Abstract: Disclosed embodiments include apparatuses, systems, and methods for facilitating surgical anastomosis. In an illustrative embodiment, an apparatus includes a first connector configured to engage an opening of a donor passage. A second connector is configured to engage an opening in a receiving passage. A separator is configured to support the first connector and the second connector and to fix relative positions of the end of the donor passage to edges of the opening in a receiving passage across a gap. The separator is configured to maintain the gap between the first connector and the second connector while multiple loops of a suture are passed through the edge of the opening in the donor passage and the edges of the opening in the receiving passage. The first connector, the second connector, and the separator are further configured to be removed from between adjacent loops of the multiple loops of the suture.

Abstract: Systems and methods to provide end to end stabilization support to the operational catheter and reduce the need to stabilize or push from the lateral wall of the aorta during coronary interventions. This reduces the potential for stroke from plaque breaking off the wall of the aorta during intervention procedures. A support and stabilization wire having one end at the femoral percutaneous access and the second end at a radial percutaneous access is established for end to end stabilization. A bifurcated catheter having a wide lumen for procedural catheters and a narrow lumen for the support wire or catheter is advanced over the support wire to the aortic arch. A procedural catheter and a variety of different shaped guide wires may be deployed from the wide lumen of the bifurcated catheter into the right or left coronary artery to accommodate a range of aortic anatomical considerations during the coronary interventions.

Abstract: A catheter device 10 with a cutting structure or means 16 on the distal portion 14 is disclosed, along with a medical procedure for using the device. The catheter 10 is configured in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

Abstract: A catheter device 10 with a cutting structure or means 16 on the distal portion 14 is disclosed, along with a medical procedure for using the device. The catheter 10 is configured in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

Abstract: A delivery device can provide sequential delivery of a plurality of intraluminal devices or tacks held in a compressed state on the delivery device. Delivery platforms on the delivery device can hold a tack in a compressed position and be positioned between annular pusher bands that may also be radiopaque markers. The annular pusher bands can be made of wire or sections of material to increase flexibility while remaining radiopacity. A post deployment dilation device can be included. The post deployment dilation device can be a plurality of expansion filaments, a bellows, or a balloon. A tack deployment method can include allowing a self-expanding tack to expand, aligning the post deployment dilation device under the tack, and causing the post deployment dilation device to expand radial to push outward on the tack.

Abstract: A method of implanting and securing an implantable flow connector in a body of a patient for providing communication of a first space within the body of the patient with a second space within the body of the patient. The method includes providing a flow connector having a lumen having a first orifice and a second orifice, inserting a retention device into the first space within the body, subsequently inserting the flow connector through an opening in the retention device so the second portion of the flow connector extends into the first space within the body and placing the second space within the body over the retention device.

Abstract: A method for dissecting a submucosal layer includes: incising at a tissue portion surrounding an area including a lesion in a gastrointestinal tract; fixing a thread first end to the area including the lesion, the suture thread including a second end having a needle, and barbs arranged along a longitudinal axis between the first and second ends; piercing the needle to a tract wall that faces the area including the lesion and pulls the thread through the tract wall into the gastrointestinal tract; holding a state of lifting at least a portion of the area including the lesion by pulling the needle or the thread, lifting a tract wall at least the portion including the lesion, and engaging the barbs with the tract wall; dissecting the submucosal layer of the gastrointestinal tract in the state of lifting at least the portion of the area including the lesion.

Abstract: An assembly including a positioning tool that includes a probe affixed to a portion of a grasping tool, wherein a distal tip of the probe protrudes distally from the grasping tool a distance corresponding to a position for placing a magnet with the grasping tool.

Abstract: A medical apparatus for joining body lumens in a living body includes a puncture member having a lumen, a distal opening portion and a needle tip at the distal end of the lumen. The needle tip can puncture a tube wall of the body lumen to form a puncture site. The medical apparatus includes a tubular member in the lumen of the puncture member that expands radially outward and contracts radially inward and a plunger movable relative to the puncture member to release the tubular member from the distal opening portion of the puncture member. The tubular member expands to be fixed to the puncture site when the tubular member is released from the distal opening portion of the puncture member.

Abstract: A stent insertion device for connecting human digestive organs includes a first handle being connected to one side of an outer tube, the first handle including a first inner passage communicating with the outer tube, a second handle being connected to a first side of an inner tube, the second handle including a second inner passage communicating with the inner tube, wherein a mounting space is provided between the outer tube and the inner tube at a second side of the inner tube, a stent for connecting human digestive organs being compressed and mounted to the mounting space, a third handle being connected to a first side of an insulation tube, the third handle including a third inner passage communicating with the insulation tube, and a needle knife being connected to a second side of the insulation tube.

Abstract: A sleeve for enforcing the end of a hollow organ so that it can be connected with a further end of a hollow organ, the sleeve comprising a cylindrical shape and being configured to be pushed over the end of the hollow organ and for turning-over the end of the hollow organ projecting from the sleeve around an end of the sleeve, wherein the sleeve has an adjustable diameter.

Abstract: Examples of a stent are provided with interlocking joints removably coupling adjacent axial stent segments. Mating elements forming the interlocking joints maintain engagement when the stent is in the radially compressed configuration, for example, during tracking of the stent to a treatment site of a body vessel, and become disengaged during radial expansion of the stent. When disengaged, the disconnected the axial stent segments remain discrete stent structures separated from one another along the point of treatment.

Abstract: An everter device to facilitate preparation of ends of arterial segments for end-to-end microvascular anastomosis. The device includes structure that provides sufficient support to prevent unwanted buckling of arterial tissue. The everter device offsets the tendency of the arterial tissue wall to recover its natural shape and fall off securement posts or pins of a coupler ring. The structure may be in the form of an intraluminal catheter balloon. Alternately, the structure may be in the form of a plunger. Alternately, the structure may be in the form of a radially expanding member provided on a shaft. The device further has a contoured surface on an everter end to evert a free end of arterial tissue over a coupler ring, and to cause the posts or pins of the coupler ring to pierce through the everted arterial tissue. The everter end is provided with one or more openings therein, such as a circumferential slot, to receive the posts or pins of the coupler ring.

Abstract: A medical implant that includes a scaffold having at least one receptacle for an X-ray marker. The scaffold includes a first metal. At least one (preferably monolithic) X-ray marker is disposed in the receptacle. The X-ray marker includes a second metal. An electrically insulating coating is upon the X-ray marker to prevent corrosion-promoting contact between the X-ray marker and the scaffold.

Abstract: The invention is an implantable magnetic anastomosis device having an exoskeleton that directs self-assembly. The design allows the device to be delivered in a linear configuration using a minimally-invasive technique, such as endoscopy or laparoscopy, whereupon the device self-assembles into, e.g., a polygon. A coupled set of polygons define a circumscribed tissue that can be perforated, or the tissue can be allowed to naturally necrose and perforate. The device can be used to create anastomoses in a variety of tissues, such as tissues found in the gastrointestinal, renal/urinary, and reproductive tracts. New procedures for using anastomoses, e.g., surgical bypass are also disclosed.

Abstract: Apparatus, systems, and methods are provided for repairing heart valves through percutaneous transcatheter delivery and fixation of annuloplasty rings to heart valves via a trans-apical approach to accessing the heart. A guiding sheath may be introduced into a ventricle of the heart through an access site at an apex of the heart. A distal end of the guiding sheath can be positioned retrograde through the target valve. An annuloplasty ring arranged in a compressed delivery geometry is advanced through the guiding sheath and into a distal portion of the guiding sheath positioned within the atrium of the heart. The distal end of the guiding sheath is retracted, thereby exposing the annuloplasty ring. The annuloplasty ring may be expanded from the delivery geometry to an operable geometry. Anchors on the annuloplasty ring may be deployed to press into and engage tissue of the annulus of the target valve.

Abstract: An occluding device for occlusion of fluid flow through a lumen of a body vessel is manufactured by wedging fibers between adjacent coil windings of a primary coil so that the fibers extend generally radially across the primary coil body between the primary coil windings and outward therefrom. An elongated adhesive applicator is inserted into the primary coil lumen and subsequently proximally withdrawn while simultaneously depositing along the primary coil windings. The fibers and the adhesive are placed in overlapping locations so that the fibers extend through the adhesive. The fibers are thus blocked from slipping along their length relative to the coil body by the adhesive adhering to the fibers inside the primary coil lumen. The adhesive extends radially outward from the coil lumen no farther than the outer primary coil radius. The adhesive adheres to the fibers and may or may not adhere with the primary coil windings.

Abstract: Methods and apparatus for a percutaneous bypass graft system according to various aspects of the present technology include a graft section comprising a dual-sided fixation system at the anastomosis site and a tamper sheath configured to provide enhanced control during installation. The dual-sided fixation system may comprise a plurality of barbs configured to secure the graft section to an internal and external portion of a target vessel. The tamper sheath comprises a cuff at a distal end that is configured to be positioned against an outer surface of the target vessel during the percutaneous procedure.

Abstract: An intramedullary autograft harvesting instrument (100) includes a cutting rod (10) having a body (13) and a cutting head (14), a harvesting member (20) configured to be disposed about the body (13) of the cutting rod (10), and an outer tube (30) configured to be disposed about the harvesting member (20). A method of using the instrument (100) transports harvested tissue from an intramedullary canal.

Abstract: A tissue lumen stent is provided with a body having an elongated tubular configuration and a foreshortened configuration. In the foreshortened configuration, downstream and upstream ends of the body expand radially into downstream and upstream flange structures, leaving a generally cylindrical saddle region therebetween. In some embodiments, the flange structures are non-symmetrical with respect to one another. Systems and methods of using the stents are also disclosed.

Abstract: A tissue anchor includes a plate having a top surface and a bottom surface, and an array of first pins coupled with the plate, whereby each first pin includes an elongated shaft having a lower end with a first barb facing away from the bottom surface of the plate. The plate has an array of second pin apertures that are offset from the first pins, whereby each second pin aperture has a diameter that extends from the top surface to the bottom surface of the plate. The tissue anchor includes an array of second pins extending through the second pin apertures, whereby each second pin has an elongated shaft having an upper end including a second barb facing away from the top surface of the plate and a lower end including a stop that is located below the bottom surface of the plate. The elongated shafts of the second pins have outer diameters that are smaller than the diameters of the second pin apertures for allowing the elongated shafts of the second pins to slide within the second pin apertures.

Abstract: A blood vessel connecting apparatus connects a first blood vessel to a second blood vessel. The blood vessel connecting apparatus includes an elastic connection part and a fixing part. The elastic connection part has an elastic restoring force, is inserted in an end of the second blood vessel and extends along an extending direction of the second blood vessel. The fixing part fixes the elastic connection part to an inside of the second blood vessel.

Abstract: A device for anastomosis of a tubular structure comprises first and second hollow members having a rigid part and an elastic part, and a connection member for interlocking the first and second members. The elastic parts are essentially circular rings, and are made of a polymeric, a biocompatible and/or biodegradable material. The rigid parts have an outer surface that is partly semi-circular in cross section, wherein the diameter at a non-connecting end is larger than or equal to the diameter at a connecting end, which ends in an edge. The first and second members are connected to each other so that a distance is formed between the elastic parts. A cavity is formed between the rigid parts and the connection member and the tubular structure, when arranged in the device.

Abstract: An anastomosis suturing device includes a dismantable casing, a first tubular section having a proximal section encased in the casing and a distal section insertable in a tubular body of a living creature, and a second tubular section having a proximal section encased in the casing and a distal section insertable in a tubular body of the living creature.

Abstract: A uniportal surgical device having a slotted clear cannula, a blade and a housing, wherein the cannula is attached to the housing, and wherein the blade is enclosed in the housing and is slidable into the cannula is disclosed. The device further has a device for locking a viewing device in place relative to other components of the device. A method for a performing an operative procedure on a target tissue in a subject using the uniportal surgical device is also described.

Abstract: The present invention relates to an anastomosis system for realizing anastomosis between first and second hollow structures, such as end-to-side anastomosis, by way of a joining member and an applicator. The anastomosis system comprises an annular joining member adapted for joining the first and second hollow structures, a tubular member adapted to position the joining member at or proximate to a distal end of the second hollow structure and to be at least partially inserted into the second hollow structure, a support member adapted to hold the second hollow structure and a mechanism, for actuating the joining member when positioned at or proximate to the distal end of the second hollow structure, which joining member is actuated substantially radially relative to a longitudinal axis of the tubular member.

Abstract: A vessel implant for the treatment of an aneurysm, i.e. a dilatation of the cross-sectional area of a blood vessel, may include an elongate body having an inlet opening, an outlet opening, and a passage connecting the inlet opening to the outlet opening for the blood flowing through the blood vessel. The passage may be bounded in the peripheral direction by a blood-impermeable wall and the inlet opening may have a larger cross-sectional area than the outlet opening. The body may be provided with blood-permeable fixing means for the end of the body at the outlet opening side. The fixing means may be designed for contact with the vessel wall of the blood vessel. The fixing means may be designed to hold the body spaced apart from the vessel wall of the blood vessel in the region of the outlet opening.

Abstract: An intraluminar method of treating a reflux disease in a patient by implanting a device comprising a non-encircling implantable movement restriction device that, when implanted in a patient, restricts the movement of the cardiac notch in relation to the diaphragm muscle, preventing the cardia from sliding through the esophageal hiatus. The intraluminar method comprises introducing an instrument through the esophagus and into the stomach of the patient, introducing the non-encircling implantable movement restriction device through the esophagus using said instrument, affixing the non-encircling movement restriction device to the fundus wall, such that it does not encircle the esophagus or stomach, thereby preventing the cardia from sliding through the esophageal hiatus and thus reducing reflux disease without encircling the esophagus or stomach.

Abstract: A catheter device with a cutting structure or means on the distal portion is disclosed, along with a medical procedure for using the device. The catheter is utilized in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

Abstract: An exemplary tissue compression device for forming an anastomosis between first and second anatomical structures includes a first device portion and a second device portion configured to mate with the first device portion. The first and second device portions are configured to magnetically draw together to compress tissue positioned therebetween. The device further includes a circuit assembly including an electrical element and a battery configured to energize the electrical element. The electrical element may be in the form of an electromagnet or an illumination device, for example. In exemplary versions, the first device portion may include a first circuit assembly having a first electrical element and a first battery, and the second device portion may include a second circuit assembly having a second electrical element and a second battery.

Abstract: The method for producing a three-dimensional artificial tissue is a method in which a three-dimensional artificial tissue extending in a predetermined direction is produced. The method includes: preparing a device including a culture tank having a culturing space surrounded by sidewalls, and a flow channel-forming member that penetrates through the sidewalls that face each other and is suspended in the culturing space along a predetermined direction; culturing cells in the culturing space and thereby forming a three-dimensional artificial tissue through which the flow channel-forming member penetrates; and removing the flow channel-forming member from the three-dimensional artificial tissue and thereby forming a perfusion flow channel that penetrates through the three-dimensional artificial tissue.

Abstract: A tissue displacing and fastening device is provided for manipulating and fastening tissue together. The device includes a tissue displacing elements, which displaces tissue. A fold is formed from the displaced tissue and the tissue is fastened together to secure the fold.

Abstract: A kit for placing a bypass between two body vessels (R, L) of a patient comprises two catheters (10, 11), two guide wires (30, 31) moveable within one of the catheters (10, 11) each and a bypass element delivery system (52, 53, 8) for holding a bypass element (6, 7). The bypass element delivery system (52, 53, 8) is moveable along the first guide wire (30) and the bypass element delivery system (52, 53, 8) is capable of releasing and setting free the bypass element (6, 7). The kit further comprises an expansible element (40) being capable of connecting with the bypass element delivery system (52, 53, 8), of moving the bypass element delivery system (52, 53, 8) towards the opposite end of the first guide wire (30) and of setting the bypass element delivery system (52, 53, 8) free. The inventive kit enables an atraumatic placement of a bypass.

Abstract: The present disclosure provides modular magnetic anastomosis devices that can be implemented in digestive surgery or in any circumstance of anastomosis between adjacent organs or two hollow viscera. The device is minimally invasive and easily and quickly delivered using laparoscopic or endoscopic procedures.

Abstract: Devices are used to modify a metabolic pathway of a digestive system by creating a pathway within the intestinal tract through an anastomosis between a proximal location within the intestinal tract and a distal location within the intestinal tract. A magnetic anastomosis compression device includes a first arm, a second arm, a resilient member, and a pair of magnets. The magnetic anastomosis compression device further includes a degradable retaining element. The retaining element temporarily holds the first arm and second arm in a wide configuration in opposition to the bias exerted by the resilient member. Upon the degradation of the retaining element, the resilient member causes the first arm and second arm to transition to a narrow configuration. The magnetic anastomosis compression device is configured to magnetically couple with another magnetic anastomosis compression device positioned within a different location within the intestinal tract.

Abstract: A stabilization tool supports a blood vessel for suturing during cardiovascular surgery. The support vessel may typically be part of an artificial graft used in replacing an aortic arch. The stabilization tool has a central shaft with a mounting element at a first end. A plurality of retractable arms have their distal ends affixed to a second end of the central shaft. The retractable arms are movable between a nested position flanking the central shaft and a range of extended positions wherein proximal ends of the retractable arms are spaced away from the central shaft. A closing ring is slidable over the retractable arms from a deployed position adjacent the second end of the central shaft to a retracted position spaced away from the second end to move the retractable arms.

Abstract: Systems and methods for performing transcatheter coronary artery bypass grafting procedures are provided. The methods generally involve passing the graft from the aorta to the coronary artery through the pericardial space. The systems include poke-out wires, a coring device, and devices for forming anastomoses at the proximal and distal ends of a vascular graft.

Abstract: A replacement heart valve can have an expandable frame configured to engage a native valve annulus. A valve body can be mounted onto the expandable frame to provide functionality similar to a natural valve. The valve body has an upstream end and a downstream end, and a diameter at the downstream end is greater than a diameter at the upstream end.

Abstract: Tubular prosthesis for deployment in a human body passageway comprises a tubular member adapted for placement in a passageway in a human body and a tube. The tubular member has a tubular wall, first and second end openings, and a side opening formed in the tubular wall between the first and second end openings. The tube has a first end portion and a second end portion. The first end portion of the tube is disposed in the tubular member and has an opening arranged relative to the side opening such that an elongated element (e.g., a guidewire) can be passed through the tube and out from the side opening in the tubular wall where it can enter a branch passageway. The tube can be releasably secured to the tubular member in such as manner that it can be detached from the tubular member and withdrawn after the elongated element is passed through the side opening and placed in a desired position.

Abstract: An apparatus for stimulation of collateral development in ischemic cardiac regions comprises a mechanism for fluid coupling of the left ventricle of the heart to the anterior interventricular vein to stimulate collateral development in ischemic regions. The fluid coupling of the left ventricle of the heart to the anterior interventricular vein includes a control of the diastolic/systolic pressure in the venous system to be within about 20-50 mmHg. The fluid coupling of the left ventricle of the heart to the anterior interventricular vein includes inserting a transmyocardial conduit into the left ventricle and a tri-directional coupler attached to the anterior interventricular vein. An associated method for stimulation of collateral development in ischemic cardiac regions via the fluid coupling of the left ventricle of the heart to the anterior interventricular vein is disclosed.

Abstract: An implantable closure structure is delivered using minimally invasive techniques, and inhibits the migration of liquid and particulate matter from inside a physiological cavity or opening, such as an aneurysm or a septal defect, as well as inhibiting the flow of liquid and particulate matter, such as from an associated blood vessel or chamber, into the physiological cavity or opening. The device has a closure structure that covers the neck or opening of a cavity and has one or more anchoring structures for supporting and retaining the closure structure in place across the cavity or opening.

Abstract: A system for coupling a first space within a body of a patient with a second space within the body of the patient including a flow connector insertable into the first and second spaces within the body and having a conduit having a wall forming a lumen therein and first and second orifices. A first retention member is engageable with a first portion of the first space within the body and has a first opening, and the flow connector is positioned within the first opening. A second retention member is engageable with the second space within the body, the second retention member has a second opening and the flow connector is positioned within the second opening. The second retention member interlocks with the first retention member.

Abstract: The disclosed technology provides a device for sealing an aperture in a tissue of a body lumen. The device comprises a flexible support member having a base having (i) a central portion and (ii) one or more lateral support portions, to engage and/or hold a sealable member of the device against an interior surface of the tissue when the device is in the sealing position. The lateral support portions provide additional support surfaces to engage peripheral portions of the sealable member against the interior surface of the tissue.

Abstract: A medical device and a system including same are provided. The medical device includes an elongated device body, at least a portion of which is steerable within a body of a subject via at least one control wire; and a plurality of control wire guides disposed along the elongated device body and being deployable to deflect the at least one control wire away from a longitudinal axis of the elongated device body.

Abstract: Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems, and ingestible pills. In one embodiment, the implantable system comprises a device delivering a therapeutic substance to a target location within the gastrointestinal tract of a patient in order to initiate an intestinal braking effect which would promote sensations of satiety and stimulate excess weight loss for the patient.

Abstract: This disclosure includes surgical anchors and related devices and methods that can be used for surgical bone fracture fixation. Some embodiments involve the use of a polymeric cored braided suture that can be held in place by anchors implanted or inserted into bone on each side of a fracture. In some embodiments, the present anchors can be secured into the bone while maintaining high tension (e.g., relative to certain prior art methods) in the suture during the deployment process. Some embodiments can provide for tensioning (e.g., using a polymeric cored braided suture) to compress the fracture and hold the bone in place, functioning as though the suture has sewn the bone (e.g., fragments or portions) together. This can, for example, provide rigid fixation of a fracture which may be important for healing to occur. The tension preload can provide compression to maintain fixation in the face of tensile and shear loads applied to the bone (e.g., as a result of movement and weight bearing).

Abstract: A system and method for treating obesity including a first instrument containing a first magnet therein, the first instrument insertable into a stomach of a patient and the first magnet deployable into the stomach of the patient and having a first space. A second instrument contains a second magnet therein, the second instrument insertable into a bowel of a patient and the second magnet deployable into the bowel of the patient and having a second space. A stent is insertable into the first and second spaces to maintain an opening formed between the stomach and bowel.

Abstract: An implantable device consisting of a plurality of links and configured to be in one of two modes, either flexible in at least one plane or rigid in all planes. The implantable device is inserted into a body cavity in the flexible mode and transformed to the rigid mode resembling a figure eight and anchoring the device in the body cavity.

Abstract: An intravascular cuff acts as a lining between a native vessel and an intravascular prosthetic device. During deployment, the ends of the cuff curl back upon themselves and are capable of trapping native tissue, such as valve leaflet tissue, between the ends. The cuff creates a seal between the vessel and the prosthetic, thereby preventing leakage around the prosthetic. The cuff also traps any embolic material dislodged from the vessel during expansion of the prosthetic.

Abstract: Embodiments of the invention provide systems, apparatus, device and methods for sealing a puncture in a tissue wall. According to one aspect, the system includes at least one supporting element for insertion into or placement on at least a portion of a tissue wall proximate a puncture to prevent expansion of the puncture; and a closing element adapted for at least partial insertion into the tissue wall and shaped to compress at least a portion of a tissue wall in an inward direction to close the tissue puncture when inserted at least partially into the tissue wall.