Abstract: Instrument and systems for applying ablative energy to epicardial tissue via a subxiphoid access surgical approach. The instrument has a head assembly sized and shaped for a subxiphoid surgical approach to a patient's heart and defines a contact face. The head assembly includes a paddle body, a first ablation electrode, and a second ablation electrode. The ablation electrodes are coupled to the paddle body in a spaced apart, spatially-fixed fashion. The ablation electrodes are exteriorly exposed at the contact face. A tubular member extends from the head assembly and maintains wiring connected to the ablation electrodes. The instrument is manipulable to locate the contact face on epicardial tissue of a patient's heart via a subxiphoid surgical approach, such as between the left and right pulmonary vein junctions of the posterior left atrium.

Abstract: A device for cleaning surgical tools includes a housing defining an interior space, the housing comprising a funnel with a narrow end and a wide end, the narrow end of the funnel open to the interior space, a plurality of brushes disposed in the interior space of the housing and aligned with the funnel, a nozzle directed at the plurality of brushes, and a pump operable to dispense a fluid through the nozzle towards the plurality of brushes.

Abstract: Among other things, systems to encourage compliance with hand washing procedures can include: an infrared emitter that projects a first infrared beam with a transverse cross-section having a first axis and a second axis that is shorter than the first axis, the transverse cross-section having a maximum length along the first axis, the infrared emitter modulating the first infrared beam to transmit a first identification signal; wherein the infrared emitter projecting the first infrared beam is placed such that the first axis of the transverse cross-section of the first infrared beam is substantially parallel to a boundary.

Abstract: This disclosure includes apparatuses and techniques to access the right ventricle via trans-femoral vein threading a catheter or catheters to the apex or bottom of the right ventricle. Piercing through the venous or right side of the heart in the interventricular septal wall to access the left ventricle a catheter can be passed to turn upward pointing to the mitral valve. From this access point in the left ventricle the flail mitral leaflet can be sutured and tethered pulling it back into position and reattached with a grounding anchor in the right ventricle or imbedding the anchor into the septal wall. The interventricular septal wall crossing technique could include the passing of a coaxial catheter through the first access catheter where the first access catheter could act as a guide to direct the internal or second coaxial catheter toward the flail mitral leaflet.

Abstract: Among other things, systems to encourage compliance with hand washing procedures can include: an infrared emitter that projects a first infrared beam with a transverse cross-section having a first axis and a second axis that is shorter than the first axis, the transverse cross-section having a maximum length along the first axis, the infrared emitter modulating the first infrared beam to transmit a first identification signal; wherein the infrared emitter projecting the first infrared beam is placed such that the first axis of the transverse cross-section of the first infrared beam is substantially parallel to a boundary.

Abstract: Instrument and systems for applying ablative energy to epicardial tissue via a subxiphoid access surgical approach. The instrument has a head assembly sized and shaped for a subxiphoid surgical approach to a patient's heart and defines a contact face. The head assembly includes a paddle body, a first ablation electrode, and a second ablation electrode. The ablation electrodes are coupled to the paddle body in a spaced apart, spatially-fixed fashion. The ablation electrodes are exteriorly exposed at the contact face. A tubular member extends from the head assembly and maintains wiring connected to the ablation electrodes. The instrument is manipulable to locate the contact face on epicardial tissue of a patient's heart via a subxiphoid surgical approach, such as between the left and right pulmonary vein junctions of the posterior left atrium.

Abstract: Among other things, systems to encourage compliance with hand washing procedures can include: an infrared emitter that projects a first infrared beam with a transverse cross-section having a first axis and a second axis that is shorter than the first axis, the transverse cross-section having a maximum length along the first axis, the infrared emitter modulating the first infrared beam to transmit a first identification signal; wherein the infrared emitter projecting the first infrared beam is placed such that the first axis of the transverse cross-section of the first infrared beam is substantially parallel to a boundary.

Abstract: Among other things, systems and methods include an apparatus to be carried or worn by a person, the apparatus comprising: electronics to determine a cleanliness state of the person's hands; and an element separate from the electronics to communicate information associated with the person to the electronics.

Abstract: Device and method for sub-xiphoid ablation of patient tissue. A sub-xiphoid access clamp has a handle, an elongate neck coupled to the handle and first and second opposing jaws. The first and second opposing jaws have first and second opposing relief segments being generally co-planar and concave with respect to one another to form a void therebetween, and first and second opposing elongate ablation elements positioned along the first and second opposing jaws and distal of the first and second opposing relief segments relative to the handle. The first and second opposing jaws are articulate between a closed position and an open position to admit, at least in part, a second portion of tissue of the patient within the void created by the first and second opposing relief segments while the first portion of tissue is positioned between the first and second ablation elements in the closed position.

Abstract: Among other things, systems to encourage compliance with hand washing procedures can include: an infrared emitter that projects a first infrared beam with a transverse cross-section having a first axis and a second axis that is shorter than the first axis, the transverse cross-section having a maximum length along the first axis, the infrared emitter modulating the first infrared beam to transmit a first identification signal; wherein the infrared emitter projecting the first infrared beam is placed such that the first axis of the transverse cross-section of the first infrared beam is substantially parallel to a boundary.

Abstract: This disclosure includes apparatuses and techniques to access the right ventricle via trans-femoral vein threading a catheter or catheters to the apex or bottom of the right ventricle. Piercing through the venous or right side of the heart in the interventricular septal wall to access the left ventricle a catheter can be passed to turn upward pointing to the mitral valve. From this access point in the left ventricle the flail mitral leaflet can be sutured and tethered pulling it back into position and reattached with a grounding anchor in the right ventricle or imbedding the anchor into the septal wall. The interventricular septal wall crossing technique could include the passing of a coaxial catheter through the first access catheter where the first access catheter could act as a guide to direct the internal or second coaxial catheter toward the flail mitral leaflet.

Abstract: Among other things, a tool to attach a support to a heart valve annulus includes a stabilizing body that includes features to stabilize an axial position of the tool relative to the annulus, and an attachment device connected to the stabilizing body, the stabilizing body and the attachment device being movable relative to one another under control from a location remote from the tool. The support may have an expandable tubular body having a plurality of struts, a plurality of tissue anchors extending from distally facing apexes in a distal direction post-deployment, wherein axial distal advance of the implantable annulus support causes the plurality of tissue anchors to axially engage tissue, and the implantable annulus support is self-contractible from a radially enlarged engagement configuration for engaging tissue of the mitral valve annulus, to a reduced, deployed configuration for modifying mitral valve annulus geometry.

Abstract: Device and method for sub-xiphoid ablation of patient tissue. A sub-xiphoid access clamp has a handle, an elongate neck coupled to the handle and first and second opposing jaws. The first and second opposing jaws have first and second opposing relief segments being generally co-planar and concave with respect to one another to form a void therebetween, and first and second opposing elongate ablation elements positioned along the first and second opposing jaws and distal of the first and second opposing relief segments relative to the handle. The first and second opposing jaws are articulate between a closed position and an open position to admit, at least in part, a second portion of tissue of the patient within the void created by the first and second opposing relief segments while the first portion of tissue is positioned between the first and second ablation elements in the closed position.

Abstract: Among other things, an entry monitor has circuitry to detect when a person enters a monitored space and an indicator perceptible to other people in the space to indicate a cleanliness state of the hands of the person who has entered the space.

Abstract: Device and method for sub-xiphoid ablation of patient tissue. A sub-xiphoid access clamp has a handle, an elongate neck coupled to the handle and first and second opposing jaws. The first and second opposing jaws have first and second opposing relief segments being generally co-planar and concave with respect to one another to form a void therebetween, and first and second opposing elongate ablation elements positioned along the first and second opposing jaws and distal of the first and second opposing relief segments relative to the handle. The first and second opposing jaws are articulate between a closed position and an open position to admit, at least in part, a second portion of tissue of the patient within the void created by the first and second opposing relief segments while the first portion of tissue is positioned between the first and second ablation elements in the closed position.

Abstract: In general, in an aspect, an annulus of a heart valve is caused to dilate to a predetermined configuration by pushing a delivery tool distally through the annulus from one heart chamber to another heart chamber. A valve support is attached to the delivery tool. The valve support has a plurality of barbs or hooks attached thereon. While the annulus is dilated, the valve support is attached to tissue at locations along the annulus by attaching the barbs or hooks to the tissue. After attachment, the support is caused to contract.

Abstract: Among other things, an entry monitor has circuitry to detect when a person enters a monitored space and an indicator perceptible to other people in the space to indicate a cleanliness state of the hands of the person who has entered the space.

Abstract: Among other things, a tool to attach a support to a heart valve annulus includes a stabilizing body that includes features to stabilize an axial position of the tool relative to the annulus, and an attachment device connected to the stabilizing body, the stabilizing body and the attachment device being movable relative to one another under control from a location remote from the tool, from one configuration in which the support is held in a pre-attachment contracted state to another configuration in which the support is held in an expanded state for attachment at multiple locations around the annulus by action from the remote location. Among other things, an apparatus includes structural elements, and gripping elements, and configuration elements attached to the respective structural elements and each controllable to permit or prevent the ring from expanding.

Abstract: Among other things, an entry monitor has circuitry to detect when a person enters a monitored space and an indicator perceptible to other people in the space to indicate a cleanliness state of the hands of the person who has entered the space.

Abstract: An extracardiac pumping for supplementing the circulation of blood, including the cardiac output, in a patient without any component thereof being connected to the patient's heart, and methods of using same. One embodiment provides a vascular graft that has a first end that is sized and configured to couple to a non-primary blood vessel and a second end that is fluidly coupled to a pump to conduct blood between the pump and the non-primary blood vessel. An outflow conduit is also provided that has a first end sized and configured to be positioned within the same or different blood vessel, whether primary or non-primary, through the vascular graft. The outflow conduit is fluidly coupled to the pump to conduct blood between the pump and the patient. The vascular graft may be connected to the blood vessel subcutaneously to permit application of the extracardiac pumping system in a minimally-invasive procedure.