Abstract: An access tube is used for accessing an anatomic space, such as a pericardial space between the parietal and visceral pericardia. The access tube is advanced against the parietal pericardium and an anchor structure thereon embedded into the parietal pericardium. The access tube can then be used to separate the parietal and visceral pericardia and enlarge the pericardial space. After such enlargement, a needle or other access device can be introduced through the access tube into the pericardial space to provide access for a wide variety of purposes, including aspiration, infusion, and guidewire placement.

Abstract: Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Abstract: Apparatus and methods are provided for forming a working space on the interior wall of a blood vessel, such as the aorta. The working space is isolated from blood flow and permits creation of an anastomotic hole and subsequent suturing of the hole to form an end-to-side anastomosis, even while the heart is beating. The apparatus comprises tools including inflatable barriers, such as cup-shaped balloons, which engage the inner wall of the blood vessel with minimum trauma and maximum sealing. In a first embodiment, the inflatable barrier is introduced through a penetration at the site of the anastomotic attachment. In a second embodiment, the inflatable barrier is introduced through a second penetration axially spaced-apart from the site of the anastomotic attachment.

Abstract: A prosthesis includes a radially expansible scaffold in at least two circumferential anchors extending from the scaffold. The prosthesis is placed across an os between a main body lumen and a branch lumen. The scaffold is expanded within the branch lumen and the circumferential anchors deformed outwardly to conform to the wall of the main body lumen. Optionally, a second prosthesis may be placed within the main body lumen after the first prosthesis has been deployed.

Abstract: Devices, systems, methods, and kits for treating the tissue structures of the ear make use of a guide structure that can mechanically register a treatment probe with a target region of a target tissue, the guide structure being fittingly received in an auditory canal and often comprising a conformable body such as a compressible foam, or the like. The guide structure may include an articulating mechanism for selectively orienting the treatment probe toward the target region of, for example, a tympanic membrane. The guide structure may also support a videoscopic image capture device, illumination transmitting optical fibers, an aiming beam transmitter, and the like. Such structures facilitate myringotomy, tympanostomy tube placement, and the like, under local anesthesia in a doctor's office.

Abstract: Apparatus and methods are provided for forming a working space on the interior wall of a blood vessel, such as the aorta. The working space is isolated from blood flow and permits creation of an anastomotic hole and subsequent suturing of the hole to form an end-to-side anastomosis, even while the heart is beating. The apparatus comprises tools including inflatable barriers, such as cup-shaped balloons, which engage the inner wall of the blood vessel with minimum trauma and maximum sealing. In a first embodiment, the inflatable barrier is introduced through a penetration at the site of the anastomotic attachment. In a second embodiment, the inflatable barrier is introduced through a second penetration axially spaced-apart from the site of the anastomotic attachment.

Abstract: The methods and apparatus for lead placement on a surface of the heart are employed using an elongated body having proximal and distal end portions. The body defines a lead receiving passageway extending between a proximal inlet and a distal outlet for receiving a lead therethrough for contact with the heart surface. The elongated body is adapted for insertion between a pericardium and an epicardial surface. At least a portion of the body may have a non-circular cross-sectional shape adapted to retain the body orientation between the pericardium and the epicardial surface.

Abstract: Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Abstract: Devices, systems, methods, and kits for treating the tissue structures of the ear make use of a guide structure that can mechanically register a treatment probe with a target region of a target tissue, the guide structure being fittingly received in an auditory canal and often comprising a conformable body such as a compressible foam, or the like. The guide structure may include an articulating mechanism for selectively orienting the treatment probe toward the target region of, for example, a tympanic membrane. The guide structure may also support a videoscopic image capture device, illumination transmitting optical fibers, an aiming beam transmitter, and the like. Such structures facilitate myringotomy, tympanostomy tube placement, and the like, under local anesthesia in a doctor's office.

Abstract: Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Abstract: Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Abstract: Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Abstract: An access tube is used for accessing an anatomic space, such as a pericardial space between the parietal and visceral pericardia. The access tube is advanced against the parietal pericardium and an anchor structure thereon embedded into the parietal pericardium. The access tube can then be used to separate the parietal and visceral pericardia and enlarge the pericardial space. After such enlargement, a needle or other access device can be introduced through the access tube into the pericardial space to provide access for a wide variety of purposes, including aspiration, infusion, and guidewire placement.

Abstract: An access tube is used for accessing an anatomic space, such as a pericardial space between the parietal and visceral pericardia. The access tube is advanced against the parietal pericardium and an anchor structure thereon embedded into the parietal pericardium. The access tube can then be used to separate the parietal and visceral pericardia and enlarge the pericardial space. After such enlargement, a needle or other access device can be introduced through the access tube into the pericardial space to provide access for a wide variety of purposes, including aspiration, infusion, and guidewire placement.

Abstract: Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Abstract: Implantable systems for controlling flow through body lumens comprise a control module and an actuator. The actuator is implanted at least partially over the body lumen to selectively constrict the lumen and control flow therethrough. The control module includes at least a power source for operating the actuator and a remotely operated switch for controlling the power source. Usually, the control module will have programmable circuitry for adjusting on/off time, degree of closure, and the like. The switch of the control module is remotely actuated by a magnetic or other signal. The control circuitry may be remotely programmed using a hand-held programmer.

Abstract: Angiogenesis in cardiac and other tissues is promoted by the transmural delivery of angiogenic factors such as VEGF, FGF, EGF, and PDGF, through blood vessels and other body lumens into the surrounding tissue. Usually, the angiogenic factor is delivered using a catheter having infusion parts at its distal end. Optionally, the distal end of the catheter is radially expanded to engage the infusion parts directly against the blood vessel wall.

Abstract: Sleeve catheters having an interactive device near their distal ends are provided for introduction while disposed over conventional interventional and imaging catheters. Exemplary interactive devices on the sleeve catheters include ultrasonic imaging arrays, drug delivery lumens, and the like. The sleeve catheters are most commonly used with angioplasty catheters, stent placement catheters, atherectomy catheters, and the like.

Abstract: The invention provides methods and devices for delivering low level radiation to inhibit neointimal hyperplasia following angioplasty or other intravascular procedures. In an exemplary method, a balloon is inflated within a stenosed region of a blood vessel to produce a treated region. The balloon is then deflated and a radioactive source within a sleeve is aligned over the deflated balloon. The balloon is again inflated at the treated region to engage the sleeve having the radioactive source against the blood vessel within the treated region for from 1 to 40 minutes to deliver a sufficient dosage of radiation to inhibit neointimal hyperplasia.

Abstract: The catheter system comprises a balloon catheter having a removable hub. The hub is removed to permit loading of a sleeve catheter over the proximal end of the balloon catheter. The removable hub includes both a circumferential seal for preventing leakage of inflation medium from the hub and a mechanical interlock for axially securing the hub to the balloon catheter.