Abstract: Devices and methods are disclosed for the treatment or repair of regurgitant cardiac valves, such as a mitral valve. An annuloplasty device can be placed in the coronary sinus to reshape the mitral valve and reduce mitral valve regurgitation. A protective device can be placed between the annuloplasty device and an underlying coronary artery to inhibit compression of the underlying coronary artery by the annuloplasty device in the coronary sinus. In addition, the protective device can inhibit compression of the coronary artery from inside the heart, such as from a prosthetic mitral valve that exerts radially outward pressure toward the coronary artery. The annuloplasty device can also create an artificial inner ridge or retaining feature projecting into the native mitral valve region to help secure a prosthetic mitral valve.

Abstract: Systems and methods of atrioventricular valve replacement are provided. In various embodiments, an arch-like support structure is provided that is insertable and implantable into a heart and is positioned in the mitral annulus to replace a native mitral valve. The support structure is operable to support, and various systems comprise leaflet and chord structures operable to control and regular blood flow between chambers of the heart.

Abstract: The present disclosure provides embodiments of devices that are useful in the structural remodeling of various parts of the cardiovascular system, most notably the heart. Certain of the disclosed devices relate to RAMIN procedures (“remodeling and ablation using myocardial interstitial navigation”). RAMIN procedures, as described herein, represent a new family of non-surgical catheter-based procedures in order to accomplish ablation, drug delivery, re-shaping, pacing, and related structural heart interventional procedures, as desired.

Abstract: Devices and methods are disclosed for the treatment or repair of regurgitant cardiac valves, such as a mitral valve. An annuloplasty device can be placed in the coronary sinus to reshape the mitral valve and reduce mitral valve regurgitation. A protective device can be placed between the annuloplasty device and an underlying coronary artery to inhibit compression of the underlying coronary artery by the annuloplasty device in the coronary sinus. In addition, the protective device can inhibit compression of the coronary artery from inside the heart, such as from a prosthetic mitral valve that exerts radially outward pressure toward the coronary artery. The annuloplasty device can also create an artificial inner ridge or retaining feature projecting into the native mitral valve region to help secure a prosthetic mitral valve.

Abstract: The disclosure provides various embodiments of systems to facilitate the cutting of luminal tissue structures percutaneously.

Abstract: The disclosure provides various embodiments of systems to facilitate the cutting of luminal tissue structures percutaneously.

Abstract: In some implementations, a radially self-expanding endograft prosthesis is provided that includes (i) distal flange that is self-expanding and configured to flip generally perpendicularly with respect to a body of the prosthesis to help seat the prosthesis against a tissue wall, (ii) a distal segment extending proximally from the distal flange that has sufficient stiffness to maintain a puncture open that is formed through a vessel wall (iii) a compliant middle segment extending proximally from the distal segment, the middle segment being more compliant than the distal segment, and having independently movable undulating strut rings attached to a tubular fabric, the combined structure providing flexibility and compliance to allow for full patency while flexed, the segment being configured to accommodate up to a 90 degree bend, (iv) a proximal segment having a plurality of adjacent undulating strut rings that are connected to each other.

Abstract: Disclosed delivery catheters have a three-dimensional curvature that facilitates reaching the RAA from the inferior vena cava, positioning the distal end of the catheter generally parallel to the plane of the pericardial space at the puncture location within the RAA, orienting the puncturing device in a direction that avoids the right coronary artery, aorta, pulmonary artery, and other structures to prevent bystander injury to such structures, and provides sufficient rigidity to puncture through a wall of the RAA into the pericardial space.

Abstract: Devices and methods are disclosed for the treatment or repair of regurgitant cardiac valves, such as a mitral valve. An annuloplasty device can be placed in the coronary sinus to reshape the mitral valve and reduce mitral valve regurgitation. A protective device can be placed between the annuloplasty device and an underlying coronary artery to inhibit compression of the underlying coronary artery by the annuloplasty device in the coronary sinus. In addition, the protective device can inhibit compression of the coronary artery from inside the heart, such as from a prosthetic mitral valve that exerts radially outward pressure toward the coronary artery. The annuloplasty device can also create an artificial inner ridge or retaining feature projecting into the native mitral valve region to help secure a prosthetic mitral valve.

Abstract: Disclosed monopolar and bipolar tissue lacerators can comprise a wire partially covered by electrical insulation, wherein the wire has a kink defining an inner curvature, wherein the wire is exposed through the insulation at one or two exposed regions along or near the inner curvature of the kink, wherein the wire is configured to conduct electrical energy through the one or two exposed regions and through a tissue target positioned adjacent the inner curvature to lacerate the tissue target via the electrical energy. The tissue target can be a native or prosthetic heart valve leaflet in a patient's heart.

Abstract: Disclosed herein are segmented MRI-compatible interventional devices, such as catheters and guidewires, that provide desired mechanical properties while avoiding undesired interactions with MRI fields. Disclosed devices can include helical wires with insulated breaks at intervals along each wire so that the insulated wire segments are individually short enough to avoid substantial resonance and heat being generated in the wires due to an applied MRI field. The segmented wires can be organized into a braided/woven tubular configuration or a non-braided intercalated/parallel tubular configuration that provides the desired mechanical properties similar to conventional metallic braided catheters. The helical wire segments can be insulated such that the wires do not touch each other at points where they cross over each other.

Abstract: Devices, apparatus, and methods for catheter-based repair of cardiac valves, including transcatheter-mitral-valve-cerclage annuloplasty and transcatheter-mitral-valve reapposition. In particular, a target and capture device is provided for guiding a cerclage traversal catheter system through a cerclage trajectory, particularly through a reentry site of the cerclage trajectory. The target and capture device provides the user with a target through which the cerclage traversal catheter system must be guided, particularly under imaging guidance, so as to properly traverse the cerclage trajectory at any desired location, particularly at a reentry site. The target and capture device can, further, ensnare and externalize the cerclage traversal catheter system.

Abstract: Disclosed herein are embodiments of segmented metallic guidewires that are suitable for MRI catheterization. Disclosed guidewires comprise a plurality of short conductive metallic segments that individually are short enough such that they do not resonate during MRI. The conductive segments are electrically insulated from each other and mechanically coupled together end-to-end via connectors, such as stiffness matched connectors, to provide a sufficiently long, strong, and flexible guidewire for catheterization that is non-resonant during MRI.

Abstract: Devices and methods are disclosed for the treatment or repair of regurgitant cardiac valves, such as a mitral valve. An annuloplasty device can be placed in the coronary sinus to reshape the mitral valve and reduce mitral valve regurgitation. A protective device can be placed between the annuloplasty device and an underlying coronary artery to inhibit compression of the underlying coronary artery by the annuloplasty device in the coronary sinus. In addition, the protective device can inhibit compression of the coronary artery from inside the heart, such as from a prosthetic mitral valve that exerts radially outward pressure toward the coronary artery. The annuloplasty device can also create an artificial inner ridge or retaining feature projecting into the native mitral valve region to help secure a prosthetic mitral valve.

Abstract: Disclosed herein are devices and methods for closing a hole in the wall of a cardiovascular structure from the inside using a self-assembling closure device. The closure device can be delivered to the subject hole from the inside of the cardiovascular chamber using a transcatheter approach. Disclosed techniques involve deploying the closure device from the delivery device such that an endo-cameral portion of the closure device self-expands first to cover the hole from the inside, and then extra-cameral arms of the device are released to self-deploy against the outside of the wall by withdrawal of a retaining element, such as a guidewire, to secure the closure device to the wall.

Abstract: This disclosure relates to devices and methods for manipulating, such as with a suction based traction device, a target anatomic structure inside the body and delivering an ligation device around the anatomic structure. In particular examples, the target structure can be an atrial appendage, and the devices and methods are for atrial appendage ligation.

Abstract: Delivery devices for delivering encircling implants can include two separate limbs that are held together at a distal articulation by the implant being delivered. The implant can comprise a suture and/or a braided tube. The implant can extend through or over the limbs. The implant and at least a distal portion of the limbs can be compressible into a delivery shape that allows for advancement through the lumen of a delivery catheter. When the distal portion of the limbs move out of the delivery catheter, the limbs and implant can resiliently assume a loop shape that is complementary to a shape of a target around which the encircling implant is to be placed. The limbs are then retracted from along the implant to leave the implant in the desired delivery position. The delivery device can be used to place encircling implants around the heart or other targets, and the implant can be tightened to exert compressive force on the target.

Abstract: In some implementations, a radially self-expanding endograft prosthesis is provided that includes (i) distal flange that is self-expanding and configured to flip generally perpendicularly with respect to a body of the prosthesis to help seat the prosthesis against a tissue wall, (ii) a distal segment extending proximally from the distal flange that has sufficient stiffness to maintain a puncture open that is formed through a vessel wall (iii) a compliant middle segment extending proximally from the distal segment, the middle segment being more compliant than the distal segment, and having independently movable undulating strut rings attached to a tubular fabric, the combined structure providing flexibility and compliance to allow for full patency while flexed, the segment being configured to accommodate up to a 90 degree bend, (iv) a proximal segment having a plurality of adjacent undulating strut rings that are connected to each other.

Abstract: Devices and methods are disclosed for the treatment or repair of regurgitant cardiac valves, such as a mitral valve. An illustrative annuloplasty device can be placed in the coronary sinus to reshape the mitral valve and reduce mitral valve regurgitation. An improved protective device can be placed between the annuloplasty device and an underlying coronary artery to inhibit compression of the underlying coronary artery by the annuloplasty device in the coronary sinus. In addition, the protective device can inhibit compression of the coronary artery from inside the heart, such as from a prosthetic mitral valve that exerts radially outward pressure toward the coronary artery. The annuloplasty device can also create an artificial inner ridge or retaining feature projecting into the native mitral valve region to help secure a prosthetic mitral valve.

Abstract: In some implementations, a radially self-expanding endograft prosthesis is provided that includes (i) distal flange that is self-expanding and configured to flip generally perpendicularly with respect to a body of the prosthesis to help seat the prosthesis against a tissue wall, (ii) a distal segment extending proximally from the distal flange that has sufficient stiffness to maintain a puncture open that is formed through a vessel wall (iii) a compliant middle segment extending proximally from the distal segment, the middle segment being more compliant than the distal segment, and having independently movable undulating strut rings attached to a tubular fabric, the combined structure providing flexibility and compliance to allow for full patency while flexed, the segment being configured to accommodate up to a 90 degree bend, (iv) a proximal segment having a plurality of adjacent undulating strut rings that are connected to each other.