Abstract: An intervertebral disc repair system comprises an implant and a delivery tool configured to deploy the implant at least partially in a vertebral body of a patient. The implant includes an anchor member and an adjustable suture assembly coupled thereto. The delivery tool includes a proximal handle, an outer tubular member extending distally from the handle, a needle cannula slidably received within the outer tubular member having a sharpened tip for penetrating tissue (e.g., the vertebral body), an inner pusher member slidably received within the needle cannula, and an actuating mechanism coupled to the handle for selectively retracting the needle cannula relative to the outer tubular member and the inner pusher member. At least the anchor member of the implant is releasably received within the needle cannula.

Abstract: Surgical devices permitting a surgeon to access repeatedly tissue at a particular surgical site in a patient to perform multiple surgeries over time. The devices have two substantially planar and parallel leaves that are sterile, nonresorbable, and biocompatible. Each leaf forms a continuous structure and defines the entire longitudinal length of the device to accommodate the size and location of the surgical site. A base member is located in situ and adjacent the surgical site. An anchoring surface secures the device to the tissue of the patient at the surgical site. The leaves have a conjoined portion such that a manual force is required to separate the leaves, thereby expeditiously creating a pathway through which access to the tissue at the surgical site is realized with minimal tissue dissection, and the proximal ends of the leaves are not conjoined to facilitate separation of the leaves and creation of the pathway.

Abstract: A surgical device. The surgical device may comprise a transducer configured to provide vibrations along a longitudinal axis and an end effector coupled to the transducer and extending from the transducer along the longitudinal axis. The surgical device also may comprise a lower jaw extending parallel to the end effector. The lower jaw may comprise a clamp face extending toward the longitudinal axis. Also, the lower jaw may be slidable relative to the end effector to bring the clamp face toward a distal end of the end effector.

Abstract: A morcellator (1) for morcellating tissue within a body cavity of a patient is provided in combination with first (17) and second (18) tissue-pulling devices, and an insert (19). The morcellator (1) comprises a handle portion (2) having a lumen (6) passing therethrough, and an aperture (10) communicating with the proximal end of the lumen. A tube (3) extends from the handle portion and has a tissue cutting device (7) located at the distal end of the tube. The handle includes first (11) and second (12) valves associated with the lumen of the handle portion, and the first and second tissue-pulling devices have shafts of a first diameter and second diameter respectively. The insert (19) comprises a stem (21) and a body portion (20), the stem being received in the aperture (10) to form a substantially gas-tight seal in combination with the first valve (11).

Abstract: Disclosed herein is a system for releasing a ligament. In one embodiment, the system includes a proximal handle, a tubular body, and a flexible body. The tubular body includes a proximal end and a distal end. The handle is coupled to the proximal end. The flexible body extends through the tubular body and includes a tissue cutting portion. The flexible body or tubular body is longitudinally displaceable to move the tissue cutting portion between a non-deployed state and a deployed state.

Abstract: A return spring arrangement for a lancet (6) is provided by a pair of undulating plastic webs (14) formed integrally with the lancet. The undulations of the two webs (14) are shown out of phase with one another. These webs (14) are flexible and thus are caused to concertina when the tips (15) of the webs hit the interior of a lancet holder on release of a drive spring. The energy stored within the collapsed webs (14) is then released to drive the lancet back within the lancet holder. This positive return of the lancet ensures that a needle (5) will retract safely into the lancet holder, after operation, and does not rely on the spring being locked into the lancet holder and onto the lancet.

Abstract: A lancet for use with a lancing device, the lancet having a body with releasable engagement features for engagement with a cooperating portion of a lancing device, a sharp needle, and a removable endcap. A coupling portion of the lancet has a non-circular profile. The endcap includes a receptacle for covering the sharp lancet tip after use, and a sheath portion with relief openings to reduce bending of the needle during manufacture or during removal of the endcap.

Abstract: Laparoscopic instruments and trocars are provided for performing laparoscopic procedures entirely through the umbilicus. A generally C-shaped trocar provides increased work space between the hands of the surgeon as well as S-shaped laparoscopic instruments placed through the trocar when laparoscopic instrument-trocar units are placed through the umbilicus. In order to facilitate retraction of intra-abdominal structures during a laparoscopic procedure, an angulated needle and thread with either one-or two sharp ends is provided. Alternatively, an inflatable unit having at least one generally C-shaped trocar incorporated within the unit's walls can be placed through the umbilicus following a single incision. Generally S-shaped laparoscopic instruments may be placed through the generally C-shaped trocars to facilitate access to intra-abdominal structures.

Abstract: Laparoscopic instruments and trocars are provided for performing laparoscopic procedures entirely through the umbilicus. A generally C-shaped trocar provides increased work space between the hands of the surgeon as well as S-shaped laparoscopic instruments placed through the trocar when laparoscopic instrument-trocar units are placed through the umbilicus. In order to facilitate retraction of intra-abdominal structures during a laparoscopic procedure, an angulated needle and thread with either one-or two sharp ends is provided. Alternatively, an inflatable unit having at least one generally C-shaped trocar incorporated within the unit's walls can be placed through the umbilicus following a single incision. Generally S-shaped laparoscopic instruments may be placed through the generally C-shaped trocars to facilitate access to intra-abdominal structures.

Abstract: The present invention relates to a catheter suitable for conducting and positioning a medical device in an organic cavity comprising at least one side branch, such as a blood vessel, which comprises a tubular body, having a central lumen having a cross-section suitable for the passage of the medical device and a mandrel slidable in the central lumen and distally a flexible end portion. On the outer surface of the mandrel there is a longitudinal groove defining, with the inner wall of the tubular body, a passage suitable for receiving a first guide wire in a sliding manner. In addition, in the mandrel there is an inner lumen suitable for housing a second guide wire in a sliding manner. The present invention further relates to a catheter assembly comprising the aforesaid catheter and a method of use the same.

Abstract: The apparatus for deployment of an intravascular therapeutic device, includes an elongated, flexible pusher member and a therapeutic device connected to a severable portion of a first connector member mounted to the flexible pusher member with an elongated second connector member connected to the therapeutic device. The first connector member or second connector member may be capable of being broken by heat, and a heat source is provided for heating and breaking the first connector member or the second connector member to release the therapeutic device.

Abstract: The tourniquet is a lightweight, compact, and highly efficient device that can be used to assist in the control of life threatening extremity hemorrhage. The tourniquet utilizes a ratchet mechanism to obtain a mechanical advantage when tightening the tourniquet. A ratchet assembly is located a distance away from a strap end of the tourniquet and overlays a contiguous portion of the strap, allowing the tourniquet to be tightened while minimizing pinch, and further includes an elongated ratchet lever for ease of use, requiring minimal, if any, fine motor skills. The design also includes an indicator region for assistance in use of the device and a sealed and tapered strap-end with indicator for efficient use.

Abstract: A ergonomic surgical instrument is provided having a first and second trigger. The instrument comprises a shroud and at least one toggle switch located on the shroud's lateral surface for selectively engaging the first or second trigger to actuate an end-effector. The toggle fixes the position of one trigger with respect to the shroud while permitting the other trigger to actuate the end-effector.

Abstract: Insertion tool for a medical closure device for the sealing of an opening in a wall of a bodily organ, comprising a tamping force source adapted to deliver a first member to a position at the opening on one side of the wall subsequently to a second member being positioned at the opening on the opposite side of the wall. The tamping force source, which is energized prior to the tamping procedure, can be for example a spring, an elastic band or a pressurized gas container. A tamping spring can be compressed or extended upon loading. The tamping force source can be released in response to a manual operation or be triggered by retraction of the insertion tool.

Abstract: The invention provides a cardiovascular occluder for treating a cardiovascular abnormality comprising a frame and an alarmin or an alarmin activator bound to the surface of the frame. The invention further provides methods of manufacturing the cardiovascular occluder and methods of treating cardiovascular abnormalities by delivering the cardiovascular occluder.

Abstract: Wound closure methods and apparata are provided which utilize blood fluid by activating the clotting cascade of the blood fluid outside the body within a substantially enclosed sterile container then introducing the blood fluid to the wound site to complete clotting. Methods and apparata for providing ways of inhibiting anticoagulants and slowing fibrin clot degradation are also disclosed. Kits for practicing the invention singularly or in combination with and/or associated with preferred procedures are also disclosed.

Abstract: Wound closure methods and apparatuses are provided which utilize blood fluid by activating the clotting cascade of the blood fluid outside the body within a substantially enclosed sterile container then introducing coagulated blood to the wound site. Methods and apparatuses for providing ways of inhibiting anticoagulants and slowing fibrin clot degradation are also disclosed. Kits for practicing the invention singularly or in combination with and/or associated with preferred procedures are also disclosed.

Abstract: A suture system has a double ended barbed suture with a first plurality of barbs located adjacent to a first end and a second plurality of barbs located adjacent to a second end, and a body located between the first plurality of barbs and the second plurality of barbs. The body provides an anchor that can hold tissue relative to the first end and the second end of the suture. The body can slide and be positioned on said suture.

Abstract: A surgical method can include passing at least two adjustable loops of a flexible construct through at least the first tissue to extend from an outer surface of the first tissue opposite a tissue engaging surface facing the second tissue, and attaching the two adjustable loops to a first selected area of the second tissue. The method can further include positioning an elongated locking member within the two adjustable loops such that the locking member extends between the two adjustable loops adjacent the outer surface, engaging the locking member with the outer surface by drawing the two adjustable loops towards the outer surface, and compressing the first tissue between the locking member and the second tissue by tensioning the two adjustable loops. Related tissue fixation devices are also provided.

Abstract: An anchor for securing tissue to bone can include a flexible first tubular member, a flexible second tubular member, and a first suture member. The first tubular member can include a first wall defining a first passage between first and second ends. The second tubular member can include a second wall defining a second passage between first and second ends. The first suture member can couple the first tubular member and the second tubular member. The first suture member can pass through the first wall and the first passage and the second wall and the second passage. The first tubular member and the second tubular member can engage each other and deform to form an anchoring mass upon tensioning the first suture member. A method of preparing an anchor for securing tissue to bone and a method of securing a tissue to a bone are also provided.

Abstract: Knotless suture anchors are disclosed for surgical use, which contain one or more types of ratcheting mechanisms that will allow a surgeon to pull a suture strand through an anchor device in one direction, without allowing the suture strand to travel or creep backward, in the other direction. This will allow a surgeon to emplace a number of such anchors in hard bone(s) or soft tissue(s), during installation of an implant device, while the various suture strands remain loose and do not interfere with proper positioning of the implant. When the implant device is roughly in position, the surgeon can gently “snug” all of the suture strands (which preferably should be braided, to provide a non-smooth surface that will enable a stronger and more secure grip by the ratcheting mechanism), so that they will all reach a moderate plateau of gentle yet firm tension.

Abstract: An expandable interspinous process spacer implant for insertion and/or implantation between a spinous process of a superior vertebral body and a spinous process of an inferior vertebral body, the implant comprising multiple pairs of legs joined in a scissor-like fashion and pivotally coupled to each other by one or more pins, where each leg has multiple slots along its longitudinal axis. The implant further may include a pair of bearing surfaces coupled between the legs via cross pins and a first plate and second plate each of which is coupled to a pair of roller pins disposed between a pair of slots on the legs where rotation of a fastener in the fastener holes of the first and second plate results in the first plate and the second plate being drawn toward each other causing the expansion of the height of the implant.

Abstract: A surgical implant is provided that includes first and second abutment surfaces between which are positioned a force imparting mechanism. A sheath is positioned between the first and second abutment surfaces, and surrounds the force imparting mechanism. The sheath is fabricated from a material that accommodates relative movement of the abutment members, while exhibiting substantially inert behavior relative to surrounding anatomical structures. The sheath is generally fabricated from expanded polytetrafluoroethylene, ultra-high molecular weight polyethylene, a copolymer of polycarbonate and a urethane, or a blend of a polycarbonate and a urethane. The force imparting member may include one or more springs, e.g., a pair of nested springs. The surgical implant may be a dynamic spine stabilizing member that is advantageously incorporated into a spine stabilization system to offer clinically efficacious results.

Abstract: A polyaxial screw connection assembly includes a first longitudinal member comprising a bored fastener channel and a first bulbous body; a second longitudinal member comprising a cylindrical body to fit within the fastener channel, and a second bulbous body; a fastener with a bored cylindrical channel, connected to the first longitudinal member and the cylindrical body and securely couples the first longitudinal member to the second longitudinal member; a first fixation component directly connected to the first bulbous body; a second fixation component directly connected to the second bulbous body; a first pin engaged within the first longitudinal member via a bored first channel and contacting the first bulbous body causing the first bulbous body to outwardly expand; and a second pin engaged within the second longitudinal member via a bored second channel and contacting the second bulbous body causing the second bulbous body to outwardly expand.

Abstract: Systems and methods of treating spinal deformity, including one or more intervertebral implants to be introduced laterally into respective intervertebral spaces, a plurality of bone screws introduced generally laterally into vertebral bodies adjacent to the intervertebral implants and/or the intervertebral implants themselves, and a cable dimensioned to be coupled to the bone screws and manipulated to adjust and/or correct the spinal deformity.

Abstract: A method comprising attaching a screw head to a bone fixator component, wherein the screw head comprises a first portion comprising a slot and an inwardly curved bottom portion; and a second portion comprising an outwardly protruding and expandable bulbous end extending from the inwardly curved bottom portion; and wherein the bone fixator component comprises a concave socket adapted to receive the screw head; securing the bone fixator component in a bone; securing a locking pin in the screw head; engaging the locking pin with the bone fixator component; inserting a longitudinal member in the screw head; and inserting a blocker in the screw head.

Abstract: The disclosure includes a bone plate extender and extension system. The system includes a first bone plate extender and may additionally include a bone fixation element and/or an additional bone plate. The bone plate extender may be affixed to a bone portion at one end, for instance, a fractured bone portion, via a bone fixation element, and associated with a second bone plate at an opposite end, so as to facilitate alignment and stabilization of the bone and thereby correct and treat a bone fracture. The bone plate extender may include an extended body, which includes a bone plate engagement portion, a bone fixation portion, and an intercalating portion there between. In certain variations, the extended body is planar, and in certain variations the extended body is angled, curved or arced. Methods of using such bone plate extension systems for the reduction, restoration and treatment of bone fractures are also provided.

Abstract: Bone fixation system, including methods, apparatus, and kits, and comprising a bone plate and at least one instrument that attaches to the bone plate and provides at least one radiopaque region to facilitate positioning the bone plate on bone visualized by radiographic imaging. The instrument may be a handle assembly and/or a targeting guide.

Abstract: Screw back out prevention devices to inhibit screws from reverse threading or backing out are provided. The devices include first bonding materials on either a bushing in a bore of a plate or directly on the bore and second bonding materials on the screw head. The bonding materials for a bond that inhibits back out or reverse threading of the screw.

Abstract: A bone plate, having a bone screw and a rotatable lock for retaining the bone screw in place, includes a retainer element and/or a stop element. The retainer element inhibits the lock from being pushed off of the bone plate, while the stop element limits the rotational range of motion of the lock.

Abstract: The disclosed fasteners have a substantially cylindrical expansion head to secure the fastener in a support structure. The expansion fastener has a removable locking ring, a head, and a shaft extending from the distal end of the head. The exterior of the head has at least one slot extending from the edge toward the distal end. The slots can extend partially or fully to the base of the head. In one embodiment the locking ring has at least one tab that extends beyond the periphery and a tool receiving area. In one embodiment a channel having wall periphery reduction area receives a locking ring with tabs which, when rotated to contact the reduction areas expand the head. In another embodiment the locking ring has a threaded periphery that interacts with a reduced diameter threaded periphery within the head to expand the exterior of the head.

Abstract: A resonant frequency device provided with a transmitter, an amplifier and an impedance matching circuit connected to an antenna, such as a plasma antenna. A voltage or current balun could be provided between the impedance matching circuit and the antenna.

Abstract: Disclosed is an apparatus for stimulating the brain and measuring the light induced neuronal activity including a signal application unit which applies a signal to a living tissue to stimulate the neuronal cells in the living tissue; an electrode unit which detects an electrophysiological signal of the neuronal cell in response to the signal; and an insulation unit which controls an impedance of the electrode unit. The signal application unit is formed integrally with the electrode unit, so that the site where the signal is applied to the living tissue is approximated to the site where the response to the stimulation is measured.

Abstract: A system and method is provided for improving the visibility of hair on the skin surface, in a region that is bloodied or bruised, and potentially expanding the candidate pool of the hair grafts to be selected for harvesting. The system uses a light source comprising at least two emitters and the method comprises controlling the contrast between the image of the blood and the image of the skin surface. The method of the present invention may be implemented with various hair harvesting and transplantation systems, including manual, partially automated and fully automated systems.

Abstract: Apparatus and method for making and using devices that generate optical signals, and optionally also electrical signals in combination with one or more such optical signals, to stimulate (i.e., trigger) and/or simulate a sensory-nerve signal in nerve and/or brain tissue of a living animal (e.g., a human), for example to treat nerve damage in the peripheral nervous system (PNS) or the central nervous system (CNS) and provide sensations to stimulate and/or simulate “sensory” signals in nerves and/or brain tissue of a living animal (e.g., a human) to treat other sensory deficiencies (e.g., touch, feel, balance, visual, taste, or olfactory) and provide sensations related to those sensory deficiencies, and/or to stimulate (i.e., trigger) and/or simulate a motor-nerve signal in nerve and/or brain tissue of a living animal (e.g., a human), for example to control a muscle or a robotic prosthesis.

Abstract: To provide a light irradiation device capable of easily removing and reducing hair with low power light without burden on skin. The light irradiation device according to the present invention includes a light source giving pulses of light in a wavelength range from 400 to 1200 nm and a light guide distributing the pulses of light given from the light source with energy intensity of 0.2 to 10 J/cm2 at a predetermined distance from the light outgoing surface.

Abstract: A physiological thermal stimulation probe, comprising: (a) an electrically controlled heat control element with a relatively low thermal capacity and adapted for contact with tissue on one side thereof; (b) a thermal sink/source with a relatively high effective thermal capacity and a relatively low thermal impedance, such that said thermal sink/source sink can rapidly change a temperature of said heat control element, at a rate above 10 degrees Celsius per second, from a temperature of below 100 degrees Celsius; and (c) circuitry which activates said heat control element to achieve a desired temperature stimulation profile of said tissue.

Abstract: A balloon catheter is used in a closed-loop heat exchange system for manipulating the temperature of a patient. The balloon catheter is positioned in the stomach of the patient, and then expanded with a heat exchange fluid delivered through a lumen formed in the shaft of the catheter. The balloon catheter comes into contact with the wall of the stomach, and the stomach substantially conforms around the expanded balloon catheter. The heat exchange fluid is allowed to flow continuously into and out of the balloon catheter. Heat is exchanged between the balloon catheter and the stomach so as to controllably alter the temperature of at least a portion of the patient. Anti-shivering mechanisms and automatic control based on temperature feedback from the patient may be used in connection with the heat exchange system.

Abstract: Described are medical devices which are or can be used to form tubular medical devices, and related methods. Preferred devices include tubular grafts of biomaterial having lumen walls which present no seam edge that traverses the entire length of the lumen, illustratively including devices having lumen walls which have a discontinuous seam presenting multiple seam edges. Such a device may include a tubular structure formed by inserting a plurality of extensions of a biomaterial sheet through a plurality of corresponding apertures of the sheet.

Abstract: The present invention is a vascular stent comprising a cylindrical wall radially expandable from a compressed state to an expanded state and including a plurality of cells. At least one cell includes a first primary member having a first restrainer member and a second primary member having a second restrainer member. When the cylindrical wall is in the expanded state, the first and second primary members are located a greater distance from each other than when the cylindrical wall is in the compressed state. The first and second restrainer members join to maintain the cylindrical wall in the compressed state. An expansion force applied to the cylindrical wall causes the first and second restrainer members to separate, thereby freeing the cylindrical wall to expand from the compressed state to the expanded state.

Abstract: An implant delivery device preferably includes a first shaft having a proximal portion and a distal portion. The first shaft includes an outer surface and an inner surface defining a first lumen along a longitudinal axis. The distal portion includes a tip defining a taper in the distal direction toward the longitudinal axis and terminating at a distal opening. The device also includes a second shaft having a proximal portion and a distal portion and an inner surface defining a second lumen therebetween having a first cross-section. The second shaft is disposed within the first lumen such that the second lumen is generally coaxial with the first lumen to define a chamber. The distal portion of the second shaft terminates in a port having an opening in communication with the distal opening of the first shaft. The port preferably includes a second cross-section greater than the first cross-section.

Abstract: An apparatus and method to treat vulnerable plaque. In one embodiment, the apparatus has a medical device to treat an occlusive plaque, and is also adapted to release a biologically active agent to treat vulnerable plaque located downstream from the occlusive plaque. In an alternative embodiment, the apparatus has an expandable tube attached to the inner surface of a stent, and a layer of endothelial cells seeded on the inner surface of the expandable tube. The expandable tube shields a vulnerable plaque from a body lumen.

Abstract: An artificial blood vessel includes a flexible tube and a structure provided at one end portion of the tube and capable of being deformed to a first outside diameter and a second outside diameter greater than the first outside diameter, wherein the tube is provided with a lock part which is locked at a desired position when the tube is folded back from its other end portion to the inside.

Abstract: A stent and associated method for implanting a stent within a body conduit are provided. According to one embodiment, the stent includes a plurality of annular segments arranged peripherally along a longitudinal axis to define opposing free ends, wherein each annular segment includes a plurality of interconnected segment struts. The stent also includes a plurality of connector struts each extending along the longitudinal axis between, and connecting, adjacent annular segments, wherein each connector strut includes an axial section and a compensating section. In addition, at least a portion of each of the segment struts, axial sections, and compensating sections is curved.

Abstract: A low profile support frame for use as an or in an expandable intraluminal medical device includes first and second wire members that define arcuate paths having opposing curves. Connectors join the wire members, and barbs can be disposed on the connectors. The support frame has radially compressed and radially expanded configurations. When the support frame is in the radially expanded configuration, substantially no portion of the support frame is disposed on a first transverse axis of the frame opposite one end of the frame and substantially no portion of the frame is disposed on a second transverse axis of the frame opposite the other end of the frame. The support frame can be used as an intraluminal medical device by itself or as a component in a medical device that includes other components, such as a stent, prosthetic valve, occluder, or filter.

Abstract: A luminal prosthesis comprises a plurality of radially expandable prosthetic stent segments arranged axially. Two or more of the prosthetic stent segments are separable upon expansion from the remaining prosthetic stent segments and a coupling structure connects at least some of the adjacent prosthetic stent segments to each other. The coupling structure permits a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group and the coupling structure maintains or forms an attachment between the adjacent prosthetic stent segments in the first group which have been expanded together. A delivery system and methods for deploying the multiple coupled prosthetic stent segments are also disclosed.

Abstract: To provide a stent which holds various performances such as deliverability, prevention of restenosis, flexible shape conformability, and so on and is therefore adaptable not only to a bile duct but also to a blood vessel system such as a tortuous coronary artery substantially without causing restenosis. A stent with an autonomic function is made of a Ti—Ni based shape memory alloy and has a maximum expanding force at a center portion in its lengthwise direction.

Abstract: A medical device comprising a plurality of capsules, and a method of administering therapeutic agent to a patient using the same. The capsules further comprise a therapeutic agent and a multilayer polyelectrolyte shell. The medical device is adapted to apply a pressure to the capsules that is greater than or equal to the critical pressure of at least a portion of the capsules, such that therapeutic agent is released from the capsules.

Abstract: A method is provided for treating a cardiovascular disease, such as pulmonary arterial hypertension, an arrhythmia, or heart failure. One step of the method includes providing an apparatus. The apparatus includes an expandable support member having oppositely disposed proximal and distal end portions and a main body portion extending between the end portions. The proximal end portion includes a plurality of wing members extending from the main body portion. At least a portion of the expandable support member is treated with at least one therapeutic agent for eluting into a blood vessel. The expandable support member is inserted into the pulmonary vasculature and then advanced to a bifurcation in the pulmonary vasculature. The bifurcation includes the intersection of a first pulmonary vessel, a second pulmonary vessel, and a third pulmonary vessel. The expandable support member is secured at the bifurcation to treat pulmonary arterial hypertension, for example.

Abstract: Embodiments of the present disclosure provide a prosthetic heart valve and a heart valve delivery apparatus for delivery of the prosthetic heart valve to a native valve site via the human vasculature. The delivery apparatus is particularly suited for advancing a prosthetic valve through the aorta (i.e., in a retrograde approach) for replacing a diseased native aortic valve. In one embodiment, a self-expanding valve comprises an expandable stent that is shaped to maintain the valve in the aortic annulus against axial without anchors or retaining devices that engage the surrounding tissue. A delivery apparatus for delivering s self-expanding prosthetic valve can be configured to allow controlled and precise deployment of the valve from a valve sheath so as to minimize or prevent jumping of the valve from the valve sheath.