Abstract: A surgical system includes a surgical instrument that is sensitive to backlash that would adversely affect the transmission of controlled torque and position to the surgical instrument. The surgical instrument is coupled to motors in a surgical instrument manipulator assembly via a mechanical interface. The combination of the mechanical interface and surgical instrument manipulator assembly have low backlash, e.g., less than 0.7 degrees. The backlash is controlled in the surgical instrument manipulator assembly. From the drive output disk in the surgical instrument manipulator assembly to the driven disk of the surgical instrument, the mechanical interface has zero backlash for torque levels used in surgical procedures.

Abstract: A surgical instrument includes a support structure, a shaft, a shaft translation carriage including a shaft roll carrier, a shaft roll drive group, and a force sensor unit. The shaft comprises a proximal end and a distal end, and a shaft axis is defined by the proximal and distal ends. The shaft is coupled to the support structure by the shaft roll carrier. The shaft roll drive group is configured to rotate the shaft about the shaft axis and comprises a shaft roll driver, a shaft roll drive receiver, and a shaft roll drive coupling. The shaft roll drive receiver translates along the shaft axis relative to the shaft roll driver as the shaft translates along the shaft axis. The force sensor unit is configured to produce a the shaft axis.

Abstract: A robotic catheter procedure system is provided. The robotic catheter procedure system includes a bedside system and a remote workstation. The bedside system includes a percutaneous device and a drive mechanism configured to engage and to impart an axial force to the percutaneous device and to advance and retract the percutaneous device. The bedside system includes an actuator providing torque to the drive mechanism to impart the axial force to the percutaneous device, and the torque provided by the actuator is variable. The remote workstation includes a user interface configured to receive a first user input and a control system operatively coupled to the user interface. The control system is configured to communicate a control signal to the actuator. The control signal is based upon the first user input and a second input, and the actuator provides torque to the drive mechanism in response to the control signal.

Abstract: Certain aspects relate to systems and techniques for a bipolar medical instrument. In one aspect, the medical instrument includes a first end effector, a first set of one or more distal pulleys coupled to the first end effector, and a wrist configured to house the first set of distal pulleys. The medical instrument also includes a plurality of cables extending through the wrist and a first insulating member formed between the first end effector and the first set of one or more distal pulleys.

Abstract: A medical system may comprise a display system and a control system. The control system may include a processing unit including one or more processors. The processing unit may be configured to display, on the display system, an image of a field, generated by an imaging component, of view of a surgical environment. The processing unit may also be configured to generate a three-dimensional synthetic indicator for a position of an instrument outside of the field of view of the surgical environment and display the three-dimensional synthetic indicator with the image of the field of view of the surgical environment.

Abstract: Methods and systems of registering a model of one or more anatomic passageways of a patient to a patient space are provided herein. An exemplary method may include accessing a set of model points of the model of the passageways, the model points being associated with a model space, collecting measured points along a length of a catheter inserted into the passageways of the patient, the measured points determined by a shape of the catheter, and assigning points of the first set to a plurality of subsets. The exemplary method may further include registering each of the subsets with the model points to produce a plurality of registration candidates, comparing the candidates to identify an optimal subset associated with an optimal registration of the plurality of candidates that translates the set of model points and at least one set of the sets of measured points into a common space.

Abstract: An apparatus and methods of use thereof, the apparatus comprising: a medical device, configured to reside and to be manipulated within a first lumen; and a driving system, configured to manipulate—and/or control—the medical device, via a second lumen. The driving system comprising: a catheter, configured to be inserted into—and to navigate—or to be navigated—within the second lumen; and a driver, configured to travel within the catheter, and to remotely manipulate—and/or control—the medical device residing in the first lumen.

Abstract: A system for reducing glove waste comprising a glove dispensing box having an enclosure formed by a top portion, a bottom portion, a first rectangular side portion, a second rectangular side portion, a first rectangular end portion, and a second rectangular end portion, the top portion having an opening though which a glove can be pulled; a flexible sheet adhered to the glove dispensing box, wherein the flexible sheet is connected adjacent to the opening, the flexible sheet having a nonlinear, elongated slit dimensioned to permit passage of a single glove therethrough and to inhibit the passage of multiple gloves with a single manual pull; and an antimicrobial material disposed to inhibit microbial growth proximate to the slit. Also disclosed herein are accompanying methods and devices for reducing glove waste and contamination.

Abstract: A surgical draping system includes an under-draping, an over-draping, and a connecting draping connected by the under-draping and the over-draping. The surgical draping system is used to establish and maintain a surgical corridor to a surgical site or sites on a patient supported by a surgical table. The surgical draping system can accommodate rotation of the patient on the surgical table, such that the sterile surgical corridor is maintained even during such rotation. The sterile surgical corridor extends through an aperture formed in the over-draping, through an enclosed passageway formed through the connecting draping, and through an aperture formed in the under-draping.

Abstract: The present invention relates generally to methods and systems for an adjustable depth stop, which has additional optional features of tissue retraction, visualization via transparent or semi-transparent material and/or window(s) on its size, precise gradation of depth by rotation indicated on side of the device, windows on the side for irrigation while traversing, and ability to utilize this device in settings of biopsy, coagulation, laser ablation, and other non-drill-related uses whereupon depth needs to be achieved, and going past-point would be problematic, in a device (such as an catheter, electrode, or needle, but not intended for a drill) which cannot be easily “overpowered” by typically applied forces (e.g. downward pressure by typical user). This depth stop could have a nested, telescoping feature as well, so that it may be increased in length to many-fold its original length. It may be utilized as a device to be manually set, or automatically set (e.g. utilizing a robotic feature).

Abstract: A surgical intervention system, image display method, storage medium, and sterile space. The system includes a microscope having a movable head with an optical system that magnifies a targeted area and produces a digital image with an image unit. A microscope arm connects to a base that adjusts a position and/or orientation of the microscope head. A control unit processes the image and controls a display device. The microscope further includes a camera system with a surroundings camera arranged at the microscope head. A field of view of the surroundings camera includes the field of view of the optical system to capture the targeted area and an environment around the targeted area and provide a surroundings image. The control device processes the surroundings image and generates a combined view with the microscope image and the surroundings image. The control device outputs the combined view on the display device.

Abstract: An instrument device manipulator (IDM) is attached to a surgical arm of a robotic system and comprises a surgical tool holder and an outer housing. The surgical tool holder includes an attachment interface that can secure a surgical tool in a front-mount configuration (where the attachment interface is on a face opposite of a proximal extension of the surgical tool) or a back-mount configuration (where the attachment interface is on the same face as the proximal extension of the surgical tool). The surgical tool holder may rotate continuously within the outer housing. In a back-mount configuration, the surgical tool holder may have a passage that receives the proximal extension of the tool and allows free rotation of the proximal extension about the rotational axis. A surgical drape separates the IDM and robotic arm from a tool, while allowing electrical and/or optical signals to pass therebetween.

Abstract: The present invention relates to a balancing, positioning and fixating assembly for balancing a treatment device, comprising balance arm having a first arm end and a second arm end, a stepper part having a first part end and a second part end, the first arm end is connected with the second part end via a first pivot joint so that the balance arm is movable in relation to the stepper part, and an angulator device is arranged in connection with the second arm end, the angulator device is configured to connect the treatment device to the balance arm and to facilitate movement of the treatment device in different angles, wherein a spring device having a predetermined spring force is arranged along the balance arm, the spring device has a first spring end and a second spring end.

Abstract: A surgical equipment holder is disclosed. The surgical equipment holder includes a first arm pivotable relative to a base, a second arm pivotably coupled to the first arm and an end effector pivotable relative to the second arm. The surgical equipment holder may also include features on the first arm and the second arm configured to allow enhanced cleanability of the surgical instrument holder. The surgical equipment holder also includes a lever configured to actuate between a locked and unlocked position by use of a single hand by an operator. The end effector of the surgical equipment holder is configured to support and finely adjust the position of any number of surgical accessories during surgical procedures.

Abstract: A medical instrument includes an instrument shaft with exit holes near a distal end of the shaft, a tool coupled to the distal end of the shaft, and a backend. The backend may include a mechanism that manipulates a drive element that extends through the shaft and couples to the tool, a fluid inlet, and a fluid channel assembly providing fluid communication between the fluid inlet and the proximal end of the shaft. Cleaning fluid is directed into the fluid inlet, through the fluid channel assembly, and into the shaft. A chassis or other structural piece of the backend may form part of the fluid channel assembly.

Abstract: System, methods and apparatus related to surgical articles used during surgery. The system, methods and apparatus may include features such as an element/substrate added to surgical articles which enables the recognition by human visualization of the surgical articles when left inside patient bodies when viewed with medical imaging technologies. The element/substrate may include a plurality of three dimensional objects. Alternatively, the element/substrate may comprise a ribbon of radiopaque material having cut-puts or other radiolucent regions which provide image artifacts observable under fluoroscopic imaging.

Abstract: A method of forming a dental restoration for a tooth having an outer surface includes acquiring a first three-dimensional representation representative of the outer surface of the tooth; generating a design of a first part of the dental restoration based on the first three-dimensional representation of the tooth; forming the first part of the dental restoration; preparing the tooth to form a prepared tooth while forming the first part of the dental restoration; obtaining a second three-dimensional representation of the prepared tooth; generating a design of a second part of the dental restoration based on at least the second three-dimensional representation of the prepared tooth; merging the design of the second part of the dental restoration to the first part of the dental restoration; and forming the second part of the dental restoration.

Abstract: A method is provided for shaping a custom anterior dental restoration from a preform, wherein the preform comprises a preform body and a preform stem. A method is further disclosed for generating one or more nesting positions for the restoration design within the geometry of the preform body relative to the position of the preform stem. A method is further disclosed for generating machining instructions based on the selected nesting position to optimize machining for chair-side applications.

Abstract: In one aspect of the present application, a shell-shaped tooth repositioner is provided, it comprises: N successive shell-shaped tooth repositioners corresponding to N successive steps, respectively, where each of the N shell-shaped tooth repositioners is for repositioning teeth from an initial tooth arrangement of a corresponding step to a target tooth arrangement of the corresponding step, where a first bite plate is provided on a lingual side of a portion corresponding to a first tooth of each of the N shell-shaped tooth repositioners, for opening bite of anterior teeth, where relative positions between the first bite plates on the N shell-shaped tooth repositioners and the first tooth are such that each of the N shell-shaped tooth repositioners is able to open bite of the anterior teeth to an extent that is substantially consistent with a target extent, where N is a natural number greater than 3.

Abstract: The present application refers to an orthodontic aligner comprising a material that results in one side being flat and the other having the shape of teeth, or the two sides being flat. This type of contact causes dememorization of the occlusal contacts, causing relaxation. Thus, the principles of the conventional bite plate are used. In addition, people who have joint problems or pain (TMJ) or muscle pain (temporalis, masseter muscles) can use the devices without worsening the condition and with better results and pain relief. As well as patients without muscle and joint symptoms can also use the device more comfortably.

Abstract: A device and method for seating orthodontic aligners over the dentition of a user includes a light-based device having a bite plate or mouthpiece, with light-emitting elements, for contacting the aligners. Instructions are provided for using of the light-based aligner seating device by placing the mouthpiece over the aligners, applying light radiation during a predetermined number of sessions throughout a predetermined treatment period, wherein the seating and the fit between the aligners and teeth are better than without use of the light-based device.

Abstract: The present disclosure relates to ornamental indicia carrier and method of producing the same. In some embodiments, the ornamental indicia carrier comprises an ultraviolet light (“UV”) cured ink printed on a thin flexible film and combined with an adhesive layer. The ornamental indicia carrier is capable of enduring the conditions inside the mouth for an extended period of time and can be used in conjunction with a dental appliance.

Abstract: An archform configured to move a patient's teeth using non-sliding mechanics. The archform can include a double loop between two bracket connectors. The archform can include one or more hooks extending from bracket connectors to couple with elastics. The archform can include narrowed-width bracket connectors for overcrowded teeth. The archform can include interproximal segments between adjacent bracket connectors that include multiple interproximal members.

Abstract: The present invention relates to a dental implant and to a kit for said dental implant. In order to provide dental implants which meet the general requirements for a successful implantation and use and which can be easily adapted to bone variations and implant offerings, it is proposed according to the invention that the dental implant comprises a ceramic base body, a ceramic abutment, a ceramic tooth structure, and/or a connector for connecting of base body, abutment and/or tooth structure to each other, and a bushing body, which is at least in a final assembly state (E) of the dental implant received at least partly in the base body, in the abutment and/or in the tooth structure or surrounds the connector at least in sections.

Abstract: A multi-unit abutment aligning a dental implant and a screw-attached prosthesis with copings is disclosed. The multi-unit abutment has a threaded base post for attachment to the implant and a ball portion. A swivel post into the implant with the multi-unit assembly in a linear configuration. The swivel shell is then positioned and fixed at a desired tilt and azimuthal angle. The swivel shell has a mating surface for a coping. The lock screw remains accessible through an aperture in the coping when the prosthesis is positioned on the implant abutments. Different embodiments are disclosed for capturing the swivel shell on the ball. Methods for improving passive alignment of the prosthesis to the implants are described.

Abstract: The present invention may comprise a method for a treatment plan for orthodontic movement of natural teeth, the method comprising of acquiring data of oral anatomy of a patient; creating a treatment plan for the patient for orthodontic movement of natural teeth, the end result of the treatment plan for the patient being a 3D model; printing out a physical model of 3D model; mounting the physical model of the maxillary arch and mandibular arch of the patient's oral anatomy onto a dental articulator to evaluate if at least one of the following exists: if the functional occlusion data of the patient is in centric relation or if malocclusion exists between the maxillary arch and the mandibular arch; applying any corrections to the 3D model from the step of determining if malocclusion exists, to create functional occlusion data; combining the functional occlusion data with data of the oral anatomy of the patient to create a virtual treatment solution; and creating orthodontic appliances from the virtual treatment

Abstract: An intraoral scanner is provided, including a case including an opening formed at one end thereof, a light source unit disposed at the other end of the case and emitting light toward the opening, a first optical system disposed in the opening and reflecting the light emitted from the light source unit toward a subject and reflecting light reflected from the subject toward the light source unit, a second optical system disposed between the light source unit and the first optical system and reflecting light reflected from the first optical system, and an image sensor unit that detects the light reflected from the second optical system.

Abstract: A vacuum film (100) for scanning an oral cavity (101), having a perforation layer (103); a fiber layer (105) arranged on the perforation layer (103); and a texture layer (107) arranged on the fiber layer (105).

Abstract: A dental bulk block for machining, which is a glass-ceramic block including a crystalline phase in an amorphous glass matrix. The bulk block is a functionally graded material including crystalline phases where among the crystalline phases, a main crystalline phase is lithium disilicate, and an additional crystalline phase includes quartz, lithium phosphate, and at least one selected from among cristobalite and tridymite, in which the main crystalline phase has a size gradient with respect to a depth, and no interface is present at a point where a size gradient value of the main crystalline phase changes. Thus, the bulk block is useful in manufacturing artificial tooth prostheses that are similar to natural teeth and thus can not only reduce the time and processes for manufacturing artificial tooth prostheses but also obtain the effect of enhancing structural stability in terms of force distribution based on functionally graded mechanical characteristics.

Abstract: A curable composite material containing nanodiamonds, denture bases and other dental prosthetics made from the composite material and methods for treating dental stomatitis using these prosthetics.

Abstract: A dental or healthcare hose attachment device is provided. The device comprises a wrist band, a device band magnetically attached to the wrist band, and dental or healthcare device hose magnetically attached to the device band.

Abstract: Some aspects relate to systems and methods for estimating a trend associated with dental tissue. An exemplary system may include a sensor configured to periodically detect a plurality of oral images representing a plurality of exposed tooth surfaces and a computing device configured to receive the plurality of oral images from the sensor, aggregate a first aggregated oral image as a function of a first plurality of oral images detected at a first time, aggregate a second aggregated oral image as a function of a second plurality of oral images detected at a second time, and estimate a trend as a function of the first aggregated oral image and the second aggregated oral image.

Abstract: A calving monitoring system for monitoring an animal at the end of the expected gestation period includes a camera device for repeatedly taking images of the animal, a control unit for generating calving information from the images taken, and an alert device for sending an alert message according to the calving information generated. The control unit is configured so as, in each image taken, to recognize an animal image, to segment the animal image into multiple animal parts including a torso, to determine a parameter value relating to first pixels of said torso in the taken images as a time-dependent parametric function, and to detect contractions when the parameter value meets a predetermined contraction criterion. The criterion is that the parameter value exhibits at least two peaks in the predetermined time duration which have at least a predetermined minimum width and/or a predetermined minimum height.

Abstract: The present invention provides a fixating means adapted for use in hernia repair surgeries in attaching a mesh and mesh deployment means; said fixating means are attached to said mesh deployment means; and fixating means comprising: (a) a first portion coupled to said deployment means; and, (b) a second portion comprising a coil having a predetermined retracted shape; said coil is reconfigurable from a plurality of unretracted positions to a plurality of retracted positions and from said plurality of retracted positions to said plurality of unretracted positions; wherein said attachment between said deployment means and said mesh is obtained by reconfiguration of said coil from at least one of said unretracted positions to at least one of said retracted positions.

Abstract: A self-expandable double-sided surgical implant including a peripheral pocket receiving an expansion ring. The surgical implant may be used for the correction of congenital diaphragmatic hernias.

Abstract: A system and method for an improved connective tissue repair option that reduces disadvantages of conventional fixation options. Biologic press fit fixation of a connective tissue unit may include in situ expansion of a pre-compressed connective tissue unit within a prepared bone tunnel of a portion of bone. An external opening accessing a cavity of the prepared bone tunnel may be smaller than that of the cavity such that expansion of the installed/compressed connective tissue unit increases lateral fixation forces exerted by the expanding/decompressing compressed connective tissue unit within the bone tunnel.

Abstract: Medical implants comprising biocompatible materials and having surface features that may assist in biocompatibility upon implantation in the body are described. Methods for manufacturing such implants are also described. The manufacturing process may include applying a biocompatible material to a texturized surface of a mold. The implants may include various features to assist their positioning, fixation, and/or identification during and/or after implantation.

Abstract: Certain aspects of the present disclosure provide techniques for performing surgical ophthalmic procedures, such as cataract surgeries. An example method of determining one or more intraocular lens (IOL) parameters for an IOL to be used in a cataract surgery procedure includes generating, using a fused machine learning model, recommendations including one or more IOL parameters for the IOL to be used in the cataract surgery based, at least in part, on first predicted lens behavior for each of one or more IOLs by an emulated finite element analysis (EFEA) model and the second predicted lens behavior for each of the one or more IOLs by an IOL power calculator (IPC) machine learning model.

Abstract: An apparatus may be provided for determining at least one parameter of a lens for an eye, the apparatus comprising: a. means for obtaining topographic information of an anterior surface and topographic information of a posterior surface of a cornea of the eye; b. means for obtaining distance information of a retina of the eye relative to the anterior surface of the cornea of the eye; c. means for determining the at least one parameter of the lens of the eye such as to optimize focusing on the retina by ray tracing at least in part based on the topographic information of the anterior surface of the cornea, the topographic information of the posterior surface of the cornea and the distance information. A corresponding method and computer program may be provided as well.

Abstract: An apparatus for eye surgery may comprise a nozzle having a delivery lumen, an implant bay coupled to the nozzle, an implant disposed in the implant bay, and an actuator coupled to the implant bay. The actuator may comprise a housing, a plunger disposed within the housing, a bore through the plunger, a first coupling proximate to a first end of the plunger, and a second coupling integral to the housing. The bore may be fluidly coupled to the implant bay. The first coupling may be configured to receive a hydraulic driver and fluidly couple a working fluid in the hydraulic driver to the bore. A portion of the plunger may be slidingly disposed through the second coupling. In some embodiments, the second coupling may be configured to retain a drive coupling of the hydraulic driver in a fixed position relative to the housing.

Abstract: A system can include a prosthetic heart valve having a commissure post configured to receive a first portion of a fiber and a suture support configured to engage with the prosthetic heart valve. The suture support can include a first portion to interface with an inflow side of the prosthetic heart valve and a fiber holding portion to receive a second portion of the fiber. A second portion of the suture support can be coupled to the first portion of the suture guard and be movable inwardly toward the first portion of the suture guard to transform the fiber from a non-tensioned state to a tensioned state. The fiber in the tensioned state can cause the commissure post to bend inward toward a longitudinal axis of the prosthetic heart valve.

Abstract: Prosthetic heart valves, which are collapsible to a relatively small circumferential size for less invasive delivery into a patient and which then re-expand to operating size at an implant site in the patient, include a collapsible/expandable stent-like supporting structure and various components of flexible, sheet-like material that are attached to the supporting structure. For example, these sheet-like other components may include prosthetic valve leaflets, layers of buffering material, cuff material, etc. Improved structures and techniques are provided for securing such other components to the stent-like supporting structure of the valve.

Abstract: A prosthetic heart valve may include a collapsible and expandable frame that, in an expanded condition, includes a central portion, an atrial portion flaring radially outwardly from the central portion, and a ventricular portion flaring radially outwardly from the central portion. A tube positioned within the frame may have a lumen extending along a longitudinal axis of the frame, wherein the tube is formed of tissue or fabric. Prosthetic leaflets may be directly coupled to the tube to form a valve allowing blood to flow through the lumen of the tube in an antegrade direction but substantially blocking blood from flowing through the lumen of the tube in a retrograde direction. A plurality of cords may each have a first end coupled to the frame and a second end coupled to the tube. Each of the plurality of cords may extend in a radial direction toward the longitudinal axis.

Abstract: Valves constructed from low porosity leaflets are disclosed. The valves disclosed herein may be integrated into a variety of structures, such as valved conduits and transcatheter stents, and may be constructed of one or more layers. Embodiments herein are also directed to methods of using the same and methods of making the same.

Abstract: A medical valve implant includes an implant structure fastened to a base body. The base body has cells that extend in a circumferential direction of a valve implant. An end section bulges in a curved shape outwardly in a radial direction of the base body. The end section has a larger diameter than an axially adjacent collar portion of the base body. A collar includes a first cell structure provided to form, in an intended end state, an intended inner cross-section of the base body that is matched to an intended outer cross section of the implant structure. A holding device extends axially from and beyond the cells. The holding device includes a leg directly connected to a terminal end of one of the cells and a head at an opposite end of the leg. One or both of the leg and the head is canted radially inward toward a geometric center of the base body.

Abstract: A clip, docking or clamping devices for use in a valve (such as, for example, the aortic valve) to address valvular malfunction. Each clip is implanted into the valve by positioning the clip over a commissure. Each clip has at least two arms and a proximal attachment mechanism attached at a proximal end of the clip. Each clip can be introduced by catheter and can be manipulated via strings and guide wires. The clips may comprise extensions for supporting valve leaflets and/or provide stable interaction between a valve prosthesis and native tissue.

Abstract: An implantable prosthetic device can include a hybrid frame movable between a radially compressed configuration and a radially expanded configuration. The hybrid frame can include a mechanically-expandable first sub-frame comprising a plurality of struts pivotably coupled to one another, and a plastically deformable second sub-frame coupled to the first sub-frame. When the hybrid frame is in the expanded configuration, the second sub-frame can be configured to resist radial compression of the frame.

Abstract: A prosthetic heart valve includes a frame, a valve component, and an actuation mechanism. The frame has a plurality of struts interconnected by a plurality of joints and is movable between expanded and compressed configurations. The valve component is inside the frame and has a plurality of leaflets. The actuation mechanism has a first expansion element coupled to the frame at a first location and a second expansion element coupled to the frame at a second location. The actuation mechanism is configured such that moving the first expansion element and the second expansion element toward each other in a first direction results in the frame moving from the compressed configuration to the expanded configuration, and such that moving the first expansion element and the second expansion element away from each other in a second direction results in the frame moving from the expanded configuration to the compressed configuration.

Abstract: An implantable medical device is adapted to be implanted at an implantation site within the vasculature and is capable of being implanted at the implantation site within the vasculature at more than one position relative to the implantation site. This may include a relative axial position and/or a relative rotational position. The implantable medical device includes an expandable frame that is adapted to expand from a collapsed configuration for delivery to an expanded configuration for deployment, and one or more radiopaque markers disposed relative to the expandable frame such that fluoroscopic imaging of the implantable medical device during deployment provides an indication of a position of the implantable medical device relative to the implantation site. The implantable medical device may be a replacement cardiac valve such as a replacement aortic valve, for example.

Abstract: Pinch devices and access systems that can be used to secure a prosthetic heart valve to a heart valve annulus and to treat valvular insufficiency. A pinch device can be a separate expandable element from the prosthetic heart valve that is first advanced to the annulus and deployed, after which an expandable prosthetic heart valve can be advanced to within the annulus and deployed. The two elements can clamp/pinch the heart valve leaflets to hold the prosthetic heart valve in place. The pinch device can have a flexible, expandable annular frame. A combined delivery system can deliver the pinch device and prosthetic heart valve with just a single access point and aid more accurate coaxial deployment. The pinch device can be mounted near distal end of an access sheath, and a catheter for delivering the prosthetic heart valve can be passed through a lumen of the same access sheath.