Abstract: Apparatus and methods are described for use with a venous system of a subject that includes one or more tributary vessels that flow into a vein at junctions. A blood-pump-catheter includes a material configured to be placed at a downstream location that is downstream of the junctions and to at least partially occlude blood flow through the vein. The material defines a blood-outlet opening. A blood pump pumps blood from a region of the vein that is adjacent to the junctions, and through the blood-outlet opening. A blood-flow pathway directs upstream venous blood flow from an upstream location that is upstream of the junctions, to downstream of the material, without the upstream venous blood flow being pumped by the pump. Other applications are also described.

Abstract: Apparatus and methods are described including a blood pump that includes a pump-outlet tube shaped to define one or more blood-outlet openings and configured for insertion into a heart of a subject. An impeller is disposed within a distal portion of the pump-outlet tube and is configured to pump blood of the subject proximally through the pump-outlet tube, such that the blood exits the pump-outlet tube through the blood-outlet openings. A delivery tube extends, from outside a body of the subject, through the pump-outlet tube to the distal portion. A drive cable passes through the delivery tube and is configured to rotate the impeller. A proximal portion of the pump-outlet tube includes multiple strips adhered to the delivery tube. Other embodiments are also described.

Abstract: Apparatus and methods are described including a blood pump that includes an impeller configured to pump blood through a subject's body, and a frame disposed around the impeller. In a radially-non-constrained configuration of the frame, the frame defines a proximal conical portion and a cylindrical portion disposed distally to the proximal conical portion. During operation of the blood pump, the impeller moves with respect to the frame, and a range of movement of the impeller is such that at least a first portion of the impeller is disposed within the proximal conical portion of the frame during at least some of the operation of the blood pump, and at least a second portion of the impeller is disposed within the cylindrical portion of the frame during at least some of the operation of the blood pump. Other applications are also described.

Abstract: Apparatus and methods are described including rotating at least a portion of a valve frame in a first direction and subsequently rotating the valve frame in a second direction. The valve frame includes chord-recruiting arms. An outer surface of each of the chord-recruiting arms has a smooth, convex curvature that extends along substantially a full length of the chord-recruiting arm, such that during the rotation of the portion of the valve frame in the first direction, the chords slide over the outer surface of the chord-recruiting arm without be recruited or caught by the chord-recruiting arm. An inner surface of each of the chord-recruiting arms has a concave curvature, such that during the rotation of the portion of the valve frame in the second direction, the chords are recruited within a space defined by the concave curvature.

Abstract: Apparatus and methods are described including a blood pump that includes an axial shaft configured for insertion into, and rotation within, a body of a subject. An impeller is coupled to the axial shaft such that, as the axial shaft rotates, the impeller pumps blood of the subject. A thrust bearing includes a proximally-facing ceramic surface disposed distally from the axial shaft so as to inhibit distal movement of the axial shaft beyond the thrust bearing, and a distally-facing ceramic cover that covers a distal end of the axial shaft, such that the ceramic cover contacts the ceramic surface as the axial shaft rotates. Other applications are also described.

Abstract: Apparatus and methods are described for use with a venous system of a subject that includes one or more tributary vessels that flow into a vein at junctions. A blood-pump-catheter (70) includes a material (36) configured to be placed at a downstream location that is downstream of the junctions and to at least partially occlude blood flow through the vein. The material defines a blood-outlet opening (31). A blood pump (24) pumps blood from a region of the vein that is adjacent to the junctions, and through the blood-outlet opening (31). A blood-flow pathway (60) directs upstream venous blood flow from an upstream location that is upstream of the junctions, to downstream of the material (36), without the upstream venous blood flow being pumped by the pump (24). Other applications are also described.

Abstract: Apparatus and methods are described including manufacturing an impeller by forming a structure having first and second bushings at proximal and distal ends of the structure, the first and second bushings being connected to one another by at least one elongate element. The elongate element is caused to radially expand and form at least one helical elongate element, at least partially by axially compressing the structure. The helical elongate element is coated with a coupling agent configured to enhance bonding between the helical elongate element and an elastomeric layer. The coated helical elongate element is coated with the elastomeric layer. Subsequently, an elastomeric film is coupled to the helical elongate element, such that the helical elongate element with the elastomeric film coupled thereto defines a blade of the impeller. Other applications are also described.

Abstract: Apparatus and methods are described including a left-ventricular assist device that includes a pump-outlet tube shaped to define one or more blood-outlet openings and configured for insertion, through an aorta of a subject, into a left ventricle of a heart of the subject such that the pump-outlet tube traverses an aortic valve of the subject with the blood-outlet openings being disposed within the aorta. A blood pump is disposed at least partly within a distal portion of the pump-outlet tube and is configured to pump blood of the subject proximally through the pump-outlet tube. A proximal end of the pump-outlet tube is folded inwardly so as to define one or more surfaces configured to direct the blood through the blood-outlet openings by virtue of being oblique with respect to a longitudinal axis of the pump-outlet tube. Other applications are also described.

Abstract: An intraluminal device including an elongated structure formed of a plurality of wires may be provided. The intraluminal device may include a plurality of sets of looped wires longitudinally located at an intermediate area of the elongated structure. The sets of looped wires may be spaced circumferentially about the elongated structure and may be configured to cooperate with each other to form a plurality of clot entry openings. The intraluminal device may also include at least one grouping of woven wires that may be longitudinally located adjacent to the intermediate area and may be configured such that when an opening force is exerted on the elongated structure, the at least one grouping of woven wires may provide structural support to hold open first interstices between the plurality of sets of looped wires.

Abstract: Apparatus and methods are described including an axial shaft and an impeller configured for rotation within a subject's body. A coupling element includes a first portion, which is disposed around the axial shaft, is shaped to define one or more slits that facilitate a radial expansion of the first portion such that the first portion is placeable around the axial shaft, and is shape-set to have an inner diameter that is smaller than a diameter of the axial shaft such that, following placement of the first portion around the axial shaft, the first portion becomes radially contracted around, and thus locked in place with respect to, the axial shaft. A second portion of the coupling element is coupled to a bushing of the impeller. Other applications are also described.

Abstract: Apparatus and methods are described including a blood pump including an axial shaft configured for insertion into, and rotation within, a body of a subject, and an impeller coupled to the axial shaft such that, as the axial shaft rotates, the impeller pumps blood of the subject. A frame surrounds the impeller. One or more steering wires are coupled to the frame and configured to extend from the frame, to outside the body of the subject, while the frame is within the body. Other applications are also described.

Abstract: Apparatus and methods are provided, including inserting an impeller and a delivery tube into a subject's body, the delivery tube including a braid having a pick density that varies along the delivery tube's length such that a flexural rigidity of the delivery tube at a first portion of the delivery tube is less than the flexural rigidity at a second portion of the delivery tube, and the flexural rigidity at the second portion is less than the flexural rigidity at a third portion of the delivery tube. The impeller and delivery tube are positioned such that the impeller is disposed within the subject's left ventricle and the delivery tube passes the subject's aorta into the left ventricle. Using a drive cable, which passes through the delivery tube, the impeller is rotated so as to pump blood from the left ventricle into the aorta. Other applications are also described.

Abstract: Apparatus and methods are described including inserting a drive-cable end of a drive cable, which includes a plurality of coiled wires, and a hollow-shaft end of a hollow shaft, which hollow-shaft end is shaped to define multiple shaft pores, into opposing ends of a coupling tube, which is shaped to define multiple coupling-tube pores. While the drive-cable end and hollow-shaft end are inside the coupling tube, a molten material is flowed between the coiled wires at the drive-cable end via the coupling-tube pores, and into the hollow-shaft end via the coupling-tube pores and shaft pores, such that, upon solidifying, the material bonds the drive cable to the shaft. Other applications are also described.

Abstract: Apparatus and methods are provided, including a left-ventricular assist device that includes an impeller configured for insertion into a subject's left ventricle. A delivery tube passes through the subject's aorta, from outside the subject into the left ventricle. The delivery tube includes an outer layer that varies along a length of the delivery tube such that a flexural rigidity of the delivery tube at a first portion of the delivery tube, which is configured to traverse the aortic valve, is less than the flexural rigidity at a second portion, which is configured to traverse at least a portion of the aortic arch, and the flexural rigidity at the second portion is less than the flexural rigidity at a third portion, which is configured to traverse the descending aorta. Other applications are also described.

Abstract: Apparatus and methods are described including a blood pump that includes an axial shaft configured for insertion, over a guidewire, into a subject's body, and for rotation within the subject's body. The axial shaft is shaped to define a shaft lumen for passage of the guidewire therethrough. An impeller is coupled to the axial shaft such that, as the axial shaft rotates, the impeller pumps blood of the subject. A thrust bearing is disposed distally from the axial shaft so as to inhibit distal movement of the axial shaft beyond the thrust bearing. The thrust bearing is shaped to define a bearing lumen that is configured to be continuous with the shaft lumen. At least a portion of the bearing lumen is frustoconically-shaped, a wider end of the frustoconically-shaped portion of the bearing lumen facing distally. Other applications are also described.

Abstract: Apparatus and methods are described including a blood pump that includes an axial shaft configured for insertion into, and rotation within, a subject's body, and an impeller coupled to the axial shaft such that, as the axial shaft rotates, the impeller pumps blood of the subject. A frame surrounds the impeller and includes a distal conical portion. A bearing adjacent to the axial shaft is configured to stabilize the axial shaft while the axial shaft rotates. A bearing housing houses the bearing. The bearing housing is disposed at least partly within the distal conical portion of the frame such that at least 50% of the length of the bearing housing is disposed within the frame. Other applications are also described.

Abstract: Apparatus and methods are described including an axial shaft configured for insertion into, and rotation within, a ventricle of a heart of a subject. An impeller is coupled to the axial shaft and a frame surrounds the impeller. A pump-outlet tube surrounds the frame such that, as the axial shaft rotates, the impeller pumps blood proximally, from the ventricle, through the pump-outlet tube. A flat inlet guard, which is shaped to define one or more holes, is disposed around, and perpendicular to, the axial shaft and within the frame distally to the impeller, such that the blood flows to the impeller via the holes. Other applications are also described.

Abstract: Apparatus and methods are described including a left-ventricular assist device, that includes a collapsible pump-outlet tube configured for insertion, through an aorta of a subject, into a left ventricle of a heart of the subject such that the pump-outlet tube traverses an aortic valve of the subject. The device includes one or more bands, each of which is bonded to an outer wall of the proximal portion of the pump-outlet tube, without extending around a full circumference of the pump-outlet tube, such that, while the proximal portion of the pump-outlet tube is maintained in the open state, the proximal portion of the pump-outlet tube curves at respective locations of the bands. Other applications are also described.

Abstract: Apparatus and methods are described including a blood pump that includes an axial shaft configured for insertion into, and rotation within, a left ventricle of a subject, and an impeller coupled to the axial shaft such that, as the axial shaft rotates, the impeller pumps blood from the left ventricle. A frame surrounds the impeller and a tip portion is coupled to a distal end of the frame. The tip portion includes a distal curved portion, which, when deployed within the left ventricle, lies in a plane, and a proximal curved portion, which, when deployed within the left ventricle, does not lie in the plane and is curved such that, following the insertion of the axial shaft into the left ventricle via an aorta of the subject, a distal end of the proximal curved portion points toward an apex of the left ventricle. Other applications are also described.

Abstract: Apparatus and methods are described including a device configured for insertion into a left ventricle of a heart of a subject. A delivery tube is coupled to the device and configured to traverse an aortic arch of the subject while the device is within the left ventricle. An elongation-resistant fiber runs axially along the delivery tube so as to bias an orientation of the delivery tube while the delivery tube traverses the aortic arch such that the elongation-resistant fiber is disposed inside a curve of the aortic arch, thereby biasing an orientation of the device. Other applications are also described.