Abstract: A medical appliance or prosthesis may comprise one or more layers of electrospun nanofibers, including electrospun polymers. The electrospun material may comprise layers including layers of polytetrafluoroethylene (PTFE). Electrospun nanofiber mats of certain porosities may permit tissue ingrowth into or attachment to the prosthesis.

Abstract: An expandable valve (100) and valve frame device that may be implanted within the body, for example, at a position of the heart. The device may be surgically implanted and subsequently expanded at a later time. The device may include an expandable sewing member (160) surrounding the valve frame (130) at a region between upstream and downstream ends of the device, for attaching the device to surrounding tissue. The device may include a membrane (140) for blocking leakage out the side of the valve frame between opposite ends. However, the membrane may include a side opening (170) for guiding fluid flow toward an appropriate anatomical outflow tract. The device may include a hood-like covering attached to a tissue wall, for smoothly receiving and guiding fluid flow along a perpendicular bend. The device may further include a flared opening at a downstream end, providing adequate space for device attachment.

Abstract: A tapered sleeve is provided that includes a lubricating coating on an inner surface. An implant (e.g., a pre-filled silicon breast implant) is introduced into a large end of the sleeve and extruded into a surgical pocket of minimal access incision size through a small-sized end of the apparatus.

Abstract: The present invention comprises a novel and safer mechanism of deployment using a self-positioning, self-centering, and self-anchoring method. To embody the present invention, a disk-based valve apparatus allowing the repositioning and retrieval of the implantable valve while working on a dysfunctional valve structure is disclosed. The disk-based valve apparatus may comprise one or more disks, either proximal or distal, a valve-housing component and a valve component. The one or more disks may be either proximal or distal, may be either connected to each other or disconnected from each other and may either be symmetrical or have different shapes and dimensions. The disk-based valve apparatus may be self anchoring, such as anchored by pressure from the one or more disk, or may be anchored using any anchoring.

Abstract: A prosthetic heart valve configured to replace a native heart valve and having a support frame configured to be reshaped into an expanded form in order to receive and/or support an expandable prosthetic heart valve therein is disclosed, together with methods of using same. The prosthetic heart valve may be configured to have a generally rigid and/or expansion-resistant configuration when initially implanted to replace a native valve (or other prosthetic heart valve), but to assume a generally expanded form when subjected to an outward force such as that provided by a dilation balloon or other mechanical expander. An inflow stent frame is expandable for anchoring the valve in place, and may have an outflow end that is collapsible to a limited degree for delivery and expandable post-implant to facilitate a valve-in-valve (ViV) procedure. The hybrid heart valves eliminate earlier structural bands, which both reduces manufacturing time and facilitates a ViV procedure.

Abstract: Embodiments of the present invention provide prosthetic valves having sealing members on the external surface thereof. The prosthetic heart valves of the present invention are preferably delivered by catheter directly through the apex of the heart or by other close range transcatheter delivery methods. Because these methods of implantation require a shorter length of catheter, a prosthetic valve can be more accurately oriented in the desired implantation location. Fluoroscopy can be used to further assist in orientation of the valve. The sealing members of the present invention can be positioned on the prosthetic valve such that, when the prosthetic valve is implanted in a native annulus, each provided sealing member is located adjacent to a commissural point of the native valve leaflets. Because the sealing members are precisely oriented on the prosthetic valve, a physician can ensure that the sealing members are aligned with the commissural points of the native valve leaflets.

Abstract: A method of treating a heart of a patient is provided, including implanting a first tissue anchor in cardiac tissue of the patient, the first tissue anchor attached to one or more tethers that are fixed to a coupling element. A second tissue anchor is implanted in the patient. The coupling element is coupled to a first coupling site of the second tissue anchor, thereby coupling the first tissue anchor to the second tissue anchor via the one or more tethers. Thereafter, after allowing at least 24 hours for tissue growth on the first tissue anchor to strengthen anchoring of the first tissue anchor in the cardiac tissue, tension is increased between the first and the second tissue anchors by decoupling the coupling element from the first coupling site and coupling the coupling element to a second coupling site of the second tissue anchor. Other embodiments are also described.

Abstract: A torque-delivering cable is provided, which includes a first coupling. The torque-delivering cable and the first coupling are shaped so as to collectively define a first passage therethrough. A tissue anchor is further provided, which includes a tissue-engaging element and a second coupling, which second coupling is shaped so as to define a second passage therethrough. The first and the second couplings are interlockingly coupleable to each other. An elongate longitudinal locking element is additionally provided, which is shaped so as to define a sharp tip, and which (a) when reversibly disposed in the first and the second passages, maintains coupling together of the first and the second couplings, and (b) when withdrawn from the second passage, allows decoupling of the first and the second coupling from each another.

Abstract: An intraluminal prosthesis includes an outer three-dimensional (3D) anti-migration structure that is attached to the outer wall of a fully covered or partially covered stent to prevent migration and still allow stent removal at a later period of time. A method of manufacturing the intraluminal prosthesis includes attaching the anti-migration structure by usage of a polymer such as polyurethane.

Abstract: A prosthetic heart valve is designed to be circumferentially collapsible for less invasive delivery into the patient. At the implant site the valve re-expands to a larger circumferential size, i.e., the size that it has for operation as a replacement for one of the patient's native heart valves. The valve includes structures that, at the implant site, extend radially outwardly to engage tissue structures above and below the native heart valve annulus. These radially outwardly extending structures clamp the native tissue between them and thereby help to anchor the prosthetic valve at the desired location in the patient.

Abstract: A method of deploying a stent includes receiving a delivery system loaded with a stent and securing the stent in a compressed arrangement by a stent holding assembly including first and second holders having a first protective cover disposed at one end for enclosing a first fastening assembly and a second protective cover disposed at one end of the second holder for enclosing a second fastening assembly, respectively, the stent coupled to the first and second holders members by the first and second fastening assemblies, respectively. The method further includes delivering the stent in an axially expanded and a radially compressed arrangement to an implantation site, retracting the first and second protective covers to expose the first and second fastening assemblies, and actuating the first and second fastening assemblies such that the stent radially expands to engage an inner wall of a lumen.

Abstract: A method is provided of reducing tricuspid valve regurgitation of a patient. A first tissue anchor is implanted at a first implantation site in cardiac tissue in the vicinity of the tricuspid valve of the patient. A second tissue anchor is implanted at a second implantation site of the patient, different from the first implantation site. After the first and the second tissue anchors have been implanted, a longitudinal member that couples the first and the second tissue anchors together is longitudinally deflected.

Abstract: A device or substance (e.g., a breast implant material) can be introduced through a port placed in a skin incision. A blunt blade can extend laterally with respect to a distal opening of the port. The blade can be rotated with respect to the port beneath a layer of skin, such as to separate the skin from underlying tissue. A device or substance can be introduced through a proximal port opening and then through a distal port opening and into the subject via a channel provided by the port. Rotating the blade can include rotating a first blade with respect to a second blade, such as can be performed by a user with one hand manipulating handles associated with the device.

Abstract: A method of forming an implant having a porous tissue ingrowth structure and a bearing support structure. The method includes depositing a first layer of a metal powder onto a substrate, scanning a laser beam over the powder so as to sinter the metal powder at predetermined locations, depositing at least one layer of the metal powder onto the first layer and repeating the scanning of the laser beam.

Abstract: Preferred embodiments of a stent with a high degree of flexibility are shown and described. The stent can include a continuous helical winding and at least one bridge. The continuous helical winding has a plurality of circumferential sections that circumscribe a longitudinal axis from a first end to a second end to define a tube. The circumferential sections are spaced apart along the axis. The at least one bridge is configured to connect one circumferential section to an axially-spaced adjacent circumferential section. The at least one bridge extends on a plane generally orthogonal with respect to the axis.

Abstract: A human or animal joint is treated by introduction of a device between the suitably prepared articulating surfaces of the joint, and the device is anchored in both these articular surfaces with a material having thermoplastic properties. For allowing at least limited articulation of the joint after implantation, the device includes two articulating portions, wherein one of the articulating portions is anchored in each articulating surfaces of the joint. On implantation a proximal face of the device is contacted with a vibrating tool and the vibration is transmitted through parts of the device to locations in which the material having thermoplastic properties is near the bone tissue of the articulating surfaces of the joint and in which liquefaction is desired. The liquefied material penetrates the bone tissue and, on re-solidification forms a positive fit connection between the device and the bone tissue.

Abstract: A stent according to an embodiment of the invention includes an elongate body having a proximal end portion and a distal end portion. The elongate body defines a lumen and an opening in communication with the lumen between the proximal end portion and the distal end portion configured to enable the flow of fluid therethrough. The lumen is configured to have a diameter wherein the opening has a width greater than half the size of the diameter and less than the diameter of the lumen. The opening has a length at least twice the width of opening. In some embodiments, the opening is configured to laterally receive a guidewire therethrough. The elongate body can be configured to releasably couple the guidewire within the lumen of the elongate body such that the elongate body can be slidably moved along the guidewire.

Abstract: An expandable helical stent is provided, wherein the stent may be formed of an amorphous metal alloy or other non-amorphous metal with a securement. The stent is formed from flat or tubular metal in a helical coiled structure which has an undulating pattern. The main stent component may be formed of a single helically coiled component. Alternatively, a plurality of helically coiled ribbons may be used to form a stent heterogeneous in design, material, or other characteristic particular to that stent. The helical tubular structure may be secured with a securement, such as a weld, interlock or a polymer, to maintain the helical coils in a tubular configuration. The helical coils of the main stent component may be spaced apart or nestled to each other-maintain the tubular shape of the helically coiled stent and prevent the polymer layer from sagging at any point between cycles of the coils.

Abstract: An endoluminal prosthesis system for a branched body lumen comprises a branch vessel prosthesis. The branch vessel prosthesis is deployable within a branch vessel body lumen and comprises a stent having a generally tubular body portion, a flareable proximal end portion, and a coupling portion disposed intermediate the body portion and the flareable portion. The coupling portion is more crush-resistant than the body portion. The flareable proximal end may be disposed within a fenestrated stent graft wit with coupling portion disposed in the fenestration of the fenestrated stent graft.

Abstract: Polymeric stents having fracture toughness and resistance to recoil after deployment are disclosed along with methods of manufacturing such stents. Improvements to mechanical characteristics and other improvements may be achieved by having polymer chains within individual stent struts oriented in a direction that is closer to or in line with the axis of the individual stent struts. The struts are connected to each other by hinge elements that are configured to bend during crimping and deployment of the stent. Ring struts form ring structures. A ring structure can have an overall curvilinear length from about 12 mm to about 15 mm.