Abstract: A surgical robotic manipulator includes a proximal assembly and a distal assembly, each of which is operable to move in a plurality of degrees of freedom. The distal assembly is removably attachable to the proximal assembly and secured in place by a primary fastening mechanism and a secondary fastening mechanism in the form of a quick release.

Abstract: Catheter device and driving system configured to navigate the catheter through complex narrow tissue openings such as lung bronchi pathway openings of 3 millimeters or less. The device comprises a proximal catheter portion containing a hollow torque shaft, with a distal catheter portion connected to the proximal portion by an isolation transition coupler connected to this torque shaft. The distal position of the catheter is controlled by at least one steering cable/isolation coil arrangement. The system uses processor-controlled actuators that simultaneously rotate the torque shaft and the at least one steering cable/isolation coil in a 1:1 relationship, while also actuating the steering cable. The catheter is tipped by a tool plate, which can be equipped with various sensors and other instruments, connected to the outside via other conduits.

Abstract: A method of operating a surgical system includes positioning a variable stiffness end effector assembly relative to a patient. The effector assembly has an end effector support having a tool insertion device disposed therein. The method also rigidly coupes the end effector support to the tool insertion device in a first mode by forming a rigid coupling mechanism, inserting a tool within the tool insertion device, vibrating the tool insertion device with the tool and decoupling the rigid coupling mechanism and compliantly coupling the tool insertion device in a second mode after vibrating.

Abstract: Catheter device and driving system configured to navigate the catheter through complex narrow tissue openings such as lung bronchi pathway openings of 3 millimeters or less. The device comprises a proximal catheter portion containing a hollow torque shaft, with a distal catheter portion connected to the proximal portion connected to this torque shaft. The distal position of the catheter is controlled by at least one steering cable/tensioning cable arrangement. The system uses processor-controlled actuators that simultaneously rotate the torque shaft and the at least one steering cable/tensioning cable in a 1:1 relationship, while also actuating the steering cable. The catheter is tipped by a tool plate, which can be equipped with various sensors and other instruments and connected to the outside via other conduits.

Abstract: An interface for a robotic arm comprising: a body having a first axial face adapted to be connected to a distal face of a link of a robotic arm, a second axial face adapted to be connected to a proximal face of an end effector, the second axial face having a geometry differing from a geometry of the proximal face of the end effector so as to define a peripheral band in the second axial face, the peripheral band facing distally. A connection configuration is provided for the interface to be fixed to the link and for the end effector to be fixed to the interface. Circuitry is embedded in the body. At least one light source in the peripheral band, the at least one light source connected to the circuitry to produce light in a distal direction of the robotic arm.

Abstract: A robotized computer-assisted surgery system may include a processing unit and a non-transitory computer-readable memory communicatively coupled to the processing unit and comprising computer-readable program instructions executable by the processing unit for obtaining readings from some capacitive sensors representative of at least one object within range; generating a surface model of the at least one object from the readings; and continuously tracking and outputting the position and orientation of the at least one object relative to the robot arm, using the readings and the surface model.

Abstract: Robotic surgical devices having an elongate device body with a distal section having a distal section diameter and a proximal section having a proximal section diameter that is greater than the distal section diameter and first and second arms operably coupled to a distal end of the device body. In some embodiments, the elongate device body has first and second drivetrain assemblies, with both such assemblies having a pitch drivetrain and a roll drivetrain. In other embodiments, the first and second arms each have a forearm having a rotation drivetrain and a roll drivetrain.

Abstract: A system and method of breakaway clutching in a device includes a plurality of links coupled by a plurality of joints, a brake coupled to brake a first joint of the plurality of joints, and a control unit operatively coupled to the brake. The control unit includes one or more processors. The control unit switches the first joint from a first state of the first joint to a second state of the first joint in response to a determination that an external stimulus applied to the plurality of links or the plurality of joints meets at least a first criterion and switches the first joint from the second state to the first state in response to a speed associated with the first joint meeting at least a second criterion. The control unit causes more braking with the first brake in the first state than in the second state.

Abstract: The invention involves a system and method for controlling the movements of a multi-axis robot to perform a surgery at least on the spinal area of a human in vivo. The system includes controls and software coding to cause the robot to move in desired patterns to complete the surgery, which may include bone, disc and tissue removal, and may also include insertion of hardware for fusing adjacent bony structures.

Abstract: A medical system 1A includes a medical apparatus 1 that includes a continuum robot including a catheter 11 and a base unit 200, at which the catheter 11 is provided, and a support base 2 that detachably supports the medical apparatus 1. The support base 2 includes a slider 2a. A coupling portion 200k provided with an engagement portion 200a is attached to the base unit 200. The coupling portion 200k has a U-shape, and ends thereof that sandwich an opening of the U-shape are attached and fixed to the base unit 200 at a position closer to the catheter 11 and a position farther from the catheter 11. The engagement portion 200a to be engaged with the slider 2a is disposed at a lower portion of the coupling portion 200k. Accordingly, a first space 200i is formed between the base unit 200 and the engagement portion 200a.

Abstract: A robotic arm according to various implementations includes: a tool driver configured to hold a surgical tool; a first section comprising a first end coupled to a base, a second end distal from first end; a first link that includes a motor configured to rotate at least a portion of the first section around a pitch axis; a second link coupled to the first link, the second link including a motor configured to rotate at least a portion of the first section around a roll axis; and a second section comprising: a first end coupled to the second end of the first section, a second end distal from the first end, a first link that includes a motor configured to rotate at least a portion of the second section around a roll axis, a second link coupled to the first link.

Abstract: Robotic surgical procedures are successively performed on a patient's bony anatomy by engaging the patient's bony anatomy with a first tool or implant coupled to a first surgical robotic arm to perform a first procedure. A second tool or implant coupled to a second surgical robotic arm is then used to perform a second procedure while the first surgical robotic arm and the first tool or implant remain engaged with the patient's bony anatomy to stabilize the bony anatomy while the second procedure is being performed with the second surgical robotic arm and second tool or implant.

Abstract: Multi-arm robotic systems and methods for monitoring a target are provided. The system may include a first robotic arm configured to orient a first component and a second robotic arm configured to orient a second component. The first robotic arm and the second robotic arm may be co-registered. The first robotic arm may be caused to orient the first component at a first pose. The second robotic arm may be caused to orient the second component at a second pose. At least one image may be received from the first component and the second component.

Abstract: Techniques for monitoring a computer-assisted device include a plurality of manipulators, each manipulator being configured to support an instrument, each manipulator having a control point; and a control unit. The control unit is configured to: determine a first spatial configuration of the plurality of control points, the first spatial configuration being prior to a movement of a table separate from the computer-assisted device, and the movement of the table causing motion of at least one control point; determine the movement of the table; determine, based on the movement of the table and the first spatial configuration, an expected spatial configuration of the plurality of control points; determine, based on a comparison of the expected spatial configuration with an actual spatial configuration of the plurality of control points, whether to perform a remedial action; and perform the remedial action in response to a determination to perform the remedial action.

Abstract: A surgical tool includes a drive housing having an elongate shaft extending therefrom and an end effector arranged at a distal end of the shaft. At least one linkage is pivotally coupled to a distal end of the shaft about a pivot axis, and a camming feature is defined on the at least one linkage. The camming feature includes a rounded edge between a lateral side and a proximal face of the at least one linkage such that engagement of the camming feature with the distal end of a trocar will pivot the at least one linkage into alignment with a longitudinal axis of the shaft. The camming feature edge may be arranged to provide a large moment when the linkage is articulated to a high articulation angle and a smaller moment when the linkage is articulated to lower articulation angles.

Abstract: An operating range for fine work while suppressing, as much as possible, variations of the position at which the fine work is performed. A control unit of a fine work device: accepts input of the movement of a position of a tip of a fine work manipulator, the position being a fine-work operating position; calculates, with the operating position serving as a target position, driving amounts for the fine work manipulator and a robot unit, and controls operations of the fine work manipulator and the robot unit on the basis of the driving amounts.

Abstract: A cable retraction system, useful at least in vital signs monitoring systems, rolls sensors cables and tubes on rotary spring spools, inside a protective enclosure, for storage. The cables and tubes along with the sensors can easily be pulled out for use and then retracted back into the enclosure as required. This eliminates tangled cables and tubes and provides protection for the sensors by not being on dangling long cables when not in use.

Abstract: A surgical system including a base assembly having an actuator vertically movable along a z-axis. A motor in cooperation with the actuator to vertically move the actuator along the z-axis. A support member mounted to the actuator and configured to support a robotic arm. The support member movable by the actuator to vertically move the robotic arm along the z-axis. A linear sensing device mounted to the base assembly. The linear sensing device configured to connect to an operating table and sense vertical movement of the operating table relative to the base assembly. A control module configured to receive sensor signals from the linear sensing device identifying a vertical position of the operating table, and configured to operate the motor to vertically move the actuator, the support member, and the robotic arm when mounted to the support member in unison with the operating table.

Abstract: The management system mounts rear upright instrument supports on the base of a tray. Each rear support holds the rear end of instruments such as forceps or scissors with the finger holes spaced-apart. The forward end of the instruments is held by a forward support. That support has a bar over the instruments, which is positioned to be horizontal when the forward support (and the rear support) is full.

Abstract: Systems and methods for grip adjustment during energy delivery include an instrument comprising an end effector having a first jaw and a second jaw. Each of the first jaw and the second jaw have a corresponding electrode. One or more control units are configured to operate the first and second jaws in a first mode subject to a first force or torque limit to grip a material; and in response to determining that the first and second jaws are being operated in the first mode, switch to operating the first and seconds jaw in a second mode before applying electrical or thermal energy to the material using the corresponding electrodes. The operating in the second mode is subject to a second force or torque limit, lower than the first force or torque limit, that can be applied by the first and second jaws to grip the material.

Abstract: A method of detecting whether an external wire is connected to an input terminal of an electrical system includes monitoring a signal associated with the input terminal, converting the analog signal to a digital signal, and processing the digital signal through Fast Fourier Transform (FFT). The method further includes detecting whether an external cable is connected to the input terminal based on the spectral content derived from the FFT. The method can include generating a notification if an external wire is detected and implementing safety protocols that allow or prohibit delivery of electrical power to one or more external components, based on whether the external wire is detected. In an example, the electrical system is part of a medical system, and the external wire can be configured for attachment of a catheter.

Abstract: A surgical lighting system includes a light head housing, a handle, and a camera. The light head housing includes a plurality of light emitting elements therein that are arranged to emit light downward to a region of interest. The handle is mounted to the light head housing and protrudes downward from the light head housing, the handle including a handle housing having a sufficient size to be gripped by the human hand. A camera is mounted within the handle housing, the camera having a field of view that encompasses at least a portion of the region of interest. The handle housing has an upper generally tubular section mounted to the light head housing and a lower generally tubular section extending downward from a bottom of the upper generally tubular section. The outer perimeter of the lower generally tubular section is relatively wider in axial cross section than the outer perimeter of the upper generally tubular section over a portion of the upper generally tubular section.

Abstract: An implantable marker is configured to deliver a therapy to a patient and includes a marker and a target isotope. The marker is configured to enhance visibility of a treatment region of the patient when implanted in the patient and viewed with an imaging modality. The target isotope is coupled to at least a portion of the marker, and has a non-radioactive state and a radioactive state. At least a portion of the target isotope is configured to be induced from the non-radioactive state to the radioactive state when the target isotope is irradiated with one or more of gamma rays, neutrons, alpha particles, beta particles, or ions. The target isotope emits a localized therapeutic dose of radiation to target tissue adjacent the implantable marker when the target isotope is in the radioactive state.

Abstract: A system and method for anatomical markers includes an anatomical marker. The anatomical marker includes a first material observable to a first imaging modality and a second material observable to a second imaging modality. The first material is different from the second material. The first imaging modality is different from the second imaging modality. The first and second imaging modalities obtain their images without using light in a visible spectrum. In some embodiments, the anatomical marker further includes one or more superabsorbent polymers for absorbing and containing the one or more superabsorbent polymers. In some embodiments, the anatomical marker further includes a liquid or gel including the first and second materials, wherein the liquid or gel is configured to be applied to the anatomy of the patient. In some embodiments, the anatomical markers may be used to register a medical tool to anatomy of a patient.

Abstract: An endoscopic surgery platform includes a surgical bed and multiple surgical manipulators. Multiple surgical manipulators are arranged in a matrix on both sides of the surgical bed, and a positioning mechanism is arranged at the bottom of the surgical bed. The surgical manipulator can be stored at the bottom of the surgical bed through the positioning mechanism. The positioning mechanism includes a plurality of surgical manipulators positioned on the bottom of the surgical bed, a plurality of lateral moving pairs for moving along the length direction of the surgical bed, and multiple longitudinal moving pairs connected to the output end of multiple lateral moving pairs respectively and used to move along the width direction of the surgical bed. Longitudinal moving pair, lateral moving pairs and surgical manipulators are connected one by one.

Abstract: Methods and kits of materials and supplies for restoring teeth by an injection molding process and/or mold overlays in situ in a patient's mouth so as to correct the imperfect teeth of the patient's dentition. The imperfect teeth are corrected by applying restoration materials using a mold of a corrected model of the patients dentition placed over the imperfect teeth. Adjacent teeth may be covered with a polymer release material prior to injection molding of teeth to be corrected, such that the teeth to be corrected have at least one tooth between them draped with the polymer release material to provide a space adjacent to each of the corrected teeth. The corrected teeth are then covered with the polymer release material in a second round of treatment and restoration material is applied to one or more previously covered teeth to provide a first layer which simulates the dentin layer of teeth.

Abstract: Disclosed herein is a method of applying dental cement to a concave surface of a dental restoration element. The concave surface of the dental restoration element is configured to mate with a first convex surface of a dental mounting structure such that there is a dental cement gap between the concave surface and the first convex surface. The method comprises: receiving the dental restoration element; receiving a cement applicator, wherein the cement applicator comprises a second convex surface, wherein the second convex surface is a transformation of the first convex surface such that it is shrunk by a reduction factor; applying the dental cement to the concave surface; inserting the second convex surface of the cement applicator into the concave surface of the dental restoration element; and removing the cement applicator from the dental restoration element to provide the dental restoration element with the applied dental cement.

Abstract: Orthodontic appliances, systems and methods of producing and using the same are provided. A dental appliance is a unibody aligner with a top surface and a bottom surface. The unibody aligner includes an alignment portion shaped to fit over multiple teeth of a patient with the alignment portion having a buccal side and a lingual side. The unibody aligner includes a palatal portion integrally formed with the lingual side of the alignment portion. The palatal portion including one or more retention sockets with each of the one or more retention sockets shaped for fitment over an implanted temporary anchorage device (TAD).

Abstract: A system may include a body having a palatal portion of a first material and a surface shaped to match a shape of a patient's palate and extending between first tooth engagement structures shaped to engage teeth on a first side of a patient's arch and second tooth engagement structures shaped to engage teeth on a second side of a patient's arch and a reinforcement structure within the palatal portion, wherein the reinforcement structure includes at least one fiber fabricated of a second material, different than the first material, and a dimension of the at least one fiber at a middle portion between respective ends of the at least one fiber is greater than a dimension of the respective ends of the at least one fiber.

Abstract: Hybrid orthodontic archwire designs are disclosed. Hybrid archwires may have bracket-archwire sections and interproximal archwire sections in which each section can vary in cross-section shape, size, and/or material properties. Bracket-archwire sections may be configured to promote torque control and may have rectangular cross-sections. Interproximal archwire sections may be configured to be bent into force-promoting loops and may have round cross sections. Each archwire section may be straight or bent into any shape. Hybrid archwires may have sliding sections and non-sliding sections. Non-sliding sections may have male connectors configured to prevent the archwire from sliding relative to the orthodontic brackets and/or may have cross-sectional shapes, sizes, or coatings that resist sliding relative to sliding sections. Sliding sections may have linear archwire segments. Hybrid archwires may have distal or posterior non-sliding sections and an intermediate anterior or medial sliding section.

Abstract: An orthodontic post bondable to a tooth and for use with an orthodontic appliance, such as an aligner, which may be affixed via springs, wires, elastics, or orthodontic connectors in an orthodontic therapy system. The post has a cylindrical main body attached at the bottom end to a bonding pad or base element, and an open top end to receive an attaching element, such as a hybrid orthodontic screw. The body element includes an annular member disposed circumferentially around the body, providing a retaining surface for an orthodontic connector. A through channel through the post can accept an archwire for braces or to which other orthodontic equipment may be mounted.

Abstract: A multi-segment dental implant may include an apical segment including apical external threading at least partially surrounding the apical segment, wherein the apical segment defines a connection aperture including an coronal shoulder. The multi-segment dental implant may include a coronal segment including coronal external threading at least partially surrounding the coronal segment and terminating in a non-knife-edge apical skirt. The multi-segment dental implant may include a connector constructed and arranged to connect the apical segment and the coronal segment.

Abstract: Apparatus and method for installing a multi-tooth dental prosthesis in one session are shown and described. A first tool attaches to the jawbone, and serves as a foundation for subsequently used guides. Existing teeth and dental fixtures are removed, and the bone tissue is removed to accommodate the prosthesis. Subsequently, a drill guide is used to drill implant holes. An abutment guide is then used to place abutments. Copings are then installed. Next, the prosthesis may be installed and cemented to the copings. A resinous filler material may be applied to fill gaps and holes in and between the copings and the prosthesis, and is sanded smooth.

Abstract: Embodiments relate to techniques for determining 3D data for 2D points in 2D images using machine learning. A method comprises using one or more trained machine learning models to determine correspondence between captured points of a captured light pattern in one or more images and projected points of a projected light pattern and determining depth information for at least some of the plurality of captured points based on the determined correspondence.

Abstract: A flexible intelligent manufacturing and production system for a customized denture includes a server, a processing system, a cutting device, a tooth unloading device and a sintering device. The processing system, the cutting device, the tooth unloading device and the sintering device all have a function of receiving/sending commands, and are all connected to the server signal. The processing system is used for processing a three-dimensionality (3D) tooth model file and a 3D zirconium block graphic file, and generating a file. The server is used for receiving/sending the file; the cutting device is used for receiving a tool path file and cutting a zirconium block according to the tool path file. The tooth unloading device is used for receiving/sending a coordinate file and cutting a connecting rod according to the coordinate file. The sintering device is used for sintering a denture.

Abstract: The present invention relates to a blank for dental prostheses which has a first layer based on zirconium oxide ceramic and a second layer based on zirconium oxide ceramic, the first layer and the second layer differing in color and forming a boundary surface, wherein the boundary surface is formed in the course of the dental arch in an undulating shape with alternating wave troughs and wave crests, and the vertex lines of the wave crests, viewed in plan view of the boundary surface, extend radially in the mesial-distal direction.

Abstract: Animal drug delivery systems and methods. Such a system includes a carrier cartridge to carry and dispense a plurality of drug doses, a monitoring device, and a controller operatively coupled with the carrier cartridge and the monitoring device. The controller operates the carrier cartridge to dispense at least one of the drug doses to an animal subject at each of a plurality of preselected dispensing intervals. The controller is also configured to operate the monitoring device to record the animal subject ingesting the dispensed drug doses. The system may be configured to provide drug pellets to mice based on researcher needs, allow for mouse monitoring to confirm drug delivery, enable behavioral studies to be conducted using operant condition, and/or to fit into a specific lab research animal cage.

Abstract: An artificial sphincter comprising an inflatable occlusion means for occluding a body passage, a stretchable fluid reservoir, a pump means and an occlusion means. A pressurizing fluid is selectively transferred from the occlusion means to the reservoir for deflating the occlusion means so that a blocked body passage may be opened. The artificial sphincter also comprises a semipermeable check valve which always allows fluid flow towards the stretchable fluid reservoir. The pump means comprises a check valve located in between the second port of the pump and the bulb. The check valve comprises a ball, a blockage seat and one or more resilient lips located circumferentially above the ball. The check valve blocks fluid flow towards the occlusion means and allows fluid flow towards the fluid reservoir when, in use, the bulb is squeezed.

Abstract: The present disclosure provides a surgical thread including a cog thread and a mesh thread surrounding the cog thread and assembled therewith, wherein, in the mesh thread, first and second regions with different mesh shapes are repeatedly disposed in a longitudinal direction of the cog thread.

Abstract: This disclosure describes a membrane configured to guide bone and tissue regeneration for a bone defect. The membrane may comprise a first layer, a second layer, one or more perforations, a binder, and/or other components. The first layer of the membrane may be configured to contact bone. The first layer may include pores configured to promote ingrowth of bone regenerating cells into the first layer. In some implementations, the first layer may be a continuous sheet of microporous material without large perforations. The second layer may be configured to substantially prevent fibrous connective tissue from growing into the bone defect. The second layer may comprise a relatively dense structure. The second layer may be fixedly coupled to the first layer. In some implementations, the perforations may comprise co-axial through-holes having common dimensions through the first layer and the second layer. The perforations may be configured to enhance ossification.

Abstract: As may be implemented in accordance with one or more embodiments characterized herein, aspects of the present disclosure are directed to an apparatus including first and second filters, a shaft and a frame coupled to the shaft and to the first filter. The frame and shaft operate to seal a perimeter of the first filter around an opening in a sidewall of a tubular structure, by pressing the frame against the perimeter and the sidewall. The second filter is also coupled to the frame and operates with the frame to extend into a cross section of the tubular structure away from the frame and the sidewall, with the frame sealing the first filter around the opening, and to filter particles from fluid flowing past the opening and along the length of the sidewall.

Abstract: The present invention relates to a reflux disease treatment apparatus, comprising two or more movement restriction device segments adapted to form an implantable movement restriction device with an elongated shape that maintains cardia in the correct position. The movement restriction device has proximal and a distal end, wherein the distal end is adapted to stabilize and hold the proximal end. The invention further comprises a control device for controlling the stimulation device to stimulate the cardia sphincter. The distal end can be further adapted to treat obesity, for example by stretching the wall of the stomach or filling out a volume of the stomach.

Abstract: A tissue scaffold implant for expanding a stenotic lumen is provided that includes a bridge structure defining at least two angled sides and a lateral anchor integrally formed with the bridge structure. The lateral anchor is configured to be disposed against at least a portion of an external circumference of the stenotic lumen in a region near an opening formed in the stenotic lumen. At least two seat regions are defined between the at least two angled sides of the bridge structure and the lateral anchor. The at least two seat regions are configured to be received within and support the opening within the stenotic lumen, and the bridge structure and lateral anchor comprise a bioacceptable material.

Abstract: A volume filling device for treatment of obesity is placed outside the stomach wall of the patient to reduce the inner volume of the stomach, thereby affecting the patient's appetite. By providing the volume filling device outside the stomach wall, contact with stomach acids is avoided, thereby increasing the life of the device.

Abstract: Extra-urethral implants and methods of use are disclosed. Implants can treat disorders or diseases of the prostate by, for example, enlarging the lumen of the prostatic urethra.

Abstract: The present invention relates to a perivascular implant comprising (i) a housing comprising a receptacle for an effector matrix, and (ii) a fastening element adapted for at least partially embracing a tubular bodily structure, wherein said housing, said receptacle for an effector matrix, and said fastening element are arranged such that after implantation of the device the receptacle for an effector matrix at least partially is in contact with said tubular bodily structure and/or a vasculature originating from said tubular bodily structure, and to uses, methods, and kit related thereto.

Abstract: A device is provided to be implanted to create a temporary or permanent connection between two hollow structures. The hollow structures may be, for example, an aortic or large vessel aneurysm sac and a large adjacent vein.

Abstract: A quadricep graft suspension construct, having a button loop, including a generally rectangular button, defining four apertures, including an innermost pair of apertures; and a suture loop looping through the innermost pair of apertures. The construct also has a graft holding assembly, including a reinforcement of first fibers braided with two second fibers, and wherein the first fibers have a first and second lengthwise end and the second fibers continue separately, extending from the first lengthwise end to form a pair of first tails and from the second lengthwise end to form a pair of second tails and wherein the first tails are jointly swaged to a needle. And wherein the graft holding assembly is affixed to the suture loop at a position opposed to the button at least in part by the second tails being joined together about the suture loop and further includes a packaging holding the needle.

Abstract: The present invention discloses capsular stabilizers, added to or contained in an intraocular lens (IOL). The present invention also discloses IOLs configured to be affixed to capsular stabilizers, kits thereof, and methods for (i) increasing postoperative rotation stability of an IOL and preferably a toric IOL; and (ii) stabilizing an IOL within the anterior capsule for any indication, including in cases at which the posterior capsule is absent or ruptured.

Abstract: An implantable prosthetic valve can include a radially expandable and collapsible annular frame having an inflow end and an outflow end. A leaflet structure can be positioned within the frame. An annular inner skirt can be positioned around an inner surface of the frame, wherein the inner skirt includes an outflow edge portion secured to the frame and an inflow edge portion secured to the frame. An outer skirt can be positioned around the outer surface of the frame, wherein the outer skirt comprises an outflow edge portion secured to the frame and an inflow edge portion that is secured to the inflow edge portion of the inner skirt, wherein the inner and outer skirts are configured such that when the prosthetic valve is implanted, antegrade blood can flow through a space between the inflow edge portion of the inner skirt and the inflow edge portion of the outer skirt.