Abstract: An extracorporeal membrane oxygenation (ECMO) system for infusing blood with oxygen and for removing carbon dioxide from blood includes a mobile oxygen storage device to provide oxygen to an oxygenator while the patient is either stationary or in ambulation. While the patient is stationary, the oxygen storage device supplies oxygen to the oxygenator for a wall oxygen supply, and excess oxygen from the wall supply additionally refills a reserve oxygen tank. While the patient is ambulating, the oxygen storage device supplies oxygen to the oxygenator for an oxygen concentrator that is supplemented from the oxygen tank, and excess oxygen from the concentrator additionally refills the oxygen tank.

Abstract: An extracorporeal membrane oxygenation (ECMO) system for infusing blood with oxygen and for removing carbon dioxide from blood includes an outlet from the oxygen line to share oxygen from the oxygen source as between the system and a nasal cannula or other supplemental oxygen device. The ECMO system may alternatively or in addition capture oxygen-rich exhaust as a by-product of the process. This captured oxygen-rich exhaust would be recycled and shared with a nasal cannula or other supplemental oxygen device. The recycled oxygen-rich exhaust is not only richer in oxygen than air, but also warm and moist which may benefit patients beyond cold and dry oxygen from a direct oxygen source.

Abstract: Described herein are devices for approximating targeted tissue by intertwining two or more sutures together. The sutures are attached to the targeted tissue and routed to a twister device. The twister device secures end portions of the sutures and twists them to intertwine the sutures. Controlling the number of twists provides control over the forces applied to the targeted tissue. In conjunction with visualization feedback, real-time adjustments can be made to achieved targeted results, such as elimination of mitral regurgitation when the disclosed methods and apparatus are applied to mitral valve repair.

Abstract: Methods and apparatus for controlling a flow rate of an oxygenator device are described. The method includes receiving a first temperature associated with a blower of the oxygenator device, wherein the first temperature is sensed by a temperature sensor of the oxygenator device, and adjusting a flow rate of oxygen provided to a blood oxygenator by the blower based, at least in part, on the first temperature.

Abstract: A system for deployment of a protective sleeve can comprise a flexible elongate tube configured to be inserted into an opening in a target tissue and be collapsible around a longitudinal axis. The flexible elongate tube can comprise a lumen extending therethrough, wherein, when the flexible elongate tube is disposed in the opening in the target tissue, the lumen of the flexible elongate tube is configured to receive at least one tether extending through the opening in the target tissue. The system can include a deployment applicator configured to deploy the flexible elongate tube into the opening in the target tissue, the deployment applicator comprising an elongate tube engagement component associated with a distal portion, wherein the engagement component is configured to be received within the lumen of the flexible elongate tube.

Abstract: Described herein are methods and apparatus for implanting grafts to leaflets for cardiac procedures that are performed minimally-invasively while the heart is beating. The graft elongates, reinforces, and patches the leaflet. In certain disclosed examples, the graft is secured to the atrium or ventricle side of the leaflet with an artificial cord implanted on an edge of the graft to improve coaptation. In some disclosed examples, the graft is secured to both leaflets to enable an edge-to-edge procedure similar to the Alfieri technique. Some examples of the disclosed methods including introducing the graft into the ventricle and guiding it into place using artificial cords previously implanted in the leaflet.

Abstract: A method comprises coupling a first anchor to an annulus of a heart valve that is between a heart atrium and a heart ventricle, and extending a portion of a tether within the heart ventricle from the first anchor to a portion of a ventricular heart wall of the heart ventricle between an apex and a basal portion of the ventricular heart wall. The method can include positioning a second anchor over an externally oriented surface of the portion of the ventricular heart wall, and coupling the tether to the second anchor while the second anchor is over the externally oriented surface of the ventricular heart wall.

Abstract: A surgical device includes a handle, a shaft extending distally from the handle, and a curved arm projecting from a distal end of the shaft. The surgical device can be used for papillary muscle approximation procedures.

Abstract: A suture system can comprise a first and a second curved double arm needle, and a needle docking device configured to maintain the first and the second curved double arm needles in alignment with and parallel to one another and at predetermined orientations relative to the needle docking device. The system can include a needle manipulating instrument having a distal portion configured to engage the first and the second curved double arm needles while the first and second curved double arm needles are in the needle docking device, and to maintain the needles in predetermined orientations.

Abstract: A method of suturing an opening in a target tissue can comprise stitching a first suture to a first pad, stitching the first pad to a first tissue area adjacent to the opening in the target tissue and stitching a second suture to the first pad. The method can include forming a first purse-string suture, using the first suture, along a first path in the target tissue around the opening using the first suture, and forming a second purse-string suture, using the second suture, along a second path in the target tissue surrounding the first purse-string suture.

Abstract: Disclosed herein are sutures (or cords) and methods for using sutures wherein the sutures comprise a material or a combination of materials configured to increase echogenicity of the sutures. In some examples, the sutures comprise echogenic materials incorporated into suture material (e.g., ePTFE). In some examples, the sutures comprise a combination of materials with abrupt and relatively large changes in density to increase reflections of ultrasound waves. The disclosed sutures enhance echogenicity to increase visibility of the sutures using ultrasound imaging technologies. Furthermore, disclosed herein are methods that utilize the disclosed sutures in valve repairs including implanting artificial cords, sub-valvular techniques, reshaping organs, annuloplasty, and the like. Utilization of the disclosed echogenic sutures can result in superior outcomes due at least in part to physicians being able to better visualize the placement and/or tension of the echogenic sutures.

Abstract: A tissue anchor delivery device includes a handle, an elongate shaft projecting from the handle, a carrier configured to linearly translate within the handle, an elongate pusher shaft disposed at least partially within a lumen of the elongate shaft, a pusher hub coupled to the pusher shaft, the pusher hub being movably disposed within the handle and releasably coupled to the carrier, an elongate needle movably disposed at least partially within a lumen of the pusher shaft, a needle hub coupled to the needle, the needle hub being movably disposed within the handle and releasably coupled to the carrier, a suture having one or more strands that pass through at least a portion of lumen of the needle, a tissue anchor associated with a distal portion of the suture, and an actuator configured to cause movement of the carrier.

Abstract: A method of suturing a tissue opening can comprise placing a tissue-facing surface of a first pad, a second pad and a third pad over respective tissue areas adjacent to the tissue opening. The second pad can be positioned on a first side of the first pad and the third pad can be positioned on a second side of the first pad. The first and second pads can be coupled to a suture, the suture forming a stitch over the upper surface of each of the respective pads. The suture can be stitched through an area of tissue between the first pad and the second pad, between the second pad and the third pad, and between the third pad and the first pad. A first distal portion and a second distal portion of the suture can be coupled to the third pad for forming the purse-string suture.

Abstract: A delivery system comprises a first delivery shaft configured to deliver one or more sutures to a leaflet of a heart. The first delivery shaft has an end effector at a distal end of the first delivery shaft and configured to contact the leaflet. The delivery system further comprises a needle configured to extend from the distal end of the first delivery shaft and through the leaflet and a support arm configured to contact and extend at least partially along the leaflet during delivery of the needle through the leaflet.

Abstract: A tissue anchor delivery device includes a handle, an elongate shaft extending from the handle, a pusher tube disposed at least partially within a lumen of the elongate shaft, a pusher hub coupled to the pusher tube, a needle disposed at least partially within a lumen of the pusher tube, a needle hub coupled to the needle, and an actuator configured to be fixed to the pusher hub and the needle hub. The actuator is further configured to advance the needle hub and the pusher hub a first distance, thereby causing a tip of the needle to protrude from a distal end of the elongate shaft, disengage from the needle hub, and advance the pusher hub a second distance relative to the needle hub, thereby causing a distal end of the pusher tube to advance over the needle and push a coiled suture form off of the needle.

Abstract: A method of tethering can comprise providing a tether deployment device. The tether deployment device can comprise an elongate shaft comprising a lumen extending from a proximal end to a side opening, an atraumatic distal effector coupled to a distal end of the elongate shaft, and a tether deployment assembly at least partially received within the lumen. The method can include advancing the distal portion of the elongate shaft into a heart chamber, positioning a distally oriented surface of the atraumatic distal effector against a first tissue area, and advancing a distal portion of the tether deployment assembly through the side opening of the shaft. A portion of at least one tether can be deployed to the target tissue area using the tether deployment assembly while the distally oriented surface of the atraumatic distal effector is against the first tissue area.

Abstract: A device for treating a heart valve comprising a curved frame and a covering at least partially enclosing the curved frame.

Abstract: Septal defect repair involves advancing an elongate shaft into an atrium of a heart of a patient through an outer atrial wall of the heart, contacting an atrial septum of the heart with a distal end of the elongate shaft, deploying a plurality of tissue anchors from the elongate shaft in tissue of the atrial septum, and cinching suture tails associated with the plurality of tissue anchors to at least partially close a defect in the atrial septum.

Abstract: A reinforced surgical pad device can comprise a surgical pad configured to be positioned over an opening in a target tissue, and a reinforcement member configured to be associated with the surgical pad. The reinforcement member can comprise a central portion being configured to be associated with the surgical pad, and a circumferential portion around the central portion, at least a portion of the circumferential portion being configured to extend laterally beyond an outer edge of the surgical pad.

Abstract: Described herein are devices and methods for mitral valve repair. The devices and methods implant a plurality of distal anchors at an annulus of the mitral valve (e.g., the posterior annulus) and tension artificial chordae to pull the portion of the annulus toward an opposite edge and inward into the ventricle. This can effectively reduce the size of the orifice and increase coaptation. The delivery devices can be configured to be actuated to form a distal anchor made of a pre-formed knot. The delivery devices deliver the pre-formed knot in an elongate configuration. Actuation of the delivery device causes the pre-formed knot to transition from the elongate configuration to the deployed configuration by approximating opposite ends of a suture coupled to a coiled configuration to form one or more loops. After formation of the knot, the delivery device can be withdrawn.