VORRICHTUNG FÜR TRANSLUMINALE EINGRIFFE MIT GEFÜHRTEN KATHETERN ODER ANDEREN GERÄTEN, DIE DIE GEFÄSSWANDE DURCHDRINGEN

DEVICE FOR THE PRODUCTION OF PROXIMAL STASIS

OKKLUSIONSVORRICHTUNG TO THE ANASTOMOSIS

ENTRANCE OPENING WITH KLIP AND USE PROCEDURE

FABRIC-PENETRATING CATHETERS WITH TRANSDUCER TO THE PICTURE GIVING AND ASSOCIATED ONE APPLICATION METHODS

SYSTEM F�R INTERSTITIAL ONE TRANSVASKUL�RE SURGICAL INTERFERENCES

PROCEDURE AND DEVICES FOR THE PRODUCTION OF KOLLATERALEN CHANNELS IN THE LUNGS

Conduit designs and related methods for optimal flow control

DEVICES AND METHODS FOR FISTULA FORMATION

Abstract: A device for forming a fistula between two vessels comprising a handle; a first arm fixedly connected to the handle; and a second arm adjustably connected to the handle, wherein at least one of the first arm and the second arm comprises a fistula forming element.

Manufacturing conduits for use in placing a target vessel in fluid communicationwith a source of blood

A device, system and method for interstitial transvascular intervention

Method and apparatus for performing an anastamosis

A stent for arterialization of the coronary sinus and retrograde perfusion of the myocardium

APPARATUS AND METHODS TO CREATE AND MAINTAIN AN INTRA-ATRIAL PRESSURE RELIEF OPENING

The present disclosure relates to a method and a device for treating heart failure by normalizing elevated blood pressure in the left and right atria of a heart of a mammal. The present disclosure includes methods for creating and maintaining an opening in the 5 atrial septum. Tools for making an opening and enlarging the opening are also disclosed. Use of the techniques and tools described herein prolongs the patency of an intra-atrial pressure relief opening.

Catheters and related devices for forming passageways between blood vessels or other anatomical structures

Methods and apparatus for bypassing arterial obstructions and/or performing other transvascular procedures

Side branch dilatation catheter

Systems and methods for delivering drugs to selected locations within the body

Devices, systems and methods for creating sutureless on-demand vascular anastomoses and hollow organ communication channels

DEVICE AND METHOD FOR CONTROLLING IN-VIVO PRESSURE

A differential pressure regulating device is provided for controlling in-vivo pressure in a body, and in particularly in a heart. The device may include a shunt being positioned between two or more lumens in a body, to enable fluids to flow between the lumens, and an adjustable flow regulation mechanism being configured to selectively cover an opening of the shunt, to regulate the flow of fluid through the shunt in relation to a pressure difference between the body lumens. In some embodiments a control mechanism coupled to the adjustable flow regulation mechanism may be provided, to remotely activate the adjustable flow regulation mechanism.

PLACING A GUIDE MEMBER INTO THE HEART

A guide member (120) positioned through a coronary vessel, and the wall of the heart provides access to a heart chamber. A first end of the guide member (120) is passed through the coronary vessel, the heart wall into the heart chamber, and then is passed back out of the heart chamber. The end of the guide member (120) may then be used to deliver devices into the heart chamber to carry out various medical procedures. A conduit delivery system (110) is coupled to the end of the guide member, is delivered into the heart chamber, and then used to place a conduit in the heart wall to communicate the coronary vessel with the heart chamber.

METHODS AND DEVICES FOR ABLATION

An ablating device (522) has a cover (460) which holds an interface material such as a gel. The cover (460) contains the interface material during initial placement of the device (522). The ablating device (522) may also have a removable tip or a membrane (520) filled with fluid. In still another aspect the ablating device (522) may be submerged in liquid during operation.

SURGICAL RETRACTOR HAVING IMPROVED BLADES AND METHODS RELATED THERETO

The present invention relates to surgical retractors having improved blades for use on the retractor and devices for stabilizing a predetermined area for the body during a surgical procedure, more particularly to surgical retractors and stabilizing devices used in connection with minimally invasive coronary artery bypass grafting surgical procedures, and more specifically to surgical retractors and stabilizing devices especially configured for use with each other for such surgical procedures wherein the retractor (102) includes a plurality of grooves (132) on the bottom surface thereof and a plurality of blades (130) having a member (134) that is releasably received in the grooves (132) and which also allows for the pivotal movement of the blades (130) relative to the arms (113, 116) of the retractor (102) and further including nesting blades having a third section (134) which is generally linear and second sections which are preferably curved about 180 degrees to allow for the simplified ...

APPARATUS TO FACILITATE IMPLANTATION

METHOD AND SYSTEM FOR BYPASSING AN ARTERY BLOCK

A catheter system for use in bypassing a blocking (3) in an artery (1) comprises four components. These components are an arterial catheter, an intravenous ultrasound catheter, a guide-wire system, and finally a covered stent (4) used as graft. The bypassing of the blocking (3) in the artery (1) which extends along a vein (2) comprises the steps of forming a first connection (6) between said artery (1) and said vein (2) proximal to the blocking (3) in the artery (1), forming a second connection (7) between said artery (1) and said vein (2) distal to the blocking (3) in the artery (1), introducing a covered stent (4) through said artery (1) proximal to the blocking (3) therein, through said first connection (6) into said vein (2), via said vein (2) to and through said second connection (7), and into said artery (1) distal to the blocking (3) therein, such that a proximal end (9) of the covered stent (4) is positioned in the artery (1) proximal to the blocking (3) therein and a distal end ...

A DEVICE FOR CLAMPING LARGE BLOOD VESSELS

The device comprises: a first catheter (2) provided with dilators, a first inflatable balloon (3), associated to the first catheter (2) and active between an inflated configuration, in which the first inflatable balloon (3) is filled with a pressurised fluid and extends in a radial direction away from the first catheter (2), and a deflated configuration; means (4) for sending the fluid to the first inflatable balloon (3); an external tube (5), axially slidable on the first catheter (2), for covering and uncovering the first inflatable balloon (3) in the deflated configuration thereof; a second catheter (6), which can be inserted internally of the first catheter (2) and having an internal passage for a metal guide wire; a second inflatable balloon (7), associated to the second catheter (6) and active between an inflated configuration, in which the second inflatable balloon (7) is filled with a pressurised fluid and extends in a radial direction away from the second catheter (6), and a deflated ...

VASCULAR ACCESS DEVICES AND METHODS

Vascular access devices and methods of their use are provided. In one embodiment, a vascular access device includes a catheter (112) and at least one deployable wire (134). The catheter includes a primary lumen extending from a proximal end to a distal end of the catheter. The at least one deployable wire is secured to the catheter and configured to move relative to the catheter between a delivery configuration and a deployed configuration.

DEVICES AND METHODS FOR FORMING MAGNETIC ANASTOMOSES AND PORTS IN VESSELS

Methods and devices for forming magnetic anastomoses between hollow bodies. End-to-side, side-to-side and end-to-end anastomoses can be created with or without a mechanical connection between the components. The anastomotic components (542) may have various constructions and may be secured to a vessel in various manners, for example, magnetically, mechanically or adhesively. Also provided are alternative delivery devices (550), as well as devices (770, 730) for checking the position of a component on a loaded delivery device (772), and for checking the seal between a vessel and an anastomotic component (774, 776) secured thereto.

METHOD AND SYSTEM FOR MOUNTING AN MPS SENSOR ON A CATHETER

Catheter for performing a medical operation on an organic lumen, the catheter including an elongated member, a medical operational element located at a distal end of the elongated member, an electromagnetic field detector located at the distal end, and a wiring for coupling the electromagnetic field detector with a medical positioning system, wherein the medical positioning system determines the position and orientation of the distal end.

SLED ASSEMBLY FOR USE WITH A SURGICAL RETRACTOR AND MEDICAL INSTRUMENT

... ▓▓▓The present invention relates to an improved sled assembly for use with ▓surgical retractors and devices for stabilizing a predetermined area of the ▓body during a surgical procedure, more particularly to surgical retractors and ▓stabilizing devices used in connection with coronary artery bypass grafting ▓surgical procedures, and more specifically to a sled assembly having a sled ▓member and mounting mechanism thereon for use with surgical retractors and ▓medical or stabilizing devices especially configured for use with each other ▓for such surgical procedures wherein the retractor includes an external rail ▓system which enables the surgeon to position a stabilization arm system on ▓either of the arms or the rack segment of the retractor and also includes a ▓sled assembly which releasably controls the rotation of the stabilizing device ▓in a three dimensional directions relative to the retractor upon actuation of ▓a single knob or actuator.▓ ...

APPARATUS AND METHOD FOR FORMING A HOLE IN A HOLLOW ORGAN

CORING DILATOR FOR DEFINING AN APERTURE IN A TISSUE WALL

A coring tool and a dilator for defining an aperture in a tissue is presented. The system is preferably configured for generating an aperture within a ventricular wall for a method of implantation of ventricular assist devices (VAD's). The insertion tool/system includes a conduit device including a detachable dilator-coring tool and cuff which secures within a defined aperture in the tissue.

CONDUIT DEVICE AND SYSTEM FOR IMPLANTING A CONDUIT DEVICE IN A TISSUE WALL

Various embodiments of the present invention provide a conduit device including an attaching device configured for defining a helical pathway through a tissue wall and complementary ring in cooperation for securing the device within an aperture defined in the tissue wall. Some embodiments of the present invention further provide a system for implanting a conduit device in a tissue wall. More specifically, some embodiments provide a system including a coring device for defining an aperture in a tissue by removing and retaining a tissue core and securely implanting a conduit device therein so as to provide fluid communication between a first and second surface of the tissue wall via the conduit device.

SYSTEMS AND METHODS FOR PERCUTANEOUS INTRAVASCULAR ACCESS AND GUIDEWIRE PLACEMENT

A device for allowing passage of a guidewire from a primary blood vessel to an adjacent secondary blood vessel includes a main body having a primary lumen and a secondary lumen, and a piercing member disposed in the secondary lumen, and configured to be moved distally out of the secondary lumen, and to pierce through tissue while being distally moved. A third lumen located within the piercing member is configured to allow placement of a guidewire from the primary blood vessel to the adjacent secondary blood vessel. In one embodiment, the secondary lumen is configured to allow articulation of the distal end of the piercing element. The piercing member has a sharp point on one end to facilitate cutting a small communicating aperture from the primary blood vessel to the secondary blood vessel.

ULTRASONIC AND INTERVENTIONAL CATHETER AND METHOD

... 2121353 9308738 PCTABS00021 A catheter (20) having a catheter body (22) with a proximal (24) and distal end (26). The catheter (20) including an ultrasonic transducer (30; 60) proximate its distal end (26). An access port (40) being provided in the catheter (20) for delivery of a therapeutic device (54; 56) or the like to proximate the distal end (26) of the catheter body (22). A guide wire port (42) being further provided for insertion therethrough of a guide wire.

ULTRASONIC AND INTERVENTIONAL CATHETER AND METHOD

A catheter (20) having a catheter body (22) with a proximal (24) and distal end (26). The catheter (20) including an ultra- sonic transducer (30; 60) proximate its distal end (26). An access port (40) being provided in the catheter (20) for delivery of a therapeutic device (54; 56) or the like to proximate the distal end (26) of the catheter body (22). A guide wire port (42) being fur- ther provided for insertion therethrough of a guide wire.

NEOVASCULARIZATION CATHETER

The present invention is a device and a method for boring a perfusion channel into the myocardial tissue of a patient. Structurally, the present invention includes a positioning catheter and a cutting catheter. The positioning catheter is formed with an inflation lumen and a deployment lumen and has an inflatable balloon mounted at its distal end. The cutting catheter has a sharpened distal end and is advanceable through the deployment lumen of the positioning catheter. Advancement of the cutting catheter through the deployment lumen causes the distal end of the cutting catheter to be directed radially outward from the positioning catheter. In use, the positioning catheter is positioned within a target vessel. The inflatable balloon is then expanded to anchor the distal end of the positioning catheter. The cutting catheter is then advanced through the deployment lumen, projecting the distal end of the cutting catheter radially outward from the positioning catheter, boring a perfusion channel ...

TRANSABDOMINAL DEVICE FOR PERFORMING CLOSED-CHEST CARDIAC SURGERY

Surgical apparatus and devices are provided for performing closed chest cardiac surgery. A multi-lumen substantially tubular channel is inserted transabdominally to gain access to either the pleural or mediastinal space for the purposes of achieving less invasive cardiac surgery, more particularly complete revascularization CABG surgery directly on the beating heart. The said channel includes provisions for setting heart positioning and orienting devices, coronary artery stabilization devices, cannulae, catheters and sensors. The channel also has a provision such as designated multiple lumens and compliant seals for the introduction and preservation of pressurized gases within the accessed cavity. The principles and design features can be utilized in beating heart bypass surgery, valvular surgery, and general cardiac repair surgery by providing a means of introducing desired materials, surgical instruments, instrumentation into the accessed cavities.

The expansion of the medical device delivery system

一种用于将中空插管(40)连接到患者身体的中空器官的套件可以包括护套(70)，护套(70)具有在其远端处由多个翼片限定的渐缩表面。递送管(50)被可滑动地定位在护套内，使得护套和递送管形成完全包含插管的密封外壳。外壳和插管可以被完全清除空气。细长的扩张器(10)可以穿过可与护套和递送管可滑动地接合的密封组件伸出。在将充满液体的外壳推进到器官中之后，通过推进递送管来打开护套的远端，并且推进插管直到在插管的远端处的锚固件(48)离开器官内的递送管并且打开以将插管锚固在位。外部固定装置(130)可以被施加在插管上，以便将器官的壁保持在壁的内侧上的膨胀的锚固件和壁的外侧上的外部固定装置之间。

ENDOVASCULAR DEVICES AND METHODS FOR EXPLOITING INTRAMURAL SPACE

The present disclosure is directed to a apparatus. The apparatus may include a first intravascular device (100) having a distal portion. The distal portion including at least one aperture (230), at least one radiopaque marker (132,134), and at least one orienting element (220). The apparatus may further include a reentry device (80) having a body and a distal tip.

APPARATUS AND METHODS TO CREATE AND MAINTAIN AN INTRA-ATRIAL PRESSURE RELIEF OPENING

The present disclosure relates to a method and a device for treating heart failure by normalizing elevated blood pressure in the left and right atria of a heart of a mammal. The present disclosure includes methods for creating and maintaining an opening in the atrial septum. Tools for making an opening and enlarging the opening are also disclosed. Use of the techniques and tools described herein prolongs the patency of an intra-atrial pressure relief opening.

METHOD AND APPARATUS FOR EFFECTING AN AORTIC VALVE BYPASS, INCLUDING THE PROVISION AND USE OF A T-STENT FOR EFFECTING A DISTAL ANASTOMOSIS FOR THE SAME

A connector for joining a first hollow structure to the side wall of a second hollow structure, the connector comprising a fluid-constraining tube having a fluid-constraining neck extending therefrom, wherein the tube comprises a lumen having a first opening and a second opening and the neck comprises a lumen having a first opening and a second opening, the neck being joined to the tube so that the neck is in fluid communication with the tube intermediate the length of the tube, such that fluid enteπng the first opening of the tube can exit the second opening of the tube, and fluid entenng the first opening of the neck can exit the second opening of the tube at least the portions of the tube adjacent to the first opening of the tube and the second opening of the tube being biased radially outwardly so that they normally assume a radially-expanded configuration.

TRANSMYOCARDIAL IMPLANT

La présente invention concerne un implant transmyocardiaque qui permet d'établir un passage pour le flux sanguin au travers d'un myocarde, entre une cavité cardiaque et un vaisseau coronaire situé à l'extérieur du coeur. L'implant (10) comprend, d'une part un segment coronaire (12) calibré pour être reçu à l'intérieur du vaisseau, et d'autre part un segment myocardiaque (14) calibré pour traverser le myocarde et pénétrer dans la cavité cardiaque. Une zone de transition (13) relie le segment coronaire (12) au segment myocardiaque (14) de façon à faire passer le sang du segment myocardiaque (14) au segment coronaire (12). Le segment coronaire (12) et le segment myocardiaque (14) possèdent une construction ouverte de façon à permettre une croissance tissulaire dans l'épaisseur de paroi du segment coronaire (12) et du segment myocardiaque (14). Le segment myocardiaque (14) inclut un agent contrecarrant la coagulation en cascade et la formation de plaquettes.

Surgical apparatus and method for performing transabdominal cardiac surgery

An intervention is performed on a target anatomic structure of a patient body by first altering the configuration of the diaphragm through displacement or puncturing of the latter, in order to create a passageway leading into the thoracic cavity. An implement is introduced into the thoracic cavity through the passageway. The implement is then used while extending through the passageway to alter a biological tissue of the target structure or manipulate the latter. Optionally, a separating component having a peripheral wall encompassing a component channel is introduced into the passageway for receiving the implement and separating the latter from the non-target anatomic structure.

Method for percutaneous coronary artery bypass

A percutaneous system for bypassing a restriction in an artery of a mammal having an aorta includes providing a graft having a body portion with a first end, a second end and a lumen therebetween. First and second expandable stents are provided at the first and second ends of the graft, respectively. Apertures are formed in the artery, distal of the restriction, and in the aorta and the graft is inserted between the apertures. At least a portion of the first stent is inserted through the aperture in the artery and the stent is deployed to connect the first end of the graft within the artery. The second stent is positioned such that a first expandable portion is outside the aorta and a second expandable portion is within the aorta. The first and second expandable portions of the second stent are expanded to have outer diameters at least as large as the aperture in the aorta to anchor the first end of the graft in the aorta such that the lumen in the graft communicates with the aorta and ...

Methods and devices using magnetic force to form an anastomosis between hollow bodies

Methods and devices for forming an anastomosis between hollow bodies utilizes magnetic force to couple anastomotic securing components and create a fluid-tight connection between the lumens of the hollow bodies. End-to-side, side-to-side and end-to-end anastomoses can be created without using suture or any other type of mechanical fasteners, although any such attachment means may be used in conjunction with the magnetic attachment. The securing components have magnetic, ferromagnetic or electromagnetic properties and may include one or more materials, for example, magnetic and nonmagnetic materials arranged in a laminated structure. The system of anastomotic securing components may be used in many different applications including the treatment of cardiovascular disease, peripheral vascular disease, forming AV shunts for dialysis patients, etc., and may be sized and configured for forming an anastomosis to a specific hollow body, for example, a coronary artery or the aorta.

Surgical tool for coring precise holes and providing for retrieval of tissue

A tool for coring a hole in a patient's body. A housing includes a first opening and a second opening and has an axis extending therebetween. A shaft is movably positioned along the axis. A blade assembly is attached to one end of the shaft. The blade assembly comprises a cup having an open end and a closed end and a cutting edge formed around the open end. An interface is attached to the housing, which is shaped and dimensioned to communicate with a connector used to connect a medical device to a the patient's body.

Methods and devices for occluding a vessel and performing differential perfusion

The present invention includes an apparatus and methods for differentially perfusing a patient undergoing cardiopulmonary bypass. A cardiopulmonary bypass machine is configured to provide hypothermic oxygenated blood and normothermic oxygenated blood to an aortic balloon catheter. The catheter has arch perfusion ports and corporeal perfusion ports and is introduced into a patient's aorta and navigated transluminally until the occlusion balloon is located in the descending aorta. The occlusion balloon is inflated and hypothermic oxygenated blood is perfused to the arch vessels while normothermic oxygenated blood is perfused to the corporeal circulation. This procedure offers the benefit of cerebral protection from embolic events during cardiopulmonary bypass surgery.

METHODS FOR ROUTING A GUIDEWIRE FROM A FIRST VESSEL AND THROUGH A SECOND VESSEL IN LOWER EXTREMITY VASCULATURE

A catheter system can include a tubular body, and at least one of a targeting system coupled to the tubular body, an expandable member, or a fluid injection port. A method of identifying a bifurcation can include inserting a catheter system into a first vessel, positioning the catheter system at a first location, expanding an expandable member to occlude the first vessel, delivering contrast material so the contrast material pooling proximate to the expandable member, and reviewing a shape of the contrast material in the first vessel under fluoroscopy.

Devices and methods for percutaneous access, hemostasis, and closure

The present invention provides methods and devices for obtaining percutaneous access, maintaining hemostasis, and providing closure of openings in tissues of the body. In particular, the present invention provides methods and devices for maintaining hemostasis and providing closure surgical incisions of the left ventricular apex of the heart.

SYSTEMS, APPARATUSES, AND METHODS FOR CARDIOVASCULAR CONDUITS AND CONNECTORS

A cardiovascular conduit system may comprise a connector. The connector may comprise a proximal end adapted to attach to a cardiovascular organ. The proximal end may comprise a first plurality of expandable members, and each member in the first plurality of expandable members may be deployable from a delivery position to a deployed position. The first plurality of expandable members may be dimensioned to deploy inside the cardiovascular organ to secure the connector to the cardiovascular organ. The connector may comprise a distal end adapted to attach to a conduit and an opening extending through the connector. Connectors for cardiovascular conduit systems may also include expandable stents. Connectors may be rotateably secured to a conduit, and the conduit may be reinforced. Methods for forming and using cardiovascular conduit systems are also disclosed.

DEVICE AND METHOD FOR CONTROLLING IN-VIVO PRESSURE

A differential pressure regulating device is provided for controlling in-vivo pressure in a body, particular in a heart. The device may include a shunt being positioned between two or more lumens in a body, to enable fluids to flow between the lumens, and an adjustable flow regulation mechanism being configured to selectively cover an opening of the shunt to regulate the flow of fluid through the shunt in relation to a pressure difference between the body lumens. In some embodiments, a control mechanism coupled to the adjustable flow regulation mechanism may be provided to remotely activate the adjustable flow regulation mechanism.

DEVICE AND METHOD FOR CONTROLLING IN-VIVO PRESSURE

A differential pressure regulating device is provided for controlling in-vivo pressure in a body, particular in a heart. The device may include a shunt being positioned between two or more lumens in a body, to enable fluids to flow between the lumens, and an adjustable flow regulation mechanism being configured to selectively cover an opening of the shunt to regulate the flow of fluid through the shunt in relation to a pressure difference between the body lumens. In some embodiments, a control mechanism coupled to the adjustable flow regulation mechanism may be provided to remotely activate the adjustable flow regulation mechanism.

SEALING DEVICES, RELATED DELIVERY APPARATUSES, AND USES THEREOF

METHOD, SYSTEM AND DEVICES FOR TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT (TIPS) PROCEDURES

SURGICAL TRAINING DEVICE

To provide a compact surgical training device for enabling skills of techniques to be improved efficiently and effectively before acquiring clinical experiences in surgeries with high degrees of difficulty, particularly, vascular anastomosis, the surgical training device 10 to perform simulations and practices of vascular anastomosis is provided with a first holder 110 that holds a first pseudo blood vessel BV1, a second holder 120 that holds a second pseudo blood vessel BV2 to be anastomosed to the first pseudo blood vessel BV1, and a support mount 100 that supports the first and second holders 110, 120 so as to cause the entire surgical training device 10 to stand, while enabling the first and second pseudo blood vessels BV1, BV2 to be placed in respective arbitrary positions.

KATHETER UND SYSTEME FÜR EINEN PERKUTANEN INSITU ARTERIO-VENÖSEN BYPASS

Vorrichtung zum Verbinden von Hohlorganen

Vorrichtung zum Verbinden von Hohlorganen (10, 11) mit einer länglichen Halterung (31), einer Nadelhalterung (32), die an einem Ende der Halterung (31) angeordnet ist, wobei die Nadelhalterung (32) einen Überstand bildend über den Umfang der Halterung (31) radial übersteht, sowie einer Vielzahl von Nadeln (37), die auf dem Überstand der Nadelhalterung (32) aufrecht stehend die Halterung (31) umgebend angeordnet sind, wobei an der Halterung (31) benachbart und oberhalb der Spitzen der Nadeln eine Einführhilfe (35) mit in axialer Richtung der Nadeln sich erstreckenden Durchgangsöffnungen angeordnet ist, dadurch gekennzeichnet, dass die Einführhilfe (35) an ihrem von den Spitzen der Nadeln abgewandten Bereich aufblasbare Druckpolster zur Verengung ihrer Durchgangsöffnung aufweist.

VORRICHTUNG ZUR UMGEHUNG VON ARTERIELLEN VERENGUNGEN UND/ODER ZUR AUSFÜHRUNG ANDERER TRANSVASKULARER EINGRIFFE

Koronarer Anastomosekonnektor

Koronarer Anastomosekonnektor auf Polylactidbasis für die Bypasschirurgie, der die Gestalt eines T-Y-Hybrids aufweist.

System for directing therapy

CARRIAGE ARRANGEMENT FOR A SURGICAL ONE RETRAKTOR AS WELL AS FOR A MEDICAL INSTRUMENT

DEVICE FOR TRANSLUMINALE INTERFERENCES WITH LED CATHETERS OR OTHER DEVICES, GEFÄSSWANDE PENETRATING

OPTICALLY LEADING PENETRATION CATHETER AND YOUR OPERATING TECHNIQUES

DEVICE AND SYSTEM WITH AN INTERSTITIAL TRANSVASKUL�REN INTERFERENCE

EQUIPMENT FOR THE FORMATION OF A HOLE IN A HOLLOW ORGAN

INTO A VEIN OF THE BLUTKREISLAUFS OF IMPORTABLE CATHETERS

DEVICE FOR THE PRODUCTION OF PROXIMAL STASIS

DEVICE FOR INTERSTITIAL TRANSVASKULÄREN INTERFERENCE

DEVICE FOR CROSSING VASKULAREN OKKLUSIONEN

DEVICE FOR THE STABILIZATION OF A TREATMENT PLACE

TMR DEVICE

Devices for applying energy to tissue

Tissue penetrating cathethers having integral imaging transducers and their methods of use

Methods and devices for vascular surgery

Methods and devices for placing a conduit in fluid communication with a target vessel

Method and apparatus for tissue treatment

A device and an introducer for providing a supplemental flow of blood

Delivering a conduit into a heart wall to place a coronary vessel in communication with a heart chamber and removing tissue from the vessel or heart wall to facilitate such communication

ANASTOMOSIS OCCLUSION DEVICE

An anastomosis occlusion device having a low-profile shaft assembly configured for insertion into the lumen of a vessel. The device includes an expandable region at the shaft assembly distal end with a sealing membrane that spans the expandable region, and a corresponding clamping member moveable toward the expandable region. Once inserted into the vessel lumen the expandable region is deployed from a first low-profile position into a second expanded position at the target site of the anastomosis. Movement of the distal end of the clamping member, which remains located outside the vessel, against the expanded region creates a seal at the target site allowing a blood-free, graft site.

VEIN HARVESTING SYSTEM AND METHOD

A system and a method for harvesting a section of a blood vessel (V) from a patient's body for further use. The system includes an expandable hood (10) that creates a workspace for the dissection and removal of the vessel and a telescoping device that has tools at its distal end. The blood vessel (V) is cut at a distal location and a light catheter inserted to illuminate the area of dissection. The system can remove a section of the saphenous vein for use in coronary bypass surgery.

AN ANASTOMOTIC CONNECTOR AND GRAFT EXPANDER FOR MOUNTING A GRAFT

An anastomotic connector device (102) for mounting a graft (100) in which the connector has spikes (106) defining a periphery around the base ring (104). Also a graft expander (900) having a body (906), a lower diameter tube portion (908) connected by truncated cone (910) and a finger rest (902) and plunger (904).

CORING DEVICE AND CORING AND INSERTION ASSEMBLY COMPRISING SUCH A DEVICE

L'invention concerne un dispositif de carottage pour réaliser une ouverture dans une paroi tissulaire, ce dispositif comprenant : - un corps ayant un axe longitudinal, ledit corps ayant une extrémité proximale et une extrémité distale, ledit corps comportant un logement interne, - une tête de carottage (13) comportant une lame de transsection (14), cette tête étant mobile entre une position de repos et une position actionnée, - un mécanisme d'actionnement pour déplacer ladite tête entre lesdites positions, ledit mécanisme comportant une tige d'actionnement (15) à une extrémité de laquelle est placée ladite tête mobile, - une lumière (20) s'étendant à travers au moins l'extrémité proximale dudit corps, ladite tige d'actionnement (15) et ladite tête de carottage (13) pour le passage d'un élément de guidage souple, et - l'extrémité distale dudit corps forme un support d'outil (21) chirurgical, ce support d'outil (21) étant configuré pour * d'une part, recevoir par emboîtement un outil chirurgical ...

TRANSMYOCARDIAL IMPLANT

A transmyocardial implant establishes a blood flow path through a myocardium between a heart chamber and a lumen of a coronary vessel residing on an exterior of the heart. The implant (10) includes a coronary portion (12) sized to be received within the vessel. A myocardial portion (14) is sized to pass through the myocardium into the heart chamber. A transition portion (13) connects the coronary (12) and myocardial (14) portions for directing blood flow from the myocardial portion (14) to the coronary portion (12). The coronary portion (12) and the myocardial portion (14) have an open construction for permitting tissue growth across a wall thickness of the coronary portion (12) and the myocardial portion (14). The myocardial portion (14) includes an agent for controlling a coagulation cascade and platelet formation.

EXTRAVASCULAR ANASTOMOTIC COMPONENTS AND METHODS FOR FORMING MAGNETIC ANASTOMOSES

Methods and devices using magnetic force to form an anastomosis between hollow bodies. End-to-side, side-to-side and end-to-end anastomoses can be created without using suture or any other type of mechanical fasteners, although such attachment means may be used in practicing some aspects of the invention. Magnetic anastomotic components (16) may be attached to the exterior of a vessel, e.g., by adhesive, without extending into the vessel lumen. Various magnetic component configurations are provided and may have different characteristics, for example, the ability to match the vessel curvature or to frictionally engage the vessel.

DEVICES AND METHODS FOR THE TREATMENT OF HEART FAILURE

A device (10) for treating heart failure in a patient. The device (10) comprising a body (12), at least one passage (18) through the body (12), at least one one way valve ( 20) in the passage (18) and a mounting means (14) adapted for mounting the body (12) in an opening provided in the patient's atrial septum. In use, the device (10) is oriented such that, when the patient's left atrial pressure exceeds the patient's right atrial pressure by a predetermined amount, the one way valve(s) (20) opens to allow blood flow through the passage(s) from the left atrium to the right atrium to thereby reduce the left atrial pressure.

CONDUIT DEVICE AND SYSTEM FOR IMPLANTING A CONDUIT DEVICE IN A TISSUE WALL

Various embodiments of the present invention provide a conduit device including an attaching device configured for defining a helical pathway through a tissue wall and complementary ring in cooperation for securing the device within an aperture defined in the tissue wall. Some embodiments of the present invention further provide a system for implanting a conduit device in a tissue wall. More specifically, some embodiments provide a system including a coring device for defining an aperture in a tissue by removing and retaining a tissue core and securely implanting a conduit device therein so as to provide fluid communication between a first and second surface of the tissue wall via the conduit device.

APPARATUS AND METHOD FOR TARGETING A BODY TISSUE

An apparatus for targeting a desired target site on a body tissue comprising a wall of a first body cavity of a patient includes a target catheter. The framing member, when deployed into an expanded condition, has a framing member body which includes a three-dimensionally bulbous portion defining a maximum body footprint in a lateral dimension and has longitudinally spaced proximal and distal body ends which are both longitudinally spaced from the maximum body footprint. The proximal body end is attached to the target catheter. A protrusion has a diameter which is smaller than the maximum body footprint diameter. At least one target point is carried by the framing member and is adapted for placement adjacent the desired target site. At least one target pathway is attached to at least one target point. At least a portion of the target pathway is substantially spaced apart from the framing member body.

METHODS AND APPARATUS FOR CROSSING TOTAL OCCLUSIONS IN BLOOD VESSELS

Total occlusions are crossed by passing a guidewire or other penetrating wire from a point proximal to the occlusion into a subintimal space between the intimal layer and adventitial layer of the blood vessel wall. The wire is advanced to a point distal the occlusion and thereafter deflected back into the blood vessel lumen, typically using a deflecting catheter which is advanced over the guidewire after it has been positioned within the subintimal space. After the guidewire is returned to the blood vessel lumen, the deflecting catheter may be withdrawn and the guidewire is available for introduction of other interventional and diagnostic catheters.

CANNULA TIPS, TISSUE ATTACHMENT RINGS, AND METHODS OF DELIVERING AND USING THE SAME

A surgical cannula system. The surgical cannula system includes a cannula (60) having a proximal end, a distal end, and a lumen (82) extending therebetween. A tissue attachment ring (110), being configured to be coupled to a biological tissue (74), includes a lumen (117) extending therethrough. A locking mechanism (119) has a first locking state, in which the cannula (60) is configured to move with respect to the tissue attachment ring (110), and a second locking state, in which movement of the cannula (60) with respect to the tissue attachment ring (110) is resisted.

METHODS AND APPARATUS FOR BYPASSING ARTERIAL OBSTRUCTIONS AND/OR PERFORMING OTHER TRANSVASCULAR PROCEDURES

This invention is methods, devices, and systems for re-vascularization, and/or performing other medical procedures at a vascular or non-vascular intracorporeal locations within a mammalian body. The methods generally comprise the formation of at least one extravascular passageway from a blood vessel to a vascular or non-vascular target location. In the re-vascularization methods the extravascular passageway is utilized as a conduit for accessing or performing procedures at the vascular or non-vascular target location. Also disclosed are catheter devices (100, 103) and systems (138) which are usable to form the extravascular passageways of the invention, as well as apparatus for modifying, maintaining and/or closing such extravascular passageways.

METHODS AND APPARATUS FOR BLOCKING FLOW THROUGH BLOOD VESSELS

This invention is methods and apparatus for occluding blood flow within a blood vessel (22). In a first series of embodiments, the present invention comprises a plurality of embolic devices (16) deployable through the lumen (12) of a conventional catheter (10) such that when deployed, said embolic devices (16) remain resident and occlude blood flow at a specific site within the lumen of the blood vessel (22). Such embolic devices (16) comprise either mechanical embolic devices that become embedded within or compress against the lumen of the vessel or chemical vaso-occlusive agents that seal off blood flow at a given site. A second embodiment of the present invention comprises utilization of a vacuum/cauterizing device capable of sucking in the lumen of the vessel about the device to maintain the vessel in a closed condition where there is then applied a sufficient amount of energy to cause the tissue collapsed about the device to denature into a closure. In a third series of embodiments ...

TRANSVASCULAR TMR DEVICE AND METHOD

The catheter assembly (33) for performing transmyocardial revascularization through arteries or veins, and a method of using this assembly for creating TMR channels (27, 28) through the myocardium coronary artery shunts through the myocardium and a device (110) and method for injecting therapeutic agents into TMR channels interoperatively, together with a number of therapeutic agents.

CORONARY STABILIZER FOR PERFORMING BEATING HEART CARDIAC SURGERY

The present invention improves the efficiency and safety of beating heart CABG surgery through a coronary stabilizer that isolates and extrudes the target artery through the arterial window formed by its geometry and contacting perimeter, thereby facilitating surgical grafting while minimizing distortion and deflection to underlying heart tissue or minimizing restriction to the natural beating function of the heart. The coronary stabilizer is also configured with a manipulation handle that improves the surgeon's sensitivity and manual dexterity during the deployment of said stabilizer, allowing better feedback to the imposed immobilization loads to the underlying heart tissue.

NEOVASCULARIZATION CATHETER

The present invention is a device and a method for boring a perfusion channel from a coronary artery into a cardiac muscle of a patient. Structurally, the present invention includes a positioning catheter, anchor means and a cutting catheter. The cutting catheter includes a plurality of blades and is advanceable through a deployment lumen of the positioning catheter. Advancement of the cutting catheter through the deployment lumen causes a distal end of the cutting catheter to project laterally from the positioning catheter. In use, the positioning catheter is positioned within the coronary artery. The anchor means is then expanded to anchor the positioning catheter within the artery. The cutting catheter is then advanced through the deployment lumen to bore one or more perfusion channels in the myocardial tissue.

Anastomoss occlusion device

ISOLATING CARDIAC CIRCULATION

In a method for substantially isolating cardiac circulation from systemic circulation, flow between the coronary sinus and the right atrium is occluded. A venous collection device having a collection lumen and a support structure is located in the coronary sinus. The support structure is used to maintain patency of th coronary sinus during collection of fluid through the collection lumen. An artificial flow path is provided between the collection lumen and the one or more coronary arteries, thus isolating the cardiac circulation. According to the method, cardiac pumping for systemic circulation can be maintained during isolation of the cardiac circulation.

VASCULAR ANASTOMOSIS TRAINING AID

It is intended to provide a vascular anastomosis training aid by which vascular anastomosis techniques can be efficiently and effectively upgraded before conducting highly difficult operations such as coronary artery bypath operation in the clinical field in practice. A vascular anastomosis training aid (1) having a pair of first and second holders (2, 4) by which simulated blood vessels (BV1, BV2) can be freely held at an anastomotic site. Thus, an environment closely similar to a clinical performance can be reproduced, which makes it possible to efficiently and effectively upgraded vascular anastomosis techniques before conducting highly difficult operations such as coronary artery bypath operation in the clinical field in practice.

Device and method for performing multiple anastomoses

Methods and devices for creating a seal in a vessel for performing multiple anastomoses. The device includes an expandable region at the shaft assembly distal end with a sealing membrane that spans the expandable region, and a corresponding clamping member moveable toward the expandable region. Once inserted into the vessel lumen the expandable region is deployed from a first low-profile position into a second expanded position, and positioned at the target site of the anastomoses. Movement of the distal end of the clamping member, which remains located outside the vessel, against the expanded region creates a seal at the target site allowing a blood-free, graft site area that is large enough to accommodate multiples anastomoses.

Automatic quantitative vessel analysis

Apparatus and methods are described for use with an image of blood vessels of a subject. In response to a user designating a single point on the image (a) a target portion of a blood vessel is automatically identified in the vicinity of the designated point, and (b) quantitative vessel analysis is performed on the target portion of the blood vessel. An output is generated based upon the quantitative vessel analysis. Other embodiments are also described.

Apparatus and methods to create and maintain an intra-atrial pressure relief opening

The present disclosure relates to a method and a device for treating heart failure by normalizing elevated blood pressure in the left and right atria of a heart of a mammal The present disclosure includes methods for creating and maintaining an opening in the atrial septum. Tools for making an opening and enlarging the opening are also disclosed. Use of the techniques and tools described herein prolongs the patency of an intra-atrial pressure relief opening.

Apparatus and Method for Ablating Tissue

A control system alters one or more characteristics of an ablating element to ablate tissue. In one aspect, the control system delivers energy nearer to the surface of the tissue by changing the frequency or power. In another aspect, the ablating element delivers focused ultrasound which is focused in at least one dimension. The ablating device may also have a number of ablating elements with different characteristics such as focal length.

Graft Devices and Methods of Use

A tubular graft device is provided comprising a tubular member and a fiber matrix of one or more polymers about a circumference of the tubular member. The matrix may be electrospun onto the tubular tissue. In one embodiment, the tubular tissue is from a vein, such as a harvested saphenous vein, useful as an arterial graft, for example and without limitation, in a coronary artery bypass procedure. Also provided is method of preparing a tubular graft and connecting the graft between a first body space and a second body space, such as the aorta and a location on an occluded coronary artery, distal to the occlusion.

Intra-atrial implants made of non-braided material

Several unique intra-cardiac pressure devices, placement catheters, methods of placement and methods of treating heart failure are presented. The intra-cardiac pressure devices presented allow sufficient flow from the left atrium to the right atrium to enable the relief of elevated left atrial pressure and resulting patient symptoms. The intra-cardiac pressure devices are made of a non-braided material.

Automatic reduction of interfering elements from an image stream of a moving organ

Apparatus and methods are described for imaging a portion of a body of a subject that undergoes a motion cycle. A plurality of image frames of the portion are acquired. The image frames are enhanced with respect to a first given feature of the image frames, by (a) image tracking the image frames with respect to the first given feature, (b) identifying a second given feature in each of the image frames, and (c) in response to the identifying, reducing visibility of the second given feature in the image frames. The image frames that (a) have been image tracked with respect to the first given feature, and (b) have had reduced therein the visibility of the second given feature, are displayed as a stream of image frames. Other embodiments are also described.

Systems, devices, and methods for organ retroperfusion along with regional mild hypothermia

Systems, devices, and methods for organ retroperfusion along with regional mild hypothermia. In at least one embodiment of a method of organ perfusion of the present disclosure, the method comprises the steps of positioning at least part of a first catheter having a cannula within an artery of a patient, the first catheter configured to permit arterial blood to flow therethrough and further configured to permit a portion of the arterial blood to flow through the cannula, positioning at least part of a second catheter within a vein of the patient at or near a target organ, the second catheter configured to receive some or all of the portion of the arterial blood, connecting the cannula of the first catheter to a portion of the second catheter so that some or all of the portion of the arterial blood flowing through the cannula is provided into the vein to treat a condition or disease of the target organ, and reducing and/or regulating a temperature of blood flowing through the cannula using a regional hypothermia system operably coupled to the cannula.

ENDOVASCULAR DEVICES AND METHODS FOR EXPLOITING INTRAMURAL SPACE

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen. 1. A method of bypassing an occlusion in a blood vessel through a subintimal pathway , comprising:advancing a subintimal crossing device through a subintimal space between tissue layers of a vascular wall of the blood vessel adjacent to the occlusion;thereafter, advancing an orienting device into the subintimal space;expanding an orienting element of the orienting device in the subintimal space to orient a side port of the orienting device toward a lumen of the blood vessel distal of the occlusion; andadvancing a re-entry device out of the side port and into the true lumen of the blood vessel distal of the occlusion.2. The method of claim 1 , further comprising claim 1 , withdrawing the subintimal crossing device from the subintimal space prior to advancing the orienting device into the subintimal space.3. The method of claim 1 , wherein the orienting element expands in a planar orienting element.4. The method of claim 3 , wherein the planar orienting element is a preformed planar sinusoid.5. The method of claim 3 , wherein the planar orienting element is two wings that extend in opposite directions.6. The method of claim 3 , wherein the side port of the orienting device is oriented at a right angle to a plane of the planar orienting element.7. The method of claim 1 , wherein the subintimal crossing device includes a bulbous distal tip.8. The method of claim 1 , wherein the ...

Reducing mechanical stress on conductors and connection points in a position determinable interventional medical device

A medical device configured for diagnosis or treatment of tissues within a body is provided. The device includes an elongate, deformable member configured to be received within a lumen in the body and having proximal and distal ends. A position sensor is disposed at the distal end. In one embodiment, a conductor is wound about the member. The conductor is connected to the position sensor and has a first winding pitch over a first portion of the deformable member and a second winding pitch, different from the first winding pitch, over a second portion of the deformable member. In another embodiment, the member defines a neutral longitudinal axis extending between the proximal and distal ends. A conductor extending between the proximal and distal ends is connected to the position sensor at a connection node on the neutral axis.

INTERATRIAL SHUNTS HAVING BIODEGRADABLE MATERIAL, AND METHODS OF MAKING AND USING SAME

A device for regulating blood pressure between a patient's left atrium and right atrium comprises an hourglass-shaped stent comprising a neck region and first and second flared end regions, the neck region disposed between the first and second end regions and configured to engage the fossa ovalis of the patient's atrial septum, and a drug-eluting biodegradable material that biodegrades over time to release a drug that limits tissue overgrowth. The inventive device also may include a biodegradable material that biodegrades to offset flow changes caused by tissue overgrowth. The inventive device may reduce left atrial pressure and left ventricular end diastolic pressure, and may increase cardiac output, increase ejection fraction, relieve pulmonary congestion, and lower pulmonary artery pressure, among other benefits. 1. A device for regulating blood flow in a patient to treat a condition , the device comprising:a stent comprising a first flared end region, a second flared end region, a neck region disposed between the first and second flared end regions, and a passageway extending through the first flared end region through the neck region and through the second flared end region, the stent configured to shunt blood between body cavities;a biocompatible material disposed on the stent to define a sheath that channels blood flow through the passageway; anda biodegradable material disposed on an inner surface of the biocompatible material at the neck region, the biodegradable material configured to inhibit tissue overgrowth across the biodegradable material within the passageway of the stent.2. The device of claim 1 , wherein the stent comprises a plurality of rings interconnected by a plurality of longitudinally extending struts.3. The device of claim 1 , wherein the biocompatible material is disposed in the neck region claim 1 , the second flared end region claim 1 , and a portion of the first flared end region of the stent.4. The device of claim 1 , wherein the ...

Medical device and treatment method

A medical device and a treatment method, in which energy is accurately applied to a target site by suppressing a positional displacement between an expansion body and a biological tissue. The medical device includes an elongated shaft portion and an expansion body disposed in a distal portion of the shaft portion and configured to expand and contract in a radial direction. The expansion body includes a holding portion having a proximal side holding portion and a distal side holding portion configured to hold the biological tissue, and a movable portion configured to open and close the holding portion.

CANNULA LINED WITH TISSUE IN-GROWTH MATERIAL

A cannula for moving fluids between a pump and the circulatory system of a patient. The cannula includes a liner having an intermediate portion between a proximal portion and a distal portion, and a lumen extending between the proximal and distal portions. At least the intermediate portion of the liner is constructed from a tissue in-growth material for supporting the growth of endothelial cells. A jacket surrounds at least part of the liner. 1. A cannula for moving blood between a pump and a circulatory system of a patient , the cannula comprising:a liner comprising an intermediate portion between a proximal portion and a distal portion and a lumen extending between the proximal and distal portions, wherein at least the intermediate portion is constructed from tissue in-growth material adapted to contact blood flowing through the lumen for supporting the growth of endothelial cells, the proximal portion is configured for connecting to the pump and the distal portion is configured for connecting to the circulatory system;a jacket fully encapsulating the liner;an outer layer surrounding at least a part of the jacket, wherein the outer layer is constructed from tissue in-growth material;wherein the outer layer has a proximal and a distal end and an intermediate portion therebetween; anda polymeric layer extending along a partial length of the liner and the outer layer, the polymeric layer having a first portion that extends proximally from the proximal end of the outer layer to a proximal end of the cannula and a second portion that extends distally from the distal end of the outer layer to the distal end of the cannula such that the first and second portions of the polymeric layer prevent delamination of the outer layer from the jacket, the first and second portions of the polymeric layer further encapsulating the proximal and distal portions of the jacket.2. The cannula of claim 1 , wherein the tissue in-growth material is an expanded polytetrafluoroethylene claim 1 ...

Transcatheter insertion device and method

The present invention relates to a transcatheter method for providing fluid communication between two anatomical compartments. The present invention also relates to a transcatheter system comprising an intracorporeal connector for fluid communication between two anatomical compartments through at least one anatomical wall, wherein said connector is adapted to receive a flow regulating device, a connector, a flow regulating device and an insertion device.

TRANSCATHETER SYSTEM AND METHOD FOR REGULATING FLOW OF FLUID BETWEEN TWO ANATOMICAL COMPARTMENTS

The present invention relates to a transcatheter method for providing fluid communication between two anatomical compartments. The present invention also relates to a transcatheter system comprising an intracorporeal connector for fluid communication between two anatomical compartments through at least one anatomical wall, wherein said connector is adapted to receive a flow regulating device, a connector, a flow regulating device and an insertion device. 1. A transcatheter system comprising an intracorporeal flow regulating device for regulating the flow of fluid between two anatomical compartments through at least one anatomical wall , wherein the flow regulating device comprises means for intracorporeally securing the flow regulating device to an connector intracorporeal connector positioned through said anatomical wall(s).2. The system according to claim 1 , wherein the flow regulating device comprises an actuator to allow or prevent fluid flow through the intracorporeal connector.3. The system according to claim 1 , wherein the flow regulating device comprises a first portion located in use in the first compartment claim 1 , a second portion located in use in the second compartment claim 1 , and an intermediate portion located in use through the anatomical wall(s).4. The system according to claim 3 , wherein the first portion and/or the second portion comprises one or more apertures for fluid passage from the first compartment to the second compartment.5. The system according to claim 3 , wherein the first portion comprises a cross-section of larger diameter than the diameter of the cross-section of the intermediate portion.6. The system according to claim 1 , wherein when the flow regulating device is coupled to the connector claim 1 , fluid can flow from the first compartment to the second compartment claim 1 , and when the flow regulating device is not coupled to the connector claim 1 , fluid is prevented from flowing from the first compartment to the second ...

Apparatus and methods for reducing visibility of a periphery of an image stream

Apparatus and methods are described for imaging a portion of a body of a subject that undergoes a motion cycle, including acquiring a plurality of image frames of the portion of the subject's body. A given feature is identified in at least some of the image frames. At least some image frames are image tracked with respect to the feature, and the image frames that have been image tracked with respect to the given feature are displayed as a stream of image frames. Visibility of a periphery of the displayed stream of image frames is at least partially reduced. Other applications are also described.

CANNULA SYSTEM AND METHOD FOR DISCHARGING THE VOLUME OF A HEART

A cannula system for puncturing the heart is provided, comprising a cannula and a trocar. The cannula comprises a cannula shaft with a heart-side inlet and a pump-side outlet. The trocar has a trocar shaft which can be inserted into the lumen of the cannula and which comprises a puncturing tip, wherein the puncturing tip can completely cover the inlet opening of the cannula. 1. A cannula system for the puncture or volume relief of the heart , comprising a cannula and a trocar ,wherein the cannula comprises a cannula shaft with a heart-side inlet which comprises an inlet edge which delimits the inlet opening, and with a pump-side outlet and a lumen which extends between the inlet and the outlet, wherein a suture ring for connecting the cannula to the heart is arranged on an outer side of the cannula shaft and the outlet is connectable to a pump; andwherein the trocar comprises an opening for a guide wire and a trocar shaft which has a puncturing tip and is insertable into the lumen from the outlet, and the trocar shaft is longer than the lumen, so that in a puncturing configuration the puncturing tip projects out of the inlet of the cannula; andthe trocar shaft or the puncturing tip completely covers the inlet opening.2. The cannula system of claim 1 , wherein the puncturing tip comprises a peripheral sealing lip which at least partly covers the inlet edge.3. The cannula system of claim 1 , wherein the inlet edge in the axial direction to the inlet opening comprises a chamfer and the puncturing tip terminates with the inlet edge in a flush manner.4. The cannula system of claim 3 , wherein the puncturing tip is chamfered and a chamfer angle of the puncturing tip and a chamfer angle of the chamfer of the inlet edge differ from one another by less than 30°.5. The cannula system of claim 1 , wherein at least the puncturing tip of the trocar comprises an expandable cavity and the puncturing tip completely covers the inlet opening when the cavity is in an expanded state.6. ...

A Kit for Placing a Bypass

A kit for placing a bypass between two body vessels (R, L) of a patient comprises two catheters (), two guide wires () moveable within one of the catheters () each and a bypass element delivery system () for holding a bypass element (). The bypass element delivery system () is moveable along the first guide wire () and the bypass element delivery system () is capable of releasing and setting free the bypass element (). The kit further comprises an expansible element () being capable of connecting with the bypass element delivery system (), of moving the bypass element delivery system () towards the opposite end of the first guide wire () and of setting the bypass element delivery system () free. The inventive kit enables an atraumatic placement of a bypass. 1. A kit for placing a bypass between a first and a second body vessel of a patient , the kit comprisinga first catheter with a first delivery end and a second catheter with a second delivery end,a first guide wire moveable within the first catheter, the first guide wire having a first end region being moveable to the first delivery end, the first guide wire having an opposite end being opposite to the first end region,a second guide wire moveable within the second catheter, the second guide wire having a second end being moveable to the second delivery end, the second end of the second guide wire being a catch for capturing the first guide wire and for moving the first guide wire into the second catheter with a first end region of the first guide wire first, anda bypass element delivery system for holding a bypass element, the bypass element delivery system being moveable along the first guide wire from the first end region of the first guide wire, wherein the bypass element delivery system is capable of releasing and setting free the bypass element,wherein the kit comprises an expansible element the expansible element being capable of connecting with the bypass element delivery system and of moving the bypass ...

Method and apparatus for coupling left ventricle of the heart to the anterior interventricular vein to stimulate collateral development in ischemic regions

A method for stimulation of collateral development in ischemic cardiac regions comprises the 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 apparatus 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.

DEVICE FOR VESSEL HARVESTING

A device for vessel harvesting is disclosed. The device for vessel harvesting includes a distal housing, a dissector coupled to the distal housing, a drive element coupled to the dissector, and an actuator coupled to the drive element. The device for vessel harvesting may also include a rotatable dissector, a shaft coupled to the distal housing having a first articulation joint movable within a first plane, and a second articulation joint movable within a second plane, which is substantially perpendicular to the first plane, a barrel chain drive element coupled to the rotatable dissector, and an actuator coupled to the drive element. The device for vessel harvesting may also include a member slidably engaged to the distal tip. 1. A minimally invasive surgical device , comprising:a distal housing;a dissector coupled to the distal housing;a drive element coupled to the dissector; andan actuator coupled to the drive element.2. The minimally invasive surgical device of claim 1 , wherein the dissector is a blunt dissector.3. The minimally invasive surgical device of claim 1 , the dissector further comprising a base claim 1 , an arcuate appendage claim 1 , and a drive attachment.4. The minimally invasive surgical device of claim 1 , wherein the drive element further comprises a barrel chain.5. The minimally invasive surgical device of claim 4 , wherein the barrel chain further comprises a plurality of barrels.6. The minimally invasive surgical device of claim 4 , wherein the barrel chain further comprises a plurality of tabs.7. The minimally invasive surgical device of claim 1 , wherein the drive element is selected from a group consisting of a monolithic chain claim 1 , a belt claim 1 , and a linked chain.8. The minimally invasive surgical device of claim 1 , wherein the actuator is a lever.9. The minimally invasive surgical device of claim 8 , wherein the dissector is pivotable by actuating the lever.10. The minimally invasive surgical device of claim 1 , wherein the ...

SYSTEM FOR PERFORMING INTRALUMINAL CORONARY AND METHOD OF OPERATION THEREOF

A method of performing a coronary bypass procedure, the method may be performed by the flexible apparatus controlled by at least one controller, the method may include acts of: percutaneously situating the flexible apparatus into a first artery coupled to connective tissue of a chest wall; transluminally detaching at least a portion of the first artery from the connective tissue by applying ultrasound signals of a first type emitted by at least one transducer of the flexible apparatus; steering at least a portion of the detached portion first artery from a current location to a bypass location at a target artery by applying a force transmitted through the flexible apparatus situated within the first artery; and coupling, by the flexible apparatus situated within the first artery, the first artery to the target artery at the bypass location to establish flow communication between the first artery and the target artery. 1. A method of performing a bypass procedure , the method performed by a flexible apparatus controlled by at least one controller , the method comprising acts of:percutaneously situating the flexible apparatus through a first artery (LIMA) which is coupled to connective tissue of a chest wall;transluminally detaching at least a portion of the first artery surrounding the flexible apparatus to thereby detach the first artery from the connective tissue of the chest wall by applying ultrasound signals of a first type emitted by a plurality of elongated spherical transducers arranged longitudinally in a row rotationally coupled to a distal end of the flexible apparatus while rotating the plurality of elongated spherical transducers about a longitudinal axis of the flexible apparatus to transluminally detach at least a portion of the first artery surrounding the flexible apparatus from the connective tissue;driving at least on e of the plurality of elongated spherical transducers to emit ultrasound signals of the first type to transluminally fractionate the ...

SYSTEMS FOR IMPLANTING AND USING A CONDUIT WITHIN A TISSUE WALL

Various embodiments of the present invention provide a conduit system including an outer lumen, an inner lumen, and an attaching device. In other embodiments, a multiple access port device adapted for communication with at least one of an outer lumen, an inner lumen, or an attaching device of a conduit system is provided. In yet other embodiments, a system including an inner lumen that is collapsible is provided. Means for closing a conduit system are also provided, including a plug for insertion through an attaching device and a variable radius coiled member associated with an attaching device. 135-. (canceled)36. A device for attaching to a tissue wall having a first surface and a second surface , the device comprising:a port defining an opening extending along a longitudinal axis of the device; anda plurality of coils fixedly attached to the port and configured for advancing at least partially through the tissue wall such that at least a portion of each coil becomes disposed between the first surface and the second surface of the tissue wall, wherein the coils are centered on a common rotational axis.3735. The device of claim , wherein the opening of the port extends from a proximal end to a distal end of the port in a direction of the longitudinal axis of the device.38. The device of claim 37 , wherein the coils each extend distally beyond the distal end of the port.39. The device of claim 36 , wherein the common rotational axis of the coils is coaxial with the longitudinal axis of the device.40. The device of claim 36 , wherein the coils each have a radially expanding helical shape.41. The device of claim 36 , further comprising a flange extending about the port and configured for engaging the tissue wall.42. The device of claim 36 , further comprising a plug configured for releasably attaching to the port and for positioning at least partially within the opening of the port.43. The device of claim 42 , wherein the plug comprises a valve configured for ...

Determining a characteristic of a lumen by measuring velocity of a contrast agent

Apparatus and methods are described for use with a plurality of angiographic image frames of a moving lumen of a subject, including aligning the image frames with each other. Using the aligned image frames, a time it takes a contrast agent to travel a known distance through the lumen is determined. At least partially in response thereto, a characteristic of the lumen is determined, and, in response to the determined characteristic, an output is generated on a display. Other applications are also described.

CORING TOOL

The present invention related to a coring tool for preparing a core or opening through tissue and methods of use thereof. In one embodiment, the present invention include a coring tool including: (a) a frame having proximal and distal directions; (b) an operator interface element mounted to the frame and movable between a rest position and an actuated position; (c) a coring head having at least one cutting blade, the coring head being mounted to the frame for movement in the proximal and distal directions; and (d) a actuation mechanism connected between the coring head and the operator interface element, the actuation mechanism including a selector element having first and second positions, the actuation mechanism being arranged to move the coring head distally responsive to movement of the interface element from the rest position toward the actuated position when the selector element is in the first position, and to move the coring head proximally responsive to movement of the interface element from the rest position toward the actuated position when the selector element is in the second position. 120.-. (canceled)21. A method of actuating a distal coring head of a coring tool , comprising the steps of:applying a force to an operator interface element of the coring tool, the operator interface element biased in a rest position opposite the direction of application of the force such that the force moves the operator interface element to an actuated position, the application of force moving the distal coring head from a first position to a second position;removing the force from the operator interface element to allow the operator interface element to return to the rest position while the distal coring head remains in the second position;toggling a selector mechanism affiliated with the operator interface element;applying the force to the operator interface element a second time to move the distal coring head from the second position to the first position; ...

Methods and apparatus for reducing localized circulatory system pressure

The present invention is thus directed to methods and apparatus for decreasing pressure in a first portion of a vessel of the cardiac structure of a patient by implanting a shunt communicating with an area outside said first portion, whereby a volume of blood sufficient to reduce pressure in said first portion is released.

MINIMALLY INVASIVE SURGICAL APPARATUS AND METHODS

Apparatus and methods are described for performing percutaneous catheter-based interventional surgery. The apparatus comprises first and second devices that are located in adjacent body cavities, such as adjacent blood vessels, the first device being capable of transmitting a directional signal that can be received by the second device. The direction of the signal is correlated with the facility to direct therapy, such that improved accuracy in therapy placement is thereby achieved. Methods for treating patients utilising the means and apparatus are also provided. 148.-. (canceled)49. A system for treating vasculature by forming a fistula , the system comprising: a longitudinal axis;', 'an ultrasound signal transducer mounted at a non-parallel angle relative to the longitudinal axis, the ultrasound signal transducer configured to transmit an ultrasound signal at the non-parallel angle and along a directional path in a cone having position uncertainty less than 5 mm, the ultrasound signal configured to penetrate tissue outside the stenosed artery,', 'an outer sheath,', 'a lumen within the outer sheath,', 'an aperture in the outer sheath, the aperture proximal to the ultrasound signal transducer, the aperture in communication with the lumen, and', 'a needle deployable from inside the lumen to outside the lumen through the aperture and along a deployment path that is aligned with the directional path of the ultrasound signal; and, 'a launching catheter configured to be inserted in a stenosed artery, the launching catheter comprising an omnidirectional ultrasound signal receiving transducer, and', 'a reflecting cone configured to direct the ultrasound signal onto the omnidirectional ultrasound signal receiving transducer, wherein detection of the ultrasound signal by the omnidirectional ultrasound signal receiving transducer indicates that deploying the needle will exit the stenosed artery, traverse tissue between the stenosed artery and the vein, and will enter the ...

ENDOVASCULAR DEVICES AND METHODS

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes providing an intravascular device having a distal portion, inserting the device into the vascular lumen, positioning the distal portion in the vascular wall to at least partially surround the occlusion, and removing at least a portion of the surrounded occlusion from the lumen. 1. A method of treating an occlusion in a vascular lumen defined by a vessel wall , comprising:inserting a guidewire into the vascular lumen and advancing a distal end of the guidewire to a position adjacent the occlusion;advancing a catheter over the guidewire into the vascular lumen to the position adjacent the occlusion, the catheter including a balloon proximate a distal end of the catheter, a guidewire lumen having the guidewire slidably disposed therein, and a device lumen extending to a distal opening;inflating the balloon to an inflated configuration against an intima of the vessel wall at the position adjacent the occlusion;advancing a distal portion of a subintimal device disposed within the device lumen out of the distal opening and through the intima into a subintimal space within the vessel wall.2. The method of claim 1 , further comprising:delaminating tissue layers of the vessel wall adjacent the occlusion.3. The method of claim 2 , wherein delaminating tissue layers of the vessel wall includes infusing a fluid into the subintimal space.4. The method of claim 3 , wherein the fluid is infused directly into the subintimal space from the device lumen.5. The method of claim 3 , wherein the fluid is infused into the subintimal space through the subintimal device.6. The method of claim 2 , wherein delaminating tissue layers of the vessel wall includes expanding the distal portion of the subintimal device from a collapsed configuration to ...

DEVICE AND METHOD FOR CONTROLLING IN-VIVO PRESSURE

A differential pressure regulating device is provided for controlling in-vivo pressure in a body, and in particularly in a heart. The device may include a shunt being positioned between two or more lumens in a body, to enable fluids to flow between the lumens, and an adjustable flow regulation mechanism being configured to selectively cover an opening of the shunt, to regulate the flow of fluid through the shunt in relation to a pressure difference between the body lumens. In some embodiments a control mechanism coupled to the adjustable flow regulation mechanism may be provided, to remotely activate the adjustable flow regulation mechanism. 1. A device for implantation within an atrial septum of a patient's heart to treat a heart condition , the device comprising:a shunt comprising flexible material and configured to transition between a collapsed delivery state and an expanded deployed state, the shunt further configured to engage an opening in the atrial septum in the expanded deployed state and defining a continuous opening in the atrial septum to permit passage of blood through the atrial septum via the shunt, the continuous opening having a cross-sectional area dependent on blood pressure differential across the atrial septum such that blood flow through the shunt changes responsive to change in the blood pressure differential across the atrial septum.2. The device of claim 1 , wherein the shunt is configured to permit passage of blood through the atrial septum to unload an excessive filling pressure of a left ventricle in a patient with congestive heart failure.3. The device of claim 1 , wherein the shunt comprises a flexible metal.4. The device of claim 3 , wherein the flexible metal comprises Nitinol.5. The device of claim 1 , wherein the shunt comprises a shape-memory material.6. The device of claim 1 , wherein the shunt is configured to self-expand from the collapsed delivery state and the expanded deployed state.7. The device of claim 1 , wherein the ...

SYSTEMS AND METHODS FOR PERCUTANEOUS INTRAVASCULAR ACCESS AND GUIDEWIRE PLACEMENT

A device for allowing passage of a guidewire from a primary blood vessel to an adjacent secondary blood vessel includes a main body having a primary lumen and a secondary lumen, and a piercing member disposed in the secondary lumen, and configured to be moved distally out of the secondary lumen, and to pierce through tissue while being distally moved. A third lumen located within the piercing member is configured to allow placement of a guidewire from the primary blood vessel to the adjacent secondary blood vessel. In one embodiment, the secondary lumen is configured to allow articulation of the distal end of the piercing element. The piercing member has a sharp point on one end to facilitate cutting a small communicating aperture from the primary blood vessel to the secondary blood vessel. 1. A device for creating intravascular access and guidewire placement , comprising:a main body having a first lumen;a piercing member disposed in said lumen, and configured to be moved distally out of said lumen and to pierce through tissue while being distally moved;a handle attached to said main body and having an actuator for moving said piercing member;a second lumen within the piercing member; anda guidewire disposed in said second lumen for delivery into a desired site from a distal end of said second lumen.2. The device as recited in claim 1 , wherein the piercing member has a sharp point on one end thereof.3. The device as recited in claim 1 , and further comprising a third lumen within said main body claim 1 , outwardly of the first lumen.4. The device as recited in claim 2 , wherein the piercing member is retractable into the first lumen.5. The device as recited in claim 4 , wherein the third lumen is defined by a needle guide having shape memory properties claim 4 , the needle guide being actuatable to a curved orientation by adjustment of a position of the main body to create an incrementally adjustable radius of curvature on the needle guide.6. The device as recited ...

VENTRICULAR ASSIST DEVICE AND RELATED METHODS

A method and system are provided for percutaneously gaining access to oxygenated blood with one or more anastomosis devices and pumping such oxygenated blood directly to the aorta adjacent to the right atrium or left atrium via a VAD system. In one embodiment, a VAD system can be implanted with open surgery. 1. A system to assist a left ventricle of a heart , the system comprising:an anastomosis device coupled to a septum between two chambers of the heart and providing a flow path between the two chambers;a flow path including at least one conduit and configured to flow oxygenated blood from at least one of the left atrium and the left ventricle, through the anastomosis device, through the superior vena cava and back to an artery;a pumping device coupled with the at least one conduit; anda filament coupled to the anastomosis device, wherein the filament exhibits sufficient length to extend from the anastomosis device through the superior vena cava and to an access point associated with at least one of a jugular vein and a subclavian vein.2. The system of claim 1 , wherein the at least one conduit includes:a first conduit coupled with the anastomosis device and extending through the superior vena cava; anda second conduit extending through one of a brachial artery, a carotid artery, a subclavian artery, and a axillary artery and having an outlet disposed in an aortic artery.3. The system of claim 2 , wherein the pumping device is coupled between the first conduit and the second conduit.4. The system of claim 1 , wherein the pumping device is coupled between the anastomosis device and the at least one conduit.5. The system of claim 1 , wherein the pumping device is coupled directly to the anastomosis device.6. The system of claim 1 , wherein the anastomosis device is shaped and configured to be substantially flush with a left wall of the septum.7. The system of claim 1 , wherein a portion of the anastomosis device protrudes past a left wall of the septum claim 1 , and ...

Automatic quantitative vessel analysis

Apparatus and methods are described including designating within an image of blood vessels of a subject, a target portion of the blood vessels. In response to a first input from a user that designates a single point on the image, a first location within the blood vessels in a vicinity of the designated point is designated. In response to second and third inputs from the user, proximal and distal locations within the target portion are designated. The target portion is designated such that the target portion passes from the proximal location of the target portion to the distal location of the target portion, and such that the target portion includes the first location. Quantitative vessel analysis is performed on the target portion of the blood vessels, and an output is generated based upon the quantitative vessel analysis. Other applications are also described.

Vascular access devices and methods

Vascular access devices and methods of their use are provided. In one embodiment, a vascular access device includes a catheter and at least one deployable wire. The catheter includes a primary lumen extending from a proximal end to a distal end of the catheter. The at least one deployable wire is secured to the catheter and configured to move relative to the catheter between a delivery configuration and a deployed configuration.

DEVICES FOR FLUID FLOW THROUGH BODY PASSAGES

A device includes a first end portion, a second end portion, an intermediate portion between the first end portion and the second end portion, and a graft material coupled to at least the intermediate portion. The first end portion has a first end diameter. The second end portion has a second end diameter larger than the first end diameter. The intermediate portion tapers between the first end portion and the second end portion. A method of diverting fluid flow from a first passage to a second passage comprising deploying the device in a third passage between the first passage and the second passage, expanding the first end portion against sidewalls of the first passage, and expanding the second end portion against sidewalls of the second passage. 1. (canceled)2. A method of diverting fluid flow from a first vessel to a second vessel in a limb , the method comprising:inserting a first catheter in the first vessel;inserting a second catheter in the second vessel;deploying a needle from the first catheter, through tissue between the first vessel and the second vessel, and into the second vessel; and a first end portion having a first end diameter sized to correspond to a diameter of the first vessel,', 'a second end portion having a second end diameter sized to correspond to a diameter of the second vessel, and', 'an intermediate portion between the first end portion and the second end portion,, 'deploying a device in the first vessel, the second vessel, and the tissue between the first vessel and the second vessel, the device comprising expanding the first end portion coaxial with and against sidewalls of the first vessel, wherein expanding the first end portion comprises self-expanding the first end portion,', 'expanding the intermediate portion, wherein expanding the intermediate portion comprises self-expanding the intermediate portion, and', 'expanding the second end portion coaxial with and against sidewalls of the second vessel, wherein expanding the second end ...

DEVICES AND METHODS FOR FORMING VASCULAR ACCESS

The invention generally relates to catheter systems and methods for guided formation of vascular access sites (such as fistulas and grafts). According to certain aspects, a catheter system for forming a vascular access site include an elongate body comprising a distal end and configured to be inserted into a first vessel. The elongate body includes an exit port along its side that is proximal to the distal end. An imaging assembly is associated with the elongate body and configured to generate image data of the first vessel and a second vessel positioned next to the first vessel. For vascular access formation, a penetrating member of the catheter system extends out of the exit port and through a wall of the first vessel and a wall of the second vessel. 1. A catheter system for forming a vascular access site through a wall of the first vessel and a wall of the second vessel , the catheter system comprising:an elongate body comprising a distal end and an exit port adjacent the distal end of the elongate body;an imaging assembly associated with the elongate body and configured to generate image data of the first vessel and the second vessel;a needle configured to extend out of the exit port of the elongate body and through the wall of the first vessel and the wall of the second vessel, wherein the needle comprises a distal tip, an opening at the distal tip and an interior lumen extending from the distal tip; anda cauterizing element capable of extending through the opening of the distal tip of the needle.2. The catheter system of claim 1 , wherein the cauterizing element is capable of extending through the opening of the distal tip of the needle while the needle is extending out of the exit port of the elongate body.3. The catheter system of further comprising a guidewire configured to extend out of the opening of the needle.4. The catheter system of further comprising an anastomotic device configured to be inserted over the guidewire and into a fistula.5. The catheter ...

Apparatus and method for targeting a body tissue

An apparatus for targeting a desired target site on a body tissue that separates a first body cavity from a second body cavity of a patient includes a catheter having a longitudinally extending catheter lumen and adapted to provide access to the first body cavity. A framing member has a collapsed condition in which the framing member is adapted for insertion into the first body cavity through the catheter lumen and an expanded condition in which the framing member is adapted for placement within the first body cavity. The framing member has a framing member body. At least one target point is carried by the framing member and is adapted for placement adjacent the desired target site. At least one target pathway is attached to at least one target point. At least a portion of the target pathway extends through the catheter lumen. The target pathway is substantially spaced apart from the framing member body. A method of using the apparatus is also described.

ENDOVASCULAR DEVICES AND METHODS FOR EXPLOITING INTRAMURAL SPACE

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes providing a first intravascular device having a distal portion with a concave side, inserting the first device into the vascular lumen, positioning the distal portion in the vascular wall, and orienting the concave side of the distal portion toward the vascular lumen. 1. A method of facilitating treatment via a vascular wall defining a vascular lumen , comprising:advancing an intravascular device into the vascular lumen, the intravascular device comprising an elongate shaft having a bulbous distal tip and a lumen extending through the elongate shaft to the bulbous distal tip;positioning a distal portion of the elongate shaft within a subintimal space of the vascular wall; andorienting the distal portion of the elongate shaft within the subintimal space such that a re-entry device advanced through the lumen is directed toward the vascular lumen.2. The method of claim 1 , wherein orienting the distal portion of the elongate shaft is done without visualization of the distal portion of the elongate shaft within the subintimal space.3. The method of claim 1 , wherein the intravascular device further comprises an actuation member extending through the elongate shaft to the bulbous distal tip.4. The method of claim 3 , wherein orienting the distal portion of the elongate shaft includes pulling the actuation member proximally to bend the distal portion of the elongate shaft.5. The method of claim 4 , wherein after pulling the actuation member claim 4 , the distal portion of the elongate shaft forms a compound bend.6. The method of claim 4 , wherein the elongate shaft includes one or more open areas oriented along the actuation member.7. The method of claim 6 , wherein the elongate shaft defines a single row of open areas.8. The ...

INTRA-ATRIAL IMPLANTS HAVING VARIABLE THICKNESSES TO ACCOMODATE VARIABLE THICKNESS IN SEPTUM

The invention is a septal implant that can accommodate variable thicknesses of the patient's atrial septum as well the variable thicknesses of septums across a population. The invention is able to accomplish this result by having flexible annular flanges that define a gap into which the septum fits. Due to the flexible nature of the annular flanges, the gap is adjustable. 2. The device of wherein the annular gap is has a width less than a thickness of the septum when the device is undeployed.3. The device of wherein the annular gap has a width greater than a thickness of the septum when the device is undeployed.4. The device of wherein at least one of the first annular flange and the second annular flange is more flexible than the core segment.5. The device of wherein at least one of the first annular flange and the second annular flange comprises a plurality of flange segments.6. The device of wherein at least one of the plurality of flange segments is longer than another one of the flange segments.7. The device of claim 5 , wherein at least one of said plurality of flange segments comprises a radiopaque marker.8. The device of wherein the device is self-expandable upon deployment.9. The device of wherein the device is balloon-expandable.10. The device of wherein the core segment comprises a substantially open mesh.11. The device of wherein the core segment is comprised of a nonbraided material.12. The device of further comprising a flow control element having two sides and attached to said core segment.13. The device of claim 12 , wherein said flow control element opens upon an occurrence of a pressure differential between said two sides of said flow control element.14. The device of wherein said flow control element allows fluid to flow through said passage from an area of higher pressure to an area of lower pressure.15. The device of claim 14 , wherein said pressure differential is at least 2 mm Hg.16. The device of claim 12 , wherein said flow control element ...

CROSSING OCCLUSIONS IN BLOOD VESSELS

The present disclosure is directed a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method may include providing a first intravascular device having a distal portion and at least one aperture and positioning the distal portion of the first intravascular device in the vascular wall. The method may further include providing a reentry device having a body and a distal tip, the distal tip having a natural state and a compressed state and inserting the distal tip, in the compressed state, in the distal portion of the first intravascular device. The method may further include advancing the distal tip, in the natural state, through the at least one aperture of the first intravascular device. 1. A method of crossing an occlusion in a true lumen of a blood vessel via a vascular wall , comprising:advancing an orienting device into a subintimal space of the vascular wall until a distal end of the orienting device is positioned distal of the occlusion, the orienting device including a shaft having a wall defining a lumen having a longitudinal axis, a first aperture through the wall in communication with the lumen, and a second aperture through the wall in communication with the lumen;wherein the first aperture opens in a first direction away from the longitudinal axis of the lumen of the orienting device, and the second aperture opens in a second direction away from the longitudinal axis of the lumen of the orienting device;advancing a re-entry device through the lumen of the orienting device to a position adjacent the first aperture; andadvancing a distal end of the re-entry device out the first aperture until the distal end of the re-entry device is positioned within the true lumen.2. The method of claim 1 , further comprising:observing, via fluoroscopy, a position of the distal end of the re-entry device relative to the first aperture and the second aperture;confirming that the first aperture is facing the ...

APICAL CONNECTORS AND INSTRUMENTS FOR USE IN HEART WALL

The present disclosure provides an apical connector for use in a heart wall. The apical connector may include a port defining an aperture therethrough, an anchoring device extending distally from the port and configured for advancing at least partially through the heart wall, and a cannula configured for advancing through the aperture of the port and at least partially through the heart wall. The cannula may include a locking tab configured to engage the port and lock the cannula with respect to the port. 1. An instrument for coring a hole in a heart wall and attaching a cannula to a port of an apical connector , the instrument comprising:a handle;a shaft attached to the handle and extending distally therefrom;a coring anchor attached to the shaft and extending distally therefrom;a coring sleeve movably positioned over at least a portion of the shaft;a coring tube attached to the coring sleeve and extending distally therefrom;an attachment sleeve movably positioned over at least a portion of the coring sleeve; anda cannula interface attached to the attachment sleeve and extending distally therefrom.2. The instrument of claim 1 , wherein the coring anchor comprises a coil configured for advancing at least partially through the heart wall.3. The instrument of claim 1 , wherein the shaft is rigidly attached to the handle claim 1 , wherein the coring anchor is rigidly attached to the shaft claim 1 , wherein the coring tube is rigidly attached to the coring sleeve claim 1 , and wherein the cannula interface is rigidly attached to the attachment sleeve.4. The instrument of claim 1 , wherein the instrument is adjustable between a first configuration and a second configuration claim 1 , wherein the coring sleeve and the attachment sleeve are configured to rotate with the handle when the instrument is in the first configuration claim 1 , and wherein the coring sleeve and the attachment sleeve are configured to rotate relative to the handle when the instrument is in the ...

DEVICE AND METHOD FOR CONTROLLING IN-VIVO PRESSURE

A differential pressure regulating device is provided for controlling in-vivo pressure in a body, and in particularly in a heart. The device may include a shunt being positioned between two or more lumens in a body, to enable fluids to flow between the lumens, and an adjustable flow regulation mechanism being configured to selectively cover an opening of the shunt, to regulate the flow of fluid through the shunt in relation to a pressure difference between the body lumens. In some embodiments a control mechanism coupled to the adjustable flow regulation mechanism may be provided, to remotely activate the adjustable flow regulation mechanism. 1. A method for treating a heart condition , the method comprising:positioning a distal region of a sheath through a puncture of an atrial septum;exposing a first section of a shunt out of the sheath to transition the first section from a contracted delivery state to an expanded deployed state within a first atrium;retracting the shunt and the sheath towards the atrial septum until the first section of the shunt in the expanded deployed state becomes seated against the atrial septum;further retracting the sheath until a second section of the shunt is exposed from the sheath and transitions from a contracted delivery state to an expanded deployed state within a second atrium to thereby implant the shunt; andshunting blood via a passageway in the shunt between the first atrium and the second atrium.2. The method of claim 1 , wherein retracting the shunt and the sheath comprises retracting the shunt and the sheath towards the atrial septum until the first section of the shunt in the expanded deployed state becomes seated against the atrial septum as apparent by tactile feedback.3. The method of claim 1 , wherein retracting the shunt and the sheath comprises retracting the shunt and the sheath towards the atrial septum until the first section of the shunt in the expanded deployed state becomes seated against the atrial septum as ...

METHODS AND SYSTEMS FOR BYPASSING OCCLUSIONS IN A FEMORAL ARTERY

A system for deploying a stent-graft from the femoral artery into the femoral vein and back into the femoral artery in order to bypass a femoral occlusion comprises a penetration catheter and a guidewire capture and stabilization catheter. The penetration catheter may be advanced contralaterally to a location above the occlusion and the capture and stabilization catheter may be introduced upwardly through the femoral vein. The penetration tool on the penetration catheter is used in multiple steps to deploy guidewires which are then used to deploy the stent-graft in the desired location. 1. A system for placing a stent graft between a femoral artery and a femoral vein , said system comprising:a penetration catheter which carries a penetration tool adapted to penetrate and advance a guidewire between the peripheral artery and the peripheral vein;a guidewire capture and stabilization catheter adapted to (1) capture a guidewire advanced by the penetration catheter from the peripheral artery to the peripheral vein and (2) align the penetration catheter within the peripheral vein while the penetration tool penetrates and advances a guidewire into the peripheral artery.2. A system as in claim 1 , wherein the penetration catheter comprises:a shaft having a proximal end, a distal end, a guidewire lumen, and a penetration tool lumen;wherein the penetration tool is reciprocatably disposed in the penetration tool lumen and a distal end of the penetration tool deflects laterally as the tool is advanced distally.3. A system as in claim 2 , wherein the penetration tool has a guidewire lumen in addition to the guidewire lumen in the shaft claim 2 , wherein the tool guidewire lumen allows placement of a guidewire through a penetration formed by the tool.4. A system as in claim 2 , wherein the penetration catheter further comprises a stabilizing element near the distal end of the shaft.5. A system as in claim 4 , wherein the stabilizing element comprises a balloon claim 4 , an ...

APPARATUSES AND METHODS FOR USE IN SURGICAL VASCULAR ANASTOMOTIC PROCEDURES

Apparatuses and methods for use in surgical vascular anastomotic procedures. Apparatus includes a blood vessel inner wall (BVIW) sealing and hole forming device, and a hole forming actuator. BVIW sealing and hole forming device includes a hole sealing device, and an anastomotic hole generating device. Hole sealing device includes a sheath that fully encloses and holds a self-expanding hole sealing assembly, a manual hole sealing controller assembly, and a flexible control wire enclosed within a flexible tube. Anastomotic hole generating device includes outer and inner assemblies, with a conically shaped anastomotic hole generating member. Hole forming actuator includes outer and inner assemblies. Also disclosed are procedures for performing surgical vascular anastomosis using the disclosed apparatuses and methods. Particularly applicable for use in clampless types of (end-to-side) surgical vascular anastomotic procedures, for performing coronary artery bypass grafting (CABG). 1. An apparatus for use in surgical vascular anastomotic procedures , the apparatus comprising:a blood vessel inner wall sealing and hole forming device, configured to atraumatically establish and maintain, inside a blood vessel lumen, along an inner wall segment thereof, a peripheral seal around a needle sized hole in said blood vessel inner wall segment, absent of blood flow, and to form an anastomotic hole through said peripherally sealed blood vessel inner wall segment, in said blood flow absence;anda hole forming actuator, reversibly connectable to, and configured for operating, said blood vessel inner wall sealing and hole forming device.2. The apparatus of claim 1 , wherein said blood vessel inner wall sealing and hole forming device includes a hole sealing device claim 1 , configured to atraumatically establish said peripheral seal claim 1 , and comprising:a hole sealing assembly, having a reversibly expandable non-activated, collapsed configuration and a reversibly collapsible ...

Intra-atrial implants to directionally shunt blood

Several unique intracardiac pressure vents, placement catheters, methods of placement and methods of treating heart failure are presented. The intracardiac pressure vents presented allow sufficient flow from the left atrium to the right atrium to relieve elevated left atrial pressure and resulting patient symptoms but also limit the amount of flow from the right atrium to the left atrium to minimize the potential for thrombus or other embolic material from entering the arterial circulation.

MEDICAL DEVICE AND TREATMENT METHOD

A medical device is disclosed, which is capable of preventing a maintenance treatment element imparting energy to biological tissue from being displaced from a treatment target site and a treatment method performed on a heart failure patient. A medical device is disclosed, which includes a shaft portion, an expandable and contractible expansion body provided on a distal side of the shaft portion, and a maintenance treatment element disposed in the expansion body and imparting energy to biological tissue. The expansion body includes a concave portion recessed in a direction intersecting with an axial direction of the shaft portion. The maintenance treatment element is disposed in the concave portion. 1. A medical device comprising:a shaft portion;an expandable and contractible expansion body disposed distal of the shaft portion, the expansion body including a plurality of linear expansion portions disposed at different positions in a circumferential direction of the shaft portion, each of the plurality of linear expansion portions including a concave portion recessed in a direction intersecting with an axial direction of the shaft portion; anda maintenance treatment element disposed in each of the linear expansion portions and performing a predetermined maintenance treatment on biological tissue, and wherein the maintenance treatment element is disposed in the concave portion.2. The medical device according to claim 1 , wherein the expansion body includes a circulation portion allowing blood flow via a through-hole formed in an atrial septum of a patient in a state where the concave portion is disposed in the through-hole.3. The medical device according to claim 1 , wherein each of the plurality of linear expansion portions of the expansion body comprises a linear member being shaped in advance to form the concave portion when expanded to deform.4. The medical device according to claim 1 , wherein the concave portion of each of the plurality of linear expansion ...

INTRA-ATRIAL IMPLANTS MADE OF NON-BRAIDED MATERIAL

Several unique intra-cardiac pressure devices, placement catheters, methods of placement and methods of treating heart failure are presented. The intra-cardiac pressure devices presented allow sufficient flow from the left atrium to the right atrium to enable the relief of elevated left atrial pressure and resulting patient symptoms. The intra-cardiac pressure devices are made of a non-braided material. 1. A device for implanting in an opening is a septal wall in a heart of a patient , the device comprising:a. a core segment defining a passage, the core segment having a first diameter when deployed;b. a first annular flange contiguous with the core segment; andc. a second annular flange contiguous with the core segment,wherein the device is collapsible, enabling the core segment to have a second diameter less than the first diameter thereby enabling percutaneous delivery of the device to the heart of the patient, andwherein the core segment comprises a non-braided substantially open mesh.2. The device of wherein at least one of the first annular flange and the second annular flange is more flexible than the core segment.3. The device of wherein at least one of the first annular flange and the second annular flange comprises a plurality of flange segments.4. The device of wherein at least one of the plurality of flange segments is longer than another one of the flange segments.5. The device of claim 3 , wherein at least one of said plurality of flange segments comprises a radiopaque marker.6. The device of wherein the device is self-expandable upon deployment.7. The device of wherein the device is balloon-expandable.8. The device of wherein the flanges define a gap to accommodate the septal wall.9. The device of wherein the gap is variable claim 8 , thereby enabling the accommodation of variable septal thicknesses.10. The device of further comprising a flow control element having two sides and attached to said core segment.11. The device of claim 10 , wherein said ...

ENDOVASCULAR DEVICES AND METHODS FOR EXPLOITING INTRAMURAL SPACE

Devices and methods for exploiting intramural (e.g., subintimal) space of a vascular wall to facilitate the treatment of vascular disease, particularly total occlusions. For example, the devices and methods disclosed herein may be used to visually define the vessel wall boundary, protect the vessel wall boundary from perforation, bypass an occlusion, and/or remove an occlusion. 1. An orienting device for exploiting intramural space , comprising:an elongate shaft having a distal end region and a lumen extending therethrough;an orienting element disposed at the distal end region of the elongate shaft, the orienting element including an expandable structure configured to expand from a first configuration to a second configuration;a deflectable distal tip disposed distal of the orienting element, the deflectable distal tip having a distal opening in communication with the lumen of the elongate shaft; anda tension member secured to the bi-deflectable distal tip and extending proximally through the elongate shaft, wherein manipulation of the tension member causes the deflectable distal tip to deflect the distal opening.2. The orienting device of claim 1 , wherein the elongate shaft includes an articulation zone located between the deflectable distal tip and the orienting element.3. The orienting device of claim 2 , wherein the articulation zone includes a plurality of slots.4. The orienting device of claim 1 , wherein the elongate shaft includes an outer tubular member and an inner tubular member extending axially through the outer tubular member.5. The orienting device of claim 4 , wherein the tension member extending along the elongate shaft between the inner tubular member and the outer tubular member.6. An orienting device for exploiting intramural space claim 4 , comprising:an elongate shaft comprising an outer tubular layer and an inner tubular layer extending axially through the outer tubular layer, the inner tubular layer defining a lumen extending therethrough;an ...

Coring device and coring and insertion assembly comprising such a device

A coring device, for forming an opening in a tissue wall, includes a body having a proximal end, a distal end and an internal housing, a coring head having a transection blade and being movable between a rest position and an actuated position, an actuation mechanism for moving the head between the positions and having an actuation rod, at one end of which the head is placed, a lumen extending through at least the proximal end of the body, actuation rod and coring head in order to allow passage of a flexible guide element, and the distal end of the body forms a support for a surgical tool configured to receive a hollow surgical tool with a positive fit and to support this tool to permit linear guiding of the surgical tool during the movement of the latter toward the outside of the coring device.

Blood Oxygenation Treatment Methods And Devices

Methods and devices for increasing oxygenation levels in the blood supply and thereby treating the condition of hypoxemia. Multiple approaches such as pressure reduction in the pulmonary circulatory system, reducing triggering mechanisms in the main pulmonary artery and restricting flow in the pulmonary circulatory system are disclosed. Interventions associated with those approaches can including shunting, restrictors, compliance devices, pharmacologic substances, etc. 1. A method of treating hypoxemia in a patient comprising:conducting oxygen measurements of a patient's blood to establish a baseline oxygen measurement for said patient;intervening invasively in the native oxygenation process of said patient so as to increase the oxygen present in said patient's blood;conducting post-intervention oxygen measurement of said patient's blood after said intervention;comparing said post-intervention oxygen measurement with said baseline oxygen measurement to evaluate the efficacy of the intervention.2. A method according to claim 1 , wherein the intervening comprises at least one of the following intervention approaches:pressure reduction in the pulmonary circulation;reduction in the trigger pressure signal of the pulmonary artery; and,restriction of flow in the pulmonary system.3. A method according to claim 2 , wherein said intervening includes at least one of the following interventions:shunting of said pulmonary circulation;denervation of said trigger pressure signal of the pulmonary artery;restricting flow in one or more blood vessels of said pulmonary system;introducing compliance into said pulmonary circulation;introducing pharmacology substances to said patient;electrically stimulating the cardiac system of said patient; and,draining the lymphatic system.4. A method according to claim 3 , wherein shunting of said pulmonary circulation comprises right-to-right shunting of blood vessels in said pulmonary system.5. A method according to claim 4 , wherein said right- ...

Devices and methods for coronary sinus pressure relief

A method and devices for relieving pressure in the left atrium of a patient's heart is disclosed. The method includes using an ablative catheter in a minimally invasive procedure to prepare an opening from the coronary sinus into a left atrium of the patient's heart. Once the opening is prepared, the opening may be enlarged by a technique such as expanding a balloon within the opening. A stent is then placed within the coronary sinus of the patient, with a transverse portion expanding within the opening, allowing blood to flow from the left atrium to the coronary sinus and then to the right atrium. Pressure within the left atrium is thus relieved..

CORING DILATOR FOR DEFINING AN APERTURE IN A TISSUE WALL

A coring tool and a dilator for defining an aperture in a tissue is presented. The system is preferably configured for generating an aperture within a ventricular wall for a method of implantation of ventricular assist devices (VAD's). The insertion tool/system includes a conduit device including a detachable dilator-coring tool and cuff which secures within a defined aperture in the tissue. 1. An apparatus for defining an aperture in a tissue wall , comprising:a dilator having a tapered distal tip for piercing tissue in said tissue wall; anda cuff having a central aperture for receiving the cuff over the dilator;wherein in an assembled configuration, the cuff is configured to seat on the dilator at a location proximal to the distal end;wherein the cuff and dilator in the assembled configuration are configured to be inserted into the tissue by introducing the distal end of the dilator into the tissue and advancing the distal end of the dilator to dilate the tissue until the cuff is seated within the tissue wall; andwherein the dilator is configured to be retracted from the cuff such that the cuff remains in the tissue wall to form a port via the central aperture of the cuff.2. An apparatus as recited in :wherein the distal end of the dilator has one or more threads at said distal end; andwherein the one or more threads are configured for engaging the tissue and advancing the dilator into the tissue upon rotation of the dilator.3. An apparatus as recited in :wherein the cuff comprises one or more threads matching the one or more threads of the dilator; andwherein the one of more cuff threads are configured to further advance the cuff into the tissue upon rotation of the dilator.4. An apparatus as recited in claim 1 , wherein the dilator comprises a central through-hole for guiding the dilator over a guide-wire.5. An apparatus as recited in claim 1 , the cuff further comprising a collapsible sleeve for closing the central aperture upon removal of the dilator claim 1 , ...

CONDUIT DEVICE AND SYSTEM FOR IMPLANTING A CONDUIT DEVICE IN A TISSUE WALL

Various embodiments of the present invention provide a conduit device including an attaching device configured for defining a helical pathway through a tissue wall and complementary ring in cooperation for securing the device within an aperture defined in the tissue wall. Some embodiments of the present invention further provide a system for implanting a conduit device in a tissue wall. More specifically, some embodiments provide a system including a coring device for defining an aperture in a tissue by removing and retaining a tissue core and securely implanting a conduit device therein so as to provide fluid communication between a first and second surface of the tissue wall via the conduit device. 1. A coring device comprising:a coring cylinder configured for advancing through a tissue wall to define an aperture in the tissue wall by removing a tissue core from the tissue wall, the coring cylinder defining a coring bore extending along a longitudinal axis of the coring device and configured for receiving the tissue core therein; anda retrieval device configured for piercing the tissue wall, the retrieval device comprising a corkscrew configured for retaining the tissue core.2. The coring device of claim 1 , wherein the coring cylinder and the retrieval device are movable relative to one another in a direction of the longitudinal axis of the coring device.3. The coring device of claim 1 , wherein a longitudinal axis of the coring cylinder and a longitudinal axis of the retrieval device are coaxial with one another.4. The coring device of claim 3 , wherein the longitudinal axis of the coring cylinder and the longitudinal axis of the retrieval device are coaxial with the longitudinal axis of the coring device.5. The coring device of claim 1 , wherein the retrieval device is configured for piercing the tissue wall prior to removal of the tissue core from the tissue wall.6. The coring device of claim 1 , further comprising a handle engaged with the coring cylinder.7. ...

Method, apparatus and catheter for positioning terminal end of pacemaker lead, which has passed through coronary sinus, in interventricular septum

The present invention relates to a method for positioning a tip of a pacemaker lead that has passed through coronary sinus into an interventricular septum. More particularly, it relates to a method for positioning a tip of a pacemaker lead that has passed through a coronary sinus into an interventricular septum in order to more effectively transmit an electrical stimulus in a treatment using a pacemaker for patients with arrhythmia. A method of positioning a tip of a pacemaker lead, which has passed through a coronary sinus, into an interventricular septum, in order to effectively transmit electrical stimulus, includes: inserting into an intervention wire through a superior vena cava and a coronary sinus to pass through the interventricular septum and then guiding the intervention wire to an inferior vena cava; and positioning the tip of the lead into the interventricular septum by inserting the pacemaker lead along the intervention wire.

Systems and methods for treating hydrocephalus

Systems and methods for implanting an endovascular shunt in a patient is disclosed. The system having an expandable anchor configured for being deployed in a dural venous sinus of a patient at a location distal to a curved portion of a wall of an inferior petrosal sinus (IPS) of the patient; an elongate guide member coupled to, and extending proximally from, the anchor; a shunt delivery catheter having a first lumen configured to receive the guide member, and a second lumen extending between respective proximal and distal openings in the shunt delivery catheter, the shunt delivery catheter further having a penetrating element coupled to a distal end of the catheter; and the system further having a guard at least partially disposed over, and movable relative to, the penetrating element.

Devices, systems, and methods for reshaping a heart valve anulus, including the use of a bridge implant having an adjustable bridge stop

Implants or systems of implants and methods apply a selected force vector or a selected combination of force vectors within or across the left atrium, which allow mitral valve leaflets to better coapt. The implants or systems of implants and methods make possible rapid deployment, facile endovascular delivery, and full intra-atrial adjustability and retrievability years after implant. The implants or systems of implants and methods also make use of strong fluoroscopic landmarks. The implants or systems of implants and methods make use of an adjustable implant and a fixed length implant. The implants or systems of implants and methods may also utilise an adjustable bridge stop to secure the implant, and the methods of implantation employ various tools.

APPARATUS FOR ORIENTATION DISPLAY AND ALIGNMENT IN PERCUTANEOUS DEVICES

Aspects of the present invention relate to an apparatus for determining alignment between a source device and a target device. The apparatus comprises the source device, the target device, and a processing system. The source device comprises a first spatially variant field generator for generating a first spatially variant electric field, and a second spatially variant field generator for generating a second spatially variant electric field, wherein the second spatially variant electric field is angularly offset with respect to the first spatially variant electric field. The target device comprises at least one sensor configured to detect a first signal from the first spatially variant electric field and a second signal from the second spatially variant electric field. The processing system is configured to determine alignment between the first source device and the target device based on the first and second signals from the first and second spatially variant electric fields by the target device. The inventions further relate to the method of use of the apparatus and the processing system of the apparatus. 1. An apparatus for determining alignment between a source device and a target device , the apparatus comprising the source device , the target device , and a processing system , the source device comprising a first spatially variant field generator for generating a first spatially variant electric field , and a second spatially variant field generator for generating a second spatially variant electric field , wherein the second spatially variant electric field is angularly offset with respect to the first spatially variant electric field , the target device comprising at least one sensor configured to detect a first signal from the first spatially variant electric field and a second signal from the second spatially variant electric field , wherein the processing system determines alignment between the first source device and the target device based on the first ...

Systems and methods for creating a puncture between aorta and the left atrium

A method of puncturing from an aorta into a left atrium using a puncturing device. The method involves a step of accessing a carotid artery and advancing a puncturing device through the carotid artery into an aorta. Advancing a sheath and a dilator over the puncturing device through the carotid artery and into the aorta such that a puncturing tip of the puncturing device is aligned with a distal tip of the sheath and a distal tip of the dilator, forming a puncturing assembly. Positioning the puncturing assembly at a target site within the aorta to gain access to a left atrium of a heart. Tenting a tissue between the aorta and the left atrium using the puncturing assembly. Creating a puncture through the tissue by advancing the puncturing device such that a channel between the aorta and the left atrium is formed. 1. A method of puncturing from an aorta into a left atrium using a puncturing device , the method comprising the steps of:a. accessing a carotid artery and advancing a puncturing device through the carotid artery into an aorta;b. advancing a sheath and a dilator over the puncturing device through the carotid artery and into the aorta such that a puncturing tip of the puncturing device is aligned with a distal tip of the sheath and a distal tip of the dilator, forming a puncturing assembly;c. positioning the puncturing assembly at a target site within the aorta to gain access to a left atrium of a heart;d. tenting a tissue between the aorta and the left atrium using the puncturing assembly; and,e. creating a puncture through the tissue by advancing the puncturing device such that a channel between the aorta and the left atrium is formed.2. The method of claim 1 , wherein the puncturing device is a radiofrequency puncture device claim 1 , the puncturing tip comprises an electrode to deliver radiofrequency energy claim 1 , and step e. comprises delivering radiofrequency energy from the electrode while advancing the puncturing tip.3. The method of claim 1 , ...

Percutaneous system, devices and methods

A percutaneous system, method and related devices are provided. More particularly, a percutaneous system comprises one or more of an intracorporeal connector for fluid communication between two anatomical compartments, through an anatomical wall, an intracorporeal device for regulating the flow of fluid between the two anatomical compartments, and a percutaneous insertion device.

Device and method for controlling in-vivo pressure

A differential pressure regulating device is provided for controlling in-vivo pressure in body, and in particularly in a heart. The device may include a shunt being positioned between two or more lumens in a body, to enable fluids to flow between the lumens, and an adjustable flow regulation mechanism being configured to selectively cover an opening of the shunt, to regulate the flow of fluid through the shunt in relation to a pressure difference between the body lumens. In some embodiments a control mechanism coupled to the adjustable flow regulation mechanism may be provided, to remotely activate the adjustable flow regulation mechanism.

DEVICES AND METHODS FOR THE TREATMENT OF HEART FAILURE

A device for treating heart failure in a patient. The device comprising a body, at least one passage through the body, at least one one way valve in the passage and a mounting means adapted for mounting the body in an opening provided in the patient's atrial septum. In use, the device is oriented such that, when the patient's left atrial pressure exceeds the patient's right atrial pressure by a predetermined amount, the one way valve(s) opens to allow blood flow through the passage(s) from the left atrium to the right atrium to thereby reduce the left atrial pressure. 1a body;at least one passage through the body;at least one one way valve in the passage; anda mounting means adapted for mounting the body in an opening provided in the patient's atrial septum,wherein, in us; the device is oriented such that, when the patient's left atrial pressure exceeds the patient's right atrial pressure by a predetermined amount, the one way valve(s) opens to allow blood flow through the passage(s) from the left atrium to the right atrium to thereby reduce the left atrial pressure.. A device for treating heart failure in a patient, the device comprising: This application is a continuation of pending U.S. application Ser. No. 12/447,617, filed Apr. 28, 2009, which is the national phase filing of International Application No. PCT/AU2007/001704, filed Nov. 7, 2007, which application claims priority to Australian Application No. 2006906202, filed Nov. 7, 2006, each of which is herein incorporated by reference in its entirety.The present invention relates generally to devices and methods for the treatment of heart failure and, more particularly, to devices and methods for the relief of high pressure in the cardiovascular system to alleviate symptoms of cardiovascular disease.Heart failure is a common and potentially lethal condition affecting humans, with sub-optimal clinical outcomes often resulting in symptoms, morbidity and/or mortality, despite maximal medical treatment. In ...

Systems and methods for treating hydrocephalus

Systems and methods for implanting an endovascular shunt in a patient is disclosed. The system having an expandable anchor configured for being deployed in a dural venous sinus of a patient at a location distal to a curved portion of a wall of an inferior petrosal sinus (IPS) of the patient; an elongate guide member coupled to, and extending proximally from, the anchor; a shunt delivery catheter having a first lumen configured to receive the guide member, and a second lumen extending between respective proximal and distal openings in the shunt delivery catheter, the shunt delivery catheter further having a penetrating element coupled to a distal end of the catheter; and the system further having a guard at least partially disposed over, and movable relative to, the penetrating element.

INTERATRIAL SHUNTS HAVING BIODEGRADABLE MATERIAL, AND METHODS OF MAKING AND USING SAME

A device for regulating blood pressure between a patient's left atrium and right atrium comprises an hourglass-shaped stent comprising a neck region and first and second flared end regions, the neck region disposed between the first and second end regions and configured to engage the fossa ovalis of the patient's atrial septum, and a drug-eluting biodegradable material that biodegrades over time to release a drug that limits tissue overgrowth. The inventive device also may include a biodegradable material that biodegrades to offset flow changes caused by tissue overgrowth. The inventive device may reduce left atrial pressure and left ventricular end diastolic pressure, and may increase cardiac output, increase ejection fraction, relieve pulmonary congestion, and lower pulmonary artery pressure, among other benefits. 1. A device for regulating blood pressure between a patient's left atrium and right atrium to treat a cardiovascular condition , the device comprising:a stent comprising a first flared end region, a second flared end region, a neck region disposed between the first and second flared end regions and configured to engage a fossa ovalis of the patient's atrial septum, and a passageway extending from an inlet of the first flared end region through the neck region and out an outlet of the second flared end region, the stent configured to shunt blood between the left atrium and the right atrium;a biocompatible material disposed on the stent to define a continuous sheath that channels blood flow through the passageway; anda biodegradable material disposed on the device adjacent to the inlet of the first flared end region or the outlet of the second flared end region or both, the biodegradable material configured to inhibit tissue overgrowth across the biodegradable material and into the passageway of the stent.2. The device of claim 1 , wherein the stent comprises a plurality of rings interconnected by a plurality of longitudinally extending struts.3. The ...

System and method for attaching a fluid conduit to an anatomical structure

A system and method for end-to-side anastomosis to an anatomical passageway is disclosed. The system and method are particularly useful in coupling an LVAD pump to an aorta. The system and method include using a tubular graft member having a skirt flange that engages the side of the aorta, a seating assembly and a flanged stent for securing the tubular graft to the side of the anatomical passageway. An assembly for creating an opening in the side of the anatomical passageway and an assembly for delivering the tubular graft is also disclosed.

CONDUIT DEVICE AND SYSTEM FOR IMPLANTING A CONDUIT DEVICE IN A TISSUE WALL

Various embodiments of the present invention provide a conduit device including an attaching device configured for defining a helical pathway through a tissue wall and complementary ring in cooperation for securing the device within an aperture defined in the tissue wall. Some embodiments of the present invention further provide a system for implanting a conduit device in a tissue wall. More specifically, some embodiments provide a system including a coring device for defining an aperture in a tissue by removing and retaining a tissue core and securely implanting a conduit device therein so as to provide fluid communication between a first and second surface of the tissue wall via the conduit device. 144-. (canceled)45. A method for establishing fluid communication between a first surface and a second surface of a tissue wall , the method comprising:engaging the tissue wall with a conduit device such that a substantially fluid-tight seal is established between the conduit device and the tissue wall, the conduit device comprising an outer tube; andadvancing a coring device through the outer tube of the conduit device and through the tissue wall to core an aperture in the tissue wall extending from the first surface to the second surface of the tissue wall while maintaining the substantially fluid-tight seal between the conduit device and the tissue wall.46. The method of claim 45 , wherein the substantially fluid-tight seal is established between the outer tube of the conduit device and the tissue wall.47. The method of claim 45 , wherein the substantially fluid-tight seal is established between a distal end of the outer tube of the conduit device and the tissue wall.48. The method of claim 45 , wherein the outer tube of the conduit device is formed of a substantially rigid material.49. The method of claim 45 , wherein the conduit device further comprises a ring positioned about the outer tube claim 45 , and wherein the substantially fluid-tight seal is established ...

VEIN HARVESTING SYSTEM AND METHOD

A tissue illumination system and a method for harvesting a section of a blood vessel from a patient's body for further use. The tissue illumination system includes a light catheter inserted into a lumen of the blood vessel section to illuminate the vessel section and vessel side branches with an intensity which is visible to the physician from an exterior of the vessel section and also includes a viewing element insertable into the lumen and capable of viewing the illuminated vessel section. The tissue illumination system also includes at least one tool insertable into the lumen and used to harvest the vessel section. 1. A method of harvesting tissue from a human or animal body for use in coronary bypass surgery , the method comprising:inserting a light catheter into an interior region of a blood vessel and illuminating the blood vessel with the light catheter;positioning an elongate tool towards a side of the blood vessel, the elongate tool having a curved structure located at a distal end thereof capable of surrounding all or portions of the blood vessel;advancing the elongate tool to encounter side branches; andcutting the side branches.2. The method of claim 1 , wherein the side branches are of the blood vessel.3. The method of claim 1 , wherein the blood vessel is a vein.4. The method of claim 1 , wherein the blood vessel is an artery.5. The method of claim 1 , further comprising:viewing the vessel during the step of advancing the elongate tool.6. The method of claim 1 , further comprising:creating a working space adjacent the blood vessel.7. The method of claim 1 , wherein a dissection area adjacent the blood vessel is illuminated by the light catheter.8. The method of claim 1 , further comprising:harvesting the blood vessel.9. The method of claim 1 , wherein the elongate tool is adjustable in length.10. The method of claim 1 , wherein the elongate tool further comprises a cutting element.11. The method of claim 1 , wherein the elongate tool is configured to ...

APPARATUS AND METHODS TO CREATE AND MAINTAIN AN INTRA-ATRIAL PRESSURE RELIEF OPENING

The present disclosure relates to a method and a device for treating heart failure by normalizing elevated blood pressure in the left and right atria of a heart of a mammal. The present disclosure includes methods for creating and maintaining an opening in the atrial septum. Tools for making an opening and enlarging the opening are also disclosed. Use of the techniques and tools described herein prolongs the patency of an intra-atrial pressure relief opening. 1a penetrator for penetrating an atrial septum between a right atrium and a left atrium of a heart of a patient by creating an opening in the atrial septum;a tissue retaining device, wherein the tissue retaining device has a plurality of struts configured to be inserted through the opening in the atrial septum created by the penetrator in a collapsed configuration and to be positioned against the atrial septum in a radially expanded configuration;a sheath extending over the tissue retaining device and sized to allow the radially expanded tissue retaining device to be advanced through a longitudinal lumen of the sheath;andat least one mechanism configured to separate the tissue surrounding the opening in the atrial septum created by the penetrator from the atrial septum.. A system for treating heart failure, the system comprising: This application is a continuation of U.S. application Ser. No. 13/905,638, filed May 30, 2013, which is a divisional of U.S. application Ser. No. 13/370,913, filed Feb. 10, 2012, now U.S. Pat. No. 8,882,697, which claims the benefit of U.S. Provisional Application No. 61/441,546, filed Feb. 10, 2011, each of which is herein incorporated by reference in its entirety.All publications and patent applications mentioned in this specification are incorporated herein by reference in their entirety to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.The present disclosure relates to a method and ...

Magnet guided wire crossing system

A magnet guided crossing system includes a first magnet that defines a first guide passage and a second magnet that defines a second guide passage, which are positioned in respective body structures. A crossing guide includes a catheter, a direction change piece and a magnetic latch in series that together define a third guide passage that extends from a proximal end of the catheter through a latching side of the magnetic latch. The poles of the first and second magnets and the magnetic latch are oriented so that the first and second magnets and the magnetic latch have a stable magnetically latched stack configuration. A puncture wire is slidably received in the catheter.

IMPLANTING ORGAN PORTS

This document relates to medical devices (e.g., organ ports such as transapical heart ports) and methods and materials for implanting and using such medical devices. For example, organ ports and entry devices that can be used to implant an organ port are provided. 1. (canceled)2. A transapical heart port system , wherein said system comprises:(a) a transapical heart port comprising a housing having a first end region and a second end region, wherein said housing defines a channel extending between said first end region and said second end region, wherein said first end region is configured to be inserted into a chamber of a heart of a mammal, wherein said channel is configured to provide repeated access to said chamber through said channel, wherein said first end region comprises a securing portion configured to secure said first end region to an interior region of said heart, wherein said second end region comprises a securing portion configured to secure said second end region to an exterior region of said heart, and wherein said second end region comprises threads for attachment of a sheath and threads for attachment of a plug,(b) said sheath comprising an end region comprising threads, wherein said sheath is attachable to said transapical heart port via said threads of said end region of said sheath, wherein said sheath, when attached to said transapical heart port, provides access to said second end region through a chest wall covering said heart, and(c) said plug comprising threads, wherein said plug is attachable to said transapical heart port via said threads of said plug, and wherein at least a portion of said plug, when attached to said transapical heart port, is located within said channel and configured to provide hemostasis.3. The system of claim 2 , wherein said transapical heart port comprises pliable material that allows flexion of said port during beating of said heart.4. The system of claim 2 , wherein said transapical heart port comprises a ...

DEVICE AND METHOD FOR CONTROLLING IN-VIVO PRESSURE

A differential pressure regulating device is provided for controlling in-vivo pressure in a body, and in particularly in a heart. The device may include a shunt being positioned between two or more lumens in a body, to enable fluids to flow between the lumens, and an adjustable flow regulation mechanism being configured to selectively cover an opening of the shunt, to regulate the flow of fluid through the shunt in relation to a pressure difference between the body lumens. In some embodiments a control mechanism coupled to the adjustable flow regulation mechanism may be provided, to remotely activate the adjustable flow regulation mechanism. 1. A device for treating a heart condition in a patient , the device comprising:a body configured to self-expand from a contracted configuration to an expanded configuration,the body in its expanded configuration comprising a first section having a diameter that increases from a first end to a second end of the first section,wherein the body has a passageway extending through the first section, the body being configured to be delivered percutaneously to a patient's heart and to self-expand in an opening in a septum of the heart such that the passageway permits blood to flow from a first atrium to a second atrium.2. The device of claim 1 , wherein the body in its expanded configuration further comprises a second section having a first end joined at a mid-region to the first end of first section claim 1 , the passageway extending through the second section claim 1 , the second section having a diameter that increases from the mid-region to a second end of the second section.3. The device of claim 2 , wherein a junction between the first and second sections forms a constriction in the passageway.4. The device of claim 1 , wherein the body comprises a cone shape.5. A device for treating a heart condition in a patient claim 1 , the device comprising:a body configured to self-expand from a contracted configuration to an expanded ...

SYSTEMS, DEVICES, AND METHODS FOR ORGAN RETROPERFUSION ALONG WITH REGIONAL MILD HYPOTHERMIA

Systems, devices, and methods for organ Retroperfusion along with regional mild hypothermia. One such system includes a hypothermia system including a hypothermia system outlet and a hypothermia system inlet; and a connector comprising a coolant inlet, a coolant outlet, a coolant reservoir, and a blood lumen, whereby the coolant inlet is configured to couple to the hypothermia system outlet and whereby the coolant outlet is configured to couple to the hypothermia system inlet; whereby a cooling product, when the hypothermia system is connected to the connector, can flow from the hypothermia system, through the hypothermia system outlet, into the coolant inlet, through the coolant reservoir, into the coolant outlet, and into the hypothermia system inlet, so that the cooling product can cool blood flowing through the blood lumen. 1. A system , comprising:a hypothermia system comprising a hypothermia system outlet and a hypothermia system inlet; anda connector comprising a coolant inlet, a coolant outlet, a coolant reservoir, and a blood lumen, whereby the coolant inlet is configured to couple to the hypothermia system outlet and whereby the coolant outlet is configured to couple to the hypothermia system inlet;whereby a cooling product, when the hypothermia system is connected to the connector, can flow from the hypothermia system, through the hypothermia system outlet, into the coolant inlet, through the coolant reservoir, into the coolant outlet, and into the hypothermia system inlet, so that the cooling product can cool blood flowing through the blood lumen.2. The system of claim 1 , wherein the connector further comprises:a blood inlet configured to connect to a first catheter; anda blood outlet configured to connect to a second catheter;whereby the blood can flow from the first catheter, into the blood inlet, through the blood lumen, into the blood outlet, and into the second catheter.3. The system of claim 2 , further comprising the first catheter.4. The system ...

TRANSMYOCARDIAL INSERTION UNIT AND ITS USE

An insertion device that allows gaining access to the left ventricle of the heart, via the tissue forming the wall of the right ventricle and via the ventricular septum, which includes a tubular shaft with a lumen extending there through, the shaft comprising distal, proximal and central sections, whereby the distal and proximal sections are disc-shaped extended thus forming each a double disc and whereby the central section links the distally placed double disc with the proximally placed double disc and whereby pressure valves are fixed inside the shaft preferably on its distal and proximal end. 1. Insertion unit comprising:a tubular shaft with a lumen extending there through;said shaft includes distal, proximal and central sections, whereby the distal and proximal sections are disc-shaped extended thus forming each a double discwhereby the central section links the distally placed double disc, with the proximally placed double disc; andwhereby a pressure valve is fixed inside the shaft on its distal and proximal end.2. Insertion unit according to claim 1 , consisting of braided wires of memory material claim 1 , preferably nitinol.3. Insertion unit according to claim 1 , consisting in part or in total of Silicon claim 1 , Polyurethane claim 1 , PTFE claim 1 , Polyester claim 1 , biocompatible fibers claim 1 , Nitinol claim 1 , Titanium or Stainless Steel.4. Insertion unit according to claim 1 , whereby the inner and/or outer central section of shaft is covered by a biocompatible synthetic material.5. Insertion unit according to claim 1 , whereby the central section is coil shaped.6. Insertion unit according to claim 1 , whereby the tubular shaft is longitudinally extended thus forming an extended shaft claim 1 , the thus extended shaft comprising a further double disc claim 1 , with pressure valve at its proximal end.7. Device for stimulation and/or defibrillation consisting of an insertion unit according to and of at least one stimulation electrode connected to a ...

Systems and Methods for Percutaneous Access, Stabilization and Closure of Organs

Systems and methods for accessing, stabilizing and sealing a device attached to a tissue surface comprising a tissue attaching device having an outer base ring defining an opening therethrough and a distally projecting tissue attachment element. The systems variously utilize annular sealing flanges distally attached to the outer base ring outside or inside the tissue attachment element to create a fluid tight seal. The systems variously utilize coils with regions of differing pitch to create sealing tissue pressure. Methods for installing an apical attaching device with a transapical port into a patient, comprising assessing the patient's viability for installation of the apical attaching device by determining an Index of Tissue Elasticity (ITE). 18-. (canceled)9. A system for forming and closing an access site in a heart wall , the system comprising:a guide wire configured for advancing through the heart wall to form the access site;a dilator configured for advancing over the guide wire to expand the access site;a port configured for advancing over the dilator and extending through the access site, the port including a tubular body defining a central axis of the port and a plurality of vacuum suction orifices extending transverse to the central axis; anda closure device configured for advancing through the port and closing the access site, the closure device including a plug and a coil attached to the plug.10. The system of claim 9 , wherein the port further includes a proximal flange extending radially outward from the tubular body and configured for engaging an epicardial surface of the heart wall.11. The system of claim 10 , wherein the plurality of vacuum suction orifices includes one or more first vacuum suction orifices defined in the proximal flange and configured for engaging the epicardial surface.12. The system of claim 11 , wherein the plurality of vacuum suction orifices further includes one or more second vacuum suction orifices defined in an outer ...

SYSTEMS FOR PROVIDING OR MAINTAINING FLUID FLOW THROUGH BODY PASSAGES

A device includes a first end portion, a second end portion, an intermediate portion, and a graft material. The first end portion has a first end diameter. The second end portion has a second end diameter smaller than the first end diameter. The first end portion comprises a first material. The second end portion comprises a second material different than the first material. The intermediate portion is between the first end portion and the second end portion. The intermediate portion tapers between the first end portion and the second end portion. The graft material is coupled to at least the intermediate portion. 1. (canceled)2. A device for making a valve of a vessel incompetent , the reverse valvulotome comprising:a longitudinal axis;a distal portion comprising a plurality of blades, the plurality of blades having a retracted position in which the plurality of blades are parallel to the longitudinal axis and an expanded position in which the plurality of blades are non-parallel to the longitudinal axis, the plurality of blades each comprising a sharp surface facing distally and configured to at least partially ablate a valve in a vessel during distal advancement of the device through the vessel; anda proximal portion comprising a handle configured to operate the plurality of blades between the retracted position and the expanded position,wherein the device is configured to be pushed through the vessel in a direction opposite native fluid flow of the vessel from a fistula between the vessel and an artery to at least partially ablate the valve in the vessel without retrograde access.3. The device of claim 2 , wherein the handle is configured to longitudinally compress and radially expand the plurality of blades from the retracted position to the expanded position.4. The device of claim 2 , wherein the plurality of blades comprises three blades claim 2 ,wherein the three blades are circumferentially spaced by 120 degrees,wherein the three blades comprise shape ...

GRAFT DEVICES AND RELATED SYSTEMS AND METHODS

In some aspects, graft devices for a mammalian patient can include a tubular member comprising a first end; and a fiber matrix surrounding the tubular member, wherein the fiber matrix is designed and constructed to be substantially continuously tapered at the first end to define a diameter that increases as it approaches the first end. 1. (canceled)2. A graft device for a mammalian patient , the graft device comprising:a) a tubular member comprising a first end and a wall surrounding a lumen, the wall having an outer surface comprising a series of non-circular cross sections varying at least in part over a portion of a length of the tubular member; andb) a fiber matrix surrounding the tubular member comprising a deposition coating of polymer fibers deposited onto, formed along, and conforming to the outer surface of a mid portion of the tubular member, the fiber matrix having an inner circumferential surface substantially contiguous with the series of non-circular cross sections of the outer surface of the mid portion of the tubular member,wherein the fiber matrix comprises a first end, a mid portion, a second end and an asymmetric thickness profile from the first end of the fiber matrix to the second end of the fiber matrix.3. The device of claim 2 , wherein the first end of the fiber matrix has a different thickness than the second end of the fiber matrix.4. The device of claim 2 , wherein the tubular member has a first end claim 2 , a second end claim 2 , and a thickness profile from the first end of the tubular member to the second end of the tubular member claim 2 , and the thickness profile of the fiber matrix is based on the thickness profile of the tubular member.5. The device of claim 2 , wherein the mid portion of the fiber matrix comprises a thickness greater than a thickness of the first end of the fiber matrix claim 2 , the second end of the fiber matrix claim 2 , or a combination thereof.6. The device of claim 2 , wherein a thickness of the first end ...

DEVICES AND METHODS FOR EFFECTUATING PERCUTANEOUS GLENN AND FONTAN PROCEDURES

In some implementations, a radially self-expanding endograft prosthesis is provided that includes (i) distal flange that is self-expanding and configured to flip generally perpendicularly with respect to a body of the prosthesis to help seat the prosthesis against a tissue wall, (ii) a distal segment extending proximally from the distal flange that has sufficient stiffness to maintain a puncture open that is formed through a vessel wall (iii) a compliant middle segment extending proximally from the distal segment, the middle segment being more compliant than the distal segment, and having independently movable undulating strut rings attached to a tubular fabric, the combined structure providing flexibility and compliance to allow for full patency while flexed, the segment being configured to accommodate up to a 90 degree bend, (iv) a proximal segment having a plurality of adjacent undulating strut rings that are connected to each other. 1. A method of installing a tubular prosthesis through a sidewall of a native lumenal vessel , comprising: a distal annular flange configured to help seat the prosthesis when it is pulled proximally;', 'a distal tubular segment extending proximally from the distal flange that has sufficient stiffness to maintain a puncture in an open condition that is formed through a first vessel wall through which the distal segment passes;', 'a proximal tubular segment that is sufficiently stiff to seat within and urge against a second vessel wall; and, 'providing a prosthesis havingcollapsing the prosthesis onto a delivery system;delivering a distal end of the delivery system to an opening defined through a native lumenal vessel wall; anddeploying the distal annular flange inside of the native lumenal vessel wall.2. The method of claim 1 , further comprising pulling proximally on the delivery system to seat the distal annular flange.3. The method of claim 2 , further comprising deploying the distal tubular segment from the delivery system.4. The ...

Apparatus and method for targeting a body tissue

An apparatus for targeting a desired target site on a body tissue comprising a wall of a first body cavity of a patient includes a target catheter. The framing member has a longitudinal framing member core defining a central framing member axis. At least one target point is carried by the framing member and is adapted for placement adjacent the desired target site. The framing member comprises a plurality of longitudinally extending multi-segment framing strands.

TRANSCATHETER SYSTEM AND METHOD FOR REGULATING FLOW OF FLUID BETWEEN TWO ANATOMICAL COMPARTMENTS

The present invention relates to a transcatheter method for providing fluid communication between two anatomical compartments. The present invention also relates to a transcatheter system comprising an intracorporeal connector for fluid communication between two anatomical compartments through at least one anatomical wall, wherein said connector is adapted to receive a flow regulating device, a connector, a flow regulating device and an insertion device.

APPARATUS AND METHOD FOR FLUID FLOW THROUGH BODY PASSAGES

A device includes a first end portion, a second end portion, an intermediate portion between the first end portion and the second end portion, and a graft material coupled to at least the intermediate portion. The first end portion has a first end diameter. The second end portion has a second end diameter larger than the first end diameter. The intermediate portion tapers between the first end portion and the second end portion. A method of diverting fluid flow from a first passage to a second passage comprising deploying the device in a third passage between the first passage and the second passage, expanding the first end portion against sidewalls of the first passage, and expanding the second end portion against sidewalls of the second passage. 1. A device for maintaining fluid flow through at least one passage in a human or animal body, the device comprising two end portions for anchoring the device in position, and an intermediate portion which allows movement of the end portions relative to each another, the end portions and intermediate portion together defining a pathway for fluid flow through the device. This application is a continuation of U.S. patent application Ser. No. 15/701,060, filed Sep. 11, 2017, which is a continuation of U.S. patent application Ser. No. 15/143,864, filed May 2, 2016 and issued as U.S. Pat. No. 9,782,201 on Oct. 10, 2017, which is a continuation of U.S. patent application Ser. No. 14/718,477, filed May 21, 2015 and issued as U.S. Pat. No. 9,326,792 on May 3, 2016, which is a continuation of U.S. patent application Ser. No. 14/592,163, filed Jan. 8, 2015 and issued as U.S. Pat. No. 9,108,018 on Aug. 18, 2015, which is a divisional of U.S. patent application Ser. No. 13/791,185, filed Mar. 8, 2013, which is a continuation-in-part of U.S. patent application Ser. No. 12/297,498, issued as U.S. Pat. No. 8,439,963 on May 14, 2013 and filed under § 371(c) on Feb. 25, 2009 as a U.S. national stage of PCT Patent App. No. PCT/GB2007/001430 ...

Systems and methods for endovascularly accessing a subarachnoid space

Systems and methods for implanting an endovascular shunt in a patient is disclosed. The system having an expandable anchor configured for being deployed in a dural venous sinus of a patient at a location distal to a curved portion of a wall of an inferior petrosal sinus (IPS) of the patient; an elongate guide member coupled to, and extending proximally from, the anchor; a shunt delivery catheter having a first lumen configured to receive the guide member, and a second lumen extending between respective proximal and distal openings in the shunt delivery catheter, the shunt delivery catheter further having a penetrating element coupled to a distal end of the catheter; and the system further having a guard at least partially disposed over, and movable relative to, the penetrating element.

Devices for applying energy to tissue

Disclosed herein are devices for altering gaseous flow within a lung to improve the expiration cycle of an individual, particularly individuals having Chronic Obstructive Pulmonary Disease (COPD). More particularly, devices are disclosed to produce collateral openings or channels through the airway wall so that expired air is able to pass directly out of the lung tissue to facilitate both the exchange of oxygen ultimately into the blood and/or to decompress hyper-inflated lungs.

Devices for applying energy to tissue

Disclosed herein are devices for altering gaseous flow within a lung to improve the expiration cycle of an individual, particularly individuals having Chronic Obstructive Pulmonary Disease (COPD). More particularly, devices are disclosed to produce collateral openings or channels through the airway wall so that expired air is able to pass directly out of the lung tissue to facilitate both the exchange of oxygen ultimately into the blood and/or to decompress hyper-inflated lungs.

Devices for applying energy to tissue

Disclosed herein are devices for altering gaseous flow within a lung to improve the expiration cycle of an individual, particularly individuals having chronic obstructive pulmonary disease (COPD). More particularly, a medical catheter is disclosed to detect the presence of blood vessels and to produce collateral openings or channels through the airway wall so that air is able to pass directly out of the lung tissue to facilitate both the exchange of oxygen ultimately into the blood and/or to decompress hyper-inflated lungs.

Devices for applying energy to tissue

Disclosed herein are devices for altering gaseous flow within a lung to improve the expiration cycle of an individual, particularly individuals having chronic obstructive pulmonary disease (COPD). More particularly, a medical catheter is disclosed to detect the presence of blood vessels and to produce collateral openings or channels through the airway wall so that air is able to pass directly out of the lung tissue to facilitate both the exchange of oxygen ultimately into the blood and/or to decompress hyper-inflated lungs.

Systems and methods for delivering drugs to selected locations within the body

A method is provided for delivering a drug to a selected tissue region within a patient's body with a catheter having a deployable puncturing element, a drug delivery element and an orientation element on a distal portion thereof. The distal portion of the catheter is percutaneously introduced into a blood vessel, and directed endovascularly to a vessel location adjacent to the selected tissue region. The puncturing element is oriented towards the selected tissue region, and deployed to access the selected tissue region. A drug is delivered with the drug delivery element to the selected tissue region.

Stabilized tissue penetrating catheters

A tissue penetrating catheter that is usable to advance a tissue penetrator from within a blood vessel, through the wall of the blood vessel to a target location. The catheter includes at least one stabilizing device thereon for stabilizing catheter prior to advancing the tissue penetrator. The tissue penetrator may extend through a lumen in the body of the catheter and project transversely through an exit port. The stabilizing device may be located closely adjacent to the exit port, or may surround the exit port. The stabilizing device may be one or more balloons, or other mechanical structure that is expandable into contact with the inner luminal wall of the blood vessel. Desirably, the exit port is forced into contact with the blood vessel wall to shorten the distance that the tissue penetrator projects from the catheter body to the target location. The catheter is particular useful for forming blood flow tracts between blood vessels, in particular in coronary revascularization procedures. Methods of utilizing such a catheter to bypass an arterial obstruction is also disclosed.

Multifunctional tip catheter for applying energy to tissue and detecting the presence of blood flow

Disclosed herein are devices for altering gaseous flow within a lung to improve the expiration cycle of an individual, particularly individuals having Chronic Obstructive Pulmonary Disease (COPD). More particularly, devices are disclosed to produce collateral openings or channels through the airway wall so that expired air is able to pass directly out of the lung tissue to facilitate both the exchange of oxygen ultimately into the blood and/or to decompress hyper-inflated lungs.

Devices for applying energy to tissue

Disclosed here are devices (200) altering gaseous flow within a lung (118) to improve the expiration cycle of an individual, particularly individuals having Chronic Obstructive Pulmonary Disease (COPD). More particularly, devices (200) are disclosed to produce collateral openings and channels (116) through the airway wall (106) so that expired air is able to pass directly out of the lung tissue to facilitate both the exchange of oxygen ultimately into the blood and/or to decompress hyper-inflated lungs.

METHOD AND DEVICES FOR PRODUCING COLLATERAL CHANNELS IN THE LUNG

Devices for creating passages and sensing for blood vessels

Devices and methods are disclosed for creating passages in tissue and detecting blood vessels in and around the passages. The devices may be used to create channels for altering gaseous flow within a lung to improve the expiration cycle of an individual, particularly individuals having Chronic Obstructive Pulmonary Disease (COPD). In addition, the devices may be used to sample tissue during biopsy or other medical procedures where perforating a blood vessel could result in injury to a patient.

Devices for maintaining patency of surgically created channels in tissue

Devices and methods for altering gaseous flow within a lung to improve the expiration cycle of an individual, particularly individuals having chronic obstructive pulmonary disease. The methods and devices create channels in lung tissue and maintain the patency of these surgically created channels in tissue. Maintaining the patency of the channels allows air to pass directly out of the lung tissue which facilitates the exchange of oxygen ultimately into the blood and/or decompresses hyper-inflated lungs.

Devices for creating passages and sensing for blood vessels

Devices and methods are disclosed for creating passages in tissue and detecting blood vessels in and around the passages. The devices may be used to create opening in tissue without removing a sensing assembly from the tissue. The devices herein may be used for altering gaseous flow within a lung to improve the expiration cycle of an individual, particularly individuals having Chronic Obstructive Pulmonary Disease (COPD). In addition, the devices may be used to sample tissue during biopsy or other medical procedures where perforating a blood vessel could result in injury to a patient.

Systems and methods for delivering drugs to selected locations within the body

A transvascular system for delivering a drug to a tissue region from a blood vessel, such as a coronary vein, includes a catheter having a distal portion with puncturing, orientation, drug delivery, and imaging elements. The puncturing element is deployable for penetrating the vessel wall to access the tissue region. The orientation element, e.g. a “cage” including a plurality of struts and/or a radiopaque marker, has a predetermined relationship with the puncturing element, the imaging element detecting the location of the orientation element with respect to the tissue region to orient the puncturing element. The catheter is percutaneously introducing into the vessel, the puncturing element is oriented towards the tissue region, the puncturing element is deployed to access the tissue region, and the drug is delivered to the tissue region. An ablation device may also be deployed to create a cavity in the tissue region for receiving the drug therein, or an indwelling catheter may be advanced into and left in the tissue region. An implantable reservoir device is also disclosed, including an enclosed membrane on an expandable frame that defines a reservoir and includes a porous region. The reservoir device may be deployed and expanded within a blood vessel, and may be filled in situ or prefilled with a drug that passes through the porous region. Alternatively, a pair of expandable endovascular blockers may be used to isolate a section of a blood vessel which may be filled with a drug that may be absorbed by the surrounding tissue.

Stabilized tissue penetrating catheters

A tissue penetrating catheter that is usable to advance a tissue penetrator from within a blood vessel, through the wall of the blood vessel to a target location. The catheter includes at least one stabilizing device thereon for stabilizing catheter prior to advancing the tissue penetrator. The tissue penetrator may extend through a lumen in the body of the catheter and project transversely through an exit port. The stabilizing device may be located closely adjacent to the exit port, or may surround the exit port. The stabilizing device may be one or more balloons, or other mechanical structure that is expandable into contact with the inner luminal wall of the blood vessel. Desirably, the exit port is forced into contact with the blood vessel wall to shorten the distance that the tissue penetrator projects from the catheter body to the target location. The catheter is particular useful for forming blood flow tracts between blood vessels, in particular in coronary revascularization procedures. Methods of utilizing such a catheter to bypass an arterial obstruction is also disclosed.

Method, system and devices for transjugular intrahepatic portosystemic shunt (tips) procedures

The invention provides systems and methods for assisting/performing image-guided transjugular intrahepatic portosystemic shunt (TIPS) procedures in a portion of an anatomy of a patient, including a guide needle portion comprising a hollow tube having a bend toward its distal tip and a puncture needle portion that includes at least one position indicating element at its tip. The puncture needle is slidably mounted within the hollow tube of the guide needle such that a distal tip of the puncture needle can be extended from an opening in the distal tip of the guide needle and used to place a shunt between the portal and hepatic veins of a patient. The position indicating element of the puncture needle is used to produce a display of the puncture needle relative to a target vessel, including a projected path of the puncture needle that can be adjusted to accurately locate a shunt.

Device, system and method for intersititial transvascular intervention

Method and apparatus for utilizing the vascular system as a conduit to reach other vascular and extravascular locations within the body. Included are methods for revascularization wherein the extravascular passageways are formed to permit blood flow between vascular locations. Also included are methods for performing transvascular interstitial surgery (TVIS) wherein extravascular passageways are formed from a blood vessel to another vascular or non-vascular intracorporeal location. Also disclosed are devices usable for forming extravascular passageways in accordance with the invention, or for modifying, valving, maintaining or closing such passageways.

Method, system and devices for transjugular intrahepatic portosystemic shunt (TIPS) procedures

Systems and methods for assisting/performing image-guided transjugular intrahepatic portosystemic shunt (TIPS) procedures in a portion of an anatomy of a patient include a guide needle portion having a hollow tube with a bend toward its distal tip, and a puncture needle portion that includes at least one position indicating element at its tip. The puncture needle is slidably mounted within the hollow tube of the guide needle such that a distal tip of the puncture needle can be extended from an opening in the distal tip of the guide needle and used to place a shunt between the portal and hepatic veins of a patient. The position indicating element of the puncture needle is used to produce a display of the puncture needle relative to a target vessel, including a projected path of the puncture needle that can be adjusted to accurately locate a shunt.

Conduit device and system for implanting a conduit device in a tissue wall

Various embodiments of the present invention provide a conduit device including an attaching device configured for defining a helical pathway through a tissue wall for securing the device within an aperture defined in the tissue wall. Some embodiments of the present invention further provide a system for implanting a conduit device in a tissue wall. More specifically, some embodiments provide a system including a coring device for defining an aperture in a tissue by removing and retaining a tissue core and securely implanting a conduit device therein so as to provide fluid communication between a first and second surface of the tissue wall via the conduit device.

Devices, methods and systems for establishing supplemental blood flow in the circulatory system

用于治疗下肢脉管系统的设备和方法

一种导管系统能够包括管状主体、以及被耦接到管状主体的靶向系统、可扩张构件或流体注入端口中的至少一个。一种识别分叉的方法能够包括将导管系统插入到第一脉管内，将所述导管系统定位在第一位置处，扩张可扩张构件以闭塞所述第一脉管，递送对比物质因此所述对比物质靠近所述可扩张构件汇集，以及在荧光检查下回顾所述第一脉管中的所述对比物质的形状。

连接在相邻血管或其它解剖学结构上形成的开口的方法与装置

本发明为用于连接两个侧对侧解剖学通道,如血管的装置和方法。在这些通道上形成了开口,并且本发明的装置(10)被移植到此类开口中,并且跨跃通道或血管(BV 1 ,BV 2 )以便于连接通道或血管(BV 1 ,BV 2 )以使开口相互垂直对准从而可使体液从一个通道进入另一个通道。