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: An endoscopic cutting device is disclosed. The device comprises an inner catheter including an inner wall having an opening formed therethrough. The inner wall further has a cutting blade moveably disposed thereon and biasingly extends through the opening. The inner wall has a receiving member disposed thereon and is configured to cooperatively receive the cutting blade. The device further comprises an outer catheter including an outer wall moveably disposed about the inner catheter. The outer wall has an aperture formed therethrough. The aperture is configured to moveably align with the opening of the inner wall for allowing the cutting blade to biasingly extend through the opening and biasingly engage the cutting blade with the receiving member to cut.

Abstract: A prosthesis, introducer device and a method for repair of an aortic aneurysm which is positioned at least partially in the ascending aorta (62). The prosthesis (3) has a proximal end (15) and a distal end (5) and is formed from a biocompatible material, the proximal end is adapted to be surgically fastened adjacent and around the aortic heart valve (60) of a patient and the distal end is adapted to extend into the descending aorta (66). The distal end has a distally extending exposed self-expanding stent (9). The introducer device can be deployed through an incision (75) in the thoracic arch (64) and extend down the descending aorta to place the distal end of the prosthesis first and then removed so that the proximal end of the prosthesis can be sutured in place around the aortic heart valve (60).

Abstract: A surgical instrument particularly suited to endoscopic and laparoscopic insertion through a cannula of a trocar into an insufflated body cavity or lumen includes a bending member in an elongate shaft that acts to rotate an end effector about an articulation pivot joint. A proximally directed camming surface (e.g., gear segment, cam recess) aft of a pivotal attachment of the end effector to a proximal frame ground of the elongate shaft interacts with a bending member whose proximal end is ground to the proximal frame ground. Differential fluidic actuators or mechanical cam bars deflect a distal end (e.g., rack, cam point) of the bending member to effect articulation. Thereby, the end effector may act upon tissue that would otherwise be obscured, such as behind an organ. The articulated end effector also advantageously allows an endoscope to be positioned behind the end effector without being blocked by the instrument shaft.

Abstract: A flexible medical closure screen for closing a separation of first and second tissue portions is provided, which includes a mesh screen comprising tubular vertical risers, vertical strands with barbed filaments, and horizontal spacers connecting the risers and strands in a grid-like configuration. An optional perimeter member partly surrounds the screen and can comprise a perimeter tube fluidically coupled with the vertical risers to form a tubing assembly. Various input/output devices can optionally be connected to the perimeter tube ends for irrigating and/or draining the separation according to methodologies of the present invention. Separation closure, irrigation and drainage methodologies are disclosed utilizing various combinations of closure screens, tubing, sutures, fluid transfer elements and gradient force sources. The use of mechanical forces associated with barbed strands for repositionably securing separated tissues together is disclosed.

Abstract: A medical closure screen device for a separation of first and second tissue portions is provided, which includes a mesh screen comprising tubular vertical risers, vertical strands with barbed filaments, and horizontal spacers connecting the risers and strands in a grid-like configuration. An optional perimeter member partly surrounds the screen and can comprise a perimeter tube fluidically coupled with the vertical risers to form a tubing assembly. Various input/output devices can optionally be connected to the perimeter tube ends for irrigating and/or draining the separation according to methodologies of the present invention. Separation closure, irrigation and drainage methodologies are disclosed utilizing various combinations of closure screens, tubing, sutures, fluid transfer elements and gradient force sources. The use of mechanical forces associated with barbed strands for repositionably securing separated tissues together is disclosed.

Abstract: A medical device comprises a catheter, a retractable sheath, and a rolling membrane. The catheter includes a catheter shaft about which a stent in a reduced diameter configuration may be disposed. A stent retaining region of the sheath is disposed about the stent to retain the stent in the reduced diameter state prior to delivery. The rolling membrane is engaged to a portion of the sheath at an engagement region. The rolling membrane is positioned between the catheter shaft and the sheath and prior to retraction of the sheath the rolling membrane is disposed about at least a proximal section of the stent and is rollingly retracted therefrom when the sheath is retracted to deliver the stent.

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.