, systems, and devices for providing treatment to a target site are described. The system may include a guide assembly, an expandable support device coupled with the distal end of the guide assembly, and an operative member disposed on the expandable support device. The expandable support device may be configured to transition between a collapsed and expanded configuration. The expandable support device may be supported by one or more flexible supports aligned in parallel with an axis about which the expandable support device collapses and/or multiple splines arranged in a pattern configured to promote transitioning of the expandable support device between an expanded and collapsed configuration. The guide assembly may be configured to provide torque to the expandable support device. The operative member can include multiple electrodes arranged in parallel to the axis about which the expandable support device collapses.

Abstract: A method that includes introducing a catheter assembly to an obstructed region of a blood vessel lumen and recanalizing the obstructed region with the catheter assembly is disclosed. Prior to or during recanalization, a treatment agent may be delivered through the catheter assembly to a vessel region downstream to the obstructed region. The treatment agent may have a property that will inhibit reperfusion injury. Alternatively, a medical device may be introduced to an obstructed region of a blood vessel lumen and the obstructed region recanalized with the medical device. The treatment agent may be delivered to a vessel region downstream to the obstructed region. The treatment agent may include at least one of an immunosuppresant and an antioxidant.

Abstract: Disclosed is a surgical clip for end-to-end or end-to-side vascular anastomosis and for suturing blood conduits, which comprises a V-shaped base from which at least two branches project in a direction opposed to an apex of the V-shaped base. The branches each have a hook pointing toward the base, the branches are parallel to one another before plastic deformation and each branch forms with the corresponding hook a re-entrant corner with an apex angle of between 30° and 80°. The clip has three zones of preferential deformation, at an the apex of the V-shaped base and at connecting zones between the base and the branches. After plastic deformation, the two branches remain substantially parallel. The deformation of the clip has been concentrated on the apex of the base, the angle of which has narrowed under the stress of the gripper, and on the apices, which have opened.

Abstract: A method and device for securing a tissue graft within a bone passage includes providing a graft fixation device that houses a closed loop having both braided and non-braided portions. A tissue graft is looped through the closed loop at the non-braided portion to attach the tissue graft to the graft fixation device. The graft fixation device is passed through the bone passage and seated against the surface of the bone to secure the tissue graft within the bone passage.

Abstract: A suturing instrument is configured for to apply sutures to approximate, ligate, or fixate tissue in, for example, open, mini-incision, trans-vaginal, or endoscopic surgical procedures. The suturing instrument includes an elongate body member, a needle exit port, a needle receiving port, and a needle deployment mechanism. The suturing instrument eliminates the need for a preassembled needle and suture and reduces or eliminates the possibility of needle loss during suturing.

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: A surgical suturing device comprises a cartridge having a needle and suture. An elongate shaft has a proximal end and a distal end. An actuator is connected to the proximal end of the elongate shaft. A pair of jaws is connected to the distal end of the elongate shaft. The jaws have a closed position adapted to receive and retain the cartridge, and wherein the jaws are latched in the closed position. The jaws also have a partially opened position adapted to release the cartridge wherein the jaws are biased by a spring from the first opened position towards the closed position. The jaws also have and a fully opened position spaced apart further than the partially opened position, wherein spring does not bias the jaws towards the closed position.

Abstract: A method for applying and maintaining compression with a staple includes piercing a material with deformable ends of staple legs. The legs enter the material until the material applies a pre-set compressive force within a pre-defined compression range to a compression device disposed at least partly between the legs. The compression device has a compression resistor connected to a compression surface. The compression surface is movably disposed with respect to the bridge. Movement of the compression surface towards the bridge is resisted with a force imparted by the compression resistor. The legs are deformed to maintain at least some of the compressive force between the material and the compression device. Forces greater than the pre-set force are absorbed with the compression resistor. The pre-set compressive force to the material is maintained within the pre-defined compression range throughout a state change of the material.

Abstract: A hemostatic agent delivery system includes a hemostatic agent which is inert and non-reactive yet is capable of forming a stable clot when applied to an actively bleeding wound. The system also includes a delivery assembly to structure to facilitate delivery of the hemostatic agent proximate the hemorrhage site. More specifically, the delivery assembly is structured to releasably contain the hemostatic agent via a release member which is disposed in cooperative relation with a support member which contains the amount of the hemostatic agent. The release member is structured of a soluble material such that it will at least partially dissolve and release the hemostatic agent upon disposition proximate the hemorrhage site. The delivery assembly further comprises a handle member structured to facilitate delivery of the hemostatic agent to the hemorrhage site.

Abstract: A cardiac implant system including a cardiac implant such as an annuloplasty ring, a prosthetic heart valve, or a valved conduit pre-assembled at the time of manufacture with devices for securing the implant to a heart valve annulus using knotless suture fasteners. The knotless suture fasteners may be embedded within a pliant sealing edge of the cardiac implant, or they may be positioned adjacent to the sealing edge. The knotless suture fasteners are spring-biased so as to grip onto annulus anchoring sutures pass to therethrough upon removal of a restraining device, such as a hypotube inserted within the suture fasteners. Guide tubes are assembled in line with the suture fasteners to permit introduction of suture snares that pass through the suture fasteners and through the sealing edge to facilitate capture of the pre-installed annulus anchoring sutures.

Abstract: This invention provides hermetically-sealed handle assembly with a rotating trigger for use with disposable components, such as surgical clip appliers. The rotating trigger reduces the gripping force necessary to fully control the internal actuator mechanism to operate a disposable surgical clip applier to fully ligate a vessel or other tissue. The hermetic seal on the handle assembly prevents any patient fluids and other bioburden from entering the internal structures. This reduces the possibility of cross-contamination and the costs of sterilization.