Abstract: A method and system for performing anastomosis may use an anvil to control and support a tissue site during an anastomosis procedure involving tissue bonding techniques such as adhesive tissue bonding. Adhesive may be applied to mating surfaces of the graft and/or target vessels either before or after the vessels are brought into contact. Adhesive may be applied via an applicator associated with the anvil.

Abstract: Disclosed is an assembly for loading a bronchial flow control device into a container, such as into a delivery catheter. The assembly includes a funnel housing and a puller housing that mate with one another. The funnel housing defines a funnel-shaped loading cavity that receives a flow control device and that gradually reduces in size moving in a first direction. The puller housing is removably attached to the funnel housing and is also removably attachable to a bronchial flow control device that can be positioned in the loading cavity. The puller housing pulls the bronchial flow control device in the first direction through the funnel housing to gradually contract the bronchial flow control device into a compressed state of reduced size relative to the expanded state.

Abstract: A medical device which can be implanted at a target site in a living body. The device includes an inner flange formed by radial expansion of the device and an outer flange formed by axial compression of the device. The device can include an implant portion and a discard portion which separate from each other during formation of the outer flange. The separation can occur by fracturing a frangible linkage or by mechanically separating a portion of the outer flange from a deployment tool. The device can be a one piece anastomosis device for connecting a graft vessel to a target vessel without the use of conventional sutures. The inner and outer flanges capture the edges of an opening in a target vessel and secure the graft vessel to the opening in the target vessel. The device greatly increases the speed with which anastomosis can be performed over known suturing methods.

Abstract: A method and system for performing anastomosis uses an anvil to control and support a tissue site during an anastomosis procedure involving tissue bonding techniques such as tissue welding and adhesive tissue bonding. The anvil is particularly useful for supporting a wall of a coronary artery during attachment of a graft vessel in a coronary artery bypass graft procedure. The anvil is inserted into a pressurized or unpressurized target vessel and is pulled against an inner wall of the target vessel causing tenting of the thin tissue of the vessel wall. A graft vessel is then advanced to the anastomosis site and an end of the graft vessel is positioned adjacent an exterior of the target vessel. When tissue welding is used, a graft vessel fixture is positioned over the tissue surfaces to be welded in order to clamp the graft and target vessel tissue together. The tissue contacting surfaces of the anvil and/or graft vessel fixture are provided with one or more energy applying surfaces.

Abstract: An anastomosis system and method uses an anvil to control and support a tissue site during an anastomosis procedure. The anvil is particularly useful for supporting a wall of a coronary artery during attachment of a graft vessel to the coronary artery because the wall of the coronary artery is very thin, difficult to grasp, and susceptible to tearing. In one method, the anvil is inserted into a pressurized or unpressurized target vessel and is pulled against an inner wall of the target vessel causing tenting of the thin tissue of the vessel wall. A graft vessel is then advanced to the anastomosis site and an end of the graft vessel is positioned adjacent and exterior of the target vessel. Staples are inserted through the tissue of the graft vessel and the target vessel by pivoting the arms of a staple holder towards the anvil. When the ends of the staples engage staple bending features on the anvil, the ends of the staples bend over securing the graft vessel and target vessel together.

Abstract: Disclosed are methods and devices for regulating fluid flow to and from a region of a patient's lung, such as to achieve a desired fluid flow dynamic to a lung region during respiration and/or to induce collapse in one or more lung regions. Pursuant to an exemplary procedure, an identified region of the lung is targeted for treatment. The targeted lung region is then bronchially isolated to regulate airflow into and/or out of the targeted lung region through one or more bronchial passageways that feed air to the targeted lung region.

Abstract: Disclosed is a sizing device for sizing an inside diameter of a lung passageway. The device includes an elongate shaft configured for positioning in the lung passageway and a sizing element at the distal end of the shaft. The sizing element defines a range of transverse dimensions that correspond to a range of transverse dimensions suitable for use with a predetermined set of bronchial isolation devices. The device is used to determine the suitability of a bronchial isolation device for use in the lung passageway prior to using a separate delivery catheter to deliver the bronchial isolation device into the lung passageway.

Abstract: A device for everting an end of a hollow tissue structure may include a mandrel and a collar proximal to the mandrel. The mandrel may be elastomeric and deformable. At least one of the collar and the mandrel may be movable relative to the other. Deformation of the mandrel everts the end of the hollow tissue structure.

Abstract: The anastomosis device according to the present invention is a one piece device for connecting a graft vessel to a target vessel without the use of conventional sutures. The anastomosis device includes a frame for receiving and holding the end of a graft vessel in an everted position and first and second spreading members configured to be inserted into an opening in the target vessel. The first and second spreading members are arranged substantially in a plane for insertion into an opening in a target vessel, and are moved away from one another to capture the edges of the opening in the target vessel securing the graft vessel to the target vessel. One version of the anastomosis device includes a plurality of linkages arranged in two rows for grasping opposite sides of an opening in the target vessel. A portion of the linkages fold outward to trap vessel walls on opposite sides of the opening in the target vessel.

Abstract: An anastomosis device may include an outer loop and an inner loop connected to and substantially concentric with the inner loop. The outer loop and the inner loop may be connected by at least one hinge. At least one of the outer loop and the inner loop may be movable relative to the other along an axis defined by at least one hinge.

Abstract: An everter and threadthrough system useful for attaching a graft vessel to a anastomosis device which can be used to attach a graft vessel to a target vessel without the use of conventional sutures. The threadthrough system engages an end of the graft vessel and pulls the graft vessel through a deployment tool until a portion of the graft vessel extends beyond a distal end of the anastomosis device mounted on the deployment tool. The everter includes a spreading mechanism which expands the end of the graft vessel and folds the expanded end over the anastomosis device. In the case where the anastomosis device includes barbs, the everter can effect penetration of the graft vessel by the barbs. Once the graft vessel is everted over the anastomosis device, the deployment tool can be used to attach the graft vessel to a target vessel.

Abstract: Methods and systems for lung volume reduction of a patient are described. The methods include implanting a flow control device in a bronchial passageway of the lung. The flow control device regulates fluid flow through the bronchial passageway and includes a valve protector that at least partially surrounds a valve member. The valve protector has sufficient rigidity to maintain the shape of the valve member against compression.

Abstract: Disclosed is an anesthesia adapter that is suitable for the simultaneous insertion of multiple devices or instruments into the lungs during ventilation of the patient, while minimizing or eliminating gas leaks. The anesthesia adapter comprises in one embodiment a first port sized to receive a first elongate instrument; a second port sized to receive a second elongate instrument; an endotrachial tube fitting configured to be coupled to an endotrachial tube, the endotrachial tube fitting fluidly coupled to the first and second ports; and a hose fitting configured to be coupled to a ventilator hose, the hose fitting fluidly coupled to the first and second ports. The first port seals around the first elongated instrument and the second port seals around the second elongate instrument.

Abstract: An apparatus for performing anastomosis between a graft vessel and a target vessel may include a trocar that may create an opening in the target vessel. At least part of the trocar may be expandable to allow an anastomosis device to pass through the distal end thereof. The apparatus may include a holder configured to hold the anastomosis device, and place and deploy the anastomosis device in the opening created by the trocar.

Abstract: Methods and systems for lung volume reduction of a patient are described. The methods include implanting a flow control device in a bronchial passageway of the lung. The flow control device regulates fluid flow through the bronchial passageway. A region of the lung is aspirated distal of the flow control device while the patient is inhaling.

Abstract: A trocar useful for forming an incision in a target vessel for placement of an anastomosis device which may have an inner flange formed by radial expansion of the device and an outer flange formed by axial compression of the device. The trocar can have a smaller size during formation of the incision and a larger size when retracted over a deployment tool used to deploy the anastomosis device.

Abstract: A desired fluid flow dynamic to a lung region can be achieved by deploying various combinations of flow control devices and bronchial isolation devices in one or more bronchial passageways that communicate with the lung region. The flow control devices are implanted in channels that are formed in the walls of bronchial passageways of the lung. The flow control devices regulate fluid flow through the channels. The bronchial isolation devices are implanted in lumens of bronchial passageways that communicate with the lung region in order to regulate fluid flow to and from the lung region through the bronchial passageways.

Abstract: An anastomosis system for connecting a graft vessel to a target vessel includes spaced-apart arms, and an anvil connected to those arms, where that anvil has a blunt distal end. The anvil is insertable into the target vessel. One or more connectors, such as staples, may be deployed from each arm to connect the graft vessel to the target vessel.

Abstract: An apparatus for performing anastomosis between a graft vessel and a target vessel may include a connector holder having spaced-apart arms, and a member connected to the connector holder, where the member is insertable through an opening in a wall of the target vessel at least partially into the lumen of the target vessel. One or more connectors, such as staples, may be deployed from each arm to connect the graft vessel to the target vessel. One or more connectors may be deformable against the member.

Abstract: An anastomosis device may include a central region, and at least one projection connected to the distal end of the central region, where at least one projection is foldable in at least the proximal direction. An anastomosis device may include a central region, and an inner flange connected to the distal end of the central region, the inner flange deployable from a first position to an expanded position, where the inner flange includes at least one substantially triangular inner flange element.