Abstract: An assembly includes an implant and a control lead. The implant includes a tubular implant body, a circumferentially adjustable sealing collar coupled to the implant body, a rotatable sealer gear coupled to the sealing collar and configured to adjust the circumference of the sealing collar, and a locking member having a locked state and an unlocked state. The control lead is configured for rotating the locking member and moving the locking member from the locked state to the unlocked state. In the locked state, rotating the control lead does not adjust the circumference of the sealing member. In the unlocked state, rotating the control lead in a first direction rotates the locking member and the sealer gear and circumferentially expands the sealing collar. In the unlocked state, rotating the control lead in a second direction rotates the locking member and the sealer gear and circumferentially contracts the sealing collar.

Abstract: A method of implanting a prosthetic implant includes advancing a prosthetic implant into a patient's vasculature with a delivery apparatus, the delivery apparatus comprising a catheter and a control lead, the catheter including a lumen extending therethrough, the control lead extending through the lumen of the catheter, the prosthetic implant comprising an implant body, a seal extending radially outwardly from the implant body, and a locking bar coupled to the implant body and releasably coupled to the control lead, the locking bar radially offset relative to the central longitudinal axis of the implant body. The method further includes rotating the control lead of the delivery apparatus in a first direction relative to the catheter such that the locking bar rotates in the first direction relative to the implant body and the implant body expands radially from a first radially compressed state to a first radially expanded state.

Abstract: A method of implanting a prosthetic medical device at a target implantation site is provided. The method first comprises advancing a first prosthetic medical device through a subject's vasculature to a target implantation site. The first prosthetic medical device comprises a coil having an inflow end portion, an outflow end portion, and a central longitudinal axis extending from the inflow end portion to the outflow end portion. The method further comprises expanding the first prosthetic medical device from a compressed state to an expanded state to engage native vascular tissue at the target implantation site. The method subsequently comprises docking a second prosthetic medical device within the first prosthetic medical device.

Abstract: A prosthetic heart valve can comprise a stent frame radially movable between a contracted configuration and a maximum expanded configuration. The stent assembly can comprise a plurality of longitudinally extending jack strut assemblies, wherein each jack strut assembly comprises a proximal jack strut comprising a distal surface, a distal jack strut comprising a proximal surface, and a jack screw connecting the proximal jack strut and the distal jack strut. The proximal surface of each distal jack strut does not contact the distal surface of each respective proximal jack strut when the stent assembly is in the contracted configuration. The proximal surface of each distal jack strut contacts the distal surface of each respective proximal jack strut when the stent assembly is in the maximum expanded configuration.

Abstract: A vascular system includes a delivery apparatus and an endovascular device. The delivery apparatus including a catheter and a control lead. The control lead extends through a lumen of the catheter and is configured to be manipulated by a user. The endovascular device is releasably coupled to the delivery apparatus and includes an implant body, a seal extending radially outwardly from the implant body, and one or more tissue engaging elements. The seal is configured to contact native vascular tissue to reduce leakage between the native vascular tissue and the implant body. The tissue engaging elements are pivotable relative to the seal from a compressed state to an expanded state. In the compressed state, the tissue engaging elements are positioned so as to disengage the native vascular tissue. In the expanded state, the tissue engaging elements extend outwardly from the seal and are configured to engage the native vascular tissue.

Abstract: A prosthetic heart valve includes a frame, a valve, and an expansion element. The frame is movable between contracted and expanded configurations and includes first struts and second struts non-hingedly coupled together. The second struts are configured to pivot relative to the first struts as the frame moves between the contracted and expanded configurations. The valve is coupled to the frame and includes leaflets. The expansion element extends through a lumen of the first struts. The expansion element is slidable relative to the lumen of the first struts and is configured to move the frame incrementally from the contracted configuration and the expanded configuration and from the expanded configuration to the contracted configuration.

Abstract: An assembly includes an implant body and a delivery apparatus. The implant body includes a lattice structure, an adjustment member, and a control device. The lattice structure is circumferentially expandable and contractible. The adjustment member and the control device are coupled to the lattice structure. Actuating the adjustment member results in circumferential expansion or contraction of the lattice structure. The delivery apparatus includes a rotatable adjustment tool and a locking mechanism comprising a controllable catch coupled to an end portion of the rotatable adjustment tool. The rotatable adjustment tool is configured to actuate the adjustment member of the implant body upon rotation of the rotatable adjustment tool. The controllable catch of the locking mechanism is configured to selectively couple the rotatable adjustment tool to the adjustment member of the implant body.

Abstract: A multiple-firing clip device comprises a shaft comprising an exterior surface, an interior receiving therein suture fixation clips, and a distal end opening shaped to eject a suture fixation clip therefrom. The shaft defines a lateral opening and a distal shaft portion between the lateral opening and the distal end opening. A shuttle moves on the shaft and comprises a shuttle body, a snare having a distal snare portion, and a snare extension slide movable from the shuttle body along a given extent defining a slide distance and a distal end. The shuttle extends at least the distal snare portion distally through the lateral opening from the environment into the interior, through the distal shaft portion, and through the distal end opening along a length that is at least equal to the slide distance when the snare extension slide moves to the distal end of the given extent.

Abstract: A method of implanting a device in a heart includes inserting an implant into a blood vessel with a delivery apparatus. The implant includes a stent member and an adjustment member. The stent member is circumferentially expandable and contractible. The adjustment member is coupled to the stent member. The delivery apparatus includes a rotatable shaft and a locking mechanism coupled to an end portion of the shaft. The shaft of the delivery apparatus is releasably coupled to the adjustment member of the implant by the locking mechanism of the delivery apparatus. The method further includes positioning the implant at an implantation location within a heart by manipulating the delivery apparatus, and rotating the shaft of the delivery apparatus relative to the stent member of the implant to actuate the adjustment member of the implant. Actuating the adjustment member results in circumferential expansion or contraction of the stent member.

Abstract: A multiple-firing clip device comprises a shaft comprising an exterior surface, an interior receiving therein suture fixation clips, and a distal end opening shaped to eject a suture fixation clip therefrom. The shaft defines a lateral opening and a distal shaft portion between the lateral opening and the distal end opening. A shuttle moves on the shaft and comprises a shuttle body, a snare having a distal snare portion, and a snare extension slide movable from the shuttle body along a given extent defining a slide distance and a distal end. The shuttle extends at least the distal snare portion distally through the lateral opening from the environment into the interior, through the distal shaft portion, and through the distal end opening along a length that is at least equal to the slide distance when the snare extension slide moves to the distal end of the given extent.

Abstract: A multiple-firing clip device includes a hollow shaft defining a lateral opening communicating with an environment and a distal shaft portion between the lateral opening and a distal end opening. A shuttle longitudinally moves on the shaft and comprises a shuttle body defining a lumen surrounding the shaft, a snare, and a snare-extender slide defining a snare track to form a snare travel path in which the snare is disposed from the body and through the track and a portion of the body. The slide moves along a given extent defining a slide distance and a distal end and movement of the slide to the distal end shortens the snare travel path to extend the snare portion through the lateral opening, through the distal shaft portion, and distally out from a distal side of the body longer than the given extent to secure a suture with the snare.

Abstract: A multiple-firing clip device includes a hollow shaft defining a lateral opening communicating with an environment and a distal shaft portion between the lateral opening and a distal end opening. A shuttle longitudinally moves on the shaft and comprises a shuttle body defining a lumen surrounding the shaft, a snare, and a snare-extender slide defining a snare track to form a snare travel path in which the snare is disposed from the body and through the track and a portion of the body. The slide moves along a given extent defining a slide distance and a distal end and movement of the slide to the distal end shortens the snare travel path to extend the snare portion through the lateral opening, through the distal shaft portion, and distally out from a distal side of the body longer than the given extent to secure a suture with the snare.

Abstract: A method of implanting a replacement mitral valve can include expanding a replacement mitral valve to a first expanded configuration. The replacement mitral valve can include a force-expanding mitral valve lattice and a self-expanding valve trampoline lattice. The mitral valve lattice has an inflow end portion and an outflow end portion, and the valve trampoline lattice is attached to the outflow end portion of the mitral valve lattice. The method can also include rotating a plurality of jack screws connected to the mitral valve lattice. The jack screws can be configured to expand the mitral valve lattice from the first expanded configuration to a second expanded configuration.

Abstract: A prosthetic heart valve includes a frame, a valve, and an expansion element. The frame is movable between contracted and expanded configurations and includes first struts and second struts non-hingedly coupled together. The second struts are configured to pivot relative to the first struts as the frame moves between the contracted and expanded configurations. The valve is coupled to the frame and includes leaflets. The expansion element extends through a lumen of the first struts. The expansion element is slidable relative to the lumen of the first struts and is configured to move the frame incrementally from the contracted configuration and the expanded configuration and from the expanded configuration to the contracted configuration.

Abstract: A method of implanting a prosthetic implant includes advancing a prosthetic implant into a patient's vasculature with a delivery apparatus, the delivery apparatus comprising a catheter and a control lead, the catheter including a lumen extending therethrough, the control lead extending through the lumen of the catheter, the prosthetic implant comprising an implant body, a seal extending radially outwardly from the implant body, and a locking bar coupled to the implant body and releasably coupled to the control lead, the locking bar radially offset relative to the central longitudinal axis of the implant body. The method further includes rotating the control lead of the delivery apparatus in a first direction relative to the catheter such that the locking bar rotates in the first direction relative to the implant body and the implant body expands radially from a first radially compressed state to a first radially expanded state.

Abstract: A delivery apparatus can include a handle portion and at least one rotatable drive shaft. The handle portion has an actuation mechanism. The actuation mechanism includes a motor and one or more actuators. The rotatable drive shaft has a proximal end portion and a distal end portion. The proximal end portion is coupled to the motor, and the distal end portion is configured to be releasably coupled to a prosthetic heart valve. The actuation mechanism is configured to control and monitor expansion of the prosthetic heart valve. The handle is configured for actuating the actuation mechanism, tracking a response of native tissue when the prosthetic heart valve is in contact with the native tissue, and stopping expansion of the prosthetic heart valve once a rate of change of expansion of the prosthetic heart valve declines below a threshold.

Abstract: A prosthetic implant includes a circumferentially adjustable sealing collar and a rotatable sealer gear. The sealing collar has a central longitudinal axis. The rotatable sealer gear is coupled to and disposed within the sealing collar and configured to adjust the circumference of the sealing collar. The sealer gear is radially offset relative to the central longitudinal axis of the sealing collar. Rotating the sealer gear in a first direction relative to the sealing collar circumferentially expands the sealing collar. Rotating the sealer gear in a second direction relative to the sealing collar circumferentially contracts the sealing collar.

Abstract: A prosthetic implant includes a circumferentially adjustable sealing collar and a rotatable sealer gear. The sealing collar has a central longitudinal axis. The rotatable sealer gear is coupled to and disposed within the sealing collar and configured to adjust the circumference of the sealing collar. The sealer gear is radially offset relative to the central longitudinal axis of the sealing collar. Rotating the sealer gear in a first direction relative to the sealing collar circumferentially expands the sealing collar. Rotating the sealer gear in a second direction relative to the sealing collar circumferentially contracts the sealing collar.

Abstract: A vascular system includes a delivery apparatus and an endovascular device. The delivery apparatus including a catheter and a control lead. The control lead extends through a lumen of the catheter and is configured to be manipulated by a user. The endovascular device is releasably coupled to the delivery apparatus and includes an implant body, a seal extending radially outwardly from the implant body, and one or more tissue engaging elements. The seal is configured to contact native vascular tissue to reduce leakage between the native vascular tissue and the implant body. The tissue engaging elements are pivotable relative to the seal from a compressed state to an expanded state. In the compressed state, the tissue engaging elements are positioned so as to disengage the native vascular tissue. In the expanded state, the tissue engaging elements extend outwardly from the seal and are configured to engage the native vascular tissue.

Abstract: A method of implanting a device in a heart includes inserting an implant into a blood vessel with a delivery apparatus. The implant includes a stent member and an adjustment member. The stent member is circumferentially expandable and contractible. The adjustment member is coupled to the stent member. The delivery apparatus includes a rotatable shaft and a locking mechanism coupled to an end portion of the shaft. The shaft of the delivery apparatus is releasably coupled to the adjustment member of the implant by the locking mechanism of the delivery apparatus. The method further includes positioning the implant at an implantation location within a heart by manipulating the delivery apparatus, and rotating the shaft of the delivery apparatus relative to the stent member of the implant to actuate the adjustment member of the implant. Actuating the adjustment member results in circumferential expansion or contraction of the stent member.