Abstract: A suture anchor assembly, adapted to be attached to a bone, that includes an anchor, which has an undeployed state in which it is soft and flexible, and which can be deployed into a deployed state which is compacted and hard, relative to the undeployed state, and defining a hold region, where the anchor is optimally held as the anchor is deployed. Also, one or more deployment strands are engaged into the anchor and extend out of the anchor, and wherein, when the anchor is in the undeployed state, holding the anchor at the hold region and pulling on the deployment strands compacts the anchor into the deployed state. Accordingly, the anchor can be introduced into a hole in bone and held in place at the hold region, as it is transformed into the deployed state by pulling on the deployment strands, thereby anchoring the anchor in the hole.

Abstract: An elongated deployment shaft carrying a needle deployment assembly with needles carrying sutures and a stabilizer. A catcher tube over the shaft having a catcher assembly at a distal end may retain a portion of the needles when passed through the tissue into engagement with catcher assembly. The catcher and needle deployment assemblies are configured to asynchronously engage the plurality of needles when moved distally beyond the catcher assembly. A sheath over the catcher tube may sandwich the tissue against the stabilizer when expanded. A first actuator may move catcher tube distally to decrease distance between proximal and distal ends of the stabilizer expand it and may move the sheath distally to sandwich the tissue. A second actuator may deflect the needles outward to move proximally through the tissue and engage the catcher and return a portion of each not retained by the catcher to a distal position.

Abstract: An implant for improving coaptation of an atrioventricular valve in which the atrioventricular valve has a first native leaflet, a second native leaflet and an annulus includes a support structure configured to be arranged on and fixed to the annulus or to at least one of the first and second native first leaflets. The implant also includes flexible retention structure mounted to the support structure so as to prevent prolapse of the at least one of the first and second native leaflets. A method for improving coaptation of such an atrioventricular valve is also disclosed.

Abstract: Apparatus is provided for repairing a cardiac valve, the apparatus including a catheter sized for delivery through vasculature of a subject and an elongated and flexible annuloplasty structure having an elongated lumen and an annuloplasty structure axis extending along the lumen. The annuloplasty structure is sized and configured for delivery to a heart of the subject through the catheter substantially along a catheter axis of the catheter while the annuloplasty structure axis is substantially parallel to the catheter axis. The apparatus also includes a plurality of anchors configured for delivery to a region of cardiac tissue from a proximal end of the catheter toward a distal end of the catheter and substantially along the annuloplasty structure axis and the catheter axis while at least a portion of the annuloplasty structure is within a delivery passage of the catheter. Other embodiments are also described.

Abstract: The invention relates generally to methods and systems for irrigating or capturing particulates during heart pump implantation, and more specifically relates to irrigating, capturing, and removing particulates that may be released when coring a patient's heart tissue. In one aspect, a method for capturing particulates during heart pump implantation is provided that includes inserting a removable particulate capture device into a patient's heart prior to a coring procedure upon the patient's heart. The removable particulate capture device includes an expandable basket movable between collapsed and expanded configurations. The method further includes expanding the expandable basket to the expanded configuration from the collapsed configuration when the removable particulate capture device is positioned within the patient's heart to capture the particulates released during the coring procedure.

Abstract: A surgical device and procedure are provided for smoothly and easily accessing tissue to perform microsurgery, including a capsulotomy of a lens capsule of an eye. The device includes a handpiece with a tip for insertion into an incision in the cornea of the eye. A sliding element is disposed within the handpiece and a suction cup is mounted to the sliding element. The sliding element can be translated to move the suction cup into and out of the handpiece. A compression mechanism associated with the suction cup and the handpiece compresses the suction cup for deployment through the tip of the handpiece. The suction cup can expand inside the anterior chamber into a cutting position on the lens capsule. A cutting element mounted to the suction cup is used to cut a portion of the lens capsule and to remove the portion from the eye.

Abstract: A surgical cutting instrument for transapical aortic valve resection includes a cutting unit arranged on the distal end of a tool shaft and at least one mechanical cutting element for making a circular incision. The at least one cutting element can be adapted, in particular continuously adapted to different aortic diameters by means of a radially movable actuating mechanism.

Abstract: The devices and methods described herein relate to improved structures for removing obstructions from body lumens. Such devices have applicability in through-out the ho including clearing of blockages within the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.

Abstract: Incision and closure surgical device containing a guide for cutting instruments and a sutureless wound closure mechanism. A stick-to-skin tape has a central slit whose edges are reinforced by two strips that delimit a central incision groove. A removable central partition maintains a constant separation between the elastomeric strips before making the incision. A series of transverse conduits pass through the elastomeric strips and serve for drainage of the wound and for coupling the closing mechanism of the device. At the conclusion of the surgery, a removable pressure or magnetic closure comprises two bilateral flexible strips that are hooked together to approximate the elastomeric strips while facing the edges of the underlying wound. A complementary removable adapter element for laparoscopic surgery serves as a support for a trocar and as a gas containment valve. Another complementary removable adapter element serves as an ogive-shaped cutting guide for cutaneous excisional surgery.

Abstract: An ultrasonic instrument comprises a body, a shaft assembly, an ultrasonic blade, and a pivoting member. The shaft assembly extends distally from the body. The ultrasonic blade is positioned distal to the shaft assembly. The pivoting member is pivotable with respect to the blade from an open position to a closed position to thereby clamp tissue between the pivoting member and the blade. One or both of the shaft assembly or the pivoting member comprise a guide feature. The guide feature is configured to provide lateral alignment of the distal portion of the pivoting member with the blade as the pivoting member is pivoted to the closed position.

Abstract: Described herein are flexible implantable devices or stents that can conform to the shape of vessels of the neurovasculature. In some embodiments, the devices can direct blood flow within a vessel away from an aneurysm or limit blood flow to the aneurysm. In some embodiments, a vascular remodeling device includes a first section and a protruding section. During deployment, the device expands from a compressed configuration to an expanded configuration. The first section anchors the device in an afferent vessel and/or in an efferent vessel of a bifurcation and the protruding section is positioned in the junction of the bifurcation having an aneurysm and across the neck of the aneurysm or at least partially within the aneurysm.

Abstract: A disposable ultrasonic handpiece that contains a transducer and a connecting body that tapers to a surgical blade in a single piece. The housing that surrounds the ultrasonic transducer does not require waterproofing for repeated autoclaving. Also, the electrical cord that provides power to the transducer is made of very inexpensive wire, along with a low-cost electrical connector. By making the blade, connecting body with a protective sheet and transducer as a unit with an electrical terminal at the proximal end, they can be plugged and unplugged from a socket and electrical cord in the housing of the handpiece. Thus, only the unit needs to be disposed of after a procedure, making the disposable part of the handpiece even less expensive. The low-cost, disposable handpiece can be packaged along with additional disposable items that are required for one of several types surgeries.

Abstract: A system for internal iliac preservation includes a catheter having a distal catheter portion and a proximal catheter portion; a first guidewire having a proximal portion extending from the proximal catheter portion, a distal portion and a medial portion disposed between the proximal portion and the distal portion; a first outer sheath slidably disposed over distal catheter portion; and an integrated second delivery system disposed within the outer sheath at the distal catheter portion. The integrated second delivery system includes a second guidewire; an expandable stent-graft disposed over a lumen of the second guidewire, and a slidable connector slidably disposed over the medial portion of the first guidewire, where the second guidewire is slidably engaged with the slidable connection to permit movement of the integrated second delivery system along the first guidewire when the first outer sheath is retracted from distal catheter portion.

Abstract: Provided is a device and system for restricting fluid flow in physiological vessels of humans or animals, the device being configurable in a first mode to be passively propellable by fluid flow within a physiological vessel and in a second mode to at least partially occlude a physiological vessel, the device having a first cross-sectional size in the first mode and a second cross-sectional size in the second mode, wherein the second cross-sectional size is greater than the first cross-sectional size. The system has a plurality of the devices described above, a power source for powering the devices; and a controller having one or more processors for controlling the devices.

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 instrument includes a housing having a movable handle operably coupled to the housing and movable relative thereto between an initial position and a compressed position. A trigger is operably coupled to the housing within a slot defined therein and movable relative to the housing and the movable handle between an un-actuated position and an actuated position. A flange is disposed on the trigger and configured to extend distally therefrom. The flange is dimensioned to cover the slot when the trigger is moved between the un-actuated and actuated positions to avoid creating a potential pinch point between the trigger and the slot.

Abstract: An apparatus for applying point-pressure to a wound site that helps occlude open blood vessels includes a pressure applicator, a mounting plate, articulating strap attachment points, and counter-pressure cavities. The articulating strap attachment points attach to straps around a patient's body so that the apparatus is stabilized over a patient's wound. Moreover, the counter-pressure cavities permit a user to apply leverage caused by counter-force mechanism (while also applying a downward force on the pressure applicator). These features enable a user to quickly and easily apply point pressure to a wound site.

Abstract: A pre-loaded stent graft delivery device and stent graft, the stent graft delivery device. The stent graft has at least one fenestration or side arm and the fenestration is preloaded with an indwelling guide wire. Indwelling access sheaths are provided within auxiliary lumens of a pusher catheter and dilators are preloaded into the access sheaths along with the indwelling guide wire. The auxiliary lumens have an oblong cross-section. A handle assembly at a distal end of the guide wire catheter. The handle includes a multiport manifold with access ports to the auxiliary lumens in the pusher catheter. Upon deployment of the stent graft, the indwelling guide wire can be used to facilitate catheterization of a side branch or target vessel through the fenestration or be used to stabilize the access sheath during catheterization, advancement of the access sheath into the target vessel and deployment of a stent therein.

Abstract: Surgical tools and related methods articulate an actuation rod assembly via an actuation tension member. A surgical tool includes an end effector, an instrument shaft assembly supporting the end effector, an actuation rod assembly drivingly coupled with the end effector, a guide surface, a flexible tension member connected to the actuation rod assembly, and an actuation portion. The actuation rod assembly is mounted to slide within the instrument shaft assembly. The flexible tension member is connected to the actuation rod assembly at a connection. The flexible tension member includes a first portion that extends distally from the connection to the guide surface, is wrapped around the guide surface, and extends proximally from the guide surface. The actuation portion is drivingly coupled with the flexible tension member and operable to articulate the tension member to articulate the actuation rod assembly to actuate the end effector.

Abstract: A modular dilation device (100) is provided for inserting multiple dilators into a target patient tissue site. The modular dilation device includes a first dilator (104) and a second dilator (530). The first dilator has a first dilator distal end (108) and a first dilator inner lumen (114). The first dilator has a first dilator side wall opening (118). The first dilator distal end has a first dilator open tip (116). The first dilator has a first dilator open slit (120). The first dilator open slit extends between the first dilator side wall opening and the first dilator open tip. The second dilator has a second dilator distal end and a second dilator inner lumen. The second dilator distal end has a second dilator open tip. When the second dilator is joined to the first dilator, the second dilator open tip is adjacent to the first dilator side wall opening.