Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a guide extension catheter. The guide extension catheter may include a proximal member having a proximal end, a distal end, and a proximal diameter. The guide extension catheter may additionally include a collar member attached to the distal end of the proximal member, the collar member comprising a base portion and one or more ribs connected to the base portion and extending distally away from the base portion. In still some additional embodiments, the guide extension catheter may further include a distal sheath member attached to the collar member, the distal sheath member having a distal diameter larger than the proximal diameter.

Abstract: An example occlusive implant is disclosed. The example occlusive implant includes an expandable framework configured to shift between a first configuration and an expanded configuration and a fixation member disposed along the expandable framework. The fixation member includes a first engagement portion and an anchor portion. Further, the first engagement portion is designed to be secured to the expandable framework and the anchor portion extends away from an outer surface of the expandable framework.

Abstract: A pacing system configured to sense cardiac activity and to deliver pacing therapy to a patient's heart. The pacing system may comprise a first electrode configured to be positioned in a first chamber of the heart and configured to deliver a first pacing therapy to the first chamber of the heart and a second electrode configured to be positioned in the left atrial appendage and configured to deliver a second pacing therapy to the left atrial appendage. The processing module of the pacing system may be configured to time a delivery of the first pacing therapy based on a first timing fiducial and a delivery of the second pacing therapy based on a determined pacing delay between the first pacing therapy and the second pacing therapy. The determined pacing delay may be configured to maximize a flow of blood into and/or out of the left atrial appendage.

Abstract: A device for aiding in recapturing a medical device may include an elongate shaft and an expandable sheath extension coupled to a distal end of the elongate shaft. The expandable sheath extension may be laterally offset from the elongate shaft and may be self-biased toward a radially collapsed configuration. A system for deploying and recapturing a medical device may include a deployment catheter including an elongate tubular member having a lumen configured to slidably receive a medical device, and a device for aiding in recapturing the medical device after the medical device has been deployed. The elongate shaft may be configured to slidably advance the expandable sheath extension through the lumen to a guiding position wherein a proximal end of the expandable sheath extension is disposed within the lumen and a distal end of the expandable sheath extension is disposed distal of the elongate tubular member.

Abstract: A medical device for causing blood flow within a left atrial appendage (LAA) includes a flow energy capture element adapted to capture energy caused by movement within the heart. A transmission element is operably coupled to the flow energy capture element, the transmission element adapted to utilize the captured energy to cause blood flow within the LAA.

Abstract: This disclosure relates to compounds of Formula (A): Formula (A), or a pharmaceutically acceptable salt thereof, wherein DSM is a degradation signaling moiety that is covalently attached to the linker L, L is a linker that covalently attaches IRAK to DSM; and IRAK is an IRAK4 binding moiety represented by Formula (I) that is covalently attached to linker L; Formula (I) in which all of the variables are as defined in the application. Compounds or pharmaceutically acceptable salts thereof as described herein are capable of activating the selective ubiqitination of IRAK4 proteins via the ubiquitin-proteasome pathways (UPP) and cause degradation of IRAK4 proteins. The present disclosure also provides methods of treating disorders responsive to modulation of IRAK4 activity and/or degradation of IRAK4 with at least one compound described herein.

Abstract: A left atrial appendage (LAA) ligation device is adapted for ligating the LAA via a trans-septal approach, the LAA including an ostium. The LAA ligation device includes a spiral ligation element extending from an end point disposed at a periphery of the spiral ligation element to a center point of the spiral ligation element, the spiral ligation element having a diameter defined by the periphery and a length defined between the periphery and the center point. A delivery device is adapted to releasably secure the spiral ligation element and to enable rotation of the spiral ligation device.

Abstract: An expandable dilator for use with an expandable sheath includes a shaft having a tapered distal tip, a body, a proximal end, and a lumen extending longitudinally from the distal tip to the proximal end. The expandable dilator includes an expansion mechanism extending radially outward from the outer surface of the shaft. When the expandable dilator is withdrawn proximally into the expandable sheath, the expansion mechanism engages the distal end of the sheath and expands the sheath as the expansion mechanism moves proximally through the sheath.

Abstract: The present disclosure provides a 3D printer including a receiving surface for accepting the accumulation of material layers, and a gantry having a shaft and carriage that is translated along the shaft, and an extruder assembly that is articulated to rotate a printing plane, wherein the extruder assembly is attached to the carriage and the articulated extruder assembly is manipulated to rotate the printing plane away from parallel with the receiving surface.

Abstract: The present disclosure provides a 3D printer including a receiving surface for accepting the accumulation of material layers, and a gantry having a shaft and carriage that is translated along the shaft, and an extruder assembly that is articulated to rotate a printing plane, wherein the extruder assembly is attached to the carriage and the articulated extruder assembly is manipulated to rotate the printing plane away from parallel with the receiving surface.

Abstract: A patch for interposing between an implantable device and a treatment site, such as to inhibit migration (e.g., lateral shifting) of the implantable device with respect to the treatment site without interfering with contact of the implantable device with the treatment site, and/or to reduce (and preferably inhibit or prevent) damage to tissue at the treatment site and/or movement of the anchor element (used to anchor the implantable device) with respect to the treatment site. The patch may extend continuously around the perimeter of the device, or discontinuously as more than one patch. The patch may be delivered on the implantable device to the treatment site, or separately delivered and deployed before the implantable device is delivered and deployed, the implantable device being implanted over the patch and the treatment site.

Abstract: A left atrial appendage closure (LAAC) device includes an expandable member that defines a profile of the LAAC device and is moveable between a minimal diameter and a maximum diameter, the expandable member adapted to move to a deployment diameter that is intermediate the minimal diameter and the maximum diameter and that is limited by dimensions of a left atrial appendage (LAA) in which the LAAC device is deployed. A fabric extends over at least a portion of the expandable member and is adapted to accommodate changes in the expandable member between the minimal diameter and the increased diameter.

Abstract: Blood stagnation within a left atrial appendage (LAA) may be reduced by creating movement within the LAA. A variety of different actuatable devices, including magnetically actuated devices, may be implanted within the LAA. The actuatable device may be caused to become actuated, thereby causing the motion within the LAA. In some cases, causing the actuatable device to become actuated may include application of a magnetic field. In some cases, causing the actuatable device to become actuated may include subjecting the actuatable device to blood flow within the LAA.

Abstract: Blood stagnation within a left atrial appendage (LAA) may be reduced by creating movement within the LAA. A variety of different actuatable devices, including magnetically actuated devices, may be implanted within the LAA. The actuatable device may be caused to become actuated, thereby causing the motion within the LAA. In some cases, causing the actuatable device to become actuated may include application of a magnetic field. In some cases, causing the actuatable device to become actuated may include subjecting the actuatable device to blood flow within the LAA.

Abstract: An implant for occluding a left atrial appendage may include an expandable framework configured to shift between a collapsed configuration and an expanded configuration, wherein the expandable framework includes an attachment point configured to secure the expandable framework to a delivery device, and an occlusive element disposed on a proximal portion of the expandable framework, wherein the occlusive element covers the attachment point.

Abstract: Implanting a left atrial appendage closure (LAAC) device within a patient's left atrial appendage (LAA) may include advancing an assembly to a position proximate the patient's LAA. The assembly includes an LAAC device releasably secured to an LAAC delivery catheter, and one or more ultrasound transducers disposed relative to the LAAC delivery catheter. Once the LAAC device is deployed, the ultrasound transducers may be rotated relative to the LAAC device to look for leaks between the LAAC device and the LAA. In some cases, the LAAC device may be repositioned relative to the LAA when excessive leaks are found via ultrasound.

Abstract: An implantable medical device such as, but not limited to an LAAC (left atrial appendage closure) device includes an expandable frame that is moveable between a collapsed configuration for delivery and an expanded configuration for deployment, the expandable frame having a variable diameter in the expanded configuration. The expandable frame includes a central member, and a grouping of arcuate articulating members joined at one end to the first central member, each of the first grouping of arcuate articulating members extending outwardly from the first central member. A covering is disposed relative to the first grouping of arcuate articulating members.

Abstract: An implantable medical device such as but not limited to a left atrial appendage closure (LAAC) device includes an expandable frame that is movable between a collapsed configuration for delivery and an expanded configuration for deployment. The expandable frame may include a plurality of articulating members that are biased into the expanded configuration. The expandable frame may include a biasing member. The LAAC device includes a membrane or covering that spans across an end of the expandable frame. In some cases, the LAAC device may be adjustable to better fit a non-circular ostium.

Abstract: An implantable medical device includes an expandable frame that is expandable between a collapsed configuration for delivery and an expanded configuration for deployment, the expandable frame including a periphery defined by the expandable frame. A covering spans at least part of the expandable frame. An expandable element is secured relative to the periphery, the expandable element is adapted to seal against an irregular body opening such as an irregular-shaped ostium of a patient's LAA (left atrial appendage).

Abstract: An implantable medical device such as but not limited to a left atrial appendage closure (LAAC) device includes an expandable frame that is movable between a collapsed configuration for delivery and an expanded configuration for deployment. The expandable frame may include a plurality of articulating members that are biased into the expanded configuration. The expandable frame may include a biasing member. The LAAC device includes a membrane or covering that spans across an end of the expandable frame.