Abstract: Embodiments of the present disclosure provide a delivery apparatus for a prosthetic heart valve. Disclosed delivery apparatuses can include a housing, a steerable shaft, a slide nut, and a threaded shaft disposed over the slide nut. The slide nut can have an external threaded surface and an internal surface comprising a slot. The threaded shaft can have an internal threaded surface engaging the external threaded surface of the slide nut. The delivery apparatus can further include an elongated nut guide extending into the slot of the nut to restrain the slide nut against rotation relative to the housing, and a pull wire having a proximal end portion extending into the housing and coupled to the slide nut, and a distal end portion coupled to a distal end portion of the steerable shaft. The threaded shaft can be rotatable relative to the housing to produce axial movement of the slide nut within the threaded shaft.

Abstract: An assembly for collapsing a prosthetic heart valve includes a compression member having a plurality of arms pivotable between a first orientation in which side edges of adjacent arms are spaced apart from one another and a second orientation in which the adjacent arms contact one another. A translating member is movable along the arms to pivot the arms from the first orientation to the second orientation to collapse the prosthetic heart valve. A separation tool includes ribs defining channels sized to receive the struts of a stent of a prosthetic heart valve to keep the struts separated from one another as the prosthetic heart valve is collapsed.

Abstract: A system and method for installing/implanting a leadless implant can include a leadless implant with shortened tine-based anchors and an implantation tool with a modified tip. The tines can extend from a surface of the leadless implant and may include a preformed curve or other shape to enable the tine to hook into or grapple tissue. The implantation tool may be provided with a modified tip to assist with proper alignment, insertion, and anchoring of the shortened tines. A tip of the implantation tool can have a reduced inner diameter to cause the tine tips to be approximately normal to the surface of the tissue to which the implant is being anchored. Upon deployment of the leadless implant, the tines of the anchoring mechanism are appropriately aligned for proper insertion so that robust anchoring is achieved.

Abstract: Extravascular implant tools that utilize a bore-in mechanism to safely access extravascular locations and implant techniques utilizing these tools are described. The bore-in mechanism may include a handle and a helix extending from the handle. The bore-in mechanism is used, for example, in conjunction with a tunneling tool to traverse the diaphragmatic attachments to access a substernal location. The tunneling tool may be an open channel tunneling tool or a conventional tunneling tool (e.g., metal rod).

Abstract: Described herein is a suture for connecting a human or animal tissue comprising a suture strand, wherein at least two protrusions are provided on the suture strand, the protrusions are provided spaced apart from each other along the suture strand. Also described herein is a soft anchor, the soft anchor having a proximal end and a distal end in an insertion direction. At the proximal end and the distal end the soft anchor includes respectively at least one opening for a suture. The proximal end and the distal end of the soft anchor are connected with at least one, in particular two, connecting portions. The soft anchor has a first state, in which it is adapted to be inserted into a bore in the insertion direction, and a second state, in which it is locked in a bore. In the first state, the distal end and the proximal end defines the extension of the soft anchor in insertion direction.

Abstract: Systems, devices and methods for removing a blood clot (10) from a blood vessel (12). Various uses of suction pressure and positive pressure, proximal and/or distal to the blood clot (10) assist with clot dislodgement and removal. The pressure(s) may be constant and/or cycled/pulsed to assist with clot dislodgement and/or removal. Various further devices assist with separating the clot (10) from the vessel (12).

Abstract: Devices, methods, and systems for prosthesis delivery to patient vasculature are provided. A prosthesis delivery device provided herein delivers a prosthesis to the vasculature of a patient and permits an operator to deploy the prosthesis using a single action mechanism to deploy the prosthesis at a standard deployment rate and a dual action mechanism to deploy the prosthesis at an accelerated deployment rate. Deploying the prosthesis at an accelerated deployment rate results in alterations to the deployed prosthesis structure because the prosthesis is deployed with increased axial compression that results in the prosthesis having increased radial force.

Abstract: Treatment of an aneurysm or other vascular defect can be facilitated or enhanced by an implant delivered with a thermally activated detachment system. A delivery system can include an implant with a proximal portion that defines a port. A pusher device can include arms extending distally from a junction of the pusher device and through the port, with distal sections of the arms disposed within the implant. The arms can, at a certain temperature, transition from engagement with the implant to a shape that facilitates release of the implant. Additionally or alternatively, a coil can engage an outer surface of the implant at the proximal portion and transition to a shape that facilitates release of the implant.

Abstract: Improved medical suturing devices, systems, and methods for loading a needle in a suturing device, particularly standard surgical needles. An exemplary device includes a body having one or more clamps for grasping a needle and a needle loader supporting the needle in a delivery position suitable for advancing through a minimally invasive aperture and a needle loading position suitable for grasping with a clamp of the device. Preferably, the needle loader includes an elongate body having a rotatable needle holding member and is releasably coupleable with the device body such that the needle is moveable between positions from a proximal portion of the device. Methods includes selecting a standard surgical needle, advancing the needle loader device into a body of a patient, and moving the needle to a needle loading position for grasping and suturing with one or more clamps of the device.

Abstract: A valve prosthesis, an implantation device, and methods for use are provided. The devices described herein may be used for transcatheter delivery of an aortic valve prosthesis or transapical delivery of a mitral valve prosthesis. The implantation device can utilize movable claspers for both positioning and anchoring the valve prosthesis, reducing the extent of imaging needed during the implantation procedure.

Abstract: A stent delivery device includes a sheath covering a compressed stent and a housing. The housing includes a mover reel coupled to an actuator that rotates the mover reel in a winding direction when actuated. A sheath pull wire is coupled to the mover reel and the sheath. Rotation of the mover reel in the winding direction winds the sheath pull wire on the mover reel and moves the sheath in a proximal direction. A pre-mover is provided separate from the actuator, the pre-mover including an arm having a proximal end engaged with the mover reel to prevent rotation in the locked position. The pre-mover includes a pre-mover actuator coupled to the arm and having a portion projecting outside of the housing, wherein movement of the pre-mover actuator disengages the arm from the mover reel and rotates the mover reel a predetermined amount in the winding direction.

Abstract: An endoscopic surgical clip applier is provided, wherein a distal end of the surgical clip applier is introduced to a target surgical site through a cannula having a fixed diameter lumen. The surgical clip applier comprises an endoscopic portion supported by and extending from a handle assembly, and a pair of jaws supported at a distal end of an outer tube, wherein the pair of jaws are movable between a fully open condition and approximated conditions. When the pair of jaws are in the fully open condition the pair of jaws extend radially beyond an outer diameter of the outer tube to a dimension greater than the fixed diameter of the lumen of the cannula; and when the pair of jaws are in at least one approximated condition the pair of jaws have a transverse dimension permitting passage through the lumen of the cannula.

Abstract: A braided stent having an integral retrieval and/or repositioning loop includes a plurality of wires having first and second ends interbraided in a braided pattern to form a tubular stent having opposed atraumatic first and second open ends with each open end having a circumference; wherein said first and second wires ends are disposed at said second stent open end and said wires are looped at said second stent open end so that none of the first or second wires ends are exposed at the circumference of second stent open end; wherein at least of two of said wires are formed into a repositioning and/or retrieval loop having an elongated portion circumferentially disposed at said first opposed open end; and wherein said reposition and/or retrieval loop comprises two sections which run adjacent to each other prior to crossing to permit grabbing of both sections simultaneously by a practitioner.

Abstract: The present invention relates to an adjustable trajectory guide having a guide portion adapted to hold or provide a guiding for a medical instrument along a defined trajectory, and at least one adjustment section comprising: at least one elongated flexible beam member connected at its first end to the guide portion, and having at its second end a first engagement interface adapted to provide a connection to a support structure holding the trajectory guide; at least one second engagement interface which is movable relative to the at least one beam member and which is adapted to provide a connection to an actuator, at least one coupling member coupling the first end of the beam member to the second engagement interface, wherein the coupling member is capable of transmitting force and/or torque from the second engagement interface to the first end of the beam member.

Abstract: A portable therapeutic massage mat includes a base and a plurality of protrusions extending from the base. The protrusions may have a square pyramidal shape or other suitable shapes. The plurality of protrusions, the base, or the entire massage mat may be formed of a material that includes at least one thermochromic pigment. The material that includes the thermochromic pigment may be a thermoplastic elastomer. When a user sits or rests upon the portable massage mat for a time, local blood flow increases causing a rise in local body temperature which is exhibited by a color change of the portable massage mat, due to the thermochromic pigment. The increased local blood flow provides beneficial therapeutic effects such as reducing the appearance of cellulite, relieving minor aches and pain, and relieving minor muscle spasms.

Abstract: A system for treating a bifurcation includes first and second delivery catheters. The first catheter has a first shaft, a first expandable member adjacent the distal end of the first shaft, an auxiliary expandable member disposed under the first expandable member, and a first radially expandable stent disposed over both the first expandable member and the auxiliary expandable member. The second delivery catheter has a second shaft, and a second expandable member adjacent the distal end of the second shaft. A portion of the second catheter is disposed under a portion of the first stent, and a portion of the second delivery catheter passes through a side hole in the first stent. The first stent is crimped over the first and second catheters such that the first stent remains attached to the first and the second catheters during advancement of the catheters through a blood vessel.

Abstract: An inflation device includes a syringe body containing a bore. The bore holds a fluid that is used to inflate a separate device such as a dilation balloon. A plunger assembly slides within the syringe bore and contains a sealing member that forms a fluid tight seal with the syringe body. A shut-off valve is disposed within the distal end of the syringe body. The distal end of the syringe body has a fluid bypass channel fluidically coupled to the aperture of a connector. The shut-off valve has a spring-biased moveable piston with a bypass lumen contained therein, wherein the bypass lumen forms a fluid path between the bore and the fluid bypass channel when the pressure of the fluid is below a threshold value. The fluid path between the bore and the fluid bypass channel is interrupted when the pressure of the fluid is above the threshold value.

Abstract: Disclosed are systems and methods for performing soft tissue repair by delivering a suture through the soft tissue and underlying bone at two or more fixation points that can be spaced apart from each other and connected by the suture on the surface of the soft tissue. The two or more fixation points and the suture connected there between can be a continuous strand of suture, which can form a stitching assembly that can provide sufficient fixation in the bone and minimize disruption to the soft tissue and bone. In an example, the suture can be delivered into the bone using one or more implants that can catch the suture to drive the suture through the tissue and into the bone. The one or more implants can include structural features to aid in securing the suture to the implant. In an example, the suture can include structural features or be formed of a material to aid in fixation of the suture in the bone.

Abstract: Assemblies, devices and methods are provided for suture management associated with surgical procedures for anchoring suture to bone. Suture elements mounted to suture anchors are terminated in suture loops or tags, and associated stop members that in combination with visual coding provide suture identification, prevent accidental unmounting of suture from suture anchors, and reduce the number of suture legs requiring active management during complex arthroscopic repairs. The present invention also provides exemplary drivers that can be used with the various methods and devices disclosed herein, or with other methods and devices known in the art.

Abstract: This invention presents a non-pneumatic tourniquet device designed for quick, easy application to an injured digit, such as a finger or a toe. One preferred embodiment comprises a frame, which is affixed to a flexible layer or membrane, and allows for an opening for the insertion of the injured digit through the device. This easy to use apparatus temporarily checks the bleeding or blood flow by applying an external pressure or a compression to the blood vessels in an appendage and also allows for exsanguination of the injured area.