Abstract: A set of devices and associated methodology for percutaneously closing a puncture through the wall of an artery. The method includes inserting a guide wire through a percutaneous entry and into the artery; using the guide wire to guide an insertion of an introducer catheter into the artery; inserting a balloon catheter through the introducer catheter and into the artery; obtaining a tube having a clamp configured to selectively clamp to the introducer catheter; loading the tube with a plurality of fasteners, each fastener individually tethered to a suture; clamping the tube loaded with fasteners onto the introducer catheter, thereby aligning the puncture with a distal working end of the tube; ejecting two or more of the fasteners from the tube to attach onto the artery; percutaneously tying together the tethered sutures of the attached fasteners to draw the attached fasteners together, closing the puncture.

Abstract: A closure system for delivering a sealant to an arteriotomy. A distal section of the closure system can include overlapping inner and outer sleeves that can expand with expansion of the sealant. A proximal section of the closure system can include a handle portion and a sheath adapter extending from the handle portion. The handle portion can comprise one or more actuators that when depressed or engaged can assist in deployment of the sealant in the arteriotomy and can further include tamping of the sealant and/or retraction of an expandable member. The sheath adapter can removably engage a side port or an irrigation line of a standard procedural sheath. When the sheath adapter is secured to the procedural sheath, movement of the closure system can also move the procedural sheath.

Abstract: The present invention provides a prosthetic heart valve device that has a frame, and a leaflet assembly having a plurality of leaflets that are secured to the frame. The frame is defined by an annular body and has three spaced-apart commissure regions, each commissure region having a commissure post extending from a proximal outflow end of the frame. A first clipping arm and a second clipping arm extend from opposite sides of each commissure post, each clipping arm extending from each commissure post at an obtuse angle with respect to each commissure post. Each clipping arm has a free end with a tip provided at the free end. The body has a first diameter at a location where the tips of the clipping arms are located, and the tips of the clipping arms extend away from define a second diameter, with the second diameter being greater than or equal to the first diameter.

Abstract: Disclosed is a covered stent (100), including a hollow tubular main body (10), and a window (20) provided on a side wall of the tubular main body (10). An elastic supporting member (30) is provided at a periphery of the window (20); an imaging member (40) is provided on the elastic supporting member (30); and at least part of the imaging member (40) is movably connected to the elastic supporting member (30). Since the imaging member (40) and the elastic supporting member (30) are located at the periphery of the window (20), the imaging member (40) and the elastic supporting member (30) enable the periphery of the window (20) to simultaneously have a good imaging performance and a good supporting performance.

Abstract: A surgical clamp for aligning the margins of incised or wounded tissue has jaws with parallel clamping faces, and a handle for manipulating the clamp to align the margins of the tissue. The jaws are in a normally closed position, however they can be opened by compressing the handle to open the jaws. Prongs project from the inferior surface of the jaws. The clamp is positioned in a desired position over the margins of a wound to be closed, the prongs engage the margins of the wound to be aligned, and the jaws are closed by releasing compressive force on the handle. As the jaws close the prongs help move the tissue into alignment. Suture guide slots through the jaws assist in the placement of precisely placed sutures across the incision. The disclosed surgical clamp is particularly suited for selectively closing and reopening surgical incisions, such as a sclerotomy incision in the eye. Methods are disclosed for using the clamp during intraocular and other surgical or minimally invasive procedures.

Abstract: A tourniquet device includes a first jaw having a first tapered tip, and a second jaw having a second tapered tip. The first and second jaws are moveable towards one another to provide a pressure to a member positioned between the jaws. The first tapered tip is offset from the second tapered tip such that the first tapered tip and the second tapered tip are moveable relative to one another in separate planes and the first tapered tip is moveable past the second tapered tip as the first and second jaws are moved towards one another.

Abstract: A suture having a first end for penetrating tissue, an elongated suture body having a periphery; a plurality of retainers on the periphery, and a second end having a variable loop of variable circumference, wherein the variable loop includes a fixed loop slidably engaging the elongated body for slidingly varying the circumference of the variable loop, and wherein the first end may pass through the variable loop to secure tissue as an anchor, the anchor preventing movement of the suture in the direction of deployment of the first end.

Abstract: A sizing tool for use in implanting a composite valved conduit having a prosthetic heart valve on a distal end attached to a conduit graft that extends to a proximal end. The tool includes a proximal handle and a distal shaft, a prosthetic heart valve sizer having an axis affixed to a distal end of the shaft, and a conduit graft replica having an axis mounted on the shaft proximal to the heart valve sizer. A method of securing a composite valved conduit includes introducing to an excised ascending aorta the sizing tool, measuring the aortic annulus with the prosthetic heart valve sizer, and determining whether the coronary arteries have sufficient length or whether an additional tubular coronary extension segment is required to add to one or both of the ends of the coronary arteries by extending the coronary arteries toward the conduit graft replica.

Abstract: A system for treating tissue includes an applicator having a bushing and a control member and a clip assembly having a capsule with a channel extending therethrough. The channel includes proximal and distal portions. The distal portion extends distally from the proximal portion and flaring outward in a single plane to form opposing flared sections. The assembly also includes clip aims include proximal ends slidably received within the channel to move the arms between tissue receiving and tissue clipping configurations. The assembly further includes a yoke including a distal portion connected to the arms and a proximal portion configured to be connected to the control member so that longitudinal movement of the control member relative to the capsule moves the arms between the tissue receiving and clipping configurations. The yoke is positioned in the capsule so that the yoke is deformable in the plane in which the capsule flares outward.

Abstract: The present invention relates to methods of repairing an inguinal hernia defect including . . . a first portion forming a partial spherical cap surface shaped and dimensioned . . . a second portion extending from an inferior edge of the first portion . . . characterized in that the piece further includes: a third portion forming an arched part extending longitudinally in the inferior direction from a medial inferior corner of the first portion, the arched part extending radially substantially in the front direction, the third portion being intended to face the medial inferior area of the inguinal anatomy, and introducing the prosthesis into a patient.

Abstract: A device for cardiac surgery is disclosed, having a) a plurality of pairs of suture guides spaced about the frame; b) a plurality of suture tubes, with one suture tube corresponding to each pair of suture guides; c) a plurality of snares, each corresponding to and passed through one of the plurality of suture tubes so that a handle at one end of the snare protrudes from a proximal end of the corresponding suture tube and a snare loop at another end of the snare protrudes through a distal end of the corresponding suture tube, and wherein the snare loop further protrudes through one of the suture guides in the corresponding pair of suture guides; and d) a plurality of sutures, each corresponding to one of the pairs of suture guides and coupled to the suture guide in the corresponding pair of suture guides which does not have the snare loop passing through it.

Abstract: A surgical device for suturing a body lumen is described, as well as methods for suturing tissue employing the surgical device. The device can include a body having a shaft and a foot for insertion into an opening in the body lumen. The device can include tissue ports between the shaft and the foot configured to receive tissue surrounding the opening in the body lumen. The foot can include a suture secured to needle capture devices. The device can include needles that can be advanced through tissue and into the needle capture devices. The needle capture devices can then be withdrawn, thereby harvesting the suture, which can then be used to close the opening in the body lumen.

Abstract: A tissue guard includes a body defining an open proximal end, an open distal end, and a lumen extending through the body between the open proximal end and the open distal end. A lip extends radially outwardly from the open proximal end of the body, the lip including a finger extending from an exterior peripheral surface thereof. The finger includes a flange at a distal end thereof adapted to operably engage an underside of a proximal ring of an access device to secure the tissue guard therein.

Abstract: Self-rolling mechanical apparatuses for removing material from a body lumen include a tractor tube portion that rolls and inverts over itself in a continuous motion, tractor-like, to draw material into the tractor tube, wherein the tractor tube rolls over itself without requiring any additional internal support at the distal-facing region of the tractor tube.

Abstract: An end effector for use and connection to a robot arm of a robotic surgical system, wherein the end effector is controlled and/or articulated by at least one cable extending from a respective motor of a control device of the robot surgical system, is provided. The end effector includes a wrist assembly, and a jaw assembly. The jaw assembly includes a cam pulley rotatably supported on at least one support plate of the jaw assembly, wherein the cam pulley is operatively connected to a proximal end of each of the jaws of the jaw assembly such that rotation of the cam pulley results in one of an opening and closing of the jaw assembly.

Abstract: A clip applier assembly may include a surgical clip and a clip applier. The surgical clip may include first and second leg members configured to ligate tissue. The first leg member may include a first proximal portion, a first distal portion, a first inner surface, and a first outer surface. The first outer surface may have a convex curvature. The second leg member may include a second proximal portion, a second distal portion, a second inner surface, and a second outer surface. The second leg member may further include an inner portion and an outer portion separated by a channel. The second outer surface may be formed on the outer portion and have a convex curvature. The clip applier may have a first jaw member configured to engage the first outer surface and a second jaw member configured to engage the second outer surface.

Abstract: A medical device for removing an intravascular thrombus includes: a rotatable tubular driving shaft in which a spiral-shaped carrier is provided on an inner surface thereof; a cutting part that is provided on a distal side of the driving shaft and cuts the thrombus; and an elongated resistive body that is disposed in a lumen of the driving shaft and can be rotated relative to the driving shaft.

Abstract: A tourniquet device includes a first jaw having a first tapered tip, and a second jaw having a second tapered tip. The first and second jaws are moveable towards one another to provide a pressure to a member positioned between the jaws. The first tapered tip is offset from the second tapered tip such that the first tapered tip and the second tapered tip are moveable relative to one another in separate planes and the first tapered tip is moveable past the second tapered tip as the first and second jaws are moved towards one another.

Abstract: Disclosed herein is a delivery system for percutaneous heart valve repair, the delivery system including a steerable sheath configured to provide percutaneous access into a heart and to deliver an implant. The system may also have a steering mechanism configured to manipulate and orient the implant, a ball joint mechanism configured to connect the steerable sheath to the steering mechanism, a main knob assembly configured to advance and retract a multilumen shaft assembly, a stabilizing tool including a plurality of prongs configured to engage the implant within the heart to make an intimate contact with the heart tissue using a stabilizer and a tongue assembly, and a back assembly including: the actuation mechanism, a suture routing mechanism, a tip lock mechanism, and a back cover configured to protect all sutures being cut by mistake.

Abstract: An ultrasonic instrument includes a body, an actuation assembly, a shaft assembly, and an end effector. The actuation assembly includes a mode selection member and an activation member. The shaft assembly extends distally from the body. The shaft assembly includes an acoustic waveguide. The end effector includes an ultrasonic blade. The ultrasonic blade is in acoustic communication with the acoustic waveguide. The end effector is configured to be activated in a first activation mode in response to actuation of the activation member when the mode selection member is in a first position. The end effector is configured to be activated in a second activation mode in response to actuation of the activation member when the mode selection member is in a second position.