Abstract: A method of preparing a ventricular partitioning device for implantation using a delivery system can include coupling the ventricular partitioning device to a delivery catheter, loading the ventricular partitioning device and a portion of the delivery catheter into a sleeve and creating a liquid-tight seal between a portion of the sleeve and the delivery catheter, coupling a distal end of the sleeve to a guide catheter, and delivering fluid through at least one of the first fluid delivery port or the second fluid delivery port. The method can be performed with the delivery catheter or the sleeve having a first fluid delivery port positioned thereon. The method can be with the guide catheter having a second fluid delivery port positioned thereon.

Abstract: A method of preparing a ventricular partitioning device for implantation using a delivery system can include coupling the ventricular partitioning device to a delivery catheter, loading the ventricular partitioning device and a portion of the delivery catheter into a sleeve and creating a liquid-tight seal between a portion of the sleeve and the delivery catheter, coupling a distal end of the sleeve to a guide catheter, and delivering fluid through at least one of the first fluid delivery port or the second fluid delivery port. The method can be performed with the delivery catheter or the sleeve having a first fluid delivery port positioned thereon. The method can be with the guide catheter having a second fluid delivery port positioned thereon.

Abstract: A system for treating cardiac dysfunction can include an expandable device for insertion into a heart, a foot configured to contact a portion of the heart, a support frame, and a membrane coupled to the support frame. The support frame can include a plurality of radially expandable struts each having a first free end configured to extend beyond the foot and a second end coupled to the foot. The plurality of radially expandable struts can include a plurality of staggered stops, and each of the stops can be positioned on a respective one of the struts proximal to the first free end of the respective one of the struts. Method for treating cardiac dysfunction can include implanting the systems described herein into a chamber of the heart.

Abstract: A system for treating cardiac dysfunction can include an expandable device for insertion into a heart, a foot configured to contact a portion of the heart, a support frame, and a membrane coupled to the support frame. The support frame can include a plurality of radially expandable struts each having a first free end configured to extend beyond the foot and a second end coupled to the foot. The plurality of radially expandable struts can include a plurality of staggered stops, and each of the stops can be positioned on a respective one of the struts proximal to the first free end of the respective one of the struts. Method for treating cardiac dysfunction can include implanting the systems described herein into a chamber of the heart.

Abstract: Devices, systems, and methods are provided for user input to control automated movement of catheters and other elongate bodies. Fluid drive systems can be used to provide robotically coordinated motion. Precise control over actual robotic catheter-supported tools are enhanced by moving a virtual version of the tool from a starting location of an actual tool to a desired ending position and orientation. A processor of the system can then generate synchronized actuator drive signals to move the tool without following the (often meandering) path input by the system user. The progress of the tool along a multi-degree-of-freedom trajectory can be controlled with a simple 1D input. Standard planar or proprietary input devices can be used for orientation and translation movements. Hybrid image display with 2D and 3D components is provided, along with spacial constrained movement to workspace boundaries.

Abstract: Devices, systems, and methods can articulate catheters and other tools using fluid drive systems that provide robotically coordinated motion. The drive power will often be transmitted from a fluidic driver to the catheter through a series of pneumatic or hydraulic channels and the driver can be isolated from a sterile field by encasing the driver in a sterile housing and directing drive fluid through a sterile junction between the catheter and driver. Interventional physicians can retain tactile feedback by manually advancing the catheter over a wire or the like, and can subsequently bring an interface of the catheter down into engagement with a corresponding driver interface once a therapeutic tool approaches a target site. A sensor may provide signals during manual advancement of the driver and catheter along the catheter axis.

Abstract: Described herein are implant delivery systems and methods for controllably deploying an expandable device in a ventricle, the left atrial appendage, or other portion of the heart of a patient. In some embodiments, the implant delivery system includes means for loosening or releasing a suture on a perimeter region of the expandable device in order to control the expansion or contraction of the expandable member. In some such embodiments, loosening or releasing the suture expands the perimeter region of the expandable device to secure the expandable device in the ventricle of the patient, while tightening the suture contracts the perimeter region of the device. The system may include one or more monitoring devices to monitor aspects of the heart, such as hemodynamics.

Abstract: A method of preparing a ventricular partitioning device for implantation using a delivery system can include coupling the ventricular partitioning device to a delivery catheter, loading the ventricular partitioning device and a portion of the delivery catheter into a sleeve and creating a liquid-tight seal between a portion of the sleeve and the delivery catheter, coupling a distal end of the sleeve to a guide catheter, and delivering fluid through at least one of the first fluid delivery port or the second fluid delivery port. The method can be performed with the delivery catheter or the sleeve having a first fluid delivery port positioned thereon. The method can be with the guide catheter having a second fluid delivery port positioned thereon.

Abstract: A system for treating cardiac dysfunction can include an expandable device for insertion into a heart, a foot configured to contact a portion of the heart, a support frame, and a membrane coupled to the support frame. The support frame can include a plurality of radially expandable struts each having a first free end configured to extend beyond the foot and a second end coupled to the foot. The plurality of radially expandable struts can include a plurality of staggered stops, and each of the stops can be positioned on a respective one of the struts proximal to the first free end of the respective one of the struts. Method for treating cardiac dysfunction can include implanting the systems described herein into a chamber of the heart.

Abstract: A delivery system for delivering an implantable device can include a delivery catheter, a sleeve, and a guide catheter. The delivery catheter can have a tubular body having a proximal end and a distal end, such that the distal end of the delivery catheter is configured to couple to the implantable device. The sleeve can define a lumen configured to receive the delivery catheter and the implantable device coupled thereto. A first fluid delivery port can be positioned on the delivery catheter or the sleeve. A mechanical seal can be coupled to the sleeve and configured to form a liquid-tight seal with the delivery catheter. A guide catheter can have a tubular body having a proximal end, a distal end, and a second fluid delivery port positioned thereon, wherein the proximal end of the guide catheter is configured to be connected to a distal end of the sleeve.

Abstract: Described herein are implant loading and delivery systems for treating heart failure. An implant loading system may include a funnel having a flared first end and a second end, such that the flared first end is configured for receiving and collapsing the expandable implant, and a sleeve removably coupled to the second end of the funnel and configured to transfer the expandable implant to a guide catheter. The expandable device may have a foot for contacting a first interior wall portion of a heart, a support frame including a plurality of radially expandable struts, and a membrane coupled to the support frame. The expandable device may be coupled to a delivery catheter. An expansion member coupled to a distal end of the delivery catheter may apply pressure to the support frame of the expandable device to move the expandable device from a collapsed configuration to an expanded deployed configuration.

Abstract: A system for improving cardiac function is provided. A foldable and expandable frame having at least one anchoring formation is attached to an elongate manipulator and placed in a catheter tube while folded. The tube is inserted into a left ventricle of a heart where the frame is ejected from the tube and expands in the left ventricle. Movements of the elongate manipulator cause the anchor to penetrate the heart muscle and the elongate manipulator to release the frame. The installed frame minimizes the effects of an akinetic portion of the heart forming an aneurysmic bulge. Devices and methods are described herein which are directed to the treatment of a patient's heart having, or one which is susceptible to heart failure, to improve diastolic function.

Abstract: Medical devices, systems, and methods for catheter-based structural heart therapies, including positioning of prosthetic mitral valves, make use of catheter structures that can flex when advanced over a pre-bent guidewire. Telescoping transseptal access systems use steering segments that are disposed proximal of a relatively rigid catheter segment (the segment optionally supporting a prosthetic valve) by engaging tissue adjacent the right atrium near the proximal end of the valve, and by telescoping a relatively rigid needle guide distally from the valve across the right atrium to engage tissue of the fossa ovalis. Hybrid pull-wire/balloon articulation systems may optionally employ relatively stiff pull-wire articulation within the right atrium, and relatively flexible balloon articulation systems within the left atrium. More generally, hybrid systems may have catheter systems with pullwires or movable sheath, along with fluid drive and robotic control components.

Abstract: Described herein are implant delivery systems and methods for controllably deploying an expandable device in a ventricle, the left atrial appendage, or other portion of the heart of a patient. In some embodiments, the implant delivery system includes means for loosening or releasing a suture on a perimeter region of the expandable device in order to control the expansion or contraction of the expandable member. In some such embodiments, loosening or releasing the suture expands the perimeter region of the expandable device to secure the expandable device in the ventricle of the patient, while tightening the suture contracts the perimeter region of the device. The system may include one or more monitoring devices to monitor aspects of the heart, such as hemodynamics.

Abstract: Systems for partitioning a ventricle of a heart include a partitioning device or implant, and an applicator for inserting, repositioning and/or removing the partitioning device. The implant may support the ventricle wall and may reduce the volume of the ventricle. The delivery system for delivering and deploying a partitioning device into a ventricle may include a catheter having a distal coupling element for coupling to a partitioning device in a collapsed configuration; the catheter may also have an expansion member for applying force to the partitioning device to fully expand it into a deployed configuration and to secure or seal it against the ventricle wall.

Abstract: Devices and systems including implants (which may be removable) and methods of using them for reducing ventricular volume. The implants described herein are cardiac implants that may be inserted into a patient's heart, particularly the left ventricle. The implant may support the heart wall, or may be secured to the heart wall. The implants are typically ventricular partitioning device for partitioning the ventricle into productive and non-productive regions in order to reduce the ventricular volume.

Abstract: A delivery system for delivering an implantable device can include a delivery catheter, a sleeve, and a guide catheter. The delivery catheter can have a tubular body having a proximal end and a distal end, such that the distal end of the delivery catheter is configured to couple to the implantable device. The sleeve can define a lumen configured to receive the delivery catheter and the implantable device coupled thereto. A first fluid delivery port can be positioned on the delivery catheter or the sleeve. A mechanical seal can be coupled to the sleeve and configured to form a liquid-tight seal with the delivery catheter. A guide catheter can have a tubular body having a proximal end, a distal end, and a second fluid delivery port positioned thereon, wherein the proximal end of the guide catheter is configured to be connected to a distal end of the sleeve.

Abstract: A system for improving cardiac function is provided. A foldable and expandable frame having at least one anchoring formation is attached to an elongate manipulator and placed in a catheter tube while folded. The tube is inserted into a left ventricle of a heart where the frame is ejected from the tube and expands in the left ventricle. Movements of the elongate manipulator cause the anchor to penetrate the heart muscle and the elongate manipulator to release the frame. The installed frame minimizes the effects of an akinetic portion of the heart forming an aneurysmic bulge. Devices and methods are described herein which are directed to the treatment of a patient's heart having, or one which is susceptible to heart failure, to improve diastolic function.

Abstract: Described herein are implant loading and delivery systems for treating heart failure. An implant loading system may include a funnel having a flared first end and a second end, such that the flared first end is configured for receiving and collapsing the expandable implant, and a sleeve removably coupled to the second end of the funnel and configured to transfer the expandable implant to a guide catheter. The expandable device may have a foot for contacting a first interior wall portion of a heart, a support frame including a plurality of radially expandable struts, and a membrane coupled to the support frame. The expandable device may be coupled to a delivery catheter. An expansion member coupled to a distal end of the delivery catheter may apply pressure to the support frame of the expandable device to move the expandable device from a collapsed configuration to an expanded deployed configuration.

Abstract: A system for improving cardiac function is provided. A foldable and expandable frame having at least one anchoring formation is attached to an elongate manipulator and placed in a catheter tube while folded. The tube is inserted into a left ventricle of a heart where the frame is ejected from the tube and expands in the left ventricle. Movements of the elongate manipulator cause the anchor to penetrate the heart muscle and the elongate manipulator to release the frame. The installed frame minimizes the effects of an akinetic portion of the heart forming an aneurysmic bulge. Devices and methods are described herein which are directed to the treatment of a patient's heart having, or one which is susceptible to heart failure, to improve diastolic function.