Abstract: A heart valve delivery system may be provided. The heart valve delivery system may include at least a first catheter movable relative to second and third catheters, arranged in a telescoping configuration. The second catheter may be movable relative to and extend from the distal end of the third catheter. The delivery system may include a first adjustable flexure radius associated with the second catheter, and a second flexure radius. The delivery system may include at one control handle assembly configured to permit the catheters to rotate together, independently adjust the first and second flexure radii, cause relative axial movement between the catheters, and permit the ejector to cause relative movement between a heart valve and a capsule connected to the first catheter.

Abstract: A prosthetic valve for implantation within a native heart valve may be provided. The prosthetic valve may include an annular valve body, as well as a plurality of ventricular anchoring legs and a plurality of atrial anchoring arms configured to extend radially outward from the annular valve body. The ventricular anchoring legs and grasping segments of the atrial anchoring arms may be configured to substantially restrict axial movement of the annular valve body within the native heart valve. In addition, anchoring segments of the atrial anchoring arms may be configured for lateral deformation relative to the native heart valve.

Abstract: A prosthetic heart valve, which may include an expandable annular outer frame having a tubular portion and at least one tissue anchor portion configured to extend from the tubular portion, may be provided. The at least one tissue anchor portion may have a plurality of attachment locations. The prosthetic heart valve may also include an expandable inner frame configured at least partially within the expandable annular outer frame. The expandable inner frame may be connected to the expandable annular outer frame solely at one or more of the plurality of attachment locations of the at least one tissue anchor portion.

Abstract: A prosthetic valve for implantation within a native mitral valve may be provided. The prosthetic valve may include an annular valve body, a plurality of atrial anchoring arms configured to extend radially outward from the annular valve body, and a plurality of ventricular anchoring legs configured to extend radially outward from the annular valve body. The arms may be configured to engage an atrial portion of the native mitral valve and the ventricular anchoring legs may be configured to engage a ventricular portion of the native mitral valve. The atrial anchoring arms and the ventricular anchoring legs may be positioned relative to each other such that when the atrial anchoring arms and ventricular anchoring legs engage the native mitral valve, a volume between the atrial anchoring arms and ventricular anchoring legs is configured to be substantially filled with tissue.

Abstract: A prosthetic valve delivery system may be provided. The prosthetic valve delivery system may include a first catheter and a first steering mechanism configured to bend the first catheter within a first steering plane. The prosthetic valve delivery system may also include a second catheter coaxially arranged within the first catheter and a second steering mechanism configured to bend the second catheter within a second steering plane, different from the first steering plane. Moreover, the prosthetic valve delivery system may include a capsule positioned distal to both the first catheter and the second catheter. The capsule may be configured to retain a prosthetic valve therein during transvascular advancement of the capsule.

Abstract: Apparatuses and methods for use in surgical vascular anastomotic procedures. Apparatus includes a blood vessel inner wall (BVIW) sealing and hole forming device, and a hole forming actuator. BVIW sealing and hole forming device includes a hole sealing device, and an anastomotic hole generating device. Hole sealing device includes a sheath that fully encloses and holds a self-expanding hole sealing assembly, a manual hole sealing controller assembly, and a flexible control wire enclosed within a flexible tube. Anastomotic hole generating device includes outer and inner assemblies, with a conically shaped anastomotic hole generating member. Hole forming actuator includes outer and inner assemblies. Also disclosed are procedures for performing surgical vascular anastomosis using the disclosed apparatuses and methods. Particularly applicable for use in clampless types of (end-to-side) surgical vascular anastomotic procedures, for performing coronary artery bypass grafting (CABG).

Abstract: Apparatuses and methods for use in surgical vascular anastomotic procedures. Apparatus includes a blood vessel inner wall (BVIW) sealing and hole forming device, and a hole forming actuator. BVIW sealing and hole forming device includes a hole sealing device, and an anastomotic hole generating device. Hole sealing device includes a sheath that fully encloses and holds a self-expanding hole sealing assembly, a manual hole sealing controller assembly, and a flexible control wire enclosed within a flexible tube. Anastomotic hole generating device includes outer and inner assemblies, with a conically shaped anastomotic hole generating member. Hole forming actuator includes outer and inner assemblies. Also disclosed are procedures for performing surgical vascular anastomosis using the disclosed apparatuses and methods. Particularly applicable for use in clampless types of (end-to-side) surgical vascular anastomotic procedures, for performing coronary artery bypass grafting (CABG).

Abstract: An expandable prosthetic valve for implantation within a native mitral valve may be provided. The prosthetic valve may include an expandable valve body having an atrial end, a ventricular end opposite the atrial end, and an intermediate portion extending between the atrial end and the ventricular end. The valve body may include a plurality of struts intersecting at junctions. The prosthetic valve may also include a plurality of tissue anchoring legs extending from junctions within the intermediate portion of the valve body. At least one of the tissue anchoring legs may have a cross-sectional area which is larger by at least 20% than a cross-sectional area of a strut extending between the at least one tissue anchoring leg and an adjacent tissue anchoring leg.

Abstract: Prosthetic valves and methods of implanting prosthetic valves may be provided, including an expandable prosthetic valve for implantation within a native heart valve. The prosthetic valve may include an annular valve body and atrial anchoring arms configured to extend radially outward from the annular valve body. Each atrial anchoring arm may have a proximal arm end and a distal arm end. The flexibility of at least one atrial anchoring arm may vary substantially from the proximal arm end thereof to the distal arm end thereof. The prosthetic valve may also include a plurality of ventricular anchoring legs configured to extend radially outward from the annular valve body. Each ventricular anchoring leg may have a proximal leg end and a distal leg end. Each ventricular anchoring leg may have a substantially constant flexibility from the proximal leg end to the distal leg end.

Abstract: A prosthetic valve for implantation within a native mitral valve may be provided. The prosthetic valve may include an annular valve body, a plurality of atrial anchoring arms configured to extend radially outward from the valve body, and a plurality of ventricular anchoring legs configured to extend radially outward from the valve body. The prosthetic valve may also include a blood-inflatable cuff situated between the arms and legs. The cuff may be configured to substantially fill a volume between the arms and the legs when the cuff is fully inflated with blood.

Abstract: Apparatus and methods are described for treatment of a urethra that is constricted due to benign prostatic hyperplasia (BPH). A positioning device is used to determine a location of the area of the urethra that is constricted and is to be treated. An execution device includes a dilation balloon, a cutter, an implant carrier, and an implant, the implant and the implant carrier both being disposed outside the outer surface of the dilation balloon. The urethra is dilated by expanding the dilation balloon, and a cut is formed in the inner surface of the urethra using the cutter. The implant is released into the cut within the inner surface of the urethra subsequent to the cutter forming the cut in the inner surface of the urethra, to thereby maintain the urethra in a dilated state. Other embodiments are also described.

Abstract: Provided is an anastomosis arrangement for joining two opposite stumps of a tubular organ in a streamlined anastomosis procedure. The arrangement includes a pair of axially symmetric stump-coupling members that accommodate pairs of counterpart suturing needles, linked together by common suturing threads, and manipulable by a needle-manipulation element to extract the needles tips from the stump-coupling members for piercing walls of the stump.

Abstract: A sheath for use in performing surgical vascular anastomotic procedures, and applications thereof. Sheath includes a sheath main portion (tubular member) having a sheath main portion distal end, and a (cylindrical or conical) sheath main portion proximal open end, and also includes a sheath distal end portion, continuous with sheath main portion distal end, and having at least one intra-sheath fluid (blood, water, air) flow passageway (tunnel), each extending and passing entirely through inside of the sheath distal end portion, via two differently located parts thereof. Sheath distal end portion further includes an intra-sheath control wire anchoring and fixing pocket (cavity), and a sheath control wire passageway. Each intra-sheath fluid flow passageway facilitates continuous flow of blood vessel lumen fluids (blood, water, air) through the overall sheath.

Abstract: Apparatuses and methods for use in surgical vascular anastomotic procedures. Apparatus includes a blood vessel inner wall (BVIW) sealing and hole forming device, and a hole forming actuator. BVIW sealing and hole forming device includes a hole sealing device, and an anastomotic hole generating device. Hole sealing device includes a sheath that fully encloses and holds a self-expanding hole sealing assembly, a manual hole sealing controller assembly, and a flexible control wire enclosed within a flexible tube. Anastomotic hole generating device includes outer and inner assemblies, with a conically shaped anastomotic hole generating member. Hole forming actuator includes outer and inner assemblies. Also disclosed are procedures for performing surgical vascular anastomosis using the disclosed apparatuses and methods. Particularly applicable for use in clampless types of (end-to-side) surgical vascular anastomotic procedures, for performing coronary artery bypass grafting (CABG).

Abstract: A surgical device is provided. The surgical device includes a housing adapted for mounting on a finger of a user; and at least one guide tube attached along a length of the housing. The guide tube is configured for guiding a tissue repair implant from a proximal opening to a distal opening thereof.

Abstract: Embodiments of the present disclosure include apparatus for use at a native valve of a heart of a subject. A delivery tool has a shaft, a capsule disposed at a distal portion of the tool, and a balloon that is disposed within the capsule and coupled to the shaft. A tubular frame of a prosthetic valve is compressed around the balloon, such that shape-memory flanges of the prosthetic valve, and a shape-memory upstream support portion of the prosthetic valve, are each constrained within a respective capsule-portion of the capsule. The capsule is openable by moving the capsule-portions apart, such that the flanges and the upstream support portion automatically deflect radially outward, while the tubular frame remains compressed around the balloon, and inflation of the balloon plastically expands the tubular frame radially. Other embodiments are also described.

Abstract: Apparatus and methods are described including a valve frame defining a frame aperture and at least one arm attached to a portion of the valve frame on a ventricular side of said frame aperture. The at least one arm is configured to extend radially from the portion of the valve frame such that a chord receiving surface of the arm is sized and shaped to deploy among a region of the chords of the native mitral valve. The arm is curved, with an interior of the arm facing a direction in which the valve frame is configured to be rotated during deployment of the prosthetic mitral valve apparatus within the native mitral valve and with the arm having a concavely rounded leading edge facing at least partially in a circumferential direction. Other applications are also described.

Abstract: Apparatus (20) for testing a prosthetic leaflet (10) includes a bar (22); a light source (24); a detector (26); an actuator (40); a gauge (28); a display (82); and circuitry (84). The leaflet is draped over the bar. The light source emits a beam of light (32). The detector detects the beam, and generates a detection-signal indicative of detection of the beam. Actuation of the actuator moves the bar with respect to the beam. The gauge measures an elevation of the bar above the beam, the elevation changing with the moving of the bar by the actuator. The circuitry is configured: (i) to receive the measured elevation from the gauge, (ii) to receive the detection-signal from the detector, and (iii) in response to the detection-signal, to drive the display to display the elevation that was measured when the detection-signal was received by the circuitry.

Abstract: A surgical device is provided. The surgical device includes a housing adapted for mounting on a finger of a user; and at least one guide tube attached along a length of the housing. The guide tube is configured for guiding a tissue repair implant from a proximal opening to a distal opening thereof.

Abstract: Apparatus and methods are described including a valve frame configured to support a prosthetic valve within a native atrio-ventricular valve. The valve frame includes a frame body that includes an atrial portion configured to be positioned such that, when the valve frame is deployed, at least a portion of the atrial portion is disposed on an atrial side of the native atrio-ventricular valve, and a ventricular portion configured to be positioned such that, when the valve frame is deployed, at least a portion of the ventricular portion is disposed within a ventricle of the subject. At least one arm is configured to extend from the ventricular portion of the frame body. Other applications are also described.