Abstract: A valvuloplasty balloon assembly includes a balloon (50) provided with end shoulders (64, 66) preferably integral with end cones (54, 56) of the balloon (50). The end shoulders (64, 66) provide a substantially perpendicular stop shoulder (68) at either end of the cylindrical portion (52) of the balloon (50). The restraining shoulders (64, 66) act to hold the balloon (50) within a valve (16) of a heart (10), for instance. This prevents unwanted slippage of the balloon (50) during a valvuloplasty procedure and thus prevents possible damage caused as a result of such slippage.

Abstract: A method and apparatus for functionally occluding the lumen of the left atrial appendage (LAA) is provided. Access to the LAA is through an epicardial approach. The devices function to capture the LAA through various non-invasive means. After capturing the LAA with the devices and methods provided, a clamping device is preferably disposed about the base of the appendage. In certain embodiments, the appendage remains viable subsequent to the functional occlusion of the lumen.

Abstract: Apparatus (100) for performing a surgical anastomosis include a tubular body (102) having an expandable anchor (114) operatively coupled near a distal end thereof. The apparatus further includes a sleeve (104) slidably received about the tubular body. The sleeve has an expandable anchor operatively coupled near a distal end thereof. The expandable anchor of the tubular body has an annular (116) ring concentric with a longitudinal axis defined by the tubular body.

Abstract: Methods and apparatus for sealing a puncture or incision formed percutaneously in tissue separating two internal portions of the body of a living being with an anchor, a sealing plug and a filament connecting the anchor and sealing plug are disclosed. The methods and apparatus provide for automatic tamping of the sealing plug. In addition, torque required to tamp the sealing plug is automatically sensed and gear ratios of an automatic tamping device are automatically changed in response to sensed changes in torque. A planetary transmission may be used to automatically change gear ratios in response to the changes in torque.

Abstract: In one aspect, the present invention relates to a surgical instrument for providing an access to a target of interest of a living subject. In one embodiment, the surgical instrument has a bearing member, a shaft member and a probe. The bearing member has a first end portion, an opposite, second end portion, a body portion defined therebetween having a longitudinal axis, and a shoulder portion extending from the second end portion. The body portion defines a bore therein along the longitudinal axis. The shoulder portion defines a passage substantially coaxial with and in communication with the bore. The shaft member has an first end portion and an opposite, second end portion, and is slidably received in the bore of the bearing member. The shaft member defines a space extending from the first end portion to the second end portion.

Abstract: An embodiment of the invention provides a prosthesis delivery system comprising a delivery catheter having an expandable member and a prosthesis carried over the expandable member. The prosthesis includes a radially expandable scaffold section and at least two anchors extending axially from an end thereof; and means for capturing at least the anchors to prevent the anchors from divaricating from the expandable member as the catheter is advanced through a patient's vasculature.

Abstract: Methods and devices provide for temporary partial aortic occlusion to achieve diversion of blood flow to the brain in patients suffering from cerebral ischemia. The device can include an expandable frame with a membrane mounted on a first portion of the frame. The membrane can have at least one opening. In some embodiments, the membrane has an outer region and an inner region, and an opening in the inner region. In use, the frame can expand to conform to the inner walls of the aorta and the membrane can at least partially occlude the aorta thereby increasing cerebral perfusion. The frame can include one or more anchors to aid in maintaining the device in position against the arterial blood flow pressure.

Abstract: Devices and methods generally provide enhanced stabilization, exposure and/or treatment of a cardiac valve annulus. Methods generally involve introducing a stabilizing member beneath one or more leaflets of a heart valve to engage the annulus at an intersection between the leaflets and the interior ventricular wall of the heart. Force is then applied to the stabilizing member to stabilize and/or expose the valve annulus. In some embodiments, the stabilizing member may include a series of hydraulically driven tethered anchors, such as hooks or clips, for engaging and cinching valve annulus tissue to decrease the diameter of a regurgitant valve. Alternatively, other treatments may be delivered by a stabilizing member, such as radiofrequency energy, drugs, bulking agents or shape memory stents. A second stabilizing member may also be introduced above the leaflets for further stabilization.

Abstract: Apparatus and methods are provided comprising an implantable non-hydraulic ring that encircles and provides a controllable degree of constriction to an organ or duct and an external control that powers and controls operation of the ring. The ring includes a rigid dorsal periphery that maintains a constant exterior diameter, and a compliant constriction system that reduces intolerance phenomena. A high precision, energy efficient mechanical actuator is employed that is telemetrically powered and controlled, and maintains the ring at a selected diameter when the device is unpowered, even for extended periods. The actuator provides a reversible degree of constriction of the organ or duct, which is readily ascertainable without the need for radiographic imaging. Methods of use and implantation also are provided.

Abstract: A robotic catheter system includes a housing and a drive assembly. The drive assembly is supported by the housing and configured to impart movement to a catheter device and includes a first channel configured to receive the catheter device. The robotic catheter system includes at least one magnet positioned adjacent to the first channel to allow the magnet to interact with the catheter device to assist in the retention of the catheter device within the first channel.

Abstract: Devices and methods used in termination of a tissue tightening procedure are described. Termination includes the cinching of a tether to tighten the tissue, locking the tether to maintain tension, and cutting excess tether. In procedures involving anchors secured to the tissue, the tether is coupled to the anchors and the tissue is tightened via tension applied to the anchors by cinching the tether. In general, the devices and methods can be used in minimally invasive surgical procedures, and can be applied through small incisions or intravascularly. A method for tightening tissue by fixedly coupling a first anchor to a tether and slidably coupling a second anchor to the tether, securing both anchors to the tissue, applying tension to the tether intravascularly, fixedly coupling the tether to the second anchor, and cutting the tether is described. The tissue to be tightened can comprise heart tissue, in particular heart valve annulus tissue.

Abstract: A solution is provided to release a tissue cinching loop within a body having a first thread having a first end and a second end, and a second thread having a first half having a first tip, a second half having a second tip, a bottom half having a link, and a top half, wherein the first end is inserted through the link. A first knot is formed around the first thread with the top half thereby forming a loop where the diameter of the loop decreases as the knot is pushed into the body and the first thread is pulled out of the body and where the loop is released within the body when the first end is pulled out of the body.

Abstract: Intraocular implants and delivery instruments are disclosed for treating ophthalmic conditions and ocular disorders, such as glaucoma. The implants are configured to extend between the anterior chamber of the eye and a fluid outflow path or physiologic outflow pathway, such as Schlemm's canal, of the eye for enhancing outflow of aqueous from the anterior chamber so as to reduce intraocular pressure. The implants can have features for anchoring the implant into Schlemm's canal as well as preventing the walls of Schlemm's canal from closing the outlet of the implants. The delivery instruments can be steerable so as to make implantation easier. Additionally, the instruments can be configured to hold a plurality of implants so that multiple implants can be implanted through one incision without removing the instrument from the incision between serial implantations.

Abstract: A biodegradable intralumenal device that is capable of drug delivery. The device has circular hoops connected by one or more flexible links defining a substantially cylindrical configuration capable of having a closed configuration and an open configuration. Each hoop mateably connects with or interlocks with an adjacent hoop in the open configuration in order to retain this configuration subsequent to delivery of the device.

Abstract: A surgical gripper includes a gripping section opened/closed to grip an object to be gripped and an operation section which opens/closes the gripping section, wherein the gripping section is configured to be opened/closed by the operation section to take a gripping mode of gripping the object to be gripped so that treatment is performed by the object to be gripped, an adjusting mode of gripping the object to be gripped by a gripping force lower than that of the gripping mode so that an arrangement of the object to be gripped is adjusted while the object to be gripped is held, and a releasing mode of releasing the object to be gripped.

Abstract: A system for treating a septal defect having a suture-like implantable treatment apparatus and devices for delivering the implantable treatment apparatus and methods for treating a septal defect are provided. The suture-like apparatus is preferably implantable through a septal wall or portion thereof. The treatment system can include a flexible elongate body member, a delivery device configured to deliver the suture-like apparatus, a stabilization device configured to stabilize the delivery device and a positioning device configured to position the delivery device in a desired location. The suture-like device can include a suture body coupled with one or more lock devices or anchor devices.

Abstract: A catheter assembly for deployment in a vessel includes a catheter shaft extending from a proximal end portion to a distal end portion. A balloon is operatively coupled to the distal end portion of the catheter shaft. At least one cutting member is coupled to the catheter assembly. As the balloon is inflated, the cutting member is moved to a position to cut a portion of the vessel.

Abstract: A detachable introducer and method of using such introducer is disclosed for inserting an embolic coil deployment system into the tortuous vasculature of the human brain for placing an embolic coil within an aneurysm. The introducer includes a sheath having a lumen, a side opening and a longitudinal slit. A deployment catheter with a conical expander member is slideably disposed through the side opening of the sheath and through the lumen of the sheath. The conical expander member detaches the introducer from the deployment catheter through the longitudinal slit of the sheath.

Abstract: Methods for enhancing the lubricity of implant delivery devices are provided. The present methods of enhancing the lubricity of an intraocular lens inserter reduce the force required to express an intraocular lens therefrom. By reducing the force required to express an intraocular lens from an inserter, intraocular lens delivery is improved.

Abstract: A flexible stent having a waveform pattern formed from a sheet of biocompatible material and into a tubular shape for maintaining the patency of a lumen such as in a coronary vessel. The waveform pattern of the stent is formed from a flat sheet of malleable, biocompatible material by, for example, photochemically etching the sheet biocompatible material and leaving a framework or plurality of closed cells. The waveform pattern is formed into a tubular shape around a deflated, delivery catheter balloon with segments of the closed cells being interposed only overlapping a reinforcing member extending longitudinally along the stent. The stent material is treated to reduce the coefficient of friction of the material and to aid in the radial expansion of the stent with the balloon. Radiopaque markers are positioned at the ends of the stent to aid the physician in positioning the stent at an occlusion site.