Abstract: Methods and devices for sculpting bones, particularly in preparation for implanting prosthetic devices to replace articulating bone joint surfaces. Improved bone removal devices including burr mills driven by gears and loop drives are provided. Reciprocating cutters and belt cutters are also provided. Some devices have either integral or removable expandable portions to vary the force and bone resection depth. Devices can have irrigation ports and plenums to remove bone fragments. Some cutters are dual cutters, adapted to remove bone in two or more regions, such as the knee joint, simultaneously.

Abstract: The invention provides a rotational atherectomy system, device and method comprising a flexible, elongated, rotatable drive shaft with a pre-curved abrasive section disposed within a catheter that deforms the abrasive section to a substantially straight profile and, when the abrasive section is moved distally out of the catheter, the abrasive section resumes its pre-curved profile. Directional ablation is achieved by rotation of the drive shaft along its pre-curved axis as the abrasive section is urged against a portion of the lumen wall.

Abstract: The invention provides a rotational and/or axially translatable atherectomy system, device and method comprising a flexible, elongated drive shaft or catheter comprising an expandable and collapsible conical coil with a cutting edge on the coil's large diameter proximal end. When retracted, the coil's sections are collapsed around each other, held together in the retracted position by a sheath that, when distally retracted, allows the coil to automatically expand. The coil is expanded at a point distal to the occlusion, then pulled proximally to cut the occluding material near the lumen wall. The proximal pulling force may be combined with low-speed rotation and/or translation and/or axial vibration at low to ultrasonic frequency.

Abstract: A transmyocardial implant establishes a blood flow path through a myocardium between a heart chamber and a lumen of a coronary vessel residing on an exterior of the heart. The implant includes a coronary portion sized to be received with the vessel. A myocardial portion is sized to pass through the myocardium into the heart chamber. A transition portion connecting the coronary and myocardial portion for directing blood flow from the myocardial portion and into the coronary portion. The transition portion is an arcuate bend and at least a portion of the arcuate bend terminates at the vessel opening at a point of tangency of the arcuate bend.