Abstract: A catheter-based system for accessing specific body cavities percutaneously and minimizing patient trauma is provided. In the preferred embodiment, in order to create an aperture at an access site in a patient's existing tubular body organ structure, a delivery sheath is passed axially along the interior of a portion of the existing tubular body organ structure to place a distal end of the delivery sheath near the access site. A centering wire is passed axially along the interior of the delivery sheath, piercing through from inside to outside of the patient's existing tubular body organ structure at the access site by causing an end portion of the centering wire to emerge from the distal end of the delivery sheath. A cutting catheter is passed substantially coaxially over the centering wire and axially along the interior of the delivery sheath.

Abstract: A self-retracting body, which may have a bore, may be inserted into a biological passage. A dilating balloon may be used to expand the body toward an inner wall of the passage. The body may include an anchor that may engage the wall. The anchor may include a tip that is within the body before the body expands and extends away from the body during expansion. The body may include an opening that may receive a portion of the wall. The portion may be fixed to the body. The body may retract toward a central portion of the passage after the anchor engages the wall. The wall may be drawn toward the central passage and the diameter of the passage may be reduced. In some embodiments, a liner may be provided for the passage. In some embodiments, a baffle may be provided for the passage.

Abstract: Heart valve attachment apparatus and methods that significantly reduce attachment times are provided. The apparatus and methods utilize a connector band to form an interface between a uni-directional valve and a tissue annulus. The connector band is secured to the tissue annulus by retention fingers.

Abstract: A plurality of structures that resiliently attract one another are provided for implanting in a patient around a body tissue structure of the patient. For example, the body tissue structure may be the esophagus, and the plurality of structures may be implanted in an annulus around the outside of the esophagus, the annulus being substantially coaxial with the esophagus. The attraction may be between annularly adjacent ones of the structures in the annulus, and it may be provided, for example, by magnets or springs. The array of structures is preferably self-limiting with respect to the smallest area that it can encompass, and this smallest area is preferably large enough to prevent the apparatus from applying excessive pressure to tissue passing through that area.

Abstract: Methods and apparatus for making an anastomotic connection between first and second tubular fluid conduits are provided. For example, a connector may be configured for attachment to the first and second tubular fluid conduits and have an interior thereof substantially accessible to the interior of the first tubular fluid conduit. The connector may be configured for annular enlargement. An expandable structure is provided having a first portion configured to annularly enlarge the connector by engaging the interior of the connector. A second portion may be configured to extend through an opening in the medial portion of the first tubular fluid conduit.

Abstract: Methods and apparatus for delivering and installing a new length of tubing between two sections of a patient's existing body organ tubing and at least partly outside of that existing structure. For example, the new length of tubing may be for the purpose of providing the patient with a coronary bypass. The new tubing may be an artificial graft, a natural graft (harvested elsewhere from the patient), or both. The new tubing is installed at the operative site primarily by providing at least one graft location with instrumentation inserted through the patient's existing tubular body organ structure. Assistance in installing the new tubing may be provided by minimally invasive surgical access openings in the patient's chest. The tubing may be delivered through the patient's existing tubular body structure or, alternatively, through the surgical access openings.

Abstract: Implantable devices for use in a non-sterile environment of a patient's anatomy are medicated or include medication. For example, the housing of the device and/or members for securing the device to the patient's anatomy (e.g., the muscular esophageal wall) may be medicated to, among other things, prevent a rejection mechanism from being triggered, to prevent or reduce bacterial infection, or to promote tissue ingrowth. The medication may be for medicating tissue at the implant site, or for medicating some other portion of the patient's anatomy.

Abstract: Methods and apparatus are provided that gather a patient's body tissue and then secure the gathered tissue in a reduced area utilizing a securing structure. The securing structure mainly resides on one side of the tissue to minimize or eliminate both foreign material and the amount of manipulation or activity on the other side of the tissue. The securing device is matched to the desired amount of tissue manipulation to minimize the structure. The gathered and secured tissue can surround a septal defect to obstruct or close the defect itself.