Abstract: A heart valve assembly includes a base including a multi-lobular annular shape within a plane, a valve member or other annular body including a multi-lobular shape complementary to the shape of the base, and cooperating connectors on the base and the annular body for connecting the annular body to the base. The base includes an anchoring ring, and a flexible cuff for attaching the base to a biological annulus. The base and the annular body include guides for aligning their multi-lobular shapes, e.g., visual, tactile, or other markers, or tethers that extend from the base that are slidable through the annular body. During use, the base is attached to a biological annulus, the annular body is directed adjacent the annulus, oriented such that the multi-lobular shape of the annular body valve member is aligned with the base, and the annular body is attached to the base.

Abstract: A heart valve assembly includes a prosthesis and a prosthetic valve to replace a preexisting natural or prosthetic heart valve within a biological annulus. The prosthesis includes an annular member, a flexible core at least partially defining a sewing cuff extending radially outwardly from the annular member, a rail ring disposed between the flexible core and the annular member, and a plurality of guide rails extending from the rail ring through respective openings in the flexible core. A fabric covering covers the prosthesis, and the guide rails extend through respective openings in the fabric covering. The prosthetic valve includes a frame including receptacles for receiving respective guide rails. After implanting the prosthesis within a biological annulus, the prosthetic valve is advanced along the guide rails until retention elements on the guide rails engage the receptacles to secure the prosthetic valve relative to the prosthesis.

Abstract: Apparatus and methods are provided for treating sleep apnea, snoring, and the like using an implant within an oropharyngeal region adjacent an anterior longitudinal ligament. The implant may include a relatively narrow central region between first and second relatively wide outer regions. In one embodiment, one of the outer regions is compressible to allow the outer region to be directed through or behind the ligament such that the central region is disposed within or behind the ligament, the outer region being resiliently expandable after passing through or behind the ligament. In another embodiment, the implant may include one or more tines or other features that may be directed into adjacent tissue to secure the implant within the oropharyngeal region.

Abstract: A heart valve assembly includes a base including a multi-lobular annular shape within a plane, a valve member or other annular body including a multi-lobular shape complementary to the shape of the base, and cooperating connectors on the base and the annular body for connecting the annular body to the base. The base includes an anchoring ring, and a flexible cuff for attaching the base to a biological annulus. The base and the annular body include guides for aligning their multi-lobular shapes, e.g., visual, tactile, or other markers, or tethers that extend from the base that are slidable through the annular body. During use, the base is attached to a biological annulus, the annular body is directed adjacent the annulus, oriented such that the multi-lobular shape of the annular body valve member is aligned with the base, and the annular body is attached to the base.

Abstract: Devices for attaching a first mass and a second mass and methods of making and using the same are disclosed. The devices can be made from an resilient, elastic or deformable materials. The devices can be used to attach a heart valve ring to a biological annulus. The devices can also be used for wound closure or a variety of other procedures such as anchoring a prosthesis to surrounding tissue or another prosthesis, tissue repair, such as in the closure of congenital defects such as septal heart defects, tissue or vessel anastomosis, fixation of tissue with or without a reinforcing mesh for hernia repair, orthopedic anchoring such as in bone fusing or tendon or muscle repair, ophthalmic indications, laparoscopic or endoscopic tissue repair or placement of prostheses, or use by robotic devices for procedures such as those above performed remotely.

Abstract: A heart valve assembly includes a prosthesis and a prosthetic valve to replace a preexisting natural or prosthetic heart valve within a biological annulus. The prosthesis includes an annular member, a flexible core at least partially defining a sewing cuff extending radially outwardly from the annular member, a rail ring disposed between the flexible core and the annular member, and a plurality of guide rails extending from the rail ring through respective openings in the flexible core. A fabric covering covers the prosthesis, and the guide rails extend through respective openings in the fabric covering. The prosthetic valve includes a frame including receptacles for receiving respective guide rails. After implanting the prosthesis within a biological annulus, the prosthetic valve is advanced along the guide rails until retention elements on the guide rails engage the receptacles to secure the prosthetic valve relative to the prosthesis.

Abstract: A heart valve assembly includes a base including a multi-lobular annular shape within a plane, a valve member or other annular body including a multi-lobular shape complementary to the shape of the base, and cooperating connectors on the base and the annular body for connecting the annular body to the base. The base includes an anchoring ring, and a flexible cuff for attaching the base to a biological annulus. The base and the annular body include guides for aligning their multi-lobular shapes, e.g., visual, tactile, or other markers, or tethers that extend from the base that are slidable through the annular body. During use, the base is attached to a biological annulus, the annular body is directed adjacent the annulus, oriented such that the multi-lobular shape of the annular body valve member is aligned with the base, and the annular body is attached to the base.

Abstract: Devices for attaching a first mass and a second mass and methods of making and using the same are disclosed. The devices can be made from an resilient, elastic or deformable materials. The devices can be used to attach a heart valve ring to a biological annulus. The devices can also be used for wound closure or a variety of other procedures such as anchoring a prosthesis to surrounding tissue or another prosthesis, tissue repair, such as in the closure of congenital defects such as septal heart defects, tissue or vessel anastomosis, fixation of tissue with or without a reinforcing mesh for hernia repair, orthopedic anchoring such as in bone fusing or tendon or muscle repair, ophthalmic indications, laparoscopic or endoscopic tissue repair or placement of prostheses, or use by robotic devices for procedures such as those above performed remotely.

Abstract: An electrosurgical instrument having an active electrode with a portion that is coated with an insulative material. An exposed portion of the electrode is effective to treat tissue while the insulative coating minimizes energy dissipation into surrounding isotonic solution.

Abstract: A laparoscopic introducer and method of use comprise a laparoscopic channel and a guide channel for a secondary instrument. Upon initial insertion of the introducer, the guide channel closely conforms to the body of the introducer so as to only negligibly increase the cross-sectional profile thereof. Following insertion, the guide channel can be distended by means of a dilator. Thus, the guide channel allows a secondary instrument to be inserted into the body to perform laparoscopic procedures wherein the instrument is inserted and utilized along the same longitudinal axis as the laparoscope. Thus, the number of laparoscopic ports are reduced and visual distortions associated with triangulation are avoided. The guide channel is constructed from an extremely thin, but very strong and noncompliant membrane which may also be reinforced by means of a force distribution mechanism.

Abstract: A catheter comprising an elongated catheter body having a distal end and an elongated flexible guidewire having proximal and distal ends. The guidewire includes a rounded enlargement between the ends of the guidewire. The guidewire is mounted on the catheter body for movement longitudinally relative to the catheter body between a first position in which the rounded enlargement is adjacent the distal end of the catheter body and a second position in which the rounded enlargement is located distally of the position the rounded enlargement occupies in the first position.

Abstract: A surgical access device comprises an introducer with a main endoscopic channel and an auxiliary or secondary instrument channel. The introducer exhibits an extremely narrow cross-sectional profile in order to minimize the size of the portal or other entry point necessary to gain access into the patient's body, thereby minimizing pain and discomfort to the patient and allowing a wide variety of endoscopic procedures to be performed on an out-patient basis. The narrow profile of the introducer is maintained upon introduction by a guide channel which can be stored in a first position so as to closely conform to the profile of the introducer. The guide channel is provided with a set in order to maintain its stored position upon introduction; however, post introductively, the set in the guide channel can be readily released in order to deploy the guide channel and allow insertion of a secondary surgical instrument.

Abstract: A surgical access device and method are provided for endoscopic surgeries comprising biopsies or other surgical cutting procedures. The device generally comprises a substantially rigid first channel associated with a first port and a second channel associated with a second port of a proximal housing. The first or main channel extends to a curved distal end of the device, and the second channel is connected to a guide channel extending tangential to the main channel. The guide channel comprises substantially noncompliant material and has a pre-insertion position such that a cross-section of an inserted portion of the device is substantially the same as a cross-section of the main channel. A preferred method of the present invention includes the use of an open-loop device formed at a distal tip of an introducer and an aspiration tube during the location, excision and removal of one or more tissue specimens.

Abstract: A method of viewing an interior passage of a patient using an endoscope and a catheter which includes a catheter body having a distal end and a lumen opening at the distal end and a displacing member. The method comprises advancing the catheter into the passage in the patient with the displacing member extending beyond the distal end of the catheter body when the catheter body is at a region of the passage. The endoscope is provided in the lumen of the catheter with the endoscope being movable longitudinally relative to the catheter and being at a location for viewing the interior passage. The method includes relatively displacing the distal end of the catheter body and material within or forming the passage within a zone of the interior passage utilizing the displacing member and viewing at least a portion of such zone of the interior passage utilizing the endoscope.

Abstract: An everting catheter system comprising an elongated outer tubular body having an outer body lumen and an opening leading from the outer body lumen, an elongated inner tubular body movable longitudinally in the outer body lumen and having an inner body lumen and an everting element coupled to the outer body and the inner body so that with movement of the inner body longitudinally in the outer body lumen the everting element can be everted and inverted. The system also includes an elongated instrument, such as a transfer catheter, movable longitudinally in the inner body lumen relative to the inner body. A coupling releasably couples the instrument to the outer body in a substantially fixed longitudinal position with respect to the outer body.

Abstract: A method of depositing reproductive material into the reproductive tract of a female comprising inserting an elongated transfer catheter into the reproductive tract of a female. The transfer catheter includes an elongated catheter body having an elongated passage extending through the catheter body and terminating in a distal opening at a distal end of the catheter body. The distal opening opens both axially and laterally of the catheter body. The method also includes introducing the reproductive biological material through the passage and the distal opening of the catheter body into the reproductive tract.

Abstract: An everting catheter system which includes an elongated outer catheter having an outer catheter lumen and an opening, an elongated inner catheter movable in the outer catheter lumen and having the inner catheter lumen adapted to receive an elongated instrument and an everting element coupled to the outer catheter and the inner catheter. With movement of the inner catheter in the outer catheter lumen, the everting element can be everted through the opening of the outer catheter. A controller is coupled to the inner catheter for moving the inner catheter in the outer catheter lumen and for moving the instrument in the inner catheter lumen.

Abstract: A catheter for fallopian tube access comprising an elongated catheter body having a proximal region, a distal end and an elongated passage extending from the proximal region to the distal end. The elongated passage terminates in a distal opening at the distal end. The catheter body has an enlarged distal body portion and the distal opening is on the distal body portion. The distal body portion has a deflecting surface in the elongated passage adjacent the distal opening for directing a member or fluid passed through the elongated passage out of the distal opening along a path having a component which extends laterally of the catheter body.

Abstract: A catheter comprising an elongated, flexible catheter body having a distal end portion which is curved in an unstressed condition. The catheter body has a through lumen and a mandrel lumen. A mandrel is provided in the mandrel lumen, and the mandrel has a distal end portion configured to at least partially straighten the curve of the distal end portion of the catheter body. The mandrel is movable between an extended position in which the mandrel at least partially straightens the curve of the distal end portion of the catheter body and a retracted position in which the catheter body is more curved than in the extended position of the mandrel.

Abstract: A method of delivering a substance to a fallopian tube of a patient which includes obtaining transcervical access to a fallopian tube with an everting catheter. Access to the fallopian tube is obtained by everting an everting element of the everting catheter in the fallopian tube. A substance selected from the group consisting of biological material and cytotoxic agents is then delivered through the everting catheter to the fallopian tube to deposit the substance in the fallopian tube.