Abstract: A surgical tool according to one or more embodiment may include: an end effector; an elongate element that drives the end effector; a hollow shaft that includes a proximal end portion and a distal end portion which is coupled to the end effector; a driving member which the elongate element led via the shaft is wound on; a guide pulley that is disposed between the proximal end portion of the shaft and the driving member and guides the elongate element; and a tension pulley that is disposed between the proximal end portion of the shaft and the guide pulley and biases the elongate element.

Abstract: A suture anchoring system having an implant body that defines a bore space extending longitudinally about a central axis from a proximal end to a distal end of the implant body. A tapering interference portion is provided on an interior surface of the implant body and extends into the bore space, the taper being toward the central axis of the implant body bore space from the proximal end to the distal end of the implant body. An anchor has a threaded anchor portion extending therefrom and defines a threaded bore, where the extended threaded anchor portion configured to be received in the bore space of the implant body. A slot is defined in the threaded anchor portion, the slot configured to receive the interference portion of the implant body; and a threaded plug is configured to be received in the threaded bore of the anchor.

Abstract: In some examples, a tool for, e.g., creating a sub-sternal tunnel in a patient or other use, is described. The tool may include a handle and a tunneling shaft coupled to the handle. The tunneling shaft extends from a proximal end to a distal end, and at least a portion of the tunneling shaft extends in a curved orientation between the first end to the distal end. The distal end of the tunneling shaft includes a cutting tool having a sharp edge. The cutting tool is moveable from a recessed position in which the sharp edge of the cutting tool is recessed into the distal end of the tunneling shaft to a deployed position in which the sharp edge of the cutting tool extends beyond the distal end of the tunneling shaft in the deployed position, e.g., to cut pericardium, scar tissue, and/or connective tissue with the sharp edge.

Abstract: In some examples, a catheter includes an elongated body including a proximal portion and a distal portion. The elongated body includes an inner liner, an outer jacket, a structural support member positioned between at least a portion of the inner liner and at least a portion of the outer jacket, and an expandable member coupled to the structural support member at the distal portion of the elongated body. The expandable member may be configured to expand radially outward, e.g., to engage a clot within vasculature of a patient.

Abstract: A method is described for use at a valve of a heart of a subject, the valve having an annulus, and the heart having an atrium upstream of the valve. A distal end of a manipulator is transluminally advanced into the atrium. A first part of an implant that includes an elongated contracting member is anchored to a first site on the annulus using the manipulator. The distal end of the manipulator is then pointed at a second site on the annulus such that a central longitudinal axis of the manipulator is disposed at an angle of 45-90 degrees with respect to a surface of the annulus. A second part of the implant is then anchored to the second site using the manipulator. Subsequently, the first site and the second site are drawn together by applying tension to the contracting member. Other embodiments are also described.

Abstract: An operating structure of a surgical clip applier is provided to drive a clip clamping unit. The operating structure of the surgical clip applier comprises: a body; a front driving element for driving the clip clamping unit; a restoring spring for driving the front driving element to move backward; a press-control element pivotally connected to the body; a front driving arm pivotally connected to the press-control element; and a lower driving arm with two ends pivotally connected to the body and the front driving arm, respectively, to drive the front driving element to move forward.

Abstract: An intraluminal device and a method of removing a clot from a body lumen with an intraluminal device may be provided. The intraluminal device may include a hollow elongated shaft and a radially-expandable mesh segment situated distal to the elongated shaft. The elongated shaft may be secured relative to a first portion of the mesh segment. The intraluminal device may additionally include a core wire affixed to a second portion of the mesh segment and extending through the elongated shaft. The elongated shaft may be configured to radially expand the mesh segment by axially moving the first portion of the mesh segment relative to the second portion of the mesh segment. In addition, the core wire may be configured to radially expand the mesh segment by axially moving the second portion of the mesh segment relative to the first portion of the mesh segment.

Abstract: A method is used to reduce a volume of a stomach of a patient. The method includes inverting a portion of a stomach wall to thereby create an inverted portion. An expandable member is positioned adjacent to the outer surface of the inverted portion. The expandable member is expanded to thereby expand the inverted portion. The expanded expandable member has a first outer diameter. A base region of the inverted portion is cinched to thereby capture the expanded expandable member in the expanded inverted portion. The expanded expandable member has a first outer diameter. Expanding and cinching provide a cinch diameter to first outer diameter ratio from approximately 0.5:1 to approximately 0.9:1.

Abstract: Surgical instruments having a rotary drive that can selectively actuate multiple end effector functions are described herein. In at least one embodiment, a surgical instrument includes a shaft, an end effector coupled to the shaft, a rotatable drive shaft coaxially disposed within an inner lumen of the shaft, and a plurality of selectively engageable clutches configured to transfer torque from the rotatable drive shaft to the end effector. Each of the clutches is configured to convert the rotation of the drive shaft into one of a plurality of movements of the end effector relative to the outer shaft.

Abstract: A device for treating tissue including a capsule including a channel extending therethrough; clip arms extending from a proximal end to a distal end, proximal ends received within the channel to be moved between a tissue receiving configuration, in which distal ends of the arms are separated, and a tissue clipping configuration, in which distal ends of the arms are moved toward one another, the arms including proximal and distal portions, the proximal portion including longitudinal legs extending from the proximal end to the distal portion, a plane of the legs being rotated about a longitudinal axis of the arms from a plane including the distal portion; and a yoke including proximal and distal portions, the distal portion being releasably coupled to the clip legs via a pin, the pin is inserted through the distal portion.

Abstract: Disclosed is an atrial appendage clip delivery system, which includes a handle shell, a push rod, a connection pipe and a support base; a passage is provided in the handle shell along a length direction; one end of the push rod is slidably disposed in the passage; the support base is provided with a mounting window for mounting an atrial appendage clip; the atrial appendage clip includes a first clip arm and a second clip arm capable of opening in parallel or closing; the handle shell, the connection pipe and the support base are sequentially connected and communicate; the first clip arm or the second clip arm is fixedly connected with an upper side or a lower side of the mounting window; the second clip arm or the first clip arm is movably connected with the lower side or the upper side of the mounting window.

Abstract: Inverting tube thrombectomy apparatus for removing clot that are configured to prevent compression of the apparatus that may separate the distal end of the apparatus from the clot and may make it difficult to advance the apparatus to engage with the clot, particularly in a tortious vessel. The apparatuses and methods of using them described herein may be adapted to prevent tension in the flexible tube that is rolling and inverting over the distal end of the inversion support catheter when capturing a clot. Also described herein are inverting tube thrombectomy apparatus that are configured to reload either automatically or manually within the vessel to capture additional clot material.

Abstract: An implantable medical lead may include an electrode at a distal portion of the lead that is configured to monitor or provide therapy to a target site. The lead may include a visible indicator that is visible to the naked eye of a clinician at a medial portion of the lead that is configured to indicate when the electrodes of the lead are longitudinally and radially aligned properly to monitor or treat the target site. A clinician may insert the lead into the patient using an introducer sheath inserted to a predetermined depth into the patient and subsequently aligning the distal portion of the lead by orienting the indicator at an entry port of the introducer sheath.

Abstract: The present disclosure relates to heart valve prostheses, delivery devices, actuation handles, and other improved devices and methods that facilitate delivery of a heart valve prosthesis to a defective native valve structure in a patient, such as the aortic valve.

Abstract: A medical device includes an elongate body and an inflatable balloon attached to and partially surrounding at least a section of the elongate body. The inflatable balloon is selectively inflatable between a deflated state and an inflated state. Engagement between the balloon and a physiological lumen is provided, in part, by multiple protrusions extending from the inflatable balloon and having various physical and functional characteristics. In certain implementations, the balloon may be configured to exhibit various separation forces by applying different strains to the balloon, such as by varying the degree to which the balloon is inflated or deflated.

Abstract: An artificial heart valve stent including: a tubular stent body having an inflow side end and an outflow side end, the inflow side end and the outflow side end being opposite to each other; an inflow side skirt surrounding the external wall of the stent body; and an outflow side skirt surrounding the external wall of the stent body. In a spread state, free ends of the inflow side skirt and the outflow side skirt extend toward the inflow side end; and the inflow side skirt cooperates with the outflow side skirt to clamp heart valve tissues. The artificial heart valve stent can be steadily arranged on heart valve tissues, prolong the service life of an artificial heart valve and reduce the risk of another artificial heart valve replacement for the patient.

Abstract: Described herein are methods and apparatus for approximating targeted tissue using locking sutures. The locking sutures can be configured to receive suture ends that are interweaved through portions of the locking sutures. In a pre-deployment configuration, a locking suture can slide along suture tails and can be positioned at a target location within a target region. Once a desired position and/or tension is achieved, the locking suture can be transitioned to a post-deployment configuration where the locking suture constricts around the suture tails to inhibit relative movement between the suture tails and the locking suture.

Abstract: Suture/needle constructs are disclosed in which either a first round or flat section of suture can be crimped on a needle. If the first section is round, then a transition to flat second section is formed by a braiding machine. After a short space of flat, the braiding machine weaves a bifurcation into the second section, forming third and fourth suture sections. The third and fourth suture sections transition back together again into a woven fifth section at a distance from the needle, which forms a suture loop. This looped section of the suture can then be used for whipstitching a tendon or a ligament graft.

Abstract: A device to close the left atrial appendage of a patient including a hollow shell having opposed male and female ratchet latches with the shell moveable into the left atrial appendage orifice to close the orifice by interconnecting the latches to expand the shell in conformance with the profile of the orifice.

Abstract: A suturing device includes a needle, and a shuttle. The needle has an elongated shape extending in a predetermined direction and is configured to hold a first thread-like member. The needle is reciprocally movable forward and backward in the predetermined direction and is rotatable about an axis extending in the predetermined direction. Rotation of the needle about the axis permitting the first thread-like member to cross the needle to form a loop in the first thread-like member. The shuttle includes a holding portion. The holding portion is configured to hold a second thread-like member. The shuttle is configured to permit the holding portion to pass through the loop.