Abstract: A surgical clip for a clip applier to ligate vessels. The clip contains two opposing legs connected in parallel by an apex to form a U-shape. Each leg has an outer surface with a half-round cross-sectional configuration for minimizing tissue damage by preventing clip scissoring during ligation. Each leg has an inner surface with a flat central surface, two concave grooves on opposing sides of the central surface, and two convex ridges on opposing sides of the each groove. As a vessel is ligated, vessel tissue moves into the concave grooves while remaining frictionally engaged by the compressive forces applied by the central surfaces and convex ridges of each leg so that the clip does not move on the vessel. The edges of the grooves and the edges of the ridges of each leg are rounded to prevent any cutting of the ligated vessel.

Abstract: One exemplary device includes a tubular structure having proximal and distal ends and at least one layer of braided material configured to facilitate thrombosis. The tubular structure includes an end section at the proximal or distal end having a cross-sectional dimension that is larger than that of an opening of the target site. The device also includes a stiffener wire coupled to the tubular structure, and the wire is configured to extend at least partially through the opening and facilitate securing the end section over the opening. The tubular structure and stiffener wire include respective preset, expanded configurations and are configured to be constrained to respective reduced configurations for delivery to the target site and to at least partially return to their respective preset, expanded configurations at the target site when unconstrained.

Abstract: An anastomosis suturing device includes a dismantable casing, a first tubular section having a proximal section encased in the casing and a distal section insertable in a tubular body of a living creature, and a second tubular section having a proximal section encased in the casing and a distal section insertable in a tubular body of the living creature.

Abstract: An implantable medical device such as a filter has a generally conical shape formed by a set of filter legs extending from a free distal end to an apex of the assembly and specifically to a coupling device. A retrieval element such as a hook extends from the hub of. A spacer member is disposed at the hub and is formed of a plurality of curved wire elements. The spacer member has a radius or width smaller than the greatest radius of the filter device, defined by the free ends of the filter legs. The spacer member allows the filter assembly to tilt within a vessel but limits the tilt to a maximum desired or permitted tilt, ensuring that the retrieval device remains spaced from the vessel wall and therefore not subject to tissue ingrowth.

Abstract: A method of treating a heart of a patient is provided. The method includes implanting a first tissue anchor in cardiac tissue of the patient and a second tissue anchor in the patient, such that the first and the second tissue anchors are coupled together by one or more tethers. Thereafter, after allowing at least 24 hours for tissue growth on the first tissue anchor to strengthen anchoring of the first tissue anchor in the cardiac tissue, tension is applied between the first and the second tissue anchors using at least a longitudinal portion of the one or more tethers. Other embodiments are also described.

Abstract: An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the jaws during distal movement and remain connected to the housing of the shaft assembly and in a distally advanced position during an approximation of the jaws.

Abstract: A handle for delivering, from a distal end of a catheter, a stent positioned within a sheath. The handle comprises an upper rack fixed to the handle and an upper distal block moveable along the upper rack and defining a pawl configured to permit only proximal movement in relation to the upper rack, further including an upper proximal block moveable along the upper rack and defining a pawl configured to permit only proximal movement in relation to the upper rack. The handle includes a lower rack configured to slide proximally and, alternatingly, distally in relation to the handle.

Abstract: Provided herein are methods, compositions, and devices for occluding cavities or passageways in a patient, in particular cavities or passageways in the cardiovascular system of a patient, such as the LAA of a patient's heart. The methods, compositions, and devices can be used to percutaneously occlude the LAA, decreasing the risk of thromboembolic events associated with AF.

Abstract: Devices, systems and methods are described herein to provide improved steerability for delivering a prosthesis to a body location, for example, for delivering a replacement mitral valve to a native mitral valve location. The delivery system can include a number of advantageous steering and delivery features, in particular for the transseptal delivery approach.

Abstract: Devices, systems, and methods are provided for managing suture filament during a tissue repair procedure. One exemplary embodiment of an anchor insertion tool includes a handle, an elongate shaft extending distally from the handle, and a ring disposed around the elongate shaft. The ring can be configured to slide along a length of the shaft, and can be configured to engage a filament extending from an anchor removably coupled to the shaft's distal end during a suture anchor insertion procedure. In some embodiments, the ring can include one or more slots for receiving a filament and maintaining a tension applied to the filament. The ring can also include features that prevent it from rotating with respect to the shaft, such as a boss formed on a ring's central opening that engages a slot formed in the shaft. Other devices, systems, and methods for suture anchor insertion are also provided.

Abstract: An instrument for crimping a suture fastener to a surgical suture is disclosed. The instrument has a shaft and an expanded receiving face configured to receive the suture fastener and to provide a smoothing radius for a distal end of the shaft. The instrument also has an anvil in the distal end of the shaft. The instrument further has a hammer in the distal end of the shaft and moveable relative to the anvil for crimping the suture fastener therebetween and received in the expanded receiving face. The instrument also has a pusher moveable in a direction substantially parallel to a longitudinal axis of the shaft and configured to engage at least one of the hammer and the anvil for urging the hammer and the anvil together.

Abstract: A matter elimination catheter includes a catheter body extending from a catheter proximal portion to a catheter distal portion. The catheter body includes an infusion lumen, an aspiration lumen fluidly isolated from the infusion lumen, and a septum interposed between the infusion and aspiration lumens. A drive shaft is within the infusion lumen and is configured to provide rotation near the catheter distal portion. A guide wire lumen is within the drive shaft, and the infusion lumen, the drive shaft and the guide wire lumen are fluidly separated from the aspiration lumen with the septum. In one example, fluid bearings are formed between one or more of the catheter body and drive shaft or the drive shaft and a guide wire or guide wire liner when supplied with infusion fluid through the infusion lumen.

Abstract: A method for performing thorascopic repair of heart valves includes inserting an instrument through the chest cavity and into a heart chamber providing access to a valve needing repair. A movable tip on the shaft is operable to capture a valve leaflet and a needle is operable to penetrate a captured valve leaflet and draw a suture therethrough.

Abstract: A surgical instrument including a reusable and sterilizable hub assembly and a releasably connectable disposable blade assembly allows multiple reuse of the hub assembly in conjunction with single use disposable blade assemblies.

Abstract: A catheter procedure system including a bedside system and a remote workstation is provided. The bedside system includes a catheter including an expandable percutaneous intervention device, a robotic catheter system configured to move the catheter, and an inflation device configured to cause expansion of the expandable percutaneous intervention device. The remote workstation includes a user interface configured to receive a at least first user input and a second user input and a control system operatively coupled to the user interface for remotely controlling both the robotic catheter system and the inflation device. The remote workstation includes a monitor configured to display information related to the expandable percutaneous intervention device.

Abstract: An instrument driver comprises opposing rotatable gripping pads. Each of the gripping pads includes an outer circular rim and a center hub. The pads are configured for applying a gripping force to an elongated member. The instrument driver further comprises shafts affixed to the center hubs, and a driver assembly configured for rotating at least one of the shafts, thereby causing the pads to rotate in opposite directions to linearly translate the gripped member. Each of the pads further includes a framework for partially collapsing in response to the gripping force, such that portions of the rims flatten to contact each other. Each rim has a concave gripping surface in order to facilitate vertical centering of the member between the pads. Each of the pads further includes a pair of upper and lower sprockets for interlacing with each other to prevent the elongated member from slipping out between the pads.

Abstract: An occlusion apparatus has a plastic ring with an opening at one point, encased in silicone, with a central opening of a first inside diameter, a silicone bladder in the circular, central opening, providing a hollow, semi-circular silicone ring, a mixture of sodium and potassium salts and polyacrylamide granules at a specific ration of materials enclosed in the silicone bladder, and two stirrups, one affixed on one side and the other opposite the first. The stirrups and the opening provide for spreading the apparatus by the stirrups to place the apparatus over a blood vessel, releasing the apparatus enclosing the blood vessel in the second inside diameter of the bladder, and wherein water passing through walls of the silicone bladder forms a hygroscopic gel that expands over time with further absorption of water, closing the second inside diameter of the silicone bladder, slowly occluding the blood vessel.

Abstract: A medical instrument includes: a rod including a curving portion formed on a distal side of an extension along a longitudinal axis and curved with respect to the longitudinal axis; and a sheath including an inner peripheral surface and a cutout, the cutout formed in at least one of a distal portion and a proximal portion of the sheath, the sheath configured to insert the rod along a central axis extending and defined from the distal portion to the proximal portion and to protrude the curving portion from an opening of the inner peripheral surface in the distal portion.

Abstract: A suture anchor for knotless fixation of tissue. A swivel suture anchor has an anchor tip for receiving a suture strand, for surgical tissue repair without requiring suture knots. Tension on the repair constructs is adjustable. The swivel anchor is secured in a hole in bone by advancing a fixation device, such as a cannulated interference screw, over the body of the anchor.

Abstract: A method for closing a puncture in a vessel wall of a blood vessel that includes advancing a guide member into proximity with a puncture in a vessel wall, positioning a distal end of an angle adjustment member distal to openings of the guide member, deploying the needle guides from the guide member through the openings, advancing the deflected needle guides and the suture securing devices through the vessel wall, retracting the needle guides to release the suture securing devices distally of the vessel wall, and establishing tension in the sutures to move the suture securing devices toward each other to thereby close the puncture.