Abstract: A flushing and hemostasis apparatus for a trans-catheter surgical procedure may be provided with an elongated body. A seal assembly may be located at a proximal end of the elongated body and configured to receive a distal end of an implant loading tool therethrough. A valve assembly may be located at a distal end of the elongated body and may include a flush port. In some embodiments, the valve assembly is configured to move between an open position in which the flush port is in fluid communication with the mid-section of the elongated body and a closed position in which the distal end of the elongated body is sealed off from the mid-section. A mid-section of the elongated body may be configured to receive an element protruding from the distal end of the implant loading tool. Other flushing and hemostasis tools and methods of use are also provided.

Abstract: A method of deploying a vessel assembly. The method includes deploying a first bifurcated stent device. The method also includes deploying a second bifurcated stent device mirroring the first bifurcated stent device. The method further includes deploying a tube graft bridging the first bifurcated stent device and the second bifurcated stent device.

Abstract: A tether cutting system for transcatheter annuloplasty may be provided with a flexible catheter, a handle section coupled to the proximal end of the catheter having a movable actuator, and a cutter assembly coupled to the distal end of the catheter. The cutter assembly may be provided with a blade coupled to a blade holder, a slot configured to slidably receive a tether to be cut, and a backstop configured to contact the blade. The system may further include a pull wire extending through the catheter, spanning between the movable actuator and the blade holder. In one embodiment, the movable actuator, the pull wire and the blade holder are configured to cooperate together to move the blade from a distal position, across the cutter assembly slot and towards a proximal position to cut a tether extending through the slot. Methods of use are also provided.

Abstract: The present disclosure relates to an annuloplasty apparatus configured to be implanted into the body of a subject, the annuloplasty apparatus comprising: a contractile bridging element; a bar member connected to the contractible bridging element, the bar member being provided with a rotatable connection mechanism; and a tissue anchor configured to secure the bar member to the annulus tissue by the rotatable connection mechanism, and comprising: a head portion; and a helical tissue coupling element, the proximal end of which is fixed to the head portion, wherein the helical tissue coupling element is configured to be driven into the annulus tissue by rotation, wherein the rotatable connection mechanism is at least partially configured to be rotatable relative to the bar member, thereby allowing the helical tissue coupling element to rotate further relative to the bar member when the proximal end of the helical tissue coupling element is in contact with the rotatable connection mechanism.

Abstract: A distal aortic stent graft assembly including a main body having a proximal end and a distal end. The main body defines a peripheral opening. The proximal end defines a proximal opening. The distal end defines a distal opening. The proximal opening and the distal opening are configured to perfuse blood through the main body when the main body is in a deployed state. The distal aortic stent graft assembly further includes a coupling extending radially from the main body and corresponding to the opening in the main body. The coupling is configured to align with a blood vessel and perfuse blood through the coupling when the coupling is in the deployed state.

Abstract: A method of deploying a modular multibranch stent assembly. The method includes deploying a first modular stent device in an ascending aorta. The first modular stent device includes a main body, a bypass gate extending from the main body, and a bifurcated contra limb extending from the main body. The bifurcated contra limb includes a first distal limb and a second distal limb. The method further includes deploying a first bridging stent graft in the first distal limb and/or a second bridging stent graft in the second distal limb.

Abstract: A locking system for transcatheter annuloplasty may be provided with an implantable lock body, a movable member configured to be slidably received in a lock body slot, a tether abutting portion, a coupling element located on a proximal portion of the lock body, a pull wire having a coupling member configured to detachable mate with the coupling element, a flexible catheter configured to slidably receive a portion of the pull wire, and a collar located on a distal portion of the catheter and configured to slidably receive the lock body. The pull wire and the catheter may be pushed together in a distal direction to advance the lock body along a tether, and the pull wire may be pulled in a proximal direction relative to the catheter to move the movable member towards a locked position and lock the tether to the lock body. Methods of use are also provided.

Abstract: An exemplary system for delivering annuloplasty implants includes an elongated inner catheter assembly, a manifold attached to the proximal portion of the inner catheter, a steering knob assembly coupled to the manifold, a torquer control knob assembly coupled to the manifold, and a central lead extending from a proximal portion of the torquer control knob assembly to the distal portion of the inner catheter assembly. The manifold is configured to present a medial driver tube, a lateral driver tube, a medial lead, a lateral lead, a medial tether puller and a lateral tether puller to a surgeon. Additional annuloplasty implant instrumentation and methods of use are also disclosed.

Abstract: A stent graft assembly including a main body and a branch coupling extending radially from the main body. A proximal end of the single branch stent device is configured to seal in an ascending portion of an aorta. The assembly further includes a modular stent device including a proximal end and a distal end. The proximal end of the modular stent graft is configured to couple to a distal end of the single branch stent device. The modular stent device includes a main body configured to couple inside the main body of the single branch stent device. The modular stent device includes a bypass gate and an artery leg. The modular stent device is configured to bifurcate at a bifurcation point from the main body to the bypass gate and the artery leg outside of and distal the distal end of the single branch stent device.

Abstract: The techniques of this disclosure generally relate to a modular stent device that is deployed into the ascending aorta via femoral access. The modular stent device is a base or anchor component to which additional modular stent devices can be attached to exclude diseased areas of the aorta while at the same time allowing perfusion of the brachiocephalic artery, the left common carotid artery, and/or the left subclavian artery.

Abstract: The techniques of this disclosure generally relate to a modular stent device including a main body configured to be deployed in the ascending aorta, a bypass gate configured to be deployed in the aorta, and a bifurcated contra limb. The bifurcated contra limb includes a single proximal limb that is bifurcated (split) into a first distal limb and a second distal limb. By forming the bifurcated contra limb to include a single proximal limb that is bifurcated into the distal limbs, guiding a guide wire into the relatively larger opening of bifurcated contra limb at a proximal end is simpler than guiding a guidewire into two smaller limbs extending distally from main body. Accordingly, cannulation of the bifurcated contra limb is relatively simple thus simplifying the procedure. In addition, the parallel design mimics anatomical blood vessel bifurcations to limit flow disruptions.

Abstract: An exemplary method of performing an annuloplasty procedure includes introducing a catheter into a left atrium of a heart, deploying first and second members from the catheter and anchoring them to an anterior side of a mitral valve, and deploying a third member from the catheter and anchoring it to a posterior side of the mitral valve. The first member has a first flexible tensile member attached and the second member has a second flexible tensile member attached. The third member slidably tracks over the first and the second flexible tensile members when it is being deployed. Tension is applied to the first and the second tensile members to draw the first member and the second member toward the third member, thereby bringing the posterior side and the anterior side of the mitral valve annulus into closer approximation. Annuloplasty systems, devices and components are also disclosed.

Abstract: The techniques of this disclosure generally relate to an assembly including a single branch stent device and a modular stent device configured to be coupled to the single branch stent device. The single branch stent device includes a main body and a branch coupling extending radially from the main body. The modular stent device includes a main body configured to be coupled inside of the main body of the single branch stent device, a bypass gate extending distally from a distal end of the main body of the modular stent device, and an artery leg extending distally from the distal end of the main body of the modular stent device.

Abstract: A method for deploying a stent device having a main body, a proximal coupling, and a distal coupling. The method includes extending a first guidewire in an aorta, extending a second guidewire in a brachiocephalic artery, and extending a third guidewire in an aortic branch vessel. The method further includes tracking the stent device along the first, second, and third guidewires. During the tracking step, the first guidewire extends through the main body, the second guidewire extends through the proximal coupling, and the third guidewire extends through the distal coupling. The method also includes deploying the main body within the aorta with the proximal coupling aligning with the brachiocephalic artery and the distal coupling aligning with the aortic branch vessel.

Abstract: A venous valve prosthesis includes a frame and a prosthetic valve coupled to the frame. With the venous valve prosthesis implanted in a vein, the prosthetic valve includes a closed configuration wherein an outer surface of the prosthetic valve is in contact with a wall of the vein around a circumference of the prosthetic valve to prevent blood from flowing past the prosthetic valve between the wall of the vein and the outer surface of the prosthetic valve. The prosthetic valve is configured to move to an open configuration such that at least a portion of an outer wall of the prosthetic valve partially collapses away from the wall of the vein in response to antegrade blood flow through the vein to enable blood flow between the outer surface of the prosthetic valve and the wall of the vein.

Abstract: The techniques of this disclosure generally relate to an assembly including a single multibranch stent device. The single multibranch stent device includes a main body, a proximal coupling extending radially from the main body, and a distal coupling extending radially from the main body. The main body, the proximal coupling, and the distal coupling are permanently coupled to one another and the single multibranch stent device is a single piece. By forming the single multibranch stent device as a single piece, the single multibranch stent device can be deployed in a single deployment thus simplifying the deployment procedure.

Abstract: The techniques of this disclosure generally relate to an assembly including a trifurcated modular stent device. The trifurcated modular stent device includes a main body, a bypass gate extending distally from a distal end of the main body, a primary artery leg extending distally from the distal end of the main body, and a distal artery leg extending distally from the distal end of the main body. The trifurcated modular stent device is delivered via supra aortic access such that the primary artery leg is deployed within the brachiocephalic artery providing immediate perfusion thereof.

Abstract: The techniques of this disclosure generally relate to an assembly including a docking graft. The docking graft includes a main graft defining a main lumen, a first internal lumen within the main lumen, a second internal lumen within the main lumen, and a main docking lumen within the main lumen. The first and second internal lumens are configured to receive first and second bridging stent graft therein. The main docking lumen is configured to receive a tube graft therein. The first internal lumen, the second internal lumen, and the main docking lumen being parallel to one another and extending an entire length of the docking graft when the docking graft is in a relaxed configuration. The docking graft forms the foundation, or anchor device, for attachment of the first bridging stent graft, the second bridging stent graft, and the tube graft within the aorta.

Abstract: The techniques of this disclosure generally relate to a stent-graft system including a bifurcated stent-graft, a first bifurcating branch device, and a first branch extension. The bifurcated stent-graft includes a body, a first branch limb, and a second branch limb. The first bifurcating branch device includes a body segment coupled to the first branch limb of the bifurcated stent-graft, a first branch limb, and a second branch limb. The first branch extension is within the first branch limb of the first bifurcating branch device and within an external iliac artery. The first bifurcating branch device has a wide patient applicability since the treatment can be extended proximal to the anatomical iliac bifurcation and is not limited by the common iliac artery length. The stent-graft system is suitable to treat a wide range of internal and external iliac artery diameters.

Abstract: The techniques of this disclosure generally relate to a stent-graft system including a bifurcated stent-graft, a first bifurcating branch device, and a first branch extension. The bifurcated stent-graft includes a body, a first branch limb, and a second branch limb. The first bifurcating branch device includes a body segment coupled to the first branch limb of the bifurcated stent-graft, a first branch limb, and a second branch limb. The first branch extension is within the first branch limb of the first bifurcating branch device and within an external iliac artery. The first bifurcating branch device has a wide patient applicability since the treatment can be extended proximal to the anatomical iliac bifurcation and is not limited by the common iliac artery length. The stent-graft system is suitable to treat a wide range of internal and external iliac artery diameters.