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can be releasably secured to the tubular member in such as manner that it can be detached from the tubular member and withdrawn after the elongated element is passed through the side opening and placed in a desired position.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: 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 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: 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: 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: 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: 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.

Abstract: An apparatus is operable to provide an anastomosis coupling two hollow organs, such as a duodenum and ileum. The apparatus includes a first component that is inserted through an enterotomy in a first hollow organ and a second component that is inserted through an enterotomy in a second hollow organ. The first and second components are brought together to o align the enterotomies and compress apposed layers of tissue adjacent to the enterotomies. The compressed tissue eventually necroses and the apparatus may be removed or simply pass through the hollow organ. Each component may include a set of pivoting links and a resilient member that is configured to both bias the links to an expanded configuration and grip the tissue adjacent to the enterotomy. The components may include magnets that secure the positioning of the components relative to each other and provide a compressive force on the apposed tissue.

Abstract: Exemplary embodiments provide methods and systems for delivering a prosthesis to a target location in a lumenal system of a patient. At least one tether is secured proximate the target location to serve as a rail, and a prosthesis is advanced along the rail to the target location and secured in place. Exemplary methods and systems provide for repair of the mitral and tricuspid valves, as well as abdominal aortic aneurysms, stomach valves, fallopian tubes and the pulmonary system, among others. Also disclosed are various prostheses suitable for use with the disclosed methods and systems.

Abstract: A mitral valve prosthesis is percutaneously and/or transapically deployed in at least two stages. In a first stage, a mitral annular ring platform adapted for percutaneous delivery is delivered to and anchored in the mitral valve annulus. In the second stage, a valved-stent mitral valve prosthetic device adapted for percutaneously delivery is delivered to the mitral valve annulus for mounting in the mitral annular ring platform. This approach provides a consistent platform for accepting valved-stent mitral valve prosthetic devices from different vendors to be used.

Abstract: A multi-part medical implant device assembly for use in the surgical creation of an arteriovenous fistula is described herein, the implant device having an arterial section with an arterial lumen provided therein, a venous section with a venous lumen provided therein, and a connector section with a connecting lumen provided, the connector section serving to provide a fluid pathway from the arterial section to the venous section. The device may be formed of a top and a bottom portion, where the two-part assembly may facilitate surgical implantation.

Abstract: The ventricle of a heart can be reshaped by passing a plurality of catheters from inside the ventricle to outside the ventricle through holes in the ventricle wall. Fluid-tight bags are then delivered through the catheters and expanded outside the ventricle to a diameter that is larger than the holes. A fluid substance is introduced into the bags, and the fluid substance is configured to solidify into solid pads that are also larger than the holes. The solid pads are then pulled towards each other and locked in position in order to reshape the ventricle.

Abstract: A device for creating a fistula between blood vessels operates in conjunction with a guidewire to locate and position itself so that it straddles both vessels and is able to draw them together. A fixing agent is released either from within the device or from an external needle, or both, into the procedural site. The fixing agent functions to hold the relative position of the two vessels, to seal the surrounding tissue so that any leaks that do occur don't spread into the tissue to create a hematoma, and to limit expansion of the fistula. After the vessels are in close proximity to each other and the fixing agent is applied, the device of the invention employs a cutting mechanism which opens a portal between the two vessels.

Abstract: A bioresorbable drug-eluting biopolymer suture-free blood vessel anastomosis devices can be deployed to join two blood vessels and resorbed by the body over a predetermined time period after the blood vessel has become joined. The anastomosis device can include a hollow tube that is inserted interconnect the two vessels to be jointed. A non-piercing suture is wrapped around the vessel to secure the anastomosis. The anastomosis device can include hollow tube that extends along an axis from a first end to a second end. The ends can be fitted with elements that facilitate mechanical attachment of the vessel to the anastomosis device and provide for a secure seal.

Abstract: An occluder including at least one occluding body, a multiple of elongate members forming an expanding unit capable of expanding into at least one fixation structure for fixing the occluding body within the passage thereby expanding the occluding body), the elongate members penetrating the occluding body, a locking unit for locking the expanding unit in its expanded state, fixation bushes for restricting relative movement between the elongate members and the occluding body, each fixation bush surrounding one single elongate member and abutting the occluding body, at least one thread and wherein at least one of these fixation bushes is fastened to the at least one occluding body with this at least one thread, the thread penetrating the at least one bush and the occluding body.

Abstract: A stent having an axial end to which is attached a ring of spoons of a material different from that of the stent. In one aspect, the ring of spoons is connected to the axial end through a plurality of complementary male-female form-fitting portions. In one aspect, the ring of spoons include parallel straight side edges. In one aspect, each of the side edges lies within a first distance from a facing side edge of an adjacent spoon in a stent delivery configuration, and each of the side edges lies within a second distance, greater than the first distance, from the facing side edge of an adjacent spoon in a stent deployed configuration.

Abstract: A side-to-end vascular anastomosis device comprising a diversion conduit coupled to a lower flange which is inserted into the vessel and an upper flange located on the outside of the vessel designed to clamp together to seal the incision into which the lower flange of the device is inserted.

Abstract: An implantable medical device for connecting tissue layers, such as connecting tubular tissues to create an anastomosis, includes a single elongate member and a covering material. The devices provided may also be used for other purposes including, but not limited to, partially or fully occluding openings in tissue, temporarily or permanently holding generally planar layers of tissue together, aneurysm repair, and the like.

Abstract: A system is described for performing vascular anastomosis without the use of sutures. The system includes a connector comprised of memory material and an incision seal. The connector has one end configured to securely engage a graft vessel and another end with wings and barbs. The wings are configured to securely engage an inner wall of a main vessel and the barbs are configured to lock with the incision seal. Once locked, the incision seal and the connector apply a clamping force that secures the graft vessel with the main vessel.

Abstract: Various exemplary matrix metalloproteinase (MMP) inhibiting adjuncts for surgical devices are provided. In general, an implantable adjunct can be configured to be applied to tissue by a surgical stapler in conjunction with staples. The adjunct can have at least one medicant releasably retained therein that is configured to reduce a length of the epithelialization process. In other words, the at least one medicant releasably retained in the adjunct can be configured to speed up an inflammation stage of wound healing and/or a proliferation stage of wound healing and, accordingly, reduce an amount of time before a remodeling stage of wound healing begins. The at least one medicant can be configured to be released along the staple line defined by the staples.

Abstract: A surgical instrument includes a handpiece, an elongate shaft assembly extending distally from the handpiece, an activation assembly, an end effector disposed at a distal end of the shaft assembly, and a firing beam. The handpiece comprises a cover operable to selectively expose an interior of the handpiece. The activation assembly is selectively coupleable with the handpiece and is operable to regulate the delivery of power to the end effector. The shaft comprises a selectively removable jaw assembly. The end effector has a pivoting jaw operable to pivot toward and away from the jaw assembly to thereby capture tissue. The jaw assembly and the pivoting jaw each comprise an electrode surface. The electrode surfaces are configured to seal the captured tissue by providing RF energy to the tissue. The firing beam is configured to sever the sealed tissue.

Abstract: An anastomosis device for joining hollow lumens or viscera, suitable for deployment at the surface of two superposed adjacent lumens. The device has a main tubular body of longitudinal axis (L), having first and second open ends and opposite outside and inside faces. The main tubular body has at least three columns of loops and at least three rows of loops and sets of proximal and distal radial projections extending along at least a depth (E) at the peripheries of the first and second ends respectively. The distal and proximal sets are spaced apart by a minimum internal distance (D), and further include a set of intermediate radial projections extending along at most a depth (e) and arranged between the sets of proximal and distal radial projections. The depth (e) is less than (E), and the minimum internal distance (D) is determined so as to receive two superposed adjacent lumens.

Abstract: A prosthetic aortic valve intended for native or valve-in-valve within bioprostheses includes an expandable support scaffold and valve leaflets disposed within an upper leaflet portion of the support scaffold. The valve leaflets within the upper portion may be located within the annulus (intravalvular), above the annulus, or above the native or prosthetic leaflets (supravalvular). The valve within a previously implanted degenerated heart valve such that a base or lower portion of the replacement valve is within the previously implanted valve and the upper portion is expanded within the aorta, the internal area of the valve can be increased and the hemodynamics of the valve improved. Alternatively, the valve may include separate upper and lower portions allowing the portions to be implanted sequentially if needed and the length and other characteristics of the valve to be adjusted based on patient anatomy and condition.

Abstract: A side-to-end vascular anastomosis device comprising a diversion conduit coupled to a lower flange which is inserted into the vessel and an upper flange located on the outside of the vessel designed to clamp together to seal the incision into which the lower flange of the device is inserted.

Abstract: Implantable medical devices for connecting tissue layers or occluding body conduits and tissue structures include apposition portions, a central region, and a covering material. The methods of using the devices include endoscopic deployment, and the devices may include self-expanding frameworks that facilitate a secure connection between the tissue structures. In some embodiments, one or more tethers are used to longitudinally contract the device in situ.

Abstract: A balloon-expandable shunt is disclosed for shunting a vessel which has a graft with two ends and at least one expandable support element supporting the graft from within along a length at or near at least one of its ends. The shunt is bifurcated at an aperture that leads to a side-channel and which has a closed configuration and an open configuration such that when the aperture is in the closed configuration it defines a clot-resistant inner graft surface and when the aperture is in the open configuration it is configured to provide access to the shunt for a balloon that actuates the expandable support element. A balloon configured for actuating the shunt is also disclosed. A kit has a bifurcated graft with at least one expandable support element and a balloon for actuating the at least one expandable support element.

Abstract: A scaffold includes a radiopaque marker connected to a strut. The marker is retained within the strut by one or more of a mechanical interference fit, a polymer coating or melt, and/or by friction. The marker can take the form of a bead, rivet or snap-in marker, or a tube deformed when attached to the strut. The strut is made from a tube. The strut has a thickness of about 100 microns.

Abstract: Devices and methods for forming and securing a tissue plication are disclosed herein. In one aspect, a tissue manipulation device is described that includes a first jaw member pivotally coupled to a distal end of an elongate shaft and having an articulating portion located distal to the proximal end of the first jaw member. The device also includes a second jaw member pivotally coupled to the first jaw member such that the jaws move in a first plane, and a fastener delivery member attached to the second jaw member. The articulating portion of the first jaw member is configured to move the first and second jaw members between a straight configuration in which a longitudinal axis of the elongate shaft is contained within the first plane and an articulated configuration in which the longitudinal axis of the elongate shaft is transverse to the first plane.

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: Disclosed is an occlusion device having an angle variable flat disk, comprising a single-layer disk (4), a plug (6) and a waist (5) connecting the single-layer disk (4) and the plug (6). The single-layer disk (4) is braided from elastic strands and comprises a plurality of radially-arranged support rods (40). Grids braided from elastic strands are provided on the surface of the plug (6). The waist (5) comprises at least one connecting strand. An annular interlocking structure is provided in the center of the single-layer disk (4). The plurality of support rods (40) are connected into a flat integral body via the annular interlocking structure. The connecting strand of the waist (5) is connected to the annular interlocking structure and the grids of the plug (6).

Abstract: This disclosure is directed primarily to a stent for use in the trachea. The stent has a nominally deployed state, an axially extended state and an axially compressed state. The stent has a length. In the axially extended state, the length is at least 20% greater than in the nominally deployed state.

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: A percutaneous cable is attached to a mechanical cardiac pump and is passed through the skin. Sutures can be used to stabilize the cable against movement to prevent disturbing tissue surrounding cable and thereby reduce the incidence of infection. A funnel-shaped tubular device can be used where the cable exits the skin to allow the cable to flex below or near the skin surface as may be desired to accommodate physical activity of a patient. An anchor can be attached to the cable and implanted below the skin surface to stabilize the cable against movement. The anchor can include any one or a combination of a flat mesh material, a bundle of ultrafine filaments, and a barbed filament.

Abstract: Devices and methods are described herein directed to an adaptor for use with a medical device used to suture tissue within a patient's body and/or for delivering and/or securing another medical device within a patient's body. In one embodiment, an apparatus to aid in the placement of a suture at a location within a body of a patient using a medical device includes a body and a coupler configured to couple the body to the medical device. The apparatus further includes a suture mounting portion disposed on the body that defines a suture slit configured to laterally receive therethrough a portion of a suture coupled to the medical device and to apply a frictional force to the suture to resist movement of the suture longitudinally therethrough. A magnitude of the frictional force being less than a longitudinal force applied to the suture by actuation of the medical device.

Abstract: Systems and methods introduce and deploy prosthesis into a blood vessel or hollow body organ by intra-vascular access. The prosthesis is secured in place by fasteners which are implanted by an applier that is also deployed by intra-vascular access. The applier is configured to permit controlled, selective release of the fastener in a step that is independent of the step of implantation.

Abstract: In one aspect, a gastric balloon structure includes multiple isolated non-concentric inflatable chambers and a valve system for introducing fluid into each chamber, where the structure assumes, upon inflating, a curved shape conforming to a natural three-dimensional kidney shape of the gastric cavity.

Abstract: The present invention relates to a prosthesis (200) comprising:—at least one layer of a flexible mesh (1) delimited by a peripheral outer edge (1a), said mesh having a first color, and—at least one layer (2) of porous material fixed to said mesh substantially along the perimeter of said peripheral outer edge, said layer of porous material being recessed at its central part (4), said layer of porous material having a second color, different from said first color.

Abstract: A delivery device usable to deliver an inverting implant is provided that includes a positioning mechanism that automatically initiates the inversion process once a predetermined length of the implant has exited a delivery catheter. The positioning mechanism allows the implant to be safely and accurately deployed with reduced operator experience and in a greater variety of target locations.

Abstract: An embodiment of the invention includes a sewing cuff for aortic heart valves that better approximates native anatomy by better mating with the crown-like anatomical annulus. Limiting distortion of the crown-like annulus provides better blood flow and overall valve function and provides a physician greater ease of implantation since native anatomy is not flattened. Thus, the surgeon may attach sutures to the fibrous tissue of the crown-like anatomical annulus without distorting the shape of the native anatomy. An embodiment includes a scalloped sewing cuff assembly (with semilunar arches) that tracks the crown-like annulus. Another embodiment provides a sewing cuff positioned over the majority of the valve's length, thus allowing the surgeon greater flexibility as to where he or she can attach sutures to the surgical annulus. Conventional valves, which are primarily “low-profile” devices, do not offer such ability. Other embodiments are described herein.

Abstract: An endovascular stent-graft is provided that includes a flexible stent member, which includes a plurality of struts, which are shaped so as to define a generally circumferential section; a tubular fluid flow guide, which includes a graft material, and which is attached to the stent member; and at least one fixation member shaped so as to define a base at a first end thereof and a sharp tip at a second end thereof. The base is coupled to one of the struts that are shaped so as to define the generally circumferential section. When the stent-graft is in a radially-expanded deployment state, the fixation member protrudes radially outward. When the stent-graft is in a radially-compressed delivery state, at least a portion of the fixation member between the base and the sharp tip is convex as viewed from outside the stent-graft, such that the sharp tip points radially inward.

Abstract: An electrosurgical instrument for making an end-to-end anastomosis between two hollow organ sections includes two tools movable relative to each other and each including an HF electrode by which the hollow organ sections can be fusion-welded to each other. The two tools are substantially sleeve-shaped or can at least be brought into sleeve shape so that a first tool can enclose a first hollow organ section and a second tool can enclose a second hollow organ section. Each of the electrodes is formed on an end face of each sleeve-shaped tool around which the respective hollow organ section can be everted inside out, and the two tools are movable relative to each other so that the electrodes are aligned and can clamp the everted hollow organ sections therebetween.

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: 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: A shunt rivet for implantation in the aorta and inferior vena cava to treat chronic obstructive pulmonary disease, and a method of treating chronic obstructive pulmonary disease.