Abstract: Among other things, there is disclosed structure and methods for maintaining access to a location in the body while reducing or eliminating the potential for pulling an access device (e.g. a catheter) back through an opening. An introducer sheath includes a distal indented portion and a balloon, so that once placed in a desired location through tissue, the balloon can be inflated to anchor the sheath against retraction. In particular embodiments, structure and methods for accessing the pericardial cavity via the right atrial appendage are shown.

Abstract: Among other things, there are disclosed embodiments of belts or bands that can be used in treatments for tricuspid valve regurgitation. In some embodiments, such belts may be heat-set in a particular configuration to effectively decrease tricuspid annulus when deployed around the atrioventricular groove. Embodiments include one or more tensioning sutures for applying cinching or tightening to belts when deployed, and structure for effectively distributing force during such tightening.

Abstract: A scope system is provided including an elongate tube with a distal portion and a lumen extending therethrough. The scope system also includes at least one accessory channel including a tubular structure with an accessory lumen extending therethrough, the at least one accessory channel movably disposed at least partially within the lumen of the elongate tube. The at least one accessory channel includes a distal section and a forward-viewing configuration and a side-viewing configuration. In the forward-viewing configuration, the distal section of the at least one accessory channel is substantially parallel to the distal portion of the elongate tube and in the side-viewing configuration, the distal section of the at least one accessory channel is arced at a radius greater than a radius of the distal portion of the elongate tube.

Abstract: Disclosed herein is an endoscope system and a handle for a medical device that allows for rotation of the device when a locking member is disengaged by an operator, but does not allow for rotation when the locking member is engaged. Such a handle allows for an operator to maintain the position of an endoscope even when the operator removes his or her hand from the controls of the scope.

Abstract: The present embodiments provide systems and medical formulations suitable for delivering therapeutic powders to a target site. In one embodiment, the system comprises a delivery device, a first powder being formed of particles of a first material, and a second powder being formed of particles of a second material, wherein the second material is different than the first material. At least some of the particles of the first powder and the second powder are bound together to form bonded particles. The bonded particles are simultaneously delivered to the target site by the delivery device. In one embodiment, a medical formulation may comprise carbomer present in a range between about 60-80% by weight of the formulation, bentonite present in a range of between about 5-15% by weight of the formulation, and calcium carbonate present in a range of between about 10-30% by weight of the formulation.

Abstract: A scope system is provided including an elongate tube with a distal portion and a lumen extending therethrough. The scope system also includes at least one accessory channel including a tubular structure with an accessory lumen extending therethrough, the at least one accessory channel movably disposed at least partially within the lumen of the elongate tube. The at least one accessory channel includes a distal section and a forward-viewing configuration and a side-viewing configuration. In the forward-viewing configuration, the distal section of the at least one accessory channel is substantially parallel to the distal portion of the elongate tube and in the side-viewing configuration, the distal section of the at least one accessory channel is arced at a radius greater than a radius of the distal portion of the elongate tube.

Abstract: Among other things, there is disclosed structure and methods for maintaining access to a location in the body while reducing or eliminating the potential for pulling an access device (e.g. a catheter) back through an opening. An introducer sheath includes a distal indented portion and a balloon, so that once placed in a desired location through tissue, the balloon can be inflated to anchor the sheath against retraction. In particular embodiments, structure and methods for accessing the pericardial cavity via the right atrial appendage are shown.

Abstract: The present embodiments provide systems and medical formulations suitable for delivering therapeutic powders to a target site. In one embodiment, the system comprises a delivery device, a first powder being formed of particles of a first material, and a second powder being formed of particles of a second material, wherein the second material is different than the first material. At least some of the particles of the first powder and the second powder are bound together to form bonded particles. The bonded particles are simultaneously delivered to the target site by the delivery device. In one embodiment, a medical formulation may comprise carbomer present in a range between about 60-80% by weight of the formulation, bentonite present in a range of between about 5-15% by weight of the formulation, and calcium carbonate present in a range of between about 10-30% by weight of the formulation.

Abstract: Among other things, there are disclosed embodiments of belts or bands that can be used in treatments for tricuspid valve regurgitation. In some embodiments, such belts may be heat-set in a particular configuration to effectively decrease tricuspid annulus when deployed around the atrioventricular groove. Embodiments include one or more tensioning sutures for applying cinching or tightening to belts when deployed, and structure for effectively distributing force during such tightening. Embodiments of tensioning members, protective members, and devices and methods for open-surgical placement (e.g. around a heart for annuloplasty) are also disclosed.

Abstract: A medical device for facilitating a minimally invasive surgical procedure may include a housing and an arm. The housing may be configured for engagement around an outer circumferential surface of an endoscope and may include a first cavity. The arm may include at least one cutting surface and may be movably received within the first cavity. The arm may be configured to perform a first predetermined movement along at least a first plane at a predetermined frequency.

Abstract: There are shown and described embodiments of a closure device for closing holes in tissue, for example in the right atrial appendage. The closure device in particular embodiments includes first and second mesh closure members and a tether or stem connecting them. Embodiments of a delivery device for the closure device are also described.

Abstract: A scope system is provided including an elongate tube with a distal portion and a lumen extending therethrough. The scope system also includes at least one accessory channel including a tubular structure with an accessory lumen extending therethrough, the at least one accessory channel movably disposed at least partially within the lumen of the elongate tube. The at least one accessory channel includes a distal section and a forward-viewing configuration and a side-viewing configuration. In the forward-viewing configuration, the distal section of the at least one accessory channel is substantially parallel to the distal portion of the elongate tube and in the side-viewing configuration, the distal section of the at least one accessory channel is arced at a radius greater than a radius of the distal portion of the elongate tube.

Abstract: Methods of modifying the luminal profile of a body vessel are described. An example method comprises advancing a cannula out of the distal end of a catheter disposed within the lumen of a body vessel of an animal and toward a target site on the wall of the body vessel; passing contrast dye through the cannula toward the target site; simultaneously continuing the advancing and passing until the distal end of the cannula punctures the inner layer of the wall of the body vessel at the target site; and passing a bulking agent through the cannula and into a space between connective tissue layers surrounding the vessel wall at the target site. Medical devices, medical device assemblies, and kits are also described.

Abstract: The present embodiments provide an expandable mesh comprising a first coupling element, a second coupling element, and an intermediate portion disposed between the first coupling element and the second coupling element. Proximal retraction of the first coupling element relative to the second coupling element causes the intermediate portion to flare out to an enlarged width. In one embodiment, the first coupling element comprises a first tube and the second coupling element comprises a second tube.

Abstract: A scope system is provided including an elongate tube with a distal portion and a lumen extending therethrough. The scope system also includes at least one accessory channel including a tubular structure with an accessory lumen extending therethrough, the at least one accessory channel movably disposed at least partially within the lumen of the elongate tube. The at least one accessory channel includes a distal section and a forward-viewing configuration and a side-viewing configuration. In the forward-viewing configuration, the distal section of the at least one accessory channel is substantially parallel to the distal portion of the elongate tube and in the side-viewing configuration, the distal section of the at least one accessory channel is arced at a radius greater than a radius of the distal portion of the elongate tube.

Abstract: There are shown and described embodiments of a closure device for closing holes in tissue, for example in the right atrial appendage. The closure device in particular embodiments includes first and second mesh closure members and a tether or stem connecting them. Embodiments of a delivery device for the closure device are also described.

Abstract: Methods of modifying the luminal profile of a body vessel are described. An example method comprises advancing a cannula out of the distal end of a catheter disposed within the lumen of a body vessel of an animal and toward a target site on the wall of the body vessel; passing contrast dye through the cannula toward the target site; simultaneously continuing the advancing and passing until the distal end of the cannula punctures the inner layer of the wall of the body vessel at the target site; and passing a bulking agent through the cannula and into a space between connective tissue layers surrounding the vessel wall at the target site. Medical devices, medical device assemblies, and kits are also described.

Abstract: The present embodiments provide an expandable mesh comprising a first coupling element, a second coupling element, and an intermediate portion disposed between the first coupling element and the second coupling element. Proximal retraction of the first coupling element relative to the second coupling element causes the intermediate portion to flare out to an enlarged width. In one embodiment, the first coupling element comprises a first tube and the second coupling element comprises a second tube.

Abstract: Among other things, there are shown embodiments of locking mechanisms for holding sutures in tension. Such devices may be used with implants that use or require sutures, and are easily locked remotely. In particular embodiments, a lock includes a housing member, a pin member at least partially within the housing member, and a spring biasing the pin member into the housing member. The pin member includes a gripping portion, and has a retracted condition and a locked condition. When retracted, a suture can move through the housing member and around the gripping portion of the pin member. When locked, the gripping portion of the pin member engages the suture and presses it against the interior of the housing member.

Abstract: Among other things, there is disclosed structure and methods for maintaining access to a location in the body while reducing or eliminating the potential for pulling an access device (e.g. a catheter) back through an opening. An introducer sheath includes a distal indented portion and a balloon, so that once placed in a desired location through tissue, the balloon can be inflated to anchor the sheath against retraction. In particular embodiments, structure and methods for accessing the pericardial cavity via the right atrial appendage are shown.