Abstract: A platform device for material excision or removal from vascular structures for either handheld or stereotactic table use may comprise a work element or elements configured to selectively open and close at least one articulable beak or scoopula configured to penetrate and remove intra-vascular materials or obstructions, or follow a central lumen of another device or over a wire in a longitudinal direction. Flush and vacuum tissue transport mechanisms may be incorporated. A single tube or an inner sheath and an outer sheath which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks or scoopulas and provisions for simultaneous beak or scoopula closing under rotation may be incorporated.

Abstract: In an ultrasound cutting device comprising an ultrasound transducer connected to a generator and provided with a sound conductor which is connected to a cutting blade and extends along a line which deviates from a straight line, the generator includes means for running the ultrasound waves in a controlled manner through a predetermined frequency range.

Abstract: Described are embodiments of a multilaminate or multiple layer implantable surgical graft comprising remodelable collagenous sheet material, the graft including one or more interweaving members to stitch together the graft to help prevent the layers from delaminating or separating during handling and the initial stages of remodeling. The interweaving members may comprise lines of suture, thread, individual stitches, strips of material, etc. that are woven through the layers of biomaterial in a desired pattern. In one embodiment, the interweaving members comprise a pharmacologically active substance, such as a drug, growth factors, etc. to elicit a desired biological response in the host tissue. In another embodiment, the graft further comprises a reinforcing material, such as a synthetic mesh, within the layers of remodelable biomaterial and stitched together by one or more interweaving members.

Abstract: A surgical clip applier is provided including a clip pusher bar having a flexible tab and a camming plate configured to effectuate closure of the pair of jaws. The camming plate includes a lost motion portion and the flexible tab is configured to engage the lost motion portion during an initial movement of the clip pusher bar to cause the camming plate to move with the clip pusher bar. The flexible tab is configured to disengage from the lost motion portion during a subsequent movement of the clip pusher bar to allow the clip pusher bar to move relative to the camming plate.

Abstract: Catheter comprising an inner tubular member defining a fluid lumen and inflation lumen therein. An exterior surface of the inner tubular member defines a fluid flow port in fluid communication with the fluid lumen and located along a region of the inner tubular member. Catheter further includes an outer member having a distal section movable relative to the inner tubular member and having an interior surface. A piston balloon is coupled to the inner tubular member distal to the fluid flow port and is in fluid communication with the inflation lumen. A pressure chamber is in fluid communication with the fluid flow port. Fluid introduced through the inflation lumen inflates the piston balloon to seal against the interior surface and fluid introduced through the fluid flow port and into the pressure chamber applies a force to urge at least the distal section of the outer member in a proximal direction.

Abstract: A device for transcatheter gathering of tissue of a heart valve leaflet may include an elongated tube extending in a longitudinal direction and having an open distal end, a tissue securing component disposed at the distal end of the elongated tube, and a capture tool movable in the elongated tube between a retracted position and an extended position. The elongated tube may have an inner surface and a lumen extending therethrough. The tissue securing component may include a clip having a roller and a support element. The roller may be rotatable relative to the support element. The capture tool may be operable to capture tissue of the heart valve leaflet and to draw the captured tissue into the tissue securing component. The tissue securing component may be adapted to be applied to the captured tissue to hold the captured tissue in a gathered configuration.

Abstract: Disclosed is an implantable device (1) to be used in a human and/or animal body for occluding or partially occluding defective openings, hollow spaces, organ tracts, etc. or creating a defined connecting opening between walls, organs, hollow spaces, etc. Said implantable device (1) comprises a support structure which has a great length-to-width ratio along an axis (63) in a first operating state (primary shape) while having a smaller length-to-width ratio along said axis (63) in a second operating state (secondary shape). The support structure is provided with a proximal (20) and a distal section (30) and is formed from a single wire-type element (10) by intercoiling and/or intertwining and/or interweaving like a tissue and/or a cluster and/or a net. Also disclosed is a placing system especially for such an implantable device, comprising an advancing element (5), a directing wire (6,9) and/or an inner mandrin, and at least one holding wire (80,81).

Abstract: A delivery device for a collapsible prosthetic heart valve may include a catheter assembly and an operating handle. The catheter assembly may include an inner shaft around which a compartment is defined, and a distal sheath having proximal and distal segments configured to enclose the compartment. The operating handle may include a first lead screw fixedly coupled to the proximal segment, a second lead screw coupled to the distal segment, a knob rotatable relative to a housing of the operating handle and threadedly engaged with the first lead screw, and a coupling assembly. The coupling assembly may have a first condition in which rotation of the knob in one direction moves the first lead screw but not the second lead screw, and a second condition in which rotation of the knob in the one direction simultaneously moves the first lead screw and the second lead screw.

Abstract: Embodiments of an apparatus include a needle cartridge configured to attach to and interface with an actuating device. The needle cartridge includes a housing, a needle group assembly, and a fluid port. The housing forms a cavity and includes a first aperture and a second aperture opposite the first aperture. The needle group assembly includes a needle and a needle holder. The needle group assembly is configured to move in a reciprocating motion relative to the housing along an axis from the first aperture to the second aperture. During the reciprocating motion, the needle fully retracts into the cavity through the first aperture. The fluid port is integrated with the housing and includes a hollow projection forming a conduit and extending away from the housing. The fluid port includes a third aperture, wherein the fluid port is configured to interface with a fluid delivery system.

Abstract: A hernia patch supporting tissue in-growth conforms to a tissue wall upon surgical installation and fixation within a patient. The hernia patch can include a base and positioning straps. The base is formed of two layers that are affixed to each other around the perimeter of the patch, for example by stitching. A stabilizing washer is provided between the two layers, and the stitch is provided peripherally around the stabilizing washer, keeping the washer free-floating between the layers. The base, positioning straps, and stabilizing washer are formed of a structure that does not separate the layers of the implant or form a space in the form of a pocket, and promotes more uniform and confluent tissue incorporation or in-growth after implantation. The hernia patch may further include a hydrolysable bioabsorbable cross-linked coating of a fatty acid based material, such as an omega-3 fatty acid based material.

Abstract: A loading tool for loading a collapsible prosthetic heart valve into a delivery device may include a body extending in a longitudinal direction between a proximal end and a distal end, an extension on the distal end of the body, and a slot extending through the extension from a free end of the extension toward the distal end of the body. The body may include a lumen extending between the proximal end and the distal end, the body lumen having a first diameter. The extension may have a lumen coaxial with the body lumen, the extension lumen having a second diameter less than the first diameter so as to define a shelf surface between the proximal end of the body and the free end of the extension.

Abstract: Implant tools and techniques for implantation of a medical lead, catheter or other implantable component are provided. The implant tools and techniques are particularly useful in implanting medical electrical leads in extravascular locations, including subcutaneous locations. An example implant tool for implanting a medical lead includes a rod having a handle and a shaft, and a sheath configured to be placed on the shaft of the rod. The sheath includes a body having proximal end and a distal, a channel formed by the body, the channel extending from the proximal end to the distal end of the body, and an opening that extends along the body of the sheath from the proximal end to the distal end, wherein the channel is accessible via the opening.

Abstract: An apparatus includes a body assembly, a shaft defining a longitudinal axis extending from the body assembly, an acoustic waveguide having a flexible portion, and an articulation section coupled with the shaft. A portion of the articulation section encompasses the flexible portion of the waveguide. The articulation section has a first member and a second member translatable relative to the first member. An end effector has an ultrasonic blade that is in communication with the waveguide. An articulating control assembly has a motor. The motor is operable to translate the first and second members to thereby deflect the end effector away from the longitudinal axis at the articulation section.

Abstract: Urethrotome dilators for dilating a urethral stricture, and methods for forming and using the same are disclosed. In some embodiments, the urethrotome dilator includes a first distal end with a dilating head, a second proximal end with a handle, and a stem for connecting the first end to the second end. The dilating head may have a first region, a second region, and a channel for receiving a guidewire. The first region of the dilating head may have a substantially conical surface, with a vertex at its distal end and a base at its proximal end. The second region may have a substantially flat surface and a blade for stretching tissue. The blade may be integrally formed within the second region and may extend from the flat surface. The top edge of the blade may be tapered and blunt, while the two opposing sides of the blade may be formed with sharp corners for cutting tissue.

Abstract: An apparatus includes a staple cartridge including a plurality of staples and a deck defining a plurality of openings. Each opening of the plurality of openings is associated with a corresponding staple of the plurality of staples, such that each staple is configured to pass through a corresponding opening of the plurality of openings. The apparatus further includes a deformable feature configured to be coupled to tissue in response to actuation of the staple cartridge. The deformable feature is configured to retain at least one outer portion of stapled tissue in an inwardly directed position relative to an inner portion of stapled tissue.

Abstract: Methods for deploying a fastener to close an incision or wound involve exposing the inner surface of each opposing side of the incision and inserting down into the exposed inner surfaces from above the fastener.

Abstract: In an interventional medical system, a tethering member of a catheter assembly and a holding member of a relatively compact implantable medical device are configured to interlock with one another. The tethering member includes an elongate shaft portion and a connector portion coupled to a distal end of the shaft portion, wherein the connector portion is configured to pass through a proximal-facing opening of a cavity defined by the device holding member, and to interlock with the holding member within the cavity. The connector portion of the tethering member includes a lumen extending longitudinally therethrough, which has a distal opening in fluid communication with the cavity of the device holding member, when the connector portion interlocks therewith. The catheter assembly further includes an elongate mandrel, which has a distal tip configured to extend within the lumen of the tethering member connector portion, being in sliding engagement therewith.

Abstract: Disclosed herein are gender-specific implantable mesh for inguinal hernia repair in a patient, comprising: a fabric layer comprising a side defining a surface area wherein the fabric layer is configured to enable tissue adhesion to said mesh; an anti-adhesive barrier comprising a shape configured to prevent direct contact between the fabric layer and both a spermatic cord and a genital nerve upon implantation, wherein the shape covers a part of the surface area on the side of the fabric layer, the part being less than 25%, and wherein the shape is oblique to a horizontally-oriented centerline and a vertically-oriented centerline; and a keyhole configured to fit the genital nerve and the spermatic cord of the patient therethrough without constriction, wherein the keyhole is oblique and inferior to a horizontally-oriented centerline and medial to a vertically-oriented centerline.

Abstract: A replacement heart valve locking mechanism may include a buckle member fixedly attached to a tubular anchor member defining a central longitudinal axis, a post member axially translatable relative to the buckle member, and an actuator member releasably connected to the post member at an attachment point. The post member may include a latch portion configured to engage a catch formed in the buckle member such that movement of the post member distally relative to the buckle member is prevented. The attachment point may be disposed proximal of the latch portion. Circumferential translation of the latch portion about the central longitudinal axis may disengage the latch portion from the catch.

Abstract: A deployment device for deploying a self-expanding branched stent graft. The device includes a branched stent graft retained on an introducer. The introducer includes a main catheter and an auxiliary catheter preloaded within the introducer and extending from distal the distal end of the stent graft, into the lumen of the stent graft and through an internal branch in the graft and out of the fenestration.