Abstract: Described herein are methods and apparatus for approximating targeted tissue by intertwining two or more sutures together. The sutures are attached to the targeted tissue and routed to a twister device. The twister device secures end portions of the sutures and twists them to intertwine the sutures. Controlling the number of twists provides control over the forces applied to the targeted tissue. In conjunction with visualization feedback, real-time adjustments can be made to achieved targeted results, such as elimination of mitral regurgitation when the disclosed methods and apparatus are applied to mitral valve repair.

Abstract: Described herein are devices and methods for mitral valve repair. The devices and methods implant a plurality of distal anchors at an annulus of the mitral valve (e.g., the posterior annulus) and tension artificial chordae to pull the portion of the annulus toward an opposite edge and inward into the ventricle. This can effectively reduce the size of the orifice and increase coaptation. The anchor points of the artificial chordae can be offset from the apex of the heart to achieve a targeted force vector on the annulus. In addition, some embodiments include distal anchors implanted in the posterior leaflet in addition to those at the posterior annulus. This allows differential tensioning to be applied to provide for greater flexibility in treating various configurations of mitral valves to improve coaptation.

Abstract: Apparatus and methods for delivering humidified breathing gas to a patient are provided. The apparatus includes a humidification system configured to deliver humidified breathing gas to a patient. The humidification system includes a vapor transfer unit and a base unit. The vapor transfer unit includes a liquid passage, a breathing gas passage, and a vapor transfer device positioned to transfer vapor to the breathing gas passage from the liquid passage. The base unit includes a base unit that releasably engages the vapor transfer unit to enable reuse of the base unit and selective disposal of the vapor transfer unit. The liquid passage is not coupled to the base unit for liquid flow therebetween when the vapor transfer unit is received by the base unit.

Abstract: A nasal cannula is described herein for respiratory therapy which includes a first gas supply tub with a distal end terminating in a first connector, and a nasal cannula body which includes a first end rotatably coupled to the first connector, a second end opposite the first end, a longitudinal axis extending from the first end to the second end, and a first nasal prong in fluid communication with the first gas supply tube. The first nasal prong is rotatable relative to the first gas supply tube about the longitudinal axis of the nasal cannula body.

Abstract: Nebulizer systems, apparatus, and methods are disclosed. The apparatus includes a body, a breathing gas inlet and outlet, and a barrier. The body is sized to be positioned within an adaptor of the nebulizer system. The breathing gas inlet and the breathing gas outlet are at opposite ends of the body. The barrier is coupled to the body. A plurality of holes are formed in the barrier. The plurality of holes open in a direction orthogonal to the breathing gas inlet. The system employs the apparatus in conjunction with a nebulizer and an adaptor. The method includes generating an aerosolized medicament, providing the aerosolized medicament to the adaptor, passing the aerosolized medicament through the barrier of the apparatus, providing a breathing gas to the apparatus, and flowing the aerosolized medicament and the breathing gas through the breathing gas outlet of the apparatus.

Abstract: Nebulizer systems, apparatus, and methods are disclosed. The apparatus includes a body, a breathing gas inlet and outlet, and a barrier. The body is sized to be positioned within an adaptor of the nebulizer system. The breathing gas inlet and the breathing gas outlet are at opposite ends of the body. The barrier is coupled to the body. A plurality of holes are formed in the barrier. The plurality of holes open in a direction orthogonal to the breathing gas inlet. The system employs the apparatus in conjunction with a nebulizer and an adaptor. The method includes generating an aerosolized medicament, providing the aerosolized medicament to the adaptor, passing the aerosolized medicament through the barrier of the apparatus, providing a breathing gas to the apparatus, and flowing the aerosolized medicament and the breathing gas through the breathing gas outlet of the apparatus.

Abstract: Apparatus and methods for delivering a heated and humidified mixture of oxygen and air are provided. The apparatus includes an air compressor and oxygen concentrator enclosed in the housing of a vapor transfer system. The air compressor supplies air at a first pressure to a gas inlet. The oxygen concentrator provides oxygen at a second pressure to the gas inlet. The oxygen concentrator and the air compressor are in fluid communication and are configured such that the first pressure of the compressed air and the second pressure of the oxygen are about equal. The apparatus includes a vapor transfer system having a gas passage, a liquid passage having heated liquid and vapor, and a membrane that separates the gas passage and liquid passage. The membrane is positioned to transfer vapor from the liquid passage to the gas passage.

Abstract: Systems and methods for respiratory therapy are disclosed. The system may include a nebulizer, an adaptor, and a nasal cannula. The nebulizer is operable to generate an aerosolized medicament and pass the aerosolized medicament through a nebulizer outlet port. The adaptor has a nebulizer coupling port configured to be coupled to the nebulizer outlet port. The nasal cannula is configured to provide a flow of breathing gas from a breathing gas source to the patient. The nasal cannula comprises at least one nasal prong and an attachment device positioned adjacent the at least one nasal prong. The attachment device is configured to secure the adaptor outlet port adjacent an outlet of the nasal prong. The method includes securing a nasal cannula to the patient, attaching an adaptor to the nasal cannula, generating an aerosolized medicament, transferring the aerosolized medicament into the adaptor, and providing a flow of breathing gas to the patient.

Abstract: Disclosed herein are systems, devices, and methods for nasal cannulas allowing simultaneous flow of humidified breathing gas and aerosolized medicament for use in respiratory therapy. Utilizing separate flow paths and separate cannula outlets for the heated and humidified breathing gas and for the aerosolized medicament, these systems, methods, and devices reduce condensation of the aerosolized medicament by delaying mixing of the flow of aerosolized medicament and the flow of heated and humidified breathing gas until the flows exit the cannula.

Abstract: Systems, methods, and devices for humidifying a breathing gas are presented. The system includes a source of pressurized breathing gas, a vapor transfer unit external to the source of pressurized breathing gas, a first gas tube connecting the source of pressurized breathing gas to the gas inlet of the vapor transfer unit and having a first length, a liquid supply having a heater that heats liquid, a first liquid tube coupling the liquid supply to the liquid inlet of the vapor transfer unit, and a second gas tube having a second length and connecting the gas outlet to a patient interface. The first length is greater than the second length. The vapor transfer unit includes a gas passage, a liquid passage, and a membrane separating the gas passage and the liquid passage. The membrane is positioned to transfer vapor from the liquid passage to the gas passage.

Abstract: A system for respiratory therapy that includes a nebulizer, an adaptor, and a nasal cannula. The nebulizer is operable to generate an aerosolized medicament and pass the aerosolized medicament through a nebulizer outlet port. The adaptor has a nebulizer coupling port configured to be coupled to the nebulizer outlet port. The nasal cannula is configured to provide a flow of breathing gas from a breathing gas source to the patient. The nasal cannula includes at least one nasal prong and an attachment device positioned adjacent the at least one nasal prong. The attachment device is configured to secure the adaptor outlet port adjacent an outlet of the nasal prong. A method for respiratory therapy includes securing a nasal cannula to the patient, attaching an adaptor to the nasal cannula, generating an aerosolized medicament, transferring the aerosolized medicament into the adaptor, and providing a flow of breathing gas to the patient.

Abstract: Systems, methods, and devices are described for heating nebulizer adapters. In certain embodiments, a nebulizer adapter includes a cup having an interior wall defining a gas mixing chamber, an exterior wall, and a fluid cavity disposed between the interior wall and the exterior wall. The nebulizer adapter also includes an inlet port having a fluid lumen in fluid communication with the fluid cavity and a breathing gas inlet lumen in fluid communication with the mixing chamber. The nebulizer adapter further includes an outlet having a breathing gas outlet lumen, and a drain port in fluid communication with the mixing chamber and having a drain lumen that passes from the interior wall to the exterior wall of the cup.

Abstract: Nebulizer systems, apparatus, and methods are disclosed. The apparatus includes a body, a breathing gas inlet and outlet, and a barrier. The body is sized to be positioned within an adaptor of the nebulizer system. The breathing gas inlet and the breathing gas outlet are at opposite ends of the body. The barrier is coupled to the body. A plurality of holes are formed in the barrier. The plurality of holes open in a direction orthogonal to the breathing gas inlet. The system employs the apparatus in conjunction with a nebulizer and an adaptor. The method includes generating an aerosolized medicament, providing the aerosolized medicament to the adaptor, passing the aerosolized medicament through the barrier of the apparatus, providing a breathing gas to the apparatus, and flowing the aerosolized medicament and the breathing gas through the breathing gas outlet of the apparatus.

Abstract: Apparatus and methods for delivering humidified breathing gas to a patient are provided. The apparatus includes a humidification system configured to deliver humidified breathing gas to a patient. The humidification system includes a vapor transfer unit and a base unit. The vapor transfer unit includes a liquid passage, a breathing gas passage, and a vapor transfer device positioned to transfer vapor to the breathing gas passage from the liquid passage. The base unit includes a base unit that releasably engages the vapor transfer unit to enable reuse of the base unit and selective disposal of the vapor transfer unit. The liquid passage is not coupled to the base unit for liquid flow therebetween when the vapor transfer unit is received by the base unit.

Abstract: Systems and methods for providing respiratory therapy with varying flow rates are disclosed. A system comprises a source of breathing gas, a patient interface, and a flow control device. The flow control device is configured to automatically change a rate of the flow of breathing gas. The flow control device may vary the rate of the flow of breathing gas at a frequency slower than a frequency of breathing of the patient. A method comprises coupling a patient interface to the patient, providing the flow of breathing gas to an inlet port of the patient interface, and automatically changing a rate of the flow of breathing gas with a flow control device in communication with the flow of breathing gas. The method may also comprise varying the rate of the flow of breathing gas at a frequency slower than a frequency of breathing of the patient.

Abstract: Systems, devices, and methods for coupling a tracheostomy tube to a source of humidified breathing gas are disclosed. An adaptor includes a housing, a tracheostomy tube connection device, and a baffle. The housing has an interior surface, an exterior surface, and a breathing gas port. The tracheostomy tube connection device is positioned within the housing and includes an input port for receiving a flow of humidified breathing gas from the breathing gas port and an output port for coupling with the tracheostomy tube. The tracheostomy tube connection device has an internal surface defining a breathing gas passage and an external surface spaced from the interior surface of the housing to create a condensation passage. The baffle may be positioned between the breathing gas port and the input port to cause controlled condensation from the flow of humidified breathing gas by disrupting the flow of humidified breathing gas.

Abstract: Nebulizer systems, apparatus, and methods are disclosed. The apparatus includes a body, a breathing gas inlet and outlet, and a barrier. The body is sized to be positioned within an adaptor of the nebulizer system. The breathing gas inlet and the breathing gas outlet are at opposite ends of the body. The barrier is coupled to the body. A plurality of holes are formed in the barrier. The plurality of holes open in a direction orthogonal to the breathing gas inlet. The system employs the apparatus in conjunction with a nebulizer and an adaptor. The method includes generating an aerosolized medicament, providing the aerosolized medicament to the adaptor, passing the aerosolized medicament through the barrier of the apparatus, providing a breathing gas to the apparatus, and flowing the aerosolized medicament and the breathing gas through the breathing gas outlet of the apparatus.

Abstract: Apparatus and methods for delivering humidified breathing gas to a patient are provided. The apparatus includes a humidification system configured to deliver humidified breathing gas to a patient. The humidification system includes a vapor transfer unit and a base unit. The vapor transfer unit includes a liquid passage, a breathing gas passage, and a vapor transfer device positioned to transfer vapor to the breathing gas passage from the liquid passage. The base unit includes a base unit that releasably engages the vapor transfer unit to enable reuse of the base unit and selective disposal of the vapor transfer unit. The liquid passage is not coupled to the base unit for liquid flow therebetween when the vapor transfer unit is received by the base unit.

Abstract: A humidification canister for humidifying a breathing gas, the humidification canister includes a fluid supply configured to supply a fluid and a first gas flow path in fluid communication with the fluid supply. A first gas flow path is configured to humidify the breathing gas with the fluid. A second gas flow path at least partially surrounds the first gas flow path. A method of insulating a breathing gas in a humidification canister using a gas is also disclosed.

Abstract: Devices for providing respiratory therapy to a patient are disclosed. One device includes first and second elongated lumens and a nosepiece. The elongated lumens each have a constant internal diameter. The nosepiece portion has a third lumen and a fourth lumen. The third and fourth lumens have constant internal diameters equal to those of the first and second lumens. The third and fourth lumens have inlet ends adapted to be connected to the outlet ends of the first and second lumens without constricting the internal diameter of the first and second lumens. The third and fourth lumens are configured to receive first and second flows of breathing gas from the first and second lumens and deliver the flows of breathing gas to outlets end of the third and fourth lumens. The second flow of breathing gas is maintained separate from the first flow of breathing gas within the nosepiece portion.