Abstract: A tissue cutting device includes a catheter with a window at its distal tip for admitting tissue into a catheter compartment. A cylindrical cartridge in the compartment has a cutting edge that supports an electrically conductive cutting element, e.g. a band or wire. The cutting element and adjacent tissue can be heated to a selected temperature by generating an electrical current through the cutting element. The catheter is maneuverable to position its distal end near the tissue to be cut. The catheter incorporates a vacuum feature that urges tissue into the compartment prior to cutting or severing and assists in holding the tissue during the cutting or severing process. Then, the cartridge is manipulated from the catheter's proximal end to move the cutting edge across the window, cutting the tissue. According to alternative embodiments, the cartridge is either rotated or moved axially relative to the catheter and, in either event may be capable of closing the catheter window when the cut is complete.

Abstract: A surgical instrument is used for temporary use in a medical procedure in a mammalian body. The surgical instrument is configured to be changed between two shapes upon application of one or both of heating and cooling. The instrument includes a first member, a second member having a surface configured to contact tissue, and a means to apply heating or cooling to one or both of the first member and the second member to change the shape between a first shape and a second shape. A surgical instrument also may be configured to be changed between two shapes upon removal of a constraining force. The surgical instrument includes a first member, a second member having a surface configured to contact tissue, and a constraining means to apply a constraining force to one or both of the first member and the second member to cause one or both of the first member and the second member to be in a first constrained shape. The surgical instruments may be used in minimally invasive valve surgery.

Abstract: A system and components for treating aortic aneurysms includes a reinforcing graft and fittings for securing the graft to a host vessel and to branch vessels, for example the iliac and renal arteries. Combinations of fittings and rings or other compression mechanisms secure vessels or grafts frictionally, for end-end or end-side couplings. A variety of tools are disclosed for manipulating retaining rings, everting portions of grafts or vessels in the course of coupling them to fittings, and clamping fittings while positioning the retaining rings.

Abstract: A bypass graft incorporates fixation mechanisms at its opposite ends, for securing these ends to different locations along a blood vessel, or alternatively to different locations wherein one of the locations is a different vessel or an organ defining a cavity. Mechanical fixation features such as collets or grommets can be employed, enhanced by delivery of an electrical current sufficient to heat surrounding tissue to form a thermal bond. A graft deployment system includes a tissue dilator and a needle for perforating tissue, mounted coaxially within the dilator. Intralumenal systems further include a catheter for containing the dilator.

Abstract: A bypass graft incorporates fixation mechanisms at its opposite ends, for securing these ends to different locations along a blood vessel, or alternatively to different locations wherein one of the locations is a different vessel or an organ defining a cavity. Mechanical fixation features such as collets or grommets can be employed, enhanced by delivery of an electrical current sufficient to heat surrounding tissue to form a thermal bond. A graft deployment system includes a tissue dilator and a needle for perforating tissue, mounted coaxially within the dilator. Intralumenal systems further include a catheter for containing the dilator.

Abstract: A bypass graft incorporates fixation mechanisms at its opposite ends, for securing these ends to different locations along a blood vessel, or alternatively to different locations wherein one of the locations is a different vessel or an organ defining a cavity. Mechanical fixation features such as collets or grommets can be employed, enhanced by delivery of an electrical current sufficient to heat surrounding tissue to form a thermal bond. A graft deployment system includes a tissue dilator and a needle for perforating tissue, mounted coaxially within the dilator. Intralumenal systems further include a catheter for containing the dilator.

Abstract: This invention is related to devices and systems for creating sutureless anastomoses. In particular, this invention is related to devices for deploying and securing the ends of bypass grafts designed to provide a fluid flow passage between at least two vessels or tubular structures. A variety of compressible, expandable fittings, loading and delivery sheaths, tools, and other devices for creating end-end and end-side anastomoses, as well as methods for their use, are disclosed. In addition, robotic, remotely operable systems and devices for creating sutureless anastomoses in minimally invasive applications are disclosed. The systems of this invention do not require stopping or re-routing blood flow to perform an anastomosis between a bypass graft and a host vessel. Accordingly, this invention describes sutureless anastomosis systems that do not require cardiopulmonary bypass support when treating coronary artery disease.

Abstract: Anastomosis systems include fittings and compression mechanisms for effecting end-end or end-side couplings of biological or synthetic bypass grafts to vessel locations. The fittings are tubular and surround end regions of the graft. In some applications an end region of the graft is everted and surrounds an exterior of the fitting, in which case the preferred compression mechanism is a retaining ring. A tool is used to evert the graft end region. In other applications, the fitting has an interior groove that receives an expandable retaining ring that urges the graft end region radially outwardly against the fitting. A graft deploying and securing system includes a needle for puncturing vessel tissue, a dilator, and a sheath adapted for containing a graft/fitting combination and guiding the combination into the vessel through an opening formed by the needle and dilator.

Abstract: Anastomosis systems include fittings and compression mechanisms for effecting end-end or end-side couplings of biological or synthetic bypass grafts to vessel locations. The fittings are tubular and surround end regions of the graft. In some applications an end region of the graft is everted and surrounds an exterior of the fitting, in which case the preferred compression mechanism is a retaining ring. A tool is used to evert the graft end region. In other applications, the fitting has an interior groove that receives an expandable retaining ring that urges the graft end region radially outwardly against the fitting. A graft deploying and securing system includes a needle for puncturing vessel tissue, a dilator, and a sheath adapted for containing a graft/fitting combination and guiding the combination into the vessel through an opening formed by the needle and dilator.

Abstract: An end-side anastomosis system including a fitting comprising: a base for attachment to a graft, said base be configured to form a seal with an opening in a host vessel wall; a leading petal having a cross-section with a radius of curvature approximating a radius of curvature of the host vessel, said leading petal being configured to dilate the host vessel wall opening while advancing said fitting through the opening; and a rear petal, said rear petal being deflectable to be advanced through the host vessel opening.

Abstract: A racket includes a handle section, a head section, and a connecting section positioned between the handle section and the head section. One or more of the handle section, the head section, and the connecting section include a superelastic metal. The racket, other athletic devices and other devices containing superelastic components are capable of producing a spring force in response to a deflection. The superelastic components may improve the performance of rackets, athletic devices and other devices by increasing the contact duration between the active element of the device and objects against which the devices are configured to exert a force. The superelastic components also provide increased resistance to breakage or plastic deformation of the racket, athletic device or other devices, especially when exposed to frequent deflections. Superelastic components are able to decrease the weight of rackets, athletic devices, or other devices without sacrificing strength.

Abstract: A bypass graft incorporates fixation mechanisms at its opposite ends, for securing these ends to different locations along a blood vessel, or alternatively to different locations wherein one of the locations is a different vessel or an organ defining a cavity. Mechanical fixation features such as collets or grommets can be employed, enhanced by delivery of an electrical current sufficient to heat surrounding tissue to form a thermal bond. A graft deployment system includes a tissue dilator and a needle for perforating tissue, mounted coaxially within the dilator. Intralumenal systems further include a catheter for containing the dilator.

Abstract: Described are anatomic braces, traction devices, and scaffolds containing superelastic supports capable of reinforcing anatomic joints or other structures, applying a directional force in response to a deflection, and/or producing a spring force to apply decompression or compression to the anatomy. The braces are intended to reinforce the back, knees, ankles, elbows, wrists, shoulders, neck, hips, or other anatomy commonly associated with a degree of twisting, rotation, bending, or other desired motion. The anatomic braces and traction devices also provide motion assistance and/or intensify the force during motion of anatomic structures. In particular, the anatomic braces and traction devices aid in standing, bending, throwing, kicking, jumping, running, walking, hitting, shooting, or other strenuous activity by inducing a directional force upon deflection. The braces alternatively apply a specific resistance at the anatomic joint to strengthen the muscles during training or rehabilitation.

Abstract: Described are shoes, orthodic appliances, and anatomic braces containing superelastic support members for enhanced performance. The superelastic supports provide dynamic response to deflection. As such, the superelastic supports incorporated in the soles of shoes enhance walking, running, jumping, kicking, or other motion involving the foot. The superelastic supports may be incorporated in the body of shoes to reinforce the ankle joint. The embodiments of the invention also provide superelastic supports in braces to reinforce or stabilize the knees, ankles, elbows, wrists, shoulders, back, neck, hips, or other anatomy commonly associated with a degree of twisting, rotation, bending, or other desired motion. The braces also intensify the motion of anatomic structures, apply a specific resistance at the joint to strengthen the muscles during training or rehabilitation, and/or immobilize or stabilize joints, bones, or other anatomic structures during healing of an injury.

Abstract: A sutureless anastomosis systems for securing a bypass graft to a host vessel or other tubular structure including a bypass graft and fitting. A compression mechanism may be used with the system for attachment of the bypass graft to the fitting. An electrode is connected to the fitting and an energy source. The energy source transmits energy to the electrode and causes the adjacent tissue to rise in temperature and bond to a vessel or fitting.

Abstract: Apparatus and methods are provided for thermally and/or mechanically treating tissue, such as valvular structures, to reconfigure or shrink the tissue in a controlled manner. The apparatus comprises a catheter in communication with an end effector which induces a temperature rise in an annulus of tissue surrounding the leaflets of a valve or in the chordae tendineae sufficient to cause shrinkage, thereby causing the valves to close more tightly. Mechanical clips can also be implanted over the valve either alone or after the thermal treatment. The clips are delivered by a catheter and may be configured to traverse directly over the valve itself or to lie partially over the periphery of the valve to prevent obstruction of the valve channel. The clips can be coated with drugs or a radiopaque coating. The catheter can also incorporate sensors or energy delivery devices, e.g., transducers, on its distal end.

Abstract: A sutureless anastomosis systems for securing a bypass graft to a host vessel or other tubular structure including a bypass graft and fitting. A compression mechanism may be used with the system for attachment of the bypass graft to the fitting. An electrode is connected to the fitting and an energy source. The energy source transmits energy to the electrode and causes the adjacent tissue to rise in temperature and bond to a vessel or fitting.

Abstract: An atherectomy device includes a catheter with a window at its distal tip for admitting tissue into a catheter compartment. A cylindrical cartridge in the compartment has a cutting edge that supports an electrically conductive cutting element, e.g. a band or wire. The cutting element and adjacent tissue can be heated to a selected temperature by generating an electrical current through the cutting element. The catheter is maneuverable to position its distal end near a lesion in an artery. The catheter incorporates a dilatation balloon or other feature to urge the catheter against the lesion, so that at least part of the lesion enters the compartment through the window. Then, the cartridge is manipulated from the catheter's proximal end to move the cutting edge across the window, severing the acquired tissue. According to alternative embodiments, the cartridge is either rotated or moved axially relative to the catheter, in either event closing the catheter window when the cut is complete.

Abstract: An end-side anastomosis system including a fitting comprising: a base for attachment to a graft, said base be configured to form a seal with an opening in a host vessel wall; a leading petal having a cross-section with a radius of curvature approximating a radius of curvature of the host vessel, said leading petal being configured to dilate the host vessel wall opening while advancing said fitting through the opening; and a rear petal, said rear petal being deflectable to be advanced through the host vessel opening.

Abstract: A bypass graft incorporates fixation mechanisms at its opposite ends, for securing these ends to different locations along a blood vessel, or alternatively to different locations wherein one of the locations is a different vessel or an organ defining a cavity. Mechanical fixation features such as collets or grommets can be employed, enhanced by delivery of an electrical current sufficient to heat surrounding tissue to form a thermal bond. A graft deployment system includes a tissue dilator and a needle for perforating tissue, mounted coaxially within the dilator. Intralumenal systems further include a catheter for containing the dilator.