Abstract: A method for coupling soft tissue to bone including: positioning a first anchor in a first bone bore, the first anchor having a first self-locking adjustable suture construct including a first adjustable loop, a second adjustable loop, and a pair of first ends; positioning a second anchor in a second bone bore, the second anchor having a second self-locking adjustable suture construct including a third adjustable loop, a fourth adjustable loop, and a second end; positioning the first adjustable loop relative to the soft tissue; positioning the second adjustable loop about the third adjustable loop; and tensioning the pair of first ends and the second end to pull the first adjustable loop against the soft tissue, couple the second adjustable loop to the third adjustable loop, pull the second adjustable loop against the soft tissue, and pull the third adjustable loop against the soft tissue.

Abstract: A vascular implant for replacing a native heart valve comprises a self expanding stent supporting a valve body having leaflets. The stent preferably comprises an anchoring structure configured to prevent the implant from passing through the valve annulus. For delivery, the implant is compacted within a delivery device and secured at one end. During delivery the implant is partially released from the delivery device, and positioning of the implant can be verified prior to full release. The implant can be at least partially resheathed and repositioned if desired.

Abstract: A surgical device comprises an elongate shaft having an outer tube and an inner rod positioned in the outer tube. The outer tube and inner rod each comprise a distal end and a proximal end. An actuator is operably connected to the proximal ends of the outer tube and the inner rod. An end effector is adapted for in vivo attachment to and detachment from the elongate shaft. The end effector comprises an outer casing comprising a first detent mating feature adapted to engage the distal end of the outer tube; an inner shuttle axially moveable relative the outer casing, the shuttle comprising a second detent mating feature adapted to engage the distal end of the inner rod; and a pair of surgical jaws having an opened position and closed position dependant on the relative axial position of the shuttle and casing. A tubular loader is sized to receive the end effector, the tubular loader comprising third detent mating feature adapted engage end effector.

Abstract: Surgical clip appliers are provided and include a housing; at least one handle pivotably connected to the housing; a channel assembly extending distally from the housing; a clip carrier disposed within the channel assembly and defining a channel and a plurality of windows therein; and a plurality of clips slidably disposed within the channel of the clip carrier. The surgical clip appliers further include a drive channel reciprocally disposed within at least one of the housing and the channel assembly; a wedge plate reciprocally disposed within the channel assembly; a pusher bar reciprocally positioned within the housing and the channel assembly; and a motion multiplier system having a plurality of linkage members configured to distally move the pusher bar by an incremental amount upon an initial actuation of the handles, and configured to proximally move the pusher bar and the wedge plate subsequent to the initial actuation of the handles.

Abstract: A bioerodible endoprosthesis includes a bioerodible magnesium alloy including between 50 weight percent and 92 weight percent magnesium, at least 5.5 weight percent in sum of one or more elements selected from the group consisting of Ho, Er, Lu, Tb and Tm, and at least 2.0 weight percent in sum of one or more elements selected from the group consisting of Y, Nd and Gd. The bioerodible magnesium alloy has a microstructure including equiaxed Mg-rich solid solution-phase grains having an average grain diameter of less than or equal to 15 microns and second-phase precipitates and/or ceramic nanoparticles in grain boundaries between the equiaxed Mg-rich solid solution-phase grains. The secondary-phase precipitates or ceramic nanoparticles have an average longest dimension of 2.0 micron or less. The microstructure can be produced by one or more equal-channel high-strain processes.

Abstract: A system includes a catheter including an elongated carrier, a balloon about the carrier in sealed relation thereto, the balloon being arranged to receive a fluid therein that inflates the balloon, and first and second electrodes within the balloon arranged to carry a voltage there-across including an initial high electrical voltage at an initial low current. The initial high electrical voltage causes an electrical arc to form across the first and second electrodes within the balloon. The electrical arc causes a gas bubble within the liquid, a high current to flow through the first and second electrodes, a decrease in the initial high electrical voltage, and a mechanical shock wave within the balloon. The system further includes a power source that provides the first and second electrodes with a drive voltage that creates the initial high electrical voltage at the initial current and that terminates the drive voltage in response to the decrease in the initial high electrical voltage.

Abstract: An implant delivery system comprising a catheter including at least one lumen, an implant configured to be received in the lumen, and a latching mechanism configured to be received in the implant. The latching mechanism may be configured to releasably couple the implant to a delivery wire and to transmit a torque through the delivery wire to cause at least a portion of the implant to rotate. The an implant may comprise a shaft, a spacer configured to interact with at least a portion of at least one cusp of a heart valve to at least partially restrict a flow of blood through the heart valve in a closed position, a garage configured to couple the spacer to a first end region of the shaft, and at least one anchor mechanism. The garage may define a cavity configured to receive the latching mechanism and to increase rotational and translational stability of the latching mechanism.

Abstract: A method of improving the mechanical properties of a tissue patch is provided. The method includes the steps of providing a tissue patch and placing at least one barbed suture along at least a portion of the tissue patch. The method may further include the step of placing one or more additional barbed sutures in a laterally spaced relation to the barbed suture. The barbed suture may be biodegradable or non-biodegradable.

Abstract: An implantable lumen filter (200) is described. The implantable lumen filter includes a body (202) having a proximal end (202a), a distal end (202b), and a generally tapered outer surface (204). The outer surface is formed by a plurality of struts (206a, 206b). The plurality of struts forms a plurality of apertures (210). The apertures are dimensioned to inhibit and/or to lyse particulates of a selected size from passing through the apertures. The body (202) is transitionable from a collapsed state toward a deployed state. The implantable lumen filter includes an engaging portion (220) having a proximal end (220a) and a distal end (220b). The proximal end of the engaging portion is connected to a distal end of the body. The engaging portion has a generally annular shape and is configured to engage an inner surface of a body lumen.

Abstract: Suture containing filaments of ultra-high molecular weight polyethylene (UHMwPE), characterized in that the suture contains a multi-filament yarn that is obtained by a process comprising the steps of: a) Providing a mixture containing UHMwPE, a spinning solvent and a pigment b) Spinning a multi-filament yarn from the mixture by the gel spinning process.

Abstract: A system for closure of a fascial opening is disclosed. The system may include a first capture device for pulling one end of a suture through fascial tissue on one side of a fascial opening, and a second capture device for pulling an opposing end of the suture through the fascial tissue on an opposite side of the fascial opening. A trapping device for locating and engaging the first capture device can be used, prior to the capture device being pulled through the fascial tissue, so that the trapping device can subsequently pull the suture to facilitate closure of the fascial opening. Methods and apparatuses for closure of a fascial opening are also disclosed.

Abstract: A surgical clip applier is provided including a housing; a pair of handles; a channel assembly extending from the housing; a clip carrier disposed within said channel assembly and defining a channel and a plurality of windows; a wedge plate slidably disposed within said channel assembly and being operatively connected to said handles, said wedge plate including a plurality of apertures formed along a length thereof; a plurality of clips slidably disposed within said channel of said clip carrier; and a clip follower slidably disposed within said channel of said clip carrier at a location proximal of said plurality of clips. The clip follower is configured and adapted for selective engagement with said windows of said clip carrier and said apertures of said wedge plate to distally urge said plurality of clips relative to said clip carrier upon a distal advancement of said wedge plate.

Abstract: A device for cleaning a tongue includes a body having a top surface, an opposite bottom surface, a proximal section, and a distal section. An upwardly projecting ridge is centrally disposed at the proximal section. The ridge has a first downwardly sloping side which is shaped and dimensioned to receive one of the two fingers, and a second downwardly sloping side which is shaped and dimensioned to receive the other of the two fingers. The bottom surface forms a cavity at the proximal section, the cavity is shaped and dimensioned to receive the thumb. A tongue-cleaning pad is disposed on the bottom surface at the distal section. The device can be held by either hand and used to clean the tongue.

Abstract: A device for performing one or more functions in a gastrointestinal tract of a patient includes an anchoring member and at least one actuator, sensor, or combination of both coupled with the anchoring device. The anchoring device is adapted to maintain at least part of the device within a pyloric portion of the patient's stomach and to intermittently engage, without directly attaching to, stomach tissue. Actuators perform any suitable function, such as transmitting energy to tissue, acting as a sleeve to reduce nutrient absorption, occupying space in the stomach, eluting a drug and/or the like. Sensors may be adapted to sense any suitable patient characteristic within the patient's gastrointestinal tract, such as pH, temperature, bile content, nutrient content, fats, sugars, alcohol, opiates, drugs, analytes, electrolytes and/or hemoglobin.

Abstract: A surgical suturing system comprises a shaft having a proximal end, a distal end, a longitudinal axis between the proximal and distal ends, and receiver on the distal end with a rotary drive. A cartridge is selectively attachable to and detachable from the receiver. The cartridge has a surgical needle, a length of suture connected to the needle, a needle driver operative to engage and move the needle relative the cartridge, a transmission operatively connected to the needle driver, and a torsional interface rotationally coupling the rotary drive to the transmission.

Abstract: A suture construction and method for forming a suture construction is disclosed. The construction utilizes a suture having an enlarged central body portion defining a longitudinal passage. First and second ends of the suture are passed through first and second apertures associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes constriction of the longitudinal passage, thus preventing relative motions of the captured portions of the suture.

Abstract: A method of removing material from a blood flow lumen generally includes providing a device having a cutting element and an opening, advancing the device through the blood flow lumen to a site where material is to be removed, forcing the opening toward a wall of the site where material is to be removed, and moving the cutting element and the opening so that material in the blood flow lumen is cut by the cutting element and directed into the opening for removal as the cutting element and opening are moved through the blood flow lumen. In some embodiments, the device may be deflected or bent to force the opening toward a wall to remove material. The cutting element may be rotatable and may have an axis that is movable, that is not parallel to the longitudinal axis of the device, or both.

Abstract: There are disclosed various embodiments of surgical tacks for use in surgical procedures. The tacks generally include a head and a barrel portion extending distally from the head. Preferably, the head and the barrel portion define a throughbore for receipt of a drive instrument. A thread on the head is provided to engage threads in the installation tool. A tissue thread is provided on the barrel portion to engage tissue. Distal and proximal surfaces of the tissue thread may be oriented at various angles relative to the barrel portion. There is also disclosed an insertion instrument to insert one or more tacks as well as a method of use. There is further disclosed a model device for use in explaining the operation of the instrument.

Abstract: This disclosure is directed to an aperture occlusion device and a method for occluding an aperture, including a perimembranous ventricular septal defect. The aperture occlusion device includes a wire frame element. The wire frame forms geometric shapes that include an occluder region and a securing region. The occluder region and the securing region are separated by an attachment region including a waist. The occluder region and securing region can include membranous coverings. The device can be attached to a delivery hub. The wires forming the occluder region and securing region can have a shape-memory capability such that they can be collapsed and distorted in a sheath during delivery, but resume and maintain their intended shape after delivery.

Abstract: Surgical instruments and their methods of use are disclosed. In some embodiments, the surgical instrument may include a handle and an elongated shaft assembly extending distally from the handle. The surgical instrument may also include a fastener deployment system for deploying fasteners from the elongated shaft assembly including a reciprocating driveshaft disposed within the elongated shaft assembly. The driveshaft may include an internal channel and at least one guide surface shaped and arranged to maintain an orientation of at least one fastener in the channel of the driveshaft. In other embodiments, the fastener deployment system may include a follower disposed within the elongated shaft assembly for displacing one or more fasteners within the elongated shaft assembly towards a distal fastener deployment position.